Beruflich Dokumente
Kultur Dokumente
Michael J. Kurtz
National Archives and Records
Administration
v
. . . To Those Who Served
Foreword
The Medical Department: Medical Service in the War Against Japan is the third
and concluding volume on the overseas activities of the U.S. Army Medical
Department during World War II. In the Asian-Pacific theaters of operations
Army medical personnel supported troops in a variety of remote disease-rid-
den environments, burdened by vast distances, diverse climates, and almost
insoluble logistical problems. This study recounts how the Army’s senior
medical officers pooled their talents with the scientific knowledge of the day
to overcome these obstacles and, in the process, realized significant
advances in military medicine. In the course of the long, grueling war
against Japan these dedicated professionals developed new drugs and tech-
niques for preventing and controlling disease, fielded hospitals and units
uniquely equipped to support jungle and island fighting, and perfected
amphibious medical support.
The story of these developments, as well as of the planning and organiz-
ing of theater medical services, provides practical lessons for military stu-
dents and military leaders of all ranks. I urge you to read this history for its
illuminating examples of the finest in combat medical support and organi-
zation, principles that remain vital to our military today.
ix
The Authors
Mary Ellen Condon-Rall was born in Brooklyn, New York, where she
received her primary and secondary education. She earned her B.A. and
M.A. degrees respectively from Molloy College for Women and Fordham
University, both in the New York area, and her Ph.D. degree from the
University College of the University of London in England. Beginning in
1972, she started her career as a historian with The Historical Unit of the
U.S. Army Medical Department and, in 1976, when The Historical Unit was
absorbed, moved to the U.S. Army Center of Military History. In 1990 Dr.
Condon-Rall was awarded a one-year Secretary of the Army Research and
Study Fellowship. She is the author of Disaster on Green Ramp: The Army’s
Response; a monograph on host nation medical support during the Persian
Gulf war; a chapter on the history of military anesthesia in the Anesthesia
and Perioperative Care of the Combat Casualty volume of The Textbook of Military
Medicine; and a chapter on the U.S. Army and the fight against malaria in
the forthcoming work Science and the Pacific War. She also has contributed
numerous articles on military medicine and naval history in American,
British, and Australian journals.
Albert E. Cowdrey was born in New Orleans, Louisiana, and received his
education from the schools in that city and from Tulane and Johns Hopkins
Universities. He served in the Army as an enlisted man during the years
1957–59. After teaching at Tulane University and at Louisiana State
University, he joined the staff of the U.S. Army Corps of Engineers histori-
cal office and, since 1978, that of the U.S. Army Center of Military History,
from where he retired in 1993. His interest in southern history brought him
the American Historical Association’s Herbert Feis Award in 1984, and his
prizewinning history of Army medicine in the Korean war, The Medics’ War,
has been widely adopted as a text in military medical schools. Dr. Cowdrey
is the coauthor of The Medical Department: Medical Service in the European
Theater of Operations and author of Fighting for Life: American Military Medicine
in World War II. He also has published many articles on a variety of histori-
cal topics in American, British, Canadian, and international journals.
x
Preface
The Medical Department: Medical Service in the War Against Japan is a com-
prehensive organizational and operational history of medical support in the
Asian-Pacific theaters in World War II. The narrative begins with medical
prewar planning and ends with the establishment of public health and wel-
fare in occupied Japan. In the context of fierce combat operations waged in
the geographical area extending from Australia to Alaska and from the
Gilbert Islands to Burma, we focused on how the Army Medical Department
coped with the great distances, diverse climates, disease epidemics, grave
logistical problems, and rapidly changing circumstances to maintain the
fighting strength of American troops. Flexible organization, ingenuity, and
the latest scientific advances helped medical personnel to support infantry
combat teams on isolated islands or in dense jungles, to evacuate casualties
over difficult terrain and then by sea or air, to adapt medical support to
amphibious operations, and to prevent and control disease. Cooperation
with the U.S. Navy and with the Allied medical services, especially in the
Southwest Pacific, also is covered.
Work on a volume dealing with the medical service in the war against
Japan began shortly after the end of World War II in The Historical Unit of
the Office of the Surgeon General. Over the years this unit collected original
documents, interviewed participants, and produced research note cards and
various historical drafts, from which we benefited. Although we found the
lengthy manuscripts of Warren W. Daboll and Donald Mitchell to be invalu-
able, our volume represents largely new research in primary and secondary
sources, as well as a fresh approach, theme, and organization to the subject.
For background, we drew upon the clinical volumes published by the Office
of the Surgeon General to gain insights into the medical story and also the
relevant volumes of the United States Army in World War II series, as well as
numerous subsequent scholarship, to understand the combat story.
Special acknowledgements must be made to many individuals for their
unstinting support. Members of the review panel—Dr. Jeffrey J. Clarke, Dr.
Edward J. Drea, Dr. Stanley L. Falk, Robert J. T. Joy, M.D., and Joanne M.
Brignolo—provided perceptive comments and suggestions that gave final
form to our volume. Dr. Joy, in addition, and Col. Charles J. Simpson were
always there to counsel, encourage, and give generously of their expertise
while we were working, and Lt. Col. James Carafano offered his much
appreciated help and encouragement during the final stages of production.
We are deeply grateful to the more than fifty campaign participants who
were interviewed; they shared pivotal insights that added a personal dimen-
xi
sion to the unfolding of the story. Our sincere appreciation also is given to
Jan Herman, the U.S. Navy’s Bureau of Medicine and Surgery historian, and
Sylvan Katz for lending us relevant photographs that visually enhanced our
text.
Meriting special recognition are the archivists who assisted us during our
research. We extend our gratitude to George Chalou, Fred W. Pernell,
Richard L. Boylan, and Victoria Washington of the National Archives and
Records Administration, Washington, D.C., and Richard Sommers of the
U.S. Army Military History Institute, Carlisle Barracks, Pennsylvania, for
contributing their time, knowledge, and skill. Present and former col-
leagues at the Center of Military History—Hannah M. Zeidlik, Charles
Ellsworth, Geraldine H. Harcarik, Carol I. Anderson, James B. Knight, Mary
J. Sawyer, John B. Wilson, Donna C. Everett, and Stephen E. Everett—also
were unfailing in their efforts to help us find materials.
Other key contributors at the Center are deserving of praise. Arthur S.
Hardyman and Sherry L. Dowdy used their cartographic skills to design the
maps; Beth F. MacKenzie, who also helped with the map compilations, and
John Birmingham, their desktop publishing talents to create camera-ready
copy and artwork; W. Scott Janes, his penetrating eyes to proofread the text;
Roger Wright, his craft as a photographer to reproduce a number of illus-
trations; and Susan Carroll, her meticulousness to develop the useful index,
bringing to light thoughtful queries in the process.
Finally, we are indebted to our hard-working editor, Joanne M. Brignolo,
whose literary skills, attention to detail, and technical proficiency con-
tributed immeasurably to the smooth flow of the narrative and the accura-
cy of the citations. Her uncommon efficiency, unwavering support, and
unflagging enthusiasm helped us to navigate the turbid waters of the book
publication process.
For any errors of fact or interpretation remaining in the volume, we
alone are responsible.
xii
Contents
Page
PROLOGUE: THE DRIFT TOWARD WAR . . . . . . . . . . . . . . . . . . . . . . 3
Plans and Preparations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The Approaching Crisis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Chapter
I. A MEDICAL CALAMITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Japan Attacks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
The Philippines Prepare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
The Ordeal Begins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
The Jungle Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
The End Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
The Fall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Corregidor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455
Tables
No.
1. The Chain of Evacuation, 1943–1945 . . . . . . . . . . . . . . . . . . . . . . . . 78
2. Malaria Admission Rate for Allied Units, Guadalcanal, 1943 . . . . . 126
3. Malaria Incidence in U.S. Army Forces, SWPA, 1942–1945 . . . . . . . 140
4. 5307th Composite Unit (Provisional) Casualty Profile, 4 June 1945 . . 310
Charts
1. Organization of the Office of the Chief Surgeon, USASOS, SWPA,
January 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
2. Typical Joint Malaria and Insect Control Island Organization . . . . 105
3. Scrub Typhus Admission Rate for U.S. Army Forces, New Guinea,
July–September 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
4. Organization of the Office of the Chief Surgeon, USAFICPA,
December 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
5. Organization of the Medical Service, CPBC, August 1944 . . . . . . . 275
6. Diarrhea and Dysentery Incidence in U.S. Army Forces, CBI,
1943–1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
xvi
Maps
No. Page
1. Hospitals on Oahu, December 1941–January 1942 . . . . . . . . . . . . . 12
2. Hospitals on Bataan, December 1941–January 1942 . . . . . . . . . . . . 29
3. Asian-Pacific Theaters of Operations, 1942–1945 . . . . . . . . . . . . . . 52
4. Australian Base Sections, September 1942 . . . . . . . . . . . . . . . . . . . . 62
5. Army Hospital Support, Guadalcanal,
November 1942–January 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
6. Hospitals on Papua, November 1942–January 1943 . . . . . . . . . . . . . 144
7. Hospitals in Alaska, May 1942 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
8. Army Medical Support, Operation Cartwheel,
June 1943–May 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
9. Army Medical Support, Operation Forager,
June–September 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
10. New Guinea Bases, December 1944 . . . . . . . . . . . . . . . . . . . . . . . . . 262
11. CBI Fixed Hospitals and Depots, December 1943 . . . . . . . . . . . . . . 304
12. Sixth Army Medical Support, Leyte, 26 October 1944 . . . . . . . . . . . 324
13. Sixth Army Medical Support, Luzon, 13 January 1945 . . . . . . . . . . 335
14. Prison Camp Areas in Japan, August–September 1945 . . . . . . . . . . 379
15. Hospitals on Okinawa, April 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
16. Philippine Bases, June 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Illustrations
Evacuation Under Fire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Paperback Cover
End of a Busy Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Frontispiece
Brig. Gen. Edgar King, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Pearl Harbor Casualties Receiving Care Aboard the USS Solace . . . . . . 17
U.S. Naval Mobile Base Hospital No. 2 . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Col. Wibb E. Cooper, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Col. Harold W. Glattley, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Philippine Scout Being Treated at General Hospital No. 1 . . . . . . . . . . 32
Gas Gangrene Ward at General Hospital No. 2 . . . . . . . . . . . . . . . . . . . 34
Army Nurses on Corregidor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Maj. Gen. George W. Rice, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Brig. Gen. Percy J. Carroll, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Dispensary and Ambulance in the Australian Bush . . . . . . . . . . . . . . . . 65
Army Nurse Wearing the New Field Uniform . . . . . . . . . . . . . . . . . . . . . 67
Main Ward of a Prefabricated Station Hospital . . . . . . . . . . . . . . . . . . . 72
Portable Hospital on the Move . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Portable Hospital Bivouac Area and Surgical Tent . . . . . . . . . . . . . . . . . 74
The Maetsuycker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
xvii
Page
Col. Andrew W. Smith, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Zone-of-Interior Evacuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Facilities of the 18th and 39th General Hospitals . . . . . . . . . . . . . . . . . 99
Brig. Gen. Earl Maxwell, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Island Medical Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Field Hospital on Aitutaki . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Stockades for Neuropsychiatric Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Litter-bearers Negotiating a Steep Slope . . . . . . . . . . . . . . . . . . . . . . . . . 119
Moving Casualties Under Guard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Taking Quinine Tablets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
The Jeep Ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Papuan Natives Spraying Malarious Areas . . . . . . . . . . . . . . . . . . . . . . . . 139
Awaiting Evacuation by Papuan Litter-bearers . . . . . . . . . . . . . . . . . . . . 142
Buna Casualty Arriving at the 171st Station Hospital . . . . . . . . . . . . . . . 146
Unit Dispensary at Nome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Hospital Dog Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Winter View of Attu Hospital Facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Morphine Syrettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Litter-bearers Hauling a Casualty Over the Attu Tundra . . . . . . . . . . . . 165
Offshore Evacuation of the Seriously Wounded . . . . . . . . . . . . . . . . . . . 167
General Area Occupied by a Medical Battalion on Kiska . . . . . . . . . . . 173
Medics Administering Plasma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Clearing Company, 37th Division, at Work . . . . . . . . . . . . . . . . . . . . . . . 187
Unloading Casualties at a Collecting Station . . . . . . . . . . . . . . . . . . . . . 194
Loading Casualties on a Tank Lighter . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
29th Evacuation Hospital Following the Air Attack . . . . . . . . . . . . . . . . 197
Brig. Gen. Guy B. Denit, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Evacuation by Air . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Native Litter-bearers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
11th Portable Surgical Hospital Medics Taking Care of Casualties . . . . 211
Shuttling Litter Casualties to a Clearing Station . . . . . . . . . . . . . . . . . . . 224
Tarawa Casualties on Their Way to Offshore Medical Care . . . . . . . . . . 226
Litter-bearers Removing a Kwajalein Casualty From the Front Line . . 230
Hospital Ship Fitted With Hanging Cots . . . . . . . . . . . . . . . . . . . . . . . . . 231
Wounded Native Children on Saipan . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Unloading Supplies on a Saipan Beach . . . . . . . . . . . . . . . . . . . . . . . . . 244
Aid Station Medics Caring for 77th Division Troops on Guam . . . . . . . 247
Prefabricated Buildings in New Guinea . . . . . . . . . . . . . . . . . . . . . . . . . 257
The USS Comfort Arrives at Hollandia . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Port Dispensary Tent on Biak Island . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
New Concrete Floor in a Station Hospital Ward . . . . . . . . . . . . . . . . . . 261
Typhus Commission Entomologist Gathering Mites . . . . . . . . . . . . . . . 266
Shed for Medical Supplies at Oro Bay . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Brig. Gen. John M. Willis, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
xviii
Page
USAFPOA Headquarters, Fort Shafter . . . . . . . . . . . . . . . . . . . . . . . . . . 277
147th General Hospital Upper Respiratory Ward . . . . . . . . . . . . . . . . . 279
Brig. Gen. Robert P. Williams, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Dr. Gordon S. Seagrave and Capt. John H. Grindlay . . . . . . . . . . . . . . . 289
Col. John M. Tamraz, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Anti-malaria Efforts in India’s Assam Province . . . . . . . . . . . . . . . . . . . . 293
Evacuating Chinese Casualties on a C–47 . . . . . . . . . . . . . . . . . . . . . . . . 303
Seagrave Hospital Field and Camp Areas in Myitkyina . . . . . . . . . . . . . 308
Col. George E. Armstrong, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Medics Administering Plasma to a Y-Force Casualty . . . . . . . . . . . . . . . . 316
Frontline Surgery on a Chinese Casualty . . . . . . . . . . . . . . . . . . . . . . . . 317
36th Evacuation Hospital at Palo, Leyte . . . . . . . . . . . . . . . . . . . . . . . . . 321
Shell-torn Church at Dulag, Leyte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
Unloading a Casualty at the 7th Evacuation Hospital, Villasis, Luzon . . . 332
Transporting Casualties Across Manila’s Pasig River . . . . . . . . . . . . . . . 337
Ward of the 49th General Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
Manila Bay Casualties Disembarking From an LST at Corregidor . . . . 341
Litter-bearers Evacuating Wounded From the Luzon Hills . . . . . . . . . . 344
Igorot Women Litter-bearers in the Mountains of Northern Luzon . . . 346
Pulling a Mindanao Litter Casualty Across a Deep Ravine . . . . . . . . . . 350
Guerrillas and an Infantryman Carrying a Casualty . . . . . . . . . . . . . . . . 355
American Prisoners Under Japanese Guard Sorting Equipment . . . . . 364
Prisoners on the Death March . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366
American Prisoners at Camp O’Donnell . . . . . . . . . . . . . . . . . . . . . . . . . 368
Old Bilibid Hospital Ward After Liberation . . . . . . . . . . . . . . . . . . . . . . 375
81st Division Casualties in a Jeep Ambulance . . . . . . . . . . . . . . . . . . . . . 386
Feeding a Severely Burned Seaman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
Litter-bearers Traversing Okinawa’s Difficult Terrain . . . . . . . . . . . . . . 397
Administering Whole Blood and Ether . . . . . . . . . . . . . . . . . . . . . . . . . . 403
Malaria Control Efforts on Okinawa . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406
Tank Used for Frontline Evacuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
Flight Nurse Accompanying Okinawan Casualties . . . . . . . . . . . . . . . . . 408
Col. Maurice C. Pincoffs, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420
Navy Transport Evacuating Casualties to the States . . . . . . . . . . . . . . . . 423
Liberated Allied Prisoners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
Liberated Prisoner Enjoying a Full Meal and Attentive Care . . . . . . . . 430
Brig. Gen. Crawford F. Sams, MC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433
Inoculating Against Typhoid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
xx
MEDICAL SERVICE
IN THE WAR AGAINST JAPAN
PROLOGUE
tion of penicillin, and the rapid devel- civilian medicine—relations were some-
opment during the 1930s of the sulfa times testy, sometimes mutually respect-
drugs to fight infection. American med- ful. Ultimately, both groups would con-
icine was sufficiently mature to absorb tribute in essential ways to the wartime
and, in some cases, improve upon dis- successes of American medicine.
coveries made overseas.
The Army Medical Department, how- Plans and Preparations
ever, did not keep up with the develop-
ments of the interwar years. Suffering Army studies in tropical medicine
the same neglect as the rest of the originally grew out of the Spanish-
nation’s military establishment after American War of 1898–99, which made
World War I, the medics lost the leading the United States a power with overseas
position they had attained earlier. On possessions to defend and administer.
the other hand, the 1920s and 1930s saw The “splendid little war,”1 as U.S.
medical officers more fully integrated Ambassador to Great Britain John M.
into the Army; many attended Army Hay called it, also conferred upon the
schools in other branches, and a few nation many Pacific islands, including
even studied at the prestigious the Philippines and Guam. The build-
Command and General Staff School at ing of a powerful fleet followed, as well
Fort Leavenworth, Kansas, where the as the establishment of naval bases that
nation’s future military leaders met one had to be defended by Army garrisons.
another. The Army started its own World War I complicated the situa-
Medical Field Service School at Carlisle tion, enabling the Japanese Empire to
Barracks, Pennsylvania, to train its offi- strengthen its position by acquiring for-
cers in the practical requirements of mer German possessions. Hence, the
military medicine. The tradition of sci- U.S. Army was obliged to consider the
entific medicine flourished in military possibility of war between the two
laboratories and general hospitals, espe- expanding empires, Japan and the
cially in studies of trauma and militarily United States, and to prepare plans
significant diseases. accordingly. The war plans were color-
With the opening of World War II, coded; those dealing with Japan were
medical officers of the Regular Army ORANGE. In the event of war in the
became the administrators and leaders Pacific the ORANGE plans called for the
of the Medical Department as the Army U.S. Pacific Fleet, based first on the West
expanded from a force of a quarter-mil- Coast and later at Pearl Harbor, to iso-
lion to a mass of more than eight mil- late and harass Japan through offensive
lion men and women. Most hands-on sea and air operations. The defense of
medicine became the province of the Philippines depended on the ability
reserve officers and civilian physicians, of the Pacific Fleet to sortie westward to
who received wartime commissions in relieve the archipelago, where the small
the Army of the United States (AUS).
Between the two groups—the regulars
1
who knew the Army, and the AUS offi- As quoted in Graham A. Cosmas, An Army for
Empire: The United States Army in the Spanish-American
cers who had experienced (and in some War (Columbia: University of Missouri Press, 1971), p.
cases had led) the sweeping changes in 245.
THE DRIFT TOWARD WAR 5
U.S. Asiatic Fleet was based. U.S. Army Hospital in Manila would move with all
forces in the Philippines were assigned a personnel and equipment to establish
limited defensive role. If war came, a 500-bed hospital at Mariveles.
ground troops would move to the jun- Patients would be evacuated from the
gles of Bataan, a mountainous peninsu- capital by boat.
la west of Manila, to assist in holding the Since the peninsula was known to be
entrance to Manila Bay as an anchorage highly malarial, personnel serving there
for the U.S. fleet once it had fought its were to take quinine, use mosquito nets
way across the Pacific. From the begin- at night, and cover exposed skin with
ning, many knowledgeable American mosquito repellent. Medics would sur-
leaders found the ORANGE plans quite vey the hospital area at Mariveles and
unrealistic.2 spray standing water with oil to destroy
Nevertheless, to accord with ORANGE mosquito breeding grounds. Disease
strategy, subordinate commands and control would depend to a great extent
their respective medical organizations on supplies evacuated from Manila and
developed their own contingency on the release of medical personnel
plans. The Philippine Department’s from other duties.3
Office of the Chief Surgeon had as its Like the overall war plan, the med-
basic missions the conservation of man- ical plan was unrealistic. The
power, the preservation of the health Philippine medical community of the
of the command, and the care of the prewar period found malaria control
sick and wounded. In the event of war on Bataan to be economically impracti-
the office would call up its medical cal, on account of the prevalence both
reservists in the islands and seek of the microscopic parasites that cause
recruits to supplement Regular Army the disease and the mosquito vectors
personnel. Hospitals would be expand- that spread it. To break the well-known
ed, supplies collected, and excess life cycle of the malaria parasite on
equipment and supplies shipped to such a large scale seemed an insur-
Mariveles on the Bataan Peninsula. If mountable task, and was not attempt-
retreat to Bataan was ordered, the ed. With only limited resources at their
Medical Supply Depot in Manila would command, medical authorities might
move to Corregidor, one of the forti- well have found it impossible to do
fied islands guarding the mouth of more. At the beginning of World War II
Manila Bay, and Sternberg General “the U.S. Army had not developed the
mechanics and procedures for control-
2
Louis Morton, Strategy and Command: The First Two ling malaria among large bodies of
Years, United States Army in World War II (Washington, troops in highly endemic areas.” The
D.C.: Office of the Chief of Military History,
Department of the Army, 1962), pp. 21–25, 33, 43; specialized units that would materialize
Stanley L. Falk, “Douglas MacArthur and the War during wartime did not yet exist, and
Against Japan,” in William M. Leary, ed., We Shall thus medical planners fell back upon
Return: MacArthur’s Commanders and the Defeat of Japan,
1942–1945 (Lexington, Ky.: University Press of
Kentucky, 1988), pp. 3–5. See also Joint Army and Navy
Basic War Plans Orange, 1924, pp. 1–2, file JB 325,
3
Record Group (RG) 225, and 1939, pp. 2, 8, file AG Surg, Phil Dept, First Phase Plan Orange, 1933, pp.
223, RG 407, National Archives and Records 2–5, and Plan Orange, 1936, p. 1, file AG 170, RG 407,
Administration (NARA), Washington, D.C. NARA.
6 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the techniques they knew and the man- American and Philippine forces were
power that was available.4 defeated on the beaches and had to
As military adviser to the Philippine withdraw to Bataan, medical personnel
government, Maj. Gen. Douglas would have a difficult time evacuating
MacArthur refused to accept the medical supplies to the peninsula.6
inevitability of defeat that he, like many
others, saw as inherent in the ORANGE The Approaching Crisis
plans. Defense of the Philippines rested
with the peacetime garrison of 10,000 Meanwhile, the drift toward war was
men, plus the Philippine Army, which rapid. President Franklin D. Roosevelt
MacArthur had been building and train- proclaimed a state of national emer-
ing since 1936.5 Although the Philippine gency in September 1939; in August
Army was deficient in personnel, equip- 1940, after the fall of France, Congress
ment, and supplies, MacArthur summoned the National Guard into fed-
expressed confidence in its ability to eral service and ordered the call-up of
defend the islands. He believed that the the reserves. The following month
addition of B–17 bombers would enable brought the nation’s first peacetime
him to crush the enemy on the beaches, draft.
rather than withdraw his troops to Maj. Gen. James C. Magee, the sur-
Bataan. His optimism influenced many geon general, began first to plan and
in Washington and led to a new formu- then to mobilize the Army Medical
lation in RAINBOW 5, one of the war Department for war. Throughout the
plans that superseded ORANGE. RAINBOW United States and its possessions the
5 changed and expanded the Army’s number of medical officers increased
role in the Philippines, from protecting (though it never reached the levels pre-
the Manila Bay entrance to defending scribed in the existing tables of organi-
the coasts. Medical preparations zation). Within the Office of the
changed accordingly, as the Office of Surgeon General, a separate Preventive
the Chief Surgeon centralized people Medicine Division was set up to meet the
and supplies around Manila. The dan- needs of the public health of the Army.
ger of the new arrangement was that if Contacts proliferated between Army
medical officers and the other armed
services, the quasi-official National
4
Quotation from Thomas A. Hart and William A. Research Council, the International
Hardenbergh, “The Southwest Pacific Area” in Ebbe
Curtis Hoff, ed., Communicable Diseases: Malaria, Medical
6
Department, United States Army in World War II Falk, “Douglas MacArthur,” in Leary, ed., We Shall
(Washington, D.C.: Office of the Surgeon General, Return,” p. 3; Maurice Matloff and Edwin M. Snell,
Department of the Army, 1963), p. 513. See also Paul F. Strategic Planning for Coalition Warfare, 1941–1942,
Russell, Malaria: An Account of Its Cause, Cure and United States Army in World War II (Washington, D.C.:
Prevention (Manila: Bureau of Printing, 1931), p. 37. Office of the Chief of Military History, Department of
5
MacArthur became military adviser to the the Army, 1953), p. 45; Ray S. Cline, Washington
Philippine government on 18 September 1935, less Command Post: The Operations Division, United States
than two weeks before completing his service as Army Army in World War II (Washington, D.C.: Office of the
chief of staff (21 November 1930–1 October 1935) with Chief of Military History, Department of the Army,
the rank of temporary general. Thereafter, he resumed 1951), pp. 55–59; Mark Skinner Watson, Chief of Staff:
his permanent rank of major general. The following Prewar Plans and Preparations, United States Army in
year, on 19 June, MacArthur was appointed field mar- World War II (Washington, D.C.: Historical Division,
shal of the Philippine Army. United States Army, 1950), pp. 103–04.
THE DRIFT TOWARD WAR 7
Health Division of the Rockefeller The United States spent the last
Foundation, and the Public Health months of peacetime feverishly making
Service. New medical units were orga- preparations that had been too long
nized to supplement the four regiments delayed. While some Americans clung to
then in existence. In addition to divi- pacifism or isolationism, others believed
sional medical units, seventy-six nondivi- that the only questions remaining to be
sional units were activated, including answered were when and where the blow
numbered general, station, evacuation, would fall. Then plans would encounter
and surgical hospitals, supply depots, reality, and wartime casualties would put
and laboratories. More skilled women the nation and its military medical ser-
entered the Army Nurse Corps; enlisted vices to the test of fire.
men received training as medical tech-
nicians; and the ranks of the allied pro- Interior, United States Army in World War II
fessions—pharmacists, oculists, medical (Washington, D.C.: Office of the Chief of Military
History, Department of the Army, 1956). See War
administrators, entomologists, and sani- Department, [Annual] Report of the Surgeon General, U.S.
tary engineers, among others—were Army, to the Secretary of War, 1940 (Washington, D.C.:
filled, as civilians donned the uniform Government Printing Office, 1941), pp. 172–93; idem,
[Annual] Report of the Surgeon General, U.S. Army, to the
and reserve officers reported for active Secretary of War, 1941 (Washington, D.C.: Government
duty. Major maneuvers gave new sol- Printing Office, 1941), pp. 141–42 and 153–54. See also
diers, including many officers and men Blanche B. Armfield, Organization and Administration in
World War II, Medical Department, United States Army
of the Medical Department, their first in World War II (Washington, D.C.: Office of the
taste of life in the field under simulated Surgeon General, Department of the Army, 1963), pp.
wartime conditions.7 1–68; and, in the same series, Robert J. Parks, Medical
Training in World War II (Washington, D.C.: Office of
the Surgeon General, Department of the Army, 1971),
pp. 13–41, and John H. McMinn and Max Levin,
7
The process of medical mobilization is treated in Personnel in World War II (Washington, D.C.: Office of
detail in Clarence McKittrick Smith, The Medical the Surgeon General, Department of the Army, 1963),
Department: Hospitalization and Evacuation, Zone of pp. 111–66.
CHAPTER I
A Medical Calamity
Nowhere was the imminence of war at Hickam Field, and the 14th Pursuit
and the need for increased medical Wing, with headquarters at Wheeler
resources more strongly felt than in the Field.1
nation’s major Pacific bastion, the Upon Col. Edgar King, MC, chief sur-
Hawaiian Islands. Especially after May geon of the Hawaiian Department, fell
1940, when Pearl Harbor became the the responsibility for meeting the grow-
home of the U.S. Pacific Fleet, troops, ing medical needs of the Army and—in
supplies, and equipment flowed into the event of an emergency—those of a
Oahu, the most heavily settled of the dependent civilian population as well. A
islands. Here the mission of the Army’s somewhat intimidating Regular Army
Hawaiian Department was to cooperate officer, King benefited from thirty-four
fully in defending the Navy’s largest years of experience as a military surgeon
overseas base. in the Philippines, China, the Canal
For many years the principal Army Zone, and the United States. During
unit had been the Hawaiian Division, 1940 and 1941 he acquired more med-
headquartered at Schofield Barracks ical personnel, enlarged hospital facili-
some 10 miles from Pearl Harbor. In ties, and planned future construction.
October 1941 the old four-regiment The chief surgeon also started an inten-
unit was reorganized into two three-reg- sive training program, and guided the
iment (“triangular”) divisions and sever- revision of old emergency medical plans
al nondivisional units. By December and the formulation of new ones. In
Army forces—including the two under- these endeavors he was assisted by a
strength infantry divisions, four com- comparatively small staff of 9 officers
plete coast artillery regiments, four anti- and 8 enlisted men, plus leading mem-
aircraft regiments, one company of light
tanks, and supporting service troops— 1
Joint Army and Navy Basic War Plan Orange, 1938,
numbered 43,000, then the largest con- p. 5, file JB 325, Record Group (RG) 225, National
tingent stationed outside the continen- Archives and Records Administration (NARA),
Washington, D.C.; Wesley Frank Craven and James Lea
tal United States. The air component, Cate, eds., The Army Air Forces in World War II, 7 vols.
the Hawaiian Air Force, reached a total (Chicago: University of Chicago Press, 1948–58), 1:170;
of 754 officers and 6,706 enlisted men, Mark Skinner Watson, Chief of Staff: Prewar Plans and
Preparations, United States Army in World War II
organized tactically into the 18th (Washington, D.C.: Historical Division, United States
Bombardment Wing, with headquarters Army, 1950), p. 474.
10 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
2 3
See CSurg, Haw Dept, Annual Rpt, 1940, pp. 1, CSurg, Haw Dept, Annual Rpt, 1941, p. 13, file
9–10, file 319.1–2, Historical Unit Medical Detachment 319.1–2, HUMEDS, RG 112, NARA; “History of Office
(HUMEDS), RG 112, NARA. See also King’s brief testi- of the Surgeon, United States Army Forces, Middle
mony before the Army Pearl Harbor Board in United Pacific and Predecessor Commands, 7 December
States Congress, Hearings Before the Joint Committee on the 1941–2 September 1945,” sec. 1, “Hawaiian
Investigation of the Pearl Harbor Attack, 79th Cong., 1st Department,” ch. 1, pp. 2, 7, Ms 8–5.6 AA 30/1, files of
Sess. (Washington, D.C.: Government Printing Office, the U.S. Army Center of Military History (CMH),
1946), pp. 1403–09 (hereafter cited as Pearl Harbor Washington, D.C. (hereafter cited as “History of
Attack Hearings); Mary Ellen Condon-Rall, “The U.S. OofSurg, USAFMIDPAC”). See also John H. McMinn
Army Medical Department and the Attack on Pearl and Max Levin, Personnel in World War II, Medical
Harbor,” Journal of Military History 53 (Jan 89): 65–78; Department, United States Army in World War II
Committee on Medical Preparedness, “An Appeal for (Washington, D.C.: Office of the Surgeon General,
Service,” Journal of the American Medical Association 114 Department of the Army, 1963) p. 58; Strength of the
(29 Jun 40): 2556. Army, December 1941.
A MEDICAL CALAMITY 11
HOSPITALS ON OAHU
December 1941–January 1942
Airfield
0 10
Miles PACIFIC
Haleiwea
Field
OCEAN
MAP 1
plans and created new ones. The key minor wounds would use dispensaries
existing document was the medical either at Tripler or at Forts De Russey,
annex to Emergency Plan WHITE, a civil Kamehameha, and Armstrong.7
disturbance plan aimed at controlling In 1940 King’s office devised a new
riots. The plan outlined a standard evac- medical plan that in essence restated
uation procedure, specified the military Plan WHITE, with some important addi-
hospitals to which the north and south tions. The Army Medical Department
sectors of Oahu would send casualties, became responsible for the treatment of
authorized Army medical officers to use civilians on the island of Oahu under dis-
civilian hospitals, and made military per- aster conditions. Much more than first
sonnel responsible for rendering first aid aid was now involved. Casualties must be
to civilian casualties. Tripler General collected, given emergency treatment,
Hospital would receive severely wounded evacuated, and hospitalized. In order to
from the Honolulu area, while Schofield make the plan workable, King had to
Station Hospital would treat casualties
from Schofield Barracks. Honolulu area 7
“History of OofSurg, USAFMIDPAC,” sec. 1, ch. 3, p.
military and civilians suffering only from 7, and ch. 4, p. 1, Ms 8–5.6 AA 30/1, CMH.
A MEDICAL CALAMITY 13
rely on the participation of the civilian detailed plans; and designated medical
medical and dental professions. The equipment for emergency use. When
Honolulu Medical Society gave prompt the crisis came, the Office of the Chief
cooperation; it established a prepared- Surgeon was in the process of occupying
ness committee, headed by Dr. Harry L. one school and had all necessary plans
Arnold, Sr., to help the Army devise and ready for the others.9
carry out the contingency proposals. By November Colonel King had estab-
The planning called for military control lished twenty civilian aid stations, com-
of all hospitalization, for establishment plete with the necessary trained person-
of first aid stations throughout Oahu, nel and supplies. The stockpiling of med-
and for supplementary care of military ical supplies had made good progress.
personnel by civilian doctors. Maj. Elmer Major Faus had obtained twelve trucks
D. Gay, civilian liaison officer on King’s from business firms and modified them
staff, established contact with the Red to carry litters. With the cooperation of
Cross and similar agencies and orga- the Honolulu Medical Society, the chief
nized medical teams of civilians to work surgeon had organized civilian nurses to
in the hospitals under the supervision of move into Army hospitals as soon as their
military medical personnel.8 services were called for. Civilian training
Civilian hospitals and public and pri- in first aid was under way, and the
vate buildings, like civilian doctors and women of Schofield Barracks were study-
nurses, were needed. During 1941 ing first aid. Maj. Charles C. Gill, MC,
Colonel King placed a civilian physician, assigned to Schofield Barracks, helped to
Dr. Nils P. Larsen, in charge of civilian pioneer an Army ambulance corps for
hospital expansion and evacuation. Maj. women. Supplementing such efforts, Dr.
Robert Faus, on King’s staff, headed Forrest J. Pinkerton, a civilian acting as
plans and training. Faus and Gay pre- liaison between the Red Cross and other
pared sixteen civilian hospitals—includ- public health agencies, organized a plas-
ing Queens, Children’s, St. Francis, and ma bank, responding to the American
others—to care for convalescing Medical Association Preparedness
patients evacuated from other medical Committee recommendations to the
facilities in event of an attack. During medical profession. In so far as the limi-
the summer and autumn of 1941 Gay tations of supplies and manpower
surveyed other buildings that could be allowed, Hawaii was ready to meet the
utilized. For the most part, he selected great medical emergency that lay
schools because they were fire resistant, ahead.10
easily adaptable, and located at some
distance yet not too far from military 9
“History of OofSurg, USAFMIDPAC,” sec. 1, ch. 3,
installations. He formulated a scheme pp. 3–4, Ms 8–5.6 AA 30/1, CMH; Memo, Col Edgar
for the speedy conversion of Farrington King to Ed., History of the Medical Department, U.S.
High School, Kamehameha School for Army in World War II, 22 Mar 50, sub: Supplemental
Data on the Work of the Medical Department in the
Boys, and St. Louis College; worked out Hawaiian Department, Later U.S. Army Forces in the
Pacific, then the Central Pacific Area, p. 6, file 000.71,
HUMEDS, RG 112, NARA.
8 10
Ibid., ch. 1, p. 5, Ms 8–5.6 AA 30/1, CMH; “History of OofSurg, USAFMIDPAC,” sec. 1, ch. 3,
Testimony of Maj. Gen. Walter C. Short, in Pearl Harbor pp. 1–4, an. 1, pp. 1–3, and an. 8, p. 3, Ms 8–5.6 AA
Attack Hearings, pp. 173, 182. 30/1, CMH.
14 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
plasma and warmth to forestall shock. year. The surgeons shared instruments,
Such a large number of casualties had sterilizing and shifting them from table
been brought to Tripler by the time the to table. When not performing an opera-
raid was over that they were placed on lit- tion, they relieved each other on the
ters on the floors, in the halls, and in the wards doing pre- and postoperative treat-
corridors. Chaplains comforted the ment. Both traditional methods of mili-
wounded and attended the dying. tary surgery and recent discoveries in
Powerful emotion as well as morphine chemotherapy contributed to the success
acted as an anesthetic, and many seemed in handling severe wounds. The early
unaware of their pain.13 morning attack caught many victims with
As a result of Colonel King’s prepara- bowels full, increasing fecal contamina-
tions, an admirable military staff supple- tion of abdominal wounds, and recently
mented by civilians was on hand to care eaten breakfasts added the further dan-
for the Army’s casualties. Notable was ger of undigested food. Hence, surgeons,
the contribution of a reserve officer, Dr. after suturing perforations, packed the
John J. Moorhead, a prominent New peritoneal cavity with crystalline sulfanil-
York surgeon who, on invitation of the amide, preventing much infection that
Honolulu Medical Society, had arrived a would otherwise have been inevitable.
few days before to give a course of lec- The same antibacterial agent plus sul-
tures on traumatic surgery. When word fathiazole helped to prevent infection in
came that surgeons were needed at the amputees. But delayed closure of
Tripler, Moorhead joined the effort, tak- wounds was also a factor, for wounds pre-
ing over the operating rooms at the maturely sutured sometimes became
request of Col. Alvin C. Miller, MC, the infected despite the wonder drugs. Stores
hospital commander. Moorhead briefly of plasma from civilian sources were crit-
instructed the surgical teams on the ical in preventing shock and making suc-
methods he wanted to be used, and the cessful surgery possible. Though dozens
civilian-military medical force started of the injured died of their wounds in the
work with a “fine spirit of cooperation.”14 first twenty-four hours after the raid,
Surgery was carried out in three oper- there were no deaths after the first week.
ating rooms by nine teams, four of Army The low mortality rate after the first day
surgeons, the other five of civilians resulted from skilled surgery and the use
recruited and organized during the past of sulfa drugs to prevent infection.15
13
Hickam Field Sta Hosp Annual Rpt, 1941, p. 1, file Casualties at Pearl Harbor,” U.S. Navy Medical Bulletin 40
319.1–2; Ltr, Charles Gill to his father, 10 Dec 41, sub: (Apr 42): 355–58; John J. Moorhead, “Surgical
Account of Attack on Hawaii, p. 4, file 319.1; I. S. Experience at Pearl Harbor,” Journal of the American
Ravdin and Perrin H. Long, “The Treatment of Army Medical Association 118 (28 Feb 42): 712–14. See also
Casualties in Hawaii,” pp. 1–4, and “The Problems of Walter Lord, Day of Infamy (New York: Henry Holt and
the Hickam Station Hospital, the Tripler General Co., 1957), p. 194.
15
Hospital, and the Schofield Station Hospital,” pp. 3–5, Ltr, Gill to his father, 10 Dec 41, p. 4, file 319.1;
file 314.7–2 (Wounds and Casualties) Hawaii. All in Ravdin and Long, “Problems,” intro and pp. 5, 7, file
HUMEDS, RG 112, NARA. 314.7–2 (Wounds and Casualties) Hawaii; Tripler Gen
14
Quotation from Ravdin and Long, “Problems,” p. 5, Hosp Annual Rpt, 1941, p. 19, file 319.1–2. All in
file 314.7–2 (Wounds and Casualties) Hawaii, HUMEDS, RG 112, NARA. See also Clark, Fight at Pearl
HUMEDS, RG 112, NARA. See idem, “The Treatment Harbor, pp. 78–79, 82; John J. Moorhead, Clinical
of Army Casualties in Hawaii,” Army Medical Bulletin 61 Traumatic Surgery (Philadelphia: W. B. Saunders Co.,
(Apr 42): 1–8; idem, “Some Observations on the 1945), pp. 702–25.
16 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Heavy use depleted the plasma and final victims in the days following the
blood banks, but a radio appeal for vol- raid. Many more would have lost their
unteer donors brought five hundred peo- lives but for the speed and thoroughness
ple to the doors of Queens Hospital in with which their wounds were treated.17
the first half hour. Fifteen doctors and Navy casualties received emergency
trained technicians worked at twelve treatment at aid stations in the dock
tables drawing blood, but could not take area or at a temporary dispensary set up
it as fast as it was offered. Some donors in the Navy Yard officers club. For fur-
stood in line for seven hours; many did ther care, military and civilian ambu-
not know what plasma was, but knew they lances and other vehicles moved the
were helping. The entire crew and a wounded to the U.S. Naval Hospital,
number of passengers of a Dutch ship, in Pearl Harbor; the USS Solace, a hospital
port for only a few hours, also gave blood. ship that was providentially in the har-
For days following the attack, hundreds bor; and the U.S. Naval Mobile Base
of donors were to come from all over the Hospital No. 2. Many sailors acquired
island as a result of daily radio and news- flash burns from exploding bombs or
paper appeals. The power of the events at torpedoes while rushing to battle sta-
Pearl Harbor to unify Americans was evi- tions in a state of undress. Blazing fuel
dent from the beginning.16 oil roasted men who fell, jumped, or
Lifesaving work also went on at were thrown overboard by explosions.
Schofield Station Hospital, where 118 When time permitted, medics used a
soldiers suffering from machine gun tincture of green soap with water to
wounds, fragmentation wounds, and remove oil. More often, time permitted
burns received treatment. The most seri- only scant cleaning before applying tan-
ously injured came from Wheeler Field, nic acid or gentian violet, sometimes
where a Japanese bomb penetrated a mixed with sulfa powder, to the burned
hangar that had been converted into a areas over oil. Treatment for compound
dispensary and exploded, collapsing the fractures and for shrapnel and machine
sides of the building. The wounded, gun bullet wounds followed the tradi-
including two nurses, were taken out- tional pattern of debridement, sulfa
side, placed in rows on blankets and therapy to prevent infection, and
given first aid before being evacuated to surgery. Again, plasma from civilian
Schofield. Four major surgical teams sources saved many lives.18
worked until the last serious case was
cared for, while minor surgical teams 17
Schofield Barracks Sta Hosp Annual Rpt, 1941, pp.
labored on the less seriously injured. In 2, 16, 24; Department of the Navy, Bureau of Medicine
keeping with emergency plans, dentists and Surgery, “The United States Navy Medical
Department at War, 1941–1945,” 1:20, files of Bureau of
assisted the surgeons and performed var- Medicine and Surgery Archives (BMSA), Washington,
ious hospital duties. Twenty-seven casual- D.C.; Felix Sutton, We Were There at Pearl Harbor (New
ties were dead on arrival, nine more died York: Grosset and Dunlap, 1957), p. 66.
18
“Navy Medical Department at War,” 1:2–4, 11–15,
in the first twenty-four hours, and two 19, 22–23, 64, BMSA; Charles M. Oman, Doctors Aweigh
(Garden City, N.Y.: Doubleday, Doran and Co., 1943),
pp. 5–6, 9–11; George A. Eckert and James W. Mader,
16
Clark, Fight at Pearl Harbor, pp. 85, 87. See also “The Solace in Action,” U.S. Navy Medical Bulletin 40
Honolulu Advertiser and Honolulu Star Bulletin, 8–15 Dec (Jul 42): 552–57; Ravdin and Long, “Some
41. Observations,” pp. 353–56.
A MEDICAL CALAMITY 17
Besides the soldiers and sailors, Naval Air Station went mainly to the
eighty-eight civilians had been injured. Kaneohe Territorial Hospital.19
Most were treated at civilian hospitals. After the immediate emergency had
The City Emergency Hospital took care passed, steps were taken to correct the
of the majority; Children’s Hospital inadequacies that the catastrophe had
admitted eleven youngsters with burns, revealed and also to prepare for another
shell fragments, or bullet wounds; and a attack. On the afternoon of 7 December
hospital run by and for Japanese the islands passed under martial law and
Americans was taken over by the Army, Lt. Gen. Walter C. Short, commander of
admitting four civilians with shrapnel the Hawaiian Department, became mili-
wounds. The other Honolulu hospitals tary governor. The Office of the Chief
received no civilian casualties but main- Surgeon now took over civilian structures
tained vacant beds on reserve. In rural to house four temporary hospitals under
areas of Oahu, hospitals or emergency military control. Provisional General
medical centers set up in plantation
houses cared for a few attack victims. 19
“History of OofSurg, USAFMIDPAC,” sec. 1, ch. 3,
Naval casualties from the Kaneohe Bay pp. 7–9, Ms 8–5.6 AA 30/1, CMH.
18 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
U.S. NAVAL MOBILE BASE HOSPITAL NO. 2, where 110 casualties were treated
Hospital No. 1, with a capacity of 595 pitals expanded as well, and within five
beds, opened at the Kamehameha months after the onset of war the
School for Boys on the seventh; twelve Hawaiian medical facilities were consid-
days later all of the wounded children at ered ample, at least for the time being.20
Tripler were transferred to this new hos- Medical supply kept up with the
pital, which was also designated to quickening pace. Since 7 December the
receive civilian outpatients in the event main Hawaiian supply center on Oahu
that Honolulu had to be evacuated. St. had functioned twenty-four hours a day.
Louis College, in the Kaimuki district of Colonel King planned and, during 1942,
Honolulu, began operating as set up branch depots on the islands of
Provisional General Hospital No. 2 on 8 Maui, Kauai, and Hawaii to supply the
December. On the thirteenth the service commands of those districts. On
Japanese Hospital was converted into No. Oahu he also authorized the construc-
3, and served primarily as an isolation tion of five additional warehouses at the
hospital for the Army, with a section Schofield Barracks branch depot and
reserved for Japanese-American civilians. the completion of a warehouse at Fort
The Kaneohe Territorial Hospital Ruger, which was ready for use by the
became Provisional General Hospital No. middle of February. The chief surgeon’s
4 on 10 January 1942, specializing in the
treatment of nervous and mental diseases 20
Ibid., pp. 10–11, Ms 8–5.6 AA 30/1, CMH. On 17
(see Map 1). Seven military hospitals were December 1941 Lt. Gen. Delos C. Emmons succeeded
set up on the other islands. Civilian hos- General Short as military governor.
A MEDICAL CALAMITY 19
office ordered stocks, particularly sulfa Army headquarters in the Far East, and
drugs, to be further dispersed in the var- the Philippine Commonwealth forces
ious hospitals of the Hawaiian designated for service with the U.S. mil-
Department to lessen the possibility that itary. Its principal army was Maj. Gen.
all might be destroyed in the event of Jonathan M. Wainwright’s Philippine
another attack. In April the 5th Medical Division, with three infantry and two
Supply Depot, under the command of field artillery regiments; the coast
Lt. Col. James P. Gill, MC, arrived in artillery units garrisoning the Harbor
Hawaii from the United States. Less than Defenses of Manila and Subic Bays; and
three months later the Oahu supply cen- a miscellany of others, including the 4th
ter was deactivated, and all personnel Marines, the 26th Cavalry of the
and equipment were transferred to the Philippine Scouts (PS), and three addi-
5th. But the immense job of building a tional regiments of field artillery.
logistical base for the campaigns that lay Philippine natives served both as profes-
ahead had, as yet, hardly begun.21 sional soldiers—for example, enlisted
The baptism by fire was over for the men in Wainwright’s 45th and 57th
doctors, nurses, and corpsmen, as well Infantry (PS) and other U.S. Army
as for the civilian colleagues who had units—and as militiamen in the ill-
worked beside them during the crisis on trained and ill-equipped Philippine
Oahu. Though few would have believed Army, a citizen-soldier force that
it at the time, they were comparatively President Franklin D. Roosevelt had
lucky, for the enemy did not return and called into the service of the United
no invasion fleet appeared to threaten States. The strength of USAFFE, to
the Hawaiian Islands. Not so fortunate include the air complement but not the
were other Americans 2,000 miles to the Philippine Army, was 22,532 officers and
west. In the Philippines one of the great enlisted men.22
tragedies of American military history— The Philippine Department’s Office of
in many respects a medical calamity as the Chief Surgeon, under Col. Adam E.
well—had begun to overwhelm both Schlanser, MC, initiated medical mobi-
military and civilians alike. lization planning in the winter of
1940–41. When Schlanser left the islands
The Philippines Prepare in September 1941, his successor, Col.
Wibb E. Cooper, MC, took up the task,
As of 26 July 1941 defense of the performing the dual functions of Chief
Commonwealth of the Philippines had Surgeon, USAFFE (although informally,
been entrusted to a new Army com- as the position was never established offi-
mand, the United States Army Forces in cially until early 1943), and Surgeon,
the Far East (USAFFE), under General Philippine Department. Like his prede-
MacArthur, who was promoted to lieu- cessor, he relied greatly upon the
tenant general the next day. USAFFE Philippine Division’s 12th Medical
consisted of the Philippine Department,
which before July had been the highest
22
Morton, Fall of Philippines, pp. 21, 23; Mary Ellen
Condon-Rall, “U.S. Army Medical Preparations and the
21
Ibid., ch. 1, p. 8, Ms 8–5.6 AA 30/1, CMH; Wiltse, Outbreak of War: The Philippines, 1941–6 May 1942,”
Medical Supply, p. 395. Journal of Military History 56 (Jan 92): 35–56.
20 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Regiment, a unit formed of Philippine Division; trained cadres for newly creat-
Scouts under Maj. Harold W. Glattley, ed medical detachments and provided
MC. A midwesterner and graduate of the them key noncommissioned officers;
University of Iowa’s School of Medicine, and taught the militiamen of the
Glattley served for fourteen years at Army Philippine Army the rudiments of field
hospitals in the United States and over- medicine, medical supply, and hospital-
seas before taking up his position with ization. In August 1941, as the Philippine
the Philippine Scouts. He witnessed the Division began the process of triangular-
growth of the 12th Medical Regiment ization, the 12th Medical Regiment was
from only 200 before 1941 to 22 officers reorganized locally as the 12th Medical
and 399 enlisted men by 31 July.23 Battalion,24 with a headquarters section,
This small force of Philippine natives three collecting companies, and one
and American officers participated in clearing company. A collecting company
the maneuvers of the Philippine
24
While the 12th Medical Regiment may have been
23
Wibb E. Cooper, “Medical Department Activities in reorganized locally in 1941 as the 12th Medical
the Philippines From 1941 to 6 May 1942, and Battalion, War Department directives for the action
Including Medical Activities in Japanese Prisoner of were not published until the spring of 1946. The unit’s
War Camps,” pp. 5, 20–22, file 314.7, HUMEDS, RG official designation until April 1946 was 12th Medical
112, NARA. Regiment, which is used in this volume.
A MEDICAL CALAMITY 21
and a platoon of the clearing company each Philippine Army division. When
were attached to each of the three new manpower proved insufficient (the
regimental combat teams.25 Office of the Chief Surgeon had author-
Medical service for the Air Force, ity to recruit enlisted men but not offi-
USAFFE, which before 4 August 1941 cers), local physicians and nurses were
had been called the Philippine Air commissioned in the Philippine Army
Force, was provided by a detachment at and inducted into the service of the
Nichols Field and another at Clark United States.
Field. Clark held the headquarters of On the southern islands, the Visayas
the senior flight surgeon, Lt. Col. and Mindanao, medical detachments
William J. Kennard, MC, who was a grad- were aided by local hospitals, which fur-
uate of the Army’s School of Aviation nished care on a contract basis. There
Medicine at Randolph Field, Texas, and were a number of such hospitals—mili-
had just turned thirty-five. On 16 tary, civilian government, missionary,
November the Air Force, USAFFE, was industrial, and privately owned. The sur-
reorganized as the Far East Air Force, geon coordinated and supervised the
with Maj. Gen. Lewis H. Brereton as arrangements of the Red Cross for the
commanding general. At the same time, evacuation and treatment of civilian
when the subordinate Far East Air casualties in the event of air raids, and
Service Command was activated under his arrangements later proved workable
the leadership of Col. Lawrence when combat began.27
Churchill, Colonel Kennard, who rou- As in Hawaii, the problem of provid-
tinely coordinated all medical activities ing enough hospital beds preoccupied
with Cooper’s office, additionally medical planners during the prewar
became the Air Service Command sur- buildup. Before 1941 the Army’s med-
geon. The Far East Air Force had its own ical facilities in the Philippine Islands
dispensaries, but used the fixed Army consisted of Sternberg General Hospital
hospitals and supply depots.26 and Forts John Hay, William McKinley,
For administrative and training pur- and Stotsenburg Station Hospitals on
poses the Philippine Army’s ten reserve Luzon; Fort Mills Station Hospital on
divisions had been divided into three Corregidor; and Fort Brent Station
task forces, one for northern Luzon, a Hospital on Mindanao. Three of the sta-
second for southern Luzon, and a third tion hospitals as well as Sternberg had a
for the Visayan Islands and Mindanao. dental clinic, and Sternberg also had a
Colonel Cooper assigned a medical offi- laboratory (including a veterinary sec-
cer to each force headquarters as its sur- tion) and a dispensary service. In 1940
geon. He further tried to allocate a med- these installations served approximately
ical instructor to the headquarters of 30,000 American and Philippine per-
sonnel, about one-fourth of whom were
25
dependents.28
Cooper, “Medical Department Activities,” pp.
20–22, file 314.7, HUMEDS, RG 112, NARA. On col-
lecting and clearing companies, see Table 1.
26 27
William J. Kennard, “Observations on Bataan,” 22 Cooper, “Medical Department Activities,” pp.
Aug 42, pp. 2–3, attached to idem, “History—Medical 92–95, file 314.7, HUMEDS, RG 112, NARA.
28
Department,” same date, file 000.71 (Interviews–SWPA), CSurg, Phil Dept, Annual Rpt, 1940, p. 1, file
HUMEDS, RG 112, NARA. 319.1–2, HUMEDS, RG 112, NARA.
22 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
healing of even the deepest wounds. set up a field dispensary. That after-
Stotsenburg was a small hospital, howev- noon, the enemy raided the field again,
er, and the casualties were too numer- killing 18 and wounding 30, many seri-
ous for its staff. As a result, patients were ously. The temporary dispensary and
evacuated by train to Sternberg General much equipment was strafed and one
Hospital in Manila. Soon casualties from ambulance almost destroyed. The sur-
Iba Field, who were almost as numerous, geon then moved onto a road between
were entering Sternberg as well.33 Nichols and McKinley, working in the
When war broke out, Nichols Field, open until the field was evacuated. For
about 5 miles south of Manila, was in the about two weeks, enemy aircraft bom-
midst of a construction program that barded Nichols Field almost daily,
included new barracks, quarters, killing 50 and wounding 150.35
hangars, and runways. On 8 December Almost immediately after the attack,
Lt. Col. Charles H. Moorhouse, MC, Colonel Cooper put the Manila
flight surgeon at the field, prepared for Hospital Center into operation.
the emergency by establishing four aid Composed of Sternberg General
stations at key points. Late in the after- Hospital plus eight annexes in colleges,
noon the first air raid casualties with universities, dormitories, barracks, and
minor wounds arrived. Before dawn, the Jai Alai Building, the center formed
casualties mounted as seven Japanese the focal point of medical activity. Total
bombers attacked Nichols Field itself, planned bed capacity exceeded 4,600.
destroying one hangar, killing 3 men, But in the opening days Sternberg
and wounding 15, one of whom died admitted most of the attack victims,
later. In the operating room at adjacent beginning in the early morning hours
Fort McKinley’s station hospital, other of 9 December. As raids increased in
Nichols casualties awaited surgery. They severity during the following days,
lay in unnerving silence, as a result of wounded poured in from Iba Field,
either morphine, shock, or simple relief Clark Field, Fort Stotsenburg, Nichols
at finding themselves alive, while medics Field, Cavite Naval Base, Manila, and
rinsed their wounds and “steady-handed later from the Luzon fronts. The surgi-
anesthetists drove long, glistening nee- cal teams that Cooper had organized on
dles” into their naked backs.34 the first day of hostilities were kept busy.
On 9 December Colonel Moorhouse During some peak periods all surgeons,
moved into the new barracks area and nurses, and corpsmen worked for two
days without rest, and even at other
33
Ltr, 1st Lt Willa L. Hook, CNurse, Base Sec 3, to Col
Percy J. Carroll, CSurg, USASOS, SWPA, 5 Feb 43, sub: General Hospital No. 1 on Bataan; his memoir, though
History of Medical Department Activities in the it resembles a “docudrama” in some respects, is filled
Philippines Campaign, p. 1, file 000.71 with useful observation and commentary on his combat
(Interviews–Philippines); Catherine L. Nau, “History of and prison experiences. See also Ltr, Lt Col Charles H.
the War, Philippines, 1941–1945,” p. 40, file 314.7. Both Moorhouse to SG, U.S. Army, 20 Jan 43, sub: Medical
in HUMEDS, RG 112, NARA. Nau, an American Red Service in the Philippines, December 8, 1941 to March
Cross volunteer, was assigned to Sternberg’s Social 10, 1942, pp. 1–3, file 000.71, HUMEDS, RG 112,
Service Department as a field director. NARA.
34 35
Quotation in Alfred A. Weinstein, Barbed-Wire Ltr, Moorhouse to SG, U.S. Army, 20 Jan 43, pp.
Surgeon (New York: Macmillan Co., 1948), p. 2. 1–3, file 000.71; Nau, “History of War,” p. 4, file 314.7.
Weinstein was later assistant chief of surgical service in Both in HUMEDS, RG 112, NARA.
A MEDICAL CALAMITY 25
times many slept at the hospital in order hysterical. Hospital activities were disor-
to be available when needed. The casu- ganized and in a state of turmoil.
alties suffered from injuries that includ- Medical personnel treated casualties
ed severe complicated fractures, burns, amid wailing sirens, bursting flares, and
and brain wounds. Tressa Cates, a civil- rifle fire from nervous troops who shot
ian nurse, was stunned by the carnage: at any unusual light or sound. False
. . . soon our wards, receiving rooms, reports spread of parachute invasions,
operating rooms, as well as the large hospi- gas attacks, and spy infiltrations.38
tal yard, were filled with the wounded and On 13 December Fort William
the dying. McKinley Station Hospital closed down
American and Filipino men, both civilian as a result of constant bombardment
and military, were lying everywhere on the
well-kept lawn. Many of them were charred from enemy aircraft, and much of its
and burned beyond recognition. Blood as staff was integrated with Sternberg’s.
crimson as the hibiscus flowers which Similarly, personnel from Fort
bloomed in profusion in the yard was scat- Stotsenburg Station Hospital trans-
tered everywhere.36 ferred to Sternberg on the twenty-
Since the Philippine Army headquar- fourth. Using these reserves, the Manila
ters was located across the street, Hospital Center treated about 2,000 mil-
Sternberg General Hospital observed itary and civilian patients during the
blackout regulations every night. Staff first three weeks of the war, including
members dug slit trenches on the 154 casualties transferred from the U.S.
grounds for the protection of their Naval Hospital, Canacao, at Cavite, 7
patients and themselves. Adding to miles down the coast from Manila.39
their burden was an ever-increasing As Manila’s fall became imminent,
number of victims of traffic accidents, MacArthur, who on 18 December was
resulting from the blackout in Manila promoted to the AUS rank of general,
and elsewhere.37 declared the capital an open city and
The city was a scene of mass confu- ordered the withdrawal of American and
sion. On 10 December Japanese forces Philippine troops to Bataan. With his
landed on Luzon, and two weeks later medical plans now gutted (there was no
the main enemy force came ashore, win- need for a medical center in the capital
ning quick successes against the defend- when a campaign would have to be
ers. By the end of the month the waged on Bataan), Colonel Cooper
invaders were closing in on the doomed began to evacuate medical facilities and
capital. With no protection against the
bombings, casualties mounted. Traffic
38
was congested and the population W. H. Waterous, “Reminiscences of Dr. W. H.
Waterous Pertinent to World War II in the Philippines,”
demoralized. Some people indulged in p. 17; James O. Gillespie, “Recollections of the Pacific
wild orgies of drinking; others became War and Japanese Prisoner of War Camps, 1941–1945,”
p. 8. Both in file 314.7–2, HUMEDS, RG 112, NARA.
39
Cooper, “Medical Department Activities,” pp.
36
Quotation from Tressa R. Cates, The Drainpipe Diary 48–50, file 314.7, HUMEDS, RG 112, NARA. Records
(New York: Vantage Books, 1957), p. 19. See also on all casualties during the first weeks of the war in the
Cooper, “Medical Department Activities,” pp. 48–49, Philippines were brief as a result of the tremendous vol-
file 314.7, HUMEDS, RG 112, NARA. ume of work and shortage of personnel. Also, most
37
Cooper, “Medical Department Activities,” pp. medical records were lost when the boat on which they
48–49, 84, file 314.7, HUMEDS, RG112, NARA. were being shipped was bombed.
26 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
personnel, including patients capable of River near Cabcaben. Here Army engi-
traveling, to the peninsula. On the after- neers worked to clear away bamboo
noon of the twenty-third the staff and thickets and jungle, while supply per-
patients of the Manila Hospital Center sonnel opened a medical depot on the
joined the caravan of military vans, civil- Mariveles road. Vessels carrying evac-
ian vehicles, and fleeing refugees crowd- uees docked at the towns of Lamao and
ing the one road leading through the city Cabcaben, usually in the early morning,
of San Fernando and south into Bataan. and on several occasions during air
Lt. Col. James W. Duckworth, MC, for- raids. On 29 December the remaining
merly the executive officer at Sternberg, Army nurses left Manila, and by New
established General Hospital No. 1 at Year’s Eve the last patients as well had
Limay, following General MacArthur’s departed on boats and barges.41
verbal orders. Working under intermit- As the Corregidor hospitals became
tent air attack, Maj. Peter Kempf, MC, overcrowded, General MacArthur on 28
the medical supply officer at Sternberg, December decided to evacuate the worst
moved supplies and equipment from the cases. At his order, Col. Percy J. Carroll,
various annexes in Manila and from Fort MC, commanding officer of Sternberg
McKinley Station Hospital to Corregidor General Hospital, selected 224 patients
by barge and to the Bataan Peninsula by to accompany him to Australia on the
truck. Despite all efforts, critical supplies Mactan, an interisland steamer char-
were lost to air attack or abandoned in tered by the Red Cross in the
the withdrawal.40 Philippines to serve as a hospital ship.
After leaving Manila on Christmas The doctor also took two Army nurses,
Eve, Colonel Cooper set up the main Lt. Floramund A. Fellmeth and Lt.
section of his office on Corregidor with Florence MacDonald, and a number of
the rest of the USAFFE staff. He estab- Filipino doctors and nurses serving with
lished a subdivision of his office ashore the U.S. Army. Protected by Red Cross
at General Hospital No. 1. On Christmas markings, the ship docked at Sydney,
Day most of the medical personnel Australia, after a harrowing journey, and
remaining in Manila went by boat to the patients found refuge in an
Bataan to help Maj. William D. North, Australian Army hospital. Yet some who
MC, organize General Hospital No. 2 at were hopelessly crippled had been left
a previously selected site along the Real behind, a burden to themselves and to
the medical staff during the battles that
40
James O. Gillespie, “Malaria and the Defense of followed and in prison thereafter.42
Bataan,” in Ebbe Curtis Hoff, ed., Communicable Diseases:
41
Malaria, Medical Department, United States Army in Duckworth, “History of General Hospital Number
World War II (Washington, D.C.: Office of the Surgeon One,”, p. 1, file 319.1–2 (General Hospital 1)
General, Department of the Army, 1963), pp. 500–501. Philippine Islands; Cooper, “Medical Department
See also idem, “Recollections,” p. 8, file 314.7–2; Activities,” pp. 2, 8, 53, file 314.7; Kennard,
Cooper, “Medical Department Activities,” pp. 78–79, file “Observations on Bataan,” 22 Aug 42, pp. 1–2, attached
314.7, and James W. Duckworth, “The Official History of to idem, “History—Medical Department,” same date,
General Hospital Number One, United States Army file 000.71 (Interviews–SWPA). All in HUMEDS, RG
Forces in the Far East, at Camp Limay, Bataan, Little 112, NARA.
42
Baguio, Bataan, and Camp O’Donnell, Tarlac, Cooper, “Medical Department Activities,” p. 53, file
Philippine Islands, From December 23, 1941 to June 30, 314.7; Kennard, “Observations on Bataan,” 22 Aug 42,
1943,” p. 1, file 319.1–2 (General Hospital 1) Philippine p. 1, attached to idem, “History—Medical Department,”
Islands. All in HUMEDS, RG 112, NARA. Continued
A MEDICAL CALAMITY 27
Frontline medical support varied Standing close to the front line, the
widely. The recently organized Limay facility was in actual practice more
Philippine Army medics were poorly a surgical than a general hospital.
equipped, short of blankets, litters, and Blankets blacked out doors and win-
surgical equipment. Lacking both dows. In the operating pavilion the seven
materiel and training, they were slow in tables were occupied at all times, while
moving the wounded to hospitals. By more patients lay on litters awaiting their
contrast, Lt. Col. Harold W. Glattley’s turns. During intense fighting, casualties
12th Medical Regiment (PS) functioned averaged 80 to 200 daily. Surgery
admirably, rarely losing equipment, reached its peak on 16 January, the day
improvising when necessary, and mov- after the Japanese penetrated the line,
ing its patients to the general hospitals when surgeons performed 187 major
well within the eight- to ten-hour period operations in twenty-four hours. During
that doctors considered essential. “It is the last week of the month, when the
doubtful,” declared Colonel Cooper, “if enemy was overrunning the defense line
any unit of similar size [421 men in all] and the American and Philippine forces
had ever contributed so much to the were withdrawing to the Pilar-Bagac
medical service of a major campaign.”46 road, General Hospital No. 1 moved
The objectives of medics with serious- from its quarters to open sheds at Little
ly wounded patients were the general Baguio, a onetime Army engineer camp
hospitals at Limay and Cabcaben. At on the southeast corner of Bataan, about
Limay—the village itself was “a collection 5 miles from General Hospital No. 2
of tiny bamboo shacks mounted on high near Cabcaben (Map 2).48
stilts”—they found a complex of thirty- The result of improvisation, the
eight single-story tin- or nipa-roofed Cabcaben hospital was primitive by com-
buildings in a spacious quadrangle dot- parison with Limay and even with Little
ted with lofty mango trees. In addition to Baguio. Army engineers had built the
the wards and an operating pavilion, facility from scratch in a dense jungle on
Limay provided buildings for the hospi- the edge of a stream leading to Manila
tal headquarters, officers quarters, a Bay, clearing away lush vegetation and
ward for minor surgery, a dental clinic, a bamboo and cutting a drive from the
laboratory, and a pharmacy. A huge coast road. By 5 January the basic facili-
sheet-iron warehouse fronting the beach ties for a tented hospital existed at
bulged with salvaged medical supplies.47 Cabcaben, and the first operation was
48
Cooper, “Medical Department Activities,” p. 54, file
46
Cooper, “Medical Department Activities,” pp. 20 314.7; Kennard, “Observations on Bataan,” 22 Aug 42,
(quotation), 22–23, file 314.7, HUMEDS, RG 112, p. 4, attached to idem, “History—Medical Department,”
NARA. Glattley was promoted to lieutenant colonel on same date, file 000.71 (Interviews–SWPA); Duckworth,
19 December 1941. “History of General Hospital Number One,” p. 2, file
47
Quotation from Weinstein, Barbed-Wire Surgeon, p. 10. 319.1–2 (General Hospital 1) Philippine Islands. All in
See also Cooper, “Medical Department Activities,” p. 54, HUMEDS, RG 112, NARA. Hospital No. 1 was bombed
file 314.7; Kennard, “Observations on Bataan,” 22 Aug on 30 March and again on 7 April; the Japanese high
42, p. 4, attached to idem, “History—Medical command apologized for the first attack. See Msg,
Department,” same date, file 000.71 (Interviews–SWPA); Wainwright to CG, USAFFE, Melbourne, 31 Mar 42,
Duckworth, “History of General Hospital Number One,” THU Note Cards, Historians files, HUMEDS, RG 112,
p. 2, file 319.1–2 (General Hospital 1) Philippine Islands. NARA. The nickname Little Baguio was ironic, referring
All in HUMEDS, RG 112, NARA. to a resort in the cool hills of northern Luzon.
HOSPITALS ON BATAAN
December 1941–January 1942
Airfield
XXX Corps Boundary
0 7
Mabatang
Miles
MANILA
Abucay
MT NATIB BAY
Balanga
Pilar
II PHILIPPINE
Mauban CORPS
I PHILIPPINE
CORPS
Orion
MT SAMAT
Bagac
XXX
Limay
General
X Hospital No. 1
XX (23 Dec)
Caibobo Pt XX
X MT BATAAN
Lamao
SOUTH
CHINA Longoskawayan Pt
Corregidor I
SEA
MAP 2
30 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
successfully performed that day. The site ward to division clearing stations.
possessed good water, offered conceal- Soldiers with minor wounds received
ment by tall trees, and lay close to the first- and second-echelon treatment at
Medical Supply Depot. But its disadvan- such stations before returning to the
tages were equally marked. The hospital front. As the enemy advanced, however,
was scourged by malaria and, as the cam- ambulance drivers moved patients
paign neared its end, ran short of beds, directly to the two hospitals. The latter
blankets, bandages, mosquito nets, and served increasingly as field or surgical
other necessities.49 hospitals as well, and provided a
During the second week of January melange of second-, third-, and fourth-
General Hospital No. 2 began to expand echelon care.
and improve. At maximum develop- The Philippine Army surgeon set up a
ment the facility sprawled for about general hospital on the
1,500 yards along the south bank of the Cabcaben–Mariveles road, not far from
Real River, and its personnel numbered army headquarters, to treat Philippine
some 67 officers, 83 nurses, 250 enlisted casualties in the rear areas. Since materi-
men, and 200 civilians. Hospital bound- als were limited, tents with wooden
aries were marked by three red crosses, floors became wards, a small surgical
each 40 x 60 feet, placed at the points of pavilion, and a first aid dressing room.
an equilateral triangle 1 mile from apex Bamboo platforms supplemented the
to base. The crosses were plainly visible limited number of iron beds and cots.
from the air, and the enemy, despite a Staffed by Philippine Army doctors, den-
reputation for ruthlessness, respected tists, and corpsmen, the hospital han-
them, for no bombs fell within the dled both medical cases and minor
points. But since the hospital stood a wounds, the patient census seldom rising
mile or so from the village and airfield above 100 until late in the campaign.51
at Cabcaben and 4 miles from the
Bataan Airfield, all enemy objectives, The End Approaches
the staff witnessed numerous bombings.
Such sights became more common as From 23 January to 17 February the
the front contracted.50 American positions on Bataan were
During the course of the struggle the under strong attack along the west coast
role of General Hospital Nos. 1 and 2 (the Battle of the Points) and at two
changed. Early in the campaign, evacua- places along the reserve battle line (the
tion had conformed to standard prac- Pocket Fights). During those battles the
tice, with collecting companies operat- three battalions of the 45th Infantry
ing ambulance service forward to the (PS) were fighting on two widely sepa-
various battalion aid stations and back- rated fronts. Two battalions entered
combat at Anyasan Point and the adjoin-
49
ing sector Quinauan Point, and the
Cooper, “Medical Department Activities,” p. 54, file
314.7, HUMEDS, RG 112, NARA. third battalion fought along the Tuol
50
Ibid., pp. 68–70, file 314.7; Ltr, Gen Hosp No. 2 to River near the reserve battle line. The
Surg, Phil Dept, thru CG, Phil Dept, 3 Feb 42, sub:
Sanitary Report for Month of January 1942, THU Note
51
Cards, Historians files. Both in HUMEDS, RG 112, Cooper, “Medical Department Activities,” pp.
NARA. 76–77, file 314.7, HUMEDS, RG 112, NARA.
A MEDICAL CALAMITY 31
litter bearers would come in a proces- was set up near the receiving ward, and
sion from surgery, and I would turn my a graves registration unit attended to all
flashlight to guide them to the unoccu- burial details, as well as maintained
pied beds.” The patient’s record was records.57
made from a field tag attached to his To accommodate the increasing num-
clothing at the first aid station. Then the bers of casualties, Army engineers built
corpsmen undressed him, and the nurse many additional facilities in March
“made him as comfortable as [she] 1942, including more operating theaters
could.”55 and receiving wards, some under canvas.
At first Little Baguio functioned pri- As surrender neared during April, how-
marily as a surgical hospital, transfer- ever, the hospital census soared from
ring patients to Cabcaben as necessary. 3,256 to 7,000. Medics set up wards in
However, as the number of casualties the jungle without any cover, except
increased, the hospital grew. Filipino shelter halves attached to individual cots
workmen from the surrounding coun- or beds, or sheets tied to the limbs of
tryside built bamboo shelters and trees. A nurse serving on Bataan
double- and even triple-decked beds of observed: “When we found a nice shady
the same material. Eventually, even spot we made that into a ward or a place
these additions were not enough, and for an operating room.”58
hospital personnel were forced to The most alarming factor in the situa-
spread out onto the strip of ground tion of the 80,000 troops on Bataan con-
between the two tin-roofed sheds, tinued to be the inadequate food supply.
where they cleared a patch of ground Control of the air and sea by the
for new accommodations.56 Japanese allowed them to blockade the
Meanwhile, Hospital No. 2 started to defenders with increasing effectiveness.
receive a larger number of surgical Enemy patrols made smuggling across
cases as the pace of fighting picked up. Manila Bay difficult. An enemy cruiser, a
Additional surgical tents were set up as minelayer, and eight destroyers isolated
rapidly as possible. Colonel North the whole region from the supplies avail-
developed and directed a 200-bed able in the southern islands of the
receiving ward, lighted for night work Philippines. Attempts by General
and equipped to perform minor MacArthur to introduce supplies from
surgery. Most casualties resulted from Australia met with little success. As early
shell fragments or machine gun fire, as 5 January the soldier’s daily ration
and sulfa drugs were available to help had been cut in half. From that time
prevent infection. Inadequate debride-
ment, packing wounds too tightly, and 57
Ibid., p. 56; Cooper, “Medical Department
omission of delayed primary closure, Activities,” p. 66, file 314.7, and Kennard, “Observations
however, encouraged gas gangrene, on Bataan,” 22 Aug 42, pp. 3–4, attached to idem,
which resulted in many amputations “History—Medical Department,” same date, file 000.71
(Interviews–SWPA), HUMEDS, RG 112, NARA.
and the needless loss of lives. A morgue 58
Quotation from Interv, 2d Lts Juanita Redmond
and Eunice C. Hatchitt, ANC, 6 Jul 42, sub: Their
Experiences During the Siege of Bataan and
55
Juanita Redmond, I Served on Bataan (Philadelphia: Corregidor, p. 2, file 000.71. See also James O.
J. B. Lippincott Co., 1943), pp. 46–47. Gillespie, “History of General Hospital Number 2,” p.
56
Ibid. 12, file 314.7–2. Both in HUMEDS, RG 112, NARA.
34 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
through February the daily issue aver- removed by milling, and in conse-
aged less than 30 ounces, as compared quence it lacked the thiamine that
to the peacetime garrison ration of 71 would have prevented beriberi. Even
ounces for the American Army and 64 brown rice had lost much nutritive
for the Philippine Army. Colonel value, for it was mildewed and moist.
Cooper estimated that the soldiers Scurvy and pellagra, caused respectively
received about 2,000 calories a day in by deficiencies of vitamin C and niacin,
January, about 1,500 in February, and also appeared. The soldiers used up
only about 1,000 in March. Yet they their fat reserves and then began to lose
needed about 4,000 to fight in the harsh muscle, ultimately suffering from weak-
landscape of mountains and jungles.59 ness and from night blindness, due to a
By April the ration had been reduced lack of vitamin A. The want of protein
to 17 ounces a day, of which only 1.2 was particularly debilitating for the
ounces was meat, most often canned younger soldiers, their deteriorating
corned beef. Rice took the place of condition further aggravated by diar-
wheat; about half was white, its husk rhea and dysentery; the latter ailments
were especially widespread among the
59
Morton, Fall of Philippines, pp. 367–68. Philippine troops, who were inade-
A MEDICAL CALAMITY 35
quately trained in basic military hygiene. The diet of the patients in the hospi-
By March, weight loss of twenty to thirty tals was more ample than that of the
pounds per man was common.60 troops in the field, for General
The soldiers’ meals, which hardly MacArthur ordered that they receive
deserved the name, were served twice a full rations, and on occasion they
day, breakfast at 0800 and dinner enjoyed one and a half rations. But qual-
between 1630 and 1700. The airmen ity was poor, and by the end of the cam-
had their rations drawn from the same paign the sick and wounded subsisted
quartermaster depot. No one, not even basically on rice and carabao meat.
the quartermaster officers themselves, During the early part of the siege flour,
ate any better than anyone else. A sol- coffee, tea, oatmeal, canned goods, and
dier described his dinner the day after vegetables were available in limited
he went on one-third rations as “one amounts. Milk and pineapple juice were
slice of bread, one slice [of] corn beef, given to the seriously ill, especially after
cup of tea, rice and that my friend is a quantity was received in February. By
what we now call a good chow.” On 28 April, however, the qualitative inadequa-
March General Wainwright cabled cy of the ration had begun to result in
Washington: “Our most pressing need is impaired healing. As meat became more
subsistence as only a suff[icient] quanti- and more difficult to obtain, rice
ty remains on hand in Bataan to feed formed the sole or chief component of
the troops there until Apr[il] 15 at the patient’s diet, as it did the soldier’s.
about 1/3 ration. . . .” He added, “We Noted a doctor: “It was quite a sight to
are now slaughtering all available see . . . those who should have received
carabao [water buffalo] and surplus adequate soft and liquid diet trying to
horses, and will be forced to slaughter eat a gob of sticky, gummy, half-cooked
pack mules within the next week or ten rice.”62
days. When this supply of meat is The Veterinary Corps tried to allevi-
exhausted, the chief component of the ate the food shortage by killing native
ration will no longer be available.”61 pigs and carabao. The killing of animals
for food went on from early January
60
until the time of the surrender. In all,
Ibid. See also Ltr, Moorhouse to SG, U.S. Army, 20
Jan 43, p.5, file 000.71, and Kennard, “Observations on over 2,800 carabao and approximately
Bataan,” 22 Aug 42, p. 6, attached to idem, “History— 600 other animals were slaughtered and
Medical Department,” same date, file 000.71 distributed to the Army. Foraging was
(Interviews–SWPA), HUMEDS, RG 112, NARA.
61
First quotation from James H. and William H. another way the soldiers tried to supple-
Belote, Corregidor: The Saga of a Fortress (New York: ment their food. Frontline units on
Harper and Row, 1967), p. 102; remaining quotations their own initiative secured and slaugh-
from Msg, Wainwright to AG, WD, Washington, for Gen
Marshall, 28 Mar 42, THU Note Cards, Historians file, tered animals, helping to sustain them-
HUMEDS, RG 112, NARA. See also Msg, MacArthur to selves for a few additional weeks.
CG, Svc Cmd Sector, 5 Jan 42, [sub: Reduction of
Subsistence to Half Rations], THU Note Cards,
62
Historians files, and Cooper, “Medical Department As quoted in Morton, Fall of Philippines, p. 368. See
Activities,” pp. 35, 44–45, file 314.7, HUMEDS, RG 112, also Ltr, CG, USAFFE, to CG, Harbor Defense of Manila
NARA; Redmond, I Served on Bataan, p. 37. On block- and Subic Bays, and CG, Phil Dept, 10 Feb 42, sub: Issue
ade, see Memo, G–4, USAFFE, to CofS, USAFFE, thru of Rations, THU Note Cards, Historians files,
G–2 and G–3, 21 Mar 42, sub: CG, USAFFE, Radiogram, HUMEDS, RG 112, NARA. The hospital staff ate the
THU Note Cards, HUMEDS, RG 112, NARA. same ration as troops in the field.
36 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Eventually, all available animals were streams of the foothills, where much of
slaughtered for human consumption. the fighting occurred.
Particularly painful to General Inevitably, when the supply of qui-
Wainwright, a cavalry officer, was the nine became depleted, malaria quickly
necessity for the men of the 26th Cavalry attained a devastating incidence. There
(PS) to shoot and eat the bony horses was never enough of the drug to pro-
that once had “served so gallantly.” To tect so large an army for a three-month
add to the difficulties of obtaining pro- siege. At the outbreak of war approxi-
visions, the limited amount of food avail- mately 4.5 million five-grain (.325-
able on the peninsula was slow in get- gram) tablets of quinine sulfate were
ting to the troops because the supply available in the Medical Supply Depot.
vehicles often broke down on the moun- This whole quantity would have been
tain trails. Indicative of the growing sufficient only for thirty days’ prophy-
shortage was the fact that casualties fre- laxis, on the basis of ten grains (.650
quently arrived at the hospitals, not grams) of quinine per man per day. As
complaining of their wounds but rather early as 26 January the dosage had to
requesting food.63 be reduced to five grains a day.
The second most needed item was Ultimately, the supply was so limited
quinine. Before 1941 civilian health that prophylaxis was discontinued, and
authorities had failed in their efforts to the small quantity of quinine that
carry out an effective malaria control remained was reserved for hospital
program on Bataan, where some 400 treatment only—no more than eight
square miles of marsh, rice paddy, thick grains to any individual case, however
jungle, and many streams defeated their severe. Only the timely arrival of 1 mil-
efforts to kill mosquitoes. When the war lion tablets from a medical depot on
began, the military authorities were Cebu ensured that no hospital patients
equally unable to impose control mea- were denied treatment before the sur-
sures of any significance. Instead, they render. As a result, the death rate from
relied almost entirely on quinine pro- malaria was low.64
phylaxis, which suppressed the symp- Debilitation of the troops on the line
toms of malaria without curing it. Many was another matter, for the spread of the
soldiers occupied native villages, or bar- disease among the fighting forces could
rios; sanitary conditions were poor, and not be curtailed. Insect repellents
the heavy population of refugee civilians
formed a reservoir of infection, from 64
Paul F. Russell, Malaria: An Account of Its Cause, Cure
which malaria spread rapidly to the and Prevention (Manila: Bureau of Printing, 1931), p. 37;
troops. The mosquito chiefly responsi- Gillespie, “Malaria,” in Hoff, ed., Communicable Diseases:
Malaria, p. 503; Kennard, “Observations on Bataan,” 22
ble for spreading the disease bred in the Aug 42, p. 14, attached to idem, “History—Medical
Department,” same date, file 000.71 (Interviews–SWPA),
and Interv, Redmond and Hatchitt, 6 Jul 42, p. 4, file
63
Quotation from Jonathan M. Wainwright, General 000.71, HUMEDS, RG 112, NARA. The chief carrier
Wainwright’s Story: The Account of Four Years of (vector) of malaria was Anopheles minimis flaviostris. Small
Humiliating Defeat, Surrender, and Captivity (Garden City, amounts of the new synthetic antimalarial Atabrine were
N.Y.: Doubleday, 1946), p. 53. See also Cooper, received on Bataan, but too little to make a difference.
“Medical Department Activities,” p. 99, file 314.7, On the quinine shipment, see Msg, Wainwright to AG,
HUMEDS, RG 112, NARA; Morton, Fall of Philippines, p. WD, Washington, for Gen Marshall, 28 Mar 42, THU
369; Redmond, I Served on Bataan, p. 47. Note Cards, Historians files, RG 112, HUMEDS, NARA.
A MEDICAL CALAMITY 37
proved useless; the Philippine Army sol- such noneffectives strained every facility
dier was not provided with a mosquito in the forward areas.66
bar and net, and many of the American Aid stations, normally without any
soldiers had discarded theirs as an holding capacity at all, attempted to treat
inconvenience when they retreated to 200–300 casualties, while clearing and
Bataan. By March some units in the collecting companies each held 600–900,
front line had malaria rates as high as 80 in violation of standard practice. As long
percent; on one day, the eighth, General as the front remained stable, the lush
Hospital No. 2 had 350 cases under tropical flora offered them unlimited
treatment and on the next received 260 cover and protection. But with so many
new ones. Medical officers explored the helpless troops near the front, any move-
possibility of manufacturing quinine ment along the battle line compelled
from cinchona bark. In early March Lt. immediate and massive evacuation.
Col. Arthur F. Fischer—a military intelli- Being “within easy artillery range” when
gence officer and onetime director of the enemy’s final push came, the wound-
forestry for the Philippine government ed and the medics who served them
who had introduced cinchona into the found no safety in the jungle without the
islands—was dispatched from Bataan to immunity of the Red Cross emblem.67
Mindanao to supervise the harvesting of
the bark. The venture never promised The Fall
to do more than alleviate the problem
and, as matters turned out, Fischer was Like the defenders, the enemy had suf-
still on the southern island at the time of fered severely from malaria, dysentery,
the final surrender.65 and deficiency diseases. In February the
By the beginning of March the enor- surgeon of the Japanese 14th Army esti-
mous increase in the number of patients mated that 10,000–12,000 soldiers were
with malaria, dysentery, and wounds, all ill, and enemy forces were depleted fur-
complicated by malnutrition, had so ther when the early rapid victories in the
overfilled the hospitals that retention of Philippines resulted in major troop with-
most casualties in the division areas drawals for the Netherlands East Indies
became the rule. The shortage of motor invasion. Reinforcements arrived only
fuel and the inaccessibility of forward after successes in French Indochina,
units were contributing factors, making Singapore, and Malaya freed troops and
it necessary by the end of the month to aircraft for the Philippines. By April
retain at battalion and regimental aid General Homma was ready to try again.68
stations even those with major injuries
and illnesses. Eventually, thousands of 66
Cooper, “Medical Department Activities,” pp.
32–34, file 314.7, HUMEDS, RG 112, NARA.
67
Quotation from Cooper, “Medical Department
65
Rpt, Lt Col J. O. Gillespie, CO, Gen Hosp No. 2, to Activities,” p. 26. See also Gillespie, “Malaria,” in Hoff,
Surg, Phil Dept, 10 Mar 42, sub: Malaria Control, and ed., Communicable Diseases: Malaria, p. 507.
68
Ltr, Lt Col A. F. Fischer, Svc Cmd, Luzon Force, to Gillespie, “Malaria,” in Hoff, ed., Communicable
ACofS, Svc Cmd, Luzon Force, 18 Mar 42, sub: Source Diseases: Malaria, p. 510. See also Historical Section, G–2,
of Supply of Quinine for the Philippines, THU Note Far East Command, “14th Army Operations,” Japanese
Cards, Historians files, HUMEDS, RG 112, NARA. See Studies in World War II, 1:230–31, bound as Japanese
also Gillespie, “Malaria,” in Hoff, ed., Communicable Monograph No. 1, “Philippine Operations Record, Phase
Diseases: Malaria, pp. 506–07. 1, 6 November 1941–June 1942,” Ms 8–5.1 AC 1, CMH.
38 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
On 3 April the enemy renewed the “Already,” said General King, “our
offensive with a heavy attack against the hospital, which is filled to capacity and
left wing of the II Philippine Corps, in directly in the line of hostile approach,
an attempt to gain Mount Samat. The is within range of enemy light artillery.
attack developed quickly, with the result We have no further means of organized
that three clearing stations crowded resistance.” Hospital No. 2 would clear-
with casualties were in danger of being ly be overrun the next day. Under cover
overrun by the enemy. Under supervi- of darkness, most of the seventy-eight
sion of the 12th Medical Regiment (PS), American nurses and all medical per-
a general evacuation took place over sonnel not absolutely required to tend
three nights, beginning with that of 2–3 the 12,000 sick and wounded crossed
April. Convoys of buses evacuated the II the channel to Corregidor. Corpsmen
Corps front, giving priority to stations remained to care for the patients,
nearest the fighting. Colonel Cooper whose welfare was commended to a
wrote that “total chaos” reigned in the small group of Japanese infantry at
forward areas. “Roads were congested 1700 on 9 April 1942, just two hours
beyond description. In one instance a after the Luzon Force was ordered to
convoy was caught directly between surrender.71
enemy and friendly fire.” A similar evac- Three months of starvation diet, air
uation followed in the I Philippine and artillery bombardment, and disease
Corps sector. In all, more than 7,000 had taken their toll. General King him-
patients were transported to rear areas self recalled: “When I went through the
during the period 2–7 April.69 Japanese lines on 9 April 1942 to sur-
The burden of receiving and caring render the Luzon Force and got my first
for these casualties fell mainly on the per- close view of the Japanese troops, I was
sonnel of General Hospital No. 2, whose surprised by the alert expressions on
patient census rose from 2,700 to 6,000 their faces and the vigor of their actions.
within six days. Most of the new invalids I had grown so accustomed to lackluster
suffered from malaria, dysentery, malnu- eyes and lackadaisical movements.” By
trition, and exhaustion. Hundreds of March the combat efficiency of the
walking wounded staggered into General troops had fallen by more than 75 per-
Hospital No. 1 as well. The morning of 7 cent as a result of malaria, intestinal
April found 1,840 patients on the premis- infections, and malnutrition, and on 1
es, while 400–450 waited for admission. April Colonel Cooper had written that
But after the Little Baguio facility was the combat efficiency of the troops “was
twice severely bombed because of its rapidly approaching the zero point.”
proximity to the ordnance and quarter- This physical deterioration had become
master supply points, bed patients were a determining factor in the military situ-
transferred to Hospital No. 2. Despite the ation. As General Wainwright stated in
expansion, neither hospital received any his cable to General MacArthur after the
new staff.70
71
As quoted in Morton, Fall of Philippines, p. 458. See
69
Cooper, “Medical Department Activities,” p. 36, file also Cooper, “Medical Department Activities,” pp. 37,
314.7, HUMEDS, RG 112, NARA. 76–77, file 314.7; Interv, Redmond and Hatchitt, 6 Jul
70
Ibid., pp. 37, 56, file 314.7, HUMEDS, RG 112, 42, pp. 3–4, file 000.71. Both in HUMEDS, RG 112,
NARA. NARA.
A MEDICAL CALAMITY 39
surrender of Bataan, “Physical exhaus- from about the tenth up through the
tion and sickness due to a long period of final assault on 5 May, intense and regu-
insufficient food is the real cause of this lar bombing of Corregidor became the
terrible disaster.” In turn, Japanese con- rule.73
trol of the sea and air was fundamental Before the war, medical service on
to the failure of supply. The medical dis- Corregidor had centered around the
aster had resulted from the logistical Fort Mills Station Hospital. To meet the
failure, and physical depletion had ren- demands of the increased garrison after
dered the defenders incapable of fur- 8 December, the surgeon of Harbor
ther resistance.72 Defenses assumed supervisory control
over all medical personnel on the forti-
Corregidor fied islands, in addition to his duties as
commander of the Fort Mills Station
One act remained. Corregidor, Hospital. For medical purposes
largest and most important of the forti- Corregidor was divided into zones, each
fied islands in Manila Bay, lay between of which received a detachment of two
the Bataan Peninsula and Cavite medical officers, plus noncommissioned
Province on the mainland of Luzon. officers and enlisted men. The zone sur-
Shaped like a tadpole, the island since geon cared for all troops within his area,
the days of the Spaniards had been the provided for sanitation, and ensured
center of the bay’s defense. During the that casualties were retrieved and evacu-
first few weeks after the outbreak of war, ated to the Malinta Tunnel—a difficult
preparations had included the comple- and dangerous task for those who per-
tion of Corregidor’s extensive tunnel formed it.74
system. Work was still under way when, On 30 December 1941 the Malinta
on 29 December 1941, the first enemy Tunnel facility began to function as a
bombs fell. These attacks forced the general hospital. Since it was equipped
USAFFE headquarters and the 200-bed with an operating theater, all surgery for
Fort Mills Station Hospital to move the fortified islands was performed
underground, into Malinta Tunnel. A here, and casualties from the other
period of relative quiet followed in early islands were ferried in at night for treat-
months of 1942, while the Japanese ment. Malinta provided a bombproof
expended their efforts in subduing shelter for the USAFFE headquarters;
Bataan. After Bataan’s surrender on 9 the Philippine government; the hospi-
April, they set up batteries there, and tal, now of 1,000 beds; a massive store-
house; powerplants; and machinery.
72
From a main east-west passage, 1,400
First quotation from Edward P. King, “Recollections
of the Defense Battles in Bataan,” copy (n.d. but feet long and 30 feet wide, branched
signed) in James O. Gillespie Notebook, Historians twenty-five tunnels, each about 400 feet
files, HUMEDS, RG 112, NARA; remaining quotations long, at regular intervals. Laterals in
from Morton, Fall of Philippines, pp. 404 and 463. See
also Cooper, “Medical Department Activities,” p. 79, file
73
314.7, HUMEDS, RG 112, NARA. It was sadly ironic Cooper, “Medical Department Activities,” p. 82, file
that three shipments of medical supplies—mainly qui- 314.7, HUMEDS, RG 112, NARA; Morton, Fall of
nine, sulfonamides, and vitamin preparations—arrived Philippines, pp. 479–97.
74
from the south, two by plane and one by submarine, Cooper, “Medical Department Activities,” pp. 81,
after the capitulation of Bataan. 83, file 314.7, HUMEDS, RG 112, NARA.
40 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
turn spread from the branches. All had blazed everywhere. Beach defense guns
reinforced concrete walls, floors, and were destroyed, and buildings were
overhead arches, and a ventilating sys- demolished on Malinta Hill. On the
tem. Double-track electric car lines ran twenty-second an air raid leveled an
along the main passage.75 aboveground medical depot at Fort Mills
The Malinta hospital had its own housing noncritical supplies that had not
entrance north of Malinta Hill, and the been stored in Malinta Tunnel because of
wards were in concrete-lined laterals off lack of space. Fortunately, many drugs
the main tunnel. At the beginning of the stowed away in bottles and tins and
siege there were eleven wards, the beds placed in covered trenches were not lost
placed close together and alternated in the raid. The shelling of Corregidor
head and foot. After the second month never stopped, and life in the tunnel
military authorities opened two more soon became almost unbearable, with
large tunnels and lined the main hospital oppressive air, heat, dust, flies and other
tunnel with beds. Doctors, nurses, and vermin, and the smell of the hospital and
enlisted men were assigned to each ward, human bodies everywhere.77
as they would be in a general hospital. By the middle of April the reserve
Equipment was better than on Bataan. supply of water on which the Malinta
Lieutenant Redmond, evacuated from hospital drew had dwindled consider-
Bataan to the island fortress, marveled at ably. Showers were shut off. Quarrels
the well-equipped surgical division com- flared among the crowded men and
pared to the crudities of Limay and women. Yet Maude R. Williams, a hospi-
Cabcaben; she “couldn’t get over the tal assistant who had escaped from
wonder of white enameled tables beside Bataan to Corregidor, observed how
each bed. They seemed almost indecent- those in the tunnel coped, finding
ly luxurious.” Other comforts included solace in simple joys:
an auxiliary lighting plant, neon lighting
fixtures, flush toilets, showers, and run- Under the deepening shadow of death
life on Corregidor took on a faster, more
ning water. Yet living a mole-like exis- intense tempo. The smallest and most sim-
tence underground also had certain dis- ple pleasures became sought after and trea-
comforts, as Redmond soon realized: sured as they became increasingly rare and
“The roar of shells and bombs was not so dangerous—an uninterrupted cigarette, a
muffled as I had thought at first, but cold shower, a stolen biscuit, a good night’s
sleep in the open air.
echoed and reverberated through the lat- There was a heightened feeling that life
erals; and the lack of real ventilation was was to be lived from day to day, without illu-
hard on everyone, for even the elaborate sions of ultimate victory. Many sought for-
system of fans did not keep the air from getfulness in gambling. There was no way to
getting very stuffy and hot.”76 spend the accumulated pay that bulged in
their pockets and they rattled the dice or
When the Japanese stepped up the played endless bridge, rummy and poker.78
bombing and shelling of Corregidor in
April, they quickly spread devastation
over the island’s surface. Grass fires 77
Ibid.
78
Maude R. Williams in Leon M. Guerrero, “The Last
Days of Corregidor,” Philippine Review, May 43, as quot-
75
Morton, Fall of Philippines, p. 474. ed in Morton, Fall of Philippines, p. 542. See also Belote,
76
Redmond, I Served on Bataan, p. 134. Corregidor, p. 140.
A MEDICAL CALAMITY 41
Casualties were mainly among those Despite such conditions, as well as the
on beach defense duty, or at gun posi- hopelessness of the situation, the health
tions, though no one aboveground was of the Corregidor garrison remained
safe. Coast artillerymen evacuated their relatively good. Life there was not com-
own wounded to the Malinta hospital, parable to Bataan, though the troops
while the 4th Marines took theirs to the suffered from respiratory diseases
Navy’s lateral under the south side of induced by confinement in the damp
Malinta Hill. Though the task of bringing dust-laden tunnels. Bataan survivors
Corregidor’s sick and wounded to the brought malaria with them, and shell
hospital was a difficult and hazardous holes increased fly and mosquito breed-
one, evacuation was usually fast and effi- ing grounds, but no epidemics broke
cient, and in most instances a casualty out. A basic reason was careful sanitary
reached the operating table less than an inspection by medical officers.
hour after being wounded. Good evi- Medicines, too, were readily available,
dence of speedy evacuation was the fact for a stock had been built up before the
that no cases of gas gangrene were war adequate to care for 5,700 troops
recorded. When the island was under for six months. Food, though monoto-
heavy bombardment, wounded could not nous, was enough to carry the soldiers
be carried into the tunnel, and medics through June on half rations. By then
rendered only emergency treatment.79 some vitamin-deficiency diseases had
As the bombing increased and casual- begun to appear—the first one noted
ties mounted, Williams wrote in her was beriberi. Yet only a small fraction of
diary: “Every day it seemed that the line the personnel showed evidence of suf-
of stretchers grew longer. The narrow fering from any type of vitamin deficien-
hospital corridors were crammed with cy, for canned goods gave small but bal-
the wounded, the sick, and the dying; the anced meals.81
convalescents were hurried out to make Surprisingly, few psychiatric cases
room for fresh casualties.” To treat the were recorded. The consensus of
increasing number of patients, the hospi- Colonel Cooper and his fellow medical
tal expanded into three more laterals. officers was that the situation on
The staff utilized every inch of space, lin- Corregidor, like that on Bataan, discour-
ing the walls with beds. Redmond noticed aged breakdowns because the island
that luxuries disappeared one by one: offered no escape from reality. Although
“Double-decked and triple-decked beds official medical records fail to list com-
in the hospital; civilian refugees sleeping bat fatigue as a problem on Corregidor,
in packed rows on the tunnel floors; two some of the garrison may have been
meals a day, again, and scanty rations . . . affected, especially antiaircraft artillery
dreadful, familiar and unmistakable signs
that the end was drawing near.”80
81
Memo, Lt Col J. O. Gillespie to Gen Marshall, 26
Jan 42, sub: Medical Supplies, THU Note Cards,
79
Cooper, “Medical Department Activities,” pp. 79, Historians files, and Cooper, “Medical Department
81–82, file 314.7, HUMEDS, RG 112, NARA; Morton, Activities,” pp. 81, 83, file 314.7, HUMEDS, RG 112,
Fall of Philippines, pp. 536–40. NARA; Morton, Fall of Philippines, p. 535; Belote,
80
Williams in Guerrero, “Last Days of Corregidor,” as Corregidor, pp. 132, 142–43. The relative affluence of
quoted in Morton, Fall of Philippines, p. 544; final quo- Corregidor caused much resentment on Bataan prior
tation from Redmond, I Served on Bataan, p. 134. to its fall.
42 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
crews when air attacks were at their most Bay except Corregidor, and their
intense. Early in the war, however, the artillery fire had laid waste its entire
condition often passed unrecognized by north side. On that day landings began.
doctors and unreported by the soldiers Though casualties were heavy, the
themselves, whose sense of manliness Japanese were able to establish a beach-
forbade them to show fear. Survivors head. Some troops advanced across the
tended to agree that their morale had island to the southern shore; others
not weakened until the final days, when moved westward toward Malinta Hill,
even the greatest optimists realized that the main objective of the landing. By
no help was coming.82 0130 on the sixth that force had estab-
Corregidor fell to enemy encir- lished a north-south line across the
clement and assault, not to hunger or island, with artillery and tanks already
disease. By 5 May the Japanese had coming ashore. American coast and
taken all the fortified islands of Manila antiaircraft artillerymen left their guns
to fight as infantry. However, the
82
Japanese soon were able to infiltrate the
For a recent discussion of combat stress in war, see
Roger J. Spiller, “Shell Shock,” American Heritage 41 American lines and also to set up their
(May–Jun 90): 75–87. light artillery and use it with devastating
A MEDICAL CALAMITY 43
effect. American casualties were heavy— Japanese occupation.84 For most, howev-
600 to 800 killed and about 1,000 er, prison camps and a new ordeal of suf-
wounded. Since the few litter-bearers fering lay ahead. The medical lessons of
were among the casualties, the wounded the campaign centered on the extraordi-
remained in the front line. Medical per- nary attrition imposed on both sides by
sonnel at the ruined Fort Mills supply the conditions of jungle fighting and on
depot were captured that day. At 1000 the overriding importance of seaborne
hours General Wainwright, concluding supply to maintain even small forces in
that nothing was to be gained by further island warfare. Difficult logistics, attrition
resistance, decided to surrender. During resulting from disease, and the normal
the remainder of the day the defenders problems of combat medical support all
destroyed all weapons, and at midnight interacted. With their Pacific fleet shat-
firing ceased.83 tered and their most advanced garrison
The surrender of the southern islands lost, Americans faced up to a new and
that followed brought the campaign to most difficult kind of war, one in which
an end, though small groups of an army could be shattered as much by
Americans refused to surrender and the environment as by the enemy.
soon joined Filipinos in resisting the
84
See Chapter XI for the story of the resistance move-
83
Morton, Fall of Philippines, pp. 552–61. ment in the Philippines.
CHAPTER II
palms, low-growing brush, and, in the tle studied by entomologists. Unlike pre-
marshy areas, luxuriant jungle growth. war Western colonizers, Americans
On the volcanic islands—often large could not transplant and maintain the
complex landmasses with steep cliffs traditional methods of public health in
and wooded plateaus—the climate gives the midst of war. Military discipline, new
rise to dense jungle, rain forest, and drugs like Atabrine, and new insecti-
high tropical grass. The Aleutians are as cides had to take up the slack. Among
wet, and often bitter cold as well. the commonest diseases were those
In wartime each environment spread by poor water supplies and inad-
brought its own characteristic medical equate waste disposal, especially the var-
consequences, from frostbite to jungle ious forms of dysentery. The incidence
rot. Even in the tropical regions, geog- of venereal disease and yaws depended
raphy and the accidents of settlement to a great extent upon the health of the
and trade made great differences in dis- civilian population and the opportuni-
ease patterns. Some islands were rav- ties for fraternization. Sexual contacts
aged by malaria, while others were free between soldiers and civilians were com-
of it. Coral islands rarely have freshwater mon, especially in communities made
catchments for mosquitoes to breed; on destitute by war and in those, such as Fiji
the other hand, volcanic islands, with and Aitutaki, where local mores encour-
their numerous streams, grasslands, and aged promiscuity. Yaws, related to
nonporous black soil, are rich in such syphilis but spread by nonvenereal con-
areas. While the Army fought in all tact, was a hazard in rural areas.
Pacific environments, its efforts for the Unwashed skin, high humidity, and con-
first two years of the war were concen- tact with infected natives led to bacterial
trated in the steaming disease-ridden and fungal infections. Schistosomiasis—
jungles of Melanesia.2 infection with a blood fluke commonly
found in the tropics—could only be
Endemic Diseases avoided by keeping troops, their cloth-
ing, equipment, and even their vehicles
Some of the ills faced by Army men out of infected water, a difficult precau-
and women were familiar communica- tion to take in combat. Hookworm dis-
ble diseases, under control in civilian ease could result from contact with
life in the United States but newly dan- infected earth. None of these diseases
gerous under combat conditions. were normally fatal, but all could put
Others were exotics unfamiliar to most soldiers out of action as effectively as if
American doctors, spread by vectors lit- they had been combat casualties.
2
Unless otherwise indicated, section on distance, cli- Paul A. Harper et al., “New Hebrides, Solomon Islands,
mate, and terrain based upon Fairfield Osborn, ed., Saint Matthias Group, and Ryukyu Islands,” in Ebbe
The Pacific World: Its Vast Distances, Its Lands and the Life Curtis Hoff, ed., Communicable Diseases: Malaria, Medical
Upon Them, and Its Peoples (New York: W. W. Norton and Department, United States Army in World War II
Co., 1944), pp. 21–42; Buell Whitehill, “Administrative (Washington, D.C.: Office of the Surgeon General,
History of Medical Activities in the Middle Pacific,” Department of the Army, 1963), pp. 409–14; CSurg,
block 1, pp. 1–12, and block 18b, pp. 1–5, file 314.7, USAFISPA, Annual Rpt, 1942, pp. 1–8, file 319.1–2,
Historical Unit Medical Detachment (HUMEDS), HUMEDS, RG 112, NARA; Paul F. Russell,
Record Group (RG) 112, National Archives and “Epidemiology of Malaria in the Philippines,” American
Records Administration (NARA), Washington, D.C.; Journal of Public Health 26 (Jan 36): 1–7.
46 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
in the mosquito that carries it from one of some forces, and the War
victim to another. Different species of Department took steps to send nine air
Plasmodium cause different kinds of groups there. Meanwhile, a convoy
malaria, of which the commonest in the guarded by the light cruiser USS
Pacific were vivax, or benign, and falci- Pensacola, bound for Manila when war
parum, or malignant. Malignant malaria broke out, had already been diverted to
could kill, while the effects of the so- Australia. Aboard the transport USS
called benign form included bouts of Republic were a miscellany of troops that
chills and fever, physical debility, and included air combat, field artillery, and
frequent relapses. To prevent epi- service personnel, as well as a number of
demics, command responsibility was as officers, among whom were six doctors.
important as the techniques of preven- At sea, organization of the forces on this
tive medicine and suppressive therapy. and other ships into a command began
But line officers were often slow to under Brig. Gen. Julian F. Barnes, who
relearn the importance of malaria to chose a staff of eighteen officers, includ-
military operations.3 ing a surgeon, Maj. George S. Littell,
MC. Barnes announced that his new
Problems of Leadership headquarters in Australia would be
known as the United States Forces in
Early in 1942 Australia emerged as Australia (USFIA).4
the great Allied base, playing a role in Rapid changes of command ensued.
the Pacific war like that of Great Britain Arriving at Brisbane on 22 December,
in the European fighting. Even before the same day as Barnes, Brig. Gen.
American forces in the Philippines left Henry B. Clagett relieved Barnes, pend-
Manila, Secretary of War Henry L. ing the end-of-month arrival of the
Stimson and Chief of Staff General newly appointed USFIA commander,
George C. Marshall had decided to use Maj. Gen. (later Lt. Gen.) George H.
the southern continent as a base to sup- Brett of the Army Air Forces (AAF).
ply General MacArthur and provide him Shortly after New Year’s Day, 1942,
air support. Although Britain and Brett’s headquarters relocated from a
America agreed in December 1941 to local hotel in Brisbane to Melbourne.
concentrate their forces against
Germany first, the deteriorating situa-
4
tion in the Pacific dictated the diversion Account drawn primarily from OofSurg, USAFIA,
Diary, 10, 12, 21, 27–30 Dec 41, file 314.81, Daily Diary,
10 Dec 41–31 Jul 42, HUMEDS, RG 112, NARA. See
3
Whitehill, “Medical Activities in Middle Pacific,” also Maurice Matloff and Edwin M. Snell, Strategic
block 1, pp. 1–14, 55, 56, block 14, pp. 6–8, and block Planning for Coalition Warfare, 1941–1942, United States
18a, pp. 4–5, file 314.7, HUMEDS, RG 112, NARA. See Army in World War II (Washington, D.C.: Office of the
also Earl Baldwin McKinley, ed., A Geography of Disease Chief of Military History, Department of the Army,
(Washington, D.C.: George Washington University 1953), pp. 87–88; Louis Morton, Strategy and Command:
Press, 1935); George MacDonald, The Epidemiology and The First Two Years, United States Army in World War II
Control of Malaria (London: Oxford University Press, (Washington, D.C.: Office of the Chief of Military
1957), pp. 95–97; James Stevens Simmons, Global History, Department of the Army, 1962), pp. 151–52;
Epidemiology: A Geography of Disease and Sanitation (New and Blanche B. Armfield, Organization and
York: J. B. Lippincott Co., 1944). For up-to-date infor- Administration in World War II, Medical Department,
mation on the diseases cited, see Kurt J. Isselbacher et United States Army in World War II (Washington, D.C.:
al., eds., Harrison’s Principles of Internal Medicine, 12th ed. Office of the Surgeon General, Department of the
(New York: McGraw-Hill Book Co., 1991). Army, 1963), pp. 410–11.
48 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
5
On Colonel Carroll’s escape from the Philippines Organization and Administration, pp. 411–12; Morton,
on the Mactan, see Chapter I. Strategy and Command, p. 168; and Department of the
6
OofSurg, USAFIA, Diary, 2, 5, 7 Feb 42, file 314.81, Army, Reports of General MacArthur, 4 vols. (1950; reprint
Daily Diary, 10 Dec 41–31 Jul 42; Ltr, Col George W. ed., Washington, D.C.: Government Printing Office,
Rice to Maj Gen James C. Magee, 12 Feb 42, file 201 1966), 1:21. One other officer—Maj. Jesse T. Harper—
Correspondence, Col George W. Rice, 1942–1944. Both served briefly as chief surgeon during the confused
in HUMEDS, RG 112, NARA. See also Armfield, period before Carroll’s arrival.
A NEW KIND OF WAR 49
11 12
Quotation from Interv, Condon-Rall with Carroll, The Sixth Army reached Australia early in 1943. It
26 Sep 80, p. 44, CMH. See also Air Evacuation Board, served briefly under Allied Land Forces, headed by an
SWPA, “The Medical Support of Air Warfare in the Australian general, and then, as a separate task force,
South and Southwest Pacific, 7 December 1941–15 under USAFFE for the New Britain campaign.
13
August 1945,” Report No. 35, sec. 1, vol. 1, pt. 1, pp. 11, In March 1943 MacArthur established the
13, file 314.7–2 (Army Air Forces—Medical Services) Combined Advisory Committee on Tropical Medicine,
SPA, SWPA, and Surg, 5th Air Force, Annual Rpt, 1942, Hygiene, and Sanitation, composed of a group of
pp. 2–3, file 319.1–2, HUMEDS, RG 112, NARA; American and Australian specialists, to develop preven-
Armfield, Organization and Administration, pp. 415, 436; tive medicine plans and policies for the Allied forces.
Wesley Frank Craven and James Lea Cate, eds., The The committee functioned as an unofficial staff section
Army Air Forces in World War II, 7 vols. (Chicago: until June 1944. The role of the committee is discussed
University of Chicago Press, 1948–58), 1:403–26. later in this chapter.
120° 140°
ASIAN-PACIFIC USSR
THEATERS OF OPERATIONS
1942–1945
0 1600
80° 100°
40°
C H I N A KOREA
R
T E4)
TIBET E ACT 4
H
T 23 O
I TI L
C B (UN
NEPAL CHINA THEATER
BHUTAN
(24 OCT 44)
Iw
INDIA-BURMA THEATER
(24 OCT 44) FORMOSA
A BURMA
20° I
D
N
I SOUTH
LUZON
THAILAND
PHIL
FRENCH CHINA
IPP
INDOCHINA LEYTE
IN
SEA S
E
MINDANAO
NORTH PALAU IS
BORNEO
MALAYA
AK
R AW
SA
S
U
0° Singapore
M
BORNEO CELEBES
A
INDIAN
TR
A
NEW G
NETHERLANDS EAST INDIES
OCEAN
JAVA PA
SOUTHWEST PACIFIC AR
80° 100° 120° A U S T R A L I A
MAP 3
USSR Attu
180° 160°
A
L E
U T I S
I A N
P A C I F I C
40°
PACIFIC
OCEAN
O C E A N
wo Jima MIDWAY IS
20°
MARIANA IS
MARSHALL IS
Guam
A R E A S
Truk
CAROLINE IS
Makin
Tarawa
BISMARCK GILBERT IS 0°
ARCHIPELAGO
UINEA
SOLOMON IS
APUA ELLICE IS
Chief Surgeon
Source: Adapted from Rpt, CSurg, USASOS, SWPA, 1 Jan 43, sub: Medical Service in Australia, p. 2, file 319.1–2, HUMEDS, RG
112, NARA; Thomas, “Southwest Pacific Area,” in Havens, ed., Activities of Medical Consultants, pp. 477–78.
As large as the United States but thin- convoy left home in late autumn and
ly settled (about 7.5 million population arrived in Brisbane as summer began)
in 1941), Australia possessed diverse and the fact that in Australia the tropics
environments, natural and artificial. lay toward the north.
The cities of the eastern coast, including Distances, too, were reminiscent of
Melbourne, Sydney, Canberra, and the American West, but Australia’s trans-
Brisbane, resembled other urban areas port network and industrial base were
of the developed world to which, despite less developed. A nation built on the
geography, they belonged. Much of the herding industry, it was far from being
interior and the land to the west, how- self-sufficient in manufactured goods,
ever, were almost without population, and even in some foodstuffs. In public
the scattered settlements resembling health the nation showed variations as
those of the contemporary American wide as the contemporary United States,
Southwest. Confusing to Americans advanced in the cities but primitive in
were the seasons (those on the Pensacola remote and poor regions. The war and
56 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the tropics both lay close to Australia’s a national public health issue. But such
northern and northeastern shores, and problems as tuberculosis, in milk cattle,
towns and countryside alike proved and venereal disease lay within the
unready to support a vastly increased domain of state and territorial govern-
population of strangers. ments, and those of waste disposal and
Clearly, in early 1942 cooperation was water supply within that of local town
needed among American medical per- councils. In the absence of a theater-
sonnel, their Australian military counter- level preventive medicine officer, base
parts, and the civil authorities. But the section surgeons sought out Australian
weakness of the command structure military surgeons and formed local com-
made such cooperation on a national mittees to investigate health problems
level difficult to achieve. Instead, civil afflicting both armies—the Allied
affairs administration tended to shift Services Health Council in Perth, for
downward to the level of the base sec- example, and the Cooperative Allied
tion, or even of the local camp or air- Sanitation Committee in Townsville. In
field. Increasing this tendency toward such groups every unit in the area was
local solutions to health problems was represented, and military police officers
Australia’s political structure, which, like sometimes sat in with the medics.
that of the United States, was federal in However, planning by such groups
form, with self-government characteris- was not enough in itself to bring about
tic of not only the six states but also the needed changes, nor was the coopera-
local cities, towns, boroughs, and shires tion of the civil government always
(the last closely resembling American freely given. Sometimes, when wells had
counties). Base section surgeons, often to be dug, marshes drained, cattle
working with no more than a few enlist- inspected, and anti-VD campaigns
ed assistants, opened dispensaries, found mounted, labor and funds also were
medical supplies, established relation- required. Often, poor and remote vil-
ships with local hospitals and public lages were unable, or unwilling, to make
health officials, and endeavored to sur- improvements but were quite amenable
vey health conditions over areas of coun- to the Americans doing so, provided
tryside sometimes equal to several large that they paid all costs. The Army engi-
American states. Fortunately, in April neers were sometimes called upon to
additional medical, dental, and veteri- dig drains, or at least to furnish the
nary officers arrived from the United equipment. The locals’ reasoning was
States to staff the various base sections, that outhouses and shallow wells had
bringing them up to adequate levels. presented no threat to health until the
Aided by the new arrivals, base sec- hordes of American troops arrived.
tion surgeons focused their efforts on Even in Rockhampton, a town of 35,000
preventive medicine to control commu- that served for a time as the I Corps
nicable diseases, especially malaria and headquarters, most residents refused to
dengue; to improve waste disposal, screen their windows, preferring maxi-
water supply, and the processing of mum ventilation, even though Aedes
foodstuffs; and to suppress venereal dis- mosquitoes and the dengue that they
ease (VD). Malaria resisted local con- carried were both present in the area.
trol, for the movement of troops made it The corps and the 1st Evacuation
A NEW KIND OF WAR 57
venereal disease control section was ed refugees from the East Indies and the
organized in Carroll’s office in July 1942 Philippines but also because of the
under Lt. Col. Ivy A. Pelzman, MC. increasing operations by American and
Control officers were appointed in every Australian troops in New Guinea during
base section. Support of local public late 1942. Even in the early part of the
health officials and local police was, of year a present menace existed, with a
course, essential. Some habits appeared larger one predictably to follow when sol-
paradoxical; prostitution was legal in diers returned from the fighting zone for
Australia, and yet prudery made candid rest and retraining. Yet custom was strong
discussion of the problem difficult. and the Australian government showed
Nevertheless, information campaigns little concern until May, when three orig-
were developed, sometimes using inal—that is, locally acquired—cases
posters and bulletins printed in the showed up among American troops in
United States. Prophylactic stations were Townsville, a community in the north-
set up in cities and towns frequented by eastern state of Queensland, and fifty-two
troops, and Americans and Australians more among civilians in nearby Cairns.
freely used each others’ facilities. Australian citizens were concerned that
Infected soldiers were required to give malaria-infected soldiers returning from
full information about their sexual con- Guadalcanal and Papua to hospitals in
tacts, and the provost marshal turned Queensland would spread malaria in epi-
over the information to an Australian demic proportions throughout the conti-
magistrate, who issued an order to the nent. Malaria was fast becoming a politi-
civil police to take the woman into cus- cal as well as a military problem, one that
tody for examination. If infected, she civil and military authorities had ample
was held and treated until well. cause to cooperate in solving.
Efficiency varied from place to place, Col. N. Hamilton Fairley, AMC, a spe-
but by the end of the war 50–95 percent cialist in tropical medicine with the
of contacts were being traced. The Australian Army Medical Corps,
result of the cooperative endeavor—and presided at a series of meetings called by
the movement of many men to remote alarmed officials in 1942, at which
areas or the fighting front—was a experts from the military and the states
remarkable fall in the VD rate among of Queensland and New South Wales
American troops to 4.2 per 1,000 per discussed the problem with representa-
annum by November 1944, a 90-percent tives of the Army Medical Department.
decline from mid-1942.18 An informal committee was established
Malaria was a serious threat to that investigated reports of epidemics,
Australia, not only because of the infect- developed plans, and carried out con-
trol measures through a melange of
18
Thomas H. Sternberg, et al., “Venereal Diseases,” in agencies, military and civilian. Soldiers
Ebbe Curtis Hoff, Communicable Diseases Transmitted of both armies worked to drain mosqui-
Through Contact or by Unknown Means, Medical
Department, United States Army in World War II to breeding grounds, to resettle the
(Washington, D.C.: Office of the Surgeon General, infected aboriginal population, to treat
1960), pp. 285–87. On VD in the Army, see also Allan cases as they occurred, to evacuate
M. Brandt, No Magic Bullet: A Social History of Venereal
Disease in the United States Since 1880 (New York: Oxford recurrent cases to nonmalarious areas,
University Press, 1985), p. 170. and to ensure that military personnel
A NEW KIND OF WAR 59
took suppressive drugs and used mos- (including drugs, mosquito netting, and
quito netting. insect spray) that were either not manu-
By October, however, further action factured in Australia or were of poor
was needed, for the New Guinea fight- quality. Fairley persuaded service and
ing caused theater disease rates to civilian medical authorities of the immi-
soar. With an epidemic in progress, nent dangers of malaria in the
Parliament, alarmed by the return of Southwest Pacific and obtained promis-
heavily infected Australian troops, es of antimalarials from both the United
ordered an investigation. The danger States and Great Britain. It was during
that mosquitoes would spread malaria Fairley’s Washington visit that the Office
to civilians was acute. In November the of the Surgeon General, which had
Australian Army’s director of hygiene been studying the problem of malaria
proposed that troops returning from control in areas where the U.S. Army
the fighting zone be barred for six was to operate, recommended that
months from Australia north of the malaria control organizations be
nineteenth parallel until all recurrent formed in overseas theaters. On 24
cases had been detected and sent to October 1942 Surgeon General Magee
hospitals. In December General invited General MacArthur and other
Headquarters, SWPA, adopted the rec- theater commanders to submit, without
ommendation, hoping by a continental delay, requests for the additional mili-
quarantine to prevent the epidemic tary and sanitary personnel needed to
from spreading in the troop-staging control malaria.20
areas of tropical Australia, where the cli- After a period of organizing and
mate and the plentiful anophelines training in the United States, the first
most favored the disease. Despite all malaria survey and control team arrived
measures, malaria rates were high, by in the Southwest Pacific in February
the end of the year reaching 500 cases 1943. The early months of 1943 also saw
per 1,000 troops per annum in the a marked improvement in efforts to
Southwest Pacific Area as a whole and prevent disease of all sorts, including
1,500 or more in New Guinea.19 malaria. In March General MacArthur
Meanwhile, Colonel Fairley had trav- set up, under Fairley, the Combined
eled to Washington and London Advisory Committee on Tropical
between September 1942 and January Medicine, Hygiene, and Sanitation, a
1943 to obtain antimalarial supplies group of American and Australian spe-
cialists with broad authority to develop
plans and policies to be followed by all
19
On disease rates in various theaters, see ASF [Army Allied forces. MacArthur implemented
Service Forces] Monthly Progress Rpt, 28 Feb 43, sec. 7,
p. 5, The Historical Unit (THU) Note Cards, Historians most of the committee’s recommenda-
files, HUMEDS, RG 112, NARA. The highest disease tions by directives to the troops. (Before
rates worldwide continued to be recorded in the North the committee disbanded in June 1944,
African theater, which showed 8,516 cases per 1,000
troops per annum in August 1943; see Justin M.
Andrews, “North Africa, Italy, and the Islands of the
20
Mediterranean,” in Hoff, ed., Communicable Diseases: Mary Ellen Condon-Rall, “Allied Cooperation in
Malaria, p. 262. On rates in the Southwest Pacific Area, Malaria Prevention and Control: The World War II
see CSurg, SWPA, Annual Rpt, 1942, pp. 1–4, file Southwest Pacific Experience,” Journal of the History of
319.1–2, HUMEDS, RG 112, NARA. Medicine and Allied Sciences 46 (Oct 91): 496–97.
60 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
ARAFURA SEA
Port Moresby
Darwin
Gulf of
Carpentaria
INDIAN CORAL
OCEAN SEA
NORTHERN TERRITORY
Townsville
1 2
QUEENSLAND
WESTERN AUSTRALIA
6 3
Brisbane
SOUTH AUSTRALIA
5
7
Perth NEW SOUTH WALES
Adelaide
Canberra Sydney
4
VICTORIA
Melbourne
0 500
Miles
MAP 4
1942 waves of enemy bombers, dive- tals were strafed and bombed. In the
bombers, and fighters attacked the town, aftermath the base section command
sinking the ships at anchor, demolishing abandoned Darwin; its small medical
the wharf, and damaging the nearby section evacuated American patients to
Royal Australian Air Force field and Australian hospitals in outlying towns.
many private homes. A 2,000-pound All was in confusion, for the medical ser-
bomb hit the American wing of the local vice had “no organization . . . no definite
hospital, and Australian military hospi- plan of action” and, as yet, little formal
A NEW KIND OF WAR 63
collaboration existed between the two The medics at Base Section 1 found
Allies.25 much to do. The airmen suffered an epi-
Base Section 1 headquarters moved demic of dengue, and dysentery was
12 miles south to the village of Birdum, common, brought on by polluted water.
where for a time the medical section They had little fresh food, eating
worked on the open porch of the local canned leeks, canned beetroot, and
hotel. Using available personnel, a field canned cabbage to the point of nausea.
hospital of forty beds was improvised Heat was intense, reaching 140oF. in
nearby an Australian field ambulance.26 summertime; in the dry season the red
The first substantial hospital was the dust was deep, turning to gluey mud in
work of a field unit, the nondivisional the wet; flies, mosquitoes, and ants
135th Medical Regiment, which dis- abounded. Local civilians were casual
patched both a clearing company and about public health. Farmers and town
an ambulance company from Mount Isa dwellers alike used outhouses and drew
to care for American troops. The med- their water from shallow wells, and milk
ical convoy rolled for 758 miles over a was commonly unpasteurized. The
rutted road so dusty that the vehicles refugees infected with malaria exacer-
kept an interval of 1 mile “to obtain ade- bated conditions. Once bitten by
quate visibility because of the dust,” and anophelines in the area, the stage was
on arrival set to work. The platoons built set for a rapid rise in the disease.
Coomalie Creek Hospital from the Exhausted quartermaster drivers, like
ground up, using waterpipe obtained their trucks, broke down on the inter-
from Darwin and plumbing fixtures minable dirt tracks, and small medical
from “wherever they could be found.” detachments pitched tents at the bores,
Showers, latrine buildings, and mess or wells, where men and vehicles alike
halls were fabricated of saplings and stopped to take on water. One such
bamboo. Fourteen tents held the wards. detachment worked in a basin sur-
The hospital served the 49th Fighter rounded by rocky hills, sparsely covered
Group, the 71st Bomber Squadron, base with scrubby eucalyptus trees and dead
section personnel, and a melange of spinifax grass. Flies were numerous and
engineer, quartermaster, artillery, and showed “a peculiar affinity for the eyes,
antiaircraft units.27 ears, nose, and mouth.” The incessant
wind whipped the dust into small
25
cyclones the Australians called
Quotation from Surg, Base Sec 1, Historical Rpt,
Jan–Sep 42, p. 3 (see also p. 2), attached to Gottlieb L. “Whirlies.” Amid the blowing dust, the
Orth and John A. Gallogly, comps., “Medical History of cleanliness needed for medical proce-
Base Section No. 1,” file 319.1–2 (Base Section 1) dures was difficult to attain, and tent
1942–1944, HUMEDS, RG 112, NARA. Also in the
HUMEDS collection, see Surg, 5th Air Force, Annual ropes and pegs needed constant atten-
Rpt, 1942, pp. 1–3, file 319.1–2. In April 1942 all civil-
ians were evacuated from Darwin, which became a mil-
itary reservation. Adelaide River in July; a year later, however, a hospital
26
The Australian field ambulance was equivalent to of 125 beds, the largest between Mount Isa and Darwin,
an American aid station. still functioned near Birdum. See Surg, Base Sec 1,
27
Quotations from Surg, 135th Med Regt, Annual Quarterly Rpt, Jan–Mar 43, p. 1, attached to Orth and
Rpt, pp. 26 and 28 (see also pp. 25, 27, 29), THU Note Gallogly, comps., “Medical History of Base Section No.
Cards, Historians files, HUMEDS, RG 112, NARA. The 1,” file 319.1–2 (Base Section 1) 1942–1944, HUMEDS,
base section headquarters moved to the hamlet of RG 112, NARA.
64 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
tion if the whole camp was not to blow his office, located in the dispensary
away. The drivers called the Mount tent, still consisted of one desk and one
Isa–Birdum road “The Burma Road of table and his staff of one officer and
Australia,” and while they counted no one enlisted man “who may shortly be
battle casualties they did suffer an extra- transfered [sic].”29
ordinarily high syphilis rate, presumably If this was bush medicine at its most
because they spent their paychecks frontierlike, the two base sections that
freely on the prostitutes of Mount Isa, a shared the state of Queensland grew
raucous mining town of 3,500.28 more rapidly, received a heavy influx of
Evacuation from Base Section 1 casualties from New Guinea, and built
depended on regular Qantas flights, on up, before the year was over, an elabo-
military aircraft, and on flying boats rate organization of fixed hospitals to
that carried casualties from Darwin to serve them. In mid-1942 Base Section 2
Brisbane. Air ambulances—presumably was responsible for New Guinea casual-
light planes, whose use was made nec- ties as well as for the 17,597 troops sta-
essary by the great distances and the tioned within its Australian boundaries,
roughness of the corrugated roads— but in August the Advance Base was
brought patients from the hospitals to formed at Port Moresby on Papua to
airfields or the Darwin harbor, and support the forces operating north of
alert medics kept an eye out for any the Torres Strait. Base section hospitals
empty space on outgoing aircraft that varied from tiny sections operating in
might hold a patient. The pace of hos- remote towns to larger establishments
pital construction also quickened, as along the main evacuation route. The
the Americans brought in a sawmill 12th Station Hospital in Townsville—
and began to turn out lumber, hitherto which functioned, in fact, as an evacua-
unobtainable. Some 3,000–4,000 tion hospital—occupied twenty-five pri-
troops moved in during the spring of vate homes, covering a city block in a
1942; by midyear there were 7,700 plus. residential suburb. The commander
As American hospital units entered took pride not only in his well-appoint-
Australia, personnel at the base section ed wards but also in his new morgue,
increased. Hospitals often were divid- with a refrigerator box, and the gradu-
ed, to serve the scattered camps, the ate embalmer he had located. A dramat-
overnight stations along the supply ic influx of casualties began about 1
routes, and the airfields and other December, overworking the medics and
installations that now dotted the vast embalmer, and led quickly to further
region. Medical supply depots followed expansion of the hospital. The end of
the same trend, dividing and subdivid- 1942 found the base section’s medical
ing to reduce the cost in time, wear,
and fuel that travel entailed. Yet as the 29
Quotation from Surg, Base Sec 1, Confidential
end of the year approached, the base Diary Summary, 23 Dec 42, p. 1, attached to Orth and
Gallogly, comps., “Medical History of Base Section No.
section surgeon noted in his diary that 1,” file 319.1–2 (Base Section 1) 1942–1944, HUMEDS,
RG 112, NARA. In the same document and file, see
Surg, Base Sec 1, Med Sit Rpt, 18 Jun 42, p. 2. See also
28
Med Dept Det, 29th QM Truck Regt, Quarterly Rpt, Rpt, OofSurg, USAFIA, 1 Jun 42, sub: Status of
Oct–Dec 42, p. 1, file 314.81 War Diary, 1 Jul 42–30 Jun Evacuation in Australia, file 370.5 Air Evacuation
43, HUMEDS, RG 112, NARA. Reports, SWPA, 1942, HUMEDS, RG 112, NARA.
A NEW KIND OF WAR 65
establishment large and thriving, with medical supply depot, a total of over
one general hospital, five station hospi- 2,500 beds, and nearly 1,800 patients.
tals, a field hospital, and eight portable Here too, life was fairly comfortable in
hospitals, as well as a medical supply the hospitals but much less so for small
depot. Hospital personnel served in detachments in the bush. Near
locations that ranged from suburban Rockhampton the 33d Surgical Hospital
Townsville to the evocatively named set- suffered through heavy summer rainfall
tlement of Kangaroo Dump, where and flooded latrines. But its personnel
Dispensary D worked from 7 August floored the wards to protect patients
1942 until 22 September 1944.30 from the wet, as well as landscaped the
Similarly, Base Section 3 grew rapidly grounds with fresh plantings, rustic
after its formation in January 1942 to fences, and arches that gave the area a
serve 10,973 troops already in the area. pleasant parklike appearance. Dengue,
By spring of 1943 it controlled two gen- malaria, and a variety of skin diseases
eral hospitals, two evacuation hospitals, were the main medical problems, while
two surgical hospitals, eight portables, hernias, appendectomies, and infected
the 3d Medical Laboratory at Brisbane, a wounds of various sorts kept the sur-
geons occupied. The Red Cross showed
movies at the hospital, and weekly
30
Surg, Base Sec 2, Historical Rpt, Jan–Dec 42, pp. 7, dances were held at the officers club on
12, and Ltr, Surg, Base Sec 2, 18 Apr 42, in Surg, Base
Sec 2, Quarterly Rpt, Apr–Jun 42, pp. 1–2, THU Note Friday evenings. The hospital baseball
Cards, Historians files, HUMEDS, RG 112, NARA. team played for the hotly contested
66 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
bees,” reported Captain Clements after to the wounded and a boost to morale
an inspection trip, “the dust was ankle as well.33
deep, and the ants were innumerable.” The base sections were Carroll’s
When the New Guinea fighting grew in demesne in the feudal world of the
intensity, new doubts assailed the Army Southwest Pacific Area. Beginning 1942
Medical Department about sending as the target of enemy attacks, at least in
female nurses to the embattled primi- the far north, they had found by the
tive island. But in October 1942 the year’s end their true role as parts of a
nurses of the 153d Station Hospital communications zone that compre-
arrived in Port Moresby, working there hended the entire Australian continent,
with such success that nurses of other but especially its eastern and northeast-
hospitals followed. Ankle-deep mud ern coasts. The system provided indis-
and tropical rains succeeded the arid
Australian bush. But the women proved 33
CSurg, USASOS, SWPA, Annual Rpt, p. 21, file
more durable than even the chief nurse 319.1–2, HUMEDS, RG 112, NARA. Conditions in New
had anticipated, bringing scientific care Guinea are treated extensively in Chapter IV.
68 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
pensable support to the operations that arrangement, and the two Allies deter-
began in New Guinea during mined the charges for medical treat-
September. The services of the base sec- ment on a reciprocal basis in either of
tions went beyond backup: As will be their hospitals.34
seen, their hospitals fathered many of But the chief surgeon wanted to estab-
the units that accompanied the troops lish U.S. Army hospitals to take care of
into battle. American troops wherever it was possi-
ble. He anticipated that about 100,000
Hospitalization and Evacuation troops would arrive during 1942, for
whom beds must be provided on a 9-per-
During 1942 an array of Army hospi- cent basis. In search of the requisite
tals sprang into being like an Arabian 9,000 beds, he first sought to obtain
Nights city. But more work than magic existing buildings—schools, resort
went into the achievement. In the early hotels, private houses, and civilian hospi-
days, when troop strength was at a mini- tals—to be converted into military med-
mum, providing hospitalization for the ical facilities. He soon discovered, how-
sick and injured meant dependence on ever, that the alteration of existing build-
the Australians—on not only their mili- ings was costly and, for the most part,
tary but also civilian hospital system. As unsatisfactory. (The plant of the new
early as 15 January the Australian gov- Royal Melbourne Hospital, given out-
ernment’s Administrative Planning right to the 4th General Hospital by the
Committee agreed to furnish supplies Australians, was a much appreciated
and hospitalization from either military exception to the rule.) Carroll came to
or civilian sources for three to four prefer construction of the standard
months, and longer if necessary. Army fixed hospital. But such work
Through the assistance of a joint U.S.- required time, labor, and materials that
Australian Hospitals Subcommittee and were in short supply. Meanwhile, the
the surgeon general of the Australian influx of U.S. personnel and equipment
Army, Colonel Carroll arranged for the began. Apparently, the first Army hospi-
temporary hospitalization of soldier tal to operate in Australia was the 153d
patients in Australian military facilities. Station Hospital, which arrived at
Some soldiers were treated in civilian Brisbane on 9 March and, after receiving
hospitals, though the chief surgeon pre- permission to occupy the Queensland
ferred to avoid doing so because of the Agricultural High School and College
problems involved in paying private
physicians. In March the USAFIA set up 34
Quotation from Memo, Col B. M. Fitch, AG,
the Committee on the Adaptation of USAFIA, to Gen and Spec Staff Secs, USAFIA, 24 Mar
42, sub: Committee on Adaptation of Australian
Australian Materials and Supplies, of Materials and Supplies, THU Note Cards, Historians
which Colonel Littell was a member, to files, HUMEDS, RG 112, NARA. See also Interv,
explore ways of “utilizing to the maxi- Condon-Rall with Carroll, 26 Sep 80, CMH; Alan S.
Milward, War, Economy and Society, 1939–1945 (Berkeley:
mum the existing productive capacity of University of California Press, 1977), pp. 172, 200, 276,
Australia without sacrificing the health, 355; E. Ronald Walker, The Australian Economy in War
comfort or identity of the U.S. Army.” and Reconstruction (New York: Oxford University Press,
1947), p. 147; Lyons, “Australia and New Zealand,” in
Americans paid for Australian goods Hoff, ed., Civil Affairs, pp. 536, 550; and Wiltse, Medical
and services through a lend-lease Supply, p. 403.
A NEW KIND OF WAR 69
near Gratton, admitted its first patient rationed to two glasses per passenger
on the nineteenth.35 each day, their baths cold showers in sea-
The summer was an anxious time as water, they finished the trip as an
the chief surgeon waited for the person- uncomfortable, jam-packed, often mis-
nel of twelve more hospitals, all of whom erable lot. But they did not encounter
had sailed from the United States on an any Japanese submarines or planes, and
Army transport. “I counted the days,” docked safely in Melbourne after thirty-
Carroll reported to Surgeon General nine days at sea. The long voyage ended
Magee, “until that ship docked and the anticlimactically, as they traveled from
personnel with it.” The doctors, nurses, the docks to their first billets in Australia
and corpsmen who made the trip prob- by electric tram.36
ably had similar feelings. Leaving the For the chief surgeon the anxiety was
New York Port of Embarkation in a con- not over. The equipment of the hospi-
voy, the ship was crowded; “quarters can tals was on another ship, which broke in
be adequately described by three words, two and sank near Brisbane. “I feel that
standing, sitting, and reclining room,” my heart is in pretty good shape,” wrote
wrote a unit historian. The first blackout Carroll, “because when I was called on
at sea, with “weird blue lights, dark cor- the phone and told that the ship with
ridors, and passing human shadows,” the equipment of twelve hospitals was
brought home the reality that a war was lost I still survived the shock.” But the
on. Running under Navy protection, the equipment was salvaged, and on 1
convoy arrived safely at the Panama September the medical service passed
Canal. Blimps hovered over the docks, something of a landmark: After that
the sun was fierce, and the air was date more Australian military personnel
humid. In the Pacific a cruiser and a were being cared for in U.S. Army hos-
destroyer took over the task of guarding pitals than the reverse.37
the transports, and for a time the trip Quality proved to be a problem
was idyllic, amid “flying fish, the phos- among some new arrivals, one not easily
phorescent ocean, and the southern solved, for the pressure of an advancing
cross.” Then an epidemic of diarrhea enemy and the deficiency of personnel
struck. The number of cases reached interacted to make retraining difficult.
four digits, and the voyaging medics Among enlisted men, Carroll soon dis-
coined such names as the “‘turkey trot’” covered that a minority were of hope-
and the “‘mess kit blues’” for the mala- lessly poor quality. Thus one small hos-
dy. Often ill, their drinking water pital reported that its cook’s “personal
hygiene was filthy” and impossible to
35
correct; that a man listed as a medical
Rpt, OofCSurg, USASOS, SWPA, to SG, U.S. Army,
12 Jan 43, sub: Extracts From Report of the Chief
36
Surgeon, S.O.S., Australia, December 15, 1942, p. 1, file First quotation from CSurg, USASOS, SWPA,
319 (Medical Service—1942); Interv, Lt Col John A. Semimonthly Rpt, 29 Aug 42, p. 4, THU Note Cards,
Lazzari, 5 Jul 45, file 000.71; 153d Sta Hosp Historical Historians files; remaining quotations from 6924V
Rpt, 21 Mar 43, sub: Summary of Diary From Activation [28th Surg Hosp] Historical Rpt, 7 Dec 41–30 Sep 42,
to Present Day, p. 2, file 314.81, War Diary, 1 Jul 42–30 pp. 1 and 2, file 314.81 War Diary, 1 Jul 42–30 Jun 43.
Jun 43. All in HUMEDS, RG 112, NARA. See also Darryl Both in HUMEDS, RG 112, NARA.
37
McIntyre, “Hospitalization Policy for United States CSurg, USASOS, SWPA, Semimonthly Rpt, 29 Aug
Army Personnel in Australia, 1942–1945,” p. 5, copy in 42, p. 4, THU Note Cards, Historians files, HUMEDS,
CMH. RG 112, NARA.
70 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
through the Australian bush, where, usually of heavy treated paper or fiber
very often, roads were nonexistent.40 board, plumbing in separate lavatory
By the end of 1942 twenty-three buildings, and stoves rather than a cen-
American hospitals had arrived in tral heating plant for each unit. They
Australia: four general, thirteen station, were well suited to conditions in
two field, two evacuation, and two surgi- Australia, where the climate ranged
cal. For the most part, general hospitals from temperate in southern areas to
were located in the larger cities and sta- tropical in the north.41
tion and field hospitals close to training The development of mobile hospitals
and operational centers. General hospi- was the theater’s chief innovation.
tals were large fixed installations that Carroll and his staff worked on three
provided comprehensive care for severe types: a 100-bed mobile unit mounted
cases from throughout a theater; station on trucks, a prefabricated demountable
hospitals were intended to serve a single facility, and a 25-bed portable hospital.
post; and field hospitals normally were The first—oxymoronically termed a
mobile and accompanied the troops, mobile station hospital—was created to
although in the Southwest Pacific Area support the Army during a retreat into
they often served fixed cantonments the Australian interior, if a Japanese
instead. Drawing their professional invasion took place; in the island cam-
staffs from medical schools of major uni- paigns that actually followed, the hospi-
versities in the United States, the gener- tal proved of little value, on account of
al hospitals contained considerable tal- the lack of roads. The other two, howev-
ent. The 4th at Melbourne was staffed by er, greatly improved the mobility of
Western Reserve; the 118th at Sydney by medical treatment and unquestionably
Johns Hopkins; the 42d at Brisbane by saved many lives.42
the University of Maryland; and the The chief surgeon’s office ordered
105th at Gatton, 40 miles west of from Australian manufacturers hospital
Brisbane, by Harvard. buildings prefabricated of plywood,
In early 1943 Carroll was able to masonite, or fibrolite that could be
embark on a major construction pro- transported by aircraft. Medical per-
gram that entailed an increase of 3,500 sonnel, assisted by engineers, actively
beds in Sydney and Brisbane, with 2,500 engaged in the construction and disas-
more planned for the future. In July of sembly of their own hospitals. (As a
that year, with the war moving toward result, in late 1943 Carroll suggested to
Queensland, the Australian War Cabinet the surgeon general, Brig. Gen.
approved the construction of an addi- Norman T. Kirk, that medical units dis-
tional 22,000 beds—9,000 for New
Guinea and 13,000 for Queensland. All 41
CSurg, SWPA, Annual Rpt, 1942, pp. 9–12, file
of the hospitals followed a standard 319.1–2; Interv, Lazzari, 5 Jul 45, file 000.71; Encl 4 to
Army design featuring the lightest possi- Rpt, OofCSurg, USASOS, SWPA, to SG, U.S. Army, 12
Jan 43, sub: Extracts From Report of the Chief Surgeon,
ble frame construction, with exteriors S.O.S., Australia, December 15, 1942, file 319 (Medical
Service—1942). All in HUMEDS, RG 112, NARA.
42
Encl 4 to CSurg, USASOS, SWPA, Semimonthly
40
CSurg, USASOS, SWPA, Semimonthly Rpt, 27 Jun Rpt, 15 Dec 42, file 319.1–2 (Medical Service in
42, THU Note Cards, Historians files, HUMEDS, RG Australia), THU Note Cards, Historians files,
112, NARA. HUMEDS, RG 112, NARA.
72 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
patched to forward areas include in tured units did not arrive until late
their organization one well-qualified 1943.43
plumber, one electrician, and at least Carroll’s third and most creative
two carpenters.) The hospitals consist- attempt to find a mobile facility suitable
ed wholly of portable huts; floors were for the theater’s vast distances, small
usually of concrete, roofing and wall- troop concentrations, abundant jungles,
sheeting of corrugated iron or asbestos and shortages of medics was the 25-bed
cement. The units came with tools and portable hospital. As early as June 1942
instructions for assembly. One type of work was under way in the chief sur-
building, with an air cooling system
and plumbing, might function either as
43
a surgical facility, a clinic, or a labora- CSurg, SWPA, Annual Rpt, 1942, p. 13, and CSurg,
USASOS, SWPA, Annual Rpt, 1943, pp. 15, 30–31,
tory; another, less elaborate, housed 72–76, file 319.1–2, HUMEDS, RG 112, NARA. Carroll
wards, storage houses, and offices. also suggested that medical units dispatched to forward
Factories in Sydney were producing areas include in their organizational equipment the fol-
lowing items: hammers, saws, nails, corrugated iron
American-designed prefabricated units roofing, concrete for floors, screening, pipe and pipe
by the end of 1942. American-manufac- fittings, and portable power saws, if available.
A NEW KIND OF WAR 73
THE MAETSUYCKER
sible for evacuating his own command Evacuation policy in the theater grew
under theater guidelines. Less serious from near-nonexistence in early 1942 to
cases remained in the north, ideally, and considerable complexity a year later.
more serious ones were sent south, with Transport problems in the different
the worst injured ending their journeys base sections varied so widely and meth-
in the large general hospitals, especially ods of carrying casualties were so casual
the 4th in Melbourne, whose 2,000 beds and so diverse that the Office of the
made it the biggest as well as the best Chief Surgeon initially had not estab-
equipped and staffed in Australia. lished any general policy for evacuation
Specialists were concentrated in the few from one to another. Base Section 1
large rear-area facilities, to make best use evacuated solely by air; the northern
of their talents, while the evacuation of part of Base Section 2 sent patients to
long-term cases kept beds empty and Townsville by land-based aircraft or by
ready for use near the fighting zone. seaplanes, or in the small hospital ships
Patients facing a permanent disability or loaned by the Australians. Townsville
requiring very long-term care were sent hospitals sent casualties they could not
from the 4th, 42d, 105th, and 118th hold to Base Section 3 by the same
General Hospitals to the United States as methods, or by hospital train. In the
shipping became available.47 more populous southern Base Sections
4 and 7 a relatively good roadnet and
47
railway system were available for use.
Encl 5 to CSurg, USASOS, SWPA, Semimonthly
Rpt, 15 Dec 42, THU Note Cards, Historians files, In February the chief surgeon’s office
HUMEDS, RG 112, NARA. adopted a six-month evacuation policy
A NEW KIND OF WAR 77
Aidman
The aidman, although assigned to the battalion medical section, served with the
line companies and gave first aid to the injured.
Aid Station
The battalion aid station, the first medical installation reached by a casualty
because of its location near the front line, treated shock and provided minor
surgery, dressing for wounds, and relief from pain. The battalion surgeon, aid
station personnel, and company aidmen together formed one of the three bat-
talion sections of the regimental medical detachment. A separate battalion,
however, had its own medical detachment.
Collecting Company/Collecting Station
In World War II the division surgeon commanded the division’s medical battal-
ion. Each of the battalion’s three collecting companies was designed to support
one regiment or regimental combat team. A collecting company evacuated casu-
alties from forward aid stations, and a collecting station, which the company ran,
provided additional first aid, plus oxygen and whole blood, and formed a regi-
mental holding unit for casualties until they could be taken to the rear.
Sometimes a collecting station and a portable surgical hospital worked together,
with the hospital stabilizing the seriously wounded for evacuation.
Clearing Company/Clearing Station
Also part of the medical battalion was the clearing company. The clearing station
that it operated was, in effect, a small forward hospital, providing fairly complex
treatment and informed prognosis, on which further disposition of the casualty
was based. In the Pacific clearing companies often functioned as small field hos-
pitals, because most battles were small and hospital units might be absent from
the task force or remote from the fighting line. Here again, a portable surgical
hospital might work nearby.
Portable Surgical Hospital
With a capacity of 25 beds, this small unit was developed in Australia and later
adapted to provide skilled surgical care in jungle fighting during the Papuan
campaign. Still later, it was attached to task forces to provide early frontline sur-
gical care in amphibious operations. In theory, hospital equipment and supplies
were to be carried on the backs of the thirty-three soldiers and four officers who
formed the unit. The portable might be attached to a regiment, a division, or an
army, depending on circumstances.
Field Hospital
Attached to a division or corps, the 380-bed (later 400-bed) field hospital was
intended to be highly mobile and to concentrate on the early care of casualties.
A NEW KIND OF WAR 79
Meanwhile, the United States—espe- the long supply line from the United
cially the medical depot at Fort Mason, States.49
California, from which Carroll received As the year advanced, the supply sys-
most of his supplies—struggled to pro- tem developed rapidly. Carroll’s office
vide for its forces in Australia over a dis- worked to educate its American suppli-
tance equal to more than one-quarter ers in the special requirements of the
the circumference of the Earth. In theater—lightness in weight, portability,
quality the materiel that arrived was packaging that protected against mois-
excellent, almost without exception, ture, unbreakable containers to facili-
but quantity was another matter. tate airdrops, and elimination of all
Shortages developed early in surgical heavy medical chests. Carroll recom-
and dental instruments, hospital equip- mended using small, mobile water
ment, and biologicals, which the chief purification outfits and pointed out that
surgeon attempted to make up through each hospital assembly needed its own
local procurement in Australia. Here, electricity and steam generating plants,
however, he confronted myriad reali- plus the necessary pipes and fixtures. To
ties: small population, nascent indus- render each hospital independent of
tries, heavy commitment to the war the local water supply became a theater
effort, and long history of colonial goal. The chief surgeon preferred plas-
dependence on imports. Less than 2 tic utensils to metal and glass, whenever
percent of the drugs listed in the possible. Allowances of equipment had
United States Pharmacopeia could be to be changed, he argued, on account of
manufactured from raw materials pro- the need to break hospitals up into
duced in Australia, and the standards smaller units. Generators, X-ray
of the British Pharmacopoeia governed machines, and microscopes, among
those that were. A few types of surgical other things, had to be duplicated in
instruments were in limited production each of the smaller hospital units.
by the year’s end, but manufacture of Distribution followed a like course. At
heavier hospital gear—mess and laun- first, medical depots were set up only in
dry equipment, for example—was Melbourne and Brisbane, where supplies
impeded by manpower shortages that were received. But by the end of 1942 the
filled the workforce with untrained original installations had become reserve
adolescents and by the almost com- as well as issuing depots and a system of
plete diversion of heavy industry to branch depots had developed in all base
munitions. The USASOS obtained sections, including the Advance Base at
enough from local sources to cover its Port Moresby on Papua. Each depot was
shortfalls, but time lags of three
months or more between order and 49
Encl 2 to CSurg, USASOS, SWPA, Semimonthly
delivery were common. As Carroll Rpt, 15 Dec 42, and Ltr, Col P. J. Carroll, CSurg,
made plain, he preferred American USASOS, SWPA, to Col. C. D. Buck, Med Supply Off,
Fort Mason, Calif., 29 Aug 42, THU Note Cards,
goods. He hoped to be able to depend Historians files. See also CSurg, SWPA, Annual Rpt,
upon them entirely and repeatedly 1942, p. 15, file 319.1–2, and OofSurg, Base Sec 3,
argued that medical supplies, most of Historical Rpt, n.d., sub: Diary of Medical Installations
of Base Section 3, USASOS, SWPA, pp. 7–8, file 314.81,
which were small in bulk and weight, War Diary, 1 Jul 42–30 Jun 43. All in HUMEDS, RG 112,
imposed comparatively little burden on NARA.
A NEW KIND OF WAR 81
and guns rumbled at all hours through echelon, including the bulk of the
the streets of Honolulu. administrative section, was located in
the offices of Farrington High School
The Hawaiian Base on Oahu; administration and supply
were apparently its main concerns. The
To protect soldiers and civilians from forward echelon, which was responsible
disease, to expand the Army hospital sys- for operations and training, was situated
tem, and to prepare for future offen- in the Aliamanu Crater together with
sives—these were the tasks of Colonel the commanding general and his staff.
King, the efficient chief surgeon of the Three consultants were also on the staff
Hawaiian Department who had directed of King’s office, but they were assigned
the prewar preparations and the med- to hospitals on Oahu.3
ical response to Pearl Harbor. A meticu- In March 1942 service commands
lous manager, determined to master were set up on the other islands of the
and control as far as possible all the Hawaiian archipelago, and a surgeon
activities of his office, King was ultimate- was appointed to each. Typical was the
ly obliged to loosen his grip on day-to- Hawaii Service Command on the largest
day business as the complexity of the island, Hawaii. The command surgeon,
work increased. His basic approach was Lt. Col. William A. D. Woolgar, MC, and
to assume that the enemy was capable of his staff provided medical and dental
achieving the worst—a surprise attack, care for nondivisional units, hospitaliza-
accompanied by a blockade of the tion for the 27th Infantry Division, and
islands—and to attempt to ready the management for the hospital construc-
medical service for it. “In preparation tion then under way. His area of control
for war,” he said later, “take nothing for grew steadily during 1942, as he orga-
granted—see everything.”2 nized the local hospitals and served as
Under him, the chief surgeon’s office liaison between them and King.
grew rapidly to meet the needs of the Ultimately, when the 27th Division left
expanding Army and the military gov- Hawaii, he took responsibility for the
ernment. At the time of the attack on care of the tactical forces that
Pearl Harbor King’s staff was small, con- remained.4
sisting of nine officers, eight enlisted In October a centralized services of
men, and fifteen civilians, divided into a supply organization came to the
rear and a forward echelon. The rear Hawaiian Islands. King was named sur-
geon of the new command, without
relinquishing his duties as chief surgeon
2
Quotation from Memo, Col Edgar King to Ed., and as medical adviser to the military
History of the Medical Department, U.S. Army in World
War II, 22 Mar 50, sub: Supplemental Data on the Work governor. During December the num-
of the Medical Department in the Hawaiian ber of officers assigned to his staff dou-
Department, Later U.S. Army Forces in the Pacific, bled. By that time King himself was
then the Central Pacific Area, p. 7, file 000.71. See also
Buell Whitehill, “Administrative History of Medical
3
Activities in the Middle Pacific,” block 3, pp. 13, 22–23, Whitehill, “Medical Activities in Middle Pacific,”
file 314.7. Both in Historical Unit Medical Detachment block 3, pp. 1–2, file 314.7, HUMEDS, RG 112, NARA.
4
(HUMEDS), Record Group (RG) 112, National Surg, Haw Svc Cmd, Annual Rpt, 1942, p. 1, in
Archives and Records Administration (NARA), CSurg, Haw Dept, Annual Rpt, 1942, sec. 3, file 319.1–2,
Washington, D.C. HUMEDS, RG 112, NARA.
84 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
already a brigadier general, having been skepticism to old Hawaii hands, who
promoted on 25 October, in recognition held emphatic but contradictory views
of the many hats he wore and the rapid on the ethnic Japanese, some terming
growth of the area.5 them completely loyal while others
The special circumstances of thought them entirely disloyal. “As is
Hawaii—its geography and closeness to always the case,” he remarked later, “the
the front lines, its large population of truth lay somewhere between, but
Japanese descent, and its critical func- where?” Among the Japanese were many
tion as the rear base for all Pacific oper- doctors, dentists, nurses, and medical
ations—tended to centralize unprece- technicians; their services were “desper-
dented authority in King’s hands. Civil- ately needed” and hard to refuse. Many
military relations remained especially volunteered to aid the war effort, either
important. In case of renewed enemy in or out of uniform, and those who
attack, the Army Medical Department were citizens “claimed the right to serve.”
would again be responsible for the care King was not without a touch of cyni-
of civilian casualties, while civilian doc- cism, asking, “What would have been
tors would once more play an essential the attitude of these people as a whole
role in the care of wounded servicemen. had the Battle of Midway been lost by
Hence, King assigned a member of his us?” But neither was he prepared to
staff to handle civil affairs liaison, and exclude from all service skilled people
plans were laid, in case of need, to place who might be as loyal as they claimed.
control of all hospitals, civilian and mili- For the few whose loyalty seemed capa-
tary alike, under the chief surgeon’s ble of proof, he recommended full
office; to set up first aid stations acceptance in positions of trust; for the
throughout Oahu; and to provide civil- many who could not positively be shown
ian care for military casualties wherever to be disloyal, he found positions for
the military facilities were insufficient. them chiefly in civilian service among
In essence, King’s civil affairs officer their own people, where they had “no
served as the point of contact between access to vital spots.” After the war, he
the chief surgeon’s office and the was to pay tribute to the Japanese
Honolulu Medical Society, which had Americans who “served gallantly and
already provided so much valuable aid gave much. To them my highest
at the time of Pearl Harbor. respect.”6
Japanese residents of Hawaii—com- As ever in wartime, venereal disease
prising about one-third of the popula- (VD) control was an important aspect
tion, some of whom were aliens but of civil-military relations. King’s posi-
many American citizens—formed a spe- tion gave him unusual opportunities to
cial concern. King employed a Japanese control such diseases through both mil-
maid, ignoring rumors that she planned itary and civilian channels. Until 1942
to poison him. He listened with some
6
Quotations from Memo, King to Ed., History of
Medical Department, 22 Mar 50, pp. 4–5, file 000.71,
5
Blanche B. Armfield, Organization and Administration HUMEDS, RG 112, NARA. See also Armfield,
in World War II (Washington, D.C.: Office of the Organization and Administration, pp. 376–77, and
Surgeon General, Department of the Army, 1963), p. Whitehill, “Medical Activities in Middle Pacific,” block
381. 3, p. 5, file 314.7, HUMEDS, RG 112, NARA.
ARMY MEDICINE IN NAVY THEATERS 85
the Hawaiian Department pursued its rate ever reached in this Department,”
customary course in dealing with sol- King reported.8
diers—lecturing, giving monthly physi- Official fears of biological or chemi-
cal inspections, and reporting contacts cal warfare intensified sanitary inspec-
to the military police. The situation in tions of military posts, civilian food pro-
the islands was unusual for an cessing plants, and water supply sources.
American territory in that prostitution A false report of water poisoning at
was tolerated; brothels employed physi- Hickam Field on 7 December 1941 coin-
cians, often very able ones, to check cided with King’s appointment as advis-
their inmates. The business was lucra- er to the commanding general on all
tive for both the doctors and the often matters relating to the contamination of
wealthy and influential owners of the food and drink. For all Hawaiians, rigor-
houses.7 ous and thorough preventive medicine
In May, however, General Emmons, as was the result. All residents of the
military governor, directed the islands over six months old were immu-
Territorial Board of Health to imple- nized against smallpox, typhoid, and
ment a VD control program throughout paratyphoid; all poisons were impound-
the islands. Both military and civilian ed, and their sale was strictly controlled;
doctors were ordered to report every guards were posted at water supply
case within twenty-four hours of diagno- sources, which underwent daily testing;
sis. Infected civilians were closely moni- and fresh milk was prohibited in Army
tored until certified as noninfectious. messes.
King reported that the board of health In October 1942 Emmons appointed
was energetic in its follow-ups, resulting King to the position of anti-biological
in a large number of infected men and warfare officer, in addition to his other
women being placed under treatment. duties. Now he combined the earlier ini-
Military and civilian police gathered up tiatives against sabotage by germs or poi-
streetwalkers for compulsory examina- son into a comprehensive program that
tion. Propaganda intensified; prophylac- included sending Army agents into civil-
tic stations were opened in Honolulu ian food processing and bottling plants.
and run day and night. The results of District anti-biological warfare officers
rigorous centralized control were evi- were appointed on islands other than
dent by the year’s end. At a time when Oahu. Soldiers watched the mixing of
tens of thousands of troops and thou- ingredients in Coca-Cola bottling plants;
sands of construction workers were employees were checked by Army intel-
arriving in the traditionally easygoing ligence; and civilian laboratories had to
islands, the VD rate for the command register and receive military clearance
dropped from 14 per 1,000 troops per
year in 1941 to 9.6 in 1942—“the lowest
8
Ibid., p. 285; CSurg, Haw Dept, Annual Rpt, 1942,
sec. 1, p. 7 (quotation) and encl. 1, file 319.1–2,
7
Thomas H. Sternberg et al., “Venereal Diseases,” in HUMEDS, RG 112, NARA. The system described here
Ebbe Curtis Hoff, ed., Communicable Diseases Transmitted endured until 1944, when the brothels were at last closed
Through Contact or by Unknown Means, Medical down. Despite some fears of rape and uncontrolled
Department, United States Army in World War II streetwalking, the VD rate then dropped still lower,
(Washington, D.C.: Office of the Surgeon General, apparently because the added cost and bother of finding
Department of the Army, 1960), pp. 282–83. sex partners reduced the total number of contacts.
86 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
of their work. As might be expected, the health during wartime. Throughout the
Veterinary Corps played a considerable period of the emergency, military
part in these efforts, since its primary responsibility for soldiers and civilians
work, other than the care of Army hors- alike had been concentrated in the
es and war dogs, was in the field of meat hands of one able physician. As a histo-
and dairy hygiene. The tensions that rian of the war years later pointed out,
might have resulted from excessive mili- “Hawaii emerged from the war with a
tary control were mitigated by the healthier population despite the health
Hawaiian Department’s tradition of hazards” of the time.10
working closely with civilians. Veterinary
officers cooperated with the Territorial Hospitalization
Board of Health, as well as with King’s
medical inspector and with the Army’s Hospitalization was the major med-
chemical warfare officer, whose service ical function of King’s office. The need
controlled the nation’s biological war- for hospital beds increased proportion-
fare program.9 ately with the influx of sick and wound-
In retrospect, much of this effort was ed evacuees from the Pacific fighting
needless. The fear of Japanese biological and with the buildup of troops for the
warfare in Hawaii proved to be ground- coming offensives. The chief surgeon
less, though Japan did make and use not only expanded Army hospitals on
such weapons in China. Full military con- Oahu, where prewar hospitalization had
trol lasted only through the period of the been concentrated, but also extended
most acute emergency. In February 1943 construction to the rest of the Hawaiian
the military yielded much of its authority Islands and to such southern outposts as
to the Office of Civilian Defense and to Christmas, Canton, Baker, and Fanning
the normal civilian public health agen- Islands. Expansion took varied forms.
cies. In August the Hawaiian Department Existing facilities were enlarged; new
was replaced by a new headquarters, the units introduced; and, to a limited
United States Army Forces in the Central extent, civilian hospitals preempted on
Pacific Area (USAFICPA), and King’s a provisional basis. Change came in two
duties became primarily those of medical waves: The first followed Pearl Harbor,
planning for Nimitz’ coming offensives. while the second occurred during 1943,
By the fall of 1943 the Hawaiian in anticipation of casualties from the
Islands had become the medical hub of offensives that lay ahead.
the Pacific. Vastly increased numbers of At the time of the Japanese attack,
troops and construction workers had Tripler was the only general hospital in
been accommodated and cared for. the islands, and it remained throughout
Though understandably resented by the war the principal one and the
many civilians, military control had dis- largest. Located in the city of Honolulu,
tinct advantages in the field of public Tripler grew rapidly, as its commander,
Colonel Miller, supervised the erection
of new buildings on the grounds, the
9
Whitehill, “Medical Activities in Middle Pacific,” acquisition of adjacent Army structures,
block 3, pp. 1–4, 11–13, file 314.7, HUMEDS, RG 112,
NARA. See also Armfield, Organization and
10
Administration, p. 376. Allen, Hawaii’s War Years, p. 336.
ARMY MEDICINE IN NAVY THEATERS 87
and the purchase of additional sites. The ical material” that filled its wards. Even as
enlarged establishment covered five a station hospital providing treatment to
large and four small areas. One area local people, Tripler received not only
mainly housed hospital staff, while oth- the common diseases of any American
ers specialized in surgery, medicine, con- community but also the “hopelessly
tagious diseases, and convalescent care. severe crushing and mangling” injuries
Together, they formed a major medical that resulted from accidents at the
center, the final destination of patients numerous construction sites. Casualties
evacuated from station hospitals on the flown in from the tropical battlefronts
outer islands of the Hawaiian group and suffered from an array of exotic diseases;
from those on the islands to the south. others, from the Aleutians, had to be
Tripler also served as a station hospi- treated for severe cold injury. Battle
tal for the area on Oahu between Pearl wounds and training injuries gave staff
Harbor, the mountains, and the and trainees alike broad experience with
Nuuanu Valley to the east of the har- the consequences of gunfire. New sol-
bor—a region so crowded with military diers shipped hastily to the Pacific arrived
establishments by the end of 1943 as to with many problems from civilian life,
constitute “one great fort.” It provided including psychological difficulties inten-
outpatient services for military person- sified by absence from home, the stress of
nel and their dependents, as well as for training, and the dangers of war. On
civilian workers hired by the Corps of crowded Oahu living space was at a pre-
Engineers. As consultants, specialists at mium, and victims of communicable dis-
Tripler made their skills available to eases often went to hospitals merely to
field medical officers; they also helped protect their housemates—as did hun-
to teach classes for the hospital’s own dreds of cases of pulmonary tuberculosis,
staff, for doctors whose skills were rusty whose isolation at home was no longer
after long forward service with combat feasible. “It is thought improbable,”
units, and for others newly assigned wrote the commander, almost visibly rub-
from the mainland to duty in the bing his hands, “that any year in the his-
Pacific. Finally, in 1943 the School of tory of Tripler General Hospital has
Aviation Medicine was established at brought with it such diversified patholo-
Tripler to train young and physically fit gy and such splendid clinical opportuni-
physicians as flight surgeons.11 ties [as 1943].”12
One of the world’s great military hos- During 1942–43 four new general hos-
pitals, the Tripler complex differed from pitals joined Tripler at the apex of Army
civilian institutions of equivalent scope in medicine in the Pacific. Schofield Station
its lack of connection with a medical Hospital at Schofield Barracks, already
school and its lack of a research function. the second largest in the Hawaiian
Yet new and veteran Army doctors bene- Department, reorganized and expanded
fited from the “astonishing wealth of clin- in March 1942 as a general hospital.
Though authorized a bed capacity of
only 1,000, the newly christened North
11
Tripler Gen Hosp Annual Rpts, 1942, pp. 5–6, and
1943, p. 1 (quotation), file 319.1–2, HUMEDS, RG 112,
12
NARA. Tripler admitted about 7,400 casualties in 1941, Ibid., 1943, pp. 14–15, file 319.1–2, HUMEDS, RG
8,700 in 1942, and 11,000 in 1943. 112, NARA.
88 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Sector General Hospital grew to 1,800 by nurses and enlisted men were borrowed
the end of the year, accommodating by the 147th and North Sector General
extra patients on enclosed porches. The Hospitals. The remaining staff members
204th General Hospital had a varied his- operated a station and a general hospi-
tory. After arriving in April, its staff tal on the island of Hawaii until August
trained at Tripler and North Sector, then 1943, when they moved to Oahu, serv-
split into small detachments to operate ing first at Schofield Barracks and then
provisional hospitals and to form provi- in October in new quarters at Ekahanui
sional clearing companies and ambu- Gulf, 5 miles distant. Once on Oahu the
lance battalions; finally, in November 148th General Hospital, in addition to
1943 the 204th was reunited at Waipio on its normal duties, trained officers, nurs-
Oahu and began to receive an influx of es, and enlisted men for medical service
casualties from the Pacific fighting. The with the combat forces.14
147th General Hospital, on its arrival Bustling Oahu also contained ten
from the zone of interior in June 1942, other hospitals, station or field. With the
took over Provisional General Hospital exception of the small station hospital at
No. 2 at St. Louis College, about 5 miles Hickam Field, all arrived during the last
east of downtown Honolulu. Here the two months of 1943; personnel, after
147th served the south sector of Oahu training at one of the two large hospitals,
and, like other general hospitals, the out- moved out to their duty stations.
lying islands of the Hawaiian Additionally, small medical stations
Department. Housed in permanent con- known as Army annexes, with bed capac-
crete buildings belonging to the college ities of less than 100, served Army forces
and temporary wooden structures built stationed on the other islands of the
by the Army, its normal bed capacity of Hawaiian group. Hawaii, Kauai, and
938 could easily expand to 1,500. The Maui boasted the larger hospitals;
hospital was equipped to handle all kinds Molokai and Lanai contained the Army
of patients, except those with contagious annexes. Though Army divisions sta-
or mental diseases, who were transferred tioned on the islands had their own med-
to Tripler.13 ical units, the island hospitals, under the
The last general hospital to see ser- jurisdiction of the surgeon of the island
vice in Hawaii was the 148th, which service command, cared for their seri-
arrived on Oahu one month before the ously ill patients. The smaller hospitals
147th. However, its staff soon scattered evacuated their more difficult cases by
to meet pressing needs. Small detach- Army transport planes or by interisland
ments were sent to the island of Kauai to boats to the general hospitals on Oahu.15
operate 50-bed hospitals, while some 14
148th Gen Hosp Annual Rpt, 1942, pp. 1–12, in
CSurg, Haw Dept, Annual Rpt, 1942, sec. 3; ibid., 1943,
13
North Sector Gen Hosp Annual Rpt, 1942, pp. 1–3; pp. 1–5, in CSurg, USAFICPA, Annual Rpt, 1943, sec. 3.
204th Gen Hosp Annual Rpt, 1942, pp. 1–5, in CSurg, Both file 319.1–2, HUMEDS, RG 112, NARA.
15
Haw Dept, Annual Rpt, 1942, sec. 2; ibid., 1943, pp. See 22d, 156th, and 165th Sta Hosps Annual Rpts,
1–3, in CSurg, USAFICPA, Annual Rpt, 1943, sec. 3; 1943, in CSurg, USAFICPA, Annual Rpt, 1943, sec. 6.
147th Gen Hosp Annual Rpt, 1942, pp. 2–3. All file See also Surgs, Kauai, Hawaii, and Maui Svc Cmds;
319.1–2, HUMEDS, RG 112, NARA. See also A. Edward Surgs, Kauai, Maui, Waikapu, and Molokai-Lanai Dist
Livingston, “History of the Medical Service, 147th Cmds; 156th, 165th, and Barking Sands Sector Sta
General Hospital,” pp. 1–7, file 314.7, HUMEDS, RG Hosps; Army Annex, Shingle Memorial Hosp; and
112, NARA. Continued
ARMY MEDICINE IN NAVY THEATERS 89
Farther still from the center of activi- ment, with 2 officers and 27 enlisted
ty were the outlying islands of the equa- men, and a flight surgeon, with an 8-man
torial Pacific. After the Japanese detachment. On 10 February the force
attacked Pearl Harbor, hospital units arrived at its destination, a large coral
accompanied task forces that occupied island typical of many in the central
Christmas, Canton, Fanning, and Baker Pacific. As intelligence reports had pre-
Islands, previously ungarrisoned, to dicted, the climate was good and the
build and defend air bases. Canton in island devoid of endemic disease. A med-
the Phoenix Islands, below the equator, ical detachment sent out by the
came to serve as a link in the air com- Hawaiian Department was already on
munications system in the Pacific, and the scene, caring for a small force of sol-
the small hospital there became a stag- diers, American civilians, and Polynesian
ing facility for evacuees from South natives. The station hospital took over a
Pacific battlefields. In these remote dots temporary facility that the detachment
on the map, medics set up hospitals in had opened in a deserted building,
abandoned buildings, Quonset huts, pitching beside it a tent ward to handle
and tents, and placed dispensaries in bed patients. In a remarkably short time,
dugouts protected by coral coverings. a small but functional hospital was at
Since the outlying islands were consid- work, with the usual array of depart-
ered too primitive and isolated for ments—eye, ear, nose, and throat; den-
female nurses, male hospital corpsmen tal; X-ray; laboratory; medicine and
took their places. Many served ably, surgery; registrar and receiving officer—
doing complex tasks in the operating also under canvas. A 1.5-kilowatt genera-
room without hope of advancement, tor provided power. So equipped, the
since the Army Nurse Corps was limited medics awaited their patients, whether
to women.16 injured in the construction work or
A report of the 1st Station Hospital on brought by planes in transit from the
Christmas Island gave a glimpse of one South Pacific fighting.17
such remote area. A 150-bed unit of 14 Medical supply developed steadily,
officers and 100 enlisted men, the hospi- supporting hospital expansion. Before
tal embarked on the SS President Johnson Pearl Harbor, hospitals, like other med-
and sailed from San Francisco on 31 ical units in the Hawaiian Department,
January 1942. Also on the ship was Task drew upon the medical supply depot at
Force 4591—the 2,000-plus troops of the Fort Shafter on the grounds of Tripler
102d Infantry with the mission of build- General Hospital. Supplies were more
ing and defending an air base. Besides than adequate, and overages built up in
the hospital, medical personnel for the some items that proved useful later on.
force consisted of the regimental detach- During 1942, in order to provide for the
expanding Army and for security in case
of another attack, King scattered subde-
Army Annex, Lanai City Hosp, Annual Rpts, 1942, in
CSurg, Haw Dept, Annual Rpt, 1942, sec. 3. Both file pots throughout Oahu and the outlying
319.1–2, HUMEDS, RG 112, NARA.
16
1st, 26th, and Task Force F Sta Hosps Annual Rpts,
17
1942, in CSurg, Haw Dept, Annual Rpt, 1942, sec. 3; 1st Sta Hosp Annual Rpt, 1942, pp. 1–5, in CSurg,
ibid., 1943, in CSurg, USAFICPA, Annual Rpt, 1943, Haw Dept, 1942, sec. 3, file 319.1–2, HUMEDS, RG 112,
sec. 6. Both file 319.1–2, HUMEDS, RG 112, NARA. NARA.
90 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
islands. By the end of the year Oahu In other ways as well, the expansion
alone had eleven and others were estab- produced a minimum of problems. The
lished on the islands of Maui, Kauai, and Hawaiian Islands, by contrast with the
Hawaii. In July the 5th Medical Supply South and Southwest Pacific, were rela-
Depot took over the central depot. At tively close to the continental United
the same time, a subdepot opened at States, making the importation of sup-
Hickam Field for air force personnel plies and materials much easier. Hospital
only. Both the Army and its air forces construction was given a high priority by
maintained stocks of medical supplies, Admiral Nimitz; Army engineers and
ranging from 90 to 180 days. At the end sometimes Navy Seabees assisted medics
of the year the Hawaiian Department with construction far more than in the
received an additional forty-five medical other theaters, where doctors and hospi-
maintenance units, each designed to tal corpsmen often had to pitch in and
supply 10,000 men for thirty days, which build their own structures. Most impor-
were dispersed to depots throughout the tant, no fighting raged in the area to
islands to prevent excessive loss in the hamper the growth of the Hawaiian
event of an attack. By that time shipping base. General King, nevertheless,
shortages that had become acute imme- encountered several difficulties.
diately after Pearl Harbor had been
remedied, and a constantly increasing Personnel
stream of supplies reached the islands.18
As the first Allied counteroffensive As usual, wartime priorities ensured
was getting under way in the southern that a continuous personnel shortage,
Pacific, hospital expansion in Hawaii though not comparable to the one in
showed impressive gains. By the end of Australia, would make the chief sur-
1942 the Hawaiian Department counted geon’s task of staffing the expanded hos-
nineteen hospitals in place of the three pital facilities difficult. During 1942–43
that had existed a year earlier. Seven of officer strength was consistently 5 per-
these were small, sometimes provisional, cent below that authorized. Nurses
facilities operated by personnel from remained in short supply—15 percent
the larger establishments; in the understrength in 1942—but the defi-
Hawaiian Islands, as in Australia and the ciency was gradually reduced during
South Pacific, geography compelled the 1943. Enlisted men filtered in, numbers
creation of small units to serve distant rising from 27 percent below authorized
garrisons. But because the islands were strength in 1942 to only 4 percent below
comparatively few, bed strength could in 1943. Inevitably, the theater lacked
be concentrated far more effectively sufficient physical therapists, dieticians,
than in the fighting theaters, and almost dentists, highly qualified surgeons, and
70 percent of the department’s 7,780 trained psychiatrists—scarcities that
beds remained on Oahu. existed almost everywhere during the
war. In an effort to fill the vacancies in
18
CSurg, Haw Dept, Annual Rpt, 1942, sec. 1, p. 11, specialized fields, King transferred staff
file 319.1–2; Whitehill, “Medical Activities in Middle from one facility to another, split up
Pacific,” block 3, p. 8, file 314.7. Both in HUMEDS, RG
112, NARA. See also Armfield, Organization and newly arrived organizations in order to
Administration, pp. 395–96, 399. use their personnel as replacements,
ARMY MEDICINE IN NAVY THEATERS 91
and detached individuals from one of 1941 to 960 at the end of 1943. Some
organization to fill shortages in another. of the recruits became scrub nurses;
He also recruited civilian medical per- others worked in wards. Still others took
sonnel, particularly nurses, from the advantage of Tripler’s four-month
Hawaiian Islands. Despite his efforts, course on the theory and practice of
shortages lasted well into 1944.19 anesthesia, and formed teams of anes-
In some respects, the largest hospi- thetists. In turn, they trained enlisted
tals suffered the most. As the endpoints technicians, since female nurses could
of the chain of evacuation, general hos- not accompany assault forces into bat-
pitals took up the slack for small facili- tle. In 1943 squadrons of air evacuation
ties. Organized as a 1,000-bed hospital, nurses came to Hawaii to serve with the
Tripler expanded to more than 1,500 Army Air Forces.
beds by the end of 1942. Although its Skilled women found a variety of tasks
authorized bed strength reached 1,500 to perform. An Army nurse served as liai-
in 1943, the hospital again expanded to son officer between the Nursing Division
more than 2,100 beds by the end of that of the Office of Civilian Defense and the
year. Adding beds was easy; staffing Army. Army nurses worked in public
them was difficult and slow. As a result, health, assisting the civilian community
Tripler was continually understrength. in the immunization campaigns and in a
The teaching function also burdened variety of measures for controlling
the big hospitals. Personnel sent to dysentery, polio, and dengue. In general,
Tripler for training required supervi- their morale was good as long as they
sion, demanding additional effort from were kept busy. However, like other
the staff without adding proportionate- Army officers, nurses griped about rota-
ly to the working effectiveness of the tion, leaves, and promotions. Because of
hospital.20 the personnel shortages, many did not
Army nurses and hired civilian nurses return to the mainland for four or five
found much work to do as the islands years. Only in 1945 was the Army
organized, first for defense and then for Medical Department able to adopt a pol-
attack. After hostilities started, King sent icy of rotation for nurses with two years
Army nurses from Tripler, Schofield, of overseas service.21
and Hickam hospitals to staff the provi- Unlike nurses, Army dental officers
sional facilities. As more troops came to were often called upon to work outside
the islands and new hospitals were set their own profession—by no means an
up, he dispersed nurses further, necessi- unusual demand in the Army. Hospital
tating constant recruitment from civil- units training and staffing in Hawaii
ian sources on the islands and from used dentists to direct their medical
Army sources on the mainland. The supply and transport or to serve as
nurse census rose from 195 at the end quartermaster officers and training
19 21
Whitehill, “Medical Activities in Middle Pacific,” Whitehill, “Medical Activities in Middle Pacific,”
block 3, pp. 3–4, 20, file 314.7; CSurg, Haw Dept, block 11, pp. 2–18, file 314.7; Intervs, Capt Edith A.
Annual Rpt, 1942, sec. 1, p. 13, file 319.1–2. Both in Aynes, 24 Sep 43, Capt C. Elva Collison, 16 Oct 43, and
HUMEDS, RG 112, NARA. Col Kermit H. Gates, 17 Jul 45, file 000.71; CSurg,
20
Tripler Gen Hosp Annual Rpt, 1943, pp. 1–7, file USAFMIDPAC, Annual Rpt, 1945, pp. 77–78, file
319.1–2, HUMEDS, RG 112, NARA. 319.1–2. All in HUMEDS, RG 112, NARA.
92 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
instructors. During the assault phases service extended to all islands of the
of combat, when practically no den- Hawaiian group and to Christmas
tistry was practiced, dentists were Island.23
expected to perform a number of ancil-
lary duties: assisting battalion surgeons; Care of the Troops
treating shock and maxillofacial
wounds; administering general anes- Throughout the years of preparation,
thesia; helping in the wards; and per- medical personnel of the Hawaiian
forming minor surgery to remove mis- Department practiced their skills,
sile fragments and other debris. They received training, and taught others.
might also be called upon to act as san- Meanwhile, combat units were training
itary, supply, and administrative offi- for their own roles in the fighting that
cers. To prepare for these tasks, den- lay ahead.
tists received extra training in Hawaii, The six Army infantry divisions that
especially in the areas of maxillofacial trained and staged in Hawaii—7th,
wounds and general anesthesia. 27th, 81st, 96th, 77th, and 98th—
Though traditional in the Army, such brought with them their own medical
diversions from one’s military occupa- support. For the 27th Division, this
tional specialty may help to explain why meant initially the 102d Medical
shortages of dentists occurred, espe- Regiment. A New York National Guard
cially at isolated garrisons. The dental outfit, the 27th was federalized in 1940,
section of King’s office tried to alleviate trained in Alabama and California, and
the problem by employing three prepared to move overseas. Part of the
mobile trailers to care for troops on medical preparation consisted of inoc-
outlying islands and by placing four ulations against yellow fever and
extra clinics on Oahu—in gymnasiums, typhoid. Cases of hepatitis began to
community halls, and even Japanese appear at Fort Ord, California, and the
temples—to serve units that were with- incidence rapidly grew to the dimen-
out dentists.22 sions of an epidemic while the division
With their varied responsibilities in was moving to the island of Hawaii dur-
food inspection, animal care, and the ing March 1942. Medical personnel
anti-biological warfare program, the inspected all divisional units for the
need for more veterinarians in Hawaii jaundice that was the principal symp-
was apparent early. King’s staff estab- tom of the disease; several units had to
lished schools to train food inspectors, be quarantined, and many soldiers
and Oahu soon boasted two animal hos- were hospitalized. The reason—though
pitals—the Veterinary General Hospital few were yet aware of the fact—was con-
near Fort Armstrong, and the Veterinary taminated serum used by the
Station Hospital at Schofield Barracks. Rockefeller Institute to prepare some
By the end of 1943 the Army veterinary batches of the yellow fever vaccine. The
contamination caused the only world-
22
Whitehill, “Medical Activities in Middle Pacific,”
23
block 9, pp. 2–20, file 314.7; Surg, Schofield Barracks, Whitehill, “Medical Activities in Middle Pacific,”
Annual Rpt, 1942, pp. 1–5, in CSurg, Haw Dept, Annual block 10, pp. 3–5, 18–25, file 314.7; Interv, Col Wayne
Rpt, 1942, sec. 2, file 319.1–2. Both in HUMEDS, RG O. Kester, 19 Sep 45, file 000.71. Both in HUMEDS, RG
112, NARA. 112, NARA.
ARMY MEDICINE IN NAVY THEATERS 93
cially their eyes and ears. A distinct sub- fear of psittacosis; and “any number of
specialty of aviation medicine was matur- disease-bearing insects, including the
ing during the war, as researchers studied dreaded Anopheles,” were wiped out.
the effects of acceleration, depressuriza- Despite such precautions, an epidemic
tion, high altitude cold injury, and the was touched off in July 1943 by two fliers
peculiar psychological stresses of combat who returned from the Southwest Pacific
flying—“aerio-neurosis, or cumulative Area with dengue (breakbone) fever. A
fatigue; call it what you will,” said Colonel massive military-civilian effort to destroy
Smith. Scientific considerations interact- mosquitoes resulted, as the disease
ed with the drive for an independent air spread among the civilian population.
service, producing a complicated world- Quick action limited the outbreak to
wide struggle between the Army Air Oahu, but 1,500 cases were recorded
Forces and Army Service Forces over con- before it ended.30
trol of medical logistics and hospitaliza- Prehospital medical care for coast and
tion. During these early days in the antiaircraft artillery troops was similar to
Hawaiian Department, the main com- that provided for the Seventh Air Force.
plaint of the air surgeon was the lack of On 16 March 1942 General Emmons
promotions for his subordinates, result- split the Hawaiian Coast Artillery
ing from the fact that the buildup of air Command into two separate organiza-
support had outrun paperwork. Neither tions, the Hawaiian Seacoast Artillery
the individual air bases nor the Seventh Command and the Hawaiian Antiaircraft
Air Force had an authorized table of Artillery Command. The medical service
organization, and regular medical offi- of the two organizations was much alike.
cers in the Hawaiian Islands found them- The Seacoast Artillery Command was
selves outranked by newly activated divided into four harbor defense areas,
reserve officers from the mainland.29 each with its own surgeon. The
Besides its scientific and bureaucratic Antiaircraft Artillery Command was reor-
difficulties, the Army Air Forces was itself ganized into groupments of several regi-
a source of some medical problems. ments, with a surgeon for each group-
Planes traveled daily from tropical battle- ment. Regimental surgeons were respon-
fronts to bases in the Hawaiian Islands, sible to the groupment surgeon. Unit
many carrying the wounded or sick. medics provided care to the widely dis-
Hence, quarantine was a pressing prob- persed troops through many small dis-
lem of air travel. Airmen, using hand pensaries and regimental and battalion
pumps, sprayed planes with pyrethrum aid stations. In the Seacoast Artillery
and carbon tetrachloride on their arrival Command, as in the Seventh Air Force,
and before departure. Arriving pets were the station and the tactical medical ser-
quarantined; parrots were destroyed for vices were separate endeavors.31
29 30
Quotation from Surg, 7th Air Force, Annual Rpt, Quotation from Surg, 7th Air Force, Annual Rpt,
1942, p. 6, in CSurg, Haw Dept, Annual Rpt, 1942, sec. 1942, p. 6, in CSurg, Haw Dept, Annual Rpt, 1942, sec.
2, file 319.1–2, HUMEDS, RG 112, NARA. On air med- 2, file 319.1–2, HUMEDS, RG 112, HUMEDS, NARA.
icine, see Mae Mills Link and Hubert A. Coleman, See also Allen, Hawaii’s War Years,” pp. 337–38.
31
Medical Support of the Army Air Forces in World War II Surgs, Haw Seacoast Arty and Haw AAA Cmds,
(Washington, D.C.: Office of the Surgeon General, Annual Rpts, 1942, in CSurg, Haw Dept, Annual Rpt,
USAF, 1955), pp. 305–39. 1942, sec. 2, file 319.1–2, RG 112, HUMEDS, NARA.
96 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
mand. But geography and deficient American ships made use of its harbors,
resources united to create difficult prob- and the 37th Infantry Division and 1st
lems for the medics to solve.35 Marine Division encamped there for a
Most of the South Pacific Area was few months in the summer of 1942.
open ocean. Its islands included New However, Japan’s reverses at sea demon-
Zealand, smaller but still sizable New strated that the war would be fought to
Caledonia, Fiji, and Espiritu Santo, and the north. With the departure of
thousands of small islands in the Cook, Halsey’s and Harmon’s commands to
Society, and Marquesas groups, many New Caledonia, the only headquarters
mere dots on the map. Distances were left in Auckland was the United States
great. Auckland, New Zealand, lies more Army Forces in New Zealand, with its
than 1,100 miles from New Caledonia, own surgeon—Lt. Col. Wallace I.
nearly 1,600 miles from Espiritu Santo Douglas, MC, and later Lt. Col. Amos R.
in the New Hebrides, and more than Koontz, MC—to supervise the service
2,000 miles from Guadalcanal. Cultural troops and others who remained.37 By
differences divided these lands from the end of the year New Zealand had
one another even more widely than the become simply an island command, but
miles. in many ways an atypical one.
New Zealand possessed a temperate During 1942 hospital care of
climate, large towns, and a population American troops fell first to New
predominantly of European descent.36 It Zealand facilities and then to the U.S.
resembled its huge neighbor, Australia, Navy, though the Army’s 18th General
in its dependence on grazing and on Hospital stopped off briefly on its way to
exports—mutton, wool, butter, and Fiji. Toward the end of October work
cheese. A British dominion, New began on a 1,000-bed general hospital
Zealand was self-governing, with a well- plant near Auckland, but the 39th
developed system of public health and General Hospital, which was destined to
welfare. Divided into health districts, occupy it, found the facility incomplete
each headed by a qualified physician when it arrived in November. For sever-
under a national director-general, the al months its personnel worked in Navy
island country of 2 million enjoyed the hospitals or repaid part of the Army’s
lowest death rate in the world. debt to civilian physicians by serving in
Americans came early to New the Auckland City Hospital, where doc-
Zealand, but few lingered for long. tors were in short supply. Not until
Almost from the beginning of the war, February 1943 were the first Army
patients transferred from Navy care to
35
the new plant, which had been con-
Morton, Strategy and Command, pp. 256–63; John
Miller, jr., Guadalcanal: The First Offensive, United States structed by the civil government and
Army in World War II (Washington, D.C.: Historical
Division, Department of the Army, 1949), pp. 1–3;
37
Armfield, Organization and Administration, p. 397. Colonel Koontz found sanitary conditions in the
36
Narrative on New Zealand based on Eugene T. dairy, meat, bottling, and restaurant industries to be
Lyons, “Australia and New Zealand,” in Ebbe Curtis unsatisfactory and the Health Department’s general
Hoff, ed., Civil Affairs/Military Government Public Health cooperativeness somewhat hampered by political con-
Activities, Medical Department, United States Army in siderations. See Surg, USAF and Svc Cmd [New
World War II (Washington, D.C.: Office of the Surgeon Zealand], Annual Rpt, 1943, file 319.1–2, HUMEDS,
General, Department of the Army, 1976), pp. 554–64. RG 112, NARA.
FACILITIES OF THE 18TH GENERAL HOSPITAL (top) AND THE 39TH GENERAL HOSPITAL (bottom)
100 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
loaned to the American Army. For its and canneries. Yet wartime demands
twenty-one months of operation, the multiplied such establishments, many in
39th General Hospital remained the unsatisfactory sanitary condition. Here,
only U.S. Army hospital permanently as in Australia, persuasion and educa-
assigned to New Zealand. In time, it tion in improved methods were the
expanded to more than 2,500 beds and main reliance for bringing about
added a convalescent facility as well, car- change. Milk was a special problem.
ing for over 23,000 casualties, mostly the Dairy herds were widely infected with
sick and wounded from the fighting in tuberculosis and undulant fever, and
the tropical islands to the north. New Zealand, despite its huge herding
For the men and women who served industry, had comparatively few veteri-
there, New Zealand offered many narians and no school of veterinary
amenities. Unlike their fellows in medicine. Milk was so often a cause of
Australia, most medics worked in estab- typhoid that New Zealanders themselves
lished cantonments near cities with preferred to drink condensed milk and
water and sewage systems. Venereal dis- tea. Veterinary officers failed in their
ease was never a problem. The Army set efforts to effect reforms, forcing military
up prophylactic stations, and the commanders to place milk bars off lim-
authorities cooperated freely, tracing its to their troops. But this was the only
contacts and compelling infected major sour note in an economic rela-
women to receive treatment. New tionship that saw more than 500 million
Zealand’s disease environment resem- pounds of animal foods purchased in
bled that of other temperate lands, and New Zealand for American forces in the
the lack of anophelines meant that Pacific war.
malarious servicemen who returned Much happier were the professional
from the fighting for rest and retraining contacts between American and New
could go where they pleased, enjoying Zealand physicians, both military and
the extraordinary scenery without civilian. As already noted, they cared for
endangering their hosts. each others’ patients; New Zealanders
The chief problems that developed instructed Americans in tropical medi-
between American medical officers and cine; and the Auckland branch of the
the New Zealand authorities had to do British Medical Association held month-
with food and food products. Large ly meetings with the combined staffs of
quantities of food for American troops the U.S. Navy hospitals and the 39th
were procured by the Joint Purchasing General Hospital. Good relations con-
Board, an agency of the U.S. Navy with tinued long after New Zealand had
some Army members. The board dealt ceased to be the South Pacific Area’s
with the government procurement offi- headquarters and main base, for it
cials, who then signed contracts with remained a perfect spot to rehabilitate
local producers. This setup effectively battle casualties from the jungle warfare
insulated the producers from inspection to the north.
by American officers during processing; The other islands of the South Pacific
not until 1944 were Veterinary Corps Area were either tropical or subtropical,
officers allowed to begin large-scale with heavy rainfall, high humidity, and a
inspections of slaughterhouses, dairies, variety of diseases afflicting the native
ARMY MEDICINE IN NAVY THEATERS 101
inhabitants. All were colonies of either U.S. Army forces began moving into
France or Britain. Responding to the the tropical islands of the South Pacific
distribution of vectors and the accidents Area shortly after Pearl Harbor, aiming
of settlement, ailments differed widely to prevent further Japanese advances
from island to island. New Caledonia and to protect the Allied line of com-
and the Fiji, Cook, Society, and munications to Australia. Early in 1942
Marquesas Islands were free of malaria, New Caledonia’s evident military impor-
but on the New Hebrides and the tance caused the United States to assem-
Solomons the disease was rife. The first ble and dispatch Task Force 6184, con-
epidemic of the South Pacific Area taining a mixed bag of troops and a
broke out in April 1942 on Efate in the brigade headquarters under Brig. Gen.
New Hebrides, where the malaria rate (later Maj. Gen.) Alexander M. Patch, Jr.
reached 2,700 per 1,000 troops per year, The Army’s most unusual division, the
and lesser outbreaks occurred on Americal, was formed on New
Espiritu Santo and in the Russell Caledonia from this task force in May.
Islands. Troops stationed in the eastern The 37th Division arrived in the Fijis,
part of the region suffered from filaria- while smaller units entered the Tonga
sis, caused by a parasitic worm; epi- Islands and the New Hebrides. After
demics of dengue broke out on New June, in preparation for a planned
Caledonia and Espiritu Santo. Bacillary offensive against Guadalcanal and
dysentery was common, though seldom Tulagi, troop strength continued to
serious. Venereal disease varied from increase, reaching 104,662 (including
island to island—a problem in the Fiji three divisions and five air combat
Islands, but not on New Caledonia, for groups) by the end of the year. Marine
example—influenced by local mores and naval forces were augmented as
and the efficiency of the civil govern- well, and by mid-1943 the South Pacific
ment. Natives, reservoirs of many dis- held more than 192,000 American
eases that attacked the troops, were troops. Preventive medicine and treat-
themselves highly susceptible to influen- ment of those who were sick or wound-
za and measles, and had to be protected ed absorbed the time and efforts of
from these infections. The primitive and about 1,200 medical personnel.39
tropical, not the temperate and urban,
South Pacific formed the disputed Medical Organization
region and set the terms of the medical
problem.38 The summer of 1942 saw the creation
of an Army medical organization in the
38
Benjamin M. Baker, “South Pacific Area,” in W.
39
Paul Havens, Jr., ed., Activities of Medical Consultants, CSurg, USAFISPA, Annual Rpts, 1942, pp. 1–2, and
Medical Department, United States Army in World War 1943, pp. 3–4, file 319.1–2, HUMEDS, RG 112, NARA.
II (Washington, D.C.: Office of the Surgeon General, See also Maurice Matloff and Edwin M. Snell, Strategic
1961), pp. 569–71; Paul A. Harper et al., “New Planning for Coalition Warfare, 1941–1942, United States
Hebrides, Solomon Islands, Saint Matthias Group, and Army in World War II (Washington, D.C.: Office of the
Ryukyu Islands,” in Ebbe Curtis Hoff, ed., Communicable Chief of Military History, Department of the Army, p.
Diseases: Malaria, Medical Department, United States 1953), pp. 301–05. By the spring of 1942 soldiers were
Army in World War II (Washington, D.C.: Office of the stationed on ten islands: New Zealand, New Caledonia,
Surgeon General, Department of the Army, 1963), p. Efate, Espiritu Santo, Fiji, Tongatabu, Bora Bora,
400. Aitutaki, Tongareva, and Guadalcanal.
102 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
of the South Pacific Area. Indifferent to military and the colonial governments
formalities, he readily shared equip- might or might not prevail. Naval lead-
ment with the Navy (he could get jeeps, ership, however tactful, created prob-
they could get Quonsets). He used lems. A basic difficulty was the complexi-
troopships and supply planes to move ty of the organization built up by the the-
wounded, without showing Carroll’s ater commanders. By comparison with
concern over the lack of dedicated craft; General Headquarters, SWPA, a great
he was quite willing to see soldiers hos- number of subordinate forces reported
pitalized in Navy facilities, or sailors in directly to Ghormley’s headquarters—
Army ones. Confronted by opposition USAFISPA, South Pacific Amphibious
from affiliated hospitals when he tried Force (Task Force 32); I Marine
to transfer their specialists to other units Amphibious Corps; ground troops of
needing their services, he simply waited, Allied nations; South Pacific Service
knowing that boredom would cause Squadron (nontactical); South Pacific
many underemployed professionals to Aircraft (Task Force 33), which con-
ask for transfers voluntarily. Finding that trolled land-based air; naval forces; and
the Americal Division still had the med- island bases. Each significant island had
ical regiment of an old-fashioned square its own base commander, while the vari-
division, he delayed reorganization as ous elements present on the island—sol-
long as possible, remarking to Surgeon diers, marines, airmen, Allies, and so
General Magee that “a little freedom forth—were connected vertically to the
from the restrictions and limitation[s] theater headquarters through their own
of current approved Tables of commands. In such a situation, com-
Organization . . . would improve the mand surgeons multiplied, each subject
medical service in thes [sic] theater to his own immediate commander.42
immeasurably.” Informal, diplomatic, Espiritu Santo presented an example
and precise, Maxwell won the reputa- of the problems that could arise. Largest
tion of a competent theater surgeon, of the New Hebrides and an important,
gaining a brigadier general’s star in the heavily malarious base, the French-gov-
Army and, after the war, another in what erned island lay about 480 miles from
became the independent Air Force.41 Guadalcanal. Quartermaster depots, an
But unified management at the top infantry training base, and coast artillery
could not, of itself, prevent disputes installations, as well as Navy bases and a
from arising at lower levels. Though Marine camp crowded a mountainous
Maxwell stood near the head of both ser- land, where the largest native village
vice and island command channels, his held only 152 people. Lt. Col. Arthur G.
control was hampered by the theater’s King, MC, served as both Espiritu Santo
great distances, which forced responsi- Service Command surgeon and IV
bility downward to levels where coopera- Island Command surgeon, bearing
tion among the services and between the unofficially the title of base surgeon.
42
On naval organization in the South Pacific Area,
41
Quotation from Rpt, CSurg, USAFISPA, to SG, U.S. see John Miller, jr., CARTWHEEL: The Reduction of Rabaul,
Army, 7 Dec 42, p. 2, Encl to CSurg, USAFISPA, Annual United States Army in World War II (Washington, D.C.:
Rpt, 1942, file 319.1–2. See also Interv, Maxwell, 11 May Office of the Chief of Military History, Department of
50, file 000.71. Both in HUMEDS, RG 112, NARA. the Army, 1959), pp. 67–70.
104 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Seemingly, his position as, at least infor- bringing a semblance of order to med-
mally, chief surgeon of Espiritu Santo ical policy and operations amid a baf-
ought to have been clear. In fact it was fling jumble of headquarters, services,
not. The local Service Command was and chains of command.44
under the Island Command, but New Caledonia emerged as the center
received all operational orders directly of medical activity following the transfer
from the USASOS. The surgeon of the of the area command. A cigar-shaped
Thirteenth Air Force, located on island almost 250 miles in length, New
Espiritu Santo, dealt directly with the Caledonia lies roughly halfway between
USAFISPA headquarters, even though New Zealand and the Solomons. A
air force personnel were hospitalized in colony of France for almost a century,
Service Command hospitals and air the island comprises some 8,500 square
installations were subject to Service miles of varied countryside. In late 1942
Command sanitary codes. The Navy had its inhabitants included 65,000 civilians;
no single headquarters on the island a Free French colonial government in
until October 1943, and until that time the capital, Noumea, with a battalion of
King had to negotiate on matters of troops; the Americal Division; a large
common concern with several senior naval base; a few Australian comman-
Navy medical officers, including those dos; and a service command. From the
who commanded two local Navy hospi- medical viewpoint, the ample island
tals. Under a Navy surgeon, who report- with its mild subtropical climate provid-
ed directly to the island commander, the ed an excellent base. More hospitals
joint malaria and insect control organi- were set up than anywhere else in the
zation obtained its personnel and sup- South Pacific, including the 8th and
plies from King as the Service 29th General Hospitals; the 52d
Command surgeon (Chart 2). Finally, Evacuation Hospital; and the 9th, 27th,
said King, the Marine Corps “was inte- 31st, 109th, 331st, 332d, and 336th
grated with these organizations in so Station Hospitals.
cumbersome a manner that no attempts Units newly arrived had a rough initi-
were ever made for official action.”43 ation, building their own hospital plants
None of these complications made amid torrential rains, swarming insects,
practical cooperation impossible, but and organizational confusion. But in
they did cause endless unnecessary time excellent structures took form
problems of detail. (For example, malar- mostly of wood or prefabricated materi-
ia control directives from the USASOS, als, with staff quarters and recreation
the USAFISPA, or the surgeon general buildings often of native construction
in Washington sometimes contradicted set on cement floors. Bamboo walls and
those promulgated by COMSOPAC.) thatched roofs made for cool comfort-
Personal relations and informal agree- able dwellings, and tropical flowers
ments proved the key to success in bloomed in landscaped gardens. Views
of Pacific breakers and “lofty mountains
and knife-like ridges cutting into the
43
Arthur G. King, “Medical History of Espiritu Santo
(New Hebrides) Service Command,” pp. 3–4 (quota-
44
tion), file 314.7 (South Pacific), HUMEDS, RG 112, Interv, Capt Roy Wisenbaker, 4 Feb 44, file 000.71,
NARA. HUMEDS, RG 112, NARA.
ARMY MEDICINE IN NAVY THEATERS 105
Island Command
Malariologist
Entomologist Engineer or
Parasitologist entomologist (Navy)
Army unit: 11 EM Army unit: 11 EM
Navy unit: 4–12 EM Navy unit: 4–12 EM
Labor
Skilled
Navy construction battalion
Army engineers
Unskilled
Army medical sanitary companies
Troop anti-malaria details
Natives
Source: Adapted from Harper et al., “New Hebrides, Solomon Islands, Saint Matthias Group, and Ryukyu Islands,” in Hoff,
ed., Communicable Diseases: Malaria, p. 442.
sky” welcomed soldiers wounded in bat- region as a whole. Officers of the 25th
tle or riddled with tropical diseases.45 Evacuation Hospital, arriving on
On other major islands, variation was Thanksgiving Day, began to build their
the rule. Fiji was atypical, the only island plant in a grove of cocoanut palms amid
group in which doctors, hospital corps- a sea of mud, caused by rains so heavy
men, and Army nurses (of whom about that visibility fell to three or four feet.
1,000 served in the South Pacific Area) Surgeons worked beside enlisted men,
found ready-made hospital plants like finishing the first structures before the
those of New Zealand. Espiritu Santo nurses arrived in February 1943.
presented a picture more typical of the Finding the hospital in “rainsoaked,
mud-bespattered cocoanut groves,” the
45
Ruth B. Kelly, “History of Nursing Service in the nurses spent their first weeks caring for
South Pacific, World War II,” pp. 11–12 (quotation), patients “to the tune of roaring and
file 314.7 (South Pacific); Arthur G. King, “Medical clanking tanks and bulldozers.”
History of New Caledonia Service Command,” file
314.7–2 (Medical Activities). Both in HUMEDS, RG Gradually the noise of construction
112, NARA. ended, the hospital grounds were land-
ISLAND MEDICAL CARE, from testing for malaria to caring for a dying patient
ARMY MEDICINE IN NAVY THEATERS 107
scaped, and the warmth and rain Infantry Division declared emphatically
brought tropical shrubbery to luxuriant that the effect of such disparities on
flowering. Now the nurses lived in com- morale and efficiency in Army hospitals
fortable barracks with electric lights, was bad.
showers, toilet facilities, and dayrooms, The old adage that the Navy got the
and the hospital staff enjoyed sports, gravy seemed to hold true even for the
movies, and dances when not at work.46 sick and wounded, and the amenities
Yet the nurses on Espiritu Santo—50 that the Army hospitals did attain in any
among 40,000 or so troops—experi- case were short-lived. When the front
enced some rough moments still. Their moved forward, orders arrived, and after
presence inevitably created sexual ten- a year or two the hospital staffs “tore
sions. Soldiers broke into their quarters, down the fruits of their labor and moved
necessitating the posting of armed on to build other hospitals, to work and
guards. The nurses learned, for their slave in a new theater of operations.”47
own safety, to go out only with groups,
for single escorts were sometimes Medical Innovation
attacked, and one was shot. Some med-
ical officers concluded, rightly or wrong- The greatest problem facing Maxwell
ly, that despite the exceptionally able and his staff was to adapt medical policy
service the nurses gave to the hospital, and organization, originally based on
only male attendants should be combat experience in World War I where
employed under the conditions of the land warfare along a cohesive front pre-
smaller South Pacific islands during vailed, to the geographical conditions of
wartime. the South Pacific. Reorganization of
Boredom, feelings of alienation units and innovations in hospitalization
among the exotic surroundings, and and supply were both needed.
envy of the Navy also characterized such Responding to some of the same impera-
situations. In the spring of 1943 Army tives as the medics in the Southwest
hospitals on Efate and Espiritu Santo, Pacific Area, Maxwell broke up large hos-
though much improved, remained vastly pitals into small self-supporting units and
inferior to the naval hospitals, which allotted beds and personnel to each
were housed in prefabricated buildings, island according to need. Where islands
with connecting corridors and linoleum- were too small for full hospitals, he
covered floors, and were equipped with assigned field hospital platoons, aug-
white enameled hospital beds, white menting them from time to time with
blankets, adequate supplies of linen, and surgeons from general hospitals.48
unit laundries. Soldiers did not fail to
notice that the Navy possessed much 47
Quotation from ibid., p. 10, file 314.7 (South
medical equipment that had been elimi- Pacific). See also Interv, Lt Col Willis J. Potts, 6 Apr 45,
nated from Army hospital equipment file 000.71. Both in HUMEDS, RG 112, NARA.
48
CSurg, USAFISPA, Annual Rpts, 1942, pp. 1–2, and
lists to conserve critical shipping space. 1943, pp. 4–6, file 319.1–2; Interv, Maxwell, 11 May 50,
Maj. Gen. J. Lawton Collins of the 25th file 000.71; 7th Evac Hosp Annual Rpt, 1942, p. 15, file
319.1–2; Rpt, Surg, 7th Evac Hosp, to SG, U.S. Army, 10
Aug 42, p. 7, file 319.1–1 (Bleacher). All in HUMEDS,
46
Kelly, “History of Nursing Service,” p. 9, file 314.7 RG 112, NARA. See also Baker, “South Pacific Area,” in
(South Pacific), HUMEDS, RG 112, NARA. Havens, ed., Activities of Medical Consultants, p. 573.
108 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Like Carroll, Maxwell found that part pitals to the theater; transportation
of a hospital did not necessarily form a shortages hampered their transfer from
unit capable of acting alone. Small hos- one station to another; and in 1943 the
pitals on isolated islands had to function Army occupied seven more islands or
independently, but without the neces- island groups, worsening a problem
sary skilled personnel and equipment. already severe.49
Despite occasional visits by consultants, Good relations with the Navy and the
treatment at some of these facilities was Allies took up some of the slack.
hardly up to the highest standards. Sharing facilities kept the bed shortage
Again like Carroll, Maxwell labored from reaching crisis proportions. As
under a shortage of beds. By the end of noted above, Army casualties received
1942 the Army on New Caledonia, Fiji, treatment either in New Zealand mili-
Tongatabu, Bora Bora, Aitutaki, and tary and civilian facilities or in U.S.
Tongareva had only 4,200 hospital beds Navy hospitals. In turn, the Army’s
for 110,047 troops—a ratio of fixed beds 109th Station Hospital in New
to troops of only 3.82 percent. During Caledonia treated New Zealand’s 3d
1943 bed capacity increased to 14,815 Division, and Army hospitals on Fiji
for 176,254 troops, or 8.41 percent, still
below the War Department’s goal of 10 49
CSurg, USAFISPA, Annual Rpt, 1942, pp. 2–3, file
percent. But the War Department’s own 319.1–2; Interv, Maxwell, 11 May 50, file 000.71. Both in
priorities slowed the movement of hos- HUMEDS, RG 112, NARA.
ARMY MEDICINE IN NAVY THEATERS 109
took care of Marine and Navy casualties To bear this burden while treating the
from Guadalcanal and New Georgia. combat casualties, Maxwell lacked
Army patients used Navy beds on Efate skilled hands as well as beds. As of
and Espiritu Santo in 1942 and 1943. October 1943 the difference between
However, the services shared only table of organization requirements and
mutual ignorance in treating tropical the number of personnel actually on
ills. The endemic diseases of New hand in the theater amounted to 586
Zealand resembled those of the Middle officers and nurses and 2,684 enlisted
Atlantic states at home, but the diseases men. Shortages of physician specialists
of the jungled islands were largely unfa- (psychiatrists, in particular), of dieti-
miliar to most American physicians, the cians, and of physical therapists were
more so because multiple infections marked, and the South Pacific was with-
were common and the symptoms of out professional consultants until July
malaria—usually a component of such 1943, because theater headquarters was
conditions—were varied and confus- reluctant to approve the transfer of offi-
ing. Psychological problems mingled cers for purely professional reasons.
with the physical. Psychiatrists quickly Many doctors who bore excellent pro-
learned that the proportion of neu- fessional credentials had been inade-
ropsychiatric cases in isolated garrisons quately trained for dealing either with
exceeded those resulting from combat. the dangers of combat or the complexi-
Already inclined to depression by the ties of Army administration. The physi-
poor living conditions of the tropics cian ultimately appointed, medical con-
(oppressive heat, monotony, poor food, sultant Lt. Col. Benjamin M. Baker, MC,
and the pervasive strangeness of the candidly termed himself “poorly pre-
environment), those who fell ill found pared to meet many of the problems
no encouragement in the fact that that confronted him,” a condition
their doctors seemed to know little apparently widespread in the South
about what ailed them. Unlike the Pacific Area during 1942 and 1943.51
sailors, the soldiers and marines who Geography interacted with Army per-
lived and fought ashore had a high rate sonnel practices to make the medical
of sickness. In 1943 the Army hospitals service less effective than it might have
of the South Pacific Area counted been. The professional experiences of
almost 152,000 admissions, 60,000 of doctors varied widely, and the lack of a
them malaria cases. About 23,000 casu- system able to distinguish among med-
alties were evacuated to the United ical specialties made proper assignment
States, and of these more than 28 per- difficult. Even when headquarters
cent were diagnosed with neuropsychi- ordered reassignments, island comman-
atric disorders.50 ders fought to retain skilled men,
50 51
Baker, “South Pacific Area,” in Havens, ed., Quotation from Baker, “South Pacific Area,” in
Activities of Medical Consultants, p. 598; Lindsay E. Havens, ed., Activities of Medical Consultants, p. 576. See
Beaton and M. Ralph Kaufman, “As We Remember It,” also CSurg, USAFISPA, Annual Rpt, 1943, p. 16, file
in Albert J. Glass, ed., Overseas Theaters, Medical 319.1–2; OofSurg, USAFISPA, ETMD, 4 Nov 43, p. 2,
Department, United States Army in World War II file 350.05; Kelly, “History of Nursing Service,” pp.
(Washington, D.C.: Office of the Surgeon General, 14–16, file 314.7 (South Pacific); Interv, Potts, 6 Apr 45,
Department of the Army, 1973), p. 739. file 000.71. All in HUMEDS, RG 112, NARA.
STOCKADES FOR NEUROPSYCHIATRIC CASES, at a station hospital
and on an Australian hospital ship
ARMY MEDICINE IN NAVY THEATERS 111
whether needed or not. Hence, one hos- maintenance units, maintained supply
pital with a mediocre staff might strug- levels equal to 100–200 days’ usage. He
gle under a deluge of patients, while requisitioned some supplies from the
another wasted its professional talent on USAFISPA, but shortages necessitated
an island where little demand for its ser- much swapping and sharing with the
vices existed. Colonel Baker cited the Navy. Shortages in essential drugs—
7th Evacuation Hospital, a 750-bed unit sulfaguanidine, bismuth, opium, and
affiliated with New York’s Post-Graduate antimalarials—as well as in oxygen and
Hospital that was rich in surgical talent. plasma plagued the system during 1942,
On Tongatabu, a small coral island of and all types of specialized equipment
Polynesia, its surgeons were often idle from microscopes to dental supplies
(treating superficial infections caused were in short supply and badly needed.
by insect bites was the hospital’s most A scarcity of shipping often kept
common activity), while fighting forces materiel on the docks in San Francisco,
on distant Guadalcanal were critically and a dearth of intratheater ships often
short of such men. Moved to Fiji, the 7th prevented the marriage of personnel to
became largely a malaria hospital, and equipment that arrived on different ves-
later on Guadalcanal—by then securely sels at different ports. Shipping uncer-
in Allied hands—it waited to take part in tainties pointed up the importance of air
an operation that was abandoned. Not in medical supply, and the theater’s need
until January 1945, at the invasion of for a central depot to store excess sup-
Luzon, did the hospital at last serve the plies and to provide replacements for
purpose for which it was intended. And the local depots, which were apt to be
Baker cited other cases of misused suddenly depleted when units lost their
resources, especially distressing in a equipment to enemy action.53
fighting theater where the medical sys-
tem was stretched thin.52 Preparing for War
Medical supply also had to provide
support for combat troops and garrison Compared to the Southwest Pacific
forces on numerous islands that were Area, the South Pacific Area presented a
spread over a vast area. In November medical picture of a better integrated
1942 Maxwell, in his capacity as USASOS theater of operations, even with its geo-
chief surgeon, established a base depot graphical fragmentation and the admin-
at Noumea. Here he could oversee the istrative confusion resulting from the
collection of supplies for combat opera- jumbled presence of Navy, Army, Marine
tions. To support garrison forces, Corps, island, and service commands.
Maxwell established small independent However, localism may also have encour-
depots on the other occupied islands,
which, resupplied by standard medical
53
Whitehill, “Medical Activities in Middle Pacific,”
block 3, p. 82, file 314.7; CSurg, USAFISPA, Annual
52
7th Evac Hosp Annual Rpt, 1943, exh. 2, p. 17, file Rpt, 1942, pp. 1–3, file 319.1–2. Both in HUMEDS, RG
319.1–2, HUMEDS, RG 112, NARA; Baker, “South 112, NARA. See also Charles M. Wiltse, Medical Supply
Pacific Area,” in Havens, ed., Activities of Medical in World War II, Medical Department, United States
Consultants, p. 573. Baker notes (p. 575) that he was Army in World War II (Washington, D.C.: Office of the
never officially named as medical consultant, but that Surgeon General, Department of the Army, 1968), pp.
he served in this capacity through most of the war. 422–26.
112 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
aged experimentation by officers with ini- mosquitoes (the campsite was dubbed
tiative, trying out new ideas in their own “Mosquito Hill”). Dysentery continued
units. Thus important innovations were to rage; drinkable water had to be
made by the 101st Medical Regiment, an hauled from 6 miles away; and no vehi-
organizational fossil that had escaped tri- cles were available to move the regi-
angularization to become a part of the ment’s 300,000 pounds of equipment
Americal Division in March 1942. 5.5 miles from Noumea to the bivouac.
An element of the original Task Slowly, trucks were scrounged, the camp
Force 6184 assembled and sent to New was organized, and the real business—
Caledonia early in 1942, the 101st learning to defend New Caledonia from
Medical Regiment, commanded by Lt. Japanese attack—got under way.
Col. Dale G. Friend, MC, had been Because their brassard was not respect-
inducted into federal service in January ed by the enemy, the medics armed
1941 with the National Guard’s 26th themselves with Model 1903 bolt-action
Division. All was in confusion as the rifles and began learning to shoot under
regiment embarked on the Army trans- the guidance of infantry-trained NCOs
port Santa Elena at the New York Port of and Medical Administrative Corps offi-
Embarkation. Medical materiel was on cers. An initial defense plan for New
board, but no one knew where; units Caledonia recommended that strong-
were mixed together, and officers had points be created all along the coast for
trouble locating their men. The convoy local resistance to any enemy landing. A
left New York on the twenty-third and, few hundred American infantrymen
after a voyage devoted by the medics to and a small detachment of Australian
training, to digging through holds to commandos formed sixteen to eighteen
find supplies, and to conducting cours- defensive units, and the medics’ first
es in tropical medicine, reached task was to provide them support.55
Melbourne, Australia, on 27 February. Friend split the personnel of a collect-
While stevedores reloaded the ships, ing and an ambulance company into 25-
the regiment was billeted in private man groups, each commanded by a med-
homes; then it shipped out again on an ical officer, with sufficient supplies and
“utterly filthy” vessel, where an epidem- transport to provide first-echelon care
ic of dysentery broke out. With “morale and evacuation to hospitals. Since no
and physical condition . . . seriously hospital units had yet reached the island,
impaired,” the 101st landed at Noumea he substituted his own, dividing the
on the morning of 15 March.54 101st’s clearing companies into six field
Here the 101st Medical Regiment hospitals—he used the term generically,
underwent a period of initiation much not in the sense of the regulation field
like that of the hospitals, working in tor- hospital unit—placed at strategic loca-
rential rains, in mud that resembled tions to furnish second- and third-eche-
“heavy gear grease,” and in clouds of lon care. Finally, the 101st commander
set up in Noumea what he called “a com-
plete field hospital,” operated by a clear-
54
Surg, 101st Med Regt, ETMD [Annual Rpt], 1942, ing company platoon, to render what
pp. 2–3, file 319.1–2, HUMEDS, RG 112, NARA.
Though called an ETMD, this document is actually the
55
unit’s annual report and is so filed. Ibid., p. 3, file 319.1–2, HUMEDS, RG 112, NARA.
ARMY MEDICINE IN NAVY THEATERS 113
water evacuation.” Maxwell agreed: the South Pacific Area, armed with an
“The chief problem in island warfare,” innovative spirit and ideas of real merit
he declared, “is to obtain definitive about interservice cooperation, hospital
surgery at the front.”58 construction, and forward medical sup-
The experiences of 1942 brought into port. In a variety of ways, a medical orga-
being a rough and ready organization in nization intended to support mass
armies in land campaigns had been
58
adapted to the exigencies of island
First two quotations from ibid., encl. 6, p. 2. Third
quotation from CSurg, USAFISPA, Annual Rpt, 1943, p. war—how successfully, would now be
14. Both file 319.1–2, HUMEDS, RG 112, NARA. determined in battle.
CHAPTER IV
Jungle Warfare
In January 1942 the Japanese, moving Japanese-held islands in the South and
southeast toward the American- Southwest Pacific Areas and a long,
Australian line of communications, had exhausting encounter with jungle war-
captured the harbor of Rabaul on the fare at its worst.
northeast coast of New Britain Island in
the Bismarck Archipelago. Entering the Guadalcanal
Solomon Islands, they took Tulagi in
May and thereafter planned the seizure Overall direction of the initial cam-
of Port Moresby on New Guinea’s south paign against Tulagi and “adjacent posi-
coast. Their advances threatened tions” rested in the hands of Admiral
Australia, separated from New Guinea Nimitz, who assigned it to Admiral
only by the Torres Strait, and provoked Ghormley. On Guadalcanal, where the
Allied counteraction. The struggle to Japanese had begun to build an airstrip,
halt Japan opened with an inconclusive the landing force was to consist of the
naval battle in the Coral Sea, which 1st Marine Division. Army forces were to
turned into a war of attrition on land, relieve the marines at a later date. The
sea, and in the air. Geography made it a Navy was to support the campaign, and
logistical nightmare, and climate and its construction battalions were to build
disease harassed the contending armies. or expand air bases ashore for Army and
On 2 July, in order to dislodge the Navy aircraft.1
Japanese from New Guinea, the Ghormley and his successor, Admiral
Bismarcks, and the Solomons, the U.S. Halsey, consulted General Harmon, the
Joint Chiefs of Staff ordered a two- USAFISPA commander, in the design
pronged counterattack. One offensive and execution of the campaign, particu-
was to move up the Solomon chain and larly in the preparation and execution
the other toward northern New Guinea of plans involving Army forces. Though
from Port Moresby, with the recapture Harmon was to have no operational
of Rabaul, the heavily defended main control over those forces, the Navy
Japanese base, as the final objective. For
both the Army Medical Department
1
and the theater medical service, the John Miller, jr., Guadalcanal: The First Offensive,
United States Army in World War II (Washington, D.C.:
projected operations meant their first Historical Division, United States Army, 1949), pp. 1–21
experience in supporting attacks on (quotation, p. 17).
116 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
would later delegate authority to him peratures ranging between 70o and 95o
over specific operations and for limited F., and a monsoon season that lasted
amounts of time, making him much from November to March. Flat coastal
more powerful than had originally been plains, covered with cocoanut palms or
intended. From the first, however, thick jungle, rose gradually to grassy
Harmon was responsible for the admin- plateaus. Split by deep jungle-choked
istration, training, and logistical support ravines, the plateaus merged into pre-
of all Army ground and air forces that cipitous mountains, all thickly forested.
were to participate in the Guadalcanal On that “pestilential hellhole hated by
campaign. Captain Dearing, Admiral soldier, sailor and marine,” two-thirds of
Halsey’s chief surgeon, planned medical the U.S. forces became ill, and almost
support for 18,134 marines, whose two-thirds of the Japanese who died
infantry regiments had been organized apparently succumbed to disease.3
into battalion landing teams for the
invasion.2 Invasion and Battle
Providing medical support for Army
forces participating in the Guadalcanal On 7 August the 1st Marine Division
campaign and coordinating that support under Maj. Gen. Alexander A.
with the Navy were the responsibilities of Vandegrift, USMC, invaded Guadalcanal,
Colonel Maxwell. His duties as both the aiming to seize the island and its partially
theater chief surgeon and USASOS sur- completed airfield. Landing without
geon included providing for the person- opposition, by the next day the marines
nel necessary to support Army forces; had taken the airstrip, renamed it
gathering information about the dis- Henderson Field, and established a
eases, climate, and terrain on defensive perimeter around it. But
Guadalcanal; requisitioning medical sup- attacks from Japanese bombers out of
plies through General Breene’s USASOS Rabaul caused the American fleet to sail
headquarters; storing and readying, at away, leaving the marines without naval
the depot on New Caledonia, the sup- or air support and with only meager sup-
plies to be shipped on troopships and air- plies. Reinforcements and supplies had
craft to the combat zone; and supervising to be brought in by blockade-running
a program for training medics, with the ships and by air transport.
divisions they were to support, in jungle Both Japanese and Americans began
and island warfare. to reinforce Guadalcanal. The marines
Training was essential, for
Guadalcanal was not a picturesque 3
Quotation from Jack Coggins, The Campaign for
South Pacific island paradise. Ninety Guadalcanal: A Battle That Made History (Garden City,
N.Y.: Doubleday and Co., 1972), p. 28. See also Surg,
miles in length and about 30 in width, 101st Med Regt, ETMD [Annual Rpt], 1942, encl. 5, p.
the volcanic island possessed jungled 1, file 319.1–2, Historical Unit Medical Detachment
mountains, a hot, wet climate with tem- (HUMEDS), Record Group (RG) 112, National
Archives and Records Administration (NARA),
Washington, D.C. Though called an ETMD, this docu-
ment is actually the unit’s annual report and is so filed.
2
Louis Morton, Strategy and Command: The First Two Richard B. Frank’s Guadalcanal: The Definitive Account of
Years, United States Army in World War II (Washington, a Landmark Battle (New York: Random House, 1990) is
D.C.: Office of the Chief of Military History, a recent and excellent retelling of the battle, with a
Department of the Army, 1962), p. 261. broad range of sources, including Japanese sources.
JUNGLE WARFARE 117
fought off attacks against Henderson mounted until headquarters stopped the
Field, while naval and air forces strug- advance on 25 November. By this time
gled for control of the Solomon waters. the 164th Infantry numbered less than
On 13 October the first Army unit—the 200 effectives; between the nineteenth
164th Infantry of the Americal and twenty-fifth the unit suffered 117
Division—arrived from New Caledonia. killed and 625 wounded or sick. Medics
By this time the 1st Marine Division, evacuated more than 300 from the island
weakened by an inadequate diet, was and sent another 300 to rear areas for
beginning to suffer the ravages of tropi- treatment of wounds, malaria, dysentery,
cal disease, including malaria, skin or combat fatigue. The malaria rate for
infections, and gastrointestinal disor- Allied troops on Guadalcanal reached
ders. During October malaria alone put 1,781 per 1,000 per year in November,
1,960 marines into the hospital.4 the month when malaria control person-
In early November Nimitz ordered nel at last arrived on the island.5
the remainder of the Americal Division The Joint Chiefs now ordered the
to Guadalcanal, where the battle was 25th Infantry Division, stationed on
entering its final phase. Midmonth Hawaii, to Guadalcanal to relieve the
naval and air successes halted attempts marines. Harassed for months by air
by the Japanese to reinforce their raids, naval attack, inadequate diet,
troops, and desperate enemy attacks malaria, and dysentery, the 1st Marine
against the perimeter failed. Marines Division had taken 10,635 casualties up
and soldiers now sallied from the defen- to 10 December. Only 1,472 suffered
sive perimeter to attack the Japanese in gunshot wounds, while malaria
the northwestern end of the island. The accounted for 5,749. Malnutrition and
struggle quickly developed into a kind disease had weakened many others as
of Bataan in reverse, as a stubborn well. On the ninth General Patch of the
enemy, cut off from his supplies, resisted Americal Division succeeded General
final defeat. Vandegrift as commander of U.S.
As in that earlier battle, the defense forces on Guadalcanal, including the
was tenacious and the battleground—for 2d Marine Division, and the Army
the most part, a series of steep ridges ris- assumed responsibility for the conclu-
ing from the coast to the central moun- sion of the campaign. The troops were
tains—well adapted to prolonged resis- fortunate in facing an outnumbered
tance. Green troops made slow progress; enemy ravaged by disease, living on
some collapsed from exhaustion. The inadequate rations, and, in a few
Japanese covered the entire front with instances, reduced to cannibalism.
small arms, automatic weapons, artillery, After sharp preliminary fighting, on
and mortars. The Americans were not 10 January 1943 the last offensive began.
able to gain ground, and casualties
5
Miller, Guadalcanal, pp. 173–89, 203–09, 226–27;
4
For background, see Miller, Guadalcanal, pp. 121st Medical Bn Unit History (copy), [1942–43], pp.
59–196. See also Francis D. Cronin, Under the Southern 5–8, file 300-Med-0.1, HUMEDS, RG 112, NARA. Under
Cross: The Saga of the Americal Division (Washington, the process of triangularization, the 101st Medical
D.C.: Combat Forces Press, 1951). The 164th Infantry Regiment was reorganized as the 121st Medical
was supported by Navy medics until Army medical units Battalion on 1 May 1943, when the Guadalcanal cam-
arrived. paign was over.
118 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
ELEVATION IN FEET
0 15
Miles
Note: Division clearing companies acted as field hospitals.
S O L O M O N S E A
MAP 5
12 13
Thompson, “Division Medical Battalion,” in “25th Interv, Lt Col Leon K. Gurjian, 20 Aug 43, file
Infantry Division” (copy), sec. 5, p. 163 (quotation), file 000.71; Whitehill, “Medical Activities in Middle Pacific,”
370 SWPA (Guadalcanal); 121st Med Bn Unit History block 8, pp. 43–44, file 314.7; Air Evacuation Board,
(copy), [1942–43], p. 6, file 300-Med-0.1; Rpt, Lt Col SWPA, “The Medical Support of Air Warfare in South
Arthur G. King, Med Insp, OofSurg, Americal Div, to and Southwest Pacific, 7 December 1941–15 August
CG, Americal Div, 15 Oct 42, sub: Intelligence Report 1945,” Report No. 35, sec. 1, vol. 2, pt. 2, pp. 477–78,
on Cactus (Guadalcanal), pp. 3–4, file 350.05. All in 483, file 314.7–2 (Army Air Forces—Medical Services)
HUMEDS, RG 112, NARA. SPA, SWPA. All in HUMEDS, RG 112, NARA.
JUNGLE WARFARE 123
that tablets were swallowed, medics with temperatures of 103o F. or less from
stood in mess lines and looked into frontline duty or patrol missions.17
mouths. However, the troops were oblig- Attempts to lessen the rising toll were
ed to go out on small patrols, interrupt- made by both armed services. The Navy
ing such supervision, and frequent on 20 November 1942 established a base
alerts required them to spend much malaria control unit, consisting of two
time in foxholes, making mosquito nets officers and eight enlisted men, to oil
ineffective as well.16 pools, to improve drainage, to help
In order to improve malaria disci- units choose healthful campsites, and to
pline, General Patch, on the advise of train 101st Medical Regiment techni-
Colonel Friend, in January 1943 issued cians in diagnostic work. In mid-
the Americal Division a memorandum, December Colonel Friend instituted a
in which he pointed out that less than 1 plan of action for the Americal Division,
in a 1,000 was unable to take Atabrine which included an all-out campaign to
and that yellow discoloration of the skin educate personnel in malaria control.
disappeared within ten days after dis- He established Field Hospital III, a
continuing the drug. Commanding offi- malaria facility of 400 beds staffed by
cers were instructed to impress upon medical officers and clearing company
their subordinates the necessity of using personnel, including trained techni-
mosquito nets and especially of covering cians who provided laboratory diagnosis
the body at dusk and dawn, when mos- and classification of cases. Friend made
quitoes are most prevalent. But by this treatment with suppressive Atabrine a
time malaria had reached epidemic pro- command responsibility, and appointed
portions. Ninety percent of the 1st a division malaria control officer to train
Marine Division acquired the disease. two enlisted men of every company and
The monthly malaria rate for Allied battery in malaria control.18
units ran as high as 1,781 per 1,000 But malaria discipline had been late
troops per annum in November. From 1 in coming. In January 1943, when the
November 1942 to 13 February 1943 final offensive was on, the admission
hospital admissions for malaria from rate for Allied units remained high,
Army units alone averaged 420 per 1,169 per 1,000 troops per annum.
1,000 troops per year. Malaria so deplet- Hence, the control program con-
ed some units that General Vandegrift tributed little to the defeat of the
ordered doctors not to excuse soldiers Japanese. In the post-combat period,
however, conditions on Guadalcanal
16
When the Germans were unable to obtain quinine
17
during World War I, they began to experiment with syn- Harper et al., “New Hebrides, Solomon Islands,
thetic substitutes. Work continued after the war, and in Saint Matthias Group, and Ryukyu Islands,” in Hoff,
1930 they produced Atabrine. See Bennett F. Avery, ed., ed., Communicable Diseases: Malaria, pp. 422, 426; Miller,
The History of the Medical Department of the United States Guadalcanal, pp. 210, 227; Surg, 101st Med Regt, ETMD
Navy in World War II, 3 vols. (Washington, D.C.: Bureau [Annual Rpt], 1942, encl. 11, p. 1, file 319.1–2,
of Medicine and Surgery, Department of the Navy, HUMEDS, RG 112, NARA.
18
1950–53), 1:73. See also Rpt, King to CG, Americal Div, Harper et al., “New Hebrides, Solomon Islands,
15 Oct 42, p. 6, file 350.05, and Surg, 101st Med Regt, Saint Matthias Group, and Ryukyu Islands,” in Hoff,
ETMD [Annual Rpt], 1942, encl. 11, p. 2, file 319.1–2, ed., Communicable Diseases: Malaria, p. 426; Surg, 101st
HUMEDS, RG 112, NARA; Miller, Guadalcanal, p. 227; Med Regt, ETMD [Annual Rpt], 1942, encl. 11, pp. 1–2,
and Frank, Guadalcanal, pp. 259–60. file 319.1–2, HUMEDS, RG 112, NARA.
JUNGLE WARFARE 125
noticeably improved. More Army malar- and lowered morale depleted combat
iologists came into the area and took efficiency.20
over and expanded the control work. Psychological disorders, usually
The malaria rate fell from 1,052 per termed war neurosis or battle fatigue,
1,000 per annum in March to 149 in accounted for a large percentage of
December (see Table 2). By then, large evacuees. Much of the problem resulted
portions of Guadalcanal were Anopheles- from the many pressures of combat—
free, and the command policy of admin- constant air attacks, the lack of sleep,
istering suppressive Atabrine to the gar- the enemy’s tactics of infiltration and
rison was rescinded.19 night attack. Compounding such stress-
Other problems were less important es were the Guadalcanal climate and
than malaria, but all added to the mis- environment. The profound jungle
ery of the fighting men. Diarrhea afflict- darkness, the unnerving night sounds of
ed almost all new arrivals on animals and birds, the tormenting
Guadalcanal, but soon disappeared attacks by insects and leeches, and the
after treatment with sulfadiazine or painful and distressing skin diseases all
sulfaguanidine. In the hills, water was in sapped the troops’ energy and made
short supply and the troops went them more susceptible to real and imag-
unbathed for weeks at a time. Dirt plus inary terrors.21
heat, high humidity, and filthy clothing Medical personnel learned to look for
promoted fungus infections of the skin; impending psychological breaks and,
athlete’s foot was particularly common, when they spotted early symptoms, to
as were epidermophytosis and tinea. secure the victims’ release from duty
Heavy perspiration depleted the body’s before they jeopardized the lives of
fluids and salts, causing excessive themselves and others. By the end of
fatigue, cramps, headaches, and verti- 1942 the 3d Field Hospital was treating
go; some suffered from mental confu- neuropsychiatric (NP) patients as well as
sion, and some passed out. Avitaminosis possible malingerers. Unit surgeons
was common, apparently because field began to relearn—too late to prevent
rations were so unappetizing that sol- many evacuations—a lesson taught by
diers ate only the more palatable items, World War I but since forgotten: The
frustrating quartermaster efforts to pro- best way to handle cases of war neurosis
vide a balanced diet. Weight loss was was to hold them as close as possible to
apparently about twenty pounds per the front lines.22
man, on the average. Impressed by his “We believe,” said a physician with the
experience with the effects of jungle 182d Infantry, “that the majority of these
warfare, Colonel Friend believed that cases are nothing but a direct result of
troops should not serve more than ten
days in continuous combat and should 20
Surg, 101st Med Regt, ETMD [Annual Rpt], 1942,
not remain in such an environment for encl. 5, p. 3, file 319.1–2; Rpt, King to CG, Americal Div,
15 Oct 42, pp. 5–6, file 350.05. Both in HUMEDS, RG
more than four months because disease 112, NARA.
21
Rpt, King to CG, Americal Div, 15 Oct 42, pp. 5–6,
file 350.05; Interv, Maj Theodore Lidz, 26 Mar 45, file
19
Harper et al., “New Hebrides, Solomon Islands, 000.71. Both in HUMEDS, RG 112, NARA.
22
Saint Matthias Group, and Ryukyu Islands,” in Hoff, Interv, Lidz, 26 Mar 45, file 000.71, HUMEDS, RG
ed., Communicable Diseases: Malaria, p. 423. 112, NARA.
126 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
a
Reflects the number of cases per annum per 1,000 troops.
Source: Adapted from Harper et al., “New Hebrides, Solomon Islands, Saint Matthias Group, and Ryukyu Islands,” in Hoff, ed.,
Communicable Diseases: Malaria, p. 423.
exposure to the sun and the elements, martialed.” When Berezin protested,
lack of rest and sleep, mental tension . . . Patch agreed to a compromise—treat-
and mental and physical fatigue. Our ing enlisted NPs as medical cases but
experience showed that when these men court-martialing officer NPs. In conse-
were given one or two weeks rest, regular quence, Berezin diagnosed such officers
food, a chance for a bath and rest, and as victims of blast concussions and other
common sense psychotherapy was prac- organic injuries. Meanwhile, early com-
ticed, 85% to 90% . . . requested to be plaints from unit commanders over
returned to their respective units.”23 removing NPs from the line gave way to
Guadalcanal contributed significantly attempts to have them evacuated, as
to the development of combat psychia- their uselessness in combat became
try, partly because a psychiatrist, Maj. clear.24
Martin A. Berezin, MC, for a time was Lacking almost all equipment for a
acting surgeon of the Americal Division. psychotherapeutic program, Berezin
Early on, the attitude of the line officers gave barbiturate sedation and, after one
was, if possible, even less receptive to
combat psychiatry than to malaria disci- 24
M. Ralph Kaufman and Lindsay E. Beaton, “South
pline. General Patch himself informed Pacific Area,” in Albert J. Glass, ed., Overseas Theaters,
Berezin that “neuropsychiatric cases Medical Department, United States Army in World War
II (Washington, D.C.: Office of the Surgeon General,
were a disgrace to the service, and he Department of the Army, 1973), p. 461. Definitive stud-
insisted that all cases should be court- ies of the psychiatric problems of combat, however,
were associated with the North African rather than the
Pacific theaters. Berezin contributed the material for
23
Interv, Gurjian, 20 Aug 43, p. 3, file 000.71, the section on Guadalcanal in the above-referenced
HUMEDS, RG 112, NARA. chapter.
JUNGLE WARFARE 127
or two days of rest, returned most of his the fight for Guadalcanal, disease,
cases to duty. The problems of evacua- despite continuing high rates among
tion from the island probably played a Americans, probably became more an
positive role in the next development. ally than an enemy, weakening the
Searching for some kind of positive defenders here as it had those on
therapy, he decided that his NPs could Bataan. Their own failings, however,
best be used to extend the dugouts that caused Americans to forfeit much of the
the hospital needed because of continu- advantage that an early program of
ing Japanese air attacks. Hence, the pre- malaria control might have brought
scribed remedy was an enigmatic “P&S,” them. Like the Japanese, Americans
meaning pick and shovel. Under the eye stood at the beginning of a long learn-
of hospital corpsmen, the NPs worked ing process in the waging of jungle war.26
out their convalescence, and the results
were satisfactory. “The combination of Papua
sedation, a few days of respite from com-
bat as such, the physical work, and the While South Pacific Area forces
sympathetic but dignified attitude of the planned and launched the Guadalcanal
hospital personnel enabled many of campaign, Japanese expansion on New
these soldiers to return to duty—some Guinea ignited a counteroffensive by
to full duty and others to limited duty in Southwest Pacific Area forces under
a rear echelon.” Reports from General MacArthur. The Japanese
Guadalcanal and other battlefronts con- hoped to capture Port Moresby, clearing
tributed to the Army’s decision in their flank for later attacks against Fiji
November 1943 to create the post of and New Caledonia. The Battle of the
division psychiatrist, which previously Coral Sea in May 1942 thwarted enemy
had not existed.25 plans for an amphibious attack on
The Japanese on Guadalcanal suf- Moresby. Instead, after seizing the north
fered the same diseases as the coast settlement of Buna in July ahead
Americans. Although the enemy had of the Allies, the Japanese launched
access to quinine—Japan had occupied their forces overland along the narrow
the Netherlands East Indies, the world’s Kokoda Trail through the Owen Stanley
chief supplier—he appeared to lack any Range.
systematic malaria control. Army histori- The struggle that followed imposed
an John Miller, jr., later wrote, “Among terrible burdens both on the troops who
the Japanese probably every man was a fought and on the medics who attempt-
victim.” As the Allies took control of the ed to preserve their lives in some of the
air and sea lanes, thus cutting off deliv- world’s most hostile terrain. New Guinea
ery of food supplies, the Japanese is, next to Greenland, the world’s largest
starved as well, and physical depletion island—over 300,000 square miles of
increased the incidence of disease. The dense jungles, reeking swamps, and tow-
few enemy prisoners captured revealed ering cloud-swathed mountains. In
evidence of nutritional diseases, includ- shape, it appropriately resembles a pre-
ing beriberi. During the last stages of historic creature, with the beaked head
25 26
Ibid., p. 462. Miller, Guadalcanal, p. 229.
128 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
of the Vogelkop Peninsula turned to the in the operation of Moresby and other
west and the tail of the Papuan New Guinea ports, directed the activities
Peninsula, scene of the fighting, extend- of U.S. service personnel in the area, and
ing to the southeast. For Army medics, supplied U.S. troops in the combat zone.
the climate was a nightmare. Many parts To consolidate U.S. and Australian supply
of Papua’s 90,540 square miles receive services in New Guinea, General
150 to 300 inches of rain a year, and 8 to Headquarters, SWPA, on 5 October
10 inches a day during the monsoon sea- established on Papua the Combined
son from November to March. The Operational Service Command.28
northern coastal areas, where the Allies’ By this time Port Moresby was on its
ultimate objective lay, consisted of dense way to becoming a major base, with new
jungle, marshy floodplain, and fields of roads, airfields, and harbor facilities. In
tall kunai grass, giving way at the edge of public health it resembled a frontier
the sea to a sandy coastal ridge dotted town. American and Australian units put
with palms. The heat of the lowlands up latrines along the beach, dumped
contrasted sharply with the cold of the their refuse into open pits, and burned
higher elevations in the Owen Stanleys. their garbage. The soldiers ate most of
Besides malaria, troops encountered their food from cans, discarding the con-
dengue, scrub typhus, dysentery, and tor- tainers. A plague of flies beset the town,
menting skin diseases that they and soon almost all troops passing
described as “jungle rot.”27 through Port Moresby could report expe-
Port Moresby, a small copra port on riences similar to those of the 4th
Papua’s south coast, was the key to supply Portable Surgical Hospital,29 which
and communications for the campaign. debarked in November. Seventy-five per-
Army engineers built airfields in north- cent of its personnel contracted diarrhea,
ern Australia and others in New Guinea “from which several . . . never completely
to defend it. In late August the recovered.” At first there was little malar-
Australians turned back a Japanese move ia, but the troops, by creating a multitude
down the coast, securing the Allied base of small water catchments exposed to
for the time being. Several weeks later, sunlight, provided perfect breeding spots
they halted the Japanese advance toward for the local anophelines.30
Port Moresby at Imita Ridge on the On 2 September Colonel Carroll, the
Kokoda Trail. Meanwhile, troops filtered USASOS chief surgeon, sent Col. Julius
in during June and July, including
Australian and American air, antiaircraft, 28
Milner, Papua, pp. 72–77, 87, 103.
engineer, and service units. On 11 August 29
Although not official until May 1943, the designation
1942 the USASOS created a base section, portable surgical hospital is used throughout this volume.
30
Rpt, Maj Neil W. Swinton, CO, 4th Port Hosp, to
called Advance Base, under Brig. Gen. Surg, 32d Inf Div, 12 Mar 43, sub: Criticism of Portable
Dwight F. Johns. The Advance Base aided Hospitals—Final Report, p. 2 (quotation), file 319.1;
OofSurg, Adv Base, New Guinea, Sanitary Rpt, Sep 42,
p. 1, file 721.5 SWPA (Adv Base D Monthly Reports)
27
Quoted words from Robert L. Eichelberger, in col- 1942–1943. Both in HUMEDS, RG 112, NARA. See also
laboration with Milton Mackaye, Our Jungle Road to D. Clayton James, The Years of MacArthur, 3 vols.
Tokyo (New York: Viking, 1950), p. 39. See also Samuel (Boston: Houghton Mifflin Co., 1970–85), 2:247, and
Milner, Victory in Papua, United States Army in World Alan S. Walker, The Island Campaigns, Australia in the
War II (Washington, D.C.: Office of the Chief of War of 1939–1945, Series 5, Medical (Canberra:
Military History, 1957), pp. 56–58. Australian War Memorial, 1957), pp. 15–37.
JUNGLE WARFARE 129
M. Blank, MC, with a small staff to portable hospital personnel for the com-
Moresby to set up the Office of the ing campaign. Carroll recommended a
Advance Base Surgeon at General training program that included setting
Johns’ headquarters. During the next up exercises, marching, climbing hills
few months Blank’s staff established a with loads, and surviving on reduced
supply depot in the Moresby area for rations. Meanwhile, Colonel Miehe,
stores coming in from Brisbane and with the assistance of his division sur-
Townsville; arranged for the delivery of geons, reorganized the medical units of
hospital units and equipment to the the 32d and 41st Infantry Divisions.
combat zone by aircraft, parachute, and Both divisions were triangular, and their
ship; investigated the available water three regiments, strengthened by addi-
supply; and selected sites around tional units, were intended to function
Moresby for three fixed hospitals and a separately as combat teams. Hence, the
medical laboratory. With the surgeons 107th Medical Battalion of the 32d
of the corps, the divisions, the Fifth Air Division and the 116th Medical
Force, and the Australian Army, Colonel Battalion of the 41st Division had to be
Blank worked on problems of hygiene, divided as well. Each regimental combat
sanitation, and malaria control. team (RCT) received a three-platoon
Unfortunately, no real medical plan- collecting company and a clearing com-
ning was possible. No malaria control pany platoon to provide organic sup-
units were available to accompany the port. Since the clearing company of the
troops. Hospitals arrived slowly; at the divisional medical battalion contained
end of November the total available to only two platoons, Miehe was obliged to
American forces in New Guinea were reduce the personnel and equipment of
one 200-bed facility near Port Moresby each in order to support all three RCTs.
and a 500-bed station hospital 17 miles Similarly, hospital corpsmen in the col-
away. As the I Corps surgeon, Col. lecting companies faced the backbreak-
William J. Miehe, MC, remarked, “The ing labor of littering the wounded
simultaneous movement of medical through jungles without respite. In an
installations and combat units was not attempt to prepare themselves, the med-
well coordinated.” When epidemics ical units supporting the regimental
began, inadequate bed strength com- combat teams trained vigorously, attend-
pelled an evacuation policy of only ed lectures by Australian instructors on
seven days and the hasty dispatch to jungle warfare, and participated in land-
Australia even of minor cases, depleting ing and field maneuvers with the units
the strength of the Army.31 they supported. But their time was limit-
Shortcomings notwithstanding, the ed. By October most were on their way
chief surgeon hoped to condition his to New Guinea.32
31 32
Surg, I Corps, Annual Rpt, 1942, pp. 1–24 (quota- Simon Warmenhoven, “Medical Department, 32d
tion, p. 15), file 319.1–2, HUMEDS, RG 112, NARA. See Division, Papuan Campaign,” pp. 22–23, file 370
also Blanche B. Armfield, Organization and (Papuan Campaign) SWPA; 163d Inf [Regt] Combat
Administration in World War II, Medical Department, Team Quarterly Rpt, Jan–Mar 43, p. 4, file 319.1. Both in
United States Army in World War II (Washington, D.C.: HUMEDS, RG 112, NARA. The terms regimental task force
Office of the Surgeon General, Department of the and infantry combat team were used interchangeably at the
Army, 1963), pp. 431–32, 442–43. time for the official designation regimental combat team.
130 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
der of the campaign, they carried the Soon a logistical and medical disaster
fever with them.35 threatened the American and Australian
The rest of the 126th and 128th forces. Reaching the front weary and
Regimental Combat Teams had arrived short of food and medical supplies, the
in the Buna area from the airfields or by troops lived on one-third rations, barely
shuttle boat during the first half of enough to sustain life, and hunger
October, and the Fifth Air Force flew in increased their susceptibility to disease.
the 32d Division’s third regimental com- Their feet were swollen; those who had
bat team, the 127th, direct from thrown away their shelter halves on the
Australia in November. The entire divi- march slept without protection from the
sion was now in place. The Japanese, dug heavy rains. Bad weather and Japanese
in along the sandy palm-dotted coastal air attacks launched from Rabaul dis-
ridge, waited in three highly fortified rupted supply by air and by sea. (Much
defense areas. Buna, a hamlet boasting of the horror of the campaign resulted
twelve houses, was the objective of the from the fact that in the beginning each
32d Division, while Gona, with its ten side proved strong enough to interdict
houses, and Sanananda Point were the the other’s supplies but not strong
goals of the Australian 7th Division.36 enough to protect its own.)
Between the forces of the two Allies Quinine, salt tablets, vitamin pills,
ran the Girua River, now at flood stage. and tablets for chlorinating water in the
Drier areas held coconut and rubber early days were hard to come by.
plantations and native gardens of taro, Dysentery, accompanied by bloody
yams, sugarcane, bananas, and bread- stools, high fever and prostration, afflict-
fruit. The troops had to cut their way ed almost all. The incidence of malaria
through the jungle, dense with under- steadily rose. Only victory could bring
growth and festooned with thorny vines. relief, but the attackers lacked tanks,
Thriving mangrove and sago choked the mortars, artillery, and flamethrowers,
swamps, now flooded to depths up to 7 and the Navy refused to risk its ships
feet. Roads were mere tracks, and rain- among the uncharted reefs offshore.
fall averaged 121 inches a year. The For a time the Japanese bunkers, built in
region was “literally a pesthole,” with the drier soil of the coast, appeared
endemic malaria, dengue, scrub typhus, invulnerable. Sick, hungry, and dispirit-
various forms of dysentery, and the usual ed, the Americans showed little stomach
array of tormenting skin diseases to add for fighting, and yet immobility might
to the misery of the troops.37 mean their destruction by disease.38
Angered by the lack of progress,
35
Quotation from E. J. Kahn, Jr., “The Terrible Days of General MacArthur ordered the I Corps
Co. E,” Saturday Evening Post, 8 Jan 44. See also Hanson
W. Baldwin, “Doughboy’s March—A High Point in War,” commander, Lt. Gen. Robert L.
New York Times, 7 May 44, and Lida Mayo, Bloody Buna Eichelberger, to Buna to revitalize the
(New York: Doubleday and Co., 1974), pp. 70–75. American effort. The appearance of the
36
Sanananda Point was quite swampy; here Japanese
bunkers had to be built aboveground. troops horrified him: “No one,” he
37
Milner, Papua, pp. 126–128 (quotation, p. 126); wrote, “could remember when he had
Mayo, Bloody Buna, p. 87; Rpt, Col George W. Rice, been dry. The feet, arms, bellies, chests,
Surg, GHQ, SWPA, 20 Nov 42, sub: Medical Estimate of
the New Guinea Situation (Buna Area), p. 2, file 705,
38
HUMEDS, RG 112, NARA. Milner, Papua, pp. 196–97; James, MacArthur, 2:241.
132 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Allied planners were turning their eyes to the combat teams. Warmenhoven
the Japanese forces further up the coast, reported that “53 percent of this group
at Lae and Salamaua.41 of soldiers were running a temperature
On 9 January Eichelberger relieved ranging between 99 degrees to 104.6
the 126th Regimental Combat Team, degrees. . . . In order of prevalence, the
which had been aiding the Australians cause of the rise in temperature is due
on the Sanananda front. Fourteen hun- to the following: Malaria, Exhaustive
dred strong when first committed to States, Gastro-Enteritis, Dengue Fever,
action in the third week of November, Acute Upper Respiratory Infection, and
the unit now numbered 165. Five days Typhus (scrub).” He noted that the divi-
later, in the 32d Division area, the I sion sick call rate was 24 percent and ris-
Corps commander greeted the weary ing. Some 2,952 soldiers suffering from
survivors “with band music and with disease and fever were already in the
what might well be described as a mar- hospital, and medics were evacuating 50
tial welcome. Actually it was whatever to 100 daily to Port Moresby because of
face could be put upon it, a melancholy illness. The fighting had ended for the
homecoming. Sickness, death, and moment, but many veterans would
wounds had taken an appalling toll. . . . carry the effects of the campaign
They were so ragged and so pitiful that throughout their lives.43
when I greeted them my eyes were wet.”
On the twenty-first the last remaining Medical Support
enemy, half-starved and disease-ridden,
gave up.42 Under the conditions of Papua, med-
On 10 January 1943 Maj. E. ical support was never more than a hold-
Mansfield Gunn, MC, a medical officer ing operation. Care in the combat zone
on General Eichelberger’s staff, wrote was limited to aid stations, collecting
to a friend: “Sickness of all sorts, partic- and clearing stations, eleven portable
ularly of the various tropical fevers is on surgical hospitals, and one field hospital
the increase also, so I expect that almost platoon. Medical officers and hospital
everyone in the division will come out corpsmen sought to keep the troops
of here either wounded or sick. I do not going, providing suppressive treatment
intend to paint a depressing picture, for malaria and first aid for skin dis-
but that is the truth as things stand eases, and they sought to treat the
today.” Immediately following the cam- wounded as far forward as possible,
paign, Lt. Col. Simon Warmenhoven, knowing well the slowness of evacuation
MC, the 32d Division surgeon, ordered and the dangers of infection.
his enlisted medics to take the tempera- Aiding the wounded entailed consid-
tures of 675 soldiers—a cross section of erable risk. On Papua the red cross gave
no protection. The 17th Portable
41
Surgical Hospital “never displayed the
Milner, Papua, p. 368.
42
Quotation from Eichelberger, Our Jungle Road, pp. Red Cross and our men never wore the
56–57. See also Milner, Papua, p. 334, and Mayo, Bloody arm brassard.” Hospitals were bombed
Buna, pp. 170–71. Some enemy forces were able to infil-
trate Allied lines and escape to the west bank of the
43
Kumusi River, where they reestablished contact with the As quoted, to include statistics, in Milner, Papua,
defenders of Lae and Salamaua. pp. 323–24. See also Mayo, Bloody Buna, pp. 180–88.
134 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
unmercifully, and medics were shot been developed for the portables,
while carrying litters, dressing wounds lighter than canvas but even more
on the field, or dragging casualties to prone to decay in the moist heat of New
aid stations. They learned that dressings Guinea—the hospital occupied a hol-
had to be dyed khaki or jungle green, low, shielded by tall black-rubber trees
because snipers took aim at white ban- and the luxuriant vegetation of the
dages. Even casualties tore off their ban- swamps. The surgeons worked exactly as
dages in order not to be an easy target.44 Carroll had intended (a rare occurrence
From the battalion aid stations, relay on Papua), providing emergency stabi-
teams carried the wounded 800 to 1,200 lizing treatment. They did not hold any
yards back over twisting trails to collect- soldier ill with fever or who could safely
ing stations and portable surgical hospi- travel to the rear, and gave those who
tals, often housed in shelters of leaves arrived after dark beds until morning.
cut from the jungle, where they received All day and night bullets struck the trees
additional treatment. Casualties were and perforated the tops of the tents; the
sorted; ideally, those needing immediate fact that the Japanese had little artillery
surgery went to the portables, while made the position tenable. Yet during a
those not so seriously wounded or too ill single week—its first on the line—the
to remain near the front were sent to tiny hospital performed sixty-seven
clearing stations, usually 2 miles farther major surgical procedures, including
to the rear. Though Carroll had intend- amputations, resections of the bowel,
ed portables to be divisional units, in and serious chest operations.45
this campaign they were attached to the Besides the skill and courage of its
regimental combat teams and worked in staff, the 3d Portable Surgical Hospital’s
the regimental areas. success depended on the sulfa drugs to
Hard labor and danger were the lot of prevent infection and on the extraordi-
the staffs. The four officers and twenty- nary toughness of the human frame,
five enlisted men of the 3d Portable able in many cases to survive fatigue,
Surgical Hospital, after flying from Port hunger, sickness, wounds, and the trau-
Moresby into Dobodura, carried their ma of surgery. The surgeons hoped for
1,250 pounds of equipment in pack the death of one young man who had
frames to the front near Buna. Here lost the left side of his face to shrapnel—
they set up close to the regimental col- nothing remained, recorded their com-
lecting station, forward of the command mander, but “one big hole.” But the sol-
post and only about 300 yards from the dier had “an uneventful convalescence”
Japanese. Sheltered by tents—probably and was evacuated, hideously disfigured
the mercerized cotton tents that had but alive.46
The portables played many roles on
44
Quotation from 17th Port Surg Hosp Quarterly Papua. To Miehe, Carroll made a plea
Rpt, Jan–Mar 43, p. 6, file 319.1. See also
Warmenhoven, “Medical Department, 32d Division,”
45
pp. 4, 7, file 370 (Papuan Campaign) SWPA. Both in Warmenhoven, “Medical Department, 32d
HUMEDS, RG 112, NARA. Pvt. Hymie Y. Epstein on the Division,” pp. 1–9, 23, 24, file 370 (Papuan Campaign)
Sanananda Track and T. Sgt. Edwin C. DeRosier in SWPA, HUMEDS, RG 112, NARA.
46
front of Buna, killed while retrieving the wounded, 3d Port Surg Hosp Historical Rpt, Sep–Dec 42, p. 6,
were awarded the Distinguished Service Cross posthu- bound in “Histories, Portable Surgical Hospitals in WW
mously. See Milner, Papua, pp. 165, 175. II,” HUMEDS, RG 112, NARA.
JUNGLE WARFARE 135
for their proper use as surgical hospitals, did frontline surgery beside the collect-
endorsing a proposal of Colonel Rice, ing station of the 128th Regimental
soon adopted, to rename them portable Combat Team. Fever victims and the
surgical hospitals to emphasize their slightly wounded were sent back to the
main purpose. But as the number of 14th Portable Surgical Hospital, a mile
wounded increased—and especially, as a to the rear, while the 18th and 22d
tide of sick mounted—regimental sur- Portable Surgical Hospitals formed an
geons, desperately short of beds and fac- evacuation point from which casualties
ing great difficulties in evacuating were dispatched either by boat down the
through jungle and swamps, began to coast to Pongani or by native litter-bear-
exploit the portables as supplementary ers or jeep ambulances up the trail to
aid stations or as holding wards for Dobodura. The 19th Portable Surgical
malaria cases. Surgeons, trained for a Hospital, operating in the Australian
specific task involving specialized skills, sector, served as both a surgical hospital
found themselves giving first aid and and a small evacuation facility. In all
providing for the care and evacuation of ways, said Colonel Warmenhoven, the
the sick. 32d Division surgeon, the portables
Then, as engineers built usable roads, “proved to be of tremendous value to
the basic logic of the portable was the medical service given the division. It
upended. Medics scrounged for tent- would be hard to give an exact estimate
age, often heavy canvas, and equipment of the number of lives that were defi-
that was both unauthorized and non- nitely saved by their emergency surgery
portable; they acquired vehicles to move and heroic work performed near the
their patients to the airstrips, especially front lines. They have proven that they
the invaluable jeep ambulances, have a definite place with combat troops
equipped with brackets to hold litters. in this type of warfare.” The portables
Unable to move their possessions, with reported a mortality rate of 3.6 percent
beds full of malaria cases, sometimes in their patients, equal to many hospi-
housed in huts of grass or palms, many tals that were more elaborately staffed
portables ended the Buna campaign and more safely situated. Signifying
looking like anything but the units their success was the reluctance of the
Carroll had designed for frontline units they served to part with them.
surgery. Yet much surgery continued to Early in March 1943 the portables were
be done in them. Orthodox or not, they temporarily removed from the USASOS
gained universal praise.47 and assigned to the field forces.48
In fact, versatility was their prime Success was gained at the cost of
virtue in a campaign so hastily organized much suffering. In part, the portables’
and so poor in resources. In one of the
many small forward chains of evacua- 48
Warmenhoven, “Medical Department, 32d
tion, the 23d Portable Surgical Hospital Division,” p. 27 (quotation), file 370 (Papuan
Campaign) SWPA, and the Port Surg Hosp Annual
Rpts, 1942, file 319.1–2, for the 14th, p. 2; 18th, p. 3;
19th, p. 4; 22d, pp. 4–6; and 23d, pp. 2–3. All in
47
Ltr, Col Percy J. Carroll, CSurg, USASOS, SWPA, to HUMEDS, RG 112, NARA. See also Augustus
Col William J. Miehe, Surg, I Corps, 21 Dec 42, p. 1, file Thorndike, “Surgical Experiences With the Wounded
322 Correspondence re: Portable Surgical Hospitals of the Buna Campaign,” New England Journal of Medicine
(SWPA) 1942, HUMEDS, RG 112, NARA. 231 (1944): 649–51.
136 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
problems reflected New Guinea condi- worked, the 23d Portable Surgical
tions. Estimates that soldiers could Hospital was unable to get supplies
carry sixty to seventy pounds of equip- from either regiment or division, and
ment proved quite unrealistic on fed itself and its patients by foraging. Its
Papua, where native carriers by law commander complained that his subor-
could not be burdened with more than dinates needed contact with a chain of
forty pounds. Complaints of exhaustion supply; that they needed rest and relief
and reports of portables discarding periods as much as other troops; and
equipment on the trail caused new that they needed native carriers to move
efforts to lighten their authorized their gear, if key technicians were not to
equipment still further. Other difficul- arrive at each new location too exhaust-
ties stemmed from the fact that no one ed to do their work. Miehe, as the I
seemed sure of what equipment Corps surgeon, urged that all mobile
belonged to whom. Working at the hospitals should come under the field
front line under fire, with antiaircraft forces; however, Carroll strenuously
and mortar fragments falling into the opposed the idea and, using his short-
operating room as the surgeons lived position as USAFFE chief surgeon,
JUNGLE WARFARE 137
paramount in New Guinea, and no disease, were put off limits. Experts locat-
effective response took shape until ed and mapped mosquito breeding
after the Buna campaign was over. areas, and they turned the information
General Eichelberger considered the over to unit commanders, who were
health conditions at Buna a command assigned the responsibility for control
and training failure, and Chief of Staff measures. Parasitologists with the survey
General Marshall noted the prevalence units took blood smears from the troops
of disease, reporting that “priorities for on suppressive Atabrine to determine
munitions overrode those for the nec- the minimum effective dosage, not only
essary [mosquito] screening and other to save supplies of the drug but also to
materiel to provide protection at the minimize its toxic side effects.
bases, also there has not been suffi- By then, such work was all the more
ciently rigid sanitary discipline as to the essential because the engineers had
individual soldier.”52 extended their efforts, clearing jungle,
The whole theater, from the Supreme letting in sunlight, and spreading the
Commander down, had to become transient pools of water in which the
involved in the fight against malaria. It local vectors preferred to breed. Indeed,
did so in 1943. In April Carroll was able the 32d Division’s disease rate for all
to announce the appointment of a fevers—malaria, dengue, and of unde-
Public Health Service officer, Col. termined origin—peaked in February,
Howard F. Smith, MC, as theater malari- when the battle was over, at 5,358 per
ologist. MacArthur had already estab- 1,000 troops per year. Carroll, backed by
lished the Combined Advisory his commanders, launched a program
Committee on Tropical Medicine, for training unit anti-malaria details
Hygiene, and Sanitation. In turn, the before their outfits departed to fight in
committee estimated the amounts of malarious areas. He wanted to see many
antimalarial drugs needed by the theater more American enlisted men supple-
and used its direct access to MacArthur ment the few then attending an anti-
to ensure top shipping priority for drugs, malaria school established by the
equipment, and supplies. The north Australian Army at Port Moresby, and
coast of New Guinea, from Dobodura to malaria survey units to accompany or
Oro Bay, was divided into sections, and immediately follow the battalion combat
malariologists and survey units, now teams that had begun leapfrogging up
arriving from the United States, were the New Guinea coastline. The 41st
assigned to each. Native villages, poten- Division, replacing the hard-hit 32d,
tial sources both of malaria and venereal adopted a policy of treating uncompli-
cated cases as far forward as possible
52
Ibid.; Ltr, Brig Gen Charles C. Hillman, OSG, ASF, and returning them to duty.53
WD, to SG, U.S. Army, 12 Jul 43, sub: Report of For a time, such measures appeared
Observations of Medical Service in Southwest Pacific to succeed. But when fighting began
and South Pacific Areas, pp. 2–4, file 333 (Hillman)
1943; Surg, I Corps, Quarterly Rpt, Jan–Mar 43, p. 5, again, the malaria rate rose once more;
file 319.1. All in HUMEDS, RG 112, NARA. Quotation
as cited in Armfield, Organization and Administration, p.
53
442. See also Jay Luvaas, ed., Dear Miss Em: General Warmenhoven, “Medical Department, 32d
Eichelberger’s War in the Pacific, 1942–1945 (Westport, Division,” p. 10, file 370 (Papuan Campaign) SWPA,
Conn.: Greenwood Press, 1972), p. 39. HUMEDS, RG 112, NARA.
JUNGLE WARFARE 139
in the summer of 1943 “medical casual- The Buna campaign was Southwest
ties which lead to evacuation from the Pacific Area’s own school, in which
forward areas . . . outnumbered surgical General Headquarters learned the
casualties by 7 to 10 fold,” and as usual power of malaria and began to adopt
the prime cause of disease was malaria. measures in hopes of combating it. Why
As Carroll prepared to leave the theater a new lesson was needed, after Bataan, is
in December 1943, he admitted that still far from clear, but the improvised
losses to malaria still ran too high— nature of the campaign, the lack of
about 5,000 soldiers a month were then resources, and the divided medical
falling ill (see Table 3). He ended his tour establishment were contributory factors.
as chief surgeon with the plea that “the What a strong chief surgeon with direct
malaria control problem be given more access to the commander-in-chief might
consideration by all commanders from have accomplished must remain prob-
the top down.”54 lematical. As matters actually went, the
Allies were fortunate that the enemy,
54
Ibid., pp. 9–10, file 370 (Papuan Campaign) SWPA;
Comments and Recommendations, Medical Ltr, Brig Gen Percy J. Carroll, CSurg, USASOS, SWPA,
Department, USAFFE, p. 2 (first quotation), attached to CG, USASOS, SWPA, 8 Dec 43, sub: Medical Service
to Exh. 1 of Ltr, Brig Gen Hugh J. Morgan, OofCSurg, in the Southwest Pacific Area, p. 6 (second quotation),
USAFFE, to Brig Gen Percy J. Carroll, CSurg, USAFFE, file 333 (Carroll) 1943. All in HUMEDS, RG 112,
12 Aug 43, file 333 (Brig Gen Hugh J. Morgan) SWPA; NARA.
140 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
here as on Guadalcanal, was also unable al disease ceased to matter for the dura-
to control the disease. At least both sides tion of the campaign.55
suffered more or less equally, and by the Scrub typhus, a disease related to epi-
end of the campaign the Japanese had demic louse-borne typhus, was spread by
entirely lost the power to supply either chiggers, the larvae of trombiculid mites
medicine or food to their remaining that lived in a variety of locations but
troops. especially favored the four- to seven-foot
Other diseases meant less than malar- stands of knife-edged kunai grass that
ia in military terms, though all were dis- spotted the landscape. Fortunately, the
tressing and at least one was far more disease spread only from mite to man
deadly. Infectious hepatitis, dengue, and not from man to man, and conse-
and respiratory infections occurred. quently never became epidemic. Yet the
Sanitation was impossible and diarrhea mortality caused by scrub typhus (as
common, though Miehe recorded that high as 30 percent of those infected)
newly introduced tablets for chlorinat- made it important. Clearing vegetation
ing water “are working out excellently.” likely to harbor the mites and using
Skin diseases were persistent and some- insect repellants were about the only
times disabling. Caused by a variety of measures available; no means of immu-
agents, including bacteria, fungi, and nization existed, and treatment meant,
yeasts, such afflictions increased in pro- in essence, careful nursing of the
portion to the amount of clothing patient through a dangerous period of
worn, because clothing prevented evap- very high fever, often accompanied by
oration of sweat and kept the skin vivid hallucinations. Hence, a visiting
damp. Yet, without long trousers and consultant recommended to Surgeon
shirts, the troops were more susceptible General Kirk that “one or more medical
to insect bites and insect-carried dis- officers with suitable laboratory assis-
eases, as well as abrasions that quickly tants, qualified in the study of rickettsial
became infected. One group of diseases infections, should be assigned to a labo-
was not a problem on Papua. Whether
because of exhaustion, Atabrine, or the 55
Surg, I Corps, Annual Rpt, 1942, p. 22, file 319.1–2,
appearance of the local women, venere- HUMEDS, RG 112, NARA.
JUNGLE WARFARE 141
way to avoid increasing shock. Along the Moresby became the standard route of
coast, medics turned to boats to evacu- evacuation.58
ate casualties, sometimes taking them all On 24 November the 2d Platoon, 2d
the way to Milne Bay at the tip of the Field Hospital, flew in to Dobodura and
Papuan Peninsula, an increasingly began operating a hospital of 150–200
important base despite the fact that it beds in a large flat area close to the
was “one of the most unhealthy malarial airstrip. With the 2d and 9th Portable
spots in the world.” Some of the sick and Surgical Hospitals, the platoon soon
wounded traveled to offshore luggers on
native double canoes, the platform 58
107th Med Bn Quarterly Rpt, Jan–Mar 43, Co C, p.
between the two hulls accommodating 2 (first quotation), file 319.1; Surg, Fall River Sub-base
ten litters. But as airstrips opened, the [Milne Bay], Monthly Rpt, 12 Dec 42, p. 2 (second quo-
tedious voyage down the coast was large- tation), file 319.1 (HQ USASOS Fall River Monthly
Reports) Oct 42–Dec 43; 18th Port Surg Hosp Annual
ly abandoned, and the quick flight over Rpt, 1942, pp. 3–4, file 319.1–2. All in HUMEDS, RG
the passes of the Owen Stanleys to Port 112, NARA.
JUNGLE WARFARE 143
formed the main combat evacuation sta- up on the main trail leading to the
tion for the Buna front (see Map 6). point. In January 1943, as the Japanese
Army engineers carved roads through defense fell apart, medical units
the bush, and by the third week of attached to the 163d Regimental
December collecting stations and Combat Team, which was built around
portable surgical hospitals operating on the 163d Infantry, 41st Division, evacuat-
the coast had moved to the Dobodura ed the sick and wounded by litter to
trail. Casualties leaving the combat zone three portable surgical hospitals strung
by air soon numbered on average over out in a line extending north from
100 a day. Soputa. Casualties might go through all
Here, as at the front, the war spared no three, bypass one or another, or go
one. In the Philippines the Japanese had directly to an airfield for transport out
generally respected hospitals, but on of the combat zone.60
Papua they attacked deliberately and C–47 transports, after ferrying troops
often. The 2d Field Hospital platoon was and supplies in, returned to Port
repeatedly struck; on 7 December Moresby filled with either 6 or 9 litters
Japanese planes strafed and bombed in or 15 to 25 walking wounded. Incoming
the morning, and in the afternoon eigh- planes signaled to the ambulances at
teen bombers, shielded by Zeros, their destination by displaying a white
returned to rain demolition and antiper- flag for ambulatory and a red for litter
sonnel bombs. Many ambulatory casual- patients. The quick removal of casualties
ties fled back to their units for safety, and from the combat zone—often soldiers
the unit commander, Maj. Lemuel C. wounded in the morning were in hospi-
Day, MC, later died of a heart attack, tal beds in the afternoon—improved
brought on by the labor of moving the troop morale, relieved the straining of
hospital under deep forest cover. In forward area hospitals, and reduced the
“heavy jungle . . . damp, dark, muddy, and need for carrying medical supplies for-
mosquito ridden,” the medics like their ward. During the Buna campaign the
patients soon fell victims to malaria.59 old question of military medicine—is it
On the Sanananda front, collecting better to bring medical treatment to the
platoons supporting the 126th wounded or the wounded to medical
Regimental Combat Team evacuated treatment?—was answered, despite the
casualties to combined collecting and portables, on balance by evacuation. In
clearing stations, and thence to the December 1942 planes carried some
portable surgical hospitals that had set 3,300 American and 4,300 Australians
on the 90-mile, 45-minute flight to
59
Ward’s Drome near Port Moresby. Over
2d Field Hosp Quarterly Rpt, Jan–Mar 43, p. 2
(quotation), file 319.1, and Annual Rpt, 1942, pp. 4–6, the course of seventy days of fighting,
file 319.1–2, HUMEDS, RG 112, NARA. The hospital’s about 13,000 American and Australian
other platoons were operating at Base Section 2, in casualties followed the same route, sav-
Australia, and at Milne Bay; see Warmenhoven,
“Medical Department, 32d Division,” pp. 3, 7, 8–22, file
370 (Papuan Campaign) SWPA. West of the Girua,
60
evacuation was primarily from the Australian airstrip at 163d Inf [Regt] Combat Team Quarterly Rpt,
Popondetta; see 163d Inf [Regt] Combat Team Jan–Mar 43, pp. 1–14, file 319.1, HUMEDS, RG 112,
Quarterly Rpt, Jan–Mar 43, p. 12, file 319.1. Both in NARA. The 163d had replaced the 126th Regimental
HUMEDS, RG 112, NARA. Combat Team earlier in the month.
144 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
NEW ON
HOSPITALS BRITAIN
PAPUA
November 1942–January 1943
Huon Arawe
Airfield
Peninsula
Finschhafen ELEVATION IN FEET
Lae
0 3000 6000 9000 and Above
Huon Gulf
0 150
N Salamaua
NE ORT Wau Miles
W HE
G A
PA UIN ST
PU EA
A S O L O M O N
S E A
5th and 19th Portable Surgical Hospitals
O
Gona Buna
2d Platoon, 2d Field Hospital Kiriwina I
E
Dobodura
Embogo 22d, 14th, and 18th Portable Surgical Hospitals
Kokoda Wairopi Bofu
Pongani Tufi
T
S
Ioribaiwa Goodenough I
Port A Jaure
Wanigela Collingwood
Moresby N
L Bay
E
Y Fasari
153d and 171st Station Hospitals Kapa Kapa
10th Evacuation Hospital RA
NG
E
Abau
Milne Bay
MAP 6
ing many a life that would otherwise The first two months of U.S. troop
have been lost on the interminable jun- operations showed that the fixed hospi-
gle trails or during the long, dangerous tal facilities around Port Moresby were
voyages along the coast.61 inadequate to meet the need. By the
end of November, when American
61
Rpt, Capt M. M. Steinberg, 7 Mar 43, sub: wounded and fever casualties began
Evacuation of Patients by Air, pp. 1–2, file 314.7–2 arriving in increasing numbers, hospital
(Evacuation); 5th Air Force Annual Rpt, 1942, pp. 7–8,
file 319.1–2; Surg, I Corps, Quarterly Rpt, Jan–Mar 43, facilities around the Advance Base head-
p. 7, file 319.1. All in HUMEDS, RG 112, NARA. quarters consisted only of the 500-bed
JUNGLE WARFARE 145
153d Station Hospital and a 200-bed Guinea to remain low. After treatment,
mission hospital operated by a provi- those who were expected to be unfit for
sional battalion of the 135th Medical duty more than fourteen days were sent
Regiment. At Colonel Miehe’s request, on to mainland Australia, usually to
the 10th Evacuation Hospital (750 beds) Townsville or Brisbane. Returning trans-
and the 171st Station Hospital (500 port planes, bombers, an Australian hos-
beds) arrived at Moresby in December. pital ship, and two sea ambulance trans-
In a period of three weeks the bed ports took part in the lift. Since planes
capacity of hospitals on the south shore flew the 680 miles to Townsville in less
of New Guinea expanded to approxi- than five hours and a ship took two days,
mately 2,428. From 21 November 1942 doctors here, as on Guadalcanal, pre-
to 29 January 1943 the hospital units in ferred air evacuation. For the three
the Port Moresby area cared for over months from November 1942 through
10,000 casualties, nearly 6,000 from the January 1943, 3,405 casualties left New
32d Division alone.62 Guinea by air, only 935 by sea.64
Living conditions remained poor. In Necessary as it was, evacuation
January an inspecting officer found that removed substantial numbers of fight-
the hospitals were operating in the deep ing men from New Guinea as a whole, as
mud of the rainy season and that nurses well as from the fighting zone on the
quarters were “very, very poor” and the north shore. If all evacuees had been
staffs overworked. Makeshifts of inade- severely injured, their departure would
quate equipment were ingeniously con- have been essential both to their own
trived; fuse boxes served as containers well-being and to the needs of the
for sterile dressings and metal ammuni- Advance Base, which could not hope to
tion-box liners for operating room sinks. maintain facilities for definitive care
Work performed at the 10th Evacuation equal to those of the Australian hospi-
Hospital was limited to additional tals. But such was not the case. Miehe
debridement of wounds, putting casts on complained that hospitals in Australia
fractures, and occasional amputations received many quite trivial cases.
where signs of gangrene had appeared. Indicating the same problem was the
As its name implied, the unit served pri- theater’s neuropsychiatric evacuation
marily to ready casualties for evacuation, rate.65
not to return them to the battle, and the Like the marines and soldiers on
lack of a convalescent center and a Guadalcanal, fighting men on Papua
replacement depot ensured that few faced the danger of violent death in a
would find their way back to the north
coast before the campaign was over.63 64
Air Evacuation Board, SWPA, “Medical Support of
The pressure of the malaria epidemic Air Warfare,” Report No. 35, sec. 1, vol. 2, pt. 2, p. 483,
caused the evacuation policy for New file 314.7–2 (Army Air Forces—Medical Services) SPA,
SWPA, HUMEDS, RG 112, NARA.
65
Surg, I Corps, Annual Rpt, 1942, p. 19, file 319.1–2,
62
Surg, I Corps, Annual Rpt, 1942, p. 15, file 319.1–2, HUMEDS, RG 112, NARA. A thirty-day evacuation pol-
HUMEDS, RG 112, NARA. icy was inaugurated in December 1942. The transfer of
63
Rpt, Libasci, n.d., p. 1 (quoted words), file 333.1 the 1st Marine Division from Guadalcanal to the
(Trip to New Guinea) SWPA; 10th Evac Hosp Annual Southwest Pacific Area brought thousands of new
Rpt, 1942, p. 8, The Historical Unit (THU) Note Cards, malaria cases, thus complicating the situation in
Historians files. Both in HUMEDS, RG 112, NARA. Australia.
146 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
escape from danger, and therefore exag- where boats forwarded materiel up the
gerated their symptoms. By the time coast to Buna. The 2d Platoon, 2d Field
they reached the general hospitals in Hospital, at Dobodura was not only the
Australia most were, for all military pur- main evacuation unit but the issue
poses, ruined men. Often their journey point for medical supplies as well.
did not stop there. During 1943 almost Where no airfields existed, supplies
40 percent of evacuations out of theater were dropped by parachute. Jeeps,
were listed as “mental” and over 10 per- native porters—indeed, any available
cent as psychotics, meaning, in the par- transport—carried them to the front
lance of the time, that they had severe from the airstrips, the beaches, and the
and tenacious symptoms.67 coastal inlets. Early in the campaign,
The same year brought the beginning supply was disrupted by shipping
of a determined effort by Carroll and his uncertainties in Australia, enemy air
psychiatric consultant to reverse these attacks on ship convoys, bad weather,
extraordinary figures by educating med- and lack of land transport.
ical officers to substitute a diagnosis of Widespread, though temporary, short-
exhaustion for that of mental illness and ages of tents, litters, cots, rations, and
by providing small treatment centers quinine resulted. Litters remained a
close to the line. But, as with malaria, problem, accumulating at Moresby,
reform came later. The Buna campaign where they were not needed, and dis-
created the problem, and ended with it appearing with the wounded from
still unsolved.68 Buna, where they were.
But by mid-December more luggers
Supply had become available for coastwise ship-
ment, while the construction of addi-
Medical supply was one of the tional airfields on coconut plantations
brighter spots of the campaign, despite permitted expansion of the airlift.
the fact that it remained a rough and Though supply remained tenuous, sus-
ready affair. Any available ship carried tained by expedients, the efficiency of
materiel from Australia to New Guinea. Major Libasci’s section in forwarding
The 9th Medical Supply Depot at Port materiel from Australia, as well as the tri-
Moresby stored and distributed sup- umph of the Allies on the sea and in the
plies via C–47 transports that flew over air, enabled the system to improve
the Owen Stanleys or to Milne Bay, steadily to the end of the campaign.69
The Papuan campaign gave the Allies
67
Interv, Col S. Alan Challman, 13 Sep 45, file 000.71, their first land victory in the war against
HUMEDS, RG 112, NARA. Japan. But because their soldiers were
68
Memo, Col William L. Wilson to Ex Off, [OSG], 1
Nov 43, sub: Visit to Southwest Pacific Area, p. 10, file
333 (Visit of [Col Wilson] to SWPA) 1943, which sug-
69
gests that many NPs were actually retarded men who Charles M. Wiltse, Medical Supply in World War I,
should not have been overseas in the first place. For an Medical Department, United States Army in World War
interesting and detailed account by Carroll’s neuropsy- II (Washington, D.C.: Office of the Surgeon General,
chiatric consultant, see Rpt, Challman, 5 Mar 43, file Department of the Army, 1968), pp. 417–18, 438;
333 SWPA (Trip by Challman) 1943. Both in HUMEDS, Warmenhoven, “Medical Department, 32d Division,”
RG 112, NARA. See also Lindsay E. Beaton and M. pp. 14, 25, file 370 (Papuan Campaign) SWPA,
Ralph Kaufman, “As We Remember It,” in Glass, ed., HUMEDS, RG 112, NARA; James, MacArthur, 2:231,
Overseas Theaters, pp. 748–49. 234; Eichelberger, Our Jungle Road, pp. 34–35, 39.
148 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
UNIT DISPENSARY AT NOME, consisting of two Yakutat huts placed end to end
of only 75,000, was too sparsely settled widespread problem was common respi-
for acute sanitary or venereal disease ratory infection, which reached its high-
problems to develop. For most of the est rate (249.5 per 1,000 troops per
soldiers who served there, access to annum) in 1942 and thereafter fell
women was limited. Yet the 32,000 rapidly as a result of increased experi-
native Indians, Aleuts, and Eskimos, by ence, better clothing, and the construc-
reason of their isolation, were highly tion of weathertight cantonments. Even
susceptible to the white man’s diseases in this respect, Alaska was not much
and readily fell victims to common worse off than the United States; troops
childhood diseases, such as measles and stationed in the department largely
whooping cough, and to tuberculosis as escaped a national epidemic of respira-
well. Among some tribes, local customs tory diseases in the winter of 1943–44,
permitted casual sex and, through con- except for fliers who picked up infec-
tact with infected outsiders, many tions in the zone of interior and, on their
women had acquired venereal disease return, became sources of disease
(VD); amazing some soldiers, they not among the Alaska garrison. As in other
only asked no money for sexual favors theaters, troops in the department suf-
but also gave their lovers ivory trinkets fered from the hepatitis epidemic of
and other keepsakes when they parted. 1942, caused by contaminated yellow
Army medics provided treatment for fever vaccine. But the 2,749 cases of 1942
civilians as well as soldiers and, to ensure fell to 37 in 1943, and by the end of the
that VD did not become a problem for war the disease had almost disappeared.
the command, pursued an active pro- Some sanitary problems were encoun-
gram of prevention among the troops by tered, especially when the new posts
physical inspections and propaganda were under construction. Especially in
films, posters, and lectures. Prophylactic the tundra, the high Alaskan water table
stations and individual kits were both posed some difficulties in waste disposal,
made available. The result of all these and may have helped to account for a
factors was an extraordinarily low inci- fairly high level of diarrheal diseases
dence of VD throughout the war, never during 1942–43. Clothing was a matter
exceeding 8.3 per 1,000 troops per year. of intense medical interest under
Outbreaks of other diseases, either Alaskan conditions, and medical officers
among new soldiers on post or among worked with Quartermaster Corps rep-
civilians in remote villages, were con- resentatives to devise protective gear.
tained by distance and never posed the Experts from both branches were fre-
threat of a serious epidemic outbreak. quent visitors to Alaska, and an experi-
Overall, the Alaskan Department mental board was set up by the Alaska
enjoyed excellent health. The cold cli- Defense Command to study all aspects
mate proved on balance to be more a of cold weather operations.
blessing than a curse. Gnats and mosqui- The most notable medical feature of
toes were abundant in summertime but service in Alaska was a paradox. Soldiers
were mere pests, spreading no infec- were healthier than in any other over-
tions; brown rats swarmed in some areas, seas theater, and in some respects
but typical rat-borne diseases were healthier than in the United States, and
absent. As might be expected, the most yet their isolation and perhaps their lack
ALASKA: THE PYRRHIC VICTORY 153
of a significant role in the war caused and dental technicians were not easy to
them to believe, and report to the obtain. Personnel shortages throughout
medics, that their health deteriorated in 1942 paralleled other Alaskan shortages,
Alaska.6 notably in housing and equipment. As
If disease was rare, the problems of in all combat theaters, troops of the
providing medical support for the combat arms built up more rapidly than
troops and evacuating the few who support troops, and in consequence
became ill were severe. Alaskan geogra- Moore was unable to reach his goal of
phy dictated defense by scattered gar- medical self-sufficiency at each Alaskan
risons, rather than by concentrations of station.7
mobile reserves. Medical support was The workings of the personnel system
necessarily dispersed as well. The rapid did little to relieve his difficulties.
opening of twenty-one posts and the Medical personnel were requisitioned by
increase in Army forces to 94,000— grade and number through the Western
more than the civilian population of Defense Command under procedures
Alaska—made the first thirteen months that proved to be inflexible and slow.
of the war a difficult time at best, and Enlisted men were sometimes trans-
distance and unit fragmentation made ferred from other types of units in Alaska,
the difficulties worse. Typically, the med- but, as usual, commanders seized the
ical detachment supporting the 4th opportunity to reassign those of poor
Infantry was divided into battalion med- quality. In December 1941 all the Alaskan
ical sections, one remaining with the stations together provided only 744
regimental headquarters and the 1st medics (128 officers and 616 enlisted
Battalion at Adak Island, another men) to support 23,800 soldiers and air-
accompanying the 2d Battalion to men. Five months later, however, on the
Nome, and a third following the 3d eve of the Japanese attack, 2,089 medics
Battalion to Fort Richardson. (211 officers and 1,878 enlisted men)
Even this degree of dispersion caused supported 51,000 troops—46 per 1,000,
some problems, among them the ques- or slightly below the 5-percent ratio that
tion of how the regiment’s two dentists Army doctrine held to be adequate.8
were to be divided among three sec- Equally strained during the days of the
tions. But there were worse cases. Some buildup was the hospital system. The
units were not so much divided as disin- Alaskan environment and the military sit-
tegrated. The 138th Infantry, for exam- uation, by tying troops to their scattered
ple, served simultaneously in eight posts
from Juneau to Atka, a distance of 2,000
7
miles! To function properly, medical CSurg, Alaska Def Cmd, Annual Rpt, 1943, p. 1, 4–5,
file 319.1–2; McNeil, “Medical Department in Alaska,”
sections needed additional personnel pp. 67, 96–98, file 314.7–2 (Medical Activities) Alaska.
and equipment, but X-ray and laborato- Both in HUMEDS, RG 112, NARA. See also Clarence
ry technicians, pharmacists, anesthetists, McKittrick Smith, The Medical Department:
Hospitalization and Evacuation, Zone of Interior, United
States Army in World War II (Washington, D.C.: Office
6
CSurg, Alaska Def Cmd, Annual Rpts, 1942, pp. 5–7, of the Chief of Military History, Department of the
12–14, and 1943, pp. 6–7, file 319.1–2; McNeil, Army, 1956), p. 142.
8
“Medical Department in Alaska,” pp. 289–92, file Strength of the Army, 1941, 1942; McNeil, “Medical
314.7–2 (Medical Activities) Alaska. All in HUMEDS, Department in Alaska,” p. 80, file 314.7–2 (Medical
RG 112, NARA. Activities) Alaska, HUMEDS, RG 112, NARA.
154 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
stations, precluded large centralized hos- that the strength of support forces
pitals. Hence, as each post opened in lagged during a buildup continued to
turn, Moore established an unnumbered hold true. By that time, the increased
station hospital with a bed capacity equal strength of the command meant that
to 5 percent of the post’s planned 4,600 beds were now authorized. In
strength. General, evacuation, surgical, terms of formal requirements, the
and convalescent hospitals were never medics had actually lost a little ground.9
sent to Alaska. By the end of 1940 Moore Hence, familiar problems continued.
had a long-established 25-bed hospital at In remote areas small troop units were
Chilkoot Barracks, plus new 100-bed fragmented beyond the capacity of
facilities at Annette Island, Yakutat, and organic medical units to support them.
Ladd airfields, and a new 600-bed hospi- The station hospitals had to come to the
tal at Fort Richardson, and one year later rescue. On the island of Adak, for exam-
five station hospitals at Sitka, Kodiak, ple, many small groups of soldiers were
Dutch Harbor, Seward, and Nome. By 31 entirely without medical care, obliging
May 1942 he had added 50-bed hospitals hospital personnel to organize dispen-
at Juneau and Cordova; a 100-bed facility saries and to staff them themselves.
at Naknek; and larger station hospitals, Scattered posts and Alaskan weather
each with a potential bed capacity of 500, combined to put heavy burdens on evac-
at Cold Bay and on Umnak Island (see uation as well. To move casualties
Map 7). Upon these facilities fell the bur- between stations in Alaska, medics used
den of caring not only for soldiers and water, rail, and air. Of these, air was by
airmen but also for some sailors, for far the best—a quick, flexible mode of
Allied servicemen including both transport that exploited the many new
Canadians and Russians, for civilians airfields and gave the sick and injured an
unable to find care in understaffed hos- easy ride. Roads tended to be few, long,
pitals off post, and for Alaskan natives in and poor, and water transport slow and
need of emergency help. hard to schedule. Evacuation by rail was
In September numbered station hos- only possible between points on the
pitals were assigned to Alaska, and the Alaska Railroad. In 1941 a few patients
period of most intense shortage was had been carried by air in bombers, but
over. Problems of personnel procure- in 1942, after much difficulty, Moore
ment were eased, and station hospitals obtained light planes for use as air ambu-
were sent from the United States to help lances and even equipped them with skis
support the many new posts. By the end or floats for greater flexibility in reach-
of the year the Alaska Defense ing remote outposts. Transportation
Command counted 539 officers and between large bases and between Alaska
3,789 enlisted men of the Medical and the United States was provided in
Department to support more than the same manner as elsewhere in the
94,000 troops, or 4.6 percent as against Pacific. When Moore’s requests for dedi-
the authorized 5 percent. Bed strength
rose rapidly; in July only 1,565 of 3,724 9
CSurg, Alaska Def Cmd, Annual Rpts, 1942, pp. 3–5,
authorized beds were available, but by and 1943, p. 1, file 319.1–2; McNeil, “Medical
Department in Alaska,” pp. 99, 169–73, 176, file
the end of the year the total neared 314.7–2 (Medical Activities) Alaska. All in HUMEDS,
2,000. Nevertheless, the general rule RG 112, NARA.
ALASKA: THE PYRRHIC VICTORY 155
cated C–53 transports were rejected, he The rain and rough seas of maritime
turned, like other chief surgeons, to Alaska proved even more of a challenge
cargo and transport planes of the Air than the Arctic interior. Aleutian storms
Transport Command’s Alaska Wing. could isolate an island for days or weeks
Straps or brackets were installed to hold at a time, and turn much of the land-
litters on return flights. Eventually, even scape into a morass. On Adak, station
heat was provided, though many evac- hospital personnel watched in amaze-
uees traveled under blankets in unheat- ment as a tractor and trailer used to
ed cargo compartments, where tempera- move patients sank “halfway out of
tures fell below 0°F.10 sight” in muskeg. A medical officer, dis-
No summary account can convey the patched to aid an injured man on
problems that had to be overcome to Nikolai, was “swamped once or twice” in
treat and evacuate the sick and injured. rough seas, finally reaching shore in a
As Colonel Moore remarked, “Weather crash boat; the patient, despite a severe-
[in Alaska] is always available in a variety ly fractured skull, was brought off
of forms.” Medical personnel won hard- through “terrific surf” and survived.
earned decorations for work that would Another doctor walked with a rescue
have been routine anywhere else. party for seventeen hours through a
Equipment authorizations provided too snowstorm to treat a Seabee with appen-
few vehicles for local conditions and the dicitis; at journey’s end he operated on
wheeled vehicles that could be obtained the spot, saving the man’s life. Such
were largely roadbound. In February incidents were almost as harrowing as
1943 a three-vehicle convoy—a 21⁄2-ton combat.12
truck, an ambulance, and a caterpillar Limited transportation, distance, and
tractor—required nine hours to carry climate also affected medical supply.
one injured man 33 miles; the ambu- During the buildup Moore had little to
lance failed when the road ended, and do with supply. Medical units arrived
the tractor dragged the truck through with their equipment, and the Seattle
snowdrifts, up steep slopes, and through Port of Embarkation shipped medical
three frozen streams to the destination. maintenance units to the various posts
At Nome a dog team evacuated patients on the basis of strength reports. Without
from outlying posts to the station hospi- such automatic resupply the remoter
tal, dragging a basket sled large enough stations would have been in desperate
to carry a litter. The sled litter, called an straits, and yet to ship the maintenance
akhio, was the handiwork of an Eskimo units from Seattle was not to ensure that
enlisted medic. Other medics developed they arrived. Ship sailings and air service
toboggans for carrying patients.11 were both irregular, ports of entry might
be icebound, and transshipment within
Alaska ran afoul of the poor transport
10
McNeil, “Medical Department in Alaska,” pp. 136, system. Hence, delay was common. At
268–70, file 314.7–2 (Medical Activities) Alaska; CSurg,
Alaska Def Cmd, Annual Rpt, 1942, pp. 17–18, file McGrath some medical apparatus
319.1–2. Both in HUMEDS, RG 112, NARA.
11
CSurg, Alaska Def Cmd, Annual Rpt, 1942, p. 2
12
(quotation), file 319.1–2; McNeil, “Medical As quoted in McNeil, “Medical Department in
Department in Alaska,” p, 258, file 314.7–2 (Medical Alaska,” pp. 261, 263, file 314.7–2 (Medical Activities)
Activities) Alaska. Both in HUMEDS, RG 112, NARA. Alaska, HUMEDS, RG 112, NARA.
156 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Nome
ALAS
St. Matthew I
BERING Sew
SEA Iliamna
LA
Naknek
Pribilof Is Naknek Post Station Hospital
U
S
IN Kodiak
N
PE Fort G
A Kodiak I
A SK
N
IS AL
T IA
EU
AL Fort Mears Station Hospital Cold Bay
Fort Glenn Station Hospital Unimak I
Fort Randall Station Hospital
Dutch Harbor
Unalaska I
Umnak I
MAP 7
arrived partly in the fall of 1942 and the perishables, such as X-ray film and bio-
rest in the spring of 1943. Nothing logicals, might be outdated at the time
moved during the winter. they arrived. Local procurement was
In November 1943 Moore imple- only a partial answer to shortages,
mented a requisition system, but prob- though the larger cities provided
lems continued. Eight months might imported products and sold some local
pass from the time a requisition was sub- items and manufactured others. Many
mitted until the article was received, and posts, however, were far from such
ALASKA: THE PYRRHIC VICTORY 157
Fairbanks
HOSPITALS IN ALASKA
Ladd Field Station Hospital May 1942
Airfield
0 200
KA
Miles
GULF OF ALASKA
H
I G
HW
Sitka AY
Ketchikan
sources. Storage was a continuing ings in the intense cold of the central
headache. Sometimes, as on Adak, sup- plateau. A clutter of different shelters—
plies brought into half-built camps were Quonsets, dugouts, basements of post
simply dumped on the open tundra. buildings, pyramidal tents, and off-post
Not surprisingly, linens mildewed, plas- structures like schools—served to pro-
ter set, and film deteriorated. Many tect medical supplies. The chief surgeon
items, especially biologicals, required found that coordinating the movement
not only shelter but also heated build- of supplies was one of his most impor-
158 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
tant duties, for spot shortages remained that point, convinced Washington that a
the rule even after supplies became gen- serious threat existed to the nation’s
erally adequate.13 northernmost outpost. Only the
In mid-1942 the medical service in Japanese proved able to do that.
Alaska was in its most difficult phase of
growth—short of personnel and hospital The Enemy Attacks
beds and intermittently embarrassed for
essential supplies. The Alaska Defense The Japanese plan to strike at Midway
Command was able to live with these Island also provided for a diversionary
shortages, but only as long as it remained assault upon the Aleutians. Scheduled
essentially disengaged from the fighting. for early June 1942, the invasion objec-
Its ability to support combat operations tives were to conquer new outposts for
was uncertain. Efforts by General the Japanese defense perimeter, to pre-
Buckner to make his command a signifi- vent Americans from using the
cant part of the war effort had not, at Aleutians to attack Japan, and to
obstruct U.S.-Soviet military coopera-
tion in the North Pacific. Forewarned by
13
Ibid., pp. 141–42, 496–501, file 314.7–2 (Medical naval intelligence, the Army strength-
Activities) Alaska; CSurg, Alaska Def Cmd, Annual Rpts,
1942, p. 7, and 1943, p. 2, file 319.1–2. Both in ened Alaska’s air defenses, sending lim-
HUMEDS, RG 112, NARA. ited reinforcements, including some
ALASKA: THE PYRRHIC VICTORY 159
B–17s, to the Eleventh Air Force. The returned. Defeat of their main thrust in
war suddenly veered toward Alaska, and the Battle of Midway far to the south left
soon resulted in the Alaska Defense their forces in the Aleutians dangerous-
Command’s first combat casualties.14 ly isolated and exposed to counterat-
During the first morning hours of 3 tack. Though Buckner and DeWitt
June, fighters and bombers from two argued for a northern approach to
carriers of a Japanese amphibious task Japan along the Aleutians, the real
force attacked Dutch Harbor on the motive for the American action that fol-
island of Unalaska. High explosive and lowed was probably psychological—to
incendiary bombs struck naval installa- remove the sole enemy lodgment on
tions and nearby Fort Mears. Late the American soil.
following day the Japanese planes In any case, preparations for an
returned, destroying oil storage tanks, assault soon were under way. The
wrecking one wing of a naval hospital, buildup was rapid, though always con-
and damaging a beached barracks ship. strained by the greater importance and
The two-day attack claimed forty-three more pressing needs of the South and
lives, including thirty-three soldiers. Southwest Pacific campaigns. New posts
Though it stood in the target area, the were established, some in the interior
Fort Mears Station Hospital treated and some on the Pribilof Islands in the
sixty-four wounded, evacuating bed Bering Sea. Most, however, were in the
patients to foxholes and performing Aleutians for use as bases in offensive
nonemergency surgery at night. An operations. U.S. forces occupied Adak
underground hospital, begun after the on 30 August and nearby Atka on 16
first attack, was pushed to completion by September 1942, where, as they hud-
medical personnel in the aftermath of dled in foxholes, seeking shelter from
the raids. Surprised observers noted an ceaseless cold rain and biting wind, they
immediate rise in morale. The monoto- learned the misery of the Aleutian fight-
ny was broken, the enemy had become ing. By mid-September Army planes
visible, and the war was real at last.15 from a newly built airstrip on Adak were
Meanwhile, on 6 June Japanese forces bombing Kiska, only 200 miles to the
occupied the island of Kiska, in the west- west.
ern Aleutians. Then they seized remote The growth in air strength signaled
Attu, briefly abandoned it, but later the approaching battle in the Aleutians.
In early 1943 a joint operation for eject-
14
Conn, Engelman, and Fairchild, Guarding the ing the Japanese began. In January
Outposts, pp. 58–61; Maurice Matloff and Edwin M. Army troops seized Amchitka, only 70
Snell, Strategic Planning for Coalition Warfare, 1941–1942, miles from Kiska, and constructed an
United States Army in World War II (Washington, D.C.:
Office of the Chief of Military History, Department of airfield there. By mid-February the
the Army, 1953), pp. 224–25. Eleventh Air Force was harassing the
15
CSurg, Alaska Def Cmd, Annual Rpt, 1942, p. 15, invaders whenever the weather would
file 319.1–2; McNeil, “Medical Department in Alaska,”
p. 544, file 314.7–2 (Medical Activities) Alaska. Both in allow. An enemy relief convoy was dri-
HUMEDS, RG 112, NARA. See also Conn, Engelman, ven off, and the coming of spring found
and Fairchild, Guarding the Outposts, pp. 261–62. the Japanese seemingly cut off from
Underground operating rooms provided protection
both from the enemy and the weather, and were con- their homeland, with U.S. bases extend-
structed at several hospitals. ing up to their front door. On 1 April
160 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Nimitz and DeWitt issued a joint direc- operations to work. During the
tive for the invasion of Attu.16 approach to the target the naval com-
Basic to the preparations under way mander was in charge of the attacking
was the organization of an amphibious force; then, as the landing force
force to strike at the enemy. Doctrine advanced inland, the ground comman-
for such a force derived primarily from der took charge. Medical care was like-
Marine Corps thinking during the 1920s wise a joint endeavor. Aboard ship, the
and, more especially, from the creation Navy took responsibility for the health
of the Fleet Marine Force in 1933. and care of the entire force. When a
Marine experiments in amphibious war- landing was accomplished, control
fare had grown up in the context of pre- passed from one service to the other at
war plans that envisioned a fighting the water’s edge or the high-tide mark.
advance by the Navy across the Pacific in Elements of the divisional medical bat-
the event of war with Japan. The con- talion were designated to accompany
cept demanded advanced bases for refu- the assault forces, followed by a careful-
eling, supply, and repair, and suggested ly orchestrated succession of units that
to marine officers a new function for gradually built up a comprehensive
their organization. The doctrine they Army-run medical system as the beach-
developed had been accepted by the head expanded. Eventually, hospital pla-
Navy, and, according to Marine Corps toons gave the forces ashore the power
historians, “the War Department put the to hold substantial numbers of casual-
Navy text between Army covers and ties, obviating the need to evacuate that
issued it [in 1941] as Field Manual would have depleted their strength. In a
31–5.”17 successful operation, evacuation poli-
Amphibious warfare was not new, but cy—that is, the number of days of treat-
the technique for making a successful ment that could be given ashore—rose
attack by large modern forces against a continuously from the first lodgment.
hostile shore was one of the major mili- Clearly, much training was needed if
tary innovations of World War II. officers and enlisted men of two services
Complex problems in command, tactics, were to play well their roles in so com-
and supply had to be solved for such plex a drama, staged under enemy fire.
Like others, medical units had to learn
the art of combat-loading their supplies,
16
Louis Morton, Strategy and Command: The First Two with the items they would need first on
Years, United States Army in World War II (Washington,
D.C.: Office of the Chief of Military History, Department top in the holds. They had to provide
of the Army, 1962), pp. 421–28; Conn, Engelman, and medical personnel to assist the Navy in
Fairchild, Guarding the Outposts, pp. 270–76; CSurg, staffing landing craft that were marked
Alaska Def Cmd, Annual Rpt, 1942, pp. 3–4, file 319.1–2,
HUMEDS, RG 112, NARA. A good account of the war of for use as seagoing ambulances. At the
the Aleutians can be found in Brian Garfield, The same time, the medics had to learn the
Thousand-Mile War: World War II in Alaska and the skills that all soldiers needed to get
Aleutians (New York: Doubleday and Co., 1969).
17
Frank O. Hough, Verle E. Ludwig, and Henry I. themselves and their basic equipment
Shaw, Jr., Pearl Harbor to Guadalcanal, History of U.S. ashore, to organize their units, and to
Marine Corps Operations in World War II work under fire.
(Washington, D.C.: Historical Branch, G–3 Division,
Headquarters, U.S. Marine Corps, 1958), pp. 14–15 The 7th Infantry Division and other
(quotation, p. 14). units destined to participate in the inva-
ALASKA: THE PYRRHIC VICTORY 161
sion trained under Marine guidance at Though rigorous, the training was defi-
Fort Ord, near Monterey. Using tech- cient in some crucial ways. For one thing,
niques developed during the the climatic conditions on the California
Guadalcanal and North African cam- coast were altogether unlike those the
paigns, Maj. Gen. Holland M. Smith, troops would face in the Aleutians. They
USMC, director of the amphibious practiced amphibious tactics but received
training course, led the 7th under its no training in protecting themselves
commander Maj. Gen. Albert E. Brown, against the cold, and the medics learned
who also was named commander of the nothing of the problems they would face
landing force, through amphibious in the mountainous country that lay
training that included wet and dry net ahead. Indeed, the training was directed
practice, boat landings on Monterey almost wholly toward the landing and lit-
Beach, training cruises, and landings tle toward the problems that would be
elsewhere along the coast. General faced once ashore. Some command deci-
Brown’s troops were organized into reg- sions about equipment were ill-consid-
imental landing teams, each composed ered. In May Quartermaster Corps
of three autonomous battalion landing experts recommended the use of winter-
(or combat) teams. Each sailed on a sin- ized boots called shoepacs, only to have
gle ship, accompanied by a platoon the division commander select a leather
drawn from the collecting companies of boot instead. Clad in hoodless field jack-
the 7th Medical Battalion under Lt. Col. ets, rather than parkas, and in unlined
Robert J. Kamish, MC. Remembering woolen trousers that garrison troops in
the events at Guadalcanal, where the Alaska had already learned were too thin
transports had been withdrawn soon for the climate, the invading force depart-
after the landing, Lt. Col. Laurence A. ed with little understanding of the physi-
Potter, MC, division surgeon and task cal ordeal before them.19
force surgeon, divided the 14th and the Medical personnel were assigned their
20th Field Hospitals into three platoons, roles in the invasion. Aidmen and battal-
each capable of operating independent- ion medical sections sailed in the same
ly as a 100-bed holding facility. Since ships as the units they supported. At
combat impended, the hospital pla- each beachhead a single collecting pla-
toons were staffed with male nurses.18 toon would go ashore with the first wave,
to gather the wounded and administer
18
first aid. Battalion medical sections
Surg, 7th Inf Div, Annual Rpt (copy), 1943, pp. 2–3,
file 319.1–2; Rpt (copy), Lt Col Robert J. Kamish, Cdr, would land with the fifth and sixth waves,
7th Med Bn, n.d., sub: Medical Evacuation on Attu, p. to set up and operate the aid stations. As
1, file 319.1; Rpt (copy), Lt Col Laurence A. Potter, the battalions moved inland, the aid sta-
Surg, Task Force [51], 10 Jun 43, sub: Attu Operation,
pp. 5–6, file 319.1; McNeil, “Medical Department in tions were to follow, leaving a few per-
Alaska,” pp. 555–57, file 314.7–2 (Medical Activities) sonnel on the beach to receive casualties
Alaska. All in HUMEDS, RG 112, NARA. For a general
discussion of amphibious medical support in the Pacific
19
war, see Mary Ellen Condon-Rall, “Medical Aspects of Nelson L. Drummond, Jr., “The Attu Operation,” 6
Amphibious Operations Involving U.S. Army Forces Jul 45, pp. 37–40, and Rpt, R & D Br, Mil Planning Div,
During the War Against Japan,” in Daniel M. OQMG, to Opns Br, Mil Planning Div, OQMG, 13 Oct
Masterson, ed., Naval History: The Sixth Symposium of the 43, sub: Operations on Attu, The Historical Unit
U.S. Naval Academy (Wilmington, Del.: Scholarly (THU) Note Cards, Historians files, HUMEDS, RG 112,
Resources, 1987), pp. 276–88. NARA.
162 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
until relieved. Litter-bearers from the Of Attu itself and the enemy force lit-
collecting platoons followed to evacuate tle was known. Unsuited to agriculture
the aid stations. Last would come the and devoid of mineral resources, Attu
division clearing company, divided into had received slight attention in the past,
two platoons to support the major invad- except from a government geodetic sur-
ing forces. With their arrival, the first vey that mapped its coastline. The interi-
small hospital-type facilities and their or was largely a blank, and aerial pho-
holding wards would be ashore on Attu. tographs yielded little because of the fog.
Shore party medical sections would take “The loneliest spot this side of hell,” the
over care of the wounded on the beach- 40-by-20-mile island lies at the western-
es, delivering serious cases to the ships most end of the Aleutian chain and has
for evacuation. Field hospital platoons, the same uninviting climate and terrain
each capable of independent action, as the rest. The Japan Current moderates
would follow at the orders of the landing Attu’s temperature at the price of causing
force commander.20 dense fog and frequent storms, when
“the wind relieves the monotony . . . by
providing rain or snowfall in any combi-
20
McNeil, “Medical Department in Alaska,” pp. nation of three directions: down, up, or
554–57, file 314.7–2 (Medical Activities) Alaska,
HUMEDS, RG 112, NARA. The contemporary doctrine horizontal.” In the warmer months the
and techniques of amphibious action are outlined in snow melts, making the soil wet and
the Navy’s Landing Operations Doctrine, U.S. Navy, 1938, boggy, and barely capable of holding a
and in the Army’s Medical Service in Joint Overseas
Operations, Field Manual 8–25 (1940), and Landing man, much less a vehicle. Above the tree-
Operations on Hostile Shores, Field Manual 31–5 (1941). less valleys loom ridges of bare rock and
ALASKA: THE PYRRHIC VICTORY 163
patchy snow, and beyond is the “jumbled, thick fog, a party of scouts went ashore
barren mountain-mass of the interior,” from U.S. submarines. The invasion
where peaks rise to 3,000 feet.21 was on.
Many soldiers must have thought the By evening Brown’s troops were land-
desolate island was not worth fighting ing in force on the shore of Massacre
for. But many died to secure it, in part Bay, on beaches Blue and Yellow, and
because information on the Japanese north of Holtz Bay, on beaches Red and
defenders was scanty, including the fact Scarlet. The enemy, blinded by the fog,
that reinforcements had increased their provided no opposition. By the end of
number to about 2,400.22 D-day 1,500 soldiers were ashore in the
north and 2,000 in the south. With no
Regaining Attu casualties to care for on the beaches, the
medics methodically carried out their
Task Force 51, the armada of ships part of the plan. The collecting platoons
carrying the invasion forces to Attu, ren- of the 7th Medical Battalion landed and
dezvoused in late April at Cold Bay. established contact with the combat
General Brown’s assault force totaled team medics. Shore party medical sec-
about 11,000, including a reserve land- tions relieved the collecting platoons on
ing force held in readiness on Adak for the beaches, allowing them to follow the
use if needed. Three bays indent the combat teams in search of the enemy.
eastern coast of Attu: Massacre Bay in All seemed to be going well.23
the south, Sarana in the middle, and Hopes of a quick victory vanished in
Holtz in the north. The Japanese had the days that followed. The Southern
concentrated on a rocky bulge of land Landing Force was the first to meet
between Sarana and Holtz Bays, where trouble. The fog, lifting from the low-
an airfield was under construction, and lands, clung to the upper slopes of the
the Americans planned two major land- ridges, and rifle and mortar fire from
ings to envelop them. above the fogline hit the Americans as
On 4 May the task force, including they advanced up Massacre Valley from
warships, transports, and mine sweep- the beaches. Clearly visible in the tree-
ers, left Cold Bay. Foul weather and less landscape to an enemy they could
high waves delayed the planned land- not see, they made slow and costly
ing on the seventh, and, while the progress. By 13 May their advance had
troops waited below decks in the reached a stalemate in the passes lead-
rolling transports, Army planes from ing out of the valley. Meanwhile, the
Amchitka hit Attu with ninety-five tons Northern Landing Force bogged down
of bombs. Before dawn on 11 May, in as well. The troops from beach Red
advanced along a ridgeline on the
north shore of Holtz Bay, but the
21
McNeil, “Medical Department in Alaska,” p. 548 Japanese, driven off the high ground,
(first quotation), file 314.7–2 (Medical Activities)
Alaska, and CSurg, Alaska Def Cmd, Annual Rpt, 1942,
23
p. 2 (second quotation), file 319.1–2, HUMEDS, RG Rpt (copy), Kamish, n.d., pp. 1–2, file 319.1;
112, NARA; Conn, Engelman, and Fairchild, Guarding McNeil, “Medical Department in Alaska,” pp. 557–58,
the Outposts, p. 280 (third quotation). file 314.7–2 (Medical Activities) Alaska; Surg, 7th Inf
22
Conn, Engelman, and Fairchild, Guarding the Div, Annual Rpt (copy), 1943, pp. 2–3, file 319.1–2. All
Outposts, pp. 279, 295. in HUMEDS, RG 112, NARA.
164 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
clung tenaciously to the reverse slope Nothing could lessen the combina-
and gradually brought the invaders to a tion of backbreaking labor and con-
standstill. stant danger that was the litter-bearers’
As casualties mounted, medics and daily lot. The steep slopes of the ridges
combat units alike faced the fact that exhausted them, forcing medical offi-
two enemies were in the field, the cers to augment the squads from the
Japanese and Attu itself. Both supply customary four to six or even eight
and evacuation were proving to be a men. Inert, suffering bodies had to be
nightmare. Until roads could be built, manhandled through morasses and
wheeled and even tracked vehicles sank hauled by ropes up ridges of slippery
into the wet and spongy tundra. Soldiers bare rock under sniper and machine
walked as if on mattresses of moss. Every gun fire. Without cover, the bearers
needed article had to be hand-carried to sometimes had to roll a casualty off the
the front from dumps on the beaches. litter to lower his profile by a few inch-
There, disorder and confusion reigned. es. Additional bearers were drafted
Officers and enlisted men “were forced wherever they could be found, from
to search along the beach for necessary the medical battalion, the hospitals, the
equipment, stand guard over it after- shore parties, the Navy’s corpsmen, or
ward, and then carry it over almost the line units. All were needed; over
impassable ground. . . .”24 one especially difficult route, 400 bear-
Casualties had to be borne to the rear ers worked in relays to evacuate the
on litters, across the rocks and tundra, wounded of three infantry battalions.
and the long litter hauls resulted in Everywhere, the litter-bearers were tar-
many deaths among head and abdomi- gets themselves. The enemy fired on lit-
nal cases. Soldiers died from internal ter parties without mercy, obliging
hemorrhage only a few miles but many medical personnel to arm themselves,
hours from treatment. Morphine fight, and sometimes die for their
syrettes, introduced on Attu, proved patients.25
invaluable in keeping the wounded Forward treatment and evacuation
quiet and relatively pain-free during were marked by many expedients. In
long rough hauls. Aside from morphine, the cold forward aid stations dried plas-
the medic’s best friend was the fog, ma proved to be a liability, hard to dis-
which hid him and his patient from the solve and likely to plug the needles. In
foe—a fickle friend, however, apt to fade consequence, most casualties received
briefly before the pale Aleutian sun or their first plasma at the clearing sta-
blow away at critical moments. Litter- tions, which had moved close to the
bearers worked at night, but in the late
Arctic spring the hours of darkness were 25
Rpt (copy), Kamish, n.d., pp. 1–2, 14, file 319.1;
all too brief. McNeil, “Medical Department in Alaska,” pp. 559–67,
file 314.7–2 (Medical Activities) Alaska; Surg, 7th Inf
Div, Annual Rpt (copy), 1943, p. 3, file 319.1–2; Rpt
24
29th Field Hosp Annual Rpt (copy), 1943, p. 14 (copy), Potter, 10 Jun 43, pp. 2, 7, file 319.1; Rpt, Plt
(quotation), file 319.1–2; McNeil, “Medical Cdr, 14th Field Hosp, to HQ, Task Gp 16.11, 16 Jun 43,
Department in Alaska,” p. 559, file 314.7–2 (Medical sub: Brief Summary of the Highlights of Organization,
Activities) Alaska. Both in HUMEDS, RG 112, NARA. pp. 1–2, Encl to 14th Field Hosp Annual Rpt (copy),
See also Conn, Engelman, and Fairchild, Guarding the 1943, file 319.1–2. All in HUMEDS, RG 112, NARA.
Outposts, pp. 288–91. Each syrette contained a half-grain dose.
MORPHINE SYRETTES; below, LITTER-BEARERS HAULING A CASUALTY OVER THE ATTU TUNDRA
166 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
fighting in order to shorten litter were taken by Navy ship or plane direct
hauls. (The move also made them to the zone of interior.26
extremely vulnerable, as events were to The Japanese were still far from beat-
show.) In the north the wounded were en. After four days of fighting, senior
taken to a platoon of the 20th Field military leaders realized that they had
Hospital, situated at the base of a 250- underestimated the enemy. While
foot cliff that rose a few hundred yards General Brown demanded more troops
from the beach. Here, the medics had and road-building equipment, the
constructed an elevator—a caterpillar mounting evidence that his forces were
tractor on the clifftop that winched a bogged down convinced the North
12- by 12-foot sled loaded with two lit- Pacific Fleet commander, Vice Admiral
ters down the long slippery slope. Thomas C. Kinkaid, to replace him. The
Because enemy fire restricted shore-to- new commander, Maj. Gen. Eugene M.
ship evacuation, the platoon did much Landrum, arrived on Attu on 16 May,
surgery ashore. The hospital’s other just as the Northern Landing Force was
two platoons landed at Massacre Bay, breaking the deadlock around Holtz
pitching a cluster of pyramidal tents in Bay. The next day the enemy retreated
ankle- or knee-deep mud. By the end of in the direction of Chichagof Harbor.
the fighting its wards held 443 patients. Threatened in the rear, the Japanese
The more serious cases were taken off- force in the south that had been block-
shore by landing craft for treatment on ing one pass out of Massacre Valley also
shipboard, through pounding surf. withdrew. By the twentieth the Southern
Once they were aboard, Army ship hos- Landing Force had cleared a second
pital platoons and personnel of the pass as well, and emerged from the val-
179th Station Hospital took over their ley. Then the two American pincers
care. closed upon the enemy’s last redoubt.27
Gradually greater order emerged in Medical support by now had become
the rear areas. The casualty who easier. By 20 May engineer-built roads
reached the hospital platoons was out of enabled tractors and jeeps to carry sup-
serious danger. As the field hospitals plies forward from the beach and casual-
became established and X-ray equip- ties back from relay stations, putting an
ment was brought ashore, evacuation end to many of the long litter hauls.
policy was set at three weeks. Some Units already ashore advanced, and oth-
longer-term cases—especially of cold ers landed. The complicated lines of
injury and battle fatigue—were held on evacuation were simplified. Additional
the island; Colonel Potter set up a con- slides were built, where tractors could
valescent hospital on the west side of
Massacre Bay, where, at one point, 600 26
Surg, 7th Inf Div, Annual Rpt (copy), 1943, p. 3, file
patients were under treatment. The seri- 319.1–2; Rpt (copy), Potter, 10 Jun 43, pp. 3, 7, 9, file
ously wounded were, for the most part, 319.1; 20th Field Hosp Annual Rpt (copy), 1943, p. 2,
file 319.1–2; McNeil, “Medical Department in Alaska,”
quickly evacuated. A few of the worst pp. 568–72, file 314.7–2 (Medical Activities) Alaska. All
injured went by ship or plane to Adak in HUMEDS, RG 112, NARA.
27
for transfer to other Alaskan station hos- Conn, Engelman, and Fairchild, Guarding the
Outposts, pp. 293–94; McNeil, “Medical Department in
pitals, where preparations had been Alaska,” pp. 552–53, file 314.7–2 (Medical Activities)
made to receive them. Most, however, Alaska, HUMEDS, RG 112, NARA.
ALASKA: THE PYRRHIC VICTORY 167
28 29
Rpt (copy), Kamish, n.d., pp. 6–7, file 319.1; Rpt (copy), Kamish, n.d., p. 10, file 319.1; McNeil,
McNeil, “Medical Department in Alaska,” pp. 573–74, “Medical Department in Alaska,” pp. 574, file 314.7–2
file 314.7–2 (Medical Activities) Alaska. Both in (Medical Activities) Alaska. Both in HUMEDS, RG 112,
HUMEDS, RG 112, NARA. NARA.
168 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
days past, the medical units were unpro- still had to be hunted down, the brief,
tected either by the infantry or by bitter campaign was over.31
defenses of their own. Medics, like their
patients, lay helpless in sleeping bags The Balance Sheet
and were stabbed to death through the
bags and the canvas of their collapsing Counting up their casualties and the
tents. Capt. John W. Bassett, MC, a clear- bodies of the enemy, the Americans
ing company commander, was shot and recorded some grim statistics. Out of a
killed instantly while trying to organize a force totaling some 15,500 soldiers by
defense. Another officer woke from his the end of the campaign, 549 had been
sleep as a Japanese bayonet pierced his killed and 1,148 wounded. For the
nose, tongue, and neck, pinning him to Japanese, 2,350 had been killed and 29
the ground; the attacker withdrew the taken prisoner. The bitterness of the
weapon, and the officer miraculously fighting was reflected in the fact that 71
escaped, wounded but alive. On top of Americans had been either killed or
the hill that bore their name, engineer wounded for every 100 defenders on the
troops finally stopped the Japanese near island; only Iwo Jima was to exact a pro-
the site of the clearing station. But the portionately heavier toll. Sixty-nine per-
enemy held much of the American rear cent of the American battle dead had
area for the greater part of the day. In perished of gunshot wounds. Some 12
the fighting 19 medical officers and percent were victims of the bayonet, in a
enlisted men were killed and 27 others war where much less than 1 percent was
wounded.30 the norm—remarkable testimony to the
Since the Japanese now blocked many price exacted by the enemy’s final ban-
evacuation routes, casualties of the zai charge. But battle injuries were not
heavy fighting could not be moved back. the whole story. More than 2,100
Medics at forward posts stayed with their Americans had been put out of action
patients; at the clearing station on by disease and nonbattle injuries. Total
Engineer Hill, almost encircled by the American casualties outnumbered the
Japanese, treatment continued through- whole Japanese defense force by a ratio
out the fighting. American forces coun- of 3 to 2.32
terattacked, and by sunset the enemy The medics had suffered their own
had retreated. The wounded from the losses—32 killed and 58 wounded, or
valley floor began to move again by trac- about 7.5 percent of their personnel,
tor-loads to the hilltop. By the next after- more than half during the enemy’s final
noon 238 wounded had reached the charge. Though they had armed them-
beaches of Massacre Bay. As for the selves by one means or another, their lack
Japanese, they had virtually ceased to of training had made them ineffective
exist. Though a few surviving snipers
31
McNeil, “Medical Department in Alaska,” pp.
30
Quotation from Conn, Engelman, and Fairchild, 575–76, file 314.7–2 (Medical Activities) Alaska,
Guarding the Outposts, p. 294. See also Rpt (copy), HUMEDS, RG 112, NARA.
32
Kamish, n.d., p. 7, file 319.1; McNeil, “Medical Conn, Engelman, and Fairfield, Guarding the
Department in Alaska,” pp. 554, 575, file 314.7–2 Outposts, p. 295; McNeil, “Medical Department in
(Medical Activities) Alaska. Both in HUMEDS, RG 112, Alaska,” pp. 577–78, file 314.7–2 (Medical Activities)
NARA. Alaska, HUMEDS, RG 112, NARA.
ALASKA: THE PYRRHIC VICTORY 169
fighters and a danger to themselves and clearly by contrast with that of the
others. Their relative helplessness pro- enemy. Although the Japanese were vir-
voked much bitter comment, causing tually exterminated, and their medical
Colonel Kamish to recommend “that equipment and installations destroyed,
medical troops operating against Japs be the Americans were able to piece
armed with a carbine and given adequate together an instructive picture of their
instruction in its use and in the use of medical service. For first-echelon care,
hand grenades[;] that medical troops be each company had one officer or non-
instructed in security in the battle zone[;] commissioned officer and two enlisted
that line commanders be impressed with men attached, with litter-bearers drawn
the responsibility of guarding medical from the combat troops when necessary.
installations in their vicinity[; and] that The next echelon consisted of a dress-
Division Headquarters furnish such ing station and an ambulance section to
installations . . . fighting protection.”33 evacuate casualties to the rear. This ech-
The lack of experience and foresight elon was variously called a medical unit,
that pervaded the whole Attu operation casualty clearing station, or divisional
did not reflect on individual medics. bearer section. During the battle the
Colonel Kamish wrote: “The [Medical] enemy set up such stations in tents in
Battalion Command is proud that the the forward areas; some semipermanent
line soldier, notoriously contemptuous dispensaries, which accommodated per-
of the Medical Corps, has nothing but haps 25 casualties each, were established
praise for its members since the opera- in well-camouflaged structures that were
tions on Attu.” War correspondent dug into the ground. In one of these the
William Gillman was critical of the Americans found 18 dead: The Japanese
Army’s overall performance, but he medical officer had killed his patients
praised the medics for defending their before he shot himself.
patients at risk of their own lives when The next and highest Japanese med-
the enemy, bayonet in hand, stormed ical echelon on Attu was the field hospi-
through the lines. “Everybody agreed tal. At first the Japanese had evidently
that the medics were heroes,” he used a building on the eastern side of
declared. For its service during the bat- Holtz Bay; later, after converting the
tle, the 7th Medical Battalion received a building into a barracks, they began con-
presidential citation that hailed its “gal- struction of a new hospital further up
lant efforts” and its achievements in Holtz Valley, where the Americans found
evacuation under fire.34 only equipment stored. The enemy had
Accomplishments and failings of the also used as an aid station or hospital a
medical service on Attu showed up large cave overlooking Holtz Bay. Total
beds on the island were estimated at 200
33
Rpt (copy), Kamish, n.d., p. 19 (quotation), file for a garrison of 2,300—a respectable
319.1; McNeil, “Medical Department in Alaska,” p. 577, number by American standards.
file 314.7–2 (Medical Activities) Alaska. Both in
HUMEDS, RG 112, NARA. The Japanese on Attu apparently suf-
34
First quotation from Rpt (copy), Kamish, n.d., p. fered no epidemics, although pneumo-
16, file 319.1; second and third quotations as cited in nia, tuberculosis, and dysentery cases
McNeil, “Medical Department in Alaska,” p. 577, file
314.7–2 (Medical Activities) Alaska. Both in HUMEDS, had, on occasion, been evacuated from
RG 112, NARA. the island. On the other hand, medical
170 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
practice had been primitive. Recovered In other respects, the Japanese had
enemy medical officers’ diaries and an made intelligent efforts to preserve the
interview with a captured Japanese med- health of their men. They chlorinated
ical sergeant supplied a wealth of details their water and followed their national
on enemy medical service. Medical offi- custom of providing weathertight bath-
cers and enlisted men carried first aid houses with heated communal tubs. The
kits, containing instrument sets, an anti- clothing and boots of the Japanese sol-
septic—usually tincture of iodine—dress- diers were serviceable and warm, so
ings and bandages, a few drugs, syringes much so that American soldiers some-
in metal cases, and needles. No evidence times took caps and footwear from the
could be found that the Japanese used enemy dead at risk of being shot by their
sulfa drugs on Attu; they did not use plas- own comrades. Living and dead,
ma or give blood transfusions. Their sur- Japanese soldiers showed no evidence of
geons performed major operations with cold injury—a startling contrast to the
local or spinal, rather than general, anes- Americans.36
thetics. Faced with defeat, medical per- Nonbattle injuries put more U.S. sol-
sonnel sometimes injected the seriously diers out of commission than the enemy
wounded with morphine before the did, and by far the greatest source of
wounded committed suicide with hand incapacitating injury was the wet cold of
grenades. Addiction, however, was rare Attu. Average temperature in the valleys
among the Japanese soldiers, and popu- was a relatively mild 37°F., but on the
lar stories that the frenzy of the banzai ridges, where most of the fighting took
charge had been drug-induced were place, the average was 24°, and nightly
without foundation. temperatures sank as low as 10°. As the
Preventive medicine was a curious fighting grew heavy, U.S. troops were
melange. Japanese soldiers took cre- pinned down for several days at a time
osote to prevent food poisoning and in water-soaked foxholes, unable to
downed cod liver oil and vitamins as exercise their feet and legs. Since the
dietary supplements. A medical officer’s boggy tundra made evacuation difficult,
diary recorded, “We are all taking vita- many injured walked to aid stations on
min pills. Cases of typhus and TB come sore, swollen feet and in temperatures
up. We can take no chances.” Other that averaged about 35°F.
cases of the seemingly magical use of Originally trained for desert fighting,
preventive measures were observed. The the landing force troops were unable to
Japanese poured oil on pools of water, cope with these problems. They had not
although Attu had no mosquitoes; the been taught to remove their wet boots
garrison reportedly had participated in frequently, dry their socks and inner-
the Burma campaign, and may have
continued a practice learned there on 36
Rpt (copy), ACofS, G–2, Alaska Def Cmd, to ACofS,
the assumption that it was somehow G–2, Advance CP, Adak, Alaska Def Cmd, 17 Jul 43, sub:
Japanese Medical Facilities on Attu, p. 3, file 319.1–1
related to health.35 (Fergusson), HUMEDS, RG 112, NARA. The Japanese
use of creosote pills for internal antisepsis dates back to
the Russo-Japanese war. For a good description of
35
Rpt (copy), ASurg, Advance CP, Alaska Def Cmd, to Japanese medicine on Attu, see Ronald V. May, “Battle
SG, U.S. Army, 22 Jul 43, sub: Japanese Medical Service, at Attu—the Japanese Side,” Journal of the Council on
p. 3, file 319.1–1 (Bitner), HUMEDS, RG 112, NARA. America’s Military Past 13 (Dec 85): 3–9.
ALASKA: THE PYRRHIC VICTORY 171
soles, and massage their feet to increase and food. Cases of general exposure
circulation. Lack of training interacted went to the hospital; the 20th Field
with equipment failures. The Alaska Hospital, for example, treated 116 cases
Defense Command, as already noted, during the battle. The same facility
issued the wrong boots and chose the cared as well for 342 cases of exposure
wrong clothing for the wet, muddy with trench foot. Although not life-
Aleutian weather. The experience of threatening, trench foot was a disabling
three special units pointed up the injury. Within twelve to fourteen hours
importance of command errors. The after exposure, throbbing, tingling,
7th Scout Company and the 7th Cavalry cramping, and increasing numbness of
Reconnaissance Troop landed on beach the feet signaled the onset of the prob-
Scarlet; promptly lost their way; and, in lem. The victims’ feet swelled, turning
the course of five days, suffered 401 blue or mottled blue and white and the
cases of exposure. On the other hand, soles waxy white; severe cases became
the Alaskan Scouts, a combat intelli- painful and blistered. Many felt as if they
gence force that had been trained for were walking on wooden feet. The sever-
the climate and terrain, fought the ity of injury was directly proportionate
entire campaign wearing shoepacs and to the length of time that shoes and
suffered only 1 case of cold injury.37 socks were worn unchanged.
Soldiers on Attu suffered three types In the field and convalescent hospi-
of cold injury—mild exposure, general tals, medics treated trench foot by bed
exposure, and immersion or trench rest, elevating the feet, and maintaining
foot. Medics did not hospitalize cases of asepsis, allowing the feet to warm gradu-
mild exposure, but returned them to ally without artificial heat. When the
duty after rest behind the lines and skin was broken, they gave the patient
nourishment with warm drinks, whiskey, sulfadiazine orally to prevent infection.
During the battle 1,242 cases were taken
37
to the hospitals on the shore, and 241
Rpt (copy), Potter, 10 Jun 43, pp. 5, 6, 8–9, file
319.1; McNeil, “Medical Department in Alaska,” p. 582, severe cases were evacuated to the ships.
file 314.7–2 (Medical Activities) Alaska. Both in Overall, the rate of cold injury for the
HUMEDS, RG 112, NARA. See also Tom F. Whayne and twenty-two days of the campaign was
Michael E. DeBakey, Cold Injury, Ground Type, Medical
Department, United States Army in World War II equivalent to 1,301 per 1,000 troops per
(Washington, D.C.: Office of the Surgeon General, year. The ratio of wounded in action to
Department of the Army, 1958), pp. 90–92; Albert cold injury equaled 1:1 at Attu, an unac-
Lesser, “Report on Immersion Foot Casualties From the
Battle of Attu,” Annals of Surgery 121 (Mar 45): 259; ceptable wastage of soldiers.38
Constantin P. Yaglou and William L. Hawley, Other nonbattle losses included the
“Disabilities Due to Environmental and Climatic usual range of neuropsychiatric, gas-
Factors,” in Ebbe Curtis Hoff, ed., Special Fields, Medical
Department, United States in World War II
38
(Washington, D.C.: Office of the Surgeon General, 20th Field Hosp Annual Rpt (copy), 1943, pp. 4, 7,
Department of the Army, 1969), pp. 242–44; Tom F. file 319.1–2; Rpt (copy), Potter, 10 Jun 43, pp. 7–8, file
Whayne, “Clothing,” in idem, Personal Health Measures 319.1; McNeil, “Medical Department in Alaska,” pp.
and Immunization, Medical Department, United States 581–84, file 314.7–2 (Medical Activities) Alaska. All in
Army in World War II (Washington, D.C.: Office of the HUMEDS, RG 112, NARA. See also Patterson, “Effect
Surgeon General, 1965), pp. 66–67; and R. H. on Extremities,” p. 63; Whayne and DeBakey, Cold
Patterson, “Effect of Prolonged Wet and Cold on the Injury, p. 94; Lesser, “Immersion Foot Casualties,” p.
Extremities,” Bulletin of the U.S. Army Medical Department 259; and Whayne, “Clothing,” in Hoff, ed., Personal
75 (Apr 44): 62. Health Measures, p. 66–67.
172 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
trointestinal, and respiratory cases. The defenses were deemed stronger than
20th Field Hospital admitted 94 neu- those on Attu. Hence, preparations to
ropsychiatric cases, a small number con- invade had been under way since before
sidering the conditions of the fight, only the Attu operation. In late 1942 assault
29 of whom had to be evacuated from forces began assembling at Fort Ord for
the island. The 46 cases of acute diar- amphibious training. Medical units
rhea treated at the same field hospital emphasized rigorous physical condition-
reflected the problems of sanitation in ing for litter-bearers, and went through
battle: Soldiers ate their rations from the usual exercises with the other troops
unwashed canteen cups, and sometimes as well: climbing down cargo nets; taking
failed to chlorinate their drinking water; part in small-boat landings; and gaining
streams, their source of drinking water, familiarity with LSTs (landing ship,
were also preferred spots for excretion, tank). Field hospital platoons were again
perhaps because of the protection to land with the units they supported.
offered by the banks. But these problems Taking heed of the Attu lessons
were minor, and despite the cold wet cli- learned, and of intelligence estimates
mate and the great number of exposure that about 10,000 enemy troops gar-
cases, respiratory ailments were few.39 risoned Kiska, the Army doubled the size
In sum, Attu presented a picture both of the assault force to 34,400 ground
of high battle losses, resulting in part troops, including 5,300 Canadians. All
from intelligence failures that included were commanded by Maj. Gen. Charles
ignorance of the terrain and enemy H. Corlett, U.S. Army. Units were added
strength, and also of high nonbattle loss- with experience in the type of fighting
es, many traceable to erroneous com- that had developed on Attu, including a
mand decisions regarding the training, mountain combat team, a regimental
clothing, and equipment of the troops. combat team from the Alaska Defense
The all but forgotten battle deserves to Command, and the tough 1st Special
be remembered, among other things, as Service Force. The 17th Infantry, which
another painful step taken by American had fought on Attu, took the place of a
commanders on the way to learning the nonveteran infantry regiment. All of this
difficult art of protecting their soldiers introduced some confusion into medical
in a worldwide war. planning, for different components were
making ready in California, Canada, and
Regaining Kiska Alaska. Advanced amphibious training
continued at Adak and Amchitka even as
After Attu, the last enemy toehold Navy warships began to hurl shells at
upon American soil to be recaptured was Kiska, and the Eleventh Air Force, using
Kiska. Initially considered the main tar- airstrips on Attu and the nearby island of
get for the American counterattack, Shemya, started bombing runs. The inva-
Kiska had been bypassed because its sion was set for 15 August 1943.40
39 40
20th Field Hospital Annual Rpt (copy), 1943, p. 4, Conn, Engelman, and Fairchild, Guarding the
file 319.1–2; McNeil, “Medical Department in Alaska,” Outposts, pp. 295–96; McNeil, “Medical Department in
p. 584, file 314.7–2 (Medical Activities) Alaska. Both in Alaska,” pp. 589–90, file 314.7–2 (Medical Activities)
HUMEDS, RG 112, NARA. Alaska, HUMEDS, RG 112, NARA.
ALASKA: THE PYRRHIC VICTORY 173
In making their plans the medics with the weapons they had fired at Fort
relied heavily upon reports from Attu, Ord—carbines for officers and M–1
the advice of veterans of the Aleutian rifles for enlisted men. This time they
fighting, and lessons learned from were to have a fighting chance.
amphibious operations in the South Nearly 3,000 medical personnel
Pacific. Once again, they assumed that accompanied the invasion forces. Task
they had to provide care in case the force surgeon, Lt. Col. H. E. Bill, MC,
Navy should be pulled away within thir- with a staff of 4 officers and 6 enlisted
ty-six hours of the landing, as had hap- men, operated out of Corlett’s headquar-
pened on Guadalcanal. The danger of ters. Four landings were planned on two
cold injury was treated with utmost seri- major sectors of the coast; hence, two
ousness by Corlett, and the troops were medical officers from the 59th Medical
issued shoepacs, parkas, rain suits, Battalion acted as sector surgeons on the
water-resistant trousers, and face masks. staffs of the sector commanders. In order
All received instruction in caring for to make self-sufficient the autonomous
themselves, and especially for their feet; battalion landing groups—the basic tacti-
before the troops went ashore, they cal units of the campaign—the field med-
rubbed lanolin into their feet, and med- ical units again had to be reorganized.
ical personnel performed a last-minute The medical battalion was first expanded
foot inspection. The medics went armed with additional collecting and clearing
174 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
companies, drawn from nondivisional large force of defenders who would fight
sources, and then split into sections, to the death in a wilderness of fog,
which in turn were attached to the land- rocks, and tundra.42
ing groups. This setup was even more Early on the morning of 15 August—it
radical than on Attu; the medical battal- was that rarity, a fine Aleutian day—the
ion ceased to exist for the duration of the amphibious force of nearly 100 ships
campaign, no plans being made to recon- under the command of Rear Admiral
stitute it as the assault forces converged.41 Francis W. Rockwell began arriving off
Hospital platoons were to carry Kiska, an island 25 miles long and less
ashore, in rucksacks and on packboards, than 2 miles wide. Intelligence indicated
enough supplies for thirty-six hours; that the enemy was concentrated on the
other medical units were to take with eastern side, in the Kiska Harbor area
them supplies for three days. Additional and around Gertrude Cove. Hence, land-
supplies, including medical mainte- ings began on the island’s west side. By
nance units, were combat loaded on 0840 landing craft were putting ashore
transports and cargo vessels for early the first troops of the Southern Landing
debarkation. A supply depot on every Force, their destination the hills above
beach was to distribute supplies to the the beach. Next morning, the Northern
troops. In case units became isolated, Landing Force landed at two beaches
fifty-eight parachute packs were ready near Kiska volcano on the northwestern
with morphine syrettes, heating pads, side of the island. As on Attu, the land-
bandages, sulfa drugs, and brief instruc- ings were unopposed. The weather rapid-
tions for use. Casualty estimates reflect- ly returned to the Aleutian norm in the
ed the harsh experience of Attu; almost days that followed. But no one could find
2,500 were expected to die and 7,000 the Japanese. U.S. forces penetrated the
more to fall sick or be wounded. The mist-covered interior of Kiska, encoun-
Alaska Defense Command designated tering no defenders and hearing only the
station hospitals to receive casualties— shots of their own tense, trigger-happy
the 179th Station Hospital at Adak with men. At night they huddled in wind and
1,500 beds; Fort Richardson with anoth- rain, awaiting the enemy, and patrols
er 800 beds, if needed; Forts Mears at fired on one another in the darkness,
Dutch Harbor, Randall at Cold Bay, and killing and wounding. Until 22 August
Greeley in Kodiak, with 300 beds each; the Americans searched for the Japanese
and Fort Glenn at Umnak, with 100 in vain. Apparently, the enemy had evac-
beds. Further evacuation was to be by air uated the island, perhaps as early as 28
and water from Adak to Seattle. The tac- July; exploiting the Aleutian fog,
tical and medical planning for Kiska Japanese cruisers and destroyers had car-
grappled with the perceived reality—a ried away the entire garrison. Now with
only the weather as the enemy, the troops
41
on the beaches of Kiska smashed crates
McNeil, “Medical Department in Alaska,” pp.
594–97, file 314.7–2 (Medical Activities) Alaska; 59th into kindling, appropriated tents and
Medical Bn War Diary, 1943, pp. 6–11, file 319.1. Both
in HUMEDS, RG 112, NARA. See also G. Allen Lane,
42
“Medical Experiences With the 13th Canadian Infantry McNeil, “Medical Department in Alaska,” pp. 597,
Brigade at Kiska,” Journal of the Canadian Medical 599–600, file 314.7–2 (Medical Activities) Alaska,
Services, May 44, p. 284. HUMEDS, RG 112, NARA.
ALASKA: THE PYRRHIC VICTORY 175
stoves, and broke open medical supplies my,” which was performed in a hospital
in search of whiskey.43 tent by the light of a gasoline lantern.
During the first days, as U.S. forces Overall, 28 died, about a tenth of 1 per-
moved inland expecting to see the cent of those who came ashore, as
enemy, attached aidmen and part of a against the 30-percent casualties and 9-
collecting company went with them to percent deaths that had been predicted
provide first-echelon care. In view of the for the invasion force as a whole.44
casualties from friendly fire, the medics In deserting Kiska, the Japanese gave
were needed. Carrying litters remained up their last foothold on Alaska. The
as difficult as ever, because of the boggy threat of invasion vanished, though the
tundra and snow-covered hills. Other enemy continued intermittent air activity
medical units followed. The field hospi- over the Aleutians for another two
tals landed, pitched tents, gathered cots, months. On Attu, medics turned into
and treated the first days’ casualties. The builders, as they had on other Pacific
6th Field Hospital was able to provide islands, constructing sturdy huts to house
definitive treatment within twenty-four the 328th Station Hospital that was to
hours of the first landing and X-ray ser- serve the garrison. Meanwhile, American
vice within three days. When it became planes based on Shemya Island shifted to
clear that the enemy had evacuated the the offensive, mounting an attack on the
island, the field hospitals moved into Japanese-held Kurile Islands. But serious
the area around Gertrude Cove and fighting in the Aleutians was over.
Kiska Harbor. The following month they The Alaskan theater remained inactive
reorganized as station hospitals. but not useless from the autumn of 1943
Meanwhile, most of the invasion force to the end of the war. The air raids on the
moved ashore, a total of 28,452 troops. Kuriles tied down hundreds of Japanese
Despite the lack of opposition, they, too, aircraft, and tens of thousands of
gave the medics some work to do, suf- Japanese troops prepared to oppose a
fering a casualty rate of 2.7 per 1,000 possible American invasion. Nevertheless,
troops per day. Accidents, friendly fire, in response to complaints by Secretary of
booby traps, and land mine explosions War Stimson that too many doctors were
accounted for most casualties, and being wasted there, Surgeon General
trench foot for the rest. But for evident Kirk reduced the fixed-bed requirement
reasons, the nonbattle casualty rate was to 4 percent of total troop strength.
low. Of 130 diagnoses of trench foot, 76 Dispersion and distance, however, still
came from the 17th Infantry, the conse- required a more substantial medical
quence of injuries suffered on Attu. One establishment than numbers alone might
man died of gas gangrene; another have suggested. In most respects, the sub-
required the “inevitable appendecto- sequent medical history of the territory
was unremarkable, except for a brief flur-
43
Ibid., p. 603, file 314.7–2 (Medical Activities)
44
Alaska; 30th Field Hosp Annual Rpt (copy), 1943, pp. McNeil, “Medical Department in Alaska,” pp.
9–11, file 319.1–2. Both in HUMEDS, RG 112, NARA. 606–08 (quotation, p. 606), file 314.7–2 (Medical
See also Conn, Engelman, and Fairchild, Guarding the Activities) Alaska; Rpt (copy), Potter, 10 Jun 43, p. 8, file
Outposts, pp. 297–98, and Samuel Eliot Morison, History 319.1. Both in HUMEDS, RG 112, NARA. Cold injury,
of United States Naval Operations in World War II, 15 vols. by damaging the tissues, predisposes to subsequent
(Boston: Little, Brown and Co., 1964), 7:62–63. injury. See Lane, “Medical Experiences,” p. 287.
176 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
ry over Japanese balloons in the last year rations for the Kiska invasion showed
of the war. Colonel Moore was named both willingness and capacity to learn
anti-biological warfare officer on the sup- from the mistakes of the past. The tech-
position, which proved baseless, that the niques of amphibious warfare were
balloons, launched from the enemy’s steadily being refined, and in the South
home islands, might carry biological and Southwest Pacific—less than a year
weapons.45 after Guadalcanal, and only a few
Beginning with serious blunders, the months after Attu—were applied with
nation’s third amphibious campaign of impressive competence in a series of
World War II ended with an attack victories in the Solomons, New Guinea,
upon a deserted island. Yet the prepa- and nearby islands.
45
Ltrs, Henry L. Stimson, SofW, to Maj Gen Norman Service in the Defense Commands, 1942–1945,” pp.
T. Kirk, SG, U.S. Army, 20 Nov 43, and Kirk to Stimson, 36–37, file 314.7. All in HUMEDS, RG 112, NARA.
23 Nov 43, THU Note Cards, Historians files; 20th Field Some personal accounts of medical activities on Attu
Hosp Annual Rpt (copy), 1943, p. 3, file 319.1–2; 6th can be found in the War Department’s publication The
Field Hosp Annual Rpt (copy), 1943, pp. 6–7, file Capture of Attu as Told by the Men Who Fought There
319.1–2; Scioto Herndon, “Organization of the Medical (Washington, D.C: Infantry Journal Press, 1944).
CHAPTER VI
Amphibious Advance
The closing of the Papuan and strategically encircle Rabaul, whose
Guadalcanal campaigns left the forces conquest was the ultimate objective of
of General MacArthur’s Southwest both commanders. In April at a confer-
Pacific Area (SWPA) and Admiral ence in Brisbane, MacArthur and
Halsey’s South Pacific Area (SPA) free Halsey agreed on a plan that aimed at
to embark on new efforts against the the capture of successive forward air
Japanese. The enemy’s stronghold was bases. The complex operations
his fortified base at Rabaul on New involved received the code name
Britain, a large island separated from CARTWHEEL.1
the northeastern coast of New Guinea Troops of both theaters would be
by the Vitiaz Strait. obliged to fight once again in New
At the Casablanca Conference in Guinea and the Solomon Islands, with
early 1943 the Allies decided on new their harsh mountains, roadless jun-
advances in the region. The Joint gles, and tropical diseases that includ-
Chiefs devised an arrangement by ed malaria, dengue, and scrub typhus.
which Halsey would command a new Yet by mid-1943 the SWPA medical ser-
advance up the Solomon chain under vice was better able to support combat
the general direction of MacArthur, operations. Hard lessons had been
while the latter’s own forces would learned in preventive medicine;
simultaneously resume their fighting amphibious support techniques were
advance westward along New Guinea’s rapidly improving, with many landing
north coast, exploiting the sea to avoid craft to double as floating ambulances
endless slogging through jungles and or hospital ships; and the 2d Engineer
mountains. Southwest Pacific forces Special Brigade, with its own medical
would fight in New Guinea, New
Britain, and the Admiralty Islands, 1
John Miller, jr., CARTWHEEL: The Reduction of Rabaul,
while South Pacific troops would United States Army in World War II (Washington, D.C.:
engage the enemy in the Solomons. Office of the Chief of Military History, 1959), pp. 1–19,
26–27; Samuel Eliot Morison, History of United States
Ground forces from both theaters Naval Operations in World War II, 15 vols. (Boston: Little,
would secure the Woodlark and Brown and Co., 1947–62), 6:95–96; D. Clayton James,
Kiriwina Islands off Papua. The pincer The Years of MacArthur, 3 vols. (Boston: Houghton
Mifflin Co., 1970–85), 2:308. Unless otherwise noted,
movement resulting from these cam- the framework of strategy and military events for this
paigns would gradually isolate and chapter is drawn from these sources.
178 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
battalion, the 262d, had arrived to surgeon Colonel Miehe, planned tacti-
move troops ashore, to organize the cal medical support and coordinated
beaches, and to provide smooth evacu- the medical services of Army, Navy, and
ation to ships offshore. In the South Marine units. Both Hagins and Miehe
Pacific Area, by contrast, whether kept in close contact with Colonel
because of the complex command Kennard, the senior flight surgeon, and
arrangements or some other factor, the with Navy Capt. Albert T. Walker, MC,
opening battles would show that the the surgeon of Rear Admiral Daniel E.
SPA medical service had fallen behind Barbey’s VII Amphibious Force.4
in its planning and preparations.2
While the forces assembled and CARTWHEEL Opens
trained, the theater surgeons brought in
replacements, requisitioned supplies, CARTWHEEL opened at the end of June
and did preliminary planning for hospi- with three simultaneous thrusts. In the
talization, sanitation, and malaria con- first, SPA and SWPA forces seized
trol. Since the USASOS was responsible Woodlark and Kiriwina, “practically vir-
for the logistical support of American gin jungle islands” off Papua’s north-
ground forces in the Southwest Pacific eastern coast, and built bomber bases to
Area, Carroll, as the chief surgeon, and strike at the Solomons and Rabaul. In
his staff provided medical support for the second, mounted from the New
the coming campaign, including base Guinea coastal town of Morobe, a bat-
development. On 15 June the forward talion combat team of the 162d Infantry,
echelon of the Sixth Army surgeon’s 41st Infantry Division, landed at Nassau
office was redesignated as the Office of Bay in heavy seas and blinding rain, aim-
the Surgeon, ALAMO Force, an organiza- ing at the Japanese-held town of
tion under the direct command of Salamaua. Here, medical support was
General MacArthur.3 Sixth Army sur- provided by the 116th Medical
geon Colonel Hagins, assisted by I Corps Battalion—its collecting company and a
platoon of its clearing company—and by
three portable surgical hospitals, one
2
On the development of landing craft, see Frank O. for each battalion combat team. The
Hough, Verle E. Ludwig, and Henry I. Shaw, Jr., Pearl
Harbor to Guadalcanal, History of U.S Marine Corps clearing platoon remained at Morobe.
Operations in World War II (Washington, D.C.: The other medical units accompanied
Historical Branch, G–3 Division, Headquarters, U.S. the combat team; they advanced in sin-
Marine Corps, 1958), pp. 23–34. On the engineer
brigades, see William F. Heavey, Down Ramp! The Story of gle file along narrow coastal trails to join
the Army Amphibian Engineers (Washington, D.C.: an Australian brigade fighting its way
Infantry Journal Press, 1947). The 3d and 4th Engineer northeastward from Wau. Reinforced by
Special Brigades followed at the end of 1943 and in
mid-1944, respectively. the rest of the 162d Infantry, the com-
3
The ALAMO Force, an independent tactical organi-
4
zation virtually interchangeable with the Sixth Army, Buell Whitehill, “Administrative History of Medical
was MacArthur’s way of evading the creation of a true Activities in the Middle Pacific,” block 18g, pp. 52–53,
combined command by isolating the Australian ground file 314.7; Rpt, Surg, Alamo Force, 30 Sep 43, sub:
force commander, General Sir Thomas Blamey. For a Medical Activities, p. 1, The Historical Unit (THU)
personal view of MacArthur as a leader, strategist, and Note Cards, Historians files. Both in Historical Unit
friend, see Roger O. Egeberg, General MacArthur and the Medical Detachment (HUMEDS), Record Group (RG)
Man He Called “Doc” (New York: Hippocrene Books, 112, National Archives and Records Administration
1983). Egeberg was MacArthur’s physician. (NARA), Washington, D.C.
AMPHIBIOUS ADVANCE 179
bined force under Australian command had their assigned tasks. Australian
fought an enemy dug in along the tops organic medical units—regimental aid
of steep jungle-covered ridges.5 posts and an advanced dressing sta-
From battalion aid stations casualties tion—accompanied the assault troops.
were carried by native litter-bearers to Forty minutes after H-hour the 532d
the beach. “Over trails hardly wide Engineer Boat and Shore Regiment of
enough for a man to walk,” wrote the the 2d Engineer Special Brigade came
41st Division historian, “skirting cliffs ashore in its own landing craft (all other
often five hundred feet high, they car- vessels were provided by the Navy’s VII
ried the wounded safely and gently. Amphibious Force) to organize the
Always there was the soothing comment, beach and bulldoze a road inland
‘Sorry Boss,’ at the lightest jolt of the lit- through the cocoanut groves that lay
ter.” On the shore a collecting platoon beyond. The regimental medical
and portable surgical hospitals stood detachment set up aid stations on the
ready with operating rooms dug into the sand, and a medical company of the
sand, embanked with logs or sandbags 262d Medical Battalion established a
and covered with tents. In the later clearing station beside the central axis
stages of the Salamaua fight the 24th of the beach. Medics unloaded and car-
Portable Surgical Hospital moved ried their own equipment; all went
inland to aid the Australians, sending its armed with rifles, pistols, or carbines.
transportable wounded to the coast over The only potentially serious foul-up was
the same steep and winding trails. Both a breakdown in communication with
supply and evacuation were by landing the Navy. Fearing enemy bombers at
craft, which continuously provided sup- Morobe, the large troop carriers—LSTs
port from the sea. Salamaua fell on 12 (landing ship, tank) and LCIs (landing
September, but the cost was high: The craft, infantry)—were rerouted to Buna,
162d Infantry lost 102 killed and 447 a fact discovered by a medical officer
wounded, and malaria, dysentery, and from the Sixth Army headquarters, who
skin infections further reduced its instructed the 262d to shift medical
troops from 2,554 to 1,763.6 resupply down the coast.7
While the Japanese still resisted at Then American paratroopers of the
Salamaua, the Australian 9th Division 503d Parachute Infantry descended on
stormed ashore to the enemy’s rear, an enemy airstrip at inland Nadzab, in
near Lae. Medics of the two Allies each the Markham River valley. Their C–47s
came in low and fast, and each jumped
5
Surg, Med Det, 112th Cav, Quarterly Rpt, Jul–Sep with some 90 pounds of equipment.
43, p. 1, THU Note Cards, Historians files; Surg, 41st Many drifted into the jungle, snagging
Inf Div, Quarterly Rpt, Apr–Jun 43, p. 1, file 319.1. Both
in HUMEDS, RG 112, NARA. their chutes in the tops of trees. Natives
6
Quotations from William F. McCartney, The again helped to retrieve casualties, and
Jungleers: A History of the 41st Infantry Division prompt action by the regimental med-
(Washington, D.C.: Infantry Journal Press, 1948), p. 55.
Statistics from Miller, CARTWHEEL, p. 202. See also 116th ical detachment in administering blood
Med Bn Diary, 1 Jul–5 Oct 43, file 319.1 (116th Medical
Battalion Diary) 14 Dec 42–30 Oct 43; Notes on Surg,
7
Med Det, 162d Inf, Sanitary Rpt, Aug–Sep 43, pp. 1–2, Rpt, Maj Albert M. Dashiell, 14 Sep 43, sub: Landing
and on idem, Quarterly Rpt, Jul–Sep 43, pp. 1–2, Operations, THU Note Cards, Historians files,
Historians files. All in HUMEDS, RG 112, NARA. HUMEDS, RG 112, NARA.
180 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
plasma saved many lives. Three died and icated hospital ships, but one LST—
34 were injured in the jump; skirmish- number 464—was converted into a 175-
ing on the ground cost an additional 8 bed hospital to care for casualties from
killed and 12 wounded—all in all, a the landing beaches and transport them
small price for a major prize.8 to Milne Bay. Six to eight Navy medical
A few weeks later the Australians, sup- officers and about forty corpsmen
ported by the 2d Engineer Special staffed the vessel.9
Brigade and by Company B, 262d The Japanese fought back with vigor,
Medical Battalion, landed on the tip of both on the ground and with heavy air
the Huon Peninsula, capturing raids from fields in New Guinea and
Finschhafen on 2 October (see Map 8). Rabaul. Casualties were evacuated to the
Again the Navy provided partially con- beaches during the hours of darkness, a
verted LST–Hs, each carrying a naval
medical officer and equipment for 9
“Seventh Amphibious Force Command History, 10
emergency surgery. A medical corpsman January 1943–23 December 1945,” pp. 65, 76–77, file
rode each of the smaller “Higgins 314.7 (7th Amphibious Force) SWPA; Surg, 2d Engr
Spec Bde, Quarterly Rpt (copy), Jul–Sep 43, pp. 11, 13.
boats,” landing craft with drawbridge Both in HUMEDS, RG 112, NARA. See also Alan S.
bows. The assault force was without ded- Walker, The Island Campaigns, Australia in the War of
1939–1945, Series 5, Medical (Canberra: Australian
War Memorial, 1957), p. 182. The partially converted
8
503d Parachute Inf Quarterly Rpt (copy), Jul–Sep LST–H also was used in the New Britain and Hollandia
43, file 319.1, HUMEDS, RG 112, NARA. campaigns, which are discussed later in this chapter.
AMPHIBIOUS ADVANCE 181
NEW
IRELAND
B I S M A R C K
A R C H I P E L A G O
Rabaul
107th Medical Battalion (-)
262d Medical Battalion (-)
670th Medical Clearing Company (-)
5th, 6th, 8th, 13th, 17th, and 22d Portable Surgical Hospitals
23d Field Hospital
5th Malaria Survey Unit
Madang
Cape Gloucester
Kiriwina I
O
W
Gona Buna
E
N
Dobodura
Kokoda
Goodenough I
S
T
A
N
Port L D'ENTRECASTEAUX
Moresby E
Y ISLANDS
RA
NG
E
Milne Bay
MAP 8
ARMY MEDICAL SUPPORT
OPERATION CARTWHEEL
June 1943–May 1944
ELEVATION IN FEET
0 150
Miles
Note: Not all inclusive.
Feni Is
Green Is
112th Medical Battalion
52d Field Hospital
21st Evacuation Hospital
Buka I 31st and 33d Portable Surgical Hospitals
BOUGAINVILLE
l Regiment (-)
ion Hospital
able Surgical Hospitals
ion Hospital
CHOISEUL
S O L O M O N
O N Shortland I I S L A N D S
Treasury Is
Vella SANTA ISABEL
Lavella Kolombangara
NEW T
H
E
GEORGIA S
L
O
T
Rendova
Florida I
Woodlark I
Russell Is
118th Medical Battalion (-)
25th Medical Battalion (-)
112th Medical Battalion (-)
17th Field Hospital
GUADALCANAL
184 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Japanese units garrisoned the natural as staging areas for further action. The
harbors as well as the airfields on enemy garrison on Rendova scattered,
Kolombangara, Vangunu, and New and the clearing company and
Georgia’s Munda Point. Collecting Company C set up there. But
Colonel Maxwell, the USAFISPA chief Japanese air attacks wreaked havoc on
surgeon, prepared for an advance American supply dumps along the
against New Georgia with the assistance beach, destroying most of the clearing
of Col. Franklin T. Hallam, MC, the XIV station’s equipment. For a time only
Corps surgeon. Responsible for tactical emergency treatment could be given,
coordination of the medical services of and wounded waited twenty-four hours
the Army and the Navy, Hallam estab- or more for hospital care on
lished good working relations with the Guadalcanal. Of all deaths by enemy
senior medical officers of both services action sustained during the campaign,
and the restive Army Air Forces. But 50 percent occurred in the first two
even as ships headed north from bases weeks.
in the Russell Islands and Guadalcanal, Leaving the clearing company to
deficiencies in medical manpower cast replace its equipment, the 43d
shadows over the large, complex cam- Division’s 172d and 169th Infantry, sup-
paign that lay ahead. Maxwell had not ported only by a few collecting platoons,
yet adopted SWPA’s innovation of the crossed Blanche Channel to northwest
portable surgical hospital, and the 43d New Georgia, aiming an assault at
Infantry Division entered battle some Munda airfield. Meanwhile, a mixed
30–35 percent understrength in medical force of soldiers and marines from
personnel, both officer and enlisted—a Guadalcanal landed north of Munda to
forbidding statistic, given the primitive cut Japanese communications. On both
tropical terrain where both soldiers and fronts jungle fighting at its worst
marines would have to fight. The med- ensued. The troops pushed their way
ical evacuation plan relied on support through trackless terrain, alternately
by a single clearing company, which steep and swampy. Mud, heat, and
would act as the division hospital, and by unceasing rain slowed progress. All the
two collecting companies. For the dismal complications of diarrhea, dysen-
moment, the 17th Field Hospital tery, and skin infections harassed the
remained on call in the Russells.12 men. Malaria, despite rigorous control
On the night of 29–30 June elements measures, was a constant problem for
of the 43d Division, supported by the units whose soldiers were already infect-
collecting companies of its 118th ed when they came ashore. Fatigue, dan-
Medical Battalion, made simultaneous ger, and sickness brought on stress reac-
landings on Rendova, southern New tions; tension was unrelenting, for the
Georgia, and Vangunu. Bitter fights in enemy skillfully infiltrated American
sodden jungles and flooded marshes lines at night. Even veterans were sub-
yielded control of important anchorages ject to strange delusions: “In their
minds, the phosphorescence of rotten
12
logs became Japanese signals. The smell
Memo, Lt Col H. S. Tubbs to CofS, USAFISPA, 6
Jun 43, sub: Planning New Georgia Operation, THU of the jungle became poison gas. . . .
Note Cards, HUMEDS, RG 112, NARA. The slithering of the many land crabs
AMPHIBIOUS ADVANCE 185
was interpreted as the sound of was likewise enlarged, with the newly
approaching Japanese.”13 arrived 25th Division supported by its
In the darkness the troops fired their 25th Medical Battalion and the 37th
weapons and hurled grenades blindly. Division by its 112th Medical Battalion.
Almost 16 percent of casualties were On 28 July the 17th Field Hospital land-
later judged to have been caused by ed and opened on the islet of Kokorana,
friendly fire—a high proportion, even off Rendova (see Map 8). (A Navy malar-
for jungle fighting. Neuropsychiatric ia control unit had landed two weeks
casualties were many; the 169th Infantry earlier, surveyed campsites, and oiled
alone suffered 700 by 31 July. troop bivouac areas.)15
Contributing to a crisis in morale were Meanwhile, a new offensive began,
hunger and the difficulty of getting the employing infantry, tanks, flamethrow-
wounded to treatment. Since the ers, and artillery support. Fighting as dif-
absence of roads prohibited the use of ficult and bloody as any on Guadalcanal
vehicles, except jeeps on the wider trails, followed before Griswold’s forces
some regiments had to carry forward secured Munda airfield on 6 August.
their own ammunition, supplies, and Mopping-up operations and seizure of
casualties. The clearing station on the nearby islands of Vella Lavella and
Rendova was quickly overwhelmed, Arundel took another six weeks.
exposing the inadequacy of medical Between 23 July and 10 September the
support for the bruising battle.14 112th Medical Battalion alone treated
Soon the theater command realized more than 3,000 cases, including almost
that the New Georgia front must be revi- 1,000 battle casualties.16
talized, new tactics developed, and a The four-month campaign for the
more efficient supply system estab- central Solomons was over, but at a
lished. At the urging of General heavy cost. American battle casualties
Harmon, the USAFISPA commander, totaled 1,094 dead and 3,873 wounded;
Admiral Halsey ordered the XIV Corps added to the victims of accident, dis-
staff to New Georgia to take over supply, ease, and stress, more than 8,300 casual-
administration, and planning. On 11 ties were evacuated during July, August,
July Maj. Gen. Oscar W. Griswold, the and September. As the initial invasion
corps commander, arrived on Rendova. force, the 43d Division suffered the
Shortly afterward, elements of the 25th most; its 172d Infantry counted 1,550
Infantry and 37th Infantry Divisions wounded or sick, 777 from a single bat-
were ordered in, and on 17 July talion. The Japanese numbered about
Griswold took command of the expand- 2,500 dead, and successfully evacuated
ed New Georgia forces. Medical support some 9,400 others. They lost the fight,
but had perhaps more reason than the
13
Quotation from Miller, CARTWHEEL, pp. 108–09. See
also ASF [Army Service Forces] Monthly Progress Rpt,
15
30 Nov 43, sec. 7, p. 8, THU Note Cards, Historians 112th Med Bn Annual Rpt, 1943, p. 4, THU Note
files, HUMEDS, RG 112, NARA. Cards, Historians files; CSurg, USAFISPA, Annual Rpt,
14
Rpt, Surg, XIV Corps, to CSurg, USAFISPA, 31 Oct 1943, pp. 9–10, file 319.1–2. Both in HUMEDS, RG 112,
43, sub: Medical Service, New Georgia Campaign, p. 32, NARA. See also “Navy Medical Department at War,”
Encl to 1st End, CSurg, USAFISPA, to SG, U.S. Army, 11 1:109, BMSA.
16
Nov 43, file 370 (Medical Service, New Georgia 112th Med Bn Annual Rpt, 1943, p. 4, THU Note
Campaign) SPA, HUMEDS, RG 112, NARA. Cards, Historians files, HUMEDS, RG 112, NARA.
186 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
which depleted the line units. Matters and Marine units ashore and afloat pro-
were no better when the battle wounded vide adequate hospital facilities; no hos-
reached the rear areas, for hospitaliza- pital was available until the Navy’s Cub
tion was inadequate in the beginning Three unit arrived in late September.20
and, despite improvements, remained so In late July matters improved. The
throughout the campaign. During the 37th Division brought in its clearing
first month of combat, a period of heavy company, which worked in two platoons;
casualties when no hospitals at all were and the 25th Division brought one clear-
available, the clearing station on
Rendova provided beds equal to only 1.5 20
Whitehill, “Medical Activities in Middle Pacific,”
percent of the entire force. (By contrast, block 18g, pp. 7–13, file 314.7; 118th Med Bn Annual
Rpt, 1943, p. 2, file 319.1–2; CSurg, USAFISPA, Annual
on Guadalcanal the Americal Division Rpt, 1943, p. 10, file 319.1–2; Rpt, Surg, XIV Corps, to
had been supported by three clearing Surg, USAFISPA, 31 Oct 43, pp. 2–3, 8–9, Encl to 1st
companies, all reinforced, with a total of End, CSurg, USAFISPA, to SG, U.S. Army, 11 Nov 43,
file 370 (Medical Service, New Georgia Campaign)
800 beds—about 5 percent of division SPA. All in HUMEDS, RG 112, NARA. The Navy’s Cub
strength.) Nor did the available Navy Continued
188 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
ing platoon to New Georgia, while the made—that the holds were clean and
other supported its 35th Infantry in the cots readied before the customary
invasion of nearby Vella Lavella. In all, departure time of 1800. Frequently, the
about 375 clearing station beds were ships unloaded so late in the afternoon
added to 250 made available through that little time was left to bring casualties
expansion of the original clearing sta- aboard, make them comfortable, and
tion on Rendova. And on the twenty- exchange litters and blankets. Sailors
eighth the 250-bed 17th Field Hospital joked that LST meant “Large Slow
arrived. Yet the average bed strength of Target,”21 and the voyages to
875 during August was equal only to 3 Guadalcanal, lasting between twenty
percent of the expanded forces in the and twenty-four hours, lent credence to
New Georgia group, still insufficient the name. For many of the wounded,
given the level of combat and the hostile taking into account delays on New
environment. Casualties were slow to Georgia and on shipboard, seventy-two
reach these facilities but quick to leave or even eighty-four hours might elapse
them. Until 15 August an evacuation between initial injury and definitive
policy of twenty-four hours prevailed, treatment. Inevitably, wounds became
and after that three to five days. Only on infected, and gas gangrene sometimes
20 September, when the campaign was set in.22
drawing to a close, did the command at Until Munda airfield became opera-
last attain a seven-day policy. tional on 14 August, evacuation by air
For wounded troops returning to the was limited to those whose condition
bases, “hurry up” once more gave way to required immediate care. Navy amphibi-
“wait.” The road to treatment proved ous planes carried such casualties,
longer than the 200 miles of water to despite Hallam’s complaint that the slow
Guadalcanal might suggest. LSTs bore and clumsy “dumbos” required the pro-
87 percent of New Georgia’s casualties, tection of fighter planes urgently need-
averaging 100–200 or more per trip, but ed for combat. The whole situation was
their management was far from ideal. greatly eased when the airfield opened;
Problems began with scheduling. wounded soldiers, sailors, and marines
Medical units ashore had to make their alike were dispatched in marine-piloted
own arrangements with the ships’ com- craft of the Air Transport Command’s
manders, an uncertain method at best; Pacific Wing. Until then, New Georgia
careful coordination was needed even to too often presented the image of an
ensure that basic preparations were area of severe combat and rampant dis-
21
Three unit was established in September 1942 to oper- Arrangements on LSTs improved after Colonel
ate as a 200-bed base hospital or, depending on the mis- Hallam contacted Navy officers with whom he had
sion, as a number of dispensaries. Hospital personnel worked before the campaign to see that more medical
and equipment could be divided to function as sepa- supplies and a second medical officer were added to
rate groups, where needed. Arriving in the South each ship.
22
Pacific in the spring of 1943, elements of the Cub Whitehill, “Medical Activities in Middle Pacific,”
Three unit participated in the Rendova and New block 18g, pp. 2–8, file 314.7; Rpt, Surg, XIV Corps, to
Georgia operations before, in its entirety, being sent to CSurg, USAFISPA, 31 Oct 43, pp. 5–6, Encl to 1st End,
Munda, New Guinea, in September. On 16 January CSurg, USAFISPA, to SG, U.S. Army, 11 Nov 43, file 370
1944, effective 24 December 1943, the Cub Three unit (Medical Service, New Georgia Campaign) SPA. Both
was redesignated as U.S. Naval Base Hospital No. 11. in HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 189
ease, its sick and wounded unable to be treated patients with fluids, rest, and
treated or even to be evacuated in suffi- doses of sulfaguanidine. But prevention,
cient time to promote their recovery.23 not cure, ensures combat readiness, and
The New Georgia disease picture was by that standard performance was poor.
mixed but on the whole unsatisfactory. Admissions reached 500 per 1,000
Anopheles mosquitoes were not abundant troops per year in August; 18 percent of
by Solomon Islands standards, and a hospital admissions were caused by diar-
Navy malaria control unit, landing in rhea and dysentery, a substantial drain
July, helped to prevent new cases of the on the command.25
disease from becoming a major prob- The major medical problem encoun-
lem. Practically, all malaria cases were tered at New Georgia, however, was the
recorded in soldiers previously infected high incidence of stress-related ail-
on Guadalcanal. There the 25th ments, all lumped under the general
Division had an admission rate of 1,313 classification of war neuroses. Included
per 1,000 troops per year; the unit actu- were problems that ranged from
ally recorded a lower rate on New exhaustion to psychosis. The 43d
Georgia during the fighting. Yet those Division, though it comprised only 40
who entered battle “thoroughly saturat- percent of the forces on the island, con-
ed with malaria” fell sick with alarming tributed almost 80 percent of the vic-
frequency, as New Georgia’s 2,900 tims. Most cases occurred during the
admissions for malaria testified.24 first month of combat, when hospitaliza-
Other diseases were clearly of local tion was severely limited, a 24-hour evac-
origin. Poor field sanitation produced uation policy was in effect, medical per-
serious outbreaks of diarrhea and dysen- sonnel were 30–35 percent short of
tery, to which line commanders, sol- authorized levels, and no psychiatrist
diers, and the medics all contributed, was in the area. Some casualties were
because of poor discipline and inade- “the picture of utter exhaustion”; others
quate supervision. Waste disposal was were agitated, trembling and starting at
ineptly handled, and the absence of every sound, “crying, wringing their
screens on messes, kitchens, and latrines hands, mumbling incoherently,” and
allowed the fly population to increase; a “trying to escape impending disaster.”26
limited water supply made washing of At first, these victims were simply
utensils difficult, and the troops’ hands shipped out. The 43d evacuated 1,950 of
were seldom clean. Medical personnel its 2,500 neuropsychiatric (NP) cases; a
psychiatrist working at Fiji later remem-
23
Whitehill, “Medical Activities in Middle Pacific,” bered receiving several hundred such
block 18g, pp. 6–7 (“dumbos,” p. 6), file 314.7; Rpt, patients from New Georgia in a single
Surg, XIV Corps, to CSurg, USAFISPA, 31 Oct 43, p. 6,
Encl to 1st End, CSurg, USAFISPA, to SG, U.S. Army, 11 day. Yet for many there was a simple
Nov 43, file 370 (Medical Service, New Georgia cure. Removing NPs from the line and
Campaign) SPA. Both in HUMEDS, RG 112, NARA. giving them three to four days of rest, a
24
ASF Monthly Progress Rpt, 30 Nov 43, sec. 7, p. 9
(quotation), THU Note Cards, Historians files;
25
OofSurg, XIV Corps, Summary of New Georgia ASF Monthly Progress Rpt, 30 Nov 43, sec. 7, p. 8–9,
Campaign, pp. 1–2, file 370 (New Georgia Campaign) THU Note Cards, Historians files, HUMEDS, RG 112,
SPA; Whitehill, “Medical Activities in Middle Pacific,” NARA.
26
block 18e, pp. 28–29, file 314.7. All in HUMEDS, RG Whitehill, “Medical Activities in Middle Pacific,”
112, NARA. block 18g, p. 36, file 314.7, HUMEDS, RG 112, NARA.
190 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
bath, and nourishing food enabled quate hospitals, with laboratory person-
75–80 percent to recover completely. nel to speed diagnosis of the many trop-
Later to reach the combat zone, both ical ills.28
the 37th and the 25th Divisions set up If the medical side of the campaign
rest camps, salvaging, in Hallam’s opin- for New Georgia was run worse than the
ion, about 2,000 who might otherwise campaign for Guadalcanal, the struggle
have been evacuated. Again, the need itself was in some respects more wear-
for forward-area psychiatrists was driven ing. The soldiers and marines on New
home. In response to such combat expe- Georgia were unable to fight a largely
rience, and to “continued and repeated defensive battle, as the marines had on
pressure from senior medical officers in Guadalcanal, where the fighting was
the combat theaters,” the War aggressive throughout. In the earlier
Department established the position of campaign Henderson Field had fallen
division psychiatrist in November to the Americans almost at once, virtual-
1943.27 ly undefended; on New Georgia, Munda
Summarizing the New Georgia situa- airfield yielded only after a bitter and
tion, Hallam emphasized that disease protracted struggle. Of courage there
(including psychiatric disorders) war- was much evidence on New Georgia,
ranted major consideration in opera- among the medics as well as the line.
tional planning. Of a force of soldiers The medics of the 118th Medical
and marines that never exceeded Battalion alone received three Silver
35,000, a total of about 13,500 admis- Stars, a Legion of Merit, twenty-one
sions had been recorded—again, as at Purple Hearts, and a variety of other
Attu, more than the whole enemy garri- decorations; one medic, Pfc. Frank J.
son. Of these, 27 percent had been Petrarca, was awarded the Medal of
wounded, 11 percent injured, and 62 Honor. Yet in the last analysis the battle
percent sick. In future operations, was won by the sheer weight of numbers,
Hallam emphasized, the forces would and the medical support system did not
need mobile surgical units; forward sur- work very well at all.29
gical teams; medical, surgical, and psy- The situation cried out for planning
chiatric consultants; convalescent camps that would not again send one division to
to conserve manpower; and more ade- do the work of three, or a clearing station
to perform the duties of a field hospital.
27
To the theater’s credit, learning was swift.
Quotation from Lloyd J. Thompson, “Early
Developments, Personnel, and Education and Training,” It was New Georgia, not Guadalcanal,
in Albert J. Glass, ed., Overseas Theaters, Medical that compelled USAFISPA headquarters
Department, United States Army in World War II to face up to the medical realities of jun-
(Washington, D.C.: Office of the Surgeon General,
Department of the Army, 1973) p. 196n9. On the divi- gle warfare, and the theater’s last major
sion psychiatrist position, see WD Cir 290, 9 Nov 43, p. 2. fight, at Bougainville, was conducted in a
See also Intervs, Slaughter, 23 Dec 43, and Maj Theodore far more competent style.
Lidz, 26 Mar 45, file 000.71; Ltr, M. Ralph Kaufman to
Col Earl Maxwell, 16 Dec 43, sub: Neuropsychiatric
28
Experiences With the 17th Infantry Division, in OofSurg, OofSurg, XIV Corps, Summary of New Georgia
USAFISPA, ETMD, 6 Jan 44, file 350.05; and Personal Campaign, pp. 1–2, file 370 (New Georgia Campaign)
Opinion of Maj Harold J. Barker, MC, as to the New SPA, HUMEDS, RG 112, NARA.
29
Georgia Campaign, 6 Sep 43, THU Note Cards, 118th Med Bn Annual Rpt, 1943, an. 3, p. 2, file
Historians files. All in HUMEDS, RG 112, NARA. 319.1–2, HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 191
were not lost to their units through evac- Before airfields opened, ships and
uation; only forty-eight were removed PBY “Catalina” amphibious planes evac-
from the island during the first six uated casualties from Bougainville. Both
weeks. The campaign’s record in this proved unsatisfactory. For casualties to
respect set it apart from all previous reach an amphibious plane entailed
Allied efforts in the Pacific fighting.34 transfers by litter or jeep to the beach,
Yet the jungle and the enemy com- and from there by tank lighter to a small
bined to impose serious difficulties on crash boat. The crash boat then maneu-
the medics and their charges. Until mid- vered to the plane’s side gunport,
December the marines evacuated from through which the stretcher was man-
battalion aid stations to field hospitals handled aboard. Evacuation by LST
by amphibious tractors through the required movement by litter or jeep to
swamps. Then construction crews com- the beach, and then by tank lighter to
pleted a road system within the perime- the ship. Most Army casualties, however,
ter that allowed motor ambulances to came late enough in the campaign to be
provide rapid and efficient service even evacuated by land-based aircraft, as air-
during the March attacks. Most casual- field construction on Bougainville
ties arrived at a hospital within three enabled Marine C–47s to carry casual-
hours of wounding, and many within ties back to Guadalcanal on return runs.
one hour. But evacuation for those who Those needing a long period of conva-
ventured outside the perimeter lescence went further, by ship or air to
remained difficult and dangerous. Espiritu Santo or New Caledonia.
Patrols moved as far as 8,000 yards into The primary innovation that distin-
enemy-held territory. Casualties had to guished Bougainville was that the Navy
be littered back over ridges and draws, assumed sole responsibility for planning
exhausting bearers and patients alike. and coordinating all evacuation from
Some who were wounded on patrol did the beachhead. Centralized control
not reach a hospital until twenty-four to resulted in minimal confusion and delay
forty-eight hours had elapsed, receiving and, in combination with adequate bed
only the care that a single aidman could strength on shore, assured that those to
provide during that window of time.35 be evacuated were truly in need of care
that went beyond the capacities of the
34
Whitehill, “Medical Activities in Middle Pacific,” island.36
block 18g, pp. 58–77, file 314.7; Surg, XIV Corps, Strict attention to the mistakes made
Annual Rpt, 1943, pp. 1–2, file 319.1–2. Both in
HUMEDS, RG 112, NARA. See also “Navy Medical on New Georgia also enabled the Office
Department at War,” 1:123–24, 135, BMSA; Sir Duncan of the Chief Surgeon, USAFISPA, to
Stout, “The New Zealand Medical Services,” in Sir deal more effectively with disease.
Arthur Salusbury MacNalty and W. Franklin Mellor,
eds., Medical Services in War: The Principal Medical Lessons Except for combat fatigue and malaria
of the Second World War (London: Her Majesty’s brought in by the troops, problems were
Stationery Office, 1968), pp. 701–11. few. Of 40,500 who served on
35
Whitehill, “Medical Services in Middle Pacific,”
block 18g, pp. 64–65, file 314.7; Rpt (Extract), Col J. M.
Roamer, Intel Dir, ASF, 12 Jul 44, sub: Lessons From the
36
Experiences of the 3d Marine Division in the Whitehill, “Medical Activities in Middle Pacific,”
Bougainville Operations, p. 25, file 350.07 block 18g, pp. 66–67, file 314.7, HUMEDS, RG 112,
(Bougainville Operations, 3d Marine Div) SPA. Both in NARA; “Navy Medical Department at War,” 1:132–37,
HUMEDS, RG 112, NARA. BMSA.
194 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Bougainville, only about 5,000 suffered scattered cases of severe illness: scrub
ailments other than enemy-inflicted typhus, contracted by troops on patrol;
wounds, a remarkably low proportion amebic dysentery; diphtheria; and hook-
on an island afflicted with many infec- worm infection. Malaria was fairly com-
tious diseases. Perhaps because of its mon, and yet, despite the island’s dense
larger population, Bougainville (unlike Anopheles population, almost all cases
New Georgia) recorded malaria, resulted from earlier infections. Credit
dengue, scrub typhus, filariasis, pneu- for preventing more infections belonged
monia, influenza, and intestinal para- to the efforts of the joint malaria and
sites among its endemic ills. Skin dis- insect control organization (similar to
eases were common among the natives, SWPA’s joint tropical disease control
as were eye infections and diphtheria.37 committee) under Comdr. James J.
In such an environment the American Sapero, MC, USN. Pre-invasion indoctri-
forces suffered much discomfort and nation of the troops, stressing individual
malaria discipline, was supplemented on
Bougainville with a well-planned and
37
Whitehill, “Medical Activities in Middle Pacific,” well-executed program of ditching,
block 18g, pp. 58, 69–77, file 314.7, HUMEDS, RG 112,
NARA; “Navy Medical Department at War,” 1:130–31, draining, dusting, and oiling that was
BMSA. begun immediately after the first landing
AMPHIBIOUS ADVANCE 195
and carried out by malaria survey and exhaustion or combat fatigue; for them
control detachments, which had gradual- the camp provided a quiet respite
ly increased in number during 1943. before they returned to duty. In contrast
Other health problems were less to the heavy evacuations from New
threatening. The wet, steaming jungle Georgia, over 90 percent of the 37th
and the limited opportunities to bathe Division’s battle fatigue cases returned
resulted in the usual skin conditions, to duty. Division psychiatrists, appearing
which were painful and distressing but for the first time during this campaign,
seldom required hospitalization. The provided expert diagnoses to the 37th
casual company’s rest camp, by treating and the Americal Divisions, which
skin diseases along with ear, eye, and already had good records in avoiding
sinus infections, enabled many soldiers excessive numbers of NPs. Veterans of
to stay on the island who might other- earlier campaigns, with good morale
wise have been evacuated; an expert and capable leadership, the soldiers of
dermatologist, had one been assigned, the two divisions were matured cam-
might have saved more. The majority of paigners, like the medical service that
casualties, however, were victims of supported them, and the results were
196 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the two, defended by only a few hun- bomb bursts and strafing, rescued the
dred of the more than 80,000 Japanese survivors of sinking boats.
on New Britain.40 Hospitals provided close support. A
The Army task force was built around surgical team of the 29th Evacuation
the veteran 112th Cavalry. Supporting Hospital landed with the assault troops
medical units included a clearing com- and worked on the beach, beside the aid
pany and a collecting platoon of the station (see Map 8). For the first time,
135th Medical Regiment, the 29th portables operated aboard LCTs (land-
Evacuation Hospital, and three portable ing craft, tank), assisted by mobile surgi-
surgical hospitals. On 15 December the cal teams of two surgeons and ten corps-
main landing, led by amphibious trac- men each. The LCTs frequently came
tors, took place against light opposition. under enemy air attack, both when they
Two enemy companies quickly retreat- stood inshore to evacuate casualties
ed, but planes from Rabaul attacked the from the beach and when they ferried
invaders. Army landing craft, dodging the wounded across the embattled
straits. The 29th established itself on the
boot-shaped peninsula that enclosed
40
Arawe was never used either for an airstrip or a PT the harbor. The swampy ground and the
boat harbor, the original justifications for taking it. The
118 dead and 352 wounded apparently suffered to no destruction of cover by American bom-
purpose. bardment and Japanese air attacks
198 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
forced hospital personnel to work in bad shape, and a large number, about 60
dugouts, protected by cocoanut logs percent, had to be operated [on] imme-
and sandbags. Despite this protection, diately upon arrival [in a hospital].
on 16 December a direct hit blasted the Several cases of gas infection amputations
operating room and killed two enlisted were involved.”42
men, indicating that too large a unit had LSTs specially converted for hospital
come ashore too soon in too vulnerable care were used for both surgery and
an area.41 evacuation. The LST–H crewmen made
Meanwhile, the 1st Marine Division the necessary physical alterations,
invaded Cape Gloucester on 26 installing a watertight hatch in the tank
December. The marines secured the deck bulkhead to provide ready entry
beach with ease, their main obstacle prov- into the forward troop compartments,
ing to be the swampy jungle that lay which were then converted into a receiv-
inland. But the campaign thereafter was a ing room, a scrub room for the sur-
slow, tough advance that involved hack- geons, and an operating room.
ing out jungle trails, maneuvering Ambulances entered the ship just as
through swamps, and fighting a tenacious tanks had left it, by driving up the ramp.
enemy on rain-drenched jungle ridges Ward space was provided by cots on the
and in stifling fields of shoulder-high tank deck and by bunks in the troop
kunai grass. Ashore, a Navy beach party compartments of the ship. Even when
officer, for the first time in the Southwest converted, the LST–H remained far
Pacific Area, worked with the 1st Marine from a safe or comfortable means of
Division to organize the evacuation of treating the wounded. But the
casualties. Medical units staffed by the Southwest Pacific Area had few ships
Navy bore the burden of support and came to rely upon the LST–H more
throughout the fighting; except for one than any other theater, for the ship
collecting company of the 135th Medical served medical needs without losing its
Regiment, Army medical units did not capacity for carrying troops and cargo.
arrive to relieve them until 30 January The 6th, 8th, and 13th Portable Surgical
1944. In the opinion of Army observers, Hospitals all worked aboard such ships,
forward care left much to be desired. Col. stabilizing the wounded while moving
William B. Parsons, MC, surgical consul- through the still-dangerous waters of the
tant to General Headquarters, SWPA, Dampier Strait toward Army hospitals at
observed some of the evacuees and Finschhafen, Goodenough Island,
reported: “A large percentage . . . were Buna, and Milne Bay.43
dehydrated, toxic, running a tempera-
ture, and exhausted. The wounds were in 42
Interv, Col William B. Parsons, 19 Aug 44, p. 5 (quo-
tation), file 000.71; 135th Med Regt Unit History
(copy), [1942–44], p. 3, file 300-Med-0.1. Both in
41
“Seventh Amphibious Force History,” pp. 65–66, HUMEDS, RG 112, NARA.
43
file 314.7 (7th Amphibious Force) SWPA; Interv, Sgt “Seventh Amphibious Force History,” p. 66, file
Charles T. Downer, 23 Jan 45, file 000.71; 29th Port 314.7 (7th Amphibious Force) SWPA; 6th Port Surg
Surg Hosp Annual Rpt, 1943, p. 2, file 319.1–2; Hosp Quarterly Rpts, Oct–Dec 43 and Jan–Mar 44, and
Quarterly Rpts, Oct–Dec 43, for 17th Port Surg Hosp, 8th Port Surg Hosp Quarterly Rpt, Jan–Mar 44, THU
pp. 1–2, 135th Med Regt (copy), p. 3, and 29th Evac Note Cards, Historians files; Notes on 13th Port Surg
Hosp (copy), p. 2, file 319.1. All in HUMEDS, RG 112, Hosp Quarterly Rpt, Jan–Mar 44, Historians files. All in
NARA. HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 199
After the battle, Army medical units no easy prescription to follow, given the
ashore still found much work to do, for climate.45
the enclave was scourged by disease. The An overture to the coming campaign
135th Medical Regiment furnished along the New Guinea coast, and to
ambulance service, accompanied marine some degree a distraction from it, the
patrols, ran a holding unit for air evac- New Britain battles were marked by use-
uees, and relieved a Navy clearing station ful innovations in amphibious medical
that was performing poorly its job of sup- support. While the Japanese prepared
porting the marines. Then the 30th for an attack against Rabaul that never
Evacuation Hospital arrived to support came, MacArthur now gathered his
the varied forces in the area—the forces—battle-tested and strengthened
marines, Army service troops, and air by improved intelligence, amphibious
force units. A site for the hospital’s semi- capability, and air support—to strike
permanent buildings had to be hand- deep behind enemy lines.
hacked out of the jungle’s high hard-
wood trees and matted undergrowth, CARTWHEEL Ends
mostly by native laborers. Twelve of the
twenty wards held marines suffering Lying on the north side of the Huon
from scrub typhus, Cape Gloucester’s Peninsula, 110 miles from Finschhafen,
most dangerous endemic disease the target town of Saidor was a useful
acquired in the kunai grass inhabited by site on which to construct a forward
rats harboring infected mites. The dis- airstrip. Expecting sharp counteraction
ease featured high fever and prostration, to an assault that would divide the
and in this area resulted in a mortality of Japanese 18th Army, the SWPA medical
8.3 percent.44 service provided twice as much support
Treatment required a long period of as for Salamaua, an operation of similar
hospitalization, with careful nursing. size. A task force built around the 126th
When 155 casualties were admitted dur- Regimental Combat Team of the battle-
ing February and March, the 30th tested 32d Infantry Division—about
Evacuation Hospital requested assis- 7,000 soldiers in all—received support
tance from the companies of the 135th from an amphibious medical company,
Medical Regiment. Control measures a collecting company, a clearing pla-
included clearing undergrowth from
unit areas, burning off kunai grass, and 45
135th Med Regt Unit History (copy), [1942–44],
eradicating rodents. Orders were issued pp. 3–6, file 300-Med-0.1; Quarterly Rpts (copies),
to the troops to tie their pant legs and Jan–Mar 44, for 30th Evac Hosp, pp. 2–3, and Surg,
cover their bodies as much as possible— Sixth Army, pp. 10–11, file 319.1. All in HUMEDS, RG
112, NARA. See also Francis G. Blake et al., “Studies on
Tsutsugamushi Disease (Scrub Typhus, Mite-Borne
Typhus) in New Guinea and Adjacent Islands:
44
135th Med Regt Unit History (copy), [1942–44], Epidemiology, Clinical Observations, and Etiology in
pp. 3–6, file 300-Med-0.1; Quarterly Rpts (copies), the Dobodura Area,” American Journal of Hygiene 41
Jan–Mar 44, for 30th Evac Hosp, pp. 1–2, and Surg, (May 45): 243–373; Cornelius B. Philip, “Scrub Typhus
Sixth Army, pp. 3–4, file 319.1. All in HUMEDS, RG and Scrub Itch,” in Ebbe Curtis Hoff, ed., Communicable
112, NARA. The Cape Gloucester mortality was about Diseases: Arthropodborne Diseases Other Than Malaria,
standard for New Guinea, though some areas reported Medical Department, United States Army in World War
much worse; on Goodenough Island, 25 percent of II (Washington, D.C.: Office of the Surgeon General,
those who became ill died. Department of the Army, 1964), pp. 275–91, 340–44.
200 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
toon, six portable surgical hospitals, a ber of islets paralleling Manus’ northern
field hospital, a malaria survey unit, and coast. Possessing a superb harbor and
a medical supply aviation platoon. two airfields, the Admiralties promised
Other medical units were to arrive after to make an excellent forward air base to
the initial landing. Again, four of the control the Bismarck Archipelago, as
portables functioned in effect as small well as a future staging area for later
evacuation hospitals aboard converted moves against the Philippines.
LSTs. Brig. Gen. Guy B. Denit, MC, who
The troops went ashore on 2 January replaced Carroll as chief surgeon in
1944, as scheduled, but the array of January, had to provide medical units
medical units proved to be unnecessary. for a large task force built around, not
Resistance to the landing amounted to a regimental combat team or two, but
no more than a few rifle shots; the the veteran dismounted 1st Cavalry
enemy failed to counterattack, and the Division. Support included the divi-
Allies missed an opportunity to trap two sion’s 1st Medical Squadron, a separate
withdrawing Japanese divisions between clearing company, one evacuation and
the American invaders and the two portable surgical hospitals, and
Australians advancing overland. malaria control and survey units. The
Casualties remained few, although division’s unusual structure—four regi-
some cases of scrub typhus appeared ments organized into two brigades—
when troops bivouacked in kunai grass caused a portable to be assigned to
and neglected to apply a miticide each brigade, to land and move for-
recently recommended by Army typhus ward with the troops. Native litter-bear-
experts to their clothing and blankets. ers were to be employed, to overcome
While the Allies consolidated their the obstacles of terrain that was known
gains and planned new advances, the to be difficult.47
Japanese escaping through the jungle Such preparations were timely, for
suffered new and heavy losses to hunger the infantrymen found hard fighting in
and disease.46 the Admiralties. For a month after land-
The concluding act of CARTWHEEL was ing on 28 February, the division fought a
an invasion of the Admiralty Islands. slow, arduous battle for Los Negros,
Lying north of Saidor, the group con- enduring heavy casualties. Japanese
sists of a principal island, Manus; a counterattacks sent many to the rear
smaller island, Los Negros; and a num- with grenade and mortar wounds. The
30th Portable Surgical Hospital went in
early, with the reconnaissance force, and
46
See Quarterly Rpts (copies), Jan–Mar 44, for 22d settled into Japanese dugouts near an
Port Surg Hosp, pp. 1–2; Surg, Sixth Army, pp. 4, 10–11;
Surg, 32d Inf Div, pp. 1–3, 7; 23d Field Hosp, pp. 1–3, aid station 150 yards inland. Surgeons
5; 670th Clearing Co, p. 1; and FSurg, Adv Echelon, 5th operated in one bunker, and used two
Air Force, p. 1, all file 319.1, as well as for 6th Port Surg others as wards; the flow of plasma
Hosp, THU Note Cards, Historians files, and Notes on
13th Port Surg Hosp, p. 1, Historians files. All in rarely stopped, and surgery went on all
HUMEDS, RG 112, NARA. In loc. cit., see also Interv,
Downer, 23 Jan 45, file 000.71; 135th Med Regt Unit
47
History (copy), [1942–44], p. 4, file 300-Med-0.1; and Surg, lst Cav Div, Quarterly Rpt (copy), Jan–Mar 44,
“Seventh Amphibious Force History,” p. 67, file 314.7 p. 2; Surg, Sixth Army, Quarterly Rpt (copy), Jan–Mar
(7th Amphibious Force) SWPA. 44, pp. 4–6. Both file 319.1, HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 201
Krueger, commanding general of the flotilla was part of the Navy’s Task Force
Sixth Army, declare the operation 77, which also included an armada of
ended. In all, the 1st Cavalry Division battleships, cruisers, destroyers, plus
lost 326 killed, 1,189 wounded, and 4 escort carriers sent by Admiral Nimitz to
missing; the Japanese apparently lost provide air cover. In this amphibious
about 4,000 killed and 75 captured.51 operation, the largest ever in the
Southwest Pacific Area, converted
The Road to Hollandia LST–Hs would be employed, with the
medical officer aboard each control ves-
With Rabaul neutralized, the con- sel regulating the movement of casual-
quest of Japanese-held western New ties to the ships and of medical supplies
Guinea moved into high gear. Able to and equipment to the shore. Some LSTs
follow enemy troop dispositions were to be beached to provide immedi-
through breakthroughs in signal intelli- ate surgical care to the wounded, after
gence, General MacArthur planned a which a naval medical officer was to
surprise assault on Hollandia and route them to the appropriate ship.
Aitape, coastal towns in the Netherlands Landings were planned at two inlets:
New Guinea. The region near Hollandia Humboldt Bay, on which Hollandia lies;
boasted harbors, three working air- and Tanahmerah Bay, lying westward
fields, and a fourth partly completed—a beyond the towering Cyclops Mountains.
Japanese base second only to Rabaul in The major objective was Lake Sentani,
strength. Yet, because the enemy did not which had three airfields on its north
expect to be attacked so far from Allied shore. But the way there was long—18
bases and airfields (Hollandia lies near- miles from Humboldt and 14 from
ly 600 miles west of Finschhafen), the Tanahmerah Bay—and threatened to be
16,000 defenders were known to be difficult and costly. To support its thrust
mostly airmen and service troops.52 at Tanahmerah Bay, the 24th Division
For the attack MacArthur chose the had available its 24th Medical Battalion,
24th and 41st Infantry Divisions, orga- two portable surgical hospitals, a separate
nized as the RECKLESS Task Force, a tem- clearing company, and an amphibious
porary headquarters for I Corps and its medical company; held in reserve were a
commander, General Eichelberger. collecting company from its medical bat-
Carrying the troops was Admiral talion, medical units supporting its 34th
Barbey’s VII Amphibious Force of trans- Regimental Combat Team, the division
ports, escorts, and landing craft. This reserve, and the 36th Evacuation
Hospital. Medical support was similarly
51
abundant for the 41st Division’s project-
Miller, CARTWHEEL, pp. 348–49.
52
Unless otherwise noted, combat narrative for ed landing in Humboldt Bay.
remainder of this chapter drawn from Robert Ross At dawn on 22 April 1944, under a
Smith, The Approach to the Philippines, United States naval smoke screen and a rocket barrage,
Army in World War II (Washington, D.C.: Office of the
Chief of Military History, Department of the Army, the RECKLESS Task Force came ashore
1953). On Hollandia, see Heavey, Down Ramp!, pp. from a calm sea without opposition. The
114–17, and “Navy Medical Department at War,” 1:192, barrage had sent the Japanese service
196, BMSA. On the VII Amphibious Force, see Edwin P.
Hoyt, MacArthur’s Navy: The Seventh Fleet and the Battle for troops flying into the hills, leaving
the Philippines (New York: Orion Books, 1989). behind their half-eaten breakfast of warm
AMPHIBIOUS ADVANCE 203
rice and tea. Beachheads were estab- miles away, as fires spread along the
lished; success came so quickly that, at beach, burning for two days and
1500, Generals MacArthur and Krueger destroying 60 percent of the supplies,
waded ashore in Tanahmerah Bay. American and Japanese.
Understandably, medical support at The calamity killed twenty-four
first went smoothly. At Humboldt Bay Americans and injured sixty-four, and
the 116th Medical Battalion followed delayed the landing of the 92d
the 41st Division inland along rough Evacuation Hospital and the portable
mountain trails. At Tanahmerah, howev- surgical hospitals. But the collecting pla-
er, problems developed. The two assault toon of Company B, 262d Medical
regimental combat teams, built around Battalion, had established an aid station
the 24th Division’s 19th and 21st in the center of the area. Throughout
Infantry, landed on separate beaches the night of 23–24 April the two officers
unconnected by any road. On Red and forty-four enlisted men held their
Beach 2 the troops were bottled up not post, working amid the holocaust of
by the enemy but by an inland swamp, flame and flying shrapnel to pull the
which neither they nor their vehicles burned and injured from the wreckage
could penetrate. At Red Beach 1 sol- and give first aid. Their courage won a
diers made their way up the presidential unit citation.54
Depapre–Lake Sentani trail, but even Away from the devastation on the
jeeps could not negotiate the winding beach, 41st Division forces encountered
mountainous way. Offshore, coral reefs minimal enemy resistance but rugged
prevented LSTs from approaching close- terrain and heavy downpours.
ly, and days passed before supply depots Meanwhile, troops on the Tanahmerah
could be established ashore.53 Bay–Depapre trail coped with countless
Meanwhile, a disaster occurred defiles, swollen streams, and frequent
behind the lines. In Humboldt Bay one landslides. On the march, collecting
beach had been a major Japanese sup- companies provided medical support,
ply dump, with piles of ordnance, first aid, and even basic surgery.
rations, airplane engines, and medical Supplies had to be hand-carried forward
supplies. The Americans similarly piled and casualties littered back to the beach-
their own materiel beside the dump. es. By D+3 the supply and evacuation
But on the night of D+1 a lone enemy line to Tanahmerah Bay was 12 miles
bomber scored three direct hits on the long, rainsoaked, and so difficult that it
captured dump, setting off thunderous took one to two days to walk. All the col-
blasts and sending burning missiles lecting companies and portables at
hundreds of feet into the air. Sailors in Tanahmerah were sent forward to assist.
ships offshore could see the glow from Relay points were established, where
casualties received treatment and litter-
53
bearers rested. Clearing stations and an
Rpt, Surg, 116th Med Bn, sub: Letterpress LF
[Landing Force], 17 Apr–5 May 44, p. 2, file 341-Med-
54
0.3, box 10649, and Tanahmerah Historical Rpt, 22 Rpt, Surg, 116th Med Bn, pp. 2–3, file 341-Med-0.3,
Apr–6 Jun 44, an. 14, p. 216, file 324.0–3, box 7667, RG box 10649, RG 407, NARA; Surg, 24th Inf Div,
407, NARA. See also Surg, 24th Inf Div, Quarterly Rpt Quarterly Rpt (copy), Apr–Jun 44, pp. 2–3, file 319.1,
(copy), Apr–Jun 44, p. 2, file 319.1, HUMEDS, RG 112, HUMEDS, RG 112, NARA. Unit citation reprinted in
NARA. Heavey, Down Ramp!, p. 208.
204 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
EVACUATION BY AIR
advance surgical team of the 36th use by Allied planes, evacuation by air
Evacuation Hospital cared for casualties rapidly took precedence and soon was
on the Red beaches before moving moving twice as many evacuees as the
them by boat to the 92d Evacuation longer, slower route by sea. During the
Hospital, now established at Humboldt weeks that followed, combat patrols
Bay. There Japanese medical supplies hunted down the remaining enemy; ser-
that had escaped the fire—surgical vice troops took over the region, and
instruments, soap, dressings, peroxide, General Krueger officially declared the
microscopes, an X-ray machine, and ten operation closed. American casualties
tons of quinine—were put to good use numbered only 124 killed, 1,057 wound-
by the hospitals. ed, and 28 missing; Japanese losses were
On 26 April the weary 24th Division estimated at 611 captured and over
made contact with the 41st Division at 3,300 killed. Another 7,000 enemy
Lake Sentani, a beautiful and refreshing troops tried to escape by making their
scene below grassy hills with “stranded way through the jungle to Sarmi, but
trees scattered in lonely fashion.” The apparently few survived the ravages of
Allies now possessed three airfields— starvation and disease.55
Hollandia, Sentani, and Cyclops. The
fourth at Tami, 6 miles west of 55
Surg, 32d Inf Div, Quarterly Rpt (copy), Jul–Sep 44,
Humboldt Bay, fell shortly afterward. p. 6 (quotation), and Surg, 24th Inf Div, Quarterly Rpt
The Depapre Trail was abandoned, and (copy), Apr–Jun 44, pp. 3–5. Both file 319.1, HUMEDS,
RG 112, NARA. See also Rpt, Surg, 116th Med Bn, pp.
casualties were taken to Humboldt Bay 3–4, file 341-Med-0.3, box 10649, RG 407, NARA.
instead. But as the airfields were put to Statistics from Smith, Approach to Philippines, p. 83.
AMPHIBIOUS ADVANCE 205
units in the area, ensured that small and moved into the jungle beyond.
detachments had dispensary service, and American units were compelled to with-
informed all units of his scheme of evac- draw to the X-ray River, 3 miles to the
uation and the location of the hospitals. west. Next day, while American artillery
At his disposal were a 200-bed section of opened up, patrols clashed with the
the 54th Evacuation Hospital, one enemy. Determined to restore the
portable surgical hospital for each regi- Driniumor line, they attacked on the
ment, a malaria survey unit, a malaria thirteenth. The 1st, 5th, and 18th
control unit, a separate clearing compa- Portable Surgical Hospitals accompa-
ny, and the 30th Evacuation Hospital. nied them through jungle fighting that
Such resources were more than sufficient slowly destroyed the Japanese forces
to support forces engaged in maintaining west of the river and reestablished
a defense perimeter around the airfields American control of the river’s west
and in skirmishing with Japanese patrols. bank. In the foothills at Afua the 127th
Company aidmen accompanied the Infantry and the 112th Cavalry with-
infantry; medical personnel set up aid stood desperate attacks from all direc-
stations at outlying posts, rotating back to tions by enemy soldiers who were starv-
Aitape every four to seven days for rest, a ing and fanatical, with nothing to lose.
bath, a change of clothes, and a hot meal. Heavy combat continued until
But the invasion had isolated the August. The portables worked in close
Japanese 18th Army to the east, leaving support of the regimental and battalion
the enemy few options but to attack the aid stations; in late July the 5th Portable
forces at Aitape. As the level of combat Surgical Hospital was so close to the
rose, the 112th Cavalry arrived to aug- front that its staff dug foxholes and
ment the 32d Division. Outposts were armed its ambulatory patients to defend
reinforced, and a covering force along against infiltrators. Surgeons operated
the Driniumor River was strengthened. at night in blacked-out pyramidal tents.
About 7 miles long, the river line was In theory, each portable supported one
held by the 112th and three battalions regimental combat team, but in practice
of the 32d’s 127th and 128th Infantry. all took their wounded as they came and
Casualties were carried back from served all of the infantry regiments.
advanced stations by native litter-bear- Many serious cases went back to the
ers; amphibious trucks evacuated coastal 30th Evacuation Hospital, which provid-
and swampy areas; and twice a day ed the bulk of third-echelon medical
barges transported serious cases to the care. Set up near the airfields, its 440
54th Evacuation Hospital, on an island 2 beds were filled with those suffering
miles offshore.58 severe wounds, often of the chest, head,
On the night of 10–11 July Japanese and abdomen.59
attackers crossed the Driniumor, over- Evacuation moved by water and by
running an aid station in the process, jungle trails to the coast road. During
58 59
See Quarterly Rpts (copies), Apr–Jun 44, for Surg, See Quarterly Rpts (copies), Jul–Sep 44, for Surg,
32d Inf Div, pp. 3–6; 607th Med Clearing Co, p. 1; 54th 32d Inf Div, pp. 1–3; 30th Evac Hosp, pp. 1–2; Surg,
Evac Hosp, pp. 3–4; and Surg, Sixth Army, pp. 8–9. All Sixth Army, pp. 5–7; and 656th Med Clearing Co, p. 2.
file 319.1, HUMEDS, RG 112, NARA. All file 319.1, HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 207
2d Portable Surgical Hospital and one there was no confusion in clearing and
collecting company retreated under fire setting up camp.”68
to the 54th Evacuation Hospital area Reinforcements now turned the tide.
and established a perimeter. Another During 7–20 June elements of the 6th
collecting company dug in and held its Infantry Division arrived to replace the
position, taking 11 casualties among its weary 158th Infantry. Supporting the
staff and patients before the attack division was its 6th Medical Battalion, the
ended. But the situation remained per- 2d and 11th Portable Surgical Hospitals,
ilous. The beach was too long and nar- the 37th Field Hospital, and a 200-bed
row to be held, and the enemy repeat- section of the 54th Evacuation Hospital.
edly infiltrated through the jungle. On Lt. Col. Bernard J. MacCauley, MC, the
28 May the Japanese attacked in great 6th Division surgeon, now became the
force. Reinforcements had yet to arrive, TORNADO Task Force surgeon. The attack
and two battalions of the 163d resumed, with hard fighting in the
Regimental Combat Team had left for rugged and heavily jungled terrain
Biak Island to strengthen hard-pressed around Lone Tree Hill. Here the many
troops fighting there. Remaining in the casualties strained the available medical
Wakde-Sarmi area were only four facilities; the 20th Infantry, 6th Division,
infantry battalions. suffered 305 on the first day alone.
Hence, General Krueger issued Litter-bearers were hard-pressed, with no
orders to contract the western and east- time to rig cables and move the wound-
ern perimeters. As often happens, ed by tramway; instead, squads of six,
nobody thought to tell the medics and working in relays over sloping terrain,
some were left behind. For three days carried casualties from the forward aid
before escaping to the Toem perimeter, station to an advanced ambulance post,
Clearing Company H, ALAMO Force seventy-five yards beyond.69
Reserve, was caught in a no-man’s-land The fierce struggle continued for
and forced to provide for its own three days, with frontline medical units
defense. The unit constructed pillboxes using over 1,000 pints of plasma. Under
and manned them in shifts of twenty- the circumstances the quality of care was
four hours, its soldiers armed with car- admirable, and most casualties arrived
bines, submachine guns, and gre- at the rear in good condition. Normally
nades. Personnel of the 3d Portable a 25-bed facility, the 11th Portable
Surgical Hospital, receiving their Surgical Hospital expanded to 50,
orders late, learned how quickly they admitting 102 during 17–27 June. In
could break camp and move when they one four-day period the hospital per-
had to. The commander, Maj. William
L. Garlick, MC, remembered how “the 68
See Quarterly Rpts (copies), Apr–Jun 44, for 3d
hospital melted before your eyes.” Port Surg Hosp, pp. 10–11 (quotations); 135th Med
Within two hours the patients were Regt, pp. 6–7; and Surg, Sixth Army, pp. 19–20. All file
319.1, HUMEDS, RG 112, NARA.
resting under canvas beside an 69
Rpt (copy), CO, 6th Med Bn, to CG, 6th Inf Div, 19
American mortar company. Not a sin- Jul 44, sub: Operational Report, pp. 1–2, file 306-Med-
gle casualty had been suffered, and 0.3; 11th Port Surg Hosp Historical Rpt, 30 Aug 44, p.
2, file 319.1; Quarterly Rpts (copies), Apr–Jun 44, for
Garlick reported with amazement that 54th Evac Hosp, pp. 2–3, and Surg, Sixth Army, pp.
“for the first time in our moving life 20–21, file 319.1. All in HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 211
formed eighty-seven operations, with Defeat at Lone Tree Hill broke the
only 1 death. The operating room staff Japanese, who had fought a desperate
worked continuously for seventy-two but hopeless battle. Now the Americans
hours, taking only an occasional nap. moved westward, cleaning out the
The 37th Field Hospital set up on the remaining pockets of resistance. The
shore of Maffin Bay, in direct support of mop-up included some hard fighting
the fighters; the 54th Evacuation and cost a number of casualties. By the
Hospital worked at Toem. Air evacua- end of July the 31st Infantry Division
tion from the Wakde strip carried evac- had relieved the 6th Division, and on 1
uees to Hollandia, Nadzab, or September a regimental combat team of
Finschhafen, functioning smoothly the 33d Infantry Division replaced the
throughout the struggle. SWPA’s hospi- 31st as the garrison force in an area now
tal ships visited the enclave, providing a secure. The next day General Krueger
supplementary means of evacuation.70 declared the Wakde-Sarmi operation
over. From 17 May through 1 September
70
See Quarterly Rpts (copies), Apr–Jun 44, pp. American losses were approximately 400
21–22, and Jul–Sep 44, pp. 8–9, for Surg, Sixth Army; killed, 1,500 wounded, and 15 missing.
respectively, p. 3, and pp. 2–3, for 54th Evac Hosp; and The Japanese lost 3,870 killed and 51
pp. 1–2, and pp. 1–2, for 37th Field Hosp. All file 319.1,
HUMEDS, RG 112, NARA. In loc. cit., see also 11th captured. Since only about 2,000 enemy
Port Surg Hosp Historical Rpt, 30 Aug 44, p. 2. troops remained in the area, many of
212 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the original garrison apparently died of afternoon and evening of D-day, casual-
sickness and starvation or lay buried in ties with mortar and gunshot wounds
blasted caves. In return for their efforts, began to filter back to battalion aid sta-
the Allies obtained a valuable air base tions and eventually to the clearing sta-
and a staging area for campaigns to tion on the beach. On D+1 fighting
come.71 intensified. The Japanese, dug into the
ridges and caves above the coast road,
On to Biak poured mortar and machine gun fire
upon the 162d, especially from strong-
Simultaneously with the Wakde cam- points called the East Caves and the Ibdi
paign, an assault began on Biak, an Pocket. Collecting company ambu-
island in the northwest portion of lances evacuated the wounded until the
Geelvink Bay. As usual, the targets were enemy built a roadblock, cutting off the
airfields—three of them, lying on a route. With casualties mounting and
coastal plain backed by a coral ridge cov- supplies dwindling, the 162d comman-
ered with dense tropical rainforest. der ordered ammunition, water, and a
Fiercely hot, the island was unhealthy portable surgical hospital to be loaded
and soon to become more so, as the on amphibians and taken up the coast
bodies of the slain piled up, for it was to support the isolated regiment. Once
strongly defended by Japanese forces set up under a twenty-foot ridge that
fighting from caves. offered protection from mortar fire, the
Upon this uninviting spot the hospital kept three operating tables
HURRICANE Task Force, comprised of the busy through the night of 28 May and
162d and 186th Regimental Combat most of the following day. Wounded
Teams of the 41st Division, staged sur- were so numerous that only emergency
prise landings on the morning of 27 surgery and administration of plasma
May. The troops came ashore in were attempted. Amphibians ferried the
Buffaloes over fringing reefs near the casualties across the reef, and landing
village of Bosnek, about 2 miles east of craft transported them to Bosnek or to
heavily defended Mokmer, Sorido, and the 92d Evacuation Hospital on offshore
Borokoe airfields. Initial resistance was Owi Island.72
light. Navy beach party aid stations treat- Seeking to flank the defenders, the
ed the few casualties, and amphibious 186th Regimental Combat Team set out
medical company personnel evacuated to cross an inland plateau and descend
to a collecting station on Japanese-built
coral jetties and from there to LSTs, 72
Rpt (copy), Lt Col William H. Chapman, Acting
where Navy surgical teams awaited Surg, 41st Inf Div, 30 Aug 44, sub: Medical History of
Biak Campaign, pp. 2–3, file 341.26 Historical Reports,
them. Hurricane (Biak) TF, 41st Inf Div, 27 May–19 Aug 1944;
The first serious resistance developed 116th Med Bn Med History (copy), pp. 2–4, file 319.1–2
as the 162d Regimental Combat Team, (116th Medical Battalion) SWPA, 27 May–2 Aug 1944;
Surg, I Corps, Quarterly Rpt (copy), Apr–Jun 44, pp.
supported only by a collecting company, 1–2, file 319.1; Rpt, Lt Col Robert Sterling, CO, 92d
advanced west along the beach road Evac Hosp, to Surg, 41st Inf Div, 12 May 44, sub: 92d
toward the Mokmer airfield. During the Evacuation Hospital (SM), Medical History of Biak
Operation, 6 May–30 June 1944, pp. 1–2, Encl to 92d
Evac Hosp Quarterly Rpt (copy), Apr–Jun 44, file 319.1.
71
Smith, Approach to Philippines, p. 278. All in HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 213
upon the airstrips from the northeast. about 235 survived, and of these 109
The 186th, attended by a collecting elected to stage a banzai attack that
company and a portable, marched for night. All were killed; the Japanese com-
four days in sweltering heat on a route mander, with many of his subordinates,
without water and through thickets of committed suicide. The assault on the
towering evergreens, not the familiar caves lasted until the twenty-seventh,
tropical rainforest. Both supplies and when patrols penetrated the last recess-
wounded had to be hand-carried es, now filled with burned and mangled
through harassing enemy fire. Once at bodies.74
the cliffs overlooking the Mokmer air- Mopping-up operations resumed
field, the infantry encountered devastat- against some 4,000 Japanese who had
ing mortar and artillery fire from the escaped, and by 20 August, when
inland face of the ridge. Still command- Krueger declared the operation over, all
ed by enemy guns, the airfield was use- organized resistance had ceased. The
less. Evacuation of the wounded to Japanese lost an estimated 4,700 killed
Bosnek proved to be painful and slow, and 220 captured on Biak. Most of the
via exhausting litter hauls to the sea and survivors perished later by disease, star-
night voyages by amphibians.73 vation, and suicide, or were killed dur-
During the third week in June more ing the long mopping up, which con-
forces, including additional medical tinued into the following year as one
support, invested the airfields. General occupying force succeeded another. By
Krueger, displeased with the slow early 1945 probably fewer than 1,500 of
progress, replaced the 41st Division the original Japanese garrison were
commander, Maj. Gen. Horace H. alive.75
Fuller, with Brig. Gen. Jens A. Doe and The victory cost the Allies approxi-
sent in General Eichelberger, the I mately 400 killed, 2,000 wounded, 150
Corps commander, to take charge. injured, and 5 missing. Casualties to dis-
Bringing with him the 34th Infantry, ease and stress numbered 7,234. No less
24th Division, Eichelberger was able to than 1,000 caught scrub typhus, and
pit larger forces against an enemy about 3,500 suffered fevers of undeter-
depleted in numbers, though still hold- mined origin, reflecting not only the
ing out in strong positions. unhealthiness of Biak but, as the 41st
Under intensive bombardment, most Division surgeon lamented, the fact that
defenders evacuated the East Caves. The “the laboratories attached to station and
Ibdi Pocket fell to assault. On 21 June general hospitals never reach us and at
the 162d and 186th Regimental Combat times are four to five hundred miles
Teams reached the formidable West away.” American casualties totaled
Caves, where the Japanese commander
made his last stand. Of 900 defenders 74
116th Med Bn Med History (copy), pp. 6–7, file
319.1–2 (116th Medical Battalion) SWPA, 27 May–2
Aug 1944; Rpt (copy), Chapman, 30 Aug 44, pp. 5–6,
73
116th Med Bn Med History (copy), pp. 4–6, file file 341.26 Historical Reports, Hurricane (Biak) TF,
319.1–2 (116th Medical Battalion) SWPA, 27 May–2 41st Inf Div, 27 May–19 Aug 1944. Both in HUMEDS,
Aug 1944; Rpt (copy), Chapman, 30 Aug 44, pp. 4–5, RG 112, NARA. See also Eichelberger, Our Jungle Road,
file 341.26 Historical Reports, Hurricane (Biak) TF, pp. 143, 153, and Harold Rigelman, The Caves of Biak
41st Inf Div, 27 May–19 Aug 1944. Both in HUMEDS, (New York: Dial Press, 1955), pp. 136–55.
75
RG 112, NARA. Smith, Approach to Philippines, p. 392.
214 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
9,790—mark of a struggle as harsh and hospitals meant that medical support for
unforgiving as any in the Pacific war. the troops oftentimes was inadequate.77
Medical personnel suffered unusually Proportionate to troop strength, bed
heavy losses. Portable surgical hospitals strength shrank by 2.2 percent in
worked in dugouts under mortar and August, even as epidemics broke out,
artillery fire; litter squads were prey to overcrowding the hospitals further and
snipers. In the 41st Division the medical compelling the speedy evacuation of
casualty rate exceeded that of the line minor cases. The ten- to fifteen-day evac-
troops: Collecting Company C, 186th uation policy contemplated in the origi-
Regimental Combat Team, recorded nal medical plan had to be abandoned.
losses of 35 percent. In testimony to Meanwhile, the hospitals worked under
their sufferings, the medics received a the poorest of conditions. At Bosnek
proportionately greater share of combat both the 92d Evacuation Hospital and
decorations than any other branch, Clearing Company D, 41st Division,
including the infantry.76 spent the first ten days ashore in an area
Despite this record of individual hero- congested with military targets, under
ism and collective achievement, Biak rep- daily air attack. Neither could deploy
resented a backward step in both preven- fully for lack of engineer equipment to
tion and treatment. The medics had to clear the wrecked and cratered area
do extraordinary things in part because (hence, the hospital’s removal to Owi).
too few of them were on hand. Further forward, portables sometimes
Hospitalization for the HURRICANE Task worked in shell holes under mortar and
Force proved barely adequate. The 92d artillery fire, and the clearing platoons
Evacuation Hospital provided 400 beds; on the beach road faced conditions just
each of the two clearing companies, a little less perilous.
about 250; and each of the four porta- Only evacuation worked well. The
bles, 25—about 1,000 beds in all. Every 116th Medical Battalion took responsi-
unit had an expansion capability, which bility for all evacuation ashore and the
most were obliged to use. Thus, the ini- amphibious medical company for mov-
tial allotment was equal to 6 percent of ing casualties from the beach. Roads
the force but declined as the fierce fight- enabled vehicles to do most of the work,
ing brought in new line units, with no a substantial advantage even though
equivalent increase in hospital support. broken springs, caused by the rough
Because of poor intelligence on terrain, coral tracks, shook the wounded.
disease, and enemy fortifications, project- Though difficult and dangerous, most
ed casualty rates were underestimated. litter hauls were short, down to the near-
For certain, the low shipping priority for est road, and the 135th Medical
Regiment had provided additional litter-
76
Ibid. See also Interv, Lt Col William J. Shaw, 2 Sep bearers. Along the shore, amphibious
44, p. 5 (quotation), file 000.71; Surg, Sixth Army, vehicles did yeoman service. Offshore
Quarterly Rpt (copy), Jul–Sep 44, pp. 10–12, file 319.1;
116th Med Bn Med History (copy), pp. 8, 11, file evacuation was coordinated by a beach
319.1–2 (116th Medical Battalion) SWPA, 27 May–2
Aug 1944; Rpt (copy), Chapman, 30 Aug 44, pp. 7–9,
77
file 341.26 Historical Reports, Hurricane (Biak) TF, Rpt (copy), Chapman, 30 Aug 44, p. 13, file 341.26
41st Inf Div, 27 May–19 Aug 1944. All in HUMEDS, RG Historical Reports, Hurricane (Biak) TF, 41st Inf Div, 27
112, NARA. May–19 Aug 1944, HUMEDS, RG 112, NARA.
AMPHIBIOUS ADVANCE 215
party medical officer and performed were recorded in July and August 1944,
usually at night; LSTs, hospital ships, about as many as in the whole Southwest
and, ultimately, aircraft carried the Pacific Area for the previous two years.
wounded to Hollandia for treatment. Although fewer of those who fell ill died
But efficient evacuation in combination than in previous outbreaks, the disease
with inadequate hospitalization meant put its victims, most of whom belonged to
depletion of the fighting units—a throw- the Army Air Forces, out of combat for
back to the conditions of Buna.78 about nine weeks. No preparation had
The epidemics of Biak marked a fail- been made to meet the disease, for in
ure of preventive medicine in the face of earlier campaigns it had always occurred
great odds imposed partly by nature, in kunai grass, from which Biak was free.
partly by the enemy. The island present- But here large areas were covered with
ed sanitation problems that proved low ferns and rotting vegetation inhabit-
unanswerable under combat conditions. ed by rats, which harbored the mites
Countless flies bred in the abandoned whose larvae transmitted scrub typhus.
Japanese food dumps that lined the As the incidence rose to epidemic
beach and on the unburied dead that proportions, General Denit sought help
lay aboveground or deep in caves; both from the United States of America
the dumps and the dead were all too Typhus Commission—an interservice
close to Army kitchens. Disposal of offal, group established by executive order
body waste, and corpses alike was made under the leadership of the Army
difficult by a hard subsoil of coral and Medical Department. Two experts
lava that prevented quick burial. The lit- arrived at Biak on 18 July. After studying
tle water that was available was polluted, the flora and the rats and mites, they dis-
not only by decaying flesh but also by covered the presence of two new species
alkalies leached from the coral. Bad of mites implicated in spreading the dis-
water and abounding flies both con- ease. They then assisted in implement-
tributed to outbreaks of diarrhea and ing control measures and helped to
dysentery that harried the troops.79 indoctrinate the troops in the proven
But the most serious medical problem methods of prevention—impregnating
was scrub typhus. On Biak and the small clothing with either dibutyl or dimethyl
neighboring island of Owi 1,050 cases phthalate, clearing underbrush from
unit areas, and killing wild rats. Scrub
78
typhus cases were concentrated at the
116th Med Bn Med History (copy), an. 3 to Admin
Order 1, Hurricane TF Med Plan, p. 4, file 319.1–2 92d Evacuation Hospital for a long
(116th Medical Battalion) SWPA, 27 May–2 Aug 1944; course of nursing care, followed by evac-
Rpt, Sterling to Surg, 41st Inf Div, 12 May 44, sub: Biak uation to rear bases, sometimes as far as
Operation, pp. 2–4, Encl to 92d Evac Hosp Quarterly
Rpt (copy), Apr–Jun 44, file 319.1; Rpt (copy), the zone of interior.80
Chapman, 30 Aug 44, pp. 3, 5–6, file 341.26 Historical
Reports, Hurricane (Biak) TF, 41st Inf Div, 27 May–19
80
Aug 1944. All in HUMEDS, RG 112, NARA. In loc. cit., Ibid., p. 8, file 341.26 Historical Reports, Hurricane
file 319.1, see also Quarterly Rpts (copies), Apr–Jun 44, (Biak) TF, 41st Inf Div, 27 May–19 Aug 1944; Surg, Sixth
for 135th Med Regt, pp. 4, 6–7; Surg, I Corps, p. 14; and Army, Quarterly Rpts (copies), Apr–Jun 44, pp. 29–30,
Surg, Sixth Army, pp. 24–26, plus Jul–Sep 44, p. 11. and Jul–Sep 44, pp. 12, 24–26, file 319.1; Ltr (copy), Lt
79
Rpt (copy), Chapman, 30 Aug 44, p. 7, file 341.26 Col Cornelius B. Philip to Surg, USAFFE, 5 Aug 44, sub:
Historical Reports, Hurricane (Biak) TF, 41st Inf Div, 27 Scrub Typhus on Owi and Biak Islands, pp. 1–5,
May–19 Aug 1944, HUMEDS, RG 112, NARA. Historians file. All in HUMEDS, RG 112, NARA.
216 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
tionally performed ritual cannibalism, cared for. The clearing company of the
but at least one desperate small unit of 6th Medical Battalion was swamped with
the Japanese Army practiced it on those who were too sick to be moved.
Noemfoor, as individual soldiers had at On 15 August the 29th Evacuation
Buna, merely to delay starvation.82 Hospital arrived, and by nightfall held
Four weeks after Noemfoor, on 30 630 patients in place of its normal 400.
July 1944, the last act began as Allied Nursing care remained intense, for
forces landed unopposed on the scrub typhus cases could not safely be
Vogelkop Peninsula to seize a region evacuated during the critical first three
near Cape Sansapor and construct new weeks, when complete bed rest, spoon
airfields. By this time the Imperial General feeding, and bedpan and urinal use
Headquarters had written off New were necessary. The burden was too
Guinea, which the now depleted and great for the ward personnel, and dri-
harried enemy shipping could no vers from the motor pool, mess person-
longer supply or reinforce under the nel, and sanitation teams had to be
attacks of land-based aircraft. The pulled in to assist. Each victim was out of
defenders of Sansapor fled into the hills. full service for about nine weeks; even
But if the medical personnel of the after returning to duty, he remained
6th Division expected an easy time, they weak, tired, and clumsy. The forces at
were disappointed. The Japanese might Sansapor lost 60,000 man-days to the
be defeated, but New Guinea remained disease, which demonstrated that at the
hostile. A new and severe scrub typhus end of the New Guinea fighting as at the
epidemic broke out in August, and by beginning, and despite ever-growing
the end of September 931 cases had sophistication in preventive medicine,
been recorded, with a fatality rate of 3.4 the environment could be a more dan-
percent—higher than at Biak. Again, no gerous foe than the enemy.84
kunai grass gave warning of the disease; With the capture of Sansapor the
here a rank Bermuda-like grass har- long, often desperate struggle for New
bored the vectors, and the troops who Guinea came to an end. Now thrusts
slept on the ground were apt to rise with against the Netherlands East Indies and
the telltale marks of infection. In one the Philippines impended—no longer a
regiment 403 were hospitalized within remote dream but an almost present
the first twenty days ashore, including reality. The danger to the Japanese
the regimental commander, his execu- occupiers of the Philippines did not
tive officer, ten staff officers, and five come from MacArthur’s forces only.
company commanders.83
Strict control measures were 84
Ibid., pp. 288–91; Mae Mills Link and Hubert A.
imposed, and gradually new admissions Coleman, Medical Support of the Army Air Forces in World
dropped. But the sick remained to be War II (Washington, D.C.: Office of the Surgeon
General, USAF, 1955), pp. 811–14; [6th] Division
Public Relations Section, The 6th Infantry Division in
82
See Quarterly Rpts (copies), Jul–Sep 44, for Surg, World War II, 1939–1945 (Washington, D.C.: Infantry
Sixth Army, pp. 12–15; Surg, Med Det, 158th Inf, p. 1; Journal Press, 1947), pp. 52–59. See also Quarterly Rpts
3d Port Surg Hosp, pp. 4–10; and 71st Evac Hosp, pp. (copies), Jul–Sep 44, for Surg, Sixth Army, pp. 15–19,
2–3. All file 319.1, HUMEDS, RG 112, NARA. and 29th Evac Hosp, pp. 1–2, file 319.1; and Rpt (copy),
83
Philip, “Scrub Typhus and Scrub Itch,” in Hoff, ed., CO, 6th Med Bn, to CG, 6th Inf Div, 19 Jul 44, pp. 2–3,
Communicable Diseases: Arthropodborne, pp. 287–88. file 306-Med-0.3. All in HUMEDS, RG 112, NARA.
218 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
While soldiers, sailors, and marines the north but, for the medics who sup-
fought in the South and Southwest ported them, a world away from the jun-
Pacific, others advanced across the cen- gled islands of the Solomons and New
tral Pacific, only a few hundred miles to Guinea.
CHAPTER VII
planners sought to prepare U.S. forces ful role; on larger landmasses its relative
for short but intense operations on immobility restricted the support that it
islands, most of which were primitive could offer to a constantly shifting battle
but some of which were heavily settled line. Similarly, the semimobile evacua-
by friendly or hostile populations. tion hospital proved to have little place
In the Central Pacific Area, as in the on the atolls, and its absence from the
South and Southwest Pacific Areas, com- medical service of the Central Pacific
bat team organization determined the Area caused few difficulties there. On
basic support requirements. The aim the larger islands, however, where sever-
was to saturate the island battleground al divisions were engaged, the unit
with small relatively self-contained med- might have been highly useful, and the
ical support units that could work either efforts of field hospitals to function in its
alone or in combination with others. place proved unsatisfactory, for lack of
The Joint Staff planners sought to pro- equipment and specialized professional
vide each reinforced division of about skills.2
20,000 troops, in addition to organic Landings were planned in accord
medical personnel, with a field hospital; with familiar amphibious doctrine.
two portable surgical hospitals, or the Company aidmen were to land with the
equivalent in auxiliary surgical detach- assault platoons and initiate care for the
ments; one malaria control detachment; wounded on the beach. The battalion
and one malaria survey detachment. medical section usually landed with the
The portables quickly proved their fifth wave and the collecting platoon
value, supporting anything from a divi- with the seventh and eighth waves. The
sional or separate clearing company or a battalion aid station would work on the
field hospital to a small landing force beach until relieved by the collecting
that was isolated. Surgical detachments platoon; shore party medical sections
often augmented field hospital pla- would set up near the beach as well.
toons, collecting companies, or clearing Clearing stations were to follow as soon
stations by providing forward surgery as enough ground had been won to pro-
for the seriously wounded. But experi- vide them a site free from small-arms
ence showed that the portable, with its fire. The brevity of the fighting on most
component of 33 trained enlisted men, islands meant that all wounded who
gave greater flexibility and depth than could not immediately return to duty
the surgical unit of a few medical offi- must be evacuated to the transports
cers, a single surgical nurse, and a surgi- waiting offshore. Each task force carried
cal technician.
Since mobility counted for little on 2
“History of the United States Army Forces, Middle
tiny islands and bed strength was cru- Pacific and Predecessor Commands, During World War
cial, clearing companies often received II, 7 December 1941–2 September 1945,” pt. 7,
additional equipment that enabled “Administration of Manpower,” 12:2642–44, Ms 8–5.6
AA 7/3. See also “History of Office of the Surgeon,
them to operate as 200–400-bed hospi- United States Army Forces, Middle Pacific and
tals. Proper distinctions between smaller Predecessor Commands, 7 December 1941–2
and larger islands, however, were not September 1945,” sec. 2, “Central Pacific Area,” pp.
61–63, Ms 8–5.6 AA 30/2 (hereafter cited as “History of
always made. On tiny coral islands the OofSurg, USAFMIDPAC”). Both in files of U.S. Army
expanded clearing station played a use- Center of Military History (CMH), Washington, D.C.
THE FORTIFIED ISLANDS 221
with it all the food, medicines, and other Makin was a triangular atoll, compris-
supplies the landing forces would need ing the two large islands of Kuma and
for thirty days—even the drinking water. Butaritari, where the Japanese had a sea-
Ashore, the assault forces drank from plane base with substantial fortifications
their canteens, from coconuts, and from and a permanent garrison. A little over
tanks of chlorinated water; later, while 100 miles to the south lay heavily defend-
using distillation equipment to make ed Tarawa, a similar subgroup whose
seawater potable, deep wells were dug. main island of Betio contained an air-
The experience of the other Pacific field and the administrative headquar-
theaters clearly influenced these ters for their naval forces in the Gilberts.
arrangements. The Central Pacific Area Still farther south, Apamama was the site
benefited from its late start as a combat of a lightly defended observation post.4
theater, but by the same token found Under Admiral Nimitz, Vice Admiral
only limited opportunities to introduce Raymond A. Spruance commanded the
important innovations. What the Joint Central Pacific Forces, including the V
Staff planners needed to refine Amphibious Force under Rear Admiral
amphibious warfare in their theater was Richmond Kelly Turner. Turner also
the experience of actual operations. commanded Task Force 54, the assault
This came quickly in the autumn of force—consisting of the Northern
1943.3 Attack Force (Makin), the Southern
Attack Force (Tarawa), and lesser attack
Winning the Gilberts groups—whose troops were supplied by
the V Amphibious Corps under General
The first targets were three of the six- Holland Smith. Components of the
teen coral atolls that make up the Gilbert corps were the 2d Marine Division
Islands. Lying athwart the Equator more under Maj. Gen. Julian C. Smith, USMC,
than 2,000 miles from Hawaii, the and the 27th Infantry Division under
Gilberts, with their coconut palms and Maj. Gen. Ralph C. Smith. Supporting
Micronesian inhabitants, formed an out- the Makin operation was the Army’s task
lying ring of the Japanese defense force, consisting of the 27th’s 165th
perimeter. Unknown to Americans at the Infantry and elements of its 105th
time, the Imperial General Headquarters Infantry. The task force surgeon was Lt.
had already decided to establish its main Col. Abraham Norman, MC, then com-
line in the Caroline and Marianas mander of the 27th’s 102d Medical
Islands. However, the garrisons of the Battalion and later division surgeon.
Gilberts and Marshalls had been The medical service provided an
strengthened rather than weakened, in enlisted medic for every 10 and a doctor
order to fight the most effective possible
delaying action. 4
Whitehill, “Medical Activities in Middle Pacific,”
block 18a, pp. 3–5, file 314.7, HUMEDS, RG 112,
NARA; Philip A. Crowl and Edmund G. Love, Seizure of
3
CSurg, USAFPOA, Annual Rpt, 1944, p. 4, file the Gilberts and Marshalls, United States Army in World
319.1–2; Whitehill, “Medical Activities in Middle War II (Washington, D.C.: Office of the Chief of
Pacific,” block 3, pp. 24, 30, file 314.7. Both in Military History, Department of the Army, 1955), p.
HUMEDS, RG 112, NARA. See also “History of 210. Unless otherwise noted, the combat narrative for
OofSurg, USAFMIDPAC,” sec. 2, pp. 60–63, 67–69, the Gilberts and Marshalls campaigns is drawn from the
88–99, Ms 8–5.6 AA 30/2, CMH. latter source.
222 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
for every 250 combatants. In addition to son that included a provisional field hos-
company aidmen and battalion medical pital, embarked on a nine-day voyage
detachments, the 27th Division’s 102d from Pearl Harbor. Rounds of daily calis-
Medical Battalion was present to thenics and debarkation drills helped to
strengthen the battalions and to provide pass the time. Amply supported but as
second-echelon support. The clearing yet untested in combat, the Northern
company was augmented by a provision- Attack Force arrived off Makin Atoll on
al portable surgical hospital—the first to the night of 19–20 November.6
appear in the Central Pacific Area. The Aerial photographs had revealed that
portable, provided by General King, the the Japanese defenses were concentrat-
USAFICPA chief surgeon as of August ed around the seaplane base on the
1943, soon proved to be a highly adapt- lagoon shore, where several piers jutted
able unit, able both to maintain and to into the water. Two tank barriers crossed
move itself in the field and to assume the narrow island of Butaritari from
many different guises as needed. Added lagoon to ocean, and in between lay a
equipment allowed the collecting com- heavily defended area with pillboxes
pany to establish a 400-bed hospital. In and gun emplacements that Americans
anticipation of combat, medics gave called the Citadel. In the first landing at
physicals and immunizations, checked 0830, the 105th Infantry, followed by the
their equipment, and completed their first and third battalions of the 165th
own training. Infantry, came ashore at the western end
Supplies were ample. Most, including of the island. In the second, two hours
medical requirements, were pal- later, the remaining battalion of the
letized—covered with waterproof paper 165th landed on the lagoon shore
and strapped to wooden sleds for easy between the tank barriers, splitting the
movement ashore. Combat loading defenders.
ensured that all members of a unit occu- Opposition to the landing on the
pied the same ship and that their sup- western beaches was sporadic and inef-
plies were arranged for easy access, with fective. Fortunately, most of the 800
the items needed first on top. Each bat- defenders clung to the Citadel, and
talion carried supplies for ten days on its most of the troops, despite unfavorable
assigned vessel. Supporting the fleet was tides that delayed the landing of sup-
a mobile supply base of tenders, repair plies, were ashore by the end of the first
ships, tugs, minesweepers, and fuel day. Company aidmen landed with their
barges. Among its stores was an addi- units, and medics who accompanied the
tional thirty-day supply of food and med- Army engineers, coming in with the sec-
icines for 10,000 troops.5 ond and third waves, set up aid stations.
On 10 November, while the marines Then followed the battalion medical
headed for Tarawa, the Army’s 7,000- sections, the collecting company pla-
man task force, plus artillery and a garri- toons, the portable surgical hospital,
and the clearing company.
5
Whitehill, “Medical Activities in Middle Pacific,”
block 18a, pp. 5–10, file 314.7; Surg, 27th Inf Div,
6
Annual Rpt, 1943, encl. 4, pp. 1–2, file 319.1–2. Both in Samuel Eliot Morison, History of United States Naval
HUMEDS, RG 112, NARA. Palletizing had been used in Operations in World War II, 15 vols. (Boston: Little,
the Aleutians, though not so extensively. Brown and Co., 1947–62), 7:86–90, 102–07.
THE FORTIFIED ISLANDS 223
Trouble developed on the beaches effort was made to sort casualties, and
along the lagoon shore, where the care was not uniform. Few vehicles went
Japanese had concentrated. Here the ashore, and the LVTs (landing vehicle,
invaders were peppered by small-arms tracked), also known as “Alligators,”
and automatic weapons fire as they moved only by day, for the transports
waded ashore. Not all the bullets came withdrew at night. The wounded were
from the shore. Snipers had holed up in moved mostly by litter from battalion
two wrecked ships, and American air- aid stations to collecting stations and
craft blasting at these impromptu forts then to shore party aid stations. Some
delayed the landing of the medics in the went untreated, reaching the transports
later waves. Around the Citadel the in a dangerous condition from hemor-
infantry began to take heavy casualties. rhage and shock, which personnel
For a time a collecting platoon, a battal- belonging to Navy hospital ship pla-
ion aid station, and the stations of the toons treated in sick bays and impro-
Army shore party and the Navy beach vised wards in the vacant troop spaces.8
party worked together to handle the The succeeding days’ advance was
influx of wounded. Enemy fire was aided by tanks, and evacuation by jeep
heavy and accurate, and the medical ambulances, each equipped with welded
detachment of the 105th Field Artillery steel racks to hold up to four litters. The
Battalion was driven to emulate the Americans slowly pushed the enemy
Japanese, digging a bunker and caring back toward the northeastern tip of the
for its casualties underground.7 island, moving through dense foliage
During the first six hours of fighting and marsh in the face of tenacious
about 4 percent of the command were snipers. By D+1 the portable surgical
killed or wounded. Most injuries were by hospital was in operation, and by D+2
gunshot or shrapnel, either in the the jeep ambulances were shuttling
extremities or in the buttocks of those between the aid stations and the clear-
who failed to keep down when crawling. ing station. Transports sailed with casu-
Nothing could be done ashore but pro- alties, bound for Oahu, while Navy sea-
vide supportive measures to combat planes flew a few critical cases to the
shock, control hemorrhage, and immo- Ellice Islands, about 350 miles east and
bilize fractures. Though evacuation was 600 miles south of Tarawa. By morning
usually swift—for which the crews of the of the fourth day all organized resis-
amphibious vehicles or small landing tance had come to an end, and by 24
craft used to transport troops from the November the American combat forces
Navy flotilla to the shore received the began to depart, leaving behind a small
special thanks of the medics—little garrison with medical support from the
1st Provisional Field Hospital. Army
engineers soon began to carve out air-
7
Whitehill, “Medical Activities in Middle Pacific,”
block 18a, pp. 13–20, file 314.7; Ltr, Cmdr E. R. Hering,
8
Med Observer, Fwd Echelon, Galvanic, to CofS, V Interv, Capt Hilbert Ehrlich, 21 Dec 43, file 000.71;
Amphibious Corps, n.d., sub: Medical Situation, Whitehill, “Medical Activities in Middle Pacific,” block
Galvanic, Encl F to V Amphibious Corps Spec Staff Offs 18a, pp. 21–26, file 314.7. Both in HUMEDS, RG 112,
Rpt on Galvanic, The Historical Unit (THU) Note NARA. See also Edmund G. Love, The 27th Infantry
Cards, Historians files. Both in HUMEDS, RG 112, Division in World War II (Washington, D.C.: Infantry
NARA. Journal Press, 1949), pp. 23–55.
224 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
fields, and evacuation by air became mortars, rather than by artillery. Gas
standard, as in most places throughout gangrene infections were apparently
the Pacific.9 absent. A small number of injuries,
Despite the fierceness of the fight, the some severe, were inflicted by swords,
cost of conquering Makin was not reflecting the romanticism or despera-
great—66 dead, 152 wounded, and 33 tion of the defenders. The enemy’s
sick and injured. By destroying enemy whole garrison were either killed or cap-
gun emplacements, the pre-invasion tured; most fought to the death, a num-
bombardment assured that the great ber committed suicide when their situa-
majority of wounds were caused by small tion became hopeless, and one enemy
arms, hand grenades, and small-caliber officer, taken captive while wounded,
resisted medical treatment, trying to
9
Interv, Ehrlich, 21 Dec 43, file 000.71, HUMEDS, bite and kick the medical officer who
RG 112, NARA; Department of the Navy, Bureau of attended him.10
Medicine and Surgery, “The United States Navy
Medical Department at War, 1941–1945,” 1:177, files of
10
Bureau of Medicine and Surgery Archives (BMSA), Interv, Ehrlich, 21 Dec 43, file 000.71, HUMEDS,
Washington, D.C. RG 112, NARA.
THE FORTIFIED ISLANDS 225
the Gilbert Islands and 39.65 for the were ordered to cooperate in seizing the
marines. By supplying airfields for land- islands of Kwajalein, the world’s largest
based air support, the newly conquered atoll.
Gilberts contributed crucially to the The division surgeon, Colonel Potter,17
next campaign, where Admiral Nimitz’ and the 7th Medical Battalion comman-
command quickly demonstrated that it der Colonel Kamish, approached the
had learned much from the struggle just problems of the new assault with their
completed.15 Alaskan experience as well as the knowl-
edge recently gathered in the Gilberts to
The Marshalls guide them. The collecting companies
would be broken down into platoons,
Lying halfway between Hawaii and one to support each battalion landing
New Guinea, the 700-mile-long archipel- team and the clearing company
ago of the Marshalls, containing natural equipped with additional equipment to
and developed harbors, airfields, and a function as a 200-bed division hospital in
seaplane base, presented a tempting tar- case of need. A portable surgical hospital
get. All of its thirty-four atolls and two was to go ashore at Eniwetok. Backup at
thousand islands are flat, with none ris- Kwajalein would be provided by the 31st
ing more than 30 feet above sea level. Field Hospital, with three platoons and a
Most supported coconut, breadfruit, headquarters section. Except for the
and pandanus trees, and some a thriving clearing companies and the hospital pla-
tropical undergrowth as well.16 toons, whose heavy equipment was to be
Some Japanese strongholds in the secured to pallets in waterproof wrap-
islands could be bypassed and neutral- pings, all medical personnel would carry
ized. But the atolls of Kwajalein, their initial supplies on their backs.
Eniwetok, and Majuro had to be taken. Overall responsibility for the casual-
Heavily garrisoned Kwajalein would ties that occurred between the beach
require two simultaneous assaults, caus- and the reef fell to the medical section
ing General Holland Smith to divide his of the 708th Amphibian Tank Battalion.
ground troops into four landing forces. In each of the four landing groups
The newly formed 4th Marine Division established by Admiral Turner the Navy
and the 7th Infantry Division, recently designated one amphibian to act as an
arrived in Hawaii from the Aleutians, ambulance, once its original load of
assault troops had been discharged on
15
Percentage rates based on statistics from the fol- the beach. Each amphibian ambulance
lowing sources: Stetson Conn, Rose C. Engelman, and was assigned a physician or highly quali-
Byron Fairchild, Guarding the United States and Its fied technician and three enlisted
Outposts, United States Army in World War II
(Washington, D.C.: Office of the Chief of Military medics. Flying the red cross, these LVTs
History, Department of the Army, 1964), p. 295; Robert were to pick up casualties from the
Ross Smith, The Approach to the Philippines, United States
Army in World War II (Washington, D.C.: Office of the
17
Chief of Military History, Department of the Army, Potter’s later career was a distinguished one. Only
1953), p. 577; and Crowl and Love, Gilberts and thirty-four years old at the time of the Marshalls cam-
Marshalls, pp. 125, 156. paign, he served with the Medical Corps until 1969,
16
Whitehill, “Medical Activities in Middle Pacific,” retiring as a major general after serving as the United
block 18b, pp. 3–4, file 314.7, HUMEDS, RG 112, States Army, Europe, surgeon and the Brooke Army
NARA. Medical Center commander.
228 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
water and from disabled vehicles, Attack Forces and the Majuro Attack
administer first aid, carry them across Group headed for the Marshalls. Majuro
the reef, and then transfer them to Navy proved to have been abandoned by the
landing craft for ferrying to the trans- enemy, and the American flag was raised
ports. If conditions offshore proved less on the morning of the thirty-first.
serious than anticipated, the ambu- Occupation of the various islands of the
lances were to remain on the beach and atoll followed without incident, and the
work there. The 7th Medical Battalion’s medics found little to do but conduct
executive officer was assigned as med- sanitary surveys of the fortunate natives
ical control officer to the naval control who, like the soldiers, had been spared a
vessel that guided each landing. Posted battle. Kwajalein was another matter.
at the line of departure, he was to main- On 31 January the convoys bearing
tain contact with the beachmaster, the the Northern and Southern Attack
amphibians, and the transports, to coor- Forces arrived at the huge atoll to begin
dinate the movement of casualties and Operation FLINTLOCK. The two landed
supplies.18 almost 50 miles apart, reflecting the size
Training for the new campaign was rig- of Kwajalein, whose eighty islands sur-
orous. In Hawaii the medics, like line round a 655-square-mile lagoon. Flat,
troops, took long road marches, qualified and covered with palm trees, the islands
in swimming, studied security measures, resemble the Florida Keys in size, topog-
fired small arms, and learned the rudi- raphy, and climate. At the northern end
ments of jungle fighting. Unit field prob- of the atoll, Roi and Namur, two islands
lems prepared them to work with the bat- linked by a sand spit, contained an air-
talion landing teams that they were to field and controlled the northern
support. Doctors and clearing platoon anchorages and entrances into the great
personnel polished their specialties in lagoon; Kwajalein Island was similarly
the hospitals of Oahu, and the enlisted sited and armed at the southern end.
men drew fatigue details to give the col- The native inhabitants, ill-treated and
lecting platoons as much time as possible forced to labor for the Japanese, proved
to follow their own, more field-oriented to be well disposed to the Americans.
training programs. Finally, in memory of The seizure of Roi-Namur fell to the
the epidemics that had followed the ear- marines of the Northern Attack Force,
lier battles, training of all personnel heav- that of Kwajalein to the infantry.20
ily emphasized sanitation.19 On the first day a few outlying islets
By the third week of January 1944 the fell quickly and with little resistance.
assault forces were ready. Setting out Then on the morning of D+1, following
from Oahu, the Northern and Southern a lethal naval bombardment, amphib-
ians carried the whole assault wave of
18
Whitehill, “Medical Activities in Middle Pacific,” the 7th Division across the reef to
block 18b, pp. 10–15, file 314.7; Notes on OofSurg, Kwajalein. Soldiers of the 32d and 184th
USAFICPA, ETMD, 4 Apr 44, encl. 5, pp. 1–2,
Historians files. Both in HUMEDS, RG 112, NARA. See Regimental Combat Teams swarmed
also “History of OofSurg, USAFMIDPAC,” sec. 2, pp.
75–79, Ms 8–5.6 AA 30/2, CMH.
19 20
Whitehill, “Medical Activities in Middle Pacific,” S. L. A. Marshall, Island Victory: The Battle of
block 18b, pp. 16–18, file 314.7, HUMEDS, RG 112, Kwajalein Atoll (Washington, D.C.: Infantry Journal
NARA. Press, Penguin Books, 1944), pp. 49–52.
THE FORTIFIED ISLANDS 229
ashore on Red Beaches 1 and 2 at the who saw it. The troops would talk about
western end of the 21⁄2-mile-long island. it for days to come.”22
At the northeastern end were barracks, By nightfall on 4 February Kwajalein
warehouses, and headquarters build- Island had fallen, and two days later the
ings; at the center, an airstrip neared mission of the Southern Force was com-
completion. The coral island was flat plete, at a cost of 142 dead, 845 wound-
and sandy, and the pre-invasion bom- ed, and 2 missing. Enemy losses were
bardment had left a cratered moon- high—almost 5,000 dead; Japanese and
scape piled with rubble.21 Korean prisoners of war totaled 206.
Opposition to the landing was light, Meanwhile, the marines of the
but resistance stiffened as the 184th Northern Force had seized Roi-Namur
Regimental Combat Team advanced and nearby islets, losing 313 dead and
along the lagoon side of the island and 502 wounded to the enemy’s 3,500
the 32d Regimental Combat Team killed.23
along the ocean side. Debris blocked
the troops’ vision, and the enemy Medical Support
fought back from pillboxes, bunkers,
and networks of trenches camouflaged Two collecting companies and one
with palm fronds. Disorganized but clearing platoon of the 7th Medical
tenacious defense gave the battle the Battalion plus four shore party medical
character of urban warfare. “You often sections supported the two regimental
see Kwajalein described as a ‘jungle’ combat teams that fought on the large
battle,” wrote historian S. L. A. island, while collecting platoons alone
Marshall, “but . . . what happened there handled the casualties on nearby islets.
possessed nearly all of the attributes of The medical battalion headquarters was
house-to-house fighting,” with bitter set up about 200 yards inland, midway
skirmishes around ruined buildings and between the two landing beaches.
endless bloody work to be done in clear- Ambulances were landed from the first
ing out snipers. Frenzied resistance also day, establishing motor evacuation, and
occurred on nearby islands. Marshall by D+4 clearing stations were receiving
told the story of an aidman, Pfc. Vonnie wounded.
W. Gray, on the islet of Gehh, who Offshore, the suppression of enemy
crawled forward under fire to dress the fire by a murderous opening barrage
arm of a wounded soldier. While he and the presence of many amphibians
worked, an explosion flung another brought welcome changes. No carnage
into the air, who landed with right leg like that at Tarawa occurred in the water.
shattered and bleeding. Gray went to Amphibian ambulances evacuated from
his aid, working calmly under intense the beaches. On D+1 a platoon of the
fire, “an example of courage that stimu-
lated and enriched every fighting man 22
Quotations from Marshall, Island Victory, pp. 103
and 44. See also Heinl and Crown, Marshalls, pp.
100–07.
21 23
Robert D. Heinl, Jr., and John A. Crown, The Heinl and Crown, Marshalls, pp. 53–58, 108–14.
Marshalls: Increasing the Tempo (Washington, D.C.: Whitehill, “Medical Activities in Middle Pacific,” block
Historical Branch, G–3 Division, Headquarters, U.S. 18b, p. 92, file 314.7, HUMEDS, RG 112, NARA, gives
Marine Corps, 1954), pp. 26–27, 55–58. the total Army wounded as 1,001.
230 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
HOSPITAL SHIP FITTED WITH HANGING COTS, to handle the overflow of evacuees
quently to transports. At high tide the garrison forces began. Some complaints
LCTs evacuated the wounded directly about the evacuation process were
from the beaches; at other times they heard: More hospital ships would have
were usually obliged to wait beyond the been welcome, and too many transfers
reef. For some casualties the entire trip from one craft to another had taken
from front line to transport or hospital place in the inshore waters. Yet by and
ship took three hours and for others as large, considering the complexity of the
many as fifteen; the average was a bit less operation and the many medical units
than six. Relatively quick evacuation working independently on islets (the
became a key to the low mortality rate Southern Attack Force captured twenty-
that distinguished the battle for six islands, of which twelve were occu-
Kwajalein. pied by the enemy), the process had
In turn, the ships (including the Navy been effective and the cooperation of
hospital ships USS Solace and USS Relief) the two services outstanding. Carefully
on hand for the operation evacuated to prepared and veteran troops were
Oahu, a 2,100-mile voyage that took another part of the equation; light casu-
eight to twelve days. By the end of alties were the third. When an observer
March airfields in the Marshalls had commented that the evacuation chain
been cleared and completed, and air could easily have handled three times as
evacuation of the few casualties from the many casualties, he paid tribute both to
232 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Hospital did the same on Engebi. The that lies about 1,000 miles from the
customary outbreak of dysentery fol- nearest American base on Eniwetok and
lowed the victory, and was suppressed by about 1,300 miles from Tokyo. Relatively
the same methods as on Kwajalein. large, the islands are diversified in form
Despite bitter fighting, medical person- and appearance, with swamps and sug-
nel had met with few surprises. The arcane fields, fair-sized towns, and pre-
Central Pacific Area forces had cipitous mountains. The new assault
learned—seemingly, had mastered—the would be a huge effort, involving
art of amphibious warfare. Yet there 106,000 U.S. forces, including 50,000
were dangers even in success. The soldiers. The Marianas could not fail to
bloody Gilberts campaign had stimulat- evoke a fanatical defense, if only
ed thought and innovation. By contrast, because American planes operating
“the relative ease with which the from Saipan and Tinian could threaten
Marshall Islands campaign had been the Philippines and Japan itself.
executed influenced the thinking in the In preparation for the coming cam-
Medical Section as it undoubtedly did in paign U.S. forces seized undefended or
other sections and divisions of the Joint lightly defended islands on approaches
Staff to the end that an optimistic atti- to the Marianas; constructed air and
tude had been adopted in the develop- naval bases; and, by constant bombard-
ment of the plans for the Marianas, or ment, neutralized the enemy bastion at
FORAGER Operation.” As a result, Truk in the Caroline Islands to the
“casualty estimates proved to be too low” south. Saipan and Tinian were assigned
for the complex and desperate struggle to the V Amphibious Corps, consisting
that lay ahead.28 of the 2d and 4th Marine Divisions and
the 27th Infantry Division. Guam was to
Operation FORAGER be assaulted by the III Amphibious
Corps, formerly the I Marine
Quick if sometimes costly victory in Amphibious Corps, consisting of the 3d
the Gilberts and Marshalls heartened Marine Division and 1st Marine
the Joint Chiefs to advance the Central Provisional Brigade then staging on
Pacific Area’s schedule for Operation Guadalcanal.29
FORAGER in the Mariana Islands. On 12 The Office of the Chief Surgeon
March the Chiefs approved an attack faced formidable problems in support-
against the islands of Saipan and Tinian, ing so vast an operation against distant
under Japanese mandate since World reef-encircled islands of difficult terrain.
War I, and against Guam, an American Invasion planning began shortly after
mandate that had fallen to the enemy in the completion of the Marshalls cam-
the opening days of World War II.
The Marianas are of both volcanic
29
and coral origin, an arc 425 miles long Whitehill, “Medical Activities in Middle Pacific,”
block 18d, pp. 5–7, file 314.7, HUMEDS, RG 112,
NARA; Philip A. Crowl, Campaign in the Marianas,
28
OofSurg, USAFMIDPAC, “Organization in Pacific United States Army in World War II (Washington, D.C.:
Ocean Areas,” 28 Jan 46, p. 19 (quotations), Historians Office of the Chief of Military History, Department of
files; Whitehill, “Medical Activities in Middle Pacific,” the Army, 1960), pp. 28–29. Unless otherwise noted,
block 18b, pp. 60–74, file 314.7. Both in HUMEDS, RG the combat narrative for the Marianas campaign is
112, NARA. drawn from the latter source.
234 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
paign. For the Saipan and Tinian opera- Prewar Navy experience in Guam pro-
tions, the theater allocated the Army’s vided a wealth of precise information on
31st Field Hospital and the 96th and the disease environment of the coming
97th Portable Surgical Hospitals to assist campaign. The accidents of history and
the Navy medics supporting the the topography of the islands had deter-
marines. Three new medical units, mined which vectors were present and
called corps evacuation hospitals, were which were not. The malaria-bearing
established to provide the marines third- Anopheles was absent from the entire
echelon backup, but no similar organi- Marianas chain, but the Aedes, which
zations were provided to the soldiers of transmitted dengue, was abundant.
the 27th Division, who were seemingly Insect control units were assigned to the
destined for a reserve role. The division invasion forces, but shipping shortages
had its own 102d Medical Battalion, with delayed them, a fact that would cost the
support from the 38th Field Hospital garrison forces dearly. On Guam sanitary
and the 98th Portable Surgical Hospital. conditions among the inhabitants were
Finally, Admiral Nimitz alerted the 77th poor, especially in the capital, Agana.
Infantry Division on Oahu to be ready Venereal diseases and yaws were common
for possible movement to Guam as the among the native population, a light-
reserve. The division was supported by skinned people of mixed racial stock who
its own 302d Medical Battalion, the 36th had endured Spanish, American,
Field Hospital, and the 95th Portable German, and now Japanese occupation.
Surgical Hospital (Map 9). On Saipan the military and medical pic-
Floating support would be unusually ture was complicated by a civilian popula-
strong. Four hospital ships were provid- tion of 30,000, of whom 90 percent were
ed, and the transport USS Bolivar was so said to be Japanese or Korean civilians—
extensively modified as to be, in effect, a the first substantial group of enemy
fifth. An array of smaller craft, including nationals to be met in the Pacific war.
LSTs, were fitted out to play the same Experience with epidemics in earlier
role temporarily. Because of the great campaigns led to improvements in pre-
distances involved, casualties would be ventive medicine techniques. Equipment
carried by sea to the Marshalls and was developed to permit airplane spray-
retained in holding units until air evac- ing of DDT; burial details were trained,
uation could be instituted to Hawaii. with special squads set aside to spray
Penicillin, which had appeared in small corpses with sodium arsenite; and sani-
quantities in the Pacific theaters late in tary precautions were urged upon all
1943, was stockpiled to be shipped by air troops. Again, field exercises and hospi-
to the front.30 tal training prepared the medics for their
new task.31
30
Combined Operations Headquarters (London), Between 29 and 31 May 1944 a flotilla
Bulletin Y/41, U.S. Operations Against Saipan and of 110 transport vessels set out from
Guam in the Marianas, Sep 44, p. 27, file 370; Army
Service Forces (ASF) Monthly Progress Rpt, 31 Jan 45,
31
sec. 7, pp. 5–6, THU Note Cards, Historians files; Whitehill, “Medical Activities in Middle Pacific,”
Whitehill, “Medical Activities in Middle Pacific,” block block 18d, pp. 12–15, 66–67, file 314.7; Surg, Saipan
18d, pp. 13–14, 96–97, file 314.7. All in HUMEDS, RG Island Cmd, Annual Rpt, 1944, pp. 4–5. Both in
112, NARA. See also “History of OofSurg, USAFMID- HUMEDS, RG 112, NARA. See also “Navy Medical
PAC,” sec. 2, pp. 79–81, Ms 8–5.6 AA 30/2, CMH. Department at War,” 1:300–01, BMSA.
THE FORTIFIED ISLANDS 235
0 30
TINIAN I
Miles
Note: Not all inclusive.
ROTA I
JAPAN
Iwo Jima
MARIANA IS
GUAM
PHILIPPINES Enlarged
302d Medical Battalion Area Guam
36th Field Hospital
95th Portable Surgical Hospital
289th Station Hospital CAROLINE IS
PALAU IS
MAP 9
Pearl Harbor across the intervening geon general, traveled with the expedi-
3,200 miles of ocean. A number of mis- tion to support the Saipan garrison,
cellaneous units, assigned by the sur- including a sanitary company and teams
236 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
corps commander, Holland Smith, now talions the enemy isolated the
a lieutenant general, relieved the divi- Americans from their supplies and cut
sion commander. Under new leader- their routes of evacuation. At a time
ship, the soldiers then joined in the final when the battered units took over 900
drive against the Japanese redoubts in casualties, the Japanese controlled the
the mountainous center and the north- roads to the collecting stations. When
ern end of the island.34 Maj. Edward B. McCarthy, commander
By 20 June all elements of the 27th of the 2d Battalion, 105th Infantry,
Division were ashore. Savage fighting assembled a party to seek help for his
scattered the landscape with dead and wounded, American artillery mistakenly
wounded, and the maps with grim nick- zeroed in, driving the infantrymen into
names—Death Valley, Harakiri Gulch. the ocean for safety. Some walking
Just before daybreak on 7 July the 105th wounded got through; moving in the
Infantry, bivouacked between the shore- opposite direction, a few litter-bearers at
line and the cliffs on the coastal great personal risk slipped into the aid
Tanapag Plain, woke to a wild counter- stations, and a single bold driver forced
attack. Some 3,000 Japanese overran the his jeep ambulance through in midafter-
American positions, decimating the 1st noon. Others followed when an
and 2d Battalions. Only at the regimen- American counterattack cleared the
tal command post in Tanapag village was way, and Alligators nosed up to the near-
the attack at last halted, in house-to- est beach to carry off the wounded. As
house fighting. usual in such situations, litters disap-
Notable in the 3d Battalion, 105th peared from the point of severest pres-
Infantry, was the courage of the regi- sure with the wounded who lay on them,
ment’s dentist, Capt. Ben L. Salomon, and aidmen had to improvise others
DC, who had volunteered to care for the from blankets and poles. Night had fall-
wounded in place of an injured battal- en before all who needed care were
ion surgeon. Seeing his aid station over- removed from the front.36
run, Salomon seized a rifle to cover the By 9 July Saipan was secure. The
escape of his wounded. Then he took Japanese had ceased to exist as an orga-
over a machine gun whose crew had nized force; their commander commit-
been killed. “He seemed to be having ted suicide after ordering the final attack,
the time of his life,” the division histori- which he was too sick to lead in person.
an related. “He fired so fast and well that Once the enemy forces on the northern
witnesses say he piled up the enemy in end of the island were flushed out and
front of his gun until he no longer had destroyed, the marines departed to
a field of fire.” Two days later Salomon’s attack Tinian, and the infantry remained
body was found, “still slumped over the on Saipan to mop up stragglers.
machine gun, riddled with bullets.”35 The victory had been costly. Of
Yet for a time matters were grim. By 71,034 American officers and enlisted
overrunning the perimeters of two bat-
36
Whitehill, “Medical Activities in Middle Pacific,”
block 18d, pp. 50–52, file 314.7; Rpt, CO, 102d Med Bn,
34
On the Marine-Army controversy, see Crowl, 20 Jul 44, sub: Operational Report, p. 7, An C to Rpt,
Marianas, pp. 199–201. Surg, 27th Inf Div, 1 Aug 44, sub: Forager Operational
35
Love, 27th Infantry Division, p. 457. Report, file 370. Both in HUMEDS, RG 112, NARA.
238 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
men committed to the battle, 14,111 who had survived the enemy’s devastat-
(about 20 percent) were listed as killed, ing bombardment of the landing craft
wounded, or missing—roughly the same huddled for almost thirty hours under
casualty rate as at Tarawa. Losses includ- an artillery barrage ashore. The beach
ed 3,674 soldiers and 10,437 marines. resembled a massacre; wounded, dead
The defenders were virtually extermi- and dying lay everywhere. Navy aidmen
nated, and hundreds of the Japanese carrying seabags of medical supplies
civilians who had made the island their were the first to reach them, administer
home wrote a grim epilogue to the first aid, and attempt to remove them
struggle by leaping to their deaths from from the beach for treatment. But early
the northern cliffs. Persuaded that the evacuation was haphazard and slow.
Americans would torture and kill them, When battalion aid stations were set up,
much of the civil population had litter-bearers set out to retrieve sur-
retreated with their armed forces, taking vivors. Hospital corpsmen took losses of
heavy casualties. Because farmers on their own; in the 4th Marine Division
Saipan fertilized with nightsoil, the alone, 161 medics were wounded.
earth was heavily seeded with the spores The Navy beach party medical sec-
of tetanus and the bacilli that cause gas tions came ashore next, one for each
gangrene. Wounded civilians, lacking battalion landing team. Composed of
inoculations, were often infected. one medical officer and eight hospital
American medics were too few to care corpsmen each, these sections constitut-
properly for internees until the battle ed the link between medical care ashore
was over, and internment camps quickly and afloat. Digging in above the high
became overcrowded and filthy. In all, water mark, they set up casualty evacua-
some 28,000 civilians were interned in tion stations that were quickly over-
the Marianas, most on Saipan and whelmed by the wounded. One such sta-
Tinian, and their sufferings added to tion treated over 1,000 troops in four
the human toll of the fighting.37 days. Jeep ambulances speeded evacua-
tion from the front lines, but were them-
The Medical Problem selves hit time and again by enemy fire.
When a Japanese fleet threatened the
With its tens of thousands of dead invasion, the transports were ordered to
and wounded, the Saipan battle was sea, and a potential medical crisis devel-
marked by recurring medical crises. The oped. While the Battle of the Philippine
marines landed first, under conditions Sea took shape, medical personnel
of great danger and confusion, and ashore struggled to make do minus their
Navy medics faced the task of bringing backup. LSTs were not fully equipped
some degree of medical order to the for complex surgery, and only first aid
beachhead. The task was far from easy, was available on the beach. Enemy
especially in the first three days. Marines artillery and mortar fire continued to
harass the beaches, causing casualties to
37
Statistics from Crowl, Marianas, p. 265; see also pile up in aid and evacuation stations.
Morison, Naval Operations in World War II, 8:170–212. On D+3 (19 June), however, the hospital
On civilians, see ASF Monthly Progress Rpt, 31 Jan 45,
sec. 7, pp. 6–7, THU Note Cards, Historians files, ships arrived, and the transports
HUMEDS, RG 112, NARA. returned a few days later. The sea battle
THE FORTIFIED ISLANDS 239
treatment. The other two platoons for all were targets of enemy attack. No
worked near the 102d Medical Battalion, component was properly defended,
where they received large numbers of leading the hospital commander to urge
casualties from the banzai charge of 7 that defense platoons be assigned to
July. For a time beds were filled to over- hospital units, not only to guard against
flowing; casualties lay everywhere on the the enemy but to assist with the digging-
ground on litters or blankets. The Navy in chores that took medical personnel
and portable hospital surgeons who away from their charges, often at times
arrived to help had to cope with the clut- when their services were badly needed.41
ter of bodies and insufficient operating Psychiatric cases made up about 6 per-
tables. Nevertheless, from 7 to 9 July, cent of the more than 5,000 casualties
under air raids and shrapnel falling from suffered by the 27th Division from all
antiaircraft fire, surgery went on around causes during FORAGER. Under the guid-
the clock.40 ance of the division psychiatrist, working
The 38th Field Hospital, too, had its at the 38th Field Hospital, all were ini-
adventures. All of its elements dug in, tially recorded as “combat fatigue” cases
40 41
Whitehill, “Medical Activities in Middle Pacific,” Ibid., p. 31, file 314.7; Rpt, 38th Field Hosp, 4 Sep
block 18d, pp. 25, 30–31, 42–46 (quotation, p. 44), 53, 44, pp. 3–4, file 350.09. Both in HUMEDS, RG 112,
file 314.7, HUMEDS, RG 112, NARA. NARA.
THE FORTIFIED ISLANDS 241
and received treatment that by now had evacuation hospital be used instead of
become standard. On admission those the field hospital for this type of medical
who were able ate hot food, took a cool coverage.”43
shower, and shaved; then, once in bed, These were not the dimensions of a
they were visited by the psychiatrist and disaster. But the figures recorded a sys-
sedated with sodium amytal. As usual, tem straining at its upper limits, and
symptoms mimicked many serious disor- implied a maximum burden on the
ders—manic depression, schizophrenia, medics who were themselves enduring
and Parkinsonism. Most stayed in the much of the danger that had faced
hospital only four or five days. Those their patients on the front lines.
who did not respond in thirty-six to sev- Overcrowded facilities for the troops
enty-two hours were evacuated to the also meant too rapid evacuation for
hospital ships. Despite the unfortunate some casualties, too quick return of
location of the hospital—in an aban- others to the line, and generally insuf-
doned village between a battery of heavy ficient care for civilians and prisoners
artillery and Aslito airfield, where sud- of war. The flood of wounded exhaust-
den blasts caused the more acute cases to ed the supply of whole blood, and con-
“literally jump off their cots”—202 of 272 tinued to do so even when division per-
patients were returned to duty by the sonnel began to donate their own.
end of the battle.42 Blood banks had to be set up on ship-
Overall, the Saipan campaign proved board to provide whole blood for the
to be more difficult and far more expen- troops invading Tinian. On Saipan
sive than American commanders had many wounded made do with plasma;
anticipated. Unexpected enemy many who received some whole blood
strength made a serious impact upon ought to have received more.44
the medical units and their overworked Serious problems also developed in
personnel. Total bed capacity of all evacuation. On land one difficulty was
Army and Marine installations was a bit the late arrival of the jeep ambulances,
over 2,000, including expansion beds. which were not unloaded until four or
But by 9 July the total patient census had five days after the landing of the person-
reached 200 per day. The 31st Field nel who were to use them. Overburdened
Hospital had a peak expansion capacity litter-bearers were further hampered by
of over 1,000 and a peak daily census of the need to move injured civilians and
the same. The medical system, especial-
ly its field hospitals, struggled to provide 43
Rpt, CO, 38th Field Hosp, 21 Jul 44, sub:
care. Numerous combat casualties led Operational Report, Saipan Campaign, p. 6 (quota-
the 38th Field Hospital’s commander to tion), An D to Rpt, Surg, 27th Inf Div, 1 Aug 44, file 370;
Whitehill, “Medical Activities in Middle Pacific,” block
recommend that the semi-evacuation 18d, pp. 14, 43–44, 53, 55, file 314.7. Both in HUMEDS,
hospital of 400 beds, with an expansion RG 112, NARA.
44
capacity of 350, or the larger “750 bed Comments and Recommendations, pp. 1–3, in Rpt,
Surg, 27th Inf Div, 1 Aug 44, file 370; Whitehill,
“Medical Activities in Middle Pacific,” block 18d, pp.
42
Rpt, Maj Albert D. Pattillo, OofSurg, 27th Inf Div, 47–58, file 314.7, HUMEDS, RG 112, NARA. See also
20 Jul 44, sub: Report of Psychiatric Casualties in the Douglas B. Kendrick, Blood Program in World War II,
27th Infantry Division During the Saipan Operation, Medical Department, United States Army in World War
pp. 1–3 (quotations, p. 1), An B to Rpt, Surg, 27th Inf II (Washington, D.C.: Office of the Surgeon General,
Div, 1 Aug 44, file 370, HUMEDS, RG 112, NARA. Department of the Army, 1964), p. 594.
242 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
prisoners of war. Alligators, halftracks, lems. Apparently, the Navy did not put a
and tanks were sometimes used to evacu- medical officer aboard the control vessel,
ate the wounded from the areas of hottest the point where evacuees were trans-
fighting, but most evacuation during the ferred from landing craft to larger ships.
tense early days and after the enemy Under the intense pressure of combat,
counterattack was done by hand, and many casualties were not triaged or prop-
some units, especially the hard-pressed erly distributed among the available
31st Field Hospital, were acutely short of ships. Certain craft had been designated
bearers for brief periods. to treat the lightly wounded and return
But the pressure on shipping caused them to the line, but they were often
the greatest difficulty. The Joint Staff mixed with the seriously wounded. Lack
planners could not have foreseen how of effective medical regulation mingled
many casualties had to be taken off the Americans with injured civilians and pris-
island—almost 2,000 the first day—nor oners of war, and left some ships empty
the absence of most transports for three while others were filled to overflowing.
days during the sea battle. The reliance Some medically equipped LSTs lacked
upon transports for all complex surgery, identifying marks, creating confusion
pending the arrival of the hospital ships, that combined with the haste or igno-
left the severely wounded ashore without rance of coxswains to compel multiple
proper treatment for about twenty-four transfers of casualties from ship to ship.
hours. After hospitals were ashore and Planners had looked to the smaller
ships were ready to receive casualties, a assault craft and the amphibians to evac-
critical period ensued, lasting roughly uate from the beaches to the LSTs and
from 26 June to 9 July, when an influx of from the LSTs to the transports and hos-
wounded, sick, and injured, including pital ships. But the reef surrounding
civilians and prisoners, taxed all facili- Saipan halted many of the landing craft,
ties. Because the number of casualties forcing additional transfers; some wound-
exceeded holding capacity both afloat ed were shifted five times from smaller to
and ashore, about 10,000, even some larger craft, undergoing stress and pain at
with only light wounds, left with ships every move. The arrival of the hospital
departing the combat area—a loss of 14 ships on D+3 eased the situation, but the
percent of the total Army and Marine number proved to be too few, leading a
assault force. However desirable for the December 1944 study by the Joint Chiefs
wounded themselves from a purely med- to recommend that two such vessels be
ical viewpoint, such figures suggested allotted for each assault division.46
that the medical system afloat and About nine-tenths of the casualties
ashore was unable to preserve the fight- evacuated from Saipan went by sea.
ing strength of the forces.45 Evacuation by tactical aircraft began on
Mix-ups in sorting casualties among 24 June, when Aslito, now renamed Isley
the ships compounded evacuation prob- airfield, became operational. Evacuees
46
Rpt, CO, 102d Med Bn, 20 Jul 44, p. 4, An C to Rpt,
45
ASF Monthly Progress Rpt, 31 Jan 45, sec. 7, p. 5, Surg, 27th Inf Div, 1 Aug 44, file 370; Rpt, 38th Field
THU Note Cards, Historians files; Whitehill, “Medical Hosp, 4 Sep 44, p. 7, file 350.09. Both in HUMEDS, RG
Activities in Middle Pacific,” block 18d, pp. 47–58, file 112, NARA. See also “Navy Medical Department at
314.7. Both in HUMEDS, RG 112, NARA. War,” 1:252, BMSA.
THE FORTIFIED ISLANDS 243
were flown to Kwajalein in seven hours, Meanwhile, the great number of casual-
as against five days by water. Here they ties overwhelmed the system and exag-
rested a few days before moving on to gerated the materiel losses.
Oahu. Poor planning, however, charac- By D+3, however, the division medical
terized the early days of air evacuation: supply dump was in operation, and when
No flight surgeon screened the casual- the transports returned a few days later,
ties; no attendants rode the planes; and the system began to work fairly well. Until
no oxygen was available, resulting in then, units and individual medics made
marked dypsnea and cyanosis when do with the supplies they carried with
planes flew above 4,000 feet. After sever- them. Throughout the initial disorder
al evacuees perished en route, rules were and later stabilization, the technique of
adopted that excluded from air evacua- lashing packages to wooden pallets cov-
tion those who suffered from head, ered with waterproof cloth or paper
chest, and abdominal wounds. Medics proved its utility. Protected from the wet,
trained in flight medicine accompanied supplies were located on the beaches
the planes, and oxygen masks and con- more easily than in separate containers,
tainers arrived on Saipan. Conditions and were hauled to inland dumps by trac-
steadily improved, as did the importance tors rather than carried by labor details.
of air evacuation, though it remained an Palletizing had been tried in the
adjunct to the sea until 17 August, when Aleutians, the Gilberts, and the Marshalls,
the Air Transport Command’s Pacific but became the norm in the Marianas; at
Wing took over medical flights from the Saipan the 27th Division palletized 80 to
Marianas. Now C–54s, staffed with corps- 90 percent of its supplies, leading even
men and flight nurses, bore the wound- the marine commander to comment on
ed in conditions of relative safety and the advantages of a system his own service
comfort, and the number of air evacuees had hitherto been slow to employ.
quickly came to equal or exceed the Resupply was standardized as well. The
number carried by ships.47 USASOS provided automatic block ship-
Unloading supplies at Saipan was a ments of special medical maintenance
difficult process, slowed by the barrier units, each meant to supply 2,000 troops
reefs and by the fact that transports, to for fifteen days. Some imbalances
avoid enemy air and submarine attacks occurred, with excesses of a few items and
after dark, stood out to sea at nightfall. shortages of others, simply because the
The withdrawal of all ships during D+2 course of events could not be foreseen.
to D+5 slowed the work further. The No supplies were brought for civilian
102d Medical Battalion lost 5–10 per- care, but the large amounts of captured
cent of its initial supplies—tents, beds, Japanese materiel took up the slack.48
blankets, and mosquito nets, among
other things—either in transit to the
48
beach or in the confusion of the dumps. ASF Monthly Progress Rpt, 31 Jan 45, sec. 7, pp. 3–4,
THU Note Cards, Historians files; Rpt, 38th Field Hosp,
4 Sep 44, p. 6, file 350.09; Rpt, Surg, 27th Inf Div, 1 Aug
44, pp. 3–4, file 370. All in HUMEDS, RG 112, NARA.
47
Whitehill, “Medical Activities in Middle Pacific,” See also Charles M. Wiltse, Medical Supply in World War
block 18d, p. 56, file 314.7, HUMEDS, RG 112, NARA; II, Medical Department, United States Army in World
“History of OofSurg, USAFMIDPAC,” sec. 2, p. 82, Ms War II (Washington, D.C.: Office of the Surgeon
8–5.6 AA 30/2, CMH. General, Department of the Army, 1968), pp. 473–74.
244 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
unexpected strengths. The medical side seemingly the least favorable of the
of the battle fitted the general picture, island’s three possible landing areas. In
as the veteran medics endured much, consequence, they achieved complete
cared for overwhelming numbers of surprise. The marines secured the island
casualties, faced constant danger, and in about a week. Except for some
coped with situations that often seemed artillery units, the 27th Division was not
close to getting out of hand. needed.
The results of the campaign were Several Army medical units originally
epochal. The enemy’s defense perime- attached to the 27th Division for the
ter had been pierced, his fleet had Saipan landing were assigned by the V
been seriously and permanently dam- Amphibious Corps to participate in the
aged by the loss of naval aircraft, and conquest of Tinian. Their contributions,
his homeland lay within reach of the however, were limited by a typhoon that
new long-range American bombers. stirred up heavy swells on the sea and
Acknowledging a crushing setback, the kept both Marine and Army units,
Japanese government of Hideki Tojo including the 31st Field Hospital, away
resigned on 18 July, the day the from the fight. Limited to their own
American victory was announced. medical personnel, the 2d and 4th
Meanwhile, the campaign for the Marine Divisions on Tinian were fortu-
Marianas moved on. nate that a low casualty rate enabled
them to care for their own. In the first
Tinian and Guam four days LSTs, with two portable surgi-
cal hospitals on board, evacuated about
Although Tinian’s 40 or so square 300 casualties before rising seas prevent-
miles was guarded from the sea by ed further movement by sea. But by that
rugged cliffs in the south and by a hilly time captured airfields on Tinian made
region in the north, most of the island air evacuation possible, and beginning
was an undulating grassy plain check- on 28 July, C–47s flew evacuees to
ered with fields of sugarcane. The land Saipan.
was perfect for the construction of air Saipan’s facilities, strengthened by
bases, of which the Japanese had already those medical units that had remained
built three. The garrison was compara- on the island due to the storm, never-
tively small, about 8,300 troops. theless provided useful support to the
Assigned to the invasion were the 2d fighting forces. In effect, only first aid
and 4th Marine Divisions, with the 27th had to be done on Tinian. Chief losers
Infantry Division in reserve. from this division of labor were enemy
With Saipan in their grasp, the civilians hurt in the action, for the
Americans proceeded at their leisure to understaffed and undersupplied Navy
study and soften up its neighbor, only medical units supporting the marines
3.5 miles away. Army artillery joined were unable to aid them properly until
Navy guns in battering defensive posi- the fighting was over. Captured
tions, discovered by overflights of recon- Japanese equipment and supplies satis-
naissance planes. On 24 July marine fied some of their needs, however, and
assault forces landed on the narrow on 9 August a 100-bed Navy facility was
rocky beaches of the northwest coast, dispatched from Saipan expressly for
246 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
their care. The buildup of Tinian as a 306th Regimental Combat Teams, 77th
major air base for attacks by very heavy Division, landed to take over perimeter
bombers on the Japanese mainland defense, while the marines sought to
ensured that medical facilities would clear the enemy from Orote Peninsula.
increase as well, and an Army station Five days of severe fighting, marked by
hospital of 1,000 beds soon arrived to fierce enemy counterattacks, secured
support the air force units stationed the region. Now the 3d Marine and 77th
there.50 Divisions pursued the enemy into the
The last phase of FORAGER was the northern part of the island, the soldiers
assault on Guam, largest of the Marianas advancing along the eastern shore, the
and a possession of the United States marines in the west. Trackless jungle,
since the time of the Spanish-American insects, rain, and deep mud created a
War. The task of its reconquest fell to combat environment reminiscent of the
General Geiger’s III Amphibious Corps, Southwest Pacific; the 77th suffered 200
which organized the assault around casualties in three days. But the hard-
three division-strength units: the 3d used enemy was beginning to disinte-
Marine Division, the 1st Marine grate, and the Chamorro natives greet-
Provisional Brigade, and the 77th ed the Americans as liberators. The final
Infantry Division in reserve. drive began on 6 August, with all the
An island of two distinct parts, Guam major American landing forces as par-
comprises a high coral plateau in the ticipants. Two days later the soldiers had
north, with sharp bluffs falling away to seized Mount Santa Rosa, the last
the beaches. The waist of the island, low Japanese stronghold, and on the tenth
and swampy, includes the capital of General Geiger declared Guam secure.51
Agana. To the south, a rough and moun- Throughout, Guam was primarily a
tainous landscape rises, with peaks 1,000 Navy show, as the loss statistics of
feet high, but the beaches are more acces- marines and soldiers demonstrated. The
sible than in the north. Because of the work of the two medical services reflect-
impassable reefs on the eastern shore, ed this fact. Supporting the 77th
landings were planned for the west. Here Division was its own 302d Medical
lies Apra Harbor and Orote Peninsula, Battalion, as well as the 95th Portable
with an enemy airfield that formed the Surgical Hospital and the 36th Field
first objective of the campaign. Hospital. The Army’s 289th Station
Anticipating strong resistance from Hospital also arrived while the fighting
the 18,500 defenders, the Americans was in progress but did not set up until
seared the 34-mile-long island with the the battle was over; the unit provided
most intense bombardment of the support mainly for naval garrison forces.
Pacific war. On 21 July the marines went By comparison, the marines brought
ashore. By evening the beaches had two large hospitals with them, plus the
been cleared. Soldiers of the 305th and organic medical units that supported
their two division-sized forces.
50
Whitehill, “Medical Activities in Middle Pacific,” The performance of the Army med-
block 18d, p. 98, file 314.7; Rpt, 38th Field Hosp, 4 Sep ical personnel was professional and with-
44, pp. 12–13, file 350.09. Both in HUMEDS, RG 112,
NARA. See also “Navy Medical Department at War,”
51
1:278–82, BMSA. Crowl, Marianas, pp. 329, 405, 437.
THE FORTIFIED ISLANDS 247
out surprises. During the first few days pany and the 95th Portable Surgical and
medical units stayed on the beach or 36th Field Hospitals—landed on 24 and
close to it. Battalion aid stations were set 25 July. The field hospital went into
up along the natural lines of drift to immediate operation at Agat, and the
intercept the walking wounded, as close clearing company and the portable fol-
to battalion command posts as possible lowed the northward advance, keeping
and often within their defensive perime- 7–8 miles behind the collecting stations.
ters. Collecting platoons landed with the Together, these units handled all emer-
rear elements of the battalion teams, but gency surgery cases from the front. In
soon recombined into collecting compa- early August two of the three field hospi-
nies because the combat elements tal platoons joined the northward move-
remained coherent during the fighting ment. The third platoon remained at
on Guam. Thus Company A, 302d Agat as backup, admitting 1,125 casual-
Medical Battalion, supported the 305th ties, two-thirds of them medical, between
Regimental Combat Team; Company B, the 8 and 14 August (see Map 9).52
302d Medical Battalion, the 306th
Regimental Combat Team; and 52
Whitehill, “Medical Activities in Middle Pacific,”
Company C, 302d Medical Battalion, the block 18d, pp. 74–81, file 314.7, HUMEDS, RG 112,
NARA; “History of OofSurg, USAFMIDPAC,” sec. 2, pp.
307th Regimental Combat Team. The 81–83, Ms 8–5.6 AA 30/2, CMH; “Navy Medical
third echelon—the 302d’s clearing com- Department at War,” 1:290–94, BMSA.
248 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
As at Saipan, reefs delayed the move- transport, and the handling of the
ment of supplies ashore, and both Army wounded was more efficient. Seven LSTs
and Navy medics labored under short- had been set aside, two equipped with
ages of supplies and equipment for the surgical teams and five to evacuate med-
first few days. Evacuation ashore was ical cases. The chief problem in using
affected by the slow arrival of vehicles. A these large landing craft was the reef;
variety of technical problems faced the often medical officers preferred routing
Seabees in moving such large items casualties by amphibious vehicles direct
ashore; once on the beach, however, the to the transports, rather than sending
difficulties that developed were all too them via the LSTs. Two transports and
familiar. Supplies were lost by breakage two hospital ships received casualties
in transit, by pilferage, and by the con- from Guam and subsequently brought
fusion that resulted from dumping them to rear area bases instead of using
materiel of all sorts on the narrow strips air evacuation.54
of sand. Looting was a serious problem; Lt. Col. John C. Ivins, MC, the 77th
supplies were stolen both aboard ship Division surgeon, complained about
and, on the beach, by those apparently the lack of a third echelon ashore, that
in search of alcohol. Even boxes that is, an evacuation hospital to receive
had been well constructed and water- casualties from the field hospital pla-
proofed were broken open, their con- toons, provide complex treatment, and
tents scattered and, ultimately, soaked transfer evacuees to the ships. The
by rain. A fifth of the 302d Medical attempt to make do without such a hos-
Battalion’s cots disappeared, compelling pital apparently reflected a literal-mind-
medics to put many of their sick and ed attempt to apply the methods appro-
wounded on the ground. Such heavy priate for atolls to combat on the largest
items as ward tents, a kitchen range, and island of the archipelago, greater in
a washing machine also vanished. Some area than all the others combined. The
losses were inevitable, but on Guam the field hospital platoons had to follow the
scale of theft was such as to interfere troops, provide treatment, receive casu-
with the proper functioning of the med- alties at the beach, and evacuate as well,
ical units.53 “an added burden,” said Ivins, “on per-
In evacuation, Guam presented fewer sonnel and transportation that was
problems than Saipan, not because already overworked.”55
organization was better but because the As the prevalence of medical casual-
number of wounded was smaller. ties indicated, sickness also marred the
Casualties, which totaled only about two- conclusion of this Central Pacific Area
fifths the number at Saipan, reached the campaign. Most of the enemy dead were
clearing station or the hospitals usually left unburied; again insect control
thirty to ninety minutes after leaving the
aid stations. The beaches were not so 54
Whitehill, “Medical Activities in Middle Pacific,”
heavily crowded with wounded awaiting block 18d, pp. 87–89, file 314.7, HUMEDS, RG 112,
NARA; “Navy Medical Department at War,” 1:294–97,
BMSA.
53 55
Whitehill, “Medical Activities in Middle Pacific,” Surg, 77th Inf Div, Quarterly Rpt, Oct–Dec 44, p. 1,
block 18d, pp. 82–83, file 314.7, HUMEDS, RG 112, THU Note Cards, Historians files, HUMEDS, RG 112,
NARA; Crowl, Marianas, pp. 358–59. NARA.
THE FORTIFIED ISLANDS 249
details had failed to land with the assault captured Japanese supplies and borrow
forces. Flies and mosquitoes, already from the 77th Division and the hospital
common, multiplied in the disorder ships offshore.57
that accompanied the fighting, and Yet Guam, despite the difficulties that
plagues of dysentery and dengue struck arose, was a comparatively easy victory.
the victorious forces. At one point in Total American losses were less than half
October, when the 77th Division was those at Saipan: some 7,800 casualties, of
preparing for new operations, its sur- whom 2,124 were killed in action or died
geon counted hospital admissions for of wounds. Most of the blood was shed by
dengue and fevers of unknown origin at the marines, who lost 6,716 to the Army’s
250 a day. The medics were not exempt; 839 and the Navy’s 245. Of the Japanese
more than half the complement of the garrison of 18,500, few survived.58
289th Station Hospital fell ill with Summing up the costs of the bitter
dengue. Skin diseases were ubiquitous, and decisive campaign for the Marianas,
from a combination of high humidity, the Americans counted nearly one-fifth
excessive sweating, contaminated soil, of their total force either dead or
and lack of laundry and bathing facili- wounded—24,518 out of an estimated
ties. On this large jungled island, troops 128,000 soldiers, sailors, and marines.
of the supposedly healthy Central Of the estimated 53,255 Japanese who
Pacific experienced conditions that had defended the islands, only 2,847
were the norm in the theaters to the survived as prisoners; the rest, except for
south.56 a few stragglers hiding in the jungle, had
Civilian sick were another serious bur- perished. The differences among the
den to medical personnel. Originally three Central Pacific Area campaigns
inclined to treat the natives well, the are suggested by the loss ratios of the
Japanese, as the war drew to a close, had two forces. On Saipan, 1 American was
requisitioned their labor on defensive killed in action to every 8.4 Japanese; on
works. Chamorros were forced into Guam, 1 to every 14.8; and on Tinian, 1
camps typified by minimal food, insuffi- to every 23.8. Overall, the average was
cient shelter, and miserable sanitary almost precisely 1 to 11.59
conditions. Hundreds died; others were Planning for the campaign had been
ill when liberated. Though internment less than satisfactory, in part because the
removed the Guamanians from the bat- easy victory in the Marshalls had made
tlefields and spared them many wound- the projections of the Joint Staff’s
ed, the Navy medical service fell heir to Logistics Division and the latter’s med-
its sick. But here, as at Saipan and ical section overly optimistic. Low esti-
Tinian, shipping priorities had prevent- mates of casualty rates resulted in hospi-
ed early movement of facilities to serve tals and hospital ships being overloaded,
civilians. Medics of the III Amphibious not only at the scene of the fighting but
Corps were obliged to scrape together
57
“Navy Medical Department at War,” 1:300–06,
56
Ibid., pp. 1–2, THU Note Cards, Historians files; BMSA.
58
Whitehill, “Medical Activities in Middle Pacific,” block Crowl, Marianas, p. 437.
59
18d, pp. 84–85, file 314.7. Both in HUMEDS, RG 112, ASF Monthly Progress Rpt, 31 Jan 45, sec. 7, p. 3,
NARA. See also “History of OofSurg, USAFMIDPAC,” THU Note Cards, Historians files, HUMEDS, RG 112,
sec. 2, pp. 81–82, Ms 8–5.6 AA 30/2, CMH. NARA.
250 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
also back through the chain of evacua- lations, which had been subject to attack
tion as far as the United States. Hardly throughout the Marianas fighting, need-
an aspect of the evacuation story could ed improved security.
be cited that did not reveal failures of Despite all failings, the epic struggle
foresight and unnecessary suffering had carried the American forces beyond
inflicted on the wounded. The failure to the atolls, prepared them for the assault
provide insect control units to accompa- on the Philippines, taught valuable
ny the landings was apparently a prod- lessons in amphibious warfare, and
uct of the very fact that made the cam- brought the day of victory measurably
paign a success. Striking so far to the closer. By the end of the year the
enemy rear compelled the fleet to carry Seventh Air Force headquarters would
immense quantities of every kind of sup- be established on Saipan and the air
plies, and priorities excluded the units assault against Japan would be under
that might have imposed successful pre- way. The Marianas would become a cen-
ventive medicine from the beginning. ter of military hospitalization, with
In reviewing accounts of the Marianas 16,500 Army beds alone, many times the
campaign, the Army Service Forces number on Oahu. As the forces pre-
headquarters drew the conclusion that pared for new battles, the support sys-
each assault division needed one 400- tem as well grew rapidly over the great
bed evacuation hospital, a mobile field Pacific distances.60
hospital, and two hospital ships; that
some mobile medical units should land 60
Rpt, Col Robert F. Bradish, CO, 821st Hosp Ctr,
with the first waves if any possibility Tinian, n.d., sub: Status Notes as of 12 June 1945, THU
existed that enemy action might compel Note Cards, Historians files; ASF Monthly Progress Rpt,
the transports to retire; that sanitary 31 Jan 45, sec. 7, pp. 1–3, THU Note Cards, Historians
files; Ltr and 1st End, OofSurg, 7th Air Force, to Surg,
details equipped to cope with flies and PACUSA, 1 Jul 46, and Surg, PACUSA, to CSurg, USAF-
mosquitoes should land in the first week PAC, 11 Jul 46, encl. 1, p. 2, bound in Surg, 7th Air
of battle; that special provision must be Force, Annual Rpt, 1946, file 319.1–2. All in HUMEDS,
RG 112, NARA. See also “History of OofSurg,
made for large numbers of civilian casu- USAFMIDPAC,” sec. 2, pp. 82–83, 88–100, Ms 8–5.6 AA
alties; and that frontline medical instal- 30/2, CMH.
CHAPTER VIII
States. Base Section 1 at Darwin closed, three large general hospitals had served
and its troops departed gladly from a a year before. Base B (Oro Bay) also
place of tedious routine and tropical began to shrink during the second quar-
heat. Base Section 3 at Brisbane was ter of 1944. Air activity moved away from
changed and downgraded as well. It had Lae, once the objective of a hard-fought
been the home of both the USASOS campaign; however, neighboring
headquarters and the Malaria Control Finschhafen, strategically located on the
School; the theater’s main distribution tip of the Huon Peninsula, remained a
center for medical supplies; and, major base. Meanwhile, the western
because of its seven hospitals and 4,000 bases grew rapidly, notably G
beds used by evacuees from New (Hollandia) and H (Biak); they mush-
Guinea, an important center of evacua- roomed into immense centers of supply,
tion to the United States. But as the with port facilities and staging areas. By
medical units followed the troops the end of 1944 more than 280,000
throughout 1944, along with the head- troops were concentrated in the last
quarters, the Malaria School was lost to three. In February 1945, as USASOS
the Intermediate Section. In June bases built up in the Philippines, the
Section 3 was renamed Base Section New Guinea bases came under the
USASOS Brisbane, with control over the newly established New Guinea Base
remaining base sections, and in Section that replaced the Intermediate
February 1945 redesignated the Section at Oro Bay.11
Australian Base Section, emphasizing Such rapid growth, especially in the
the fact that this large and once-active disease environment of New Guinea,
organization had become a rear area.10 meant serious problems for the medics.
Even in New Guinea the southern The first six months of 1944 at
and eastern bases declined. Port Finschhafen, for example, were marked
Moresby passed its peak in 1943, losing by repeated outbreaks of dengue and
its four station hospitals and turning malaria, which in the end were sup-
over American sick and wounded to pressed apparently as much by the
Australian facilities. In mid-1944 Base A return of the dry season as by the impo-
(Milne Bay) peaked and then rapidly sition of rigorous control measures. The
lost its importance; the 4,208 occupied effectiveness of strict Atabrine discipline
beds of June fell to 1,775 in December. and efforts to destroy mosquitoes, how-
As the base declined to a supporting sta- ever, became evident later in the year,
tus during 1945, a single general hospi- for both diseases were reduced to man-
tal met all the needs that six station and ageable problems. At Oro Bay the base
commander offered a prize in war
10
See Quarterly Rpts, Oct–Dec 43, pp. 1, 6, and bonds to the unit that killed the most
Jan–Mar 44, p. 1, for Surg, Base 1; respectively, p. 1, and rats; units offered their own prizes, the
p. 1, for Surg, Base 3; and pp. 10–12, and p. 5, for Surg, winner in the 25th Ordnance Medium
Base 4 (copies); plus Oct–Dec 44, pp.1–2, and Jan–Mar
45, pp. 1–2, for Surg, Base 2 (copies), and p. 1, and p.
11
1, for Surg, Base 7 (copies). All file 319.1, HUMEDS, See “USASOS Bases in New Guinea,” pp. 41–42,
RG 112, NARA. See also Diary (Extract), Australian Historians files, and Quarterly Rpts (copies), 1944 and
Base Sec, 15 Feb 45, file 323, HUMEDS, RG 112, NARA, Jan–Jun 45, for Surgs, Base D [Port Moresby], Base B
and Armfield, Organization and Administration, pp. [Oro Bay], and Base E [Lae], file 319.1. All in
476–77. HUMEDS, RG 112, NARA.
256 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Late in 1944 a new organization came gate of 3,650 beds. Actual expansion
to Finschhafen, the 26th Hospital came more slowly than King had forecast
Center, created around the nucleus of but in the end was greater; for the
the 4th General Hospital, lately at stream of casualties from the Philippine
Melbourne. Combining three or more campaign, some 8,930 beds were avail-
1,000-bed general hospitals, the center able by the end of 1944 and a total of
unified administration, enhanced spe- 9,502 by the spring of 1945. Medical per-
cialization in its component organiza- sonnel built the Army’s largest overseas
tions, and economized on medical per- facility, the 54th General Hospital, with
sonnel. Improved efficiency was neces- 3,500 beds—cutting trees, leveling the
sary; the patient census in Finschhafen ground, mixing cement, and putting up
reached 7,122 in October, with few beds the “prefabs,” until a miniature city had
to spare. Though that apparently repre- appeared in place of tropical jungle.17
sented the peak, casualties from the new Casualties were brought to the 27th
battlefields to the west continued to flow Hospital Center via LSTs, hospital ships,
into Finschhafen during late 1944 and and transports. Ambulance boats scur-
the first half of 1945. Planes delivered ried between the ships in the bay and
them to the airfields nearby, and ships the docks, bringing in new ones and car-
converted into seagoing hospitals rying those in need of long-term care to
docked and discharged their loads onto the hospital ships for transport farther
sea ambulances, high-powered launches to the rear. The theater, having previ-
that ferried them to shore. From ously only two hospital ships, as of late
Finschhafen, casualties were evacuated 1944 boasted seven, with a total capacity
to Australia until May, but thereafter of 3,675 beds. The four more elaborate
directly to the United States.16 hospital ships, which were both operat-
The base at Hollandia in western New ed and staffed by the Navy, were intend-
Guinea was set up in mid-1944 primarily ed to serve as large floating hospitals,
to prepare and support future opera- where definitive work was accom-
tions in the Philippines. Base surgeon Lt. plished, and to appear as a luxurious
Col. Everett King, MC, landed in May means of transporting the wounded to
with a small party to select hospital sites, further treatment ashore; they also func-
finding only the 36th Evacuation tioned as mobile outpatient depart-
Hospital, the 24th Medical Battalion of ments and mobile medical supply
the 24th Infantry Division, and the 9th depots. The three less elaborate hospital
Portable Surgical Hospital at work in the ships—the USS Mercy, USS Hope, and
area. By 30 June King had developed USS Comfort—were built, commanded,
plans for the proposed 27th Hospital and crewed by the Navy for the Army
Center to include four general, two sta- and were staffed by Army medical per-
tion, and one field hospital—an aggre- sonnel. All seven joined SWPA’s growing
fleet, consisting of several distinct types
16
Ibid., Oct–Dec 44, p. 2, Jan–Mar 45, p. 2, and
17
Apr–Jun 45, p. 2, file 319.1; CSurg, USASOS, SWPA, Surg, Base G [Hollandia], Quarterly Rpts (copies),
Annual Rpt, 1944, pp. 88–93, file 319.1–2; Ltrs (copies), Apr–Jun 44, p. 4, Jul–Sep 44, pp. 1–3, Oct–Dec 44, pp.
Kirk to Denit, 7 Oct 44, p. 1, and 25 Oct 44, p. 2, file 200 3–4, and Jan–Mar 45, pp. 3–5; 27th Hosp Center
Kirk-Denit Correspondence. All in HUMEDS, RG 112, Quarterly Rpt, Jan–Mar 45, pp. 2–7. All file 319.1,
NARA. HUMEDS, RG 112, NARA.
GROWTH OF THE MEDICAL SYSTEM 259
hospitals issued the necessary move- paign provided the major stimulus for
ment orders.19 growth; bed strength rose from about
The last of the big New Guinea bases 1,000 at the end of September to 4,750
opened on Biak Island in August 1944, by the end of the year and to almost
with Col. August W. Splitter, MC, as base 8,900 in March 1945. The three general
surgeon. The small field medical estab- hospitals on Biak were organized as the
lishment grew rapidly to accommodate 28th Hospital Center; a station hospital
the 51,000 troops crowding the island, on nearby Owi Island provided addi-
where their predecessors had struggled tional strength. The major difference
against the fortified caves of the from Hollandia and Finschhafen was
Japanese. Again, the Philippine cam- the fact that evacuation was almost
entirely by air from an island whose har-
19
Surg, Base G [Hollandia], Quarterly Rpts bor was small and whose airfields were
(copies), Apr–Jun 44, pp. 4–5, Oct–Dec 44, pp. 4–5, large. On 23 November 1944 C–54s
Jan–Mar 45, pp. 3–6, and Apr–Jun 45, pp. 11–12, file began to carry evacuees directly to the
319.1; CSurg, USASOS, SWPA, Annual Rpt, 1943, p.
53, file 319.1–2. All in HUMEDS, RG 112, NARA. See United States, via Guadalcanal, Canton
also Sheldon R. Uday, “The Army’s Largest Hospital Island, and Honolulu (see Map 10). Only
Overseas,” in Philip A. Schaefer, ed., 54th in Review: A when additional shipping became avail-
Resume of the Activities of the 54th General Hospital,
1943–1945 (Tokyo: Dai Nippon Printing Co., 1946); able following the end of the war in
Robert F. Futrell, “Development of Aeromedical Europe did water transport, reversing
Evacuation in the USAF, 1909–1960,” USAF Historical the usual order of things in the Pacific,
Studies No. 23 (Maxwell Air Force Base, Ala.: USAF
Historical Division, Air University, 1960), p. 357, copy replace the planes of the Southwest
in CMH. Pacific Wing, whose headquarters by
GROWTH OF THE MEDICAL SYSTEM 261
then had moved on from the hot coral injured. “To understand the injustice
island in Geelvink Bay.20 placed upon hospital personnel (indi-
Overall, the conclusion can hardly be rectly the patients) who are required to
escaped that the price of the great establish their own hospitals,” wrote a
advance of the bases during 1944, and team of medical inspectors, “one need
the care simultaneously provided to tens but see the various medical specialists . . .
of thousands of casualties, continued to with their trained professional techni-
be paid by medical personnel whose cians pouring concrete, digging drainage
numbers, though constantly increasing, ditches, building mess halls and operat-
were never large enough to do all that ing rooms, assembling and installing
was demanded of them. As Surgeon heavy equipment—in shifts because at
General Kirk wrote Denit in November the same time they must accept and treat
1944, “I don’t know how in hell we are patients.”21
going to be able to carry on this two-
ocean war with the doctors and nurses we 21
Ltr (copy), Kirk to Denit, 24 Nov 44, p. 1 (first quo-
have.” Not occasionally but habitually tation), file 200 Kirk-Denit Correspondence; Rpt,
they were required to be their own engi- Training Div, OSG, [19 Sep 45], sub: Survey of
neers while caring for the sick and Effectiveness of ASF Trained Medical Department Units
and Personnel in SWPA and POA, p. 2 (remaining quo-
tations), Historians files. Both in HUMEDS, RG 112,
NARA. On the experiences of U.S. Army hospitals, see
20
Surg, Base H [Biak], Quarterly Rpts (copies), copy of Extracts From Historical Reports [Relating to]
Jul–Sep 44, pp. 1–5, Oct–Dec 44, pp. 7–8, Jan–Mar 45, Construction, Hospital Structures, and Utilities,
pp. 2, 7–9, and Apr–Jun 45, pp. 8–9, file 319.1, Jan–Mar 44 entries, Historians files, HUMEDS, RG 112,
HUMEDS, RG 112, NARA. NARA.
P A C I F I C O C E A N a
Morotai I aC
.S. vi
to U
Geelvink Hollandia
Bay
Ceram I
N E T H E R L A N D S E A S T I N D I E S
Aroe Is N E W G
Tanimbar Is
A R A F U R A S E A
MAP 10
NEW GUINEA BASES
December 1944
nal
dalca Sea evacuation
a
Gu
n or Air evacuation
o
ant
ELEVATION IN METERS
0 300
Miles
Base G and
Hospital Center
Admiralty Is
NEW IRELAND
Rabaul
Aitape BISMARCK
Wewak
SEA
N O R T H E A S T
Madang
N E W G U I N E A NEW BRITAIN
Arawe
Saidor
Finschhafen Base F and
26th Hospital Center
Lae
U I N E A Salamaua Base E Base B and
Wau Intermediate Section Headquarters
P A P U A Kiriwina I
Base C
Oro Bay
Buna
Goodenough I Woodlark I
Base D
Port Moresby
Milne Bay
Base A
C O R A L S E A
AUSTRALIA
264 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
ation out of theater. Once on that tread- than to Americans. Hundreds of cases
mill, he was lost to duty and dispatched developed among Australians fighting
on crowded vessels, whose holding along the Kokoda Trail; mortality
capacity for such cases was never ade- among those afflicted varied greatly,
quate (neuropsychiatric cases lacked the reaching almost 10 percent in some
priority for air travel until 1945). Yet bet- areas. As Americans began fighting
ter days for the theater lay just ahead. In north of the Owen Stanleys they too fell
January 1945, a period of intense fight- ill, and cases reaching Port Moresby at
ing when stress and danger were acute, first baffled doctors. The number of
the rate for all psychoneuroses dropped cases among soldiers in the Southwest
from about 26 per 1,000 troops to 8.3 Pacific Area rose from 935 in 1943 to
and for psychoses from 17.3 to 5.7. 4,396 in 1944 and to 5,663 in 1945. The
Growing comprehension among doc- illness was more widespread than any-
tors, reinstitution of dedicated hospitals, one had imagined before the war; the
and pressure on commanders to cease fact that armies now were living and
disposing of disciplinary problems fighting in some of the most remote and
through medical channels all con- least known regions of the Earth served
tributed to a further decline that con- to reveal both its extent and its dangers.
tinued until the end of the war.24 The death rate, though 4 percent over-
Assistance from experts in the United all, was far higher in some cases, reach-
States played an important role in ing 25 percent in one virulent outbreak
reducing to manageable proportions (among Army hospital personnel, ironi-
another enduring problem of quite a cally) on Goodenough Island. The long
different sort—scrub typhus. This formi- period of nursing required was a serious
dable illness first appeared in American cause of ineffectiveness, not only among
troops in the form of isolated cases the victims of the disease but also
reported in northern Australia and the among the troops in forward areas, who
Port Moresby area of New Guinea dur- sometimes had to be detailed to help
ing 1942. Related both to louse-borne care for them.25
epidemic typhus and to Rocky In the summer of 1943 the United
Mountain spotted fever, scrub typhus States of America Typhus Commission
was better known to Japanese physi- had sent a team to New Guinea to study
cians, who called it tsutsugamushi fever, scrub typhus. Its leader was Dr. Francis
G. Blake, dean of medicine at Yale
24
CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 1, pp. University. Blake and his colleagues
93–94, file 319.1–2; Ltr (copy), Capt Charles E. Test, knew from prewar Japanese studies that
MC, 126th Sta Hosp, 7 Oct 44, sub: War Neuroses, pp. the illness was spread by the larva of a
1–9, Encl to Ltr (copy), Denit to Kirk, 24 Oct 44, file
200 Kirk-Denit Correspondence. All in HUMEDS, RG mite—in common language, by a red
112, NARA. See also S. Alan Challman and Henry A. bug that burrowed into the skin. Unlike
Davidson, “Southwest Pacific Area,” in Albert J. Glass, epidemic typhus, tsutsugamushi fever
ed., Overseas Theaters, Medical Department, United
States Army in World War II (Washington, D.C.: Office
25
of the Surgeon General, Department of the Army, Chris J. D. Zarafonetis and Myles P. Baker, “Scrub
1973), 536–41. It should be noted that in the military Typhus,” in W. Paul Havens, Jr., ed., Infectious Diseases,
medical parlance of the time a psychosis simply meant Medical Department, United States Army in World War
a psychiatric condition with severe symptoms that II (Washington, D.C.: Office of the Surgeon General,
proved impossible to alleviate. Department of the Army, 1963), pp. 112–15.
266 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
CHART 3—SCRUB TYPHUS ADMISSION RATE FOR U.S. ARMY FORCES, NEW GUINEA,
JULY–SEPTEMBER 1944
Rate a
1000
800
Sansapor Epidemic
600
200
0
1 8 15 22 29 5 12 19 26 2 9 16 23 30
July August September
a
Reflects the number of cases per annum per 1,000 troops.
Source: Adapted from Cornelius B. Philip, “Scrub Typhus and Scrub Itch,” in Ebbe Curtis Hoff, ed., Communicable Diseases:
Arthropodborne Diseases Other Than Malaria, Medical Department, United States Army in World War II (Washington, D.C.: Office of
the Surgeon General, Department of the Army, 1964), p. 288.
In the early days of each new cam- often excessive hours at the most varied
paign, all the work normally done by tasks. No doubt fatigue took some toll of
the nurses fell to the enlisted corpsmen efficiency, and grumbling was common
and technicians of the mobile medical among the stressed and overworked
units. Yet none could win the officer who felt, with some reason, that they
status that was accorded to women were the stepchildren of the theater
nurses for such work, and as soon as they served. But in the end they bore the
the firing quieted down the enlisted burden, and because of them the neces-
men found themselves displaced or sary jobs were done.31
made subject to a nurse’s orders.
“Thus, when the nurses move in,” said a The Central and South Pacific Areas
report, “the morale of the enlisted ele-
ment immediately hits bottom.” The In the Central Pacific quite different
fact that women officers were officially command problems developed and,
untouchable and undatable by enlisted under Navy leadership, found their
men did nothing to assuage such feel- own practical solutions. For soldiers,
ings. But officers and commanders of preparations for the offensive that was
field hospitals were also reported to to begin in late 1943 brought into
prefer male to female nurses, either being in September the new and high-
because of chauvinism or resentment er headquarters, the United States
toward personnel who occupied TO&E Army Forces in the Central Pacific Area
slots but were absent on the day of bat- (USAFICPA), to which the Hawaiian
tle. Meanwhile, nurses were deprived of Department was now subordinate. The
opportunities to practice their profes- implication was clear: Whereas previ-
sions and do the work for which they ously the Army’s role had been to
had volunteered. In turn, their disap- defend and, through the military gov-
pointment and sense of exclusion led ernment, to administer only the
to poor morale, psychological prob- Hawaiian Islands, it would now become
lems, and perhaps to some pregnan- actively involved in operations through-
cies, which provided a way out of the out the Central Pacific.32
theater.30 As the USAFICPA commander, Lt.
Despite Denit’s best efforts, trained Gen. Robert C. Richardson, Jr., was
medical personnel in all categories— responsible for the administration and
from enlisted men to specialists— training of all U.S. Army ground and air
remained in short supply. The chief sur- forces in the region, which now
geon was obliged to demand more and stretched from the west coast of the
more of his subordinates, to deny them United States to the east coast of China.
rotation unless replacements were in Once trained, his forces were subordi-
hand, and to compel them to work long, nated to Admiral Nimitz’ headquarters
or to the tactical commands—the V
30
Quotations from ibid., p. 6, Historians files,
HUMEDS, RG 112, NARA. See also Rpt, Maj Margaret
31
D. Craighill, MC, to AG, Wash., D.C., 8 Jun 45, sub: In October 1944 medical personnel in the
Medical and Social Condition of Women in Military Southwest Pacific Area totaled 61,787. See McMinn and
Service in the Southwest Pacific Area, box 6, Margaret Levin, Personnel, p. 368.
32
D. Craighill Papers, MHI. Armfield, Organization and Administration, p. 383.
GROWTH OF THE MEDICAL SYSTEM 271
Amphibious Force or the V Amphibious ingly. By the year’s end the number of
Corps—for employment in combat.33 beds was double that possessed by the old
Training, logistics, resupply, and the department in 1942. Seven Army divi-
construction, development, defense, sions staged in the area, and six moved
maintenance, and manning of bases all out to combat; hospitals had to be pro-
fell under the USAFICPA. If the funda- vided for task forces dispatched to the
mental organizational problem for the Gilbert, Marshall, and Mariana Islands;
medics in the Southwest Pacific Area was and the garrisons required medical sup-
unity of direction, that in the Central port of a more lasting nature. Meanwhile,
Pacific Area was the extraordinary many duties remained with the Hawaiian
expansion of the theater across thirty- Department, though care of the civilian
five degrees of longitude in the course population had by now been returned to
of about a year. As the invasion forces the islands’ doctors and public health
traversed thousands of miles of ocean officials. Port and quarantine regulations
and conquered hundreds of islands, still had to be enforced and training
hospitalization and evacuation had to areas, replacement depots, and prisoner-
keep pace. At the same time, the troop of-war camps policed.
strength of the command grew rapidly, Hawaii’s huge fixed hospital establish-
increasing some 200 percent between ment remained and in fact grew. One
June and December 1943. By charging happy consequence of its amplitude,
the USAFICPA with the responsibility when combined with King’s cordial rela-
for providing common supplies to tions with the Seventh Air Force sur-
Marine and Navy units as well as to the geon, was to exclude from this theater
Army ground forces in the Gilberts cam- the conflict between soldiers and air-
paign, Nimitz made the headquarters men over hospitalization that marred
his “logistical agency for the support of many others. With units scattered on
offensive operations.” Many new bases many islands, the airmen maintained
passed into the USAFICPA’s hands. In their own dispensaries but did not seek
March 1944 even Tarawa, hard won by to turn them into hospitals, preferring
the marines, became an Army command the treatment received in those of the
and, in May, Saipan.34 theater surgeon, especially in light of his
General King added to his many hats sympathetic attention to their special
by becoming Chief Surgeon, USAFICPA, needs. The one exception—the Hickam
in August 1943. The veteran chief sur- Station Hospital at Hickam Field near
geon of the Hawaiian Department faced Pearl Harbor—was operated by the air
challenges that were broad, complex, force, with personnel assigned by King.35
and interrelated. The command’s area The chief surgeon’s office grew, decen-
had expanded some 30 percent during tralizing functions and expanding its staff
1943, and medical facilities grew accord- of consultants. One function—civilian
liaison—declined in significance as the
33
“History of the United States Army Forces, Middle
Pacific and Predecessor Commands, During World War
35
II, 7 December 1941–2 September 1945,” pt. 2, Armfield, Organization and Administration, pp. 384,
“Structural and Functional Development of the Army 386; Buell Whitehill, “Administrative History of Medical
Command,” 3:360–65, Ms 8–5.6 AA 2/1, CMH. Activities in the Middle Pacific,” block 3, pp. 20–30, file
34
Ibid., 3:367, Ms 8–5.6 AA 2/1, CMH. 314.7, HUMEDS, RG 112, NARA.
272 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Chief Surgeon
Executive Officer
Source: Adapted from “History of the Office of the Surgeon, United States Army Forces, Middle Pacific and Predecessor
Commands, 7 December 1941–2 September 1945,” sec. 2, “Central Pacific Area,” p. 3, Ms 8–5.6 AA 30/2, CMH.
The search for a more efficient orga- headquarters, the Central Pacific Base
nization in the Navy theaters led to the Command (CPBC), assumed responsibil-
creation of logistical base commands. In ity for logistical support from the
the summer of 1944 Nimitz ordered the USAFICPA; and on 1 August the
sweeping change, in view of experience USAFICPA became the United States
gained during the westward advance of Army Forces, Pacific Ocean Areas (USAF-
the battlefront. On 15 June the South POA), still under General Richardson.
Pacific Area was redesignated the South King, leaving most of the personnel
Pacific Base Command (SPBC), and of his office in the CPBC quarters,
brought under the direct command of moved with a small staff of 9 officers
Nimitz’ headquarters; on 1 July a new and 15 enlisted men—essentially, the
274 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Surgeon
Deputy Surgeon
Executive Officer
Source: Adapted from Rpt, Col. Harry D. Offutt, 1945, sub: Close-Out Report of Medical Service, Central Pacific Base
Command, p. 6, Historians files, HUMEDS, RG 112, NARA.
transferred to the Philippines to help tion of casualties from the active the-
plan the invasion of Japan. Meanwhile, aters were the most important duties
Colonel Koontz, surgeon of the New remaining in the South Pacific, where,
Caledonia Island Command, took on in the days of the Guadalcanal fighting,
the additional duties of base command bitter and decisive struggles had been
surgeon and served out the remainder the order of the day.41
of the war in these roles. Care of com-
bat troops undergoing rehabilitation,
logistical support of three combat
41
infantry divisions (the 37th, 93d, and Whitehill, “Medical Activities in Middle Pacific,”
block 3, pp. 71–82, file 314.7, HUMEDS, RG 112,
Americal), inspection of foodstuffs pro- NARA. Maxwell was promoted to brigadier general on
cured from New Zealand, and evacua- 19 January 1944.
276 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
USAFPOA HEADQUARTERS, FORT SHAFTER, where the chief surgeon’s office was located
cy from 120 to 90 days, hospital beds ters turned out, however, the Army had
were emptied at the cost of straining to assign ten C–54s, rather than five, and
transportation, losing combatants, and some Saipan Island casualties were car-
finding replacements.43 ried by Seventh Air Force transports
Sheer distance remained the single without benefit of medical care during
greatest difficulty, whether evacuation flight. When the battle wounded crowd-
was viewed as a problem in treatment, ed the wards of the Oahu hospitals,
transport, or time. During Operation Kwajalein provided a new evacuation
FORAGER the Navy planned to evacuate route to Guadalcanal. Neuropsychiatric
by surface craft from the Marianas to cases, which rose to 25 percent of total
Kwajalein and then by air to Oahu (six evacuations during 1944, presented a
Navy and five Army planes were assigned special problem; precautionary mea-
the task). Incidental aircraft were also to sures had to be adopted to enable them
be exploited, while surface craft were to to travel by air, by sedating heavily those
evacuate from Kwajalein both to Hawaii who needed restraint. By the end of
and to the South Pacific Area. As mat- 1944 out-of-theater evacuation had fol-
lowed the same pattern, though at a
43
Whitehill, “Medical Activities in Middle Pacific,” slower pace—78 percent of casualties
block 8, pp. 8–12, file 314.7, HUMEDS, RG 112, NARA. moved by air. Emergency cases and
278 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
those requiring treatment in the United tagion” of the other troops. During 1944
States received first priority, based on a convalescent and reconditioning cen-
decisions made by disposition boards at ter expanded from 400 to 1,000 beds,
each hospital. An Air Transport and a special section for diseases of the
Command surgeon also screened evac- chest was set up at the 147th General
uees to ensure that they could endure Hospital and a center for neurosurgical
the trip.44 cases at the 218th General Hospital.
At the general hospitals on Oahu sol- Experience in the treatment of tropical
diers with wounds and illnesses contract- diseases, such as malaria and filariasis,
ed in the active theaters trickled in dur- increased with the return of casualties
ing 1943, but treatment of the troops from the forward areas. But the primary
training on the island and of civilian concern was the battle wounded, for
patients was more typical. One hospital whom at least 2,500 beds were available
reported its most interesting case—a at all times. Peaks followed the surges of
young soldier, accidentally shot through combat, with notable influxes during
the bowels during target practice, whose February, July, August, and December
life was saved, despite gross fecal conta- 1944. In fact, as the CPBC surgeon
mination, by the use of penicillin. emphasized, the command received all
Another hospital cited the treatment types of casualties, medical as well as sur-
and ultimate recovery of a civilian stung gical, nonbattle as well as battle.46
during swimming by a dangerous jelly- During 1944 the development of new
fish! For such rear area medical installa- medical complexes on captured islands
tions, the war began in earnest with the left the Hawaiian facilities little to do for
arrival of the first battle casualties from casualties but to receive the overflow of
the Gilberts. At North Sector General the forward bases. (During the Marianas
Hospital “the receipt of these casualties fighting a station hospital on Kwajalein
seemed to cause a general pick up [sic] expanded to 1,300 beds, filling newly
in morale and a feeling that . . . [its per- erected air force barracks with the
sonnel] were taking a greater part in the wounded.) Indeed, the number of beds
war effort than they had realized.”45 in the Central Pacific Base Command
The creation of the Central Pacific fell by about 2,100, the net result of a
Base Command and its medical service sharp reduction in facilities on the outer
tightened medical organization in the islands of the Hawaiian group, where
Hawaiian group. A single center was invasion clearly was no longer a threat,
established at the 22d Station Hospital and of many departures for the tactical
for neuropsychiatric cases, not only for commands and island garrisons. But by
their own treatment but to prevent “con- the end of the year the Pacific Ocean
Areas included the Marshall, Gilbert,
and Mariana Islands, and General Willis,
44
Ibid., pp. 12–15, file 314.7, HUMEDS, RG 112,
NARA. During 1945 evacuations increased by 88 per-
46
cent, to 41,857. However, this may be partly the effect of Surg, CPBC, Annual Rpt, 1944, pp. 6 (quoted
better statistics collected after December 1944. word), 19–20, file 319.1–2, HUMEDS, RG 112, NARA.
45
204th Gen Hosp Annual Rpt, 1943, app. 6, p. 6, and In neuropsychiatric admissions during World War II
North Sector Gen Hosp Annual Rpt, 1943, pp. 17, 28 the Pacific Ocean Areas stood third after the Southwest
(quotation), in CSurg, USAFICPA, Annual Rpt, 1943, Pacific Area and the Mediterranean theater. See
file 319.1–2, HUMEDS, RG 112, NARA. Reister, Medical Statistics, p. 44.
GROWTH OF THE MEDICAL SYSTEM 279
consultant in medicine, and Col. Elbert ent islands. On American Oahu houses
Decoursey, MC, commander of the 18th of prostitution were closed in 1944, with
Medical General Laboratory, was desig- a reported drop in infections. On
nated epidemiologist and sanitation French-mandated islands garrisoned by
officer. U.S. forces, civil authorities operated
But the theater still lacked a formal houses of prostitution, but the women
preventive medicine organization, a fact had to undergo regular examinations
duly noted by Brig. Gen. James S. conducted by American medical offi-
Simmons, MC, the active chief of the cers. Either way seemed to work, if care-
Preventive Medicine Service, Office of fully administered, although some cases
the Surgeon General, who conferred of infection inevitably escaped the
with General King about the problem in examiner’s eye. The Hawaiian experi-
early autumn 1944. In November Lt. ence suggested that, from the medical
Col. Thomas G. Ward, MC, became officer’s point of view if not the young
chief of a newly formed Preventive soldier’s, suppression was somewhat
Medicine Section in the Office of the more satisfactory, for the cheapness and
Chief Surgeon, USAFPOA.49 convenience of brothels increased the
Ward established a section that repli- number of sexual contacts, which in
cated in many ways the structure of turn was reflected in the incidence of
Simmons’ service in Washington. venereal disease. The difference, howev-
Traditional concerns for venereal dis- er, was not very great.
ease, sanitation, immunization, and the Nutrition presented a question of
gathering of health statistics were sup- potentially greater importance. Rations
plemented by special attention to tropi- were balanced in theory, but parts of
cal diseases, industrial hygiene, and them remained so unpalatable that the
medical intelligence. A specialist, Lt. troops, because of selective eating,
Col. Paul A. Harper, MC, was brought in developed deficiencies, a difficulty
from the South Pacific Area in late solved by requiring vitamin pills as a sup-
November to be theater malariologist, plement. Water supply continued to be
as USAFPOA subordinate commands a problem on some islands, as local
planned advances into regions where sources were still of poor quality.
the disease was endemic. Control of Lacking adequate supplies of halazone
insects increasingly meant the systemat- (chlorine) tablets, the theater attempt-
ic application of DDT. Venereal disease ed to solve the problem by sending
had never been much of a problem in water with the assault forces and estab-
the theater, and was chiefly interesting lishing filtration plants as soon as possi-
for the variety of approaches on differ- ble after victory was won.50
In many respects, Ward’s Preventive
49
Office of the Surgeon (OofSurg), United States Medicine Section apparently did little but
Army Forces in the Pacific Ocean Areas (USAFPOA), systematize the procedures already under
“History of Preventive Medicine,” p. 1, file 314.7; Office
of the Surgeon, United States Army Forces in the
Middle Pacific, “History of Preventive Medicine,” pp.
50
23–31, file 314.7; Whitehill, “Medical Activities in OofSurg, USAFPOA, “History of Preventive
Middle Pacific,” block 12, pp. 1, 10–11, file 314.7; Medicine,” pp. 43–47; Whitehill, “Medical Activities in
CSurg, USAFPOA, Annual Rpt, 1944, p. 9, file 319.1–2. Middle Pacific,” block 12, pp. 1, 18–20. Both file 314.7,
All in HUMEDS, RG 112, NARA. HUMEDS, RG 112, NARA.
GROWTH OF THE MEDICAL SYSTEM 281
way—spraying corpses with sodium arsen- prepared, called a combat project, and
ite, for example, and impregnating uni- forwarded once again through area
forms with miticides to guard troops headquarters to the War Department
against scrub typhus. Epidemiology teams for final approval. Proposals to reform
were sent into forward areas; a dengue this tedious process were often heard,
team brought aerial DDT spraying to and a new procedure was adopted by
Saipan; and in the 1945 campaigns dysen- the Army in December 1944.
tery epidemics were halted by identifying Implementation, however, proved no
the cause and applying control methods. less time-consuming than the combat
The many problems encountered in the project method, and the war ended
conquered islands suggested the need for without comprehensive reform.52
a school of preventive medicine, which Combat units arrived in theater minus
was eventually set up on Okinawa in mid- essential medical supplies. Assemblages
1945. forwarded from the mainland had simi-
Excluding the assault phases of the lar gaps, caused by spot shortages in the
various campaigns, disease caused over mainland depots. Since the units could
80 percent of the theater’s noneffectives not be sent into combat without equip-
during 1944, despite the lack of serious ment, medical supply officers in Hawaii
illnesses and a continuing low venereal had to replace any shortfalls within
disease rate. A tropical climate, crowd- schedules set by the plan of attack and
ing and stress, and poor conditions on hoped to recoup them later through req-
transports were all contributors, and uisitions from the mainland. The danger
served to underline the continuing of attack during the early years of the war
importance of preventive medicine.51 led to a program of dispersing supplies
on the outer islands of Hawaii; when
Supply American forces shifted to the attack, the
supplies had to be concentrated again, at
Medical supply presented daunting the chief surgeon’s order, to economize
challenges as the theater grew and as on time, personnel, and facilities.
assault forces, in ever greater numbers, Preparation for each combat operation
moved from the West Coast and Hawaii was a complicated affair—checking
over constantly increasing distances to equipment, deleting nonessential items,
strike at enemy-held islands. To equip a palletizing and waterproofing, preparing
large invasion force with medical sup- thirty-day 3,000-man medical mainte-
plies required initial approval by the nance units for resupply, repacking med-
War Department, requisitions to the San ical chests into canvas packs, and so forth.
Francisco Port of Embarkation, and Despite the complications intro-
endless conferences with the units duced by combat, Colonel Voorhees
involved to establish a basis of issue for reported in his October 1944 study “the
every item. Then a detailed plan was outstanding fact . . . that Medical Supply
[in the Central Pacific Base Command]
51
OofSurg, USAFPOA, “History of Preventive has been and is thoroughly adequate.”
Medicine,” pp. 43–47, file 314.7; Whitehill, “Medical
Activities in Middle Pacific,” block 12, pp. 14–15, 24, file
52
314.7; CSurg, USAFPOA, Annual Rpt, 1944, pp. 6, 9, Whitehill, “Medical Activities in Middle Pacific,”
file 319.1–2. All in HUMEDS, RG 112, NARA. block 6, p. 3, file 314.7, HUMEDS, RG 112, NARA.
282 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Both King’s thoroughness in directing action by the two technical services, and
the Hawaiian Department during the the coordinating effect of a single island
early years of the war and the long peri- command all contributed to the devel-
od of preparation for combat facilitated opment of the new medical complexes.54
the creation of a system “more satisfac- A variety of limited improvements in
tory . . . than [in] other theaters.” As supply were recorded during 1944, most
with hospitals, the arrangements in coming in response to Voorhees’ report
Hawaii designed to guard against attack and action by the theater headquarters.
had ceased to be necessary, and it was at A shift from automatic resupply to req-
Voorhees’ suggestion that the chief sur- uisition by the Central Pacific Base
geon acted to consolidate supplies in Command made for a more responsive
the Hawaiian Supply Depot. The main system, one capable of adapting to the
weakness uncovered was the absence of new phase of the war. But the 3,700
a chief supply officer in the chief sur- miles that separated Oahu from the
geon’s office. King promptly appointed Marianas complicated the process of
Maj. Donald E. Remund, MAC, and establishing a closely-knit supply net-
Willis, King’s replacement, Maj. Louis F. work. Duplication, overages, and occa-
Williams, MAC, from the Office of the sional shortfalls could be minimized but
Surgeon General.53 not eliminated, and the chief supply
The rapid growth of the hospital sys- officer, despite hopes that had attended
tem imposed supply requirements only a his appointment, depended mainly on
little less pressing than those of the informal contacts in his dealings with
assault forces earlier. Looking to future the nearly autonomous island com-
operations that would involve the com- mands. More valuable than improve-
bat of large forces, the Army planned to ments in organization was the increased
install some 8,000 fixed beds in the capability of mainland depots to assem-
Marianas—about 5,000 of them on ble and ship virtually complete hospital
Tinian, where Army engineers were con- units by mass-production methods that
structing airfields for heavy bombers to rendered hand assemblage in Hawaii
attack Japan. The location of the islands out of date. And the matured wartime
and the ample facilities for air evacua- productive capacity of the United States
tion made them ideal; however, hospitals made up for organizational failings in
demanded complex supplies, many pro- enabling the forces under Nimitz’ tacti-
vided by the engineers who built the hos- cal commanders to be supported across
pitals but some issued by the medical ser- many thousand miles of sea.55
vice. Fluorescent lighting fixtures for Voorhees’ report to Surgeon General
operating rooms in Quonset huts were Kirk on the Pacific supply situation as a
developed by the engineers in confer- whole emphasized the problems caused
ence with members of the chief sur- by the multiple commands in the
geon’s office and constructed in the field region, with no coherent system for
for all island commands, using materials redistributing excess stocks. Confirming
on hand. Field expedients, cooperative the gut feeling of many SWPA medical
53 54
Ibid., pp. 1 (quotations), 28–36, file 314.7, Dod, Corps of Engineers, p. 493.
55
HUMEDS, RG 112, NARA; Wiltse, Medical Supply, p. 481. Wiltse, Medical Supply, pp. 468–81.
GROWTH OF THE MEDICAL SYSTEM 283
officers, Voorhees found that excesses became responsible for the proper uti-
had piled up in the two Navy-run the- lization of medical personnel, but by the
aters, in part at least because the great end of 1944 the necessary records still
overseas distances had produced critical had not been completely forwarded.
shipping shortages. Stocks had accumu- Despite this gap, General Willis’ office
lated in rear areas, in some cases aban- gradually built up an alphabetical index
doned there by fighting units that file for the whole of the Pacific Ocean
expected to be issued new supplies in Areas, containing a card for each
the combat zone. Lack of a unified com- Medical Department officer, male and
mand structure prevented the transfer female, with military service and profes-
of excess supplies and supply personnel sional experience. As new medical offi-
to the areas of greatest need. The time cers were assigned to the theater, the
was fast approaching when a greater commander of the Replacement Depot
degree of unity would become essential submitted their names and qualifications
to the forces that were converging for to the chief surgeon, who offered his rec-
climactic battles in the western Pacific.56 ommendations on their assignments.
Additionally, Willis sometimes suggested
Personnel changes in the assignments of officers
already in the theater. Promotion lists
Perhaps the most striking fact about came first to the chief surgeon, who
medical personnel in the Central Pacific scanned the names to verify eligibility
Area during 1944 was that little growth and competence and then forwarded
occurred during a time of increasingly them to the command’s adjutant gener-
heavy combat—primarily because the al with his recommendations. Such an
USAFICPA and CPBC headquarters, assessment was absolutely necessary, for
after organizing and training their the promotion of a medical officer
forces, sent them to the amphibious implied having a certain level of profes-
commands to do their fighting. Army sional medical and military competence.
medical strength in Admiral Nimitz’ Introduction of the military occupa-
command was, however, large and grow- tional specialty (MOS) system during
ing. In the autumn of 1944 Army medics 1944 added a new wrinkle: Every officer
totaled about 34,500 to support 429,000 received an MOS number and letter clas-
troops; by contrast, MacArthur’s com- sification. The three top medical officer
mand had about 52,000 medics to sup- categories were 3100 (General Duty),
port 706,000 soldiers. The proportion of 3139 (Internal Medicine), and 3150
medical personnel to troops was never- (General Surgery). These specialities
theless about the same, 87 per 1,000 in accounted for over 80 percent of doctors
the Southwest Pacific Area and 81 per assigned to non-hospital units and 60
1,000 in the Pacific Ocean Areas.57 percent to hospital units in the theater,
The absorption of the former Central based on the fact that some officers held
and South Pacific Area headquarters more than one MOS classification. As a
meant that the USAFPOA chief surgeon control device, the system remained
somewhat crude because the fine points
56
Armfield, Organization and Administration, p. 454. of medical competence, such as board
57
McMinn and Levin, Personnel, p. 368. qualification and certification, were not
284 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
included. But the MOS system did help back to Oahu of nurses who had worked
to reveal some interesting peculiarities of twenty-eight months or longer in for-
the theater medical setup in midwar. ward areas.59
Psychiatrists represented 3.8 percent of Medical consultants were preoccu-
the total MOS specialists in hospitals—a pied with the qualifications of person-
welcome fact in a theater where NP evac- nel from the standpoint of improving
uations were high through 1944. A criti- the quality of medical service in the
cal shortage was in orthopedic surgeons, Pacific. Active and energetic was Col.
numbering only forty-one, even though Ashley W. Oughterson, MC, a Yale clini-
the theater had sixty-six hospital units.58 cal professor who served as surgical con-
In contrast to the reluctance dis- sultant on the USAFISPA and then
played by General Headquarters, SWPA, USAFPOA chief surgeon’s staff; he visit-
the Army commands in Navy theaters ed every medical unit in the command
tended to move their female nurses and established “broad policies and . . .
rapidly into forward areas, though not guiding principles” for combat surgery,
during actual combat. The tradition embodying his view of the war in a diary
established in the South Pacific Area that was both caustic and compassion-
continued through the reorganizations ate. The psychiatric consultant, Lt. Col.
of 1944. The Army garrison force on M. Ralph Kaufman, MC, established
Saipan received its first Army Nurse schools of military neuropsychiatry in
Corps officers in August, shortly after areas were divisions were undergoing
the island had been declared secure. rehabilitation or were being readied for
Here, like many of their patients, some combat. The Central Pacific Area
60 percent fell ill during the dengue lacked a dental consultant, although
outbreak that followed the conquest. As Col. Harry M. Deiber, DC, the CPBC
usual, they performed creditably under dental surgeon, functioned in essential-
difficult conditions. Throughout the ly that role. Like the chief nurse, Deiber
year the tendency was for nurses to also served on the USAFPOA chief sur-
move toward the front, which created at geon’s staff as an extra duty. His main
least a potential problem for the Oahu task was the difficult administrative one
hospitals. Understaffed, they drew nurs- of shuffling a consistently under-
es from hospital units staging and train- strength group of officers to provide
ing in the Hawaiian Islands; as the units support to an increasingly scattered
moved on, the nurses accompanied command.60
them, to be replaced by others newly Despite many difficulties the mood of
arrived from the mainland. But as the the medics in the Pacific theaters was
center of gravity for the Central Pacific upbeat as the winter campaigns of
Area shifted westward, the CPBC direc- 1944–45 moved closer. Against most bit-
tor of nursing—who served on the ter resistance the fighting forces had
USAFPOA chief surgeon’s staff in the
same capacity as an added duty—antici- 59
Ibid., p. 10, file 319.1–2, HUMEDS, RG 112, NARA.
pated shortages and hoped for rotation 60
Ibid., pp. 11–12 (quotation, p. 11), file 319.1–2,
HUMEDS, RG 112, NARA. Selections from
Oughterson’s diary have been published in his chapter,
58
CSurg, USAFPOA, Annual Rpt, 1944, pp. 7–8, file “From Auckland to Tokyo,” in Carter, ed., Surgical
319.1–2, HUMEDS, RG 112, NARA. Consultants, 2:767–887.
GROWTH OF THE MEDICAL SYSTEM 285
achieved major triumphs, and combat With great difficulty, the problems of
and support forces alike had matured fighting in the environment of disease-
into veterans. The problems of the med- ridden jungled islands had been met if
ical service were mainly those of success, not mastered. Now combat loomed on
and so comparatively easy to bear. The large islands with heavy populations, as
long confusion over authority in the well as on small dots of rock and coral
Southwest Pacific Area had been that a desperate enemy would defend to
brought to an end; the course of combat the death—a prospect that promised to
had reduced the South Pacific to a com- summon every reserve of skill and
munications zone and Hawaii, once courage in a medical service that had
threatened by the enemy, to a base in learned the art of saving lives in the
the distant rear of operations. midst of war.
CHAPTER IX
DR. GORDON S. SEAGRAVE (left) AND CAPT. JOHN H. GRINDLAY and Burmese nurse scrubbing
for surgery
Colonel Williams was forced to impro- But when the Japanese crossed the
vise an evacuation system, using a few Irrawaddy River in April, the Allied
hospital trains from the British and a forces withdrew in great confusion,
hospital ship, the Assam, that plied the swamping the inadequate means of
Irrawaddy River. For a time in March he moving wounded. Undoing much work,
even had air evacuation—ten C–47s. His the fragile medical system buckled
first requests were for American field under the strain. Patients who could
units—a medical regiment, three field walk took to the roads unhealed, while
hospitals, and three medical battalions. others were abandoned to die untend-
He wanted to provide small mobile units ed. Cholera, smallpox, and dysentery
as spot support to the Chinese Army broke out among the refugees, civilian
and, through the medical battalions, and military. Exhaustion, hunger, and
hoped to organize the chaotic evacua- enemy bombs and gunfire joined with
tion system as well.5 disease to mark the trails leading into
the mountains with abandoned carts,
5
Stone, “Medical Service in India and Burma,” bundles of once-prized possessions, and
1:8–13, 16, Ms 8–6.2 AG, CMH. human bones, sometimes in great mass-
290 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
es, where whole encampments perished in a blanket and shaking with a malaria
together.6 chill. He stopped and asked:
For a time Colonel Williams personal- “What’s the matter, Seagrave, got fever?”
ly delivered supplies to Seagrave’s hospi- “No, sir, I got wet and felt a little cold so
tal section. Then on 18 April the final was warming up.”
collapse began, and within ten days the “How are your feet?”
front had ceased to exist. The British “Better, sir.”
and the Chinese 5th Army retreated “You are lying.”
“Yes, sir.”
toward India, the 6th toward China.
Joining the flight of General Stilwell’s The hard-used party ended the trek by
headquarters toward Imphal, Williams climbing the steep forested ridges of the
served as the headquarters detachment Chin and Naga Hills. When Williams
medical officer throughout an epic protested that some could not keep up,
march. Despite stress and danger, the Stilwell replied, “Dammit, Williams, you
headquarters detachment was well sup- and I can stand it. We’re both older than
plied with medical support, for any of them. Why can’t they take it?” In
Seagrave’s section made up almost 40 the end they did. With medical aid at
percent of the group—doctors, mem- hand and Stilwell to drive them, they
bers of the Friends Ambulance Unit, reached Imphal without a single loss.8
Burmese nurses, and servants. Here the leaders reviewed the wreck-
All had their work cut out for them. age of a failed campaign. Thousands of
Seagrave took daily sick calls, until felled Chinese soldiers had perished during
by illness himself. When the motorized the retreat, and the condition of the
vehicles—jeeps, sedans, and trucks—had Indian refugees was pitiable. The British
to be abandoned, most of the party command attempted to put the best
marched afoot; the sick rode ponies. For face possible upon the disaster, but
part of the journey they rafted down a Stilwell refused to mask facts. “I claim we
jungle river, the Uyu, where monkeys got a hell of a licking,” declared Vinegar
screamed in the trees and tiger spoor Joe. “We got run out of Burma, and it’s
showed on the sandbars. Food and med- humiliating as hell.”9
ical supplies arrived by parachute drops Attempting to bring order out of the
into clearings, or through the canopy of chaos, Colonel Williams reunited the
dense jungle foliage. The Burmese nurs-
es, tireless walkers despite their fragile 8
Ibid., pp. 220–35 (first quotation, p. 221).
appearance, cheerfully nicknamed Commenting on Williams, who was fifty-five at the time,
Stilwell “Granddaddy” and Williams Seagrave noted on p. 208: “He is ten years older than I
“Second daddy,” and maintained the am, but he can walk circles around me.” Second quota-
tion as cited in Barbara W. Tuchman, Stilwell and the
pace better than many of the Americans.7 American Experience in China, 1911–1945 (New York:
Complaints were futile, for no one Macmillan Co., 1970), p. 296.
9
could fall behind and live. On one occa- Quotations as cited in Eric Larrabee, Commander in
Chief: Franklin Delano Roosevelt, His Lieutenants, and Their
sion Stilwell observed Seagrave wrapped War (New York: Harper and Row, 1987), p. 537. See also
Romanus and Sunderland, Mission to China, pp. 138–48;
Jack Belden, Retreat With Stilwell (New York: Alfred A.
6
Ibid., 1:16–19, Ms 8–6.2 AG, CMH. Knopf, 1943), pp. 259–368; Joseph W. Stilwell, Stilwell
7
Seagrave, Burma Surgeon, pp. 177–81 (quotations, p. Papers, arr. and ed. Theodore H. White (New York:
180), 207–19. William Sloane Associates, 1948), pp. 95–106.
THE CHINA-BURMA-INDIA CHALLENGE 291
Seagrave hospital and ordered it to guiding medical training and care for the
India’s Assam Province to aid the British Chinese forces in China. At Chungking
in caring for the refugees, mostly labor- the chief surgeon set up his office on the
ers who had worked in Burma or served rocky palisades that overhung the conflu-
the British administration there. In light ence of the Yangtze and the Chia-ling
of the crisis just endured, he now knew Rivers. For the Chinese troops in India, a
that before an effective reconquest of vacated prisoner-of-war camp at Ramgarh
Burma could begin, the Chinese Army became a training ground; the Seagrave
medical service must be completely hospital, the remnants of the Chinese
reorganized and retrained. The defeat field medical units, and the 98th Station
had left both Williams, who would Hospital, a small unit of fifty beds, pro-
become Chief Surgeon, USAFCBI, in vided support. Here Chinese medical
July, and Stilwell free of illusions about personnel heard lectures and received
the job that faced them in the theater. technical training as they performed
They had learned positive lessons as hands-on work among the patients.11
well; they knew the terrain from walking Meanwhile, the American military
it and the people who had been their structure that was to support and assist
companions in misfortune.10 the Chinese took form, with its own med-
ical system. Col. John M. Tamraz, MC,
Preparing To Counterpunch became surgeon of the United States
Army Services of Supply (USASOS) and
Substantial numbers of American air Col. Hervey B. Porter, MC, the surgeon
and service forces arrived in the CBI of the Tenth Air Force (one of the two
during the months that followed the fall tactical air commands in the theater). Lt.
of Rangoon. Their missions were to Col. Thomas C. Gentry, MC, served as
expand and protect air communication surgeon of Brig. Gen. Claire L.
with China; to begin constructing the Chennault’s American Volunteer Group
Ledo Road, which was to replace the (Flying Tigers), a force of volunteer
Japanese-held section of the Burma pilots that predated America’s entry into
Road; and to reorganize, train, and sup- the war and was later absorbed by the
ply the Chinese armies for the recon- theater air forces.
quest of Burma. In New Delhi Colonel Tamraz con-
General Stilwell established a rear-ech- centrated on the problems of medical
elon headquarters at New Delhi in July supply and hospitalization, support for
and kept an advance echelon in the Ledo Road construction crews, and
Chungking—the latter an ugly bomb-bat- the care of air force service personnel in
tered provincial town that was crowded India. As in the Pacific theaters, his sub-
by refugees and the wartime government
of China. At the end of 1942 Stilwell
11
ordered Colonel Williams to the forward Stone, “Medical Service in India and Burma,” 1:27,
39, 69–72, Ms 8–6.2 AG, CMH; Blanche B. Armfield,
headquarters, assigning him the task of Organization and Administration in World War II, Medical
Department, United States Army in World War II
(Washington, D.C.: Office of the Surgeon General,
10
Stone, “Medical Service in India and Burma,” Department of the Army, 1963), pp. 508–09, 514. See
1:19–21, Ms 8–6.2 AG, CMH; Seagrave, Burma Surgeon, also Romanus and Sunderland, Mission to China, pp.
pp. 240–41. 192–221.
292 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
upgrade service and provide care far- its own in [the CBI] until the winter of
ther forward. The lack of statistics, how- 1944–45.”16
ever, makes any assessment of his success The major responsibility of the
or failure impossible.15 USASOS headquarters was to construct
In 1944 the number of cases of diar- a new land route to China—the Ledo
rheal diseases was serious enough to Road—from India’s Assam Province
impair efficiency, probably three times through the northern Burma jungles to
the officially recorded 16,562 cases. a junction with the old Burma Road.
Even the recorded cases served to give Work began in March 1943 and ended
the CBI the highest rate for all theaters triumphantly in January 1945, when the
in World War II. The rate peaked at 326 first truck convoy set out for China. To
per 1,000 troops per annum in July, and achieve this remarkable feat of engi-
did not decline significantly until the neering—building a roadway through
following year (Chart 6). Such ills were jungle and mountains in the midst of
pervasive in India and seemingly uncon- war and in the face of an active enemy—
querable, given the climate, crowding, required the labor of thousands of
local mores, and native food-handlers. Americans and tens of thousands of
The burden on the Veterinary Corps Chinese and Indians.
officers who inspected the Army’s food Battalion and regimental medical
and supervised slaughterhouses was a detachments provided first-echelon care.
heavy one. Immunizations successfully Colonel Tamraz established a complex of
kept the serious diseases of cholera, fixed hospitals and battalion aid stations
typhoid, and typhus from endangering in the Ledo base area. Operating the aid
American troops, and a rigorous anti- stations was the responsibility of the 151st
VD program, inaugurated by Williams at Medical Battalion. Spaced a hard day’s
the end of 1942 and aided late in the march apart, the stations were small,
war by the introduction of penicillin each containing a few enlisted medics
treatment, ultimately reduced the level and sometimes a doctor who worked for
of infection to the lowest for any theater a time and then moved on. Living in
of operations. Nevertheless, both med- bashas (bamboo huts), the medics
ical and command leadership in the CBI endured heat, rain, insects, and bore-
were generally sluggish in guarding the dom, compensated in part by the natural
health of the Army there. As the Army’s setting of green mountains and the dis-
official history of the theater concludes, tant snow-capped Himalayas. How much
“Preventive medicine did not come into pleasure the homesick and the lonely
15 16
Donald B. Peterson, “China-Burma-India Theater,” Frank R. Philbrook and John E. Gordon, “Diarrhea
in Albert J. Glass, ed., Overseas Theaters, Medical and Dysentery,” in Ebbe Curtis Hoff, ed., Communicable
Department, United States Army in World War II Diseases Transmitted Chiefly Through Respiratory and
(Washington, D.C.: Office of the Surgeon General, Alimentary Tracts, Medical Department, United States
Department of the Army, 1973), pp. 830–31; John R. Army in World War II (Washington, D.C.: Office of the
Mays, “History of Neuropsychiatry in the India-Burma Surgeon General, Department of the Army, 1958), pp.
Theater in World War II,” pp. 2–5, 12–14, 17, file 376–78; Charles F. Romanus and Riley Sunderland,
314.7–2, HUMEDS, RG 112, NARA. Mays, apologizing Stilwell’s Command Problems, United States Army in
for the lack of meaningful statistics, indicates that a sta- World War II (Washington, D.C.: Office of the Chief of
tistical section organized in the theater surgeon’s office Military History, Department of the Army, 1956), pp.
began to function satisfactorily only in June 1945. 287–88 (quotation).
THE CHINA-BURMA-INDIA CHALLENGE 295
CHART 6—DIARRHEA AND DYSENTERY INCIDENCE IN U.S. ARMY FORCES, CBI, 1943–1945
Rate a
350
1944
300
250
1943
200
150
1945
100
50
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
a
Reflects the number of new admissions plus secondary diagnosis cases per annum per 1,000 troops.
Source: Adapted from Herrman L. Blumgart and George M. Pike, “India-Burma Theater of Operations,” in W. Paul Havens, Jr.,
ed., Activities of Medical Consultants, Medical Department, United States Army in World War II (Washington, D.C.: Office of the
Surgeon General, Department of the Army, 1961), p. 712.
derived from their surroundings is March 1943 the theater activated the
another matter. Probably most would Fourteenth Air Force in China under
have agreed with Sgt. Robert W. Chennault, who was promoted to major
Fromant’s sentiments, written on the general on the fourteenth. Here too
evening of 13 August 1943: “The sun was Chennault sought to establish a dispen-
out most of the day and tonite [sic] the sary at every base, and in October the
moon is beautiful. Oh for home, a car & USASOS surgeon established the 95th
freedom.”17 Station Hospital at Kunming. Meanwhile,
Medical support for the Army Air in August the theater command Army
Forces meant providing fixed hospitaliza- Air Forces, India-Burma Sector—com-
tion for the crews and ground personnel prehending the Tenth Air Force, the Air
of the Tenth Air Force, as well as supplies Service Command, and the Air Forces
for the dispensaries maintained by air Training Command—was established at
force personnel at bases in India. On 10 New Delhi, with its medical section suc-
cessively headed by Colonel Porter, in
17
Fromant’s log in Stone, comp. and ed., Crisis October by Col. William F. DeWitt, MC,
Fleeting, pp. 32–34 (quotation). and in May 1944 by Col. Clyde L.
296 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Brothers, MC, a former Tenth Air Force Medical supply was poorly handled by
surgeon. The air surgeon’s staff was min- the theater, though the complications
imal, and various air organizations, that underlay the problem were not of its
including the Air Transport Command’s making. Supplies for American troops
India-China Wing and the XX Bomber arrived from the United States in the
Command, set up in 1944 to initiate the familiar form of medical maintenance
strategic bombing of Japan from bases in units. American-sponsored Chinese
mainland Asia, were outside of his com- troops in China received lend-lease sup-
mander’s authority. These organizations plies from the United States through the
dealt directly with the air surgeon in China Defense Supply Program, estab-
Washington and the theater surgeon in lished by Congress; Chinese troops in
Chungking. India were supplied by the British under
So fractured a system seemed unlike- lend-lease agreements, which the United
ly to offer harmony among the many air States managed on behalf of China.
surgeons, the theater surgeon, and the Secondary suppliers included the
USASOS surgeon. If anything, the mul- Chinese Army Medical Administration
tiplication of theater headquarters loos- and China’s National Health
ened central authority. Instead of a two- Administration and National Red Cross
sided conflict between the Army Air Society. Nongovernmental aid came
Forces and the theater, the result from the United States via the American
appears to have been free-form compe- Red Cross, the Bureau of National Aid to
tition among the various air surgeons China, and the United China Relief.
for medical materiel and hospital space, Colonel Williams had some success coor-
both of which were in short supply. dinating his multiple sources, to a great
Relationships with the USASOS head- extent through personal contacts with
quarters were defined by a variety of their representatives, but less in main-
makeshift agreements. Only in the fall taining liaison with his own subordinate
of 1944, when the offices of theater sur- commands.
geon and USASOS surgeon were con- In December 1942, while Colonel
solidated and increased numbers of hos- Tamraz was away on an inspection tour,
pitals received, did friction diminish the chief surgeon transferred the
and more centralized control bring USASOS supply officer from New Delhi
greater orderliness to the support of the to Kunming. When Tamraz returned, he
theater’s airmen.18 appointed his dental officer to the
vacant slot. Inexperienced and lacking
18
Surg, 14th Air Force, Annual Rpt (copy), 1943, pp. supervision from the USASOS surgeon,
1–3, file 319.1–2; Surg, 10th Air Force, Annual Rpts the new supply officer performed poor-
(copies), 1943, p. 1, and 1944, p. 1, file 319.1–2; James
H. Stone, “The Hospitalization and Evacuation of Sick ly, allowing critical stocks to dwindle
and Wounded in the Communications Zone, China- without requisitioning replacements,
Burma-India and India-Burma Theaters, 1942–1946,” probably through misunderstanding of
pp. 156–59, file 314.7–2; Surg, China Air Svc Cmd,
Annual Rpt (copy), 1944, pp. 1–2, file 319.1–2. All in a War Department order that terminat-
HUMEDS, RG 112, NARA. See also Mae Mills Link and ed the automatic system in September
Hubert A. Coleman, Medical Support of the Army Air Forces 1943. The following month Tamraz
in World War II (Washington, D.C.: Office of the
Surgeon General, USAF, 1955), pp. 876, 902–07; relieved him and requested a supply
Armfield, Organization and Administration, p. 525. expert from the United States, who,
THE CHINA-BURMA-INDIA CHALLENGE 297
by Chinese soldiers, the trekkers, after a The advance resumed as the Chinese,
journey of three weeks, reached under Stilwell’s direct leadership, began
Seagrave’s surgery at Wang Ga. Then to move down a chain of valleys, at
they moved forward again, finding the whose southern end lay the town of
Chinese 3d Battalion, 112th Regiment, Mogaung, which was on the railroad
at last dug into a defensive position at line connecting Mandalay with
Ngajatzup, from which its officers Myitkyina. The commander now had in
refused to budge. the field some 50,000 Chinese in two
Here the only Medical Department well-trained and competently led divi-
casualty, T. Sgt. 4 Ronald M. Brown, was sions, while a third continued to train at
killed in an ambush. The Chinese aban- Ramgarh. A British deep-penetration
doned his body, along with several of force, the famous Chindits under Maj.
their own wounded, despite the plea of Gen. Orde C. Wingate, operated behind
an American medical liaison officer that enemy lines. The invaders had valuable
he be allowed to kill the helpless men allies in Shan and Kachin tribesmen,
painlessly with lethal doses of morphine. who loathed the Burmese and support-
Then for three months the remaining ed the Allies.
members of the team worked in a Stilwell also had an American unit of
dugout within the battalion perimeter, 3,000 troops, under Brig. Gen. Frank D.
on a wooded hilltop surrounded by a Merrill. The 5307th Composite Unit
defensive system of trenches, booby (Provisional), code-named GALAHAD,
traps, and sharpened stakes. was a volunteer regiment soon to gain
Medical supplies as usual were air- renown as Merrill’s Marauders.
dropped. Parachutes were turned into Operating on the left flank of the
sheets, blankets, towels, and lining for Chinese, the Marauders struck at the
the dirt walls of the medical dugout. Japanese rear. They traversed jungle
Gasoline cans of boiling water served as trails that plunged into deep valleys and
sterilizers, and flashlights illuminated climbed precipitous slopes, carrying
nighttime operations. The medics dis- their supplies on mules and horses and
solved dry plasma in distilled but unster- replenishing by airdrops.30
ile water, and made no attempt to steril- American medical units that had
ize dressings or surgical drapes. Yet casu- arrived in the theater during late 1943
alties, despite febrile reactions to the supported the Chinese—the 25th Field
plasma, survived; most wounds healed Hospital; the 42d, 43d, and 46th Portable
without infection, though two abdominal Surgical Hospitals; the 13th Medical
cases died. Basic medicine and antiseptic Battalion; and the 803d Medical Air
surgery, aided by doses of oral sulfathia- Evacuation Transport Squadron. The
zole, enabled the Chinese to survive a portables, long awaited, proved a key to
lengthy siege in a jungle environment. In the creation of a functional field medical
January 1944 a Chinese regiment of the system under Burmese conditions. As on
22d Division broke through, and the the islands of the Pacific, they assumed
team members returned to well-merited
decorations for their service under fire.29 30
Ibid., 1:127–28, 145, Ms 8–6.2 AG, CMH; idem,
comp. and ed., Crisis Fleeting, p. 294; Romanus and
29
Ibid., 1:104–05, 107, 109–12, Ms 8–6.2 AG, CMH. Sunderland, Command Problems, pp. 129–31, 196.
302 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
many roles besides that of rendering bearers, and without them the
frontline surgery. They functioned at American medics on the far right flank
times as collecting stations, as clearing would have been “absolutely helpless.”32
stations, as holding units at jungle As the Chinese began to advance, a
airstrips, and as medical supply points. pattern of treatment and evacuation
The USASOS headquarters by late 1943 quickly emerged. Casualties passed
probably disposed of over 10,000 beds through the hands of Chinese battalion
deployed from Karachi to Ledo, includ- and regimental detachments to
ing expansion beds. The main forward American surgical teams and then, often
concentration at Ledo—the 20th via Seagrave detachments, to the 25th
General Hospital and the 14th, 48th(-), Field Hospital. They were moved by litter,
and 73d Evacuation Hospitals—had or by litter jeep when roads were avail-
3,250 authorized beds (see Map 11). able, to forward airstrips, where a hold-
Linking the fixed hospitals to the front ing unit—called an air clearing station—
was the 151st Medical Battalion.31 cared for them until evacuated to
But the system did not reach all who Shingbwiyang or, for the most serious
needed it. Because evacuation followed cases, to Ledo. Seagrave’s evacuation pol-
the main axis of the advance, units on icy was about ten days; that of the field
the extreme left and right had great dif- hospital, six weeks.33
ficulty in sending out their casualties. As the Chinese gained confidence
GALAHAD, during its deepest jungle under Stilwell’s aggressive leadership,
marches in the late winter and early their performance in the field improved
spring of 1944, lacked any medical ser- markedly, as they pressed the Japanese
vice at all except that of its own battalion down the Hukawng and Mogaung
detachments. And Chinese forces on Valleys. Anvil to the Chinese hammer,
the right flank fared only a little better. the Marauders fought four battles, at
A surgical team accompanying the Walawbum, Shaduzup, Inkangahtawng,
Chinese 22d Division’s 1st Battalion, and Nhpum Ga. Hard fighting, com-
65th Regiment, marched through deep bined with months of marching through
jungle, over 3,000-foot ridges, drawing steamy leech-ridden jungle and over
its supplies from occasional airdrops, towering ridges, brought them close to
which were seldom sufficient. On one exhaustion.
occasion, when resupply failed for three
weeks, surgeons were reduced to bor- Medicine and Marauders
rowing knives and saws from the native
Kachins. Indeed, the Kachins made suc- Although the fate of the Ledo Road
cess and even survival possible; they pro- rested on the Chinese armies, the
vided food, shelter, guides, and litter- adventures of the Merrill’s Marauders
formed the American epic of the
31
Central Burma Campaign. In their long
Stone, “Medical Service in India and Burma,”
1:122, 133–34, 144, Ms 8–6.2 AG, CMH; Romanus and trek to Myitkyina all of the pressures of
Sunderland, Command Problems, pp. 142, 285. The 151st
Medical Battalion had been trained for desert; the 13th
32
Medical Battalion, for the Arctic. The latter unit was Stone, “Medical Service in India and Burma,”
redesignated 13th Mountain Medical Battalion on 7 1:131, 144–45 (quotation), Ms 8–6.2 AG, CMH.
33
November 1944. Ibid., 1:141–44, Ms 8–6.2 AG, CMH.
THE CHINA-BURMA-INDIA CHALLENGE 303
jungle war beset the regiment—exhaus- ined grievances and cultivating the air of
tion, disease, the invisibility of the desperation and rascality that caused
enemy. As a Marauder who became the journalists to award them their sobriquet.
unit’s eloquent historian wrote, “It Formed as a result of transient enthu-
would not be enough to say that . . . [the siasm for deep-penetration forces
march] was the worst experience I have engendered by Wingate, the regiment
ever been through. It was so incompara- was divided into three battalions and
bly the worst that at the time I could each battalion into two combat teams.
hardly believe in the rest of my life at The Marauders were to depend upon
all.”34 air supply and evacuation, on the model
A volunteer outfit of mixed and dubi- of Wingate’s Chindits; artillery support
ous antecedents, the Marauders to their was lacking. Even when they arrived in
own misfortune were the only American India in late 1943, the soldiers, many
force under Stilwell’s command— drawn from other tropical theaters, had
indeed, the only American land combat a malaria rate of 4,084 per 1,000 per
force between North Africa and New year; only Atabrine discipline enabled
Guinea. From the beginning they were a them to fight. Yet they were not without
hard-luck crew, nursing real and imag- experience. Their training under
Merrill was rigorous, and when Stilwell
34
Charlton Ogburn, Jr., The Marauders (New York: first saw them at the Burmese town of
Harper and Brothers, 1959), p. 5. Shingbwiyang on 21 February 1944, he
T I B E T
100th Station Hospital
New Delhi
Agra
NEPAL
Bombay
ILLUS
Provisional Hospital
MA
LIV
Bay of Beng
I n d i a n O c e a n
CEYLON
MAP 11
CBI FIXED HOSPITALS AND DEPOTS
Advance Medical Depot 2
111th Station Hospital December 1943
Scale 1:18,600,000
Chabua
Ledo
BHUTAN
LE
14th Evacuation Hospital
48th Evacuation Hospital (-) C H I N A
DO
FRENCH
B U R M A INDOCHINA
S 93A
P 11
VE
Rangoon
T H A I L A N D
al
Andaman Sea
Gulf of Thailand
306 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
viewed them with approval: “Tough nature of deep penetration ensured that
looking lot of babies.”35 no regular chain of evacuation could be
Medical support appeared adequate. maintained. On occasion, the lightly
Under regimental surgeon Maj. Melvin armed special operations force was oblig-
A. Schudmak, MC, the medics shared the ed to fight as line infantry. Early in April
hardships of the Marauders, enduring a Japanese attempt at counter-envelop-
constant rain, eating their own animals ment trapped the 2d Battalion for ten
when airdrops failed to materialize, and days on a barren hilltop near Nphum Ga;
suffering skin diseases, malaria, dysentery artillery fire hammered the defenders,
(one outbreak cost battalion members an who could not reply in kind. Medical and
average weight loss of 25 pounds, per sanitary problems were acute, as always
man), and scrub typhus. Clearly inade- during a siege. Water was scarce and pol-
quate to the Marauders’ needs were the luted by feces, dead animals, and human
chlorine purification tablets that formed corpses; the stink of decay hung over the
their only means of combatting polluted perimeter and a plague of flies beset its
water. No means of preventing scrub defenders. When relief arrived, casualties
typhus could be provided them, for no had to cross 6 miles of mountain trail by
vaccine existed. Compounding their suf- foot, litter, or horseback to a rest camp at
fering was a sense of heartless misuse and Hsamshingyang, where casualties, some
indifference by Stilwell, whom they felt of whom had been wounded ten to
ought to have understood as a comman- twelve days before, slept on the ground
der in a theater that was neglected by or in parachute tents. By then dysentery
Washington. was rampant, and impossible to control
Rapid motion preserved the with sulfaguanidine or paregoric.36
Marauders from some diseases—they left Throughout the march medical treat-
their own wastes behind, though they ment was elementary and evacuation
may have infected one another with prolonged. Battalion medical detach-
malaria—but the effects of exhaustion ments moved with the Marauder
multiplied throughout their march of columns; cared for the sick; collected
700 miles. Marked by symptoms of dizzi- the wounded and gave first aid; and,
ness, lack of muscle tone, anorexia, and during fights, set up aid stations. When
nausea, the attrition of the trail was inex- the march resumed, casualties walked if
orable despite adequate salt and vitamin they could, rode pack animals, or were
intake. Merrill himself eventually went carried in litters until they recovered or
down with a heart attack. Atabrine disci-
pline slipped as morale deteriorated and
36
exhaustion increased; perhaps some 13th Mountain Med Bn Annual Rpt (copy), 1944,
pp. 9–10, file 319.1–2; 896th Clearing Co [Seagrave hos-
Marauders saw malaria as the only ticket pital] Annual Rpt (copy), 1944, pp. 3–5, file 319.1–2;
out of the jungle. Rpt Extracts on Activities of U.S. Army Medical
Clashes with the enemy left the medics Department Units Assigned to Northern Combat Area
Command During the Northern and Central Burma
many wounded to care for, while the Campaigns, “Hospitalization,” p. 2, Historians files. All
in HUMEDS, RG 112, NARA. See also Stone, “Medical
Service in India and China,” 1:150, Ms 8–6.2 AG, CMH;
35
Stone, “Medical Service in India and Burma,” idem, comp. and ed., Crisis Fleeting, pp. 305–21. It
1:119–21, Ms 8–6.2 AG, CMH; idem, comp. and ed., should be noted that Stilwell used the Chindits with
Crisis Fleeting, p. 295 (quotation). similar ruthlessness and similar effects.
THE CHINA-BURMA-INDIA CHALLENGE 307
until air evacuation came to the rescue. were ordered to cross still another range
Stabilizing emergency surgery was pro- of mountains, descend into the valley of
vided briefly by a small surgical team of the Irrawaddy, and lay siege to
the 13th Medical Battalion and, on the Myitkyina. Though their depleted num-
final leg of the march to Myitkyina, by a bers—now reduced to about 1,300—
Seagrave hospital team. Lack of consis- were strengthened with Chinese units,
tent surgical support was probably the siege destroyed the 5307th as an
responsible for the fact that more effective force.
Marauders than Chinese had wound The reason was not a lack of medical
infections when they were hospitalized. support, which was more adequate than
Wingate’s forces included several on the long campaign down the
experimental helicopters, and the first Hukawng and Mogaung Valleys and on
American medical evacuation by rotary- the hard march to Myitkyina. On the
wing craft was carried out in April by Lt. march the old problems continued—
Carter Harman, a pilot of 1st Air exhaustion, limited medical care, and
Commando that supported the Chindits. near-impossible evacuation. But the
However, all air evacuation of Marauder Marauders of the 1st and 3d Battalions,
casualties apparently was left to light which had Chinese units attached, ben-
planes that landed in jungle clearings or efited from the latter’s American surgi-
on the sandbars of jungle rivers. Single- cal support. When the Allies closed in
engined L–1s and L–5s shuttled them to on Myitkyina and the Chinese seized the
landing fields, where they were trans- airfield, the closeness of the forces and
ferred to two-engine C–47 ambulance the availability of air evacuation and sup-
planes of the 803d Medical Air ply both meant better days for the
Evacuation Transport Squadron. At each Marauders. Seagrave’s medics, though
stop the air clearing stations cared for concentrating on the Chinese, served all
those in transit; local troops might staff the injured, working under the fierce
them, or the 13th Medical Battalion, or, midsummer sun of the tropics or under
farther to the rear, the 151st Medical torrential rains that marked the onset of
Battalion. At each station a medical offi- the monsoon.
cer and a handful of enlisted men— Thus on 19 May Seagrave’s surgeons
nursing orderlies, drivers, litter-bearers, laid litters across packing boxes under
laborers—provided minimum shelter in “the scorching sun and squalls of rain.”
a ward tent and elementary supportive During downpours his Burmese nurses
care. At the end of the long and tortuous held open umbrellas over the casualties
route out of combat were the wards of and the attending surgeons. A company
the 20th General Hospital or the 73d of Chinese litter-bearers bravely scoured
Evacuation Hospital at Ledo.37 the field for the wounded. The next day
Attrition along the trail was com- hospital personnel draped parachutes
pounded when the weary Marauders over bamboo poles to form impromptu
operating pavilions. The rain continued,
impeding air evacuation and aggravating
37
Stone, comp. and ed., Crisis Fleeting, pp. 323–25; shock in the wounded, who were cold
Peter Dorland and James Nanney, Dust Off: Army
Aeromedical Evacuation in Vietnam (Washington, D.C.: and wet. The 42d Portable Surgical
U.S. Army Center of Military History, 1982), p. 9. Hospital also took American casualties;
SEAGRAVE HOSPITAL FIELD AND CAMP AREAS IN MYITKYINA
THE CHINA-BURMA-INDIA CHALLENGE 309
course of the Central Burma Campaign, 1944 12,530 were in use, 7,130 by
nearly 2,000 of whom were victims of Americans and 5,400 by Chinese. Tamraz
disease (Table 4). At the end of a May attempted to meet the situation by reduc-
only about 600 of the original force ing rear-area facilities and creating new
remained. The last survivors of OLD hospitals or expanding old ones at
GALAHAD were evacuated by 4 June.40 Ramgarh and elsewhere to absorb the
Even when the ill and wounded were influx from the fighting lines. But while
back in Ledo, the demands of the inter- the medical service demanded beds,
minable siege pursued them. The fixed Stilwell’s headquarters pressed for the
hospitals were overwhelmed, and a con- immediate return to the front of all sol-
valescent facility, long needed, had only diers capable of fighting. For both rea-
begun to take patients when the casual- sons, U.S. troops newly released but in
ties from Myitkyina flooded in. The peri- need of rest and recuperation instead
od of the monsoon and the climactic were marked for duty and flung into the
battles passed amid a “kaleidoscopic replacement system. Soon they found
scene of mud, shortages, malaria, over- themselves back in Myitkyina—a new
taxed equipment, rain, disappoint- item for the Marauders’ endless list of
ments, heat, language difficulties, shift- grievances against the theater comman-
ing priorities, jungle fighting, plans dis- der and the world in general.42
carded, landslides, and homesickness.”41 As the siege went on, and throughout
The strain on the system was extraor- the campaign, the Allies were fortunate
dinary. The theater counted only 8,800 in the failures of the Japanese medical
authorized hospital beds, yet in June service. Enemy soldiers suffered from
the same diseases, but the incidence was
40
Quotations from Louis Allen, Burma: The Longest higher. Malaria was all but universal,
War, 1941–1945 (New York: St. Martin’s Press, 1984), p. and supplies of quinine were very low in
368. See also Stone, “Medical Service in India and
Burma,” 1:192, 194, Ms 8–6.2 AG, CMH.
41 42
Stone, “Medical Service in India and Burma,” Romanus and Sunderland, Command Problems, p.
2:254, Ms 8–6.2 AG, CMH. 286.
THE CHINA-BURMA-INDIA CHALLENGE 311
northern Burma. Sanitation was poor, ed, the familiar tag on the sick that read
never more so than in besieged “FUO, meaning Fever of Unknown
Myitkyina, and diarrhea and dysentery Origin, . . . might as well have read AOE,
were common. And, unlike the Allies, or Accumulation of Everything.”44
Japanese soldiers suffered from malnu-
trition, with all its attendant ills.43 The Central Burma Campaign
Myitkyina fell at last on 3 August, after
a siege of seventy-eight days. The The new troops who filled the
Marauders’ story was over. Sickness and Marauders’ ranks were reorganized into
exhaustion, not enemy weapons, had the 2d and 3d Battalions of the 475th
destroyed OLD GALAHAD. Accounts by vet- Infantry, while the 1st Battalion was
erans praised most of their doctors, formed in India from GALAHAD veterans
though the regimental surgeon may have as they were released from hospitals. The
been an exception. The real difficulties regiment was joined by the newly arrived
lay elsewhere. The starved resources of a 124th Cavalry. Together, these became
neglected theater formed a great part of the American combat units of the 5332d
the story, as did the attrition of jungle Brigade (Provisional), or MARS Task
warfare. Fighting in the CBI differed Force, which was supported by three
markedly from the Pacific. Except for portable surgical hospitals and the 18th
guerrilla forces, Allied troops on the Veterinary Evacuation Hospital. The
islands did not attempt to survive and Seagrave hospital, though formally acti-
fight for long periods deep behind vated in October 1944 as the 896th
enemy lines, and after 1942 the sea Clearing Company, retained its large
became their highway for resupply and civilian complement to help its uni-
reinforcement. Air supply, the only equiv- formed personnel provide for the
alent in the towering forested mountains, Chinese divisions.
provided no equivalent support. While the American forces were reor-
But climate, terrain, theater priori- ganized and the monsoon blew itself out,
ties, and deep penetration alone did not Stilwell prepared for autumn operations.
explain the ruin of the unit. The Initially, the Central Burma Campaign,
Marauders were called upon to act as from the American and Chinese stand-
the symbol of American will in a theater points, served to screen the roadwork by
where the Chinese and British predomi- pushing back the Japanese; to the British,
nated, neither with any strong inclina- it aided the reconquest of their Burmese
tion to the combat in northern Burma colony and secured their northern flank.
that Stilwell’s mission demanded. Early Allied goals rapidly expanded in
Hence, the commander was con- response to early successes.
strained, for political reasons, to keep In mid-October the British 36th
his one American unit fighting beyond Division advanced, strengthened with
the limits of its strength. As the Chinese elements that were supported by
Marauders’ historian rightfully suggest- the American 45th and 60th Portable
Surgical Hospitals and by elements of the
43
Rpt, Mil Intel Div, WDGS, 28 Dec 44, sub: The
Japanese Medical Record in Burma, 28 Dec 44, file
44
350.09, HUMEDS, RG 112, NARA. Ogburn, Marauders, p. 232.
312 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
13th Medical Battalion. The main 13th Medical Battalion moved British
Chinese forces moved out with support wounded to the battalion’s clearing sta-
from three other portables, Seagrave’s tion or to portable surgical hospitals. The
896th Clearing Company, and the 151st Medical Battalion operated an air
remainder of the medical battalion. For clearing station for British and Chinese
the time being, the new American casualties at Sahmaw, where C–47s shut-
brigade, with its three portables, tled to and from airfields in India. And
remained at Myitkyina to complete its Indian units established a chain of air
training. By this time conditions along clearing stations, where the wounded
the chain of evacuation had greatly waited at impromptu airstrips, some in
improved. Disease incidence declined dry rice paddies, to be evacuated by
with the onset of the dry season. Beds American aircraft.
emptied as battle casualties returned to Supplies, too, arrived by air, and a hos-
duty, and fixed hospitals, newly arrived in pital supporting the Chinese at Shwegu
the theater, began work. No less impor- underwent a “bombardment” of pack-
tant, air evacuation was now a “going con- ages of rice and horse-feed, dropped by
cern,” with a medical air evacuation supply planes unable to land in the
squadron, established air clearing sta- rough country through which the
tions, and a force of light liaison planes. Chinese 22d Division marched to the
Medically as well as militarily, this would Irrawaddy. The importance of air evacu-
be an entirely different campaign.45 ation reflected, as usual, the harsh coun-
Improved mobility on the ground was tryside of dense wet jungle and moun-
another plus. During operations in tain ridges through which the Allies
northern Burma, the capture of advanced. On the ground the portables
Mogaung had reconnected the Allies again proved themselves indispensable,
with the railway corridor that ran from keeping up with the troops and working
Rangoon to Mandalay, Myitkyina, and in the most varied locations: in a field of
Lashio. During the last phases of the smashed gliders, where the British had
Mogaung Valley offensive, American made a deep penetration landing; in
planes had dropped jeeps that were fitted jungle clearings; in buildings perilously
with flanged wheels to evacuate casualties close to the front lines, where bullets rid-
on the tracks, and occasional use of these dled the walls; and in ancient temples.46
devices had aided evacuation there and at Medics found plenty of work, for the
Myitkyina. Rail evacuation became stan- Japanese fought sharp delaying battles.
dard in the Central Burma Campaign, Yet their campaign featured planned
and a major supplement to the air evacu- withdrawals before forces they could no
ation that still dominated the theater. longer hope to best in the field. The
Cooperation between the British and Chinese invested the strategic and heav-
American medical services also grew ily defended town of Bhamo, on the east
steadily. Even in northern Burma bank of the Irrawaddy, and hard fight-
American aircraft had evacuated many
British casualties. Now ambulances of the 46
Ibid., 2:281–88 (quoted word), Ms 8–6.2 AG, CMH.
See also Annual Rpts (copies), 1944, for 13th Mountain
Med Bn, pp. 2–3, 10; 44th Port Surg Hosp, pp. 2–3;
45
Stone, “Medical Service in India and China,” 45th Port Surg Hosp, pp. 1–2; and 58th Port Surg Hosp,
2:275–81 (quoted words, p. 277), Ms 8–6.2 AG, CMH. p. 2. All file 319.1–2, HUMEDS, RG 112, NARA.
THE CHINA-BURMA-INDIA CHALLENGE 313
ward zone. Air evacuation cleared seri- Both Y- and Z-Forces, however, were
ous cases even in the absence of a med- under Chinese rather than American
ical battalion to manage evacuation command. Williams’ freedom of action
from the 5332d Brigade, and the fixed was correspondingly limited, and sup-
hospitals faced no such overload as in plies, because of the armies’ remoteness
the earlier campaign. Though the envi- from the Indian bases, were even more
ronment remained hostile, the numbers difficult to obtain than in Burma. But
of sick never became so overwhelming, his greatest problem was to impress
in part because a malaria control orga- upon the Chinese Army the importance
nization now existed, at least in the of maintaining the health of soldiers
5332d Brigade. Nor did the tactical situ- and upon civilian authorities the impor-
ation, in a winning battle marked by few tance of maintaining the health of the
retreats and no enemy envelopments, local populace in those areas where the
preclude evacuation and replacement.49 armies concentrated.50
In brief, a time of improvisation and Although Stilwell established a num-
crisis had given way to one of experi- ber of training centers in southern
ence and sure-handed competence. China, the prototype for teaching the
Between the fall of Myitkyina and that of Chinese the rudiments of military medi-
Rangoon, however, a critical situation cine opened in April 1943 at the
developed in China that demanded an Kunming training center. Manned by
American response. American personnel, the medical school,
despite poverty and language barriers,
The Chinese Puzzle provided both clinical and tactical
instruction to hundreds of Chinese med-
Problems had marked the American ical officers and enlisted men during its
experience in wartime China from the bare seven months of existence. Few
early years of the war. In January 1943 instructional aids existed; few could be
Stilwell established the Chinese obtained from India, in view of priorities
Training and Combat Command at for flights over the Hump. Manikins and
Chungking, and Williams took on the charts found in temples had to be
responsibility of developing medical pressed into use for illustrating lectures
support for the twenty-seven divisions of on physiology, anatomy, and first aid.
Y-Force, which was intended to operate Similar training was conducted at the Tali
in extreme southern China and north- Medical School, and the two institutions
east Burma. In January 1944, when the graduated about 1,000 students in all.51
Z-Force was set up to train and ready American instructors traveled from
thirty additional divisions at Kweilin for one Chinese unit to another, to spread
service against the Japanese in south- their teaching to soldiers in the field,
east China, he assumed responsibilities and Americans went on campaigns serv-
here also.
50
Smith, “Chinese Army Medical Service,” 1:42–43,
49
Stone, “Medical Service in India and China,” file 314.7; Surg, Chinese Tng and Combat Cmd,
2:330–31, 385–88, Ms 8–6.2 AG, CMH. DDT was intro- Annual Rpt (copy), 1944, pp. 2–5, 13–14, file 319.1–2.
duced into the theater in 1944, but apparently was not Both in HUMEDS, RG 112, NARA.
51
widely used until 1945. The vast area and dense jungle Smith, “Chinese Army Medical Service,” 1:47–56,
canopy made aerial spraying ineffective. file 314.7, HUMEDS, RG 112, NARA.
THE CHINA-BURMA-INDIA CHALLENGE 315
ing as unit advisers on medicine and divisions they could support. Chinese col-
health. Williams attempted to detail at lecting companies brought casualties to
least one doctor, one enlisted medic, the portables, which often evacuated in
and one veterinary enlisted man to each turn to Chinese field hospitals.
Chinese division and army. To them fell Service with Y-Force in the southern
the difficult task of improving, through China battlefields was brutal and pic-
diplomacy and tact, the medical and turesque. Five portables and 140 pack
sanitary practices of a civilization far animals crossed the Salween on a suspen-
more ancient and deeply rooted than sion bridge and then climbed rain-slick
their own. Those who were wise enabled trails into a range of hills that rose to
the I Kuan (medical officer) to gain face 11,000 feet beyond. Some pack animals
with his commander through quiet fell into the valleys, and bulls had to be
instruction and open support; those rented and turned into beasts of burden.
who were not wise merely aroused Weary Americans, exhausted by climb-
resentment by their overbearing ways.52 ing, heat, and wet, slept in grass huts or
Evacuation had to be organized as within the walls of ancient temples. Here
well. Collecting posts, division dressing too, in a temple yard, the 32d Portable
stations, and division and army field hos- Surgical Hospital set up on the night of 6
pitals were few in number, inadequately September as the battle for Tengchung, a
equipped, and thinly staffed. One solu- strategic walled city, raged around it.
tion was to assign American field and Casualties were heavy, and American
portable surgical hospitals, and by mid- medics were short of plasma. Those in
1944 Williams had been able to provide shock seldom survived; all cases of com-
three of the former and ten of the latter bined chest and abdominal wounds died
to the Chinese Army. The portables without exception. Candles illuminated
gained the respect of the troops by the operating room, and continuous rain
working far forward, not only saving prevented resupply by air.54
lives but also enhancing morale among Three field hospitals working on the
soldiers who now saw (possibly for the Salween front divided into separate pla-
first time) evidence both of a commit- toons, each of which supported a
ment and an ability to save their lives if Chinese hospital and received its most
they were wounded.53 serious cases. Litter hauls by hard-work-
In April the long-delayed fight to ing coolies were incredibly long, one
reopen the Chinese portion of the being recorded of 85 miles; American
Burma Road began as Chiang’s forces surgeons by stabilizing severe cases
crossed the Salween River. Chinese and saved an untold number of them who
American medical units were highly inte- had to make the long journey to the
grated. Some portable surgical hospitals rear. By the end of 1944 American hos-
were split in two, to provide two surgical pitals had admitted close to 20,000
teams and double the number of Chinese Chinese, more than 13,000 of them bat-
tle casualties. Almost 5 percent died in
52
Ibid., 1:57–58, file 314.7, HUMEDS, RG 112,
NARA.
53 54
CSurg, USFCT, Annual Rpt (copy), 1944, pp. 4–6; 32d Port Surg Hosp Annual Rpt (copy), 1944, pp.
CSurg, USAFIBT, Annual Rpt (copy), 1944, pp. 4–5. 3–8; 34th Port Surg Hosp Annual Rpt (copy), 1944, pp.
Both file 319.1–2, HUMEDS, RG 112, NARA. 2–4. Both file 319.1–2, HUMEDS, RG 112, NARA.
316 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
FRONTLINE SURGERY ON A CHINESE CASUALTY. A C–47 passes overheard after having dropped
supplies by parachute.
prepared to renew the offensive in the schools had been limping along.
spring of 1945.56 Armstrong willingly provided them such
Meanwhile, on 27 October General support as he could muster, sending two
Hsu Hsi Lin, director general of the platoons of the 27th Field Hospital to
Chinese Army Medical Administration, Kweiyang to operate a 300-bed hospital
approached Armstrong, suggesting that with personnel of the Chinese school.
medical training be reconstructed Together American and Chinese doc-
around a system of schools that had tors made ward rounds, held staff con-
been established by the Chinese them- ferences, and assisted one another in
selves at Kweilin and Kweiyang. surgical duties. Strictly advisers, the
Receiving little support from the Americans were limited in their ability
Chinese Army, and eclipsed by the Y- to effect reforms but encouraged by a
and Z-Force training centers, these doctor draft launched that same
October, which began to raise the cal-
iber of the Chinese personnel.
56
Surg, Chinese Combat Cmd, Annual Rpt (copy), The newly created Chinese Training
1945, pp. 1–2, file 319.1–2; Smith, “Chinese Army
Medical Service,” 1:121–38, file 314.7. Both in and Combat Command undertook to
HUMEDS, RG 112, NARA. train a new 100,000-man army to resist
318 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
The kind of warfare that impended— genitourinary. Shore parties and beach
with large American units engaged on parties were to be established as usual,
extensive landmasses amid a heavy pop- with serious cases dispatched to the ship
ulation of friendly civilians—resembled best equipped to handle them.
the European fighting of 1944 more At the landing seventeen surgically
than the Pacific campaigns to date. equipped LSTs would provide care, dis-
Hence, a strong medical establishment gorging the troops and equipment they
was necessary. The Sixth Army’s six divi- carried and then beaching themselves
sions were organized into two corps, the to enable vehicles to drive aboard with
X from the Southwest Pacific Area and the wounded. Converted APAs (trans-
the XXIV from the Pacific Ocean Areas, port, attack) would receive the seriously
plus a two-division reserve. Both corps injured offshore. For both attack forces,
were to land on northeastern Leyte, with hospital ships—vulnerable because of
the aim of establishing air and logistical their Geneva markings and lack of arma-
bases—especially airfields in the broad, ment—would arrive later. Once the
flat Leyte Valley on the western side of Sixth Army went ashore, responsibility
the island—to cover and support the would devolve upon its ranking medical
reconquest of the Philippines.2 officers: Colonel Hagins, the Sixth Army
The medical organization of the huge and task force surgeon; Col. Charles
task force followed what were by now McC. Downs, MC, the X Corps surgeon;
standard procedures. At sea the Navy and Colonel Potter, the XXIV Corps sur-
assumed responsibility for the health of geon, who had served earlier in the war
the troops, though on many ships Army as the 7th Infantry Division surgeon at
medical personnel carried out the actu- the invasion of Attu.3
al work. SWPA personnel staged and Supporting the X Corps were the
sailed from bases 700–2,000 miles away 36th and 58th Evacuation Hospitals;
on Biak, Noemfoor, Hollandia, Aitape, the 1st, 2d, and 3d Field Hospitals; the
and Manus. The X Corps was transport- 16th, 19th, and 27th Portable Surgical
ed and sustained by the U.S. Seventh Hospitals; the 135th Medical Battalion;
Fleet, the XXIV Corps by the U.S. Third two amphibious medical companies of
Fleet. MacArthur’s VII Amphibious the 2d Engineer Special Brigade’s 262d
Force provided forty casualty-converted Medical Battalion; a medical supply
LSTs (landing ship, tank), including platoon; and no less than nine anti-
twenty-three with surgical teams, to sup- malaria units—three assigned to survey
port the early phases of the landing; and six to control. Three separate col-
four carried surgical specialty teams— lecting companies and three separate
orthopedic, ophthalmic, thoracic, and clearing companies also were at the
3
Rpt, U.S. Seventh Fleet, n.d., sub: Amphibious
2
Cannon, Leyte, p. 26; Walter Krueger, From Down Operations Invasion of the Philippines, October 1944
Under to Nippon: The Story of the Sixth Army in World War to January 1945, p. 1, file 370.5, HUMEDS, RG 112,
II (Washington, D.C: Combat Forces Press, 1953), pp. NARA; Department of the Navy, Bureau of Medicine
141–53; Robert L. Eichelberger, in collaboration with and Surgery, “The United States Navy Medical
Milton Mackaye, Our Jungle Road to Tokyo (New York: Department at War, 1941–1945,” 1:356–57, files of
Viking Press, 1950), pp. 165–80. Unless otherwise Bureau of Medicine and Surgery Archives (BMSA),
noted, the tactical narrative on Leyte is drawn from Washington, D.C.; Cannon, Leyte, p. 28. On Attu, see
these sources. Chapter V.
36TH EVACUATION HOSPITAL AT PALO, LEYTE, occupying the San Salvador Cathedral
322 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
sion that in time would have a serious seize Dulag, while others struck south to
impact on the field forces.7 Abuyog, from which a very poor road
crossed the rugged mountains to the
The Landings west coast of the island. Problems in
evacuation developed early, in part
On their 3,000-mile voyage from the because the XXIV Corps had originally
Hawaiian Islands, POA troops of the III been loaded for a campaign on the
Amphibious Force endured crowded small island of Yap, northeast of the
quarters, bad ventilation, unrelenting Palaus, and was short of vehicles needed
heat, and boredom—the usual precur- for the Leyte fighting.
sors of an invasion. On 20 October 1944 Throughout the first few days division
the immense fleet approached eastern medics in both regions provided casual-
Leyte over a glassy sea. Small ranger ties with initial care. Most of the wound-
forces, supported by the 10th Portable ed at this stage were victims of enemy
Surgical Hospital, had already landed bombs—almost continuous air raids bat-
and secured several offshore islands. As tered the invaders for their first twelve
the first waves of assault craft reached days ashore—though a substantial num-
the beaches, the X Corps began to land ber were hurt by friendly fire. The Navy
to the north, near Tacloban, while the offered higher-echelon treatment on its
XXIV Corps went ashore to the south, hospital LSTs, but here serious prob-
near Dulag. lems developed. When shallow water
In the north opposition was light, and prevented most LSTs from beaching,
Tacloban, with its airfield, fell to the 1st casualties had to be transferred to small
Cavalry Division the next day. Here the boats or amphibians, and the regulating
president of the Philippines proclaimed system that was to have sent serious cases
his temporary capital; General to teams of specialists broke down under
MacArthur established his headquar- the conditions of combat.
ters; and in November the USASOS In the beginning most things seemed
began to build a major installation, Base to go well for the medics ashore on
K, and in January 1945 a new advance Leyte. By 26 October the hospitals were
base to organize a growing logistical getting established; in the X Corps sec-
establishment. tor Colonel Hagins took control of the
Meanwhile, the tide of battle in the hospitals, the 135th Medical Battalion,
north moved on, as the X Corps’ 24th and the separate medical companies as
Infantry Division entered northern the Sixth Army area organized to the
Leyte Valley. In the XXIV Corps area rear of the fighting (see Map 12).
Japanese units centered around a com- Departing from earlier SWPA policy,
plex of airfields. Despite stout resis- General Denit allowed female nurses
tance, elements of the 7th Division into Leyte on the twenty-ninth, and con-
slogged through swamps and mud to tingents were soon at work in field and
evacuation hospitals. By the time of the
Leyte operation penicillin had become
7
Rpt, Surg, X Corps, 9 Mar 45, pp. 8–11, file 210–26, plentiful not only in hospitals but also in
box 4153, Entry 427, RG 407, NARA; Surg, X Corps,
Quarterly Rpt (copy), Oct–Dec 44, p. 42, file 319.1, clearing companies, where the wounded
HUMEDS, RG 112, NARA. received it intravenously before under-
324 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Wright
SIXTH ARMY MEDICAL SUPPORT
LEYTE
26 October 1944
XXX Corps Boundary
BILIRAN
0 30
S A M A R
Miles
Palo
X
CAMOTES SEA
O
STR
DINAGAT
Panaon
AIT
Strait
PANAON
B O H O L
MAP 12
increasing distance combined with heavy Leyte Gulf, they still faced a harsh fight
rains and enemy fire to slow evacuation against reinforced Japanese Army
time. In some areas the expedients used forces and the wild sodden terrain.
recalled the Indian Wars; the wounded Decisions by the Imperial General
were dragged from the wettest spots on Headquarters ensured that the decisive
travois pulled by water buffalo. While first struggle for the Philippines on land as
aid was almost always available, such con- well as on the sea would take place on
ditions meant that a casualty might wait Leyte and that casualties sustained there
up to thirty hours for surgical care. The by both sides would be correspondingly
results would show up in the statistics of heavy. The remaining Japanese port of
the campaign: 5.6 percent of the wound- entry for its reinforcements was the west
ed would die, compared to 4 percent in coast town of Ormoc. The X Corps
the European theater; the ratio of killed moved against it from the north, cross-
to wounded would stand at 1:2.94, higher ing the mountains to enter the Ormoc
than in any prior SWPA operation; and Valley, while the XXIV Corps pushed
gas gangrene would appear in 1 percent toward Baybay, intending to turn north
of the wounded. Trench foot would once it reached the west coast. Severe
become a serious problem, for the first fighting resulted in harsh country that
time since Attu.9 was covered with dense jungle and
Meantime, the crisis of the campaign drenched by incessant rain. Typhoons
passed offshore. Even as Japanese swelled the rivers, turning the trackless
planes—including the first suicide craft, terrain into quagmires, where some
or kamikazes—battered the invaders wounded drowned. The wettest areas
and their ships, ominous intelligence had to be negotiated by amphibians, and
was received of the approach of a major long litter hauls became commonplace.
Japanese fleet. Navy transports with- Field and evacuation hospitals were
drew from the southern beaches, com- difficult to transport, while their replace-
pelling diversion of surgical LSTs from ments, the fixed hospitals, were often
the north. On 23–25 October, in one of consigned to morasses because various
the great naval battles of the war, the headquarters preempted the few dry
Seventh Fleet and elements of the spots. “Today . . . I lost the site of my con-
Third narrowly repulsed the Japanese valescent hospital to an air strip [sic],”
attack directed at the beachhead, complained Lt. Col. Paul O. Wells, MC,
wrecking much of the remaining the Base K surgeon, “and the site of a
strength of two enemy fleets. Ashore, 500 bed station [hospital] to an ord-
the Americans made progress, but won nance dump!” Ships piled up offshore;
no decision. Even though by 2 the Army Service Command found great
November they had secured four of difficulty in unloading one-third of the
Leyte’s five airfields and controlled the daily cargo it had anticipated; hospital
assemblies remained aboard, and the
9
Army Service Forces Monthly Progress Rpt, 31 May general hospitals, in particular, had trou-
45, sec. 7, pp. 18–19, Historians files; “Central ble marrying equipment to personnel.
Philippine Operation: Medical Aspects of Leyte-Samar The major exception, the 133d General
Campaign,” p. 5, file 370.2. Both in HUMEDS, RG 112,
NARA. See also “Navy Medical Department at War,” Hospital, arrived on 25 November
1:357, BMSA. aboard four LSTs; unit personnel carried
326 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
their own materiel ashore, set up the who instead recovered in distant New
hospital in the customary quagmire, and Guinea or Saipan. Indeed, by the time
opened for business the next day.10 some evacuees arrived at their destina-
But few had the happy experience of tion, they were fit to return to duty.12
traveling with their gear, and in general The medical problem for troops in
the Sixth Army’s experience with fixed the forward areas was defined by evacu-
hospitals in combat was not a happy ation more than by any other factor.
one. Some, working lamely with inade- Each corps was charged with evacuating
quate equipment, functioned far below casualties to the ships until such time as
their proper level. Many station hospi- the Sixth Army could assume responsi-
tals disappeared, merged with other bility (as matters turned out, 25 October
units, and few played significant parts in for the X Corps and 14 November for
the campaign. On the other hand, too the XXIV Corps). But as the fighting
few mobile hospitals had been provided. moved inland, transportation even to
On 24 November, thirty-four days after the forward hospitals grew more diffi-
the landing, only 2,400 beds were in cult. Jeep (1⁄4-ton) ambulances proved
operation out of more than 8,500 pre- useless in marshy areas, and too few of
sent on Leyte; on 29 December only the higher-built 3⁄4-ton ambulances and
4,900 of 11,800 were functional.11 tracked vehicles, such as Weasels, had
More than ever, the Army found itself been provided. Units working along the
depending upon the LSTs and other coasts were luckier; their wounded were
floating hospitals, which held the evacuated by landing craft or amphib-
wounded close to the fighting and pro- ians in comparative safety and much
vided them care the medical service greater comfort than those who had to
ashore could not always give. The dedi- traverse inland Leyte.
cated hospital ships served mainly to Nevertheless, soldiers wounded in the
evacuate casualties who could not be fighting on the west coast endured diffi-
treated adequately at Leyte. Praising the cult times. The whole island bulk lay
Navy, Hagins declared that, without its between them and the fleet in Leyte Gulf;
help, “the level of medical and surgical Japanese planes harried the 7th Division
care on Leyte would certainly have been and strafed the offshore craft as well. In
sub-standard.” The other effect of inad- the Ormoc corridor an Army surgeon
equate bed strength was to compel the saw a party of fifty casualties who had
evacuation of the lightly wounded, who been three days in transit without food.
ought to have been hospitalized on At night DUKWs carried some back to
Leyte and returned to their units but Baybay to receive emergency treatment
at an advanced aid station, set up by the
10
As quoted in Blanche B. Armfield, Organization and 7th Medical Battalion. Those who need-
Administration in World War II, Medical Department, ed hospital care had to be evacuated by
United States Army in World War II (Washington, D.C.: ambulance over the rough and twisting
Office of the Surgeon General, Department of the Army,
1963), p. 478. See also 133d Gen Hosp Quarterly Rpts road to Abuyog, a trip that usually lasted
(copies), Oct–Dec 44, pp. 1–2, and Jan–Mar 45, p. 1, file
319.1, HUMEDS, RG 112, NARA, and compare with sim-
12
ilar reports for the 44th, 49th, and 126th Gen Hosps. As quoted in Cannon, Leyte, p. 194. See also
11
“Central Philippine Operation,” pp. 1, 9, file 370.2, “Central Philippine Operation,” p. 9, file 370.2,
HUMEDS, RG 112, NARA. HUMEDS, RG 112, NARA.
LARGE-UNIT WAR: THE PHILIPPINES 327
two days. Not until early December did originally to fight on Yap, the XXIV
hospitalization become available on the Corps was short of supplies, as it was of
west coast and the long trip over the medical units generally. Anticipating a
mountains come to an end.13 sixty-day campaign, Sixth Army planners
Air evacuation got off to a slow start. provided the comprehensive list of med-
Enemy attacks slowed the improvement ical materiel needed in combat only for
of the Tacloban airfield, which Army that period; the troops actually carried
planners had expected to ready quickly much less, a five-day supply for the assault
for service. Evacuees awaiting flights units and a thirty-day supply for all oth-
piled up in air holding stations until 4 ers. Resupply was by medical mainte-
November. Thereafter a regular system nance units, which provided only some
developed; the wounded were routed 700 of the more than 3,000 items needed
through evacuation hospitals to air- for balanced operations.
fields, where C–54s loaded casualties Conditions at the beachheads compli-
from the XXIV Corps for the Marianas cated the picture. Heavy Japanese air
and C–47s those from the X Corps for strikes, including attacks from kamikazes,
SWPA bases. By Christmas almost 4,500 helped to disrupt and confuse unload-
had been evacuated by air, two-thirds to ing. Once on Leyte, enemy counterat-
POA bases (which may have reflected tacks, lengthening supply lines, and
the XXIV Corps’ poorer holding facili- floods and swollen streams made difficult
ties on Leyte). Only in the mopping-up the task of hauling food, ammunition,
phase of the campaign did the airfields and medicines to the troops inland.
at last begin to function as expected. When slow progress against the enemy
Then, with shipping diverted to other compelled General MacArthur to com-
battlefields, the planes began to carry mit first his reserve divisions and then
almost all of the remaining casualties of other units as well, the supply system was
Leyte’s last battles.14 obliged to support still more troops fight-
Supply, no less than evacuation, ing in ever more remote locations.
reflected not only the problems of a cam- Those in very isolated areas depend-
paign mounted from two different the- ed on airdrops. While some 70 tons were
aters but also the difficulties imposed by delivered in this way, and even delicate
the situation at Leyte itself. Intended items like bottled plasma and whole
blood generally survived, the problems
13
were evident. The 1st Cavalry Division,
Edmund G. Love, The Hourglass: A History of the 7th
Infantry Division in World War II (Washington, D.C.: fighting in the mountains between
Infantry Journal Press, 1950), p. 258; Surg, Sixth Army, Leyte and Ormoc Valleys, lived for a
Quarterly Rpt (copy), Oct–Dec 44, pp. 11–14, 19–20, time on short rations, as did Filipino
file 319.1, HUMEDS, RG 112, NARA.
14
OofSurg, USAFFE, ETMD (copy), 23 Dec 44, pp. guerrillas, who were operating as auxil-
11–12, file 350.05, HUMEDS, RG 112, NARA. For sum- iaries. A member of the 11th Airborne
mary accounts of evacuation, see Quarterly Rpts Division recorded that
(copies), Oct–Dec 44, file 319.1, loc. cit., for Surg, Sixth
Army; Surg, X Corps; Surgs, 77th and 96th Inf Divs; 36th
and 58th Evac Hosps; 1st Field Hosp; and 27th and 30th for many days, three men had only one K
Port Surg Hosps. See also Sixth United States Army, ration among them. . . . We were shorter of
“Report of the Leyte Operation, 17 October 1944–25 food than we had ever expected to be; our
December 1944,” pp. 262–64, U.S. Army Center of ammunition had to be counted by rounds
Military History Library (CMH–L), Washington, D.C. rather than by clips; we suffered awaiting
328 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
medical supplies from the skies which did tions along the coast. The paratroopers
not come; and we hated with a bitter hatred fighting in the mountains sought to rely
the gods that made the weather, the pilots on cub planes, which were fitted up as
who wouldn’t fly, and the powers that sent us
into the mountains in the first place.15 makeshift ambulances with sheets of ply-
wood and mattresses that bumped the
Such experiences notwithstanding, pilots in the nape of the neck during
most medical supply shortages, except flight. But such planes were too few, and
for isolated units, lasted only a few many wounded had to be held for days,
hours. Blood plasma, morphine or else littered by special teams over the
Syrettes, penicillin, and critical equip- mountains and through the jungles.16
ment were available in most cases where Despite many difficulties, reinforce-
they were needed. Ample quantities of ments were not the only good news for
most items had been shipped; most the invading forces that December. The
medical supplies were comparatively weather improved and unloading of the
light and could be delivered by persis- transports in Leyte Gulf proceeded.
tence or by a daring pilot in the neces- Many hospitals that had been mobile
sary quantities. But during the heavy only in theory at last became mobile in
fighting of the late autumn the supply fact, finally moving away from the sod-
lines became dangerously tenuous, a den bases where they had been detained
problem that could only be eased by an for so long by inadequate transport,
improvement in the tactical situation. heavy rain, and tactical stalemate. To
In December the 77th Infantry support the divisions on the west coast,
Division staged a new invasion. the 69th Field Hospital and the 165th
Supported by the 95th Portable Surgical Station Hospital moved to the Ormoc
Hospital, the unit landed almost unop- area, soon to be joined by the 645th
posed south of bomb-shattered Ormoc Medical Collecting Company. All were
on the west coast, splitting the enemy needed. Not only did the 77th Infantry
forces. In a foretaste of the battle for and 11th Airborne Divisions require
Manila, a fierce house-to-house battle support, but, once the pincers closed,
virtually destroyed what remained of the the X Corps as well began to send casu-
town. The northern and southern pin- alties down the valley from the north.
cers now closed on the Ormoc Valley, With transport functioning and the
where the Japanese made a desperate enemy confined to a shrinking region in
last stand. Jeep ambulances evacuated the west, other improvements in the sit-
most frontline stations, while artillery uation followed naturally. As hospitals
liaison planes served isolated areas. were able to deploy their expansion
Small boats evacuated from clearing sta- beds, fewer patients were lost to evacua-
tion from the island. Whole blood had
15
Quotation from Edward M. Flanagan, The Angels: A been available in sufficient quantities
History of the 11th Airborne Division, 1943–1946
(Washington, D.C.: Infantry Journal Press, 1948), p. 55.
16
On the supply situation, see Sixth Army, “Leyte Flanagan, Angels, p. 44; Surg, Sixth Army, Quarterly
Operation,” p. 264, CMH–L; Quarterly Rpts (copies), Rpt (copy), Oct–Dec 44, p. 20, file 319.1, HUMEDS, RG
Oct–Dec 44, for Surg, Sixth Army, pp. 36–37, Surg, X 112, NARA; [77th Division Association], Ours To Hold It
Corps, pp. 45–46, 56, and Surg, 7th Inf Div, p. 1, plus High: The History of the 77th Infantry Division in World
Jan–Mar 45, for 126th Gen Hosp, pp. 9–12, file 319.1, War II (Washington, D.C.: Infantry Journal Press, 1947),
HUMEDS, RG 112, NARA. pp. 148–59.
LARGE-UNIT WAR: THE PHILIPPINES 329
from the beginning of the campaign, copra. The war had brought the
but now began to arrive by air direct Japanese and, in the hills, quarrelsome
from San Francisco via Guam. Disease factions of guerrillas who seemed to
was not a serious threat on Leyte, for the hate each other more than the enemy.
island was not heavily malarial; the POA All had levied upon the people, a bur-
troops were not seeded with the disease; den that grew as more Japanese troops
and scrub typhus was adequately con- began to enter the island early in 1944.
trolled by the preventive measures With the American landings, small
worked out in earlier campaigns. Philippine civil affairs units (PACU),
Dengue rates were high, however, reach- which were attached to the Sixth Army,
ing 68 per 1,000 troops per year in the had begun to assume responsibility for
Sixth Army. Infectious hepatitis and their care, pending the reestablishment
schistosomiasis appeared, the latter for of a civilian government by the
the first time in the Southwest Pacific Philippine Commonwealth.18
Area, and an outbreak of amebic dysen- One of the most pressing needs was
tery raised medical concerns. But no for medical care, long neglected under
epidemics occurred, and the winding Japanese administration. Each 49-man
down of the fighting brought further Philippine civil affairs unit had a med-
improvement in a picture that was ical section of 1 officer and 5 enlisted
already comparatively bright.17 men, whose duty was to establish a func-
The winding down of the fighting tioning public health system in the
meant better days, too, for the hard- unit’s area of control—on average,
used civilian population of Leyte. A about 12 square miles. The medical offi-
poor people in the main, most of the cer set up quarantine procedures, pro-
915,000 inhabitants of the island had vided for malaria control, and launched
lived simply before the war in thatched an immunization program to protect
dwellings. They worked the fields, har- against cholera, smallpox, and other ill-
vesting rice, sugar cane, corn, and nesses, relying greatly on local civilian
doctors, nurses, and pharmacists. Most
17
CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 1, p. PCAU members were Filipinos, and
101, file 319.1–2; Surg, Sixth Army, Quarterly Rpt their work entailed coordination with
(copy), Oct–Dec 44, pp. 28, 33–34, file 319.1. Both in
HUMEDS, RG 112, NARA. See also Malcolm S. the Civil Affairs Section, Sixth Army; the
Ferguson and Frederik B. Bang, “Schistosomiasis,” in task force surgeon; and the representa-
Ebbe Curtis Hoff. ed., Communicable Diseases Transmitted tives of the civil government.
Through Contact or by Unknown Means, Medical
Department, United States Army in World War II But to expect so few to care for so
(Washington, D.C.: Office of the Surgeon General, many, in a war zone where fighting went
Department of the Army, 1960), pp. 65–72. The follow- on for months, was plainly unrealistic.
ing unit histories also proved useful in developing a pic-
ture of the campaign: Francis D. Cronin, Under the As a result, much of the burden fell on
Southern Cross: The Saga of the Americal Division the field forces, which alone had the
(Washington, D.C.: Combat Forces Press, 1951), pp. manpower and supplies to meet the
219–64; Orlando R. Davidson, J. Carl Willems, and
Joseph A. Kahl, The Deadeyes: The Story of the 96th Infantry
Division (Washington, D.C.: Infantry Journal Press,
18
1947), pp. 45–76; [77th Division Association], Ours To Cannon, Leyte, pp. 198–203; “Leyte: Historical
Hold It High, pp. 139–211; B[ertram] C. Wright, comp., Report of the 24th Infantry Division Landing Team, 20
The 1st Cavalry Division in World War II (Tokyo: Toppan October 1944–25 December 1944,” pp. 146–50,
Printing Co., 1947), pp. 71–100. CMH–L.
330 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
including 15,500 from Army ground the capital city of Manila. Secondary
troops alone, of whom 3,500 died. assaults, both airborne and amphibious,
Estimates of Japanese dead vary widely, were planned to keep the enemy off bal-
but apparently about 75,000 died, with ance, and Eichelberger’s Eighth Army
fewer than 1,000 taken prisoner.21 was to seize Mindanao and certain islands
In every sense Leyte was a major bat- in the central Philippines at the same
tle, which completed the ruin of the time. But Krueger’s Sixth Army, now
enemy’s fleet, decimated its remaining comprising the I and XIV Corps, was to
air force, and severely weakened its stage the invasion of Luzon from the
army forces defending the Philippines. north, and the effort would be a huge
But new tests for the victorious one, involving 191,000 troops in a flotilla
Americans lay ahead on Luzon. of 850 vessels. Preceded by the seizure of
sites for airfields on Mindoro Island,
Luzon which was defended only by Japanese air-
craft and a few ships, the landing on
The attack on Luzon aimed at Luzon was set for 9 January 1945.22
Lingayen Gulf, where the Japanese had
landed in their own invasion of 1941.
22
The reason was the same excellent Robert Ross Smith, Triumph in the Philippines,
United States Army in World War II (Washington, D.C.:
beaches, giving ready access to the Office of the Chief of Military History, Department of
Central Plains at whose southern end lay the Army, 1963), p. 29. Unless otherwise noted, the tac-
tical narrative on Luzon is drawn from this source. See
also Krueger, From Down Under to Nippon, pp. 211–19.
21
Quotation from CSurg, USAFWESPAC, Annual The Sixth Army’s I Corps comprised the 6th and 43d
Rpt, 1945, pt. 1, p. 11, file 319.1–2, HUMEDS, RG 112, Infantry Divisions; its XIV Corps, the 37th and 40th
NARA. Statistics from Cannon, Leyte, pp. 367–68. In late Infantry Divisions. The 25th Infantry Division, 11th
December enemy troops remaining on Leyte num- Airborne Division, 158th Regimental Combat Team,
bered about 15,000. See Stanley L. Falk, Decision at Leyte and 13th Armored Group were assigned to the Sixth
(New York: W. W. Norton, 1966), p. 312. Army reserve.
332 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Medical planning reflected the expe- 24th and 41st), the 135th Medical
rience, unity, and matured professional- Battalion, two amphibious companies of
ism of the SWPA system. Almost every the 4th Engineer Special Brigade’s
line unit could count on more medical 264th Medical Battalion, and a similar
support than ever before. Each division melange of smaller units. At army level
was backed up by its own organic units. the 135th Medical Group stood ready to
The I Corps possessed in addition three organize evacuation, once the head-
evacuation hospitals (the 29th, 54th, quarters came ashore and the battalions
and 92d), four field hospitals (the 5th, passed to the group’s control.
23d, 37th, and 43d), the 70th Medical Early evacuation and treatment of
Battalion, two amphibious companies casualties would again be the job of the
from the 3d Engineer Special Brigade’s Navy, which would provide eighteen
263d Medical Battalion, nine portable medically equipped LSTs, including six
surgical hospitals, and an array of sepa- with surgical teams on board—one to
rate collecting and ambulance compa- each invasion beach. After the beach-
nies, anti-malaria units, and a medical head had been won, the Army Service
supply platoon. Backing the XIV Corps Command would land with support that
were two large evacuation hospitals (the included depot companies, malaria sur-
7th and 21st), two field hospitals (the vey and control units, sanitary compa-
LARGE-UNIT WAR: THE PHILIPPINES 333
nies, a medical laboratory, a general dis- dezvous points, until the invasion fleet
pensary, and station hospitals. was over 40 miles in length.
Establishment of a new USASOS instal- As the ships entered Philippine
lation, Base M, would follow. The waters on 9 January, kamikazes dove out
prospect of good roads in the broad of cloud cover, smashing into vessels and
Central Plains of Luzon encouraged the sinking seventeen. Despite such harass-
provision of many ambulance compa- ment, the attack began as scheduled.
nies. The anticipated distances between The landing craft, after circling, formed
hospitals also caused planners to dedi- lines and then made for the shore. “I felt
cate three squadrons of radio-equipped as though I was going to take an impor-
L–5 artillery liaison aircraft to evacua- tant exam,” said Capt. George Sharpe,
tion. The engineers were instructed to MC, a battalion surgeon. “Shells were
build airstrips as requested by army, screeching overhead. . . . The boat
corps, and division surgeons. A few heli- struck the beach and we plunged for-
copters were also available, and would ward in water up to our waists.” Ashore,
do good service before the campaign resistance was light, and by nightfall
was over.23 some 68,000 troops had poured into a
Intelligently adapted to the changed beachhead 15 miles wide. The enemy
conditions of warfare, the medical plan kept up a harassing fire with artillery
featured an amplitude of forces unusual and mortars, causing light casualties,
for the Pacific—some 10,000 medics of who were quickly evacuated to the ships.
all sorts, more than the entire invasion Medical units gave most of their atten-
force in some lesser campaigns. By early tion to injured civilians. Again, as at
1945 the multiple commands of the Leyte, the limited resources of the
Pacific theaters and the widely separated Philippine civil affairs units obliged the
lines of attack were converging as field forces to care for hundreds of casu-
American forces neared the enemy alties from the first hours ashore.24
homeland. To assist the Luzon opera- Although the Japanese had withdrawn
tion, Admiral Nimitz supplied naval into the highlands, they represented an
forces; medical troops staged and implied threat to the landing area.
embarked from bases throughout the Hence, General Krueger sent the I Corps
South and Southwest Pacific Areas, into the hills, where stiff resistance from
some from as far away as New an enemy dug into a maze of ridges and
Caledonia. In the early days of the new ravines caused 200 battle casualties a day.
year troopships moved toward the ren- Moving the wounded to treatment
entailed long litter hauls over treacher-
23
ously steep hills, bare along the ridge
CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 1, pp.
17, 40, file 319.1–2; Quarterly Rpts (copies), Jan–Mar lines but thick with rainforest in the inter-
45, for Surg, Sixth Army, pp. 9–10, 135th Med Group,
pp. 2, 5–7, and Surg, I Corps, p. 36, file 319.1; “Seventh
24
Amphibious Force Command History, 10 January Quotations from George Sharpe, Brothers Beyond
1943–23 December 1945,” pp. 71–72, file 314.7 (7th Blood: A Battalion Surgeon in the South Pacific (Austin,
Amphibious Force) SWPA. All in HUMEDS, RG 112, Tex: Diamond Books, 1989), p. 115. See also Surg, Sixth
NARA. See also “Navy Medical Department at War,” Army, Quarterly Rpt (copy), Jan–Mar 45, pp. 10–12, file
1:375–76, BMSA; Sixth United States Army, “Report of 319.1, HUMEDS, RG 112, NARA; “Navy Medical
the Luzon Campaign, 9 January 1945–30 June 1945,” Department at War,” 1:374–78; Krueger, From Down
3:56, 155–56, CMH–L. Under to Nippon, pp. 225–27.
334 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
vening valleys. Weary litter-bearers were The main injuries were incurred in
supplemented with Filipinos and marching; medics doctored hundreds of
infantrymen pulled from the line. Medics bruised and blistered feet. Some divi-
used metal litters welded to ordinary sions outran their hospitals, which
ones as sleds for moving casualties down proved to be less mobile in fact than in
slopes and Stokes litters, secured to cable name; evacuation hospitals sometimes
systems, for crossing over precipitous val- bypassed the field hospitals that they
leys. To the rear of the collecting compa- were supposed to back up. Divisional
nies, Sixth Army ambulances carried the units and portables hugged the moving
wounded back over freshly bulldozed front, leapfrogging when necessary to
roads to mobile hospitals at San Fabian keep up. Coordinated by the 135th
(Map 13). On 15 January the Sixth Army Medical Battalion, evacuation was swift
surgeon assumed control of the medical and smooth, and ambulances surpassed
service ashore, and the 135th Medical previous SWPA experience both in num-
Group began to coordinate both on- and bers and in ease of operation.
offshore evacuation, including beach But as the distance from the hospitals
clearing stations and holding units at and the Lingayen base increased—by
airstrips. Three days later air evacuation the end of January one field and four
to Leyte commenced, using C–47s that evacuation hospitals were operating 120
departed from an airstrip at Magdalan.25 miles from the beach and the ASCOM
Meanwhile, the XIV Corps pushed hospitals there—air evacuation became
south with deliberate speed through the a necessity. By now the XIV Corps was
Central Plains toward Clark Field and fighting its first serious battle of the
Manila. Except for small delaying forces, campaign, around Clark Field and Fort
the enemy was absent. The countryside Stotsenburg, where some 30,000
featured broad flatlands, good roads, Japanese struggled fiercely to hold onto
and fields of rice dotted with small the complex. Ambulance hauls were too
towns and hamlets. The cultivated land- long; serious surgical cases needed
scape spoke of long human residence, quicker treatment. In early February
and a medical officer, driving down a Hagins, who recently had been promot-
concrete road, marveled: “It does not ed to brigadier general, ordered his
seem possible that it is the same war that small planes into service. They were
was being fought in New Guinea. The more than ever necessary, because by
medical support is in no way similar. then the battle for Manila had begun.27
Here advancement has been speedy and
one has had civilized communities to Manila
deal with all along the way.”26
While two divisions—the 37th
Infantry and 1st Cavalry—moved against
25
OofSurg, USAFFE, ETMD (copy), 20 Apr 45, pp. Manila, supported by three evacuation
55–57, file 350.05; Quarterly Rpts (copies), Jan–Mar 45,
for Surg, Sixth Army, pp. 11–17, Surg, 43d Inf Div, p. 4, hospitals, two Eighth Army elements
and Surg, 25th Inf Div, pp. 1–4, file 319.1. All in also invaded Luzon. On 28 January the
HUMEDS, RG 112, NARA. See also Sixth Army, “Luzon
Campaign,” 3:156–57, CMH–L.
26 27
29th Evac Hosp Historical Rpt, 6 Feb 45, p. 3, file Sixth Army, “Luzon Campaign,” 3:157, CMH–L.
319.1–2, HUMEDS, RG 112, NARA. Hagins was promoted on 4 January 1945.
Aringay Baguio
SIXTH ARMY MEDICAL SUPPORT
LUZON
13 January 1945
XXX Corps Boundary
ELEVATION IN FEET
Rosario
L I N G AY E N
GULF
70th Medical Battalion
263d Medical Battalion(-)
San
Fabian
Bayambang
R
i
v
e
r
MAP 13
336 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
XI Corps landed on the west coast near In the city itself a month of pitiless
Subic Bay, with five hospitals in support, combat left the 20,000 defenders and
and headed inland to seal off the Bataan 100,000 civilians dead, either massacred
Peninsula; two days later elements of the by the Japanese or killed by American
11th Airborne Division landed south of artillery. Strange scenes were recorded
the capital city and advanced swiftly in a city where liberation and destruc-
north. The Manila Naval Defense Force, tion arrived hand in hand. A medical
against the orders of the Japanese Army administrative officer found crowds cele-
commander, prepared to defend to the brating their deliverance while the city
death the objective of these converging burned: “It was about 2100 hours. The
forces.28 further we got into the town the more
Once known as the pearl of the brilliant was the orange illumination.
Orient, Manila, with its population of Crowds of people lined the streets. From
about 1 million, sprawled over 100 the balconies flags were draped. . . .
square miles, bisected by the Pasig Behind this scene of ‘victory’ the masses
River. To the north lay important of giant flames rose high. The streets
American objectives, including Santo were as brilliantly lit by the reflection as
Tomas University and Old Bilibid, Times Square in peace time [sic].”30
where thousands of Allied captives were While the battle raged, the medics
confined, while to the south lay the res- had three basic duties—to support the
idential and business districts and the attackers, to assist the innumerable civil-
magnificent 400-year-old walled city ian victims of the fighting, and to aid the
called Intramuros. As the XIV Corps liberated prisoners, whose condition
approached, the defenders blew up was fragile at best. The divisions in
bridges and set whole sections of the Manila, besides their organic units, were
city ablaze. On 4 February the backed up by three evacuation and two
Americans entered Manila, liberating field hospitals, plus separate collecting
1,275 captives at the prison as flames and clearing companies and parts of two
threatened to envelop it, and on the medical battalions. Portable surgical
next day a dash by the 1st Cavalry hospitals moved frequently, some set-
Division liberated 2,500 internees at the ting up in as many as six locations to
university as well. Finally, on the twenty- keep abreast of the fighting.
third 11th Airborne Division paratroop- The services of all units were badly
ers, accompanied by a medical officer needed. When the 37th Division stormed
and several aidmen, jumped into the the Legislative Building, the clearing sta-
prison camp south of Los Banos to res- tion of the 112th Medical Battalion
cue the prisoners.29 became a “Grand Central of unloading
ambulances, badly wounded soldiers,
28
On the Eighth Army’s contribution to the Luzon
campaign, see John F. Shortal, Forged By Fire: General
30
Robert L. Eichelberger and the Pacific War (Columbia, S.C.: Quotation from 29th Evac Hosp Historical Rpt, 6
University of South Carolina Press, 1987), pp. 105–13. Feb 45, p. 6, file 319.1–2, HUMEDS, RG 112, NARA.
After landing, the XI Corps came under the Sixth See also Krueger, From Down Under to Nippon, pp.
Army’s control. 235–70; Stanley A. Frankel, The 37th Infantry Division in
29
Surg, 11th Airborne Div, Quarterly Rpt, Jan–Mar World War II, ed. Frederick Kirker with John MacDonald
45, pp. 1–3, HUMEDS, RG 112, NARA; Flanagan, (Washington, D.C.: Infantry Journal Press, 1948), pp.
Angels, p. 89. 291–96; Wright, comp., 1st Cavalry Division, pp. 125–40.
LARGE-UNIT WAR: THE PHILIPPINES 337
inhabited marble halls and airy, spacious By mid-February the Japanese were
rooms, patients and staff alike lacked confined to areas south of the Pasig.
such essentials as water and workable toi- Progress in the fighting throughout
lets—as did everyone in Manila.32 Luzon was reflected in the establishment
The other medical workhorses of the of the Luzon Base Section in the capital
battle for Manila were the separate city. A USASOS unit, the section used its
clearing companies. Soon after 21st Evacuation Hospital to provide addi-
American forces entered the capital, the tional medical support. Opening at New
893d Medical Clearing Company moved Bilibid, 20 miles south of Manila, the
with PCAU 5 to Santo Tomas. Unlike hospital first served internees from Los
other prisoners, who had been quickly Banos, but later began to take battle
evacuated from camps endangered by casualties from divisions fighting in
the fighting, internees here remained southern Luzon. Casualties from the
on the university grounds. The clearing 11th Airborne Division also were treated
company set up a small hospital in the by the 41st Field Hospital, which worked
Education Building and received its first in Manila at Quezon City; and the 5th
patients the evening of 6 February. Field Hospital took over from a clearing
While the Philippine civil affairs unit company at Old Bilibid, treating a mixed
provided the first decent meal tasted by array of Allied nationals and American
the prisoners in many months, the Army nurses lately released, plus many
medics worked with patients who were Filipino civilians.34
profoundly malnourished and suffered Comparison is inevitable to condi-
from deficiency diseases, including tions in conquered Germany a month or
scurvy. Enemy shells fell on the universi- two later. There the high numbers of
ty, frightening away potential civilian recovered military prisoners, slave labor-
laborers, though casualties from street ers, and concentration camp inmates
fighting just outside the compound burdened the medical system greatly
were carried in for emergency treat- after the fighting had slacked off and
ment. Latrines were not functioning, the number of wounded had fallen. In
because the city water supply had failed. the smaller foretaste at Manila, however,
Garbage and debris littered the severe fighting coincided with the recov-
grounds, and clearing company drivers ery of prisoners and the heaviest casual-
trucked it away themselves, risking ties among friendly civilians in the
death in the streets during return jour- Pacific war. American medical facilities
neys with water and food.33 were hard put to handle the burden,
although assistance from Filipino health
32
care workers of all sorts provided early
Rpt (copy), CO, 71st Evac Hosp, 11 Aug 45, sub:
History of the 71st Evacuation Hospital, 11 January and welcome assistance, and evacuation
1945–30 June 1945, pp. 1–5, file 319.1; Quarterly Rpts removed many military casualties from
(copies), Jan–Mar 45, for 29th Evac Hosp, pp. 1–2, and the scene. The most difficult days came
54th Evac Hosp, pp. 1–4, file 319.1; Rpt, Capt David G.
Asherman, Med Dept Info Svc Field Off, OofCSurg,
USASOS, 17 Feb 45, sub: Report of Activities—Manila,
34
pp. 1–12, file 370 (Manila). All in HUMEDS, RG 112, See Quarterly Rpts (copies), Jan–Mar 45, for 21st
NARA. Evac Hosp, pp. 2–3, 41st Field Hosp, pp. 1–2, 5th Field
33
893d Med Clearing Co Quarterly Rpt, Jan–Mar 45, Hosp, pp. 1–2, and Surg, Sixth Army, pp. 20, 23, 26, file
pp. 1–2, file 319.1, HUMEDS, RG 112, NARA. 319.1, HUMEDS, RG 112, NARA.
LARGE-UNIT WAR: THE PHILIPPINES 339
WARD OF THE 49TH GENERAL HOSPITAL, set up in the Manila Jockey Club
in March, when the Leyte hospitals were Medical Collecting Company worked
full and some of the Sixth Army installa- both at the Rosales strip in the city,
tions were “filled far beyond their rated where L–5s landed, and at the Quezon
capacity.” But that month, too, brought City strip northeast of the capital, used
the end of fighting in Manila and the by C–47s to evacuate from Luzon. For a
beginning of reconstruction.35 time the 264th Medical Battalion operat-
Moving the wounded out of the city ed a convalescent hospital in a battered
was primarily the job of the separate col- tuberculosis sanitarium; late in February
lecting companies and amphibious med- the 227th Station Hospital took over, and
ical battalions, which maintained the the battalion moved to the Quezon
holding stations at airstrips from 8 airstrip to take on evacuation duties
February, when air evacuation from the there. The arrival of the 49th General
capital region began. Thus the 409th Hospital on 1 March, however, signaled a
new stage in the treatment of casualties
35
Sixth Army, “Luzon Campaign,” 3:158, CMH–L. at Manila, where the end of the battle
The peak in evacuations on and from Luzon came in initiated the transformation of the dev-
April, in response to rapidly increasing numbers of dis- astated city from battleground to base.36
ease victims and fresh battle casualties from the moun-
tains. On conditions in conquered Germany, see
36
Graham A. Cosmas and Albert E. Cowdrey, The Medical See Quarterly Rpts (copies), Jan–Mar 45, for Surg,
Department: Medical Service in the European Theater of Sixth Army, p. 23, 409th Med Collecting Co, p. 2, 49th
Operations, United States Army in World War II Gen Hosp, pp. 2–3, 227th Sta Hosp, pp. 1–2, and 264th
(Washington, D.C.: U.S. Army Center of Military Med Bn, pp. 1–2, file 319.1, HUMEDS, RG 112, NARA.
History, 1992), pp. 550–78. See also Sixth Army, “Luzon Campaign,” 3:158, CMH–L.
340 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
on the vehicle’s armor, ran it from the 150 American wounded, and a medical
beach along a winding road and over officer admitted: “As soon as I got all the
unsafe bridges to reach Topside, a casualties off, I sat down on a rock and
plateau 400–500 feet above Manila Bay. burst out crying. I couldn’t stop myself
Then they made the trip again for water, and didn’t even want to. I had seen
counting 200 bullet scars on the steel more than a man could stand and still
when the second trip was done.40 stay normal. . . . When I had the cases to
Utilizing underground passageways, care for, that kept me going; but after
the Japanese infiltrated at night, retak- that it was too much.”41
ing positions they lost during the day. In ten days of battle the Americans
But the Americans made progress in a suffered more than 1,000 casualties,
punishing contest, dynamiting tunnel including 210 killed. The 18th Portable
entrances and calling in napalm and Surgical Hospital received a well-earned
artillery strikes on the defenders. As Presidential Unit Citation. Over the rub-
their losses mounted, the Japanese ble flew the American flag, not quite
resorted to their usual suicide tactics. A three years after it had been lowered in
fierce counterattack in the predawn surrender. The other fortified islands in
hours of 19 February was followed by Manila Bay fell soon after Corregidor. In
scattered banzai charges that cost them this mostly symbolic victory for the
heavily. Another 40 killed themselves by Americans, 4,500 Japanese died and 20
blowing up an ammunition dump, send- surrendered.42
ing a score of American casualties into
the portable with severe blast injuries. The Mountain Campaigns
Worse was to come.
On 26 February, a little before noon, Yamashita’s decision to withdraw his
the Japanese detonated an under- main forces to the mountains of Luzon
ground arsenal at Monkey Point “amid meant, paradoxically, that some of the
scenes of carnage on both sides.” A mile hardest fighting followed attainment of
away one soldier was hurt by falling the campaign’s main strategic objec-
debris; flying rock struck a destroyer tives. The medical problem on Luzon
2,000 yards offshore. “Bits and pieces of now resolved itself into aiding the con-
American and Japanese troops splat- struction of bases—MacArthur planned
tered the ground; rock slides buried airfield complexes in the north and a
alive other men of both forces.” Medics major hospital center and a landing
worked for nearly two hours to clear the craft assembly plant on Batangas Bay,
south of Manila—while providing sup-
40
port for the fighting units. Meanwhile,
Rpt, Capt Robert M. Atkins, Supply Off, 503d RCT,
3 Mar 45, sub: Historical Record of Regimental Supply the Sixth Army’s fighting forces were
Section, 503d Regimental Combat Team, From 16 reduced, not only by the demands for
February to 2 March 1945, pp. 1–2, file INRG–503–4 manpower to construct and defend new
(503d Prcht Inf Regt—S4 Rpt, Corregidor, 16 Feb–2
Mar 45), box 21305, Entry 427, RG 407, NARA; bases but also by a shift of emphasis
Quarterly Rpts (copies), Jan–Mar 45, for Surg, Sixth
Army, p. 22, and 18th Port Surg Hosp, pp. 3–6, file
41
319.1, HUMEDS, RG 112, NARA; Krebs, Children of Smith, Triumph in Philippines, pp. 346–48 (quota-
Yesterday, pp. 352–53; McGowan, “Eighth U.S. Army,” in tions).
42
Carter, ed., Surgical Consultants, 1:571–72. Ibid., pp. 349–50.
LARGE-UNIT WAR: THE PHILIPPINES 343
that reached 100 miles, through the val- depot. The fate of the enemy wounded,
ley and over Balete Pass to the 36th meanwhile, was grimly symbolized in
Evacuation Hospital. As soon as possi- the discovery of 200 dead Japanese in
ble, air evacuation began at captured two Bayombong school buildings that
airfields, the first opening on 15 June. had been used as hospitals. All had been
Large enough for C–47s and C–54s, the killed by their own comrades to prevent
three fields seized during the month them falling into the hands of the
quickly took the place of the long trek Americans.46
through the pass. Field hospitals, too, The main feature in easing the Allied
moved into the valley; the 91st set up in medical burden was the rapid collapse
mid-June at Bayombong and the 43d at of organized resistance in the lowlands.
Cauayan, only two days after the infantry Neither the main forces in the Cagayan
passed through. By the end of the Valley, nor a task force operating on the
month the 43d relocated to the town of
Tuguegarao, now the medical center of 46
Surg, 37th Inf Div, Quarterly Rpt, Apr–Jun 45, p. 4,
the valley, with an airfield, the advance file 319. 1, HUMEDS, RG 112, NARA. In loc. cit., see
also similar reports for 70th Med Bn, 424th Collecting
headquarters of the 70th Medical Co, 637th Clearing Co, 43d and 91st Field Hosps, and
Battalion, and a growing medical supply 24th Port Surg Hosp.
LARGE-UNIT WAR: THE PHILIPPINES 347
northwest coast to cut off Japanese dled cases back to the units responsible,
escape routes, nor airborne troopers and provided correction on the spot.47
who dropped near Aparri at the point The change in the character of the
where the valley exits to the sea, suffered fighting, however, raised questions about
heavy battle casualties. Guerrillas some traditional ways of doing things.
cleared the coast, and the troopers met The jeep ambulance, essential in most
only a few enemy stragglers, as the Pacific campaigns to date, proved to be
Japanese withdrew into the mountains inferior to the light plane in the moun-
to continue resistance there. tains and less useful than the convention-
As a whole, the Luzon campaign illus- al ambulance in the Central Plains of
trated how well the medical service per- Luzon, where roads were good. The
formed in the most diverse struggle of greatest change, however, was the declin-
the Pacific war to date. Serious deficien- ing usefulness of the portable surgical
cies in care occurred along the front hospital, hitherto a key unit in the Pacific
lines, in large part because of the diffi- fighting. Wherever the ground was open,
culty of reaching casualties quickly. But the portables lost much of their reason
the characteristics of the Luzon cam- for being. As the surgeon of the 24th
paign were the size of the forces Division remarked, they were “difficult to
engaged and the fierce continuous fit into the chain of evacuation,” and he
fighting. Hence, the most important combined his two portables to form an
aspect of medical care was the effective- extra clearing platoon. In the Central
ness of surgery, and this might best be Plains many portables served as surgical
measured by the incidence of gas gan- teams attached to the collecting compa-
grene infection—one half of 1 percent nies of medical battalions.48
on Luzon as against 1 percent on Leyte. Perhaps traditions formed in earlier
The influence of the chief surgeon campaigns were part of the problem.
was an important factor. Denit pulled Accustomed to attempt daring proce-
surgical teams, each consisting of one dures, surgeons in portables had trouble
general surgeon, one orthopedist, and adjusting to a more normal situation,
six surgical technicians, from the gener- where they did only emergency stabiliz-
al hospitals and assigned them to the ing procedures and sent their patients
field and evacuation hospitals to to larger hospitals for definitive care.
improve the caliber of surgery near the Yet, in remote jungled regions, the
front. Abundant supplies of penicillin, portables continued to serve admirably
plasma, and whole blood—25,000 pints,
including some from the United States
47
by way of the Navy’s blood bank on Rpt, Trimble, 25 Dec 45, pp. 25–28; Rpt, Lt Col
Frank M. Glenn, MC, OofCSurg, USASOS, n.d., sub:
Guam—were received. Surgical consul- Notes on Surgery in the Forward Area of the Southwest
tants worked effectively, visiting field Pacific, p. 10. Both in Historians files, HUMEDS, RG
units to provide instruction and control- 112, NARA. See also Douglas B. Kendrick, Blood
Program in World War II, Medical Department, United
ling the assignment of specialists. States Army in World War II (Washington, D.C.: Office
Finally, light-plane evacuation had obvi- of the Surgeon General, Department of the Army,
ous significance for speedy surgical 1964), pp. 618–22.
48
“Leyte: Historical Report of 24th Infantry Division,”
intervention and hence for reduced risk pp. 134–35 (quotation, p. 134), CMH–L; Rpt, Glenn,
of infection. Consultants traced mishan- n.d., p. 10, Historians files, HUMEDS, RG 112, NARA.
348 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
as independent units, operating in the Sea evacuation was in the hands of the
kind of terrain they were designed for. two medical battalions, the 263d and
As late as May 1945, officer and enlisted 264th. Working through liaison person-
medics backpacked equipment to per- nel in hospitals and holding stations, the
form major surgery on a five-day’s walk battalions evacuated the seriously ill and
into the mountains of Luzon.49 wounded to Leyte and, when hospitals
Despite all obstacles, evacuation both there were full, to Biak. Hospital LSTs
on and from Luzon was an overall suc- and medically equipped APAs and hospi-
cess. The struggles of the litter-bearers tal ships carried them on slow journeys;
on mountain trails demonstrated that, increasingly, however, airplanes made
as ever, the first step was the hardest. similar trips with greater speed. In either
Once off the line, however, the wound- case, the basic organization of the
ed were moved with speed and skill. effort—liaison personnel, holding sta-
Under the 135th Medical Group, four tions, medical battalions—was the same.
medical battalions—the 70th, 135th, Of the 37,716 casualties removed from
263d, and 264th—played key roles. At Luzon between 9 January and 30 June
the corps level, they provided coordina- 1945, 25,761 or 68 percent traveled by air
tion and liaison among ambulance com- and 11,955 or 32 percent by water. Both
panies, collecting companies, and air forms of evacuation declined after May, as
and sea holding stations. the growth of hospital complexes in the
Air evacuation had never been more Philippines allowed more cases (even the
important. More helicopters might have more serious ones) to be retained there.51
made a significant contribution, but as
matters stood the single-engine L–5s The Reconquest Completed
remained the most important device for
transporting the casualty to the surgeon, While the Luzon campaign raged to
especially in rough and jungled terrain. the north, the soldiers of General
Ambulances and aircraft made more Eichelberger’s Eighth Army moved
than 160,000 trips with casualties— rapidly to open the sheltered water
ambulances, 130,000; C–47s, 12,000; route through the islands to the south.
L–5s, 18,000; and C–64s, 1,100. (Many His veterans conquered the islands of
of these trips, of course, carried the Palawan, Panay, Negros, Cebu (where
same evacuees on different legs of their fighting was especially bitter), and
journey.) Small planes were important, Bohol, as well as the Zamboanga
not only for moving the sick and wound- Peninsula of the primitive southern
ed to hospitals but also for redistribut- island of Mindanao. The campaigns
ing them to installations with available were marked by speed, tactical skill, and
beds and to facilities with specialists comparatively low casualties. However,
skilled in handling particular injuries.50 when the Eighth Army launched a drive
49 51
Rpts, Trimble, 25 Dec 45, pp. 26–27, and Glenn, n.d., See Quarterly Rpts (copies), Jan–Mar 45, for Surg,
pp. 10–11, Historians file, HUMEDS, RG 112, NARA. Sixth Army, pp. 34–35, 135th Med Group, pp. 5–8, 54th
50
M. J. Musser, Jr., and Emmett C. Townsend, “Use of Evac Hosp, p. 2, and Surg, I Corps, pp. 34–35; ibid.,
Small Air Planes for Medical Evacuation on Luzon,” Apr–Jun 45, for 70th Med Bn, pp. 3–6, 135th Med
Bulletin of the U.S. Army Medical Department 4 (Aug 45): Group, pp. 1–4, and Surg, Sixth Army, pp. 4, 25–26, and
191–96. an. 2. All file 319.1, HUMEDS, RG 112, NARA.
LARGE-UNIT WAR: THE PHILIPPINES 349
But land evacuation, from the 24th and de facto hospitals, and portables again
31st Division units advancing across the became holding units—as they had on
interior, was marked by all the scenes of New Guinea—keeping the wounded for
exhaustion, tedium, and danger of the as much as two weeks. Though battle
earlier Pacific battlefields. Distances casualties began to fall off after 10 June,
were long, roads poor, bridges blown, when effective Japanese resistance
with the terrain changing to a series of ceased, medical cases mounted rapidly
steep ridges that had narrow and wind- and refilled the beds vacated by the
ing paths in dense jungle growth. As the wounded.54
downpours of May swelled streams and
brought rivers above their banks, the
54
wounded moved by small boat, by Surg, Eighth Army, Annual Rpt (copy), 1945, encl.
9, pp. 4–5, file 319.1–2; Quarterly Rpts (copies),
artillery caterpillar and trailer, and by Apr–Jun 45, for Surg, X Corps, pp. 2–3, 8–9, Surg, 24th
water buffalo. Many medics believed that Inf Div, pp. 3–4, 26, 30th Evac Hosp, p. 2, and 99th Evac
only the L–5 kept the system working. Hosp, pp. 7–9, file 319.1. All in HUMEDS, RG 112,
NARA. See also “Report of the Commanding General,
Nevertheless, despite all efforts, col- Eighth Army, on the Mindanao Operation,” pp.
lecting companies often had to serve as 162–64, CMH–L.
LARGE-UNIT WAR: THE PHILIPPINES 351
55 56
On preventive neuropsychiatry, see, for example, Quarterly Rpts (copies), Apr–Jun 45, for Surg,
Surg, 41st Inf Div, Quarterly Rpt (copy), Jan–Mar 45, Sixth Army, p. 22 (quotation), and Surg, X Corps, pp.
pp. 10–15, file 319.1, HUMEDS, RG 112, NARA. 6–7, file 319.1, HUMEDS, RG 112, NARA.
352 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Preventive medicine, facing conditions the numbers of both wounded and sick
that were partly primitive, partly urban, declined sharply, as the Philippine bat-
and wholly disordered by war, regressed tleground became a staging area for the
even as surgery and evacuation had an invasion of Japan.58
excellent record.57 Amid the scenes of victory and recon-
General MacArthur declared the struction, the tragedy of Bataan and the
Mindanao campaign over on 20 June medical disasters of the early years of
and, ten days later, the Luzon campaign. the war in the Philippines faded from
The Eighth Army inherited the mop- view. And yet from guerrillas and liber-
ping up on Luzon, which proved to be a ated prisoners Americans were learning
formidable task against mountain much about the struggle to survive that
redoubts defended by so able a tactician had gone on behind enemy lines—and,
as General Yamashita. Commenting on in areas controlled by the Japanese, still
what he called the “illegitimate child continued. While the medical establish-
known as ‘mopping-up,’” Eichelberger ment of the armed forces had been
had remarked at Leyte: “The only differ- growing to unprecedented size and
ence between a big fight and mopping- sophistication, medicine of the most
up is that when victory is obtained primitive sort had often been the sole
nobody can call it that.” Nevertheless, reliance of Allied personnel under
enemy control.
57
Surg, Sixth Army, Quarterly Rpts (copies), Jan–Mar
58
45, pp. 21, 28–33, and Apr–Jun 45, pp. 20–25, file 319.1, Jay Luvaas, ed., Dear Miss Em: General Eichelberger’s
HUMEDS, RG 112, NARA. Despite the similar environ- War in the Pacific, 1942–1945 (Westport, Conn.:
ment, the Eighth Army’s record was better than the Greenwood Press, 1972), p. 172. A brief account of the
Sixth’s because its campaigns were shorter and enemy development of the Philippines as a medical center for
resistance was less intense. the western Pacific will be found in Chapter XIII.
CHAPTER XI
disorder of the time, helping themselves States had guaranteed the postwar inde-
to food and women by using their pendence of the Philippines, Americans
weapons in the anarchy that followed were able to stand apart from the struggle
the breakdown of the colonial adminis- of factions and individuals for power.
tration. The first coherent bands Many possessed useful military and orga-
emerged for reasons that the founders nizational skills. Colonel Fertig was a min-
of feudal Europe would have under- ing engineer who had come to the island
stood—the need to establish local secu- during the thirties. Firm, aloof, with a
rity, to obtain food, or to settle grudges.4 gray-streaked red goatee that became his
Some Americans emerged as leaders trademark, he proved able to master dif-
of these groups. Because the United ficult logistical and administrative prob-
lems. As he began to consolidate the
4
resistance, soldiers “sick from malaria,
Quotation from John Keats, They Fought Alone, (New
York: J. B. Lippincott Co., 1963), p. 77. See also Larry A. hunger and exposure, were drawn to the
Schmidt, “American Involvement in the Filipino beacon” of his leadership.5
Resistance Movement on Mindanao During the
Japanese Occupation, 1942–1945” (M.A. thesis, U.S.
5
Army Command and General Staff College, Fort Schmidt, “Resistance Movement on Mindanao,” p.
Leavenworth, Kans., 1982), pp. 74, 79, copy in CMH–L. 92, copy in CMH–L.
356 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
At first almost ignored by the cine and damn few surgical tools. . . .” A
Japanese, the guerrillas under Fertig’s single trained Filipino surgeon practiced
leadership developed an impressive orga- on Mindanao, but equipment was not to
nization. Administrative districts were set be had. Lt. Jack Hawkins, USMC, who
up, each with a controlling military unit; escaped from the Davao Penal Colony
civil government was reestablished and and joined the guerrillas, later recalled
civil law prevailed, subject to military law that maintaining the health of his sol-
in case of conflict. Soon more than 90 diers was a problem “impossible of solu-
percent of Mindanao had become, in tion. . . . I remember one poor fellow
effect, an Allied enclave behind enemy who came to our headquarters with his
lines. General Headquarters, SWPA, esti- right arm black to the shoulder with gan-
mated a force of about 38,000 guerrillas grene. Doc Munoz, our guerrilla sur-
under Fertig’s command, plus seventy geon had to remove it. There was no
radios and four airfields, and in February anesthetic.”7
1943 recognized his organization as the Fortunately, during much of the occu-
10th Military District. In 1944 Mindanao pation, fighting was at a minimum, for
became a focal point for the distribution the guerrillas, in line with SWPA policy
of supplies to guerrillas on the northern that desired intelligence above all,
islands. sought to evade rather than engage the
Fertig’s staff was elaborate, with G–1 Japanese. As the threat of an American
through G–5 sections, and an adjutant invasion grew, however, the Japanese
general, an engineer, a quartermaster, garrison lost its tolerance of the guerril-
and a signal officer. His medical organi- las and launched campaigns to extermi-
zation, on the other hand, was loose. nate them. Enemy pressure then com-
Filipino doctors were awarded officer pounded all the medical problems that
rank, and each continued to work in his were rooted in the environment of
own district; small hospitals were estab- Mindanao.
lished in secure areas to handle severe Disease was pervasive, especially vivax
cases. Many people under Fertig’s con- malaria, which affected virtually the
trol continued, as in the past, to depend entire organization to some degree. The
largely upon practicantes, irregular heal- guerrillas controlled the Del Monte
ers that an American called “the local Plantation, where the director of
witch doctors.”6 forestry in the prewar government had
Even trained physicians had little to planted 11 million cinchona trees.
work with. One of Fertig’s subordinates Fertig’s men boiled cinchona bark or
termed a field hospital “just a quiet place
to die, because there’s almost no medi- 7
First quotation from Keats, They Fought Alone, p. 205.
Keats’ book is informative but not strictly history; though
6
Quotation from Interv (telephone notes), Albert E. composed with Fertig’s assistance, and perhaps based
Cowdrey with James L. Evans, MD, 18 Aug 89, upon his unpublished memoirs, it contains lengthy con-
Historians files, Historical Unit Medical Detachment versations that apparently were made up either by Keats
(HUMEDS), RG 112, NARA. See also GHQ, FEC, or by Fertig himself and may or may not represent what
“Guerrilla Resistance Movement,” vol. 1, pt. 1, p. 85, was actually said at the time. However, in Interv, Cowdrey
CMH–L; M. Hamlin Cannon, Leyte: Return to the with Evans, 18 Aug 89, Historians files, HUMEDS, RG
Philippines, United States Army in World War II 112, NARA, Evans termed it substantially accurate.
(Washington, D.C.: Office of the Chief of Military Second quotation from Jack Hawkins, Never Say Die
History, Department of the Army, 1954), p. 16. (Philadelphia, Pa.: Dorrance and Co., 1961), p. 167.
BEHIND THE LINES 357
ground it into powder to make a pill— might be. Submarines also took chroni-
primitive expedients, and not very effec- cally sick Americans to Australia, per-
tive. More dangerous to life were respi- haps the most tenuous evacuation route
ratory diseases. Influenza was a common of the Pacific war.9
illness, and the pneumonia that fol- A submarine also brought Fertig, in
lowed it frequently fatal; tuberculosis November 1943, the man who was to be
was widespread and life-threatening. his friend, housemate, and force sur-
Guerrillas in flight from Japanese geon until early 1945. Capt. James L.
patrols treated their own injuries as best Evans, MC, was the stock record officer
they could, using picric acid from the at the 3d Medical Supply Depot in
detonators of Japanese mines on tropi- Brisbane when he joined the staff of
cal ulcers. Scarcely believable stories SWPA’s Allied Intelligence Bureau as
were told of some desperate expedi- medical adviser. A 32-year-old general
ents—an Australian named Jock practitioner, and a ham radio operator
McLaren, for example, performed an by hobby, he selected and forwarded
appendectomy on himself with only a medical supplies to guerrilla units, until
mirror and a razor blade; five days later his varied talents caused Brig. Gen.
he escaped a Japanese patrol, carrying Charles A. Willoughby of MacArthur’s
his appendix in a bottle.8 staff to send him to Mindanao in
SWPA medical support, like Japanese November 1943. He arrived on the huge
pressure, increased as the war went on. USS Narwhal, which was loaded for the
During 1943 and 1944 supplies arrived trip with 90 tons of supplies that includ-
by submarine every three months or so. ed 1.2 million tablets of Atabrine and
Medicines, including sulfa drugs and 800,000 of quinine. Evans quickly
Atabrine, were an essential part of the learned to admire Fertig and became
cargoes delivered to obscure points on both the force surgeon and command-
the long Mindanao coastline. Overall, ing officer of the radio section, giving
quantities were small. One writer has about half his time to each.10
calculated the total of supplies delivered As signalman, Evans made technical
by submarines at only 6 pounds per man improvements that resulted in round-
per year for the Mindanao guerrillas, the-clock radio communications with
and medical supplies apparently consti- Australia. As a doctor, he performed the
tuted only about 8 percent of an average varied duties of a general practitioner of
cargo. the time, including simple surgery. And
Yet SWPA’s contribution to medical as staff surgeon, he established clinics to
supply on Mindanao was absolutely serve the local people, sought to regu-
essential on qualitative grounds. During larize the loose medical organization,
1944 medical supplies were second only and was gratified to see improved care
to ordnance in priority, and were nei- bring the double benefit of enhanced
ther heavy nor bulky. Much arrived that morale among the fighters and warmer
the guerrillas could not provide them-
selves, no matter how ingenious they 9
Ibid., pp. 179–80, 184, copy in CHM–L; Interv,
Cowdrey with Evans, 18 Aug 89, Historians files,
HUMEDS, RG 112, NARA.
8 10
Schmidt, “Resistance Movement on Mindanao,” pp. Interv, James L. Evans, 29 Jun 56, file 000.71,
129–30, copy in CMH–L. HUMEDS, RG 112, NARA.
358 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
relations with the civilians. The medical needs. Included were chemotherapeutic
statistics of the operation, however, agents against malaria and yaws and a
remained a mystery. Evans’ efforts to surgical kit, wrapped in a canvas roll,
obtain written reports on sanitation and that met one of the most persistent and
disease brought in a sheaf of missives in critical deficiencies of the resistance
broken English and a variety of local forces. The size of every item was
dialects. He later recalled: “I even once designed to fit through a submarine’s
got a monthly sanitary report written hatch. Once General Headquarters,
with wry appropriateness on half a roll SWPA, accepted the list, Evans could
of toilet paper.”11 requisition as many units as he needed,
He became an able and professional use them to supply the loose regional
observer of guerrillas and their ways, a medical organization, and even provide
taste that later caused him to specialize some help to the civilians on whose
in psychiatry. Viewing their fears and goodwill survival ultimately depended.13
phobias, he noted in himself a horror of Other guerrilla leaders made do with
being bombed, but none of the jungle; medical organization as loose as Fertig’s,
in another guerrilla, terror of a Japanese but with no Evans at the center. On cen-
attack by land, but none of being tral Luzon the guerrillas, led by Col.
bombed. One American seemed to fear Marcus V. Augustin, whose nom de
the possibility of appendicitis more than guerre was Marking, assembled a secret
the enemy. Another hoarded Atabrine medical detachment to care for the sick
against the time when, in flight in the in their mountain hideouts, where the
jungle, he might not be able to obtain chief complaints were skin diseases and
more. Yet Evans rejected the notion, malaria. Not a real unit, the detachment
then popular, that psychopathic person- was composed of civilians, former
alities were especially drawn to irregular Philippine Army medical officers, and
warfare. A measure of objectivity and nurses who provided part-time assis-
even of intellectuality was needed to tance while carrying on their normal
accept and triumph over conditions of occupations. Marking’s guerrillas
life at which the flesh rebelled. A self- picked up medical supplies, including
selected group, Fertig’s men had instruments, from submarines. Then
refused to surrender. Evans considered the medical detachment members,
them, by and large, a stable and closely dressed as laborers, carried the items
bonded lot, capable of effective action into Manila, where many worked, and
in the most difficult circumstances.12 they established in the mountains a mil-
His most important contribution to itary hospital that later moved to the
Fertig’s guerrillas may have been nei- Pasig River when the battle for the capi-
ther as doctor nor communications spe- tal was raging. Here the detachment, no
cialist, but rather as a medical supply longer secret, drew supplies from the
expert. Evans developed a list of require- 43d Infantry Division’s 118th Medical
ments that was, in effect, a medical Battalion and treated both wounded
maintenance unit tailored to guerrilla
13
Ibid.; Interv, Cowdrey with Evans, Historians files,
11
Ibid. HUMEDS, RG 112, NARA. See also Keats, They Fought
12
Ibid. Alone, pp. 300–36.
BEHIND THE LINES 359
guerrillas and injured civilians. When times difficult to assess through the mist
the fighting ended, the Filipinos trans- of wartime claims and postwar romanti-
ferred their remaining casualties to a cizing. The western Leyte guerrilla war-
U.S. Army evacuation hospital. fare forces of the controversial Blas E.
This pattern—a part-time medical Miranda apparently had the form of a
organization that turned into a func- prewar division, with a division surgeon
tional unit only after the American and regimental surgeons. Miranda
forces arrived at Lingayen—apparently claimed to possess “one of the best hos-
was repeated in other groups. Some pitals ever built in the Visayas by any
arrangements were even more casual. guerrilla organization,” where major
Thus a professor from the College of and minor surgery was performed on
Medicine, University of the Philippines, “officers, enlisted men and civilians.” As
later claimed to have aided the obscure was the case elsewhere, civilian doctors
(and by SWPA unrecognized) Filipino- and nurses contributed their services
American irregular troops on Bataan. part-time. A chemist tried to find ways to
Yet the professor continued to teach substitute local herbal medicines for
throughout the war, and his “unit” never drugs that could not be imported, and
entered combat. But other and tighter an ordnance shop fabricated surgical
organizations existed on Luzon; several instruments. The guerrillas encouraged
recognized medical units, for example, civilian public health, and a veterinarian
served with future Philippine President inspected the local barrios to check for
Ramon Magsaysay’s Zambales Military animal diseases. Other organizations on
District. The Communist-led Hukbala- Leyte called in local physicians to treat
haps, whom Magsaysay would later their forces and provided rudimentary
defeat in a postwar civil conflict, were instruction to “first aiders” selected
also well organized and effective. They from the ranks to form medical pla-
divided the region of Luzon that they toons. The first submarine shipment of
controlled into five military districts, medical supplies reached Leyte in mid-
and an American who served with a 1944, though the question of how they
“Huk” battalion later recalled that his were distributed among the competing
unit had its own “intelligence, commu- resistance groups remains unclear.15
nication, ordnance, medical, and main- Unique in many ways was the organi-
tenance support systems.”14 zation established on Luzon by
Similar organization characterized Volckmann and Blackburn. Despite
other guerrilla bands, although the real their early troubles, the two escaped
effectiveness of their medical support from the Japanese and, aided by the
(as of many other activities) is some- supposedly anti-American Hukbala-
haps, crossed the Central Plains and
found a refuge in the northern moun-
14
Quotation from Donald Knox, Death March: The tains among the head-hunting Igorots.
Survivors of Bataan (New York: Harcourt Brace
Jovanovich, 1981), p. 371. See also documents in files
15
110–61, 275–2, and 309–84, box 367, Philippine Elmer N. Lear, “The Japanese Occupation of the
Archives, RG 407, NARA. Marking’s guerrillas also put Philippines: Leyte, 1941–1945,” Data Paper no. 42
in excellent service for the Sixth Army at the Ibo Dam. (Ithaca, N.Y.: Department of Far Eastern Studies,
Hukbalahap is an acronym derived from Tagalog words Cornell University, 1961), pp. 188–92 (quotations, p.
meaning People’s Anti-Japanese Army. 189).
360 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
bamboo strips.” The mobile section vival. Both men suffered severely from
under Asuncion was a medical compa- diseases and infections, and depended
ny, comprised of a collecting platoon on any treatment available so that they
and three aid stations. Each station fol- could continue to do their jobs, lead
lowed a battalion in combat.18 their forces, and fight on. The medical
Seemingly, equivalent arrangements establishment they created out of such
were made in the other sectors. In each slight materials aided them in sustaining
an organization loosely based on the morale and also in winning popular sup-
prewar Philippine Army regiment was port. In camp the discipline of preven-
set up. Field hospitals were organized, tive medicine (as they had learned
each, according to Volckmann, with 6 early) was an important aspect of not
doctors, 1 dental officer, 6–14 nurses, only maintaining health but also
and 70 enlisted men, augmented when reestablishing a sense of self-worth
necessary by civilians. The question of among defeated troops. Such medicine
supplies for this establishment is diffi- was a long way from the science of great
cult to clarify. Northern Luzon was the Army hospitals, but it met the elemental
most remote point in the Southwest needs of the guerrillas in a hard and
Pacific Area islands; on the other hand, hostile world.
Luzon contained cities, ports, and Once American units had landed at
enemy headquarters. Medical materiel Lingayen, Volckmann’s guerrillas
seems to have been sparse and obtained became semi-regular forces, enjoying
in great part from local sources, includ- many of the advantages and facing
ing the Japanese Army. As Volckmann many of the problems of the Sixth and
wrote, “Once when in desperate need of Eighth Armies. They operated in moun-
medical supplies and instruments we tainous terrain against General
found it necessary to raid two Jap instal- Yamashita’s tenacious defense; in May
lations, which were successfully moved and June 1945 they fought well as regu-
lock, stock and barrel, minus the Japs, lars while attacking Japanese positions
out into the mountains.” Prior to the at Bessang Pass. Large numbers of
Lingayen landing, supplies were seized, severely wounded casualties tested the
purchased (apparently by giving IOUs, guerrilla medics to the full. Surgical
which the American government later instruments were still few and laborato-
honored), or obtained through dona- ry facilities poor. For this reason, diffi-
tions. Medicines came by submarine cult cases and those needing to be X-
only twice, on 18 December 1944 and rayed were sent back to U.S. Army sta-
on 10 January 1945.19 tion hospitals. But litter-bearers
To Volckmann and Blackburn, the attached to the battalion aid stations
value of medical support for the guerril- carried out the wounded on Army
las was many sided. During the buildup stretchers, instead of the “bamboo beds
phases it was essential to personal sur- or hammocks” that had served in earli-
er fights. Access to regular sources of
18
Harkins, Blackburn’s Headhunters, pp. 271–72. supply meant other advantages.
19
Volckmann, We Remained, pp. 128 (quotation), 136; Requisitions by the chief surgeon
GHQ, FEC, “Guerrilla Resistance Movement,” pp.
44–45, CMH–L; USAFIP-NL, “After-Battle Report,” p. brought airdrops at first and then regu-
204, file Geog S—Luzon 370.2, CMH. lar resupply via landing craft operating
362 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
along the coast. Apparently, Volckmann ing luxury for these hard-bitten one-
established a division clearing station, time irregulars.21
elaborating the original simple chain of Medical cases continued to climb
evacuation, and his hospitals expanded until September, with an overall record
to treat the influx of wounded.20 that echoed the experience of the Sixth
Expansion was essential, and person- Army in fighting hard campaigns in the
nel and supplies were now available. In Philippine disease environment. As had
February Volckmann had established a been the case with American forces
large base hospital, which gradually early in the war, commanders proved lax
expanded from 150 to 800 beds to about enforcing malaria discipline,
accommodate both medical and surgi- which had to be made a command func-
cal cases. When rains flooded the camp tion; a court-martial was ordered for any
site, the hospital moved into large officer or enlisted man, sick of malaria,
buildings at Tagudin and obtained its who was found to have been lax about
food from a supply depot nearby. taking Atabrine. The effect, according
Surrounded by tented wards, it to one of Volckmann’s surgeons, was to
attained a 2,000-bed capacity by the reduce “malaria morbidity among our
beginning of June. By now the facility troops to 60%.” Even for a guerrilla
was in all but name a general hospital army, well acclimated and overwhelm-
and a large one, though by no means ingly Filipino in makeup and leader-
up to U.S. Army standards in equip- ship, and equipped with American Army
ment or specialists. supplies and medical backup, this old
Without large increments of civilian enemy remained unconquered as fight-
volunteers—doctors, nurses, pharma- ing ended in August 1945.22
cists, and attendants—such units could Overall, the guerrilla experience
not have functioned at all. Even so, the suggested the critical importance of
personnel “were practically on 24 very simple things in maintaining the
hours duty.” Volckmann rewarded health of irregular forces. Evans
their service with commissions, includ- emphasized that the guerrilla doctor
ing the volunteer nurses who entered ought to be young, tough, and adapt-
the Army Nurse Corps, Philippine able; a general practitioner rather than
Army. As the Japanese retreated and a specialist, with experience in surgery;
the front contracted, smaller hospitals and, above all, flexible in mind, gifted
were merged one by one into the base with patience, and able to absorb and
hospital. In July 1945 surgical cases survive defeat. The guerrilla band
had begun to decline in number, needed a few men with diverse and
though apparently the procedures per- basic skills, a short list of crucial sup-
formed increased in complexity, sug- plies and equipment that could be
gesting a more varied professional brought in over tenuous supply lines, a
staff. By now patients were wearing good working relationship between sur-
pajamas and sleeping on sheets under geon and commander, and—in medi-
mosquito nets—a condition approach-
21
Ibid., pp. 197 (quotation), 207, file Geog S—Luzon
20
USAFIP-NL, “After-Battle Report,” p. 207, file Geog 370.2, CMH.
22
S—Luzon 370.2, CMH. Ibid., p. 204, file Geog S—Luzon 370.2, CMH.
BEHIND THE LINES 363
cine as in all things—the support of the ing, usually against great odds, to save
civil population. the lives of officers, enlisted personnel,
Medical aid given by the guerrillas to captive civilians, and sometimes their
the people among whom they lived Japanese guards in camps that dotted
meant much to this relationship. Yet the Philippines, Formosa, Manchuria,
there can be no question that medical Korea, and Japan.24
aid flowed primarily from the populace The practices and cultural assump-
to the guerrillas, rather than the other tions of the Japanese military differed
way around. For medical care as for sharply from those of the Western pow-
food, information, and recruits, the ers. Japanese soldiers were routinely
guerrillas depended on the people. brutalized during training, and the
And the people sustained them—out of least resistance to orders was savagely
fear, out of loyalty to the prewar gov- punished. Combatants were, and
ernment, or out of hatred of the expected to be, treated as expendable.
Japanese.23 Surrender was a court-martial offense,
a shameful act that cut the prisoner off
Prisoners of War from his people and kindred.
Treatment facilities for casualties were
Armed and free to move about (but often grossly inadequate, for reasons
within sharp limits so as not to be detect- that may have been primarily logistical.
ed by the Japanese), the guerrillas main- Precautionary measures—for example,
tained their fighting spirit in part by safety devices installed in American
their intimate knowledge of what hap- warplanes—were regarded, with con-
pened to those who surrendered. The tempt, as unworthy and cowardly. Such
Japanese probably did not write the
worst record of World War II in dealing 24
Howard S. Levie, Prisoners of War in International
with prisoners of war; comparative Armed Conflict, International Law Studies, vol. 59
death rates suggest that that distinction (Newport, R.I.: U.S. Naval War College Press, 1978), p.
5; Bernard M. Cohen and Maurice Z. Cooper, A Follow-
was earned, either by the Germans for Up Study of World War II Prisoners of War, VA Medical
their treatment of prisoners taken on Monograph (Washington, D.C.: Department of
the Eastern Front or by the Russians for Medicine and Surgery, Veterans Administration,
1954), pp. 15–24; U.S. Department of Health,
their treatment of the Germans. Yet the Education, and Welfare, Message From the President of the
Japanese Army was guilty of mistreat- United States Transmitting the Report of the Secretary of
ment that ranged from neglect to tor- Health, Education, and Welfare, Entitled Effects of
Malnutrition and Other Hardships on the Mortality and
ture, that brought death to many pris- Morbidity of Former United States Prisoners of War and
oners, and that later caused some offi- Civilian Internees of World War II: An Appraisal of Current
cers to be tried and executed as war Information, 84th Cong., 2d Sess., 12 January 1956, H.
Doc. 296, p. 33; Wibb E. Cooper, “Medical
criminals. Department Activities in the Philippines From 1941 to
For medical personnel who fell cap- 6 May 1942, and Including Medical Activities in
tive at Bataan and elsewhere, imprison- Japanese Prisoner of War Camps,” pp. 144–49, file
314.7, HUMEDS, RG 112, NARA. The legal situation
ment meant not only sharing the mis- with respect to Japan, which had signed and ratified
eries of their comrades but also attempt- the Hague Convention of 1907 and signed but not rat-
ified the Geneva Convention of 1929, is discussed in
“International Military Tribunal for the Far East: The
23
Interv, Evans, 29 Jun 56, file 000.71, HUMEDS, RG United States of America and Others versus Araki
112, NARA. Sadao and Others,” 4:1121, CMH–L.
364 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
attitudes regarding caste, honor, ing. The fall of the Philippines in April
expendability, shame, and death were 1942 delivered tens of thousands of
premodern in origin, but formed a Americans and Filipinos into the hands
mindset much cultivated by Japanese of the Japanese. On Bataan most cap-
officers during the 1920s and 1930s.25 tives were already in poor condition
The consequences of Japanese mili- from starvation and malaria when they
tary ideology appeared early in the fight- began a march of about 100 miles, some
in trucks but many on foot, toward
25
prison camps north of Manila. No med-
Edward J. Drea, “In the Army Barracks of Imperial
Japan,” Armed Forces and Society 15 (Spring 89): 329–48; icines were available, except those the
“International Military Tribunal for the Far East,” prisoners carried themselves and the lit-
4:1142–44, CMH–L, in which the defense attorney cites tle distributed by American medical per-
the views of anthropologist Ruth Benedict. In his article
“Japanese Treatment of Prisoners in 1904–1905— sonnel at makeshift aid stations along
Foreign Officers’ Reports,” Military Affairs 39 (Oct 75): the way. Dysentery and exhaustion were
115–17, Philip A. Towle presents evidence that Japanese second to hunger, for no provision had
behavior toward prisoners of war in World War II
reversed an earlier record of humane treatment during been made for water or food. Some
the Russo-Japanese War. Filipino civilians courageously gave
BEHIND THE LINES 365
small handouts to the weary marchers, that had been moved to its stores from
but supplies were hopelessly inadequate No. 2. The combination of enemy gen-
to the need. No sanitary facilities existed erosity and American cleverness ulti-
in rest camps, and the living were often mately benefited prisoners at Camp
denied opportunity to bury the dead. O’Donnell, where Hospital No. 1 was
Brutality by the guards was erratic. sent by stages in late June and early July.
Some prisoners who fell out, unable to By the time it arrived there it was very
continue, were bayoneted and left by badly needed.27
the roadside; some were buried alive. O’Donnell was a half-completed train-
Human feeling perished; prisoners ing camp for Philippine Army recruits.
buried dead and living comrades at bay- Its bamboo and nipa structures had
onet point or abandoned fallen friends unfinished roofs and unconnected water
in the road. At San Fernando the sur- pipes. No utilities had been installed,
vivors received a bowl of rice each and and the septic system was only partially
some water, before being jammed into complete. Situated in the barren pied-
boxcars for a 25-mile journey into the mont of the Zambales Mountains, the
Tarlac Province. At the end of the jour- camp was surrounded by a heavy growth
ney they walked another 3.5 miles to of mosquito-infested cogon grass. Here
Camp O’Donnell. About 650 Americans the 9,000 American and 45,000 Filipino
and 5,000 to 10,000 Filipinos had per- survivors of the Death March endured
ished on the march.26 days of burning sun without adequate
Meanwhile, at the end of May the food, water, or medicine.
Japanese partially evacuated the hospi- Dysentery was almost unavoidable, for
tals on Bataan, sending General the prisoners lacked tools to dig latrines,
Hospital No. 2 to Cabanatuan. Patients oil to kill the maggots that swarmed
and hospital staff were provided trucks there, soap and water to clean them-
to ride in, along roads still lined with selves or their huts, fuel to boil contam-
decomposing bodies from the march. inated water, and drugs to treat illness
(Hospital patients were among the when it appeared. In consequence,
dead, for some Filipinos, hearing a the camp became one vast sewer, foul and
rumor that they were to be allowed to stinking. Clouds of flies buzzed everywhere:
return home, had left while still sick to in the latrines, where they dropped their
join the Death March.) Though eggs in teeming filth; on the faces of those
Hospital No. 2 was obliged to go empty-
handed, General Hospital No. 1, 27
Waterous, “Reminiscences,” pp. 59–62, file 314.7–2;
favored on account of its well-run ward James W. Duckworth, “The Official History of General
for Japanese prisoners, retained its own Hospital Number One, United States Army Forces in the
Far East, at Camp Limay, Bataan, Little Baguio, Bataan,
equipment and supplies plus medicines and Camp O’Donnell, Tarlac, Philippine Islands, From
December 23, 1941 to June 30, 1943,” pp. 4–5, file
319.1–2 (General Hospital 1) Philippine Islands; James
26
W. H. Waterous, “Reminiscences of Dr. W. H. O. Gillespie, “History of General Hospital Number 2,”
Waterous Pertinent to World War II in the Philippines,” pp. 23–32, file 314.7–2; idem, “Recollections of the
pp. 56–57, file 314.7–2; Cooper, “Medical Department Pacific War and Japanese Prisoner of War Camps,
Activities,” pp. 100–06, file 314.7. Both in HUMEDS, 1941–1945,” pp. 25–32, file 314.7–2; Interv, Col James W.
RG 112, NARA. See also Stanley L. Falk, Bataan: The Duckworth, 4 Jun 45, file 000.71. All in HUMEDS, RG
March of Death (New York: W. W. Norton and Co., 1962), 112, NARA. See also Alfred A. Weinstein, Barbed-Wire
pp. 197–98. Surgeon (New York: Macmillan Co., 1948), pp. 48–67.
366 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
in coma, rimming their lips and drinking ed accordingly. From 15 April to 10 July
from their half-open eyes; over open, drip- about 22,000 Filipinos and 1,500
ping ulcers of arm and leg; in filth-soaked Americans died—548 on a single day, 27
clothing. They settled in an almost solid,
quivering mass on the rice buckets as they May.28
were loaded by shovel from the steaming In early July most of the surviving
kawalis [open kettles], refusing to rise as Americans were transferred to the camp
they were waved away by K.P.’s. at Cabanatuan, where their arrival made
Eating became a tricky maneuver; one hand an unforgettable impression on the rel-
rapidly shoveled rice from mess kit into atively strong and well-off captives from
mouth while the other moved back and
forth over a rag with which the rice in the
mess kit was kept covered. 28
Quotation from Weinstein, Barbed-Wire Surgeon, p.
72. Statistics from Duckworth, “History of General
Requests to the Japanese guards for Hospital Number One,” p. 5, file 319.1–2 (General
food, medicine, and tools were turned Hospital 1) Philippine Islands, and from Gillespie,
“Recollections,” pp. 44–45, file 314.7–2, HUMEDS, RG
away. Deaths from amebic and bacillary 112, NARA. Beriberi is caused by vitamin B–1 (thiamin)
dysentery, malaria, and beriberi mount- deficiency and has two forms, wet and dry.
BEHIND THE LINES 367
Corregidor. With tears in his eyes, the Corregidor, Duckworth found the camp
camp’s medical director watched all that transformed. The old latrines had been
remained of the battling bastards of covered, and the new ones were burned
Bataan: out daily and sprinkled with lime. The
stagnant pools of water had been
Inching their way along the road came a drained and the cogon grass cut and
ragged formation of dirty, unkempt,
unshaven, half-naked forms, pale, bloated, burned, and all water for drinking was
lifeless. They staggered and stumbled, some boiled or chlorinated. The camp was
plodded, others uncertain of their balance being policed daily.
and strength lay down. . . . Limbs grotesque- Duckworth continued and amplified
ly swollen to double their normal size. Faces Schock’s work in his own way. He divid-
devoid of expression, form or life. Aged
incredibly beyond their years. Barefeet [sic] ed his unit into five subsections that pro-
on the stony road. Remnants of gunny sacks vided specialized treatment. In this way
as loin cloths. Some stark naked. Bloodshot the medics could handle the greatest
eyes and cracked lips. Smeared with excreta possible number of patients and isolate
from their bowels. Thus they came . . . to the as many sick as possible from contact
end of the road, the strong, young and alert
men of the 31st U.S. Infantry, the Air Corps, with those who were still well. He
Artillery and supporting services.29 cajoled small quantities of quinine and
diphtheria antitoxin from the Japanese,
Back at O’Donnell, General Hospital extracted more from the “grapevine,” as
No. 1 confronted the shambles that he called the camp black market, and
remained. Captives, mostly Filipinos, received still more from a married cou-
were dying at the rate of 300–500 a day, ple, Romeo and Fe Atienza, the
many in St. Peter’s Ward, a makeshift Philippine Red Cross representatives
hospital for terminal dysentery cases, who risked and suffered beatings for
where 500 patients lay on the dirt floor. bringing medicines into the camp.30
The 156 Americans at the camp also Duckworth also persuaded the
were gravely ill. Every prisoner was suf- Japanese to provide more protein and
fering from some form of deficiency dis- vitamins for the prisoners’ diet. The
ease. Since the Japanese had sent Col. daily ration of rice, watery weed soup,
James W. Duckworth, MC, the comman- and an occasional strip of carabao meat
der of No. 1, to Manila to be treated for was supplemented by small weekly addi-
appendicitis, the initial work fell to Col. tions of fresh fruit, oleomargarine,
John J. Schock, DC, a dental officer, who coconut oil, sugar, lard, and flour. A tiny
commanded in his absence. Still in pos- meat ration became standard—about 5
session of medicines, surgical instru- ounces per man per day—and the sick
ments, mattresses, and even refrigera- received some eggs and canned milk.
tors brought from Bataan, he and his The medics pitched in to build the facil-
subordinates were able to set up a rec- ities the camp desperately needed. They
ognizable medical center. Returning on constructed crude showers, strung elec-
19 July with a welcome reinforcement of
officers and enlisted medics from
30
Quoted word from Interv, Duckworth, 4 Jun 45, p.
15, file 000.71, HUMEDS, RG 112, NARA. See also
29
Gillespie, “Recollections,” p. 50. file 314.7–2, Julien M. Goodman, M.D.P.O.W. (New York: Exposition
HUMEDS, RG 112, NARA. Press, 1972), p. 49.
368 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
tric wires, laid water and sewer pipe, dug medical attention was part of
drainage ditches, and hammered Duckworth’s secret for obtaining sup-
together boardwalks over the contami- plies from the Japanese. But he succeed-
nated soil. ed also by his presence—his massive
Duckworth was remarkably successful physical build; his soldierly manner; and
in his relations with the Japanese. He his cool dignity that impressed “even . . .
obeyed their orders and maintained firm the Japanese who confronted him.”31
discipline among his medical personnel. Meanwhile, Camp O’Donnell
Finding that the Japanese lacked a den- approached the end of its unhappy histo-
tal corps, he had his own dentists work ry. The Japanese adopted a policy of
on them. American doctors provided indoctrinating the Filipinos in the glories
medical treatments as well, for of the Great East Asia Co-Prosperity
Duckworth judged Japanese Army doc-
tors to be “very low grade” in the main (a 31
First quotation from Interv, Duckworth, 4 Jun 45, p.
view commonly held by American med- 9, file 000.71, HUMEDS, RG 112, NARA; second quota-
ical officers), though he made an excep- tion from Goodman, M.D.P.O.W., p. 47. See also
Duckworth, “History of General Hospital Number
tion for the Japanese medical officer at One,” p. 5, file 319.1–2 (General Hospital 1) Philippine
O’Donnell, a Dr. Yasamira. No doubt Islands, HUMEDS, RG 112, NARA.
BEHIND THE LINES 369
Sphere, and began to send them to their O’Donnell became better. Every day
homes. With diminishing numbers, naked bodies were dragged or carried to
improving food, basic sanitation, and shallow graves. Not until 15 December
simple medical treatment, the death rate was a medical officer at Hospital No. 2
among those who remained plummeted able to record: “1st day since organiza-
from about 550 a day to 500 a month and tion of this hospital—no deaths.”33
then to 5 a month. During the last two Col. James O. Gillespie, MC, the com-
months at O’Donnell no one at all died. mander of Hospital No. 2 on Bataan,
In January 1943 the Japanese closed the had continued in that position until
camp down and sent the majority of the July, when an American camp command
Americans to Cabanatuan, minus most of was established. He then became the
their medical equipment and supplies. medical director of the entire camp,
Duckworth went to Old Bilibid, where and Lt. Col. William R. Craig, MC, suc-
most high-ranking officers were ceeded him at the hospital. In
interned, depriving the main American September Gillespie was sent to
prison camp of a skilled hand and a Formosa, the fate of many ranking offi-
source of leadership and inspiration.32 cers. Craig took his place as medical
director, and Lt. Col. Jack W. Schwartz,
Cabanatuan MC, a urologist who had turned himself
into an able general surgeon on Bataan,
Sixty-five miles north of Manila in the took over the hospital.
Central Plains of Luzon, the town of In turn, each attempted to reach as
Cabanatuan was the site of an abandoned many prisoners as possible with the inad-
Philippine Army camp. By mid-1942 equate means available to him. A camp of
about 9,000 prisoners lived there, labor- the sick surrounded the hospital, divided
ing in the camp itself, on an adjacent into wards for the acutely ill and a conva-
farm, and on a nearby airfield. Across the lescent area, while dispensaries served the
road from the main camp, General working prisoners. The hospital offered
Hospital No. 2 was just establishing itself primarily nursing care; the Japanese pro-
in barracks of bamboo and nipa when vided no medicines until late July, and
the main transfer of Americans from not much thereafter. Some contacts had
O’Donnell occurred. The hospital census developed with Filipinos outside the
rose from 420 on 8 June to 2,512 on 20 camp, and a trickle of medical supplies
July. With so many patients, many already began to be smuggled in. Nevertheless,
moribund, and with almost no supplies, in a twenty-day period of June 498 died
conditions at Cabanatuan became worse and 789 more in July. The causes were
during the same period that those at malaria, diphtheria, dysentery, and the
diseases of malnutrition. The camp ceme-
tery now held 1,287 Americans, and
32
Interv, Duckworth, 4 Jun 45, file 000.71; Cooper, would contain more than 2,400 before
“Medical Department Activities,” pp. 106–09, file 314.7;
Duckworth, “History of General Hospital Number
33
One,” pp. 5–6, file 319.1–2 (General Hospital 1) Statistics and quotation from Maj Edward R.
Philippine Islands. All in HUMEDS, RG 112, NARA. Wernitznig, MC, Diary, 8 Jun, 20 Jul, and 15 Dec 42,
See also Weinstein, Barbed-Wire Surgeon, pp. 71–103; Historians files, HUMEDS, RG 112, NARA. See also
Kary C. Emerson, Guest of the Emperor (Privately pub- Emerson, Guest of the Emperor, pp. 28–29, copy in
lished, 1977), pp. 23–24, copy in CMH–L. CMH–L.
370 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
dards of free men. But a few became use whatever vitamins were available in
kings of the hobo jungle they lived in, the poor rice diet. “In the early days [at
and most became stronger and regained Cabanatuan],” he wrote, “hundreds of
hope of ultimate liberation. cases of corneal ulcers were seen; in the
Prisoners’ sexual habits reflected the later months [of 1942] practically none
changes in their condition. When they were to be seen,” emphasizing that the
were hungriest, the drive entirely disap- change occurred before additional food
peared. As their condition improved, it and Red Cross packages became avail-
revived, manifested in nocturnal emis- able. “In my opinion this all goes to
sions and masturbation and, for those show the enormous flexibility and
who were fortunate, in brief liaisons with adaptability of the human mechanism
local women or prostitutes during work under conditions of duress.”40
details outside the wire. Homosexuality Other signs of toughness and flexibil-
also appeared, both in the form of pros- ity also were noted. Strangely enough,
titution by a few, who bartered their ser- given the situation in which they lived,
vices for food, and in more stable rela- few prisoners became psychotic.
tionships as well. “Homosexuality was Though irritability and backbiting were
present in all nationality groups,” report- common, psychoneurosis also was rare.
ed one medical officer. “This reached a Perhaps those who were susceptible to
point that . . . [one doctor] conducted a depression died early; perhaps others
weekly marital relations clinic, in an did not behave irrationally because such
effort to keep the couples happy in our symptoms evoked no sympathy and
tight society.”39 offered no escape from hunger and
A second pattern, supporting the beatings. The chief exceptions to the
first, depended on the prisoners’ physi- rule were mental disturbances resulting
cal adaptation to short rations and the from the diseases of malnutrition or
stress of prison life. Many successfully cerebral malaria. The psychotics who
reverted to a primitive level of existence, did appear were removed to locked
and “once that state was achieved, a con- wards at Old Bilibid.41
dition of relative balance resulted, mor- The matured medical service at the
bidity stabilized, and mortality rates fell, camp provided a variety of services,
at least until some severe new stress” though necessarily in rudimentary form,
occurred. Lt. Col. Willard H. Waterous, given the circumstances. The medical
MC, an eye, ear, nose, and throat spe- director established overall medical and
cialist captured on Bataan, regretted
that systematic clinical studies of the 40
First quotation from Charles G. Roland, “Stripping
phenomenon were impossible under Away the Veneer: P.O.W. Survival in the Far East as an
Index of Cultural Atavism,” Journal of Military History 53
camp conditions. He observed, however, (Jan 89): 79; remaining quotations from Waterous,
that the body could acquire the ability to “Reminiscences,” p. 102, file 314.7–2, HUMEDS, RG
112, NARA.
41
The observations of Army doctors in this respect
39
Quotations from Knox, Death March, p. 419. Most were confirmed at the end of the war by Army and Navy
prisoner narratives are reticent about sexual matters; physicians examining newly freed Allied prisoners. See
see, however, Weinstein, Barbed-Wire Surgeon, pp. Department of the Navy, “The United States Navy
160–61, 236; J. E. Nardini, “Survival Factors in Medical Department at War, 1941–1945,” 1:656, files of
American Prisoners of War of the Japanese,” American Bureau of Medicine and Surgery Archives (BMSA),
Journal of Psychiatry 109 (Oct 52): 241–48. Washington, D.C. See also Chapter XIII of this volume.
BEHIND THE LINES 373
sanitary policy, while the hospital com- fish took the place of meat in the soup.
mander saw to the acutely ill and conva- Hospital reports certified by a Japanese
lescent. Usually 50–60 officers—doctors, Army surgeon indicated that more than
dentists, veterinarians, and MACs—were 90 percent of eye problems were due to
assigned to the hospital, and about half nutritional amblyopia—dimness of
that number to the dispensary service, vision caused by avitaminosis.
organized to meet the outpatient needs Perhaps fortunately, the camp shrank
of the workers. Despite continuing short- as the ration did, for details were dis-
ages of all essentials, the medics operat- patched frequently, either to labor else-
ed dental clinics, provided sanitary where in the Philippines or to be taken
inspection services, established a rudi- (each with its attendant medical officer
mentary medical supply system, and and a small cache of Red Cross supplies)
supervised the slaughtering of animals to Japan. By the time the majority of
for food. At the hospital, surgery was per- those remaining at Cabanatuan were
formed and an eye, ear, nose, and throat evacuated to Japan in October 1944,
clinic treated corneal ulcers and loss of weight loss since capture averaged 30 to
vision resulting from avitaminosis. 35 pounds per man. By then the best
The medics could not perform mira- hope of the prisoners who remained
cles, however, and miracles were needed alive were the mounting successes of the
at Cabanatuan. In part, the insoluble Allies, which promised an ultimate lib-
problems were the work of the Japanese eration. Most of those who could be
prison doctor, a particularly heartless or killed by a radically deficient diet had
obtuse individual later convicted as a already died.42
war criminal. But major difficulties
resulted from the course of the war and Bilibid and Santo Tomas
the consequent failure of the enemy’s
logistical system. Without warning, the Manila’s military prison Old Bilibid
Japanese began to reduce the diet in the had once been condemned as unfit for
second half of 1943, until the prisoners use, but the stuccoed buildings within its
were subsisting on about 1,000 calories a 12-foot rock-and-plaster walls were
day. The diseases of malnutrition home for longer or shorter periods to
promptly reappeared; soon three-quar- many Americans during the Japanese
ters of the prisoners showed some symp- occupation. The prison housed a naval
toms of beriberi, especially the so-called hospital; served as a staging area for pris-
wet form, with edema of the eyelids, oners in transit to other camps; and pro-
limbs, and abdomen. In December 1943
another shipment of Red Cross supplies 42
Gillespie, “Recollections,” pp. 32–84, file 314.7–2;
was issued minus the medical supplies, Cooper, “Medical Department Activities,” pp. 109–22,
which were sent to Old Bilibid and file 314.7; Waterous, “Reminiscences,” pp. 64–76, file
issued to Cabanatuan on monthly requi- 314.7–2; Intervs, Duckworth, 4 Jun 45, and Lt Col
Stephen C. Sitter, 12 Sep 45, file 000.71. All in
sition. Improvement in the prisoners’ HUMEDS, RG 112, NARA. See also Musselman,
health, however, was slight, because the “Nutritional Diseases,” p. 330; Emerson, Guest of the
regular ration continued to shrink. Emperor, pp. 28–35, copy in CMH–L; Lt. Col. Albert
Fields Diary, 27 May 42–29 Jul 43, file 999.2–6, and
During 1944 each man received less Cabanatuan Hosp Med Rpts, 1943–44, file 583–1, box
than 300 grams of rice a day, and salted 165, Philippine Archives, RG 407, NARA.
374 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
vided transient quarters for the work ed after mid-1943. Gradually, meat, fat,
details sent to labor in the capital, which and even rice all but disappeared.
were accompanied by medical detach- Comdr. Thomas H. Hayes, MC, USN,
ments organized from the prison staff. who took command of the hospital in
Among its other functions, Old Bilibid October 1943, noted in his diary that his
was the center for medical service to own meals consisted of old and woody
prisoners of war throughout the radishes, a few spoonfuls of rice, and bit-
Philippines. Red Cross medical supplies ter soup. Many inmates survived only
also were stored here. Despite various because they could still buy food from
shortcomings—requisitions sometimes Filipino vendors. But even this resource
took months to fill, and permission to disappeared when Manila itself devel-
send patients to the naval hospital was oped an acute food shortage in the
hard to obtain—the centralized system spring of 1944, at least in part because
benefited prisoners of war in many ways. the interruption of gasoline supplies by
The Navy medics organized the hos- Allied attacks on Japanese shipping
pital, as far as possible, like any other immobilized motor transport.
facility with departments, wards, and Thus, hungry prisoners transferred
offices. Colonel Cooper, arriving with from Cabanatuan arrived to find their
the contingent from Cabanatuan, ration with less protein than before.
judged its physical plant the best he had During their six-week stay at Old Bilibid,
seen in any prison camp, and Colonel weight loss averaged another 15 to 17
Gillespie spoke of the “incredible luxu- pounds. Those who stayed at the prison
ry” of living in a real building with elec- lived for the remaining months of cap-
tric lights, beds, and a bathroom. The tivity on 300 grams of rice and 200
wards occupied buildings of reinforced grams of corn per man per day, plus
concrete; patients lay on Regular Army some greens, and only liberation by the
bunks; there was an abundant supply of Sixth Army prevented mass starvation.
running water; and latrines and showers By this time the prison must have resem-
were connected to the city water and bled a cross between a primitive village
sewer systems. Sanitary conditions were and a city slum. The ambulant went
satisfactory, and outbuildings housed about in rags or loincloths, thin as reeds,
dental and outpatient clinics and stored burned mahogany by the sun.44
medical supplies. Hospital records sug- Allied civilians and American nurses
gest a surprisingly well-supplied facility were more fortunate than the military
whose staff was able to perform surgery
and to provide adequate treatment for
44
prisoners, nearly all of whom were Cooper, “Medical Department Activities,” pp.
122–25, file 314.7; Interv, Duckworth, 4 Jun 45, file
malarial and grossly malnourished.43 000.71. Both in HUMEDS, RG 112, NARA. See also
Here as at Cabanatuan, however, the PhM1c Robert W. Kentner, USN, Journal, 8 Dec 41–5
ration shrank as Allied victories mount- Feb 45, BMSA; Col Paul D. Bunker Diary, 3 Jan 42–1
Mar 43, file Geog S—Philippines 314.81, CMH; Comdr
Thomas H. Hayes, MC, USN, Diary, file 999.2.224,
Philippine Archives, RG 407, NARA. Hayes’ diary has
43
Quoted words from Gillespie, “Recollections,” p. been published as A. B. Feuer, ed., Bilibid Diary: The
51, file 314.7–2, HUMEDS, RG 112, NARA. See also Secret Notebooks of Commander Thomas Hayes, POW, the
Personal Health Records, Bilibid Hosp, boxes 152–54, Philippines, 1942–1945 (Hamden, Conn.: Archon
Philippine Archives, RG 407, NARA. Books, 1987).
BEHIND THE LINES 375
captives. Although the Japanese viewed wall and on the fourth by an ornate iron
surrender by men of the armed services fence with gates. Here the Japanese
as a disgraceful act, civilians and women established a prison for civilian
were exempted from the demands of internees. In January 1942 Santo Tomas
bushido (“the way of the warrior”). They held about 3,500, and a year later about
were not, however, exempted from the 4,200, including by that time 82 female
arbitrariness and neglect that pervaded military personnel. About 70 percent of
the Japanese treatment of captives, nor the prisoners were Americans; about a
the casual brutality of guards, nor the quarter, British; the rest, a mixture of
collapse of the Japanese logistical system many other Allied countries. All had
in 1944, with its harsh consequences for been caught in the Philippines by the
prisoners of all types. outbreak of war. Together they formed a
Santo Tomas University was a small self-governing international city.
Dominican institution that occupied a An executive committee of four
60-acre campus in a densely populated Americans and two Britons managed
area of the city. Large classroom build- the internal workings of the place
ings, meant to accommodate 6,000 stu- through a network of subordinate com-
dents and a faculty of 300, were sur- mittees on everything from sanitation
rounded on three sides by a masonry and health to entertainment. All but the
376 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
smallest children—about 700 lived at seven Army nurses, three dieticians, and
Santo Tomas—were expected to work at one physical therapist—arrived early in
least two hours a day.45 July 1942. When they were permitted to
Since they were not prisoners of war, join the main body of prisoners and
the inmates had to pay for everything internees in August, they began to work
with money provided by the Red Cross or with the Navy nurses on ward duty. Capt.
borrowed from well-to-do fellow inmates. Maude Davison, ANC, became chief
Former executives of the Red Cross, nurse. In September ten more Army
Standard Oil, and General Electric nurses arrived from Mindanao, where
underwrote many bills and obtained they had been captured when their
money from friends still free in Manila. plane went down on its way from
Since vendors were allowed in to sell Corregidor to Australia. With an ample
their goods, relative prosperity was the staff of professionals at hand, the little
rule in the early days; a central kitchen hospital expanded. Preventive medicine
served two meals a day, with lunch as well was the responsibility of the sanitation
for the children, the old, and the sick, and health committee; additional show-
who received some milk, some meat, and ers and toilets were installed, and vacci-
an egg a day. Lt. Ruby F. Motley, a dieti- nations against cholera and typhoid
cian who ran the children’s kitchen, later were given by the Red Cross. Relenting
declared that all were “very healthy” and on their earlier refusal to pay the cap-
had gained weight in the prison. tives, the Japanese provided each a
Treatment for the sick was provided by stipend of 70 centavos (about 35 cents)
Dr. Charles Leach of the Rockefeller a day. Since Manila warehouses were still
Foundation, by several medical mission- stocked with food, the period from July
aries, a Manila physician, and eleven 1942 to the end of 1943 passed in rela-
Navy nurses captured at Cavite. With a tive comfort and good health, given the
small hospital and several clinics, medical fact that a prison was still a prison, that
supplies purchased from Manila or given crowding was the rule, and that food
by the Red Cross, and the assistance of intake was never entirely adequate for
Filipino doctors and nurses who visited the adults, probably averaging about
the prison, a basically healthy population 1,700 calories a day. Though no epi-
had at least adequate care.46 demics hit the adults, enteritis and skin
Such was the situation at Santo Tomas infections were common. During a
when prisoners from Corregidor—fifty- memorable period in late 1943 almost
every child in the prison came down
with—and recovered from—measles
45
A. V. H. Hartendorp, The Santo Tomas Story (New and whooping cough.47
York: McGraw-Hill Co., 1964), pp. 7–29; Michele
Manning, “Angels of Mercy and Life Amid Scenes of Then the situation darkened. Food
Conflict and Death: The Combat Experience and became harder to obtain, and in
Imprisonment of American Military Nurses in the
Philippines, 1941–1945,” p. 45, file ANC 383.6 POW
47
Nurses, Philippines, CMH. Josephine M. Nesbit, “History of the Army Nurse
46
Hartendorp, Santo Tomas, pp. 14–18, 21–22; Intervs, Corps in the Philippine Islands, September
Marie Adams, 7 Jun 45, and Ruby F. Motley, 26 Apr 45 1940–February 1945,” pp. 38–41, file 314.7; Catherine
(quoted words), file 000.71, HUMEDS, RG 112, NARA. L. Nau, “History of the War, Philippines, 1941–1945,” p.
Adams was field director of hospital service for the 10, file 314.7; Intervs, Adams, 7 Jun 45, and Motley, 26
American Red Cross at the time of her capture. Apr 45, file 000.71. All in HUMEDS, RG 112, NARA.
BEHIND THE LINES 377
February 1944 the Japanese military Americans came. The work of the doc-
took direct control of the prison, impos- tors and nurses, civilian and military,
ing many restrictions. Gift parcels became ever more difficult as, hungry
ceased to arrive, vendors were excluded, themselves, they dealt with an increasing
and outside medical assistance came to patient load. As the internees’ health
an end. Instead of providing funds to declined, the hospital became over-
internees, the Japanese began to pro- crowded and additional wards had to be
vide the food, which immediately opened. Twenty-three at Santo Tomas
declined both in quantity and quality. starved to death in December 1944 and
To make up for deficiencies in protein 32 in January 1945. In that month 475
and vegetables, adults contributed a were hospitalized. Liberation came in
part of their ration to the children. February, amid the flame and ruin of the
Supplies soon ran so low that in battle for Manila. An inmate doctor, put
November the special children’s ration into solitary because he had refused to
had to be stopped. falsify the death certificate of an internee
Inevitably, deficiency diseases had who had starved, was set free. He per-
begun to appear. Prisoners lost as much formed eight major operations on
weight between August 1944 and the lib- American casualties of the battle for
eration as during the previous two and a Manila, though “passing out cold twice
half years of confinement. By January because of his experiences with starva-
1945 the individual adult ration averaged tion and beriberi.”49
only 680 calories a day, and total weight
loss during confinement averaged 32 Prisoners Outside the Philippines
pounds for women and 51 pounds for
men. On 5 January Canadian internee Despite hunger, occasional labor
Anne Goldthorpe wrote in her diary: “I drafts, and the torture and execution of
worried last night about a lump in my a few prisoners who were accused of
stomach. Then I found it was my back- contacts with the guerrillas, civilians
bone.” Among the crowded inmates, had a comparatively easy time of it.
hunger brought intense irritability; they Military prisoners, on the other hand,
wrangled about unimportant things. As were viewed by the Japanese in a variety
recalled by a nurse, “We were ready to of ways, none conducive to long life.
claw each other’s eyes out over nothing at They were seen as enemies, as warriors
all.” Depleted, their bodies either who had failed in their duty, as a dis-
shrunken or bloated with beriberi, they posable labor force to be exploited
lived in the increasing squalor of a prison wherever needed, and as a potential
where everything was breaking down and danger if recaptured and returned to
nothing was replaced or repaired.48 duty. Exhibiting them in their helpless-
The last year of captivity was con- ness was also seen as a way to break
sumed by a struggle to survive until the down the prestige acquired by
Westerners in the Orient during the
48
First quotation as cited in Neil Henry, “A Journal of generations of imperialism.
Human Endurance,” Washington Post, 20 Mar 83.
Second quotation from Interv, Adams, 7 Jun 45, p. 26,
49
file 000.71, HUMEDS, RG 112, NARA. In loc. cit., see Interv, Adams, 7 Jun 45, p. 28, file 000.71,
also Interv, Motley, 26 Apr 45. HUMEDS, RG 112, NARA.
378 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Transferring prisoners to the center Subic Bay. After a miserable few days
of the Empire to exploit them as labor ashore, the surviving prisoners were
began early in the war. Comparatively transferred to the Enoura Maru, bound
lucky were a number of high-ranking for Formosa. This ship in turn was sunk
officers, including Colonel Gillespie, in the harbor of Takao, Formosa, by
who were shipped out during 1942 American planes. As a medic wrote,
when the seaways were safe. As the dan- “Terrible sight to see, pile of dead bod-
ger of an American invasion of the ies as result of bombing. No sleep. ‘God
islands increased during 1944, many watch over us.’” Three hundred and
more were shipped from the Philippines eleven dead prisoners were interred in a
to labor camps in Formosa, Korea, mass grave on a sandspit, while the
Manchuria, and Japan (Map 14). By that remainder continued on a third ship,
time American submarines and aircraft the Brazil Maru. Five hundred and
roamed the South China Sea, striking at eighty survivors arrived in bitter cold at
Japanese shipping wherever found. The the harbor of Moji, Japan, on 31 January
vessels carrying American prisoners 1945. Among the dead were about half
were not marked, and many were sunk the personnel of the Sternberg General
or damaged. Yet those who perished by Hospital and General Hospital No. 2.
friendly fire or by drowning were fortu- Some lines composed at Cabanatuan by
nate by comparison with those who died Lt. Henry G. Lee, who died at Takao,
of thirst, heat prostration, or dysentery may serve as the epitaph of the voyagers:
in the stinking holds.50 “If I endure—I must go on enduring /
No voyage was more harrowing than And my reward for bearing pain—is
that of the last group of American pris- pain.”51
oners to leave the Philippines, 1,619 in In their new prisons the survivors of
all, who sailed from Manila on 14 such voyages encountered a mixed bag of
December 1944 on the Oryoku Maru. Allied prisoners from all the battle-
They comprised most of the remaining grounds of the Pacific. They met high-
senior officers in the islands, including ranking officers who had been transport-
medical and dental officers of the Army ed earlier from the Philippines, including
and Navy and a number of chaplains. General Wainwright; sailors and marines
Conditions were atrocious. Packed too captured on Guam and Wake Islands;
densely into closed ovenlike holds and
denied water, some died of suffocation 51
First quotation from Wernitznig Diary, 9 Jan 45,
while others raved and fought in the Historians files, HUMEDS, RG 112, NARA; second quo-
claustrophobic darkness. tation from Henry G. Lee, “Nothing But Praise” (Culver
Soon American planes began to City, Calif:: Murray and Gee, 1948), p. 33. See also
Cooper, “Medical Department Activities,” pp. 125–33,
bomb and strafe the Oryoku Maru. file 314.7, and Gillespie, “Recollections,” pp. 73–85, file
Almost as an answer to the prisoners’ 314.7–2, HUMEDS, RG 112, NARA; Rpt, Lt Col Paul D.
prayers, the ship was hit by a bomb off Phillips to Maj Gen William F. Sharp, CG, Visayan-
Mindanao Force, 13 Oct 45, sub: Trip From Manila, P.I.,
to Moji, Japan, as Japanese P.O.W., December 13, 1944
to January 30, 1945, pp. 1–9, file Geog S—Philippines
50
See the diary of a trip on the Haro Maru repro- 314.82, CMH. Casualty figures for the voyage vary;
duced in Goodman, M.D.P.O.W., pp. 114–26. However, many sources state that only 250–300 survived. Above
there were some decent ships, as Goodman notes on p. statistics from Oryoku Maru-Enoura Maru-Brazil Maru
143. file, box 148, Philippine Archives, RG 407, NARA.
BEHIND THE LINES 379
Soya Strait
UNION OF
SOVIET
MANCHURIA SOCIALIST
REPUBLICS
HOKKAIDO
Hakodate
Sapporo
Strait
ru
ga
su
E A N
T
KOREA
Sea
of
O C
Japan Sendai
Sado Sendai
C
F I
HONSHU
Nagano
Oki Archipelago Tokyo
Fukui
C I
Tokyo
Yokohama
Kyoto Nagoya
Nagoya
P A
ra
it Osaka
St
a
re Fukuoka Matsuyama
Ko
Fukuoka SHIKOKU
Nagasaki
Prison Camp Areas in Japan
August–September 1945
KYUSHU Base camp
East
Sub-camp
China
Sea 0 200
Osumi Is Miles
MAP 14
American pilots fished from the sea; and were sometimes made in extremely cold
British, Canadian, Dutch, and Australian weather. In Formosa most prisoners were
fighting men taken in many battles of the employed in farming; in Manchuria
Far East. Officers were usually compelled many worked in factories. In Japan the
to work in the camps, though exceptions prisoners worked on farms, in mines, on
380 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
docks, and in munitions plants. In Korea meager basic allowance was supplement-
they often performed coolie labor, ed by the erratic arrival of Red Cross
pulling bullcarts to and from factories. packages, and the prisoners, most of
Officers might grow vegetable gardens; them senior officers excused from work
one medical officer, ill with beriberi, was on account of the intense cold, “got thru
put to sewing uniforms and making but- the winter in a relatively good fashion.”53
tonholes. Work in the mines was especial- By 1945 rations were at their lowest,
ly brutal, and everywhere the enlisted though a few Red Cross packages still
men bore the worst of it.52 arrived. In some camps the guards them-
Survivors of the Oryoko Maru were selves were either hungry or hoarding
issued warm clothes on their arrival in what food was available. Hunger domi-
Japan, but all prisoners were not so for- nated the prisoners’ lives, and food
tunate. Those taken from the tropics haunted their dreams. They ate anything
were often inadequately clad for the cold remotely edible. A sailor who had been
north Asian winters, and most were fed captured on Guam recalled seeing pris-
wretchedly. Living in drafty wooden oners consume “beetles, snakes, silk-
buildings, heatless or warmed only by worms, rancid copra, [and] fodder stolen
hibachis or (in Manchuria) by Russian from horses’ feed buckets.” They killed
coal stoves, they wrapped themselves and ate rats and cats; they stole chickens
cocoonlike in verminous blankets and and, in the relative privacy of the latrine,
slept on straw mats. Diet varied from tore the birds apart and gnawed the flesh
place to place, but staples included rice from their bones. But there was never
and a watery soup made with bones or enough, and deficiency diseases spread
fish scraps and sometimes thickened as before, with their complex symptoms
with weevil-infested flour. Apparently, ranging from night blindness to burning
the food commonly supplied only feet to swollen limbs. Dysentery worsened
1,500–1,700 calories a day—entirely the situation, spreading for the usual rea-
insufficient for those performing heavy sons—shallow open latrines; absence of
labor. In some areas the food that was oil, soap, and uncontaminated water;
available from nearby farms was exclud- absence of adequate fuel to boil water for
ed from the camps. At Jinsen, Korea, drinking; absence of medicines to treat
where inmates had been starving, tons of illness when it appeared.54
potatoes were found rotting in a store-
house after the camp was liberated. But 53
Gillespie, “Recollections,” pp. 80–81 (quotation), file
at Cheng Chia Tun, Manchuria, a very 314.7–2, HUMEDS, RG 112, NARA; Herman, “Prison
Diary,” Sep 79, p. 15; Goodman, M.D.P.O.W., p. 131; E.
Bartlett Kerr, Surrender and Survival: The Experience of
52
Cooper, “Medical Department Activities,” pp. American POWs in the Pacific, 1941–1945 (New York:
134–42, file 314.7, and Gillespie, “Recollections,” pp. William Morrow and Co., 1985), pp. 166–67.
54
58, 81, file 314.7–2, HUMEDS, RG 112, NARA; Rpt, Herman, “Prison Diary,” Oct 79, p. 6 (quotation);
Phillips to Sharp, 13 Oct 45, p. 10, file Geog S— Weinstein, Barbed-Wire Surgeon, pp. 190, 198–99, 234,
Philippines 314.82, CMH; Jan K. Herman, “Prison 272–84; Kerr, Surrender and Survival p. 176; J. N.
Diary,” U.S. Navy Medicine 70 (Sep 79): 13–14 and 70 Crawford and J. A. G. Reid, “Nutritional Diseases
(Oct 79): 3, 5, 9; Weinstein, Barbed-Wire Surgeon, pp. Affecting Canadian Troops Held Prisoner of War by the
219, 234–35; Goodman, M.D.P.O.W., pp. 138, 153, 184. Japanese,” Canadian Journal of Research 25 (1947):
Wainwright was confined for a time on Formosa 53–85. See also Peter Williams and David Wallace, Unit
(Taiwan), where Gillespie encountered him; then he 731: Japan’s Secret Biological Warfare in World War II (New
was transferred to Manchuria. Continued
BEHIND THE LINES 381
By the summer of 1945 even tena- Japanese medical personnel and depen-
cious survivors were showing signs of dent upon them and the camp com-
weakening. Gillespie noted that a sim- mander for facilities, supplies, and
ple walk around the compound at instruments. As a rule, the Americans
Mukden, Manchuria, to which he had were allowed a section of a building to
been relocated, brought on shortness of hold sick call. At the Tanagawa camp
breath and muscular weakness. near Osaka they worked in the hallway
Insufficient protein caused a slackening of the camp administration building,
of the abdominal wall muscles so that which also contained the Death House,
the inmates, despite their hunger, a closetlike room with space for about
developed the bulge called “rice belly.” eight patients, where the moribund
Painful blisters appeared in their were confined to die. In a room next to
mouths with no clear cause. Psycholog- the Death House the Japanese medical
ical symptoms also reflected the stresses staff made out death reports and issued
of long imprisonment, crowding, and medicines in meager amounts.56
inadequate diet. Some prisoners flew Because many prison camps lacked
into ungovernable rages over small facilities for surgery, the Japanese some-
problems; senior officers were seen times allowed serious cases to be taken
struggling furiously over small cheap to civilian hospitals for treatment. Thus,
cupboards, issued by the Japanese to prisoner patients at Senryu went to the
hold personal belongings. A burning Mitsubishi mine hospital and the seri-
sensation in the scrotum reported by ously ill at Umeda and Tanagawa into
many prisoners led Gillespie to suspect Osaka. The enlisted medical technicians
the renewed onset of pellagra, caused who transported patients to the civilian
by lack of niacin. Although the severe hospitals noted violations of sterile tech-
dementia that can result from the dis- nique even there, yet the risks had to be
ease did not appear, episodes of bizarre run for patients who would otherwise
behavior became common. A prisoner die. Partial exceptions to a generally
would report that one or more inmates bleak picture can be cited. At a camp
were “off their rockers,” and the next whose inmates worked for the Mitsui
day they would report the same of Corporation Capt. Thomas H. Hewlett,
him.55 MC, recalled that a large camp hospital
The effort to function as medical pro- was constructed and that “through the
fessionals under such conditions contin- humaneness of Baron Mitsui, a 1919
ued to tax the devotion and ingenuity of Dartmouth graduate, we did have bed
captive doctors and corpsmen. Doctors space for the sick and wounded,” includ-
were usually subordinate to the ing two surgical wards. Here he worked
on the bodies of those injured in the
corporation’s coal mines, using “dental
York: Free Press, 1989), pp. 51–62. The allegation has novocaine as an anesthetic and sharp-
been made, though in our opinion not proved, that
Western POWs were used as human guinea pigs by the ened table knives as scalpels.”57
Japanese germ warfare establishment in Manchuria. A
brief account of Japanese germ warfare and other med-
56
ical war crimes is given in Chapter XIII of this volume. Kerr, Surrender and Survival, p. 177.
55 57
Gillespie, “Recollections,” pp. 87–88 (quoted Ibid., p. 183 (second quotation); Knox, Death
words, p. 87), file 314.7–2, HUMEDS, RG 112, NARA. March, p. 377 (first quotation).
382 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
to healthy prisoners. (Even here the time. Even leaving aside such extremes
Japanese medical officer, a Lieutenant as the torture and vivisection of downed
Saito, and his orderlies seemed indiffer- airmen, the average prisoner lived a life
ent to the needs of the sick, who survived that ranged from spare downward to
largely through the efforts of a Navy sur- unendurable.62
geon, Capt. H. J. Van Peenan, MC.) At Understandably, many did not sur-
some camps American medics received vive. Of the 25,580 Army and Navy per-
substantial quantities of Red Cross ship- sonnel captured and interned in the
ments from the end of 1943 to the spring Philippines, 10,650 died—a death rate
of 1945; a few prisoners, held in onetime of 42 percent, as against less than 1 per-
health spas in Japanese mountain resorts, cent for American prisoners of war in
enjoyed mineral baths. As heartening as the Mediterranean and European the-
the supplies were the instances of kind- aters. Between 34 and 37 percent of all
ness recorded from Japanese officials, American servicemen imprisoned by the
guards, and civilians, who sometimes suf- Japanese died in captivity. Surely, the
fered at the hands of their own country- toll would have been even greater if not
men for their generosity of spirit toward for the efforts of the medical personnel
many prisoners.61 who shared captivity and all its priva-
Yet when all allowances have been tions with them.63
made, the record of Imperial Japan in
respect to its prisoners of war remained 62
On the treatment of airmen, see Chapter XIII. See
a dismal one. Neither occasional ameni- also John M. Gibbs, “Prisoner of War Camps in Japan
and Japanese Controlled Areas as Taken From Reports
ties nor individual kindness modified of Interned American Prisoners,” pp. 53–65, Ms 4–4.5A
the sufferings of those who suffered AA, CMH; Kerr, Surrender and Survival, pp. 179–80.
63
daily beatings and hard labor, nor the Office of the Adjutant General, “Army Battle
Casualties and Nonbattle Deaths in World War II, Final
fact that virtually all prisoners, even the Report, 7 December 1941–31 December 1946,” pp.
lucky ones, were hungry most of the 92–95, copy in CMH–L; Gillespie, “Recollections,” pp.
58–59, 86, file 314.7–2, HUMEDS, RG 112, NARA. See
also Cohen and Cooper, Follow-Up Study, p. 38;
61 Goodman, M.D.P.O.W., pp. 153, 169; Herman, “Prison
See, for example, Goodman, M.D.P.O.W., pp.
86–97, 182–84. Van Peenan survived the war and was Diary,” Sep 79, pp. 15–18, and Oct 79, pp. 3, 5. The
later promoted to rear admiral. A good account of the long-term effects of imprisonment are briefly discussed
camp is given in Emerson, Guest of the Emperor, pp. in Chapter XIII, as are the atrocities by Japanese med-
58–75, copy in CMH–L. ical personnel later prosecuted in war crimes trials.
CHAPTER XII
quick evacuation from the beaches, and Peleliu, and the 81st Division during its
timely support provided by the 17th battle in the Palaus suffered almost
Field Hospital and the 41st Portable 3,300 battle casualties.4
Surgical Hospital. But the harsh rocky The attack on Iwo Jima became leg-
terrain made evacuation difficult from endary for the sacrifices it entailed.
inland, the Japanese regularly fired on The volcanic and sandy island was
litter-bearers, and the slow process of needed, in the opinion of American
destroying enemy bunkers one by one planners, as an air base to halt Japanese
resulted in many wounded. Losses of raids, to provide returning B–29s an
aidmen were high, and heroism among emergency landing site, and to facili-
them was common. In one fighting unit tate fighter support of the long-range
five of the seven Silver Stars awarded for bombers. The bombers, in turn, not
bravery went to medics.3 only had a strategic mission against
Peleliu proved even more difficult to Japanese cities but also would soon be
capture. The Japanese garrison was employed tactically, at Nimitz’ request,
larger, and the Japanese commander, against Kyushu airfields in support of
Col. Kunio Nakagawa, had constructed the Okinawa invasion.
a complex of defensive positions. Here On 19 February 1945 three marine
the marines, after establishing a beach- divisions of the V Amphibious Corps
head and capturing the island’s airfield, assaulted the barren 5-mile-long island,
were halted in “savage and costly fight- supported by four medical battalions,
ing.” Losses were severe; one regiment one for the corps and each division; an
lost over half of its strength. Recalled evacuation hospital; and a field hospital.
from Angaur and attached to the 1st Offshore support featured the usual
Marine Division, the 321st Regimental attack transports, hospital LSTs, and a
Combat Team joined in the struggle. hospital ship. Maturity gained in earlier
The terrain, which the Americans campaigns keynoted the mounting of
called Bloody Nose Ridge, was sowed the operation. But in many brutal
with mines and heavily defended by lessons the Japanese had also learned
mutually supporting strongpoints. how to defend an island. Iwo was heavi-
Casualties had to be extracted by the ly fortified, and from caves and bunkers
use of ropes and pulleys. Even after the above the beaches the defenders satu-
enemy’s resistance had supposedly been rated the landing areas with accurate
broken, mopping up proved harder and deadly fire.
than on Angaur. For an island that plan- Casualties were extraordinarily heavy.
ners had optimistically expected to A party of battalion medics, led by two
seize in four days, fighting against some young medical officers, faced a typical
pockets went on until late November. situation:
More than 11,000 Japanese died on
4
Ibid., p. 51, file 314.7, HUMEDS, RG 112, NARA,
3
Buell Whitehill, “Administrative History of Medical gives 1,285 division casualties for Angaur and 2,709 for
Activities in the Middle Pacific,” block 18c, pp. 22–27 Peleliu, versus the above statistics from Smith, Approach
(quotations, pp. 26, 22), file 314.7, Historical Unit to Philippines, p. 573. Quotation from Frank O. Hough,
Medical Detachment (HUMEDS), Record Group (RG) The Assault on Peleliu (Washington, D.C.: Historical
112, National Archives and Records Administration Division, Headquarters, U.S. Marine Corps, 1950), p.
(NARA), Washington, D.C. 83.
386 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Wounded men were lying all around. It was Fire was so intense that the island’s
impossible to stand erect on the beach, and thin vegetation was virtually erased.
the corpsmen crawled from casualty to casu- Casualties ran in excess of 1,000 a day
alty to bandage wounds and administer mor-
phine and plasma. Within an hour after the for twenty-one consecutive days.
aid station had been set up, a shell exploded Holding them ashore remained exces-
at one side and fragments from it slashed into sively dangerous, and almost 18,000 had
several of the men. Dr. [William] McHugh, a to be evacuated from the island during
big, young, bluff Irishman, swore at the bad the month that followed the first land-
luck. . . . At best the corpsmen could only
work the wounded back in jumps and starts, ing despite the slow, steady progress of
stopping in shellholes to get their breath. the attack. Complicating care were high
Some of the corpsmen, who would normally losses among medical personnel. Some
have gone inland in search of casualties, did marine units lost two-thirds of their
not get off the beach, for the wounded never corpsmen. Medics were killed attending
stopped coming back.5
casualties; beach parties were blown up
5
Department of the Navy, Bureau of Medicine and with the injured; landing craft carrying
Surgery, “The United States Navy Medical Department the wounded and their attendants were
at War, 1941–1945,” 1:400–66 (quotation, pp. 415–16),
files of Bureau of Medicine and Surgery Archives sunk offshore. Some medical units took
(BMSA), Washington, D.C. higher losses than assault units, because
LARGE-UNIT WAR: OKINAWA 387
they could not disperse and hide them- group off the southwest coast of
selves and the casualties. Okinawa, as a base for shipping. The 60-
The availability of whole blood and mile-long Okinawa was to be invaded at
penicillin greatly assisted the wounded, a point midway up the west coast, north
and the island, as sterile as it looked, was of the capital of Naha, on beaches near
remarkably free from disease through the the town of Hagushi. Three marine divi-
battle and afterward. The Army’s 38th sions of the III Amphibious Force would
Field Hospital landed in the second week push north, and the four divisions of the
and began to receive wounded marines, Tenth Army’s XXIV Corps would move
and by the end of March the conquered south. Command of the whole force
island had been turned over to an Army ashore would fall to Lt. Gen. Simon B.
garrison force. While it lasted, the strug- Buckner, Jr., now the Tenth Army com-
gle had been the most intense waged by mander. The medical plan was primarily
American forces in World War II, costing the work of General Willis, the USAF-
the attackers over 6 casualties per 1,000 POA chief surgeon since November
troops per day—more than twice that of 1944. Promising the troops “all they
the battle of Normandy and almost six need, when and where required,” he
times that of the Sicilian campaign. deliberately sought to incorporate all
Americans fighting in the Pacific and the lessons learned thus far in the
the public at home were both shocked Pacific war.7
by the extraordinary losses—more than Certainly, experience was at hand.
24,000 marines and sailors, of whom Though the Tenth Army was a new cre-
almost 21,000 were battle casualties. As a ation, the principal medical officers of
vast Allied armada of 1,600 ships carry- the invasion force were veterans of earli-
ing 550,000 troops closed in on er campaigns. Col. Laurence A. Potter,
Okinawa, news from Iwo Jima grimly MC, the XXIV Corps surgeon, had
confirmed the belief of American plan- served as 7th Infantry Division surgeon
ners that the cost of attacking Japan’s at Attu and as corps surgeon at Leyte.
inner defenses was certain to be high.6 Tenth Army surgeon Col. Frederick B.
Westervelt, MC, was an experienced staff
Planning the Attack officer whose background meshed well
with Potter’s. Together they planned for
American planners had decided to the medical support they believed the
seize first the Kerama Islands, a small Tenth Army units would need, fitting
their requirements into the general
framework established by the Navy.
6
Ibid., 1:423, 464, BMSA. See also OofSurg, USAF- But much of the work of the cam-
PAC, ETMD, 9 Nov 45, app. C, pp. 16–23, and Army
Service Forces (ASF) Monthly Progress Rpt, 30 Sep 45, paign fell to a third figure, already famil-
sec. 7, pp. 2, 4, The Historical Unit (THU) Note Cards, iar to the medical personnel of the
Historians files; Whitehill, “Medical Activities in Middle Pacific theaters. General Maxwell
Pacific,” block 18f, 1:6, file 314.7. All in HUMEDS, RG
112, NARA. Of the total personnel cited for the
Okinawa invasion, about 350,000 manned the fleet and
7
about 200,000 comprised the Tenth Army and the Rpt (Extract), Plans and Opns Sec, OofSurg,
Island Command. Task Force 57, a carrier group used USAFMIDPAC, n.d., sub: Historical Account of
to screen against attacks from Formosa, belonged to Experiences Since Pearl Harbor, p. 2, Historians files,
the British Pacific Fleet. All other units were American. HUMEDS, RG 112, NARA.
388 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
moved from the South Pacific to control of army headquarters once the
become surgeon of the Tenth Army’s latter came ashore.
subordinate Army Garrison Force, com- The multiplication of preventive
monly called the Island Command, medicine units reflected inaccurate
under Maj. Gen. Fred C. Wallace. medical intelligence that pictured
Outranking Westervelt, Maxwell was Okinawa as a pesthole. In fact, the
assigned all responsibilities for evacua- rugged subtropical island was to prove
tion, hospitalization, preventive medi- exceptionally healthy, in this respect
cine, and medical supply—most of the perhaps the least threatening of any that
duties normally handled by the army the relatively lucky Central Pacific forces
surgeon. Since Maxwell could bring had yet fought upon. As Westervelt
only a few of his staff with him, noted on 1 May, “So far our troops have
Westervelt placed most of his own per- had less sickness than in garrison.” Like
sonnel on special duty with the Island the Army units, each marine division
Command medical section. This surpris- received a field hospital and a Navy
ing arrangement, for which no clear malaria and epidemic control unit; addi-
rationale emerges from surviving tionally, the III Amphibious Corps had
records, might have caused much diffi- two evacuation hospitals attached, pro-
culty but apparently did not—a tribute viding a more complete chain of evacu-
to the pragmatism of both the Island ation than the Army possessed.9
Command and Tenth Army surgeons.8 As usual, an Army shore party and a
In addition to the usual organic units, Navy beach party would guide evacua-
each Army division was to be backed up tion to vessels offshore, consisting of
by a field hospital, two portable surgical Army and Navy hospital ships, hospital
hospitals, and several anti-malaria units. LSTs, and converted APAs (transport,
Ashore, the portables would assist the attack). The Navy hospital ships were
clearing station platoons and would truly floating hospitals, with complete
advance by leapfrogging to provide medical, surgical, and neuropsychiatric
frontline support as soon as the field facilities aboard; additionally, by stock-
hospital landed. The XXIV Corps ing medical supplies, the Navy ships
brought with it a Tenth Army field hos- could act as resupply points for other
pital and a station hospital, strength- vessels. The Army hospital ships were
ened by specialist personnel from a gen-
eral hospital. An Army evacuation hos- 9
In the end the Army provided eleven field hospitals
pital was lacking. The corps’ 71st and eight portables. See ibid., 1:23–24, file 314.7;
Medical Battalion was to organize evacu- Comments (quotation) of [Col Frederick B. Westervelt,
ation from the clearing station to either Surg], Tenth Army, 1 May 45, Encl to Ltr, Brig Gen John
M. Willis, CSurg, USAFPOA, to Maj Gen Norman T.
the shore party or captured airfields. Kirk, SG, Wash., D.C., 8 May 45, file 312.1 Kirk-Willis
The corps also brought medical supply Correspondence (SWPA); Rpt (Extract), OofSurg,
teams and additional anti-malaria units. USAFMIDPAC, 24 Sep 45, sub: Okinawa Participation,
sec. 13, pp. 1–2, file 370.2; CSurg, USAFMIDPAC,
Tenth Army units would return to the Annual Rpt, 1945, p. 36, file 319.1–2; Surg, 77th Inf Div,
Quarterly Rpt, Apr–Jun 45, p. 1, THU Note Cards,
Historians files; and 77th Inf Div AAR, Okinawa, 25
8
Whitehill, “Medical Activities in Middle Pacific,” Apr–30 Jun 45, pp. 74–75, THU Note Cards, Historians
block 18f, 1:72–73, file 314.7, HUMEDS, RG 112, files. All in HUMEDS, RG 112, NARA. See also “Navy
NARA. Medical Department at War,” 1:554, BMSA.
LARGE-UNIT WAR: OKINAWA 389
less elaborate, for they were conceived staffed by Army surgeons as well as by
as evacuation vessels—hospital trans- Navy beach party medical sections.11
ports—and served effectively in that Hospitals to the rear prepared for an
role, returning about a sixth of the influx of casualties. Using the Saipan
388,000 evacuees to the United States campaign as a guide, the joint head-
during 1944 and the first half of 1945, or quarters estimated 30,000 in the first
about the same number as returned by sixty days, with about three-quarters
air. By far the largest number, however, wounded. Some 16,000 beds were to be
was carried by troop transports. made available in the Marianas and
At Okinawa the hospital ships would Oahu, about equally divided between
first display their Geneva markings, but, the Army and the Navy. Army hospitals
after two attacks, would hide blacked- in the advance casualty reception cen-
out among the transports at night. The ters expanded, including a new 5,000-
LSTs would provide patient care and bed hospital center on Tinian. Care on
would also serve as control points, Okinawa itself was slated to increase
directing the flow of wounded to the greatly in the months after the initial
APAs and the hospital ships. To shuttle landing, with an array of hospitals, labo-
the wounded from shore to ship and ratories, and specialized units of various
from ship to ship, the invasion force types scheduled to land in a pre-
would rely on seagoing ambulances. arranged order. As in the Philippines,
Landing craft in the first four waves military government detachments were
were designated to return wounded to assigned the task of dealing with a large
the hospital ships for treatment, and and, in this case, presumably hostile
craft under the control of the shore population.12
party commander would continue the Seemingly everything possible in the
work after the troops moved inland.10 way of medical supplies was provided.
By ship or plane the wounded would The Tenth Army received for the assault
be evacuated to bases in the Marianas, 25,000 litters, 50,000 blankets, 7 billion
Hawaii, and the United States. units of penicillin, 30 million vitamin
Evacuation policy followed the familiar tablets, 100,000 cans of footpowder, and
pattern: in the assault phase, immediate; 100,000 iodine swabs. In other respects,
when the island was secured, thirty days. some acknowledged gaps existed in the
Air evacuation to the Marianas was slat- preparations for the attack. Many of the
ed to begin five days after the initial troops had little opportunity for train-
assault, with the Air Transport ing; those on Leyte had hardly rested
Command’s Pacific Division taking the from the last campaign before they
majority of casualties to Saipan initially embarked for the new one. Shortages in
and to Oahu later. Army personnel bed strength existed; Colonel Westervelt
worked on two hospital ships with Navy had received only 4,500 of the 8,000
crews, and two of the hospital LSTs were mobile beds he asked for, and he lacked
11
Whitehill, “Medical Activities in Middle Pacific,”
10
ASF Monthly Progress Rpt, 31 Jul 45, sec. 7, pp. block 18f, 1:41–42, file 314.7, HUMEDS, RG 112,
34–35; OofSurg, 96th Inf Div, ETMD, 19 Jul 45, p. 2. NARA.
12
Both THU Note Cards, Historians files, HUMEDS, RG Ibid., 1:22–23, file 314.7, HUMEDS, RG 112,
112, NARA. NARA; Appleman et al., Okinawa, p. 35.
390 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
an Army evacuation hospital, none being The campaign ashore seemed easy as
available in the Pacific Ocean Areas. On the American forces moved inland. Two
the other hand, Army medical personnel airfields scheduled for capture on L+3
for the operation totaled 10,773—fewer instead fell on the first day, in usable
than for Luzon but far more than for any condition—one to the soldiers, the
of the previous operations in the Pacific other to the marines. To the north lay
Ocean Areas. As on Iwo Jima, blood rugged pine-clad mountains, seemingly
banks would be established ashore and the logical place to mount a defense. But
whole blood would be made available as most of the population, the towns of
far forward as the collecting stations. Naha and Shuri, and other airfields lay
The medics carried improved first aid to the south. Here the land featured an
kits, and sturdy Quonset huts were to old limestone plateau, pitted by the rains
replace tents for field medical units dur- and marked by low ridges and escarp-
ing the garrison phase. American ments. This too provided many natural
wartime productive capacity, like the fortresses for the defenders to exploit.
nation’s military maturity, had reached The Tenth Army now divided. The III
its zenith and in most respects an ample Amphibious Corps swung north in the
allotment of resources had been made days that followed. The advance met little
for the casualties to come.13 resistance, and the marine medical units
found their major problem in keeping
The Battle Opens up with the line units. Army forces
moved more slowly southward, and the
The 77th Infantry Division landed in medics, blessed with a measured advance
the Keramas late in March, seizing the and few casualties to treat, found no dif-
islands in a swift conquest marked by ficulty in adhering to established plans.
low casualties. Then on L-day, 1 April On L-day the clearing stations of both the
1945, a pleasant Easter morning, the 7th and the 96th Infantry Divisions had
invasion of Okinawa began. Lying in the come ashore, and that of the 7th Division
Japan current, the island is structurally opened for surgery. Similarly, the divi-
as complex as Guam, surrounded by sion’s two portables had arrived, set up,
reefs, its mountains encrusted with and begun to receive casualties, mainly
coral. The climate is temperate, with civilians injured in the prelanding bom-
wooded areas clad in conifers. On the bardment. On L+2 the 71st Medical
day of the invasion the morning air was Battalion landed, allowing divisional
cool, and little resistance was encoun- units to move forward.
tered on the Hagushi beaches. The By 7 April, when 7th Division forces
enemy appeared to have withdrawn, giv- reached the east coast of Okinawa, two
ing notice of his presence somewhere field hospitals had landed, the 69th
inland only by light artillery fire.14 opening in a wrecked school building
13
Whitehill, “Medical Activities in Middle Pacific,” See also Appleman et al., Okinawa, p. 74; “Navy Medical
block 18f, 1:50, file 314.7, HUMEDS, RG 112, NARA. Department at War,” 1:557–58, BMSA. A detailed
14
Ibid., 1:22–23, 45–47, file 314.7; Surg, 77th Inf Div, account of the 7th Infantry Division’s landing is given
Quarterly Rpt, Apr–Jun 45, p. 1, THU Note Cards, in Samuel Eliot Morison, History of United States Naval
Historians files; OofSurg, Tenth Army, ETMD, 20 Jul Operations in World War II, 15 vols. (Boston: Little,
45, p. 1, file 350.05. All in HUMEDS, RG 112, NARA. Brown and Co., 1964), 14:140–55.
LARGE-UNIT WAR: OKINAWA 391
strewn with rubble. The XXIV Corps Action began as the ships lying off-
had set up an evacuation station, and shore were bloodied by a wave of
three hospital LSTs and a fourth with a kamikazes. After 6 April scattered air
blood bank lay offshore. The lack of attacks grew rapidly into a full-scale
enemy resistance allowed the medical assault, with ten major and countless
system ashore to develop without hin- minor onsets, some of which employed a
drance, as well as offshore evacuation to 600-mph piloted flying bomb, the Ohka.
be carried on without the frenzy that The first medical surprise of Okinawa was
had attended other assaults on contest- that the ships, supposedly the refuge of
ed beaches. Despite increasing air the wounded, proved more dangerous
attacks on the fleet, a textbook opera- than the Hagushi beaches, incurring “the
tion seemed to be in progress.15 greatest casualty load among their own
The enemy, however, lay in wait. The personnel . . . in the entire war.”17
Japanese, under Lt. Gen. Mitsuru Kamikazes baffled Navy medical offi-
Ushijima who had decided not to cers, who could find no way of making
oppose the invasion on the beaches but rational plans to meet such “abnormal
to fight inland, dug in for shelter from and barbarous” tactics. Typical was the
American firepower. The defending case of the USS Morrison, one of the radar
force consisted of two divisions and an picket ships that formed the first target of
independent brigade (about 67,000 sol- the suicide planes. Aboard, no safe area
diers in all, of whom an unknown num- could be found for a main dressing sta-
ber were Okinawan draftees or tion, and no rational distribution of med-
reservists), as well as naval units, 24,000 ical personnel or equipment could be
Okinawan home guardsmen, and a mass made. Instead of acting as a team, medics
of conscripted laborers. Even older could only render first aid to the wound-
schoolchildren had been impressed into ed nearby and, like their comrades, pray.
the force. Ushijima’s units included a During the final attack on 4 May only one
tank regiment and a strong concentra- injured soldier reached the dressing sta-
tion of artillery, much of it intended for tion, where he was trapped when the ship
the Philippines but impossible to ship sank after being hit four times in ten min-
because of the disruption of Japanese utes. In the water one doctor and an
maritime traffic by American submarines uninjured corpsman swam to the various
and planes. In all, the defenders num- groups of survivors, trying to give first
bered over 100,000, holed up in 60 miles aid. A thick layer of fuel oil acted as a pal-
of natural caves and artificial tunnels.16 liative for the many severe burns. Taken
aboard a little support craft, 115 wound-
15
ed were jammed together in “complete
Surg, XXIV Corps, Daily Journal (copy), 1–8 Apr
45, file 319.1; 69th Field Hosp Quarterly Rpt (copy), disorder,” and little treatment could be
Apr–Jun 45, p. 3, file 319.1; ASF Monthly Progress Rpt, given but morphine to relieve pain.18
30 Sep 45, pp. 6–8, THU Note Cards, Historians files.
All in HUMEDS, RG 112, NARA. See also “Navy
17
Medical Department at War,” 1:560, BMSA. Quotation from “Navy Medical Department at
16
On Japanese plans and tactics, see Thomas M. War,” 1:558, BMSA. See also Morison, Naval Operations
Huber, Japan’s Battle of Okinawa, April–June 1945, in World War II, 14:170.
18
Leavenworth Paper no. 18 (Fort Leavenworth, Kans.: Quotations from “Navy Medical Department at
Combat Studies Institute, U.S. Army Command and War,” 1:562–63, BMSA. See also Morison, Naval
General Staff College, 1990), pp. 13, 19–20. Operations in World War II, 14:254–55.
392 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
spending agonized hours in the sea ed filled the medical units. Fighting was
before rescue. In rear area hospitals marked by suicidal fury, including
they could be seen, swathed like mum- attacks by island women wielding wood-
mies, breathing and taking food en spears and by soldiers and civilians
through tubes. But death by blast, fire or who charged through their own mortar
water was all too common. The Navy, fire. One American soldier “had his arm
alone of the services, would record broken by the flying leg” of a Japanese
more dead than wounded in the battle soldier, armed only with a satchel
for Okinawa—a remarkable situation, charge, who had attacked as a human
possibly unique in its history.20 bomb.22
Despite these bizarre elements, the
The Tempo Quickens ridges of Iegusugu formed a classic
Japanese defensive position. The rough
Meanwhile, the struggle ashore terrain was pocked with fortified caves
became far more difficult. Enemy resis- and hidden bunkers, both connected by
tance at first was light for the marines, tunnels, and was sown with crude but
who were moving north. Land evacua- effective mines. Lacking either clearing
tion was slowed by heavy rain, blown elements or portables, which had been
bridges, and washed-out roads that reserved for later operations on
caused amphibians to be pressed into ser- Okinawa, the collecting companies han-
vice again. Tougher was the conquest of dled all casualties. The wounded were
the rocky Motobu Peninsula. brought by litter to collecting points and
Accustomed to facing fixed defenses on by jeep ambulances to the beaches.
small islands, the marines reverted to Mining made the roads perilous, and
textbook maneuvers to envelop the main two ambulances carrying casualties, dri-
enemy stronghold, which fell on 17 April. vers, and a collecting company com-
But the hardest fighting in the north mander were destroyed. Poor sanita-
occurred on a small offshore island, Ie tion, piles of enemy dead, and a high
Shima. On 16 April the 77th Division dengue rate briefly added a serious dis-
invaded to secure a major military prize, ease outbreak to the tale of woe. The
large airfields that made the island fight lasted only five days. Hospital LSTs
resemble “a huge, immovable aircraft car- cared for the wounded offshore, and the
rier.” A strong garrison of 2,000, backed sanitary problem was quickly solved. But
by a fanatically loyal and determined civil Ie Shima was an image in miniature of
population numbering perhaps 5,000 the fighting that in the meantime had
more, fought a most tenacious battle in begun in southern Okinawa.23
the town of Ie and on the slopes of a dead Here the American divisions had
volcano, Iegusugu, which American spent the first week of April reducing
troops called the Pinnacle.21 heavily defended outposts. Then on the
Here the famed journalist Ernie Pyle ninth they encountered the enemy’s
was among 172 dead, while 902 wound-
22
Ibid., p. 160.
20 23
Over 4,900 died as against 4,824 wounded. See Surg, 77th Inf Div, Quarterly Rpt, Apr–Jun 45, pp.
Morison, Naval Operations in World War II, 14:195, 282. 1–3, THU Note Cards, Historians files, HUMEDS, RG
21
Appleman et al., Okinawa, p. 150. 112, NARA.
394 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
main line—a complex of fortified ridges were cut off from resupply. Familiar
concealing a tightly woven net of mutu- enemy doctrine emphasized attack, and
ally supporting strongpoints that pro- the instincts and personality of the 32d
tected the ancient Okinawan capital of Army’s fiery chief of staff, Lt. Gen. Isamu
Shuri. Japanese medical preparations Cho, pointed in the same direction. A
for the defense apparently had been counterattack, however, allowed
sound, with aid stations dug into the American firepower free rein to savage
underground complexes and with regu- Japanese soldiers, who withdrew blood-
lations for sanitation and exercise to ied to their defenses. In turn, General
maintain the health of troops who Buckner brought in his reserve division,
would spend much of their time the 27th, and ordered a full-scale
entombed and waiting.24 assault, preceded by air strikes and the
Sheltered from naval and air bom- heaviest bombardment of the Pacific
bardment, with artillery and mortars war. The attack on 19 April failed, result-
registered on the lines of approach, the ing in heavy casualties and the loss of
Japanese again proved themselves to be twenty-two tanks.
brave and unrelenting foes. The Then, in four days of sustained fight-
progress of the fighting was marked by ing as bitter as any in the campaign, the
an endless number of “desperate adven- Americans worked their way into posi-
ture[s] in close combat.” Suffering tions on the outer Shuri defense ring.
heavy losses, the Americans fought back Enemy defenses proved to have been
with tank-infantry teams that drove the masterfully placed. Japanese soldiers
defenders back into their caves before exploited reverse slopes brilliantly; they
blasting the openings with high explo- yielded no ground but rather died by
sives. Fighting was intense and constant. flame and demolition. American losses
The 383d Infantry, 96th Division, lost continued to be heavy. Half-tracks and
326 in one day; one battalion lost half of tanks evacuated many wounded, but
its complement. Writing to the USAF- heavy casualties and fatigue sapped the
POA chief surgeon, General Maxwell combat efficiency of the three divisions—
reported that “the opposition has been 7th, 27th, and 96th—so far committed.26
terrific, with the heaviest mortar and Hence, in late April and early May,
artillery fire [that] any of our men have Buckner reorganized. He sent the 27th
ever experienced.” Accurate enemy fire Division north to mop up; brought the
aimed at command posts in at least one marines of the III Amphibious Corps
instance fell on a nearby aid station as south to aid the attack; and replaced the
well.25 battered 96th Division with the 77th,
Yet attrition tolled more heavily on fresh from its victory on Ie Shima. The
the Japanese, who, with fewer forces, new troops arrived just in time to
receive, on 4 May, the brunt of a valiant
24
but hopeless Japanese counterattack,
Appleman et al., Okinawa, pp. 189–90, 210.
25
Ibid., pp. 118, 129, 256 (first quotation); Ltr, Brig again undertaken at the urging of
Gen Earl Maxwell, OofSurg, Island Cmd, to Brig Gen excitable officers who had lost patience
John M. Willis, CSurg, USAFPOA, 4 May 45, p. 1 (sec- with a strategy that amounted to slowing
ond quotation), Encl to Ltr, Willis to Kirk, 8 May 45, file
312.1 Kirk-Willis Correspondence (SWPA), HUMEDS,
26
RG 112, NARA. Huber, Japan’s Battle of Okinawa, pp. 67–68.
LARGE-UNIT WAR: OKINAWA 395
the Americans by dying in place. Four 14 inches of rain fell during May, hin-
days of desperate fighting produced dering everything from combat support
5,000 enemy casualties, to no purpose. to resupply to spraying DDT. Eight litter-
American losses in the hardest hit divi- bearers were needed to move a single lit-
sions were high—379 in the 7th and ter. As vehicles were immobilized, evacu-
77th together—but not comparable to ation times grew, and the combat forces
those of the Japanese. endured new misery in the water-filled
Nevertheless, the enemy still was able mudholes that sheltered them from the
to wage an effective battle of attrition. enemy. Yet the Japanese at last showed
On 11 May the 1st and 6th Marine signs of cracking. On the twenty-seventh
Divisions and the 77th and 96th the Okinawan capital of Naha fell almost
Divisions (which had returned to relieve without bloodshed to the marines, a ruin
the 7th) opened an assault on the inner more complete, if possible, than Manila
Shuri line. The fighting again featured had been. Two days later Shuri Castle
heavy Japanese mortar and artillery bar- was captured by an enveloping maneu-
rages from reverse slopes, which the ver of the 7th Division, exploiting night
Americans endured without the defend- and rain. A Japanese counterthrust led
ers’ benefit of prepared defenses. The to intense fighting in which T. Sgt.
Japanese infiltrated at night; the William Goodman, the only medic left in
Americans pressed forward during the Company I, 32d Infantry, 7th Division,
daylight hours. Incessant sniping took stopped bandaging the wounded long
its toll on both armies. enough to kill five infiltrators. But the
Seizure of a single hill—the Sugar enemy’s fortified area was in danger as
Loaf—cost the 6th Marine Division the American left and right wings both
2,662 killed or wounded and 1,289 cases advanced.28
of combat fatigue. On Ishimmi Ridge, By the end of the month the toll on
where the 77th Division’s 307th Infantry both armies was heavy. The Japanese
seized high land only to be encircled, had lost at least 50,000 dead, including
“the dead lay in pools of blood where many of their best troops. The American
they fell, or were pushed from holes to ground forces had lost over 26,000
make room for the living. An aid man killed, wounded, and missing. The rate
[sic], although wounded himself, con- of psychiatric casualties apparently was
tinued his work until his supplies were higher than in any previous Pacific bat-
exhausted.” Relieved at last, the compa- tle. But the threat of encirclement for
ny that had made the first attack the Japanese holding the Shuri defenses
returned the division area, carrying its continued to grow. Hence, General
wounded, having lost 75 percent of its Ushijima prepared for his last stand,
204 officers and enlisted men.27 skillfully withdrawing into redoubts dug
In the last week of May furious rains into hill masses, called Yaeju-Dake and
bogged down the heavy equipment, Yuza-Dake, in extreme southern
making evacuation by wheeled vehicle Okinawa. For another three weeks
almost impossible. At one airfield almost
28
Ibid., p. 382; Island Cmd AAR, Okinawa, 30 Jun 45,
27
Appleman et al., Okinawa, pp. 302, 323, 336 (quo- p. 8-XIV-7, THU Note Cards, Historians files,
tation), 338. HUMEDS, RG 112, NARA.
396 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
American soldiers and marines fought fare, in the assault of the kamikazes, and
on, until the enemy’s last positions fell. in the prodigious rains that reduced the
By 22 June, as the mop-up began, both lowlands to seas of mire.
commanders were dead, General As usual in the Pacific, medics were
Buckner killed by a chunk of coral not spared, and their casualty rate was
hurled out by the explosion of a shell the highest of any branch except the
and General Ushijima, to whom infantry. Nor were the ranks easy to fill.
Buckner had offered terms of surren- The killing and wounding of enlisted
der, by his own hand in ritual seppuku. medics left a continuing deficit of
Despite this theatrical conclusion to trained personnel in line units, because
the last great battle of World War II, of the inevitable time lag experienced
some 7,400 Japanese soldiers—an alto- by the USAFPOA chief surgeon in
gether unprecedented number—sur- obtaining replacements. Those who
rendered, most at the end of the cam- remained bore an added burden in the
paign. Civilians emerged from hiding; interim, making it necessary to pull sol-
no mass suicides occurred on Okinawa diers from combat units—on one occa-
itself, though the story was different on sion, forty field artillerymen were sent
the offshore islands. The next phase of forward as litter-bearers—to move the
the work could now proceed in greater overflow of wounded who otherwise
security—not only to rebuild Okinawa could not have been evacuated at all.
as a base for the coming invasion of Officer replacements were adequate in
Japan but also to minister to the human numbers, but Colonel Potter, the XXIV
wreckage of the 93-day campaign for the Corps surgeon, complained of the red
Ryukyus, the longest since Guadalcanal tape that obstructed their use:
and the bloodiest of the entire Pacific
An officer is killed—the Division prepares a
war.29 requisition, sends it to XXIV Corps, we send
it on to Tenth Army, who [sic] in turn, sends
The Medical Problem it to the Replacement Depot. During the
week, the Medical Officer sits around at the
The struggle had featured large Depot, while the Division operates short a
medical officer, who is physically present on
American units in continuous, grinding the Island and doing nothing.30
combat with an entrenched, desperate,
well-armed foe. But if it resembled Evacuation at the front was typical of
European war in the numbers of men many Pacific struggles. Armed company
and cannon, the Okinawa campaign was and battalion medics, litter-bearers from
essentially of the Pacific in the propor- the collecting companies, and infantry
tion of killed to captured among the replacements worked in difficult ter-
defenders, in the tactics employed by rain, hidden sometimes by chemical
both sides for the conduct of island war- smoke. At all times they were targets of
29 30
Appleman et al., Okinawa, pp. 184–474 (statistics); Surg, XXIV Corps, Daily Journal (copy), 5 May 45
Isely and Crowl, Marines and Amphibious War, pp. (quotation), file 319.1; 77th Inf Div AAR, Okinawa, 25
543–79; Hough, Assault on Peleliu, pp. 364–78. The Apr–30 Jun 45, pp. 73–76, THU Note Cards, Historians
Okinawa campaign officially ended on 2 July 1945. files; OofSurg, 96th Inf Div, ETMD, 19 Jul 45, encl. 1,
Losses at Iwo Jima were higher in proportion to the THU Note Cards, Historians files. All in HUMEDS, RG
numbers engaged. 112, NARA.
LARGE-UNIT WAR: OKINAWA 397
aimed enemy fire. It was in such condi- On another occasion Doss treated those
tions that Pfc. Desmond T. Doss of the lying in the very mouth of an enemy-
medical detachment, 307th Infantry, held cave; on a third, wounded himself,
77th Division, won the Medal of Honor. he gave up his place on a litter to a more
A conscientious objector who refused to severely injured soldier. Doss then
carry a weapon and kept the Seventh splinted his own fractured arm with a
Day Adventist sabbath every Saturday, rifle stock and crawled to safety.31
Doss at the end of April was a company Savagery, bravery, and improvisation
aidman during his unit’s assault on a marked the front line as in all the Pacific
400-foot escarpment. The troops seized fighting. Once out of the combat area,
the crest, only to be hit by furious fire however, evacuation for the first time in
from the reverse slope. As they scat-
tered, Doss remained alone at the top to
31
help casualties. He carried the wounded WD GO 97, 1 Nov 45, p. 2; [77th Division
Association], Ours To Hold It High: The History of the 77th
to the edge and, after tying them to lit- Infantry Division in World War II (Washington, D.C.:
ters, lowered them to friendly hands. Infantry Journal Press, 1947), pp. 303–04.
398 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the experience of many veterans of the beaches (Map 15), some 4,000 to
assumed the form dictated by field ser- 6,000 yards from the fighting line—close
vice regulations. The 77th Division sur- enough that enemy shells sometimes
geon reported that his main supply road landed in the hospital areas. Most
was usable, that evacuation times were worked under canvas, or in abandoned
short, that an efficient shuttle of ambu- dwellings, and many used the lull that fol-
lances was easy to maintain, and that the lowed the landings to organize and pre-
wounded from the clearing station— pare themselves for the heavy work
aided by whole blood, for the first time ahead. At first under division control,
available at collecting stations—were in they passed in sequence to the XXIV
good condition. Similarly, the 96th Corps and then to the Tenth Army, the
Division surgeon said that “the terrain higher headquarters, when it arrived. As
and road nets [sic] lent themselves well the chain of evacuation grew more com-
to the needs of rapid evacuation.” plex, corps clearing stations moved
Before and after (though not during) ahead of the hospitals, to treat less seri-
the rains, such conditions briefly creat- ous cases, and the corps’ 71st Medical
ed the image of conventional warfare on Battalion took over the movement of
Okinawa.32 wounded from clearing stations to hospi-
Until the field hospitals came ashore, tals. Between 25 April and 20 June five
division ambulances moved casualties field hospitals not attached to divisions
from aid stations to the Hagushi beach- also arrived. They worked in a variety of
es, where clearing stations and portables ways, some serving in effect as station and
awaited them. Once transferred to Navy others as small evacuation hospitals. Four
beach party medics, they were carried by station hospitals arrived in late May and
landing craft offshore to the hospital June, to receive the overflow of casualties
LSTs. Here, after treatment and sorting, from the fighting in the south.34
the seriously injured were sent on to For most of the campaign the field
hospital ships and transports for evacua- hospitals were the key elements in
tion to the Marianas. In the general hos- treating the wounded ashore. They
pitals on Saipan, the impact of Iwo Jima served diverse functions, just as the
and Okinawa was abrupt. As casualties portables had during earlier small-unit
flooded in, surgical services burgeoned fighting, receiving the sick and wound-
and ward medical officers stood round- ed. Yet, because the expected casualties
the-clock duty.33 from sickness did not materialize in the
The treatment received by the wound- numbers the Army had anticipated, few
ed on Okinawa in many ways was a model hospitals, despite the heavy casualties,
of matured forward medicine. Beginning operated much in excess of their rated
to arrive on L+5, field hospitals estab- capacity. (In the 31st Field Hospital, for
lished themselves at road junctions south
34
31st Field Hosp AAR (copy), Okinawa, 1945, pp.
32
Surg, 77th Inf Div, Quarterly Rpt, Apr–Jun 45, p. 3; 1–4, file 319.1; 69th Field Hosp Quarterly Rpt (copy),
96th Inf Div AAR, Okinawa, 1 Apr–30 Jun 45, p. 20 Apr–Jun 45, pp. 2–4, file 319.1. Both in HUMEDS, RG
(quotation). Both THU Note Cards, Historians files, 112, NARA. See also Tenth Army, “Action Report:
HUMEDS, RG 112, NARA. Ryukyus, 26 March to 30 June 1945,” pp. 11-XV-8 to 11-
33
148th Gen Hosp ETMD, 20 Oct 45, pp.1–5, file XV-14, U.S. Army Center of Military History Library
350.05, HUMEDS, RG 112, NARA. (CMH–L), Washington, D.C.
LARGE-UNIT WAR: OKINAWA 399
Ie Shima
HOSPITALS ON OKINAWA Imadomari
Miles
Nago
E A S T
OKINAWA
C H I N A
S E A
Ishikawa
CHIMU BAY
Bishi R Taba
74th Field Hospital Hagushi
76th Field Hospital
82d Field Hospital
31st Field Hospital Futema
Ozato
NAKAGUSUKU
Naha BAY
Shuri
OROKU Yonabaru
PENINSULA
Minatoga
MAP 15
example, the campaign brought in 7,660 booby-traps, concertina wire and well-
surgical cases but only 876 medical armed guard posts” were at the peak of
cases.) Moreover, the field hospitals were medical and military efficiency. A con-
well served by other units. Forward med- stantly improving system of sorting and
ical units, defending themselves in evacuation prevented the wounded from
perimeters surrounded by “trip-flares, piling up, especially after the Tenth
400 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Although overworked, the surgeons first to the triage ward, where an experi-
had some compensating advantages. enced surgeon examined him, X-rays
Supporting the severely injured both in were made, and his priority for surgery
transit and in surgery was an abundant was established. If he was in shock or in
supply of whole blood. Naval Air danger of shock—a potentially fatal con-
Transport Service planes, equipped with dition caused by blood loss, with typical
special refrigeration units, flew blood symptoms of cold, anxiety, and elevated
from Los Angeles and San Francisco to pulse rate—he was sent to a special shock
Guam. Initially, ships carried it to ward, where teams of internists went into
Okinawa, but air service began on 18 action. Routine tests determined among
April. As employed in the Philippines, a other things the percentage of red cells
specially equipped LST received, stored, in a given volume of blood, and hence
and disbursed the blood. Twice as much the amount of blood lost. He then
whole blood as plasma was used; whole received plasma, intravenous glucose,
blood replaced plasma in the manage- and probably the amount of whole blood
ment of shock and burns. Blood was needed. When ready for surgery, he was
given as far forward as collecting stations, taken to one of the tented operating
and the officer in charge of the Army’s rooms, with tarpaulin floors to minimize
blood program, Lt. Col. Douglas B. the intrusion of dust or mud.
Kendrick, visited Okinawa during the bat- Here steam from an autoclave provid-
tle to inspect field hospitals, to give lec- ed warmth. Enlisted surgical technicians
tures on the advantages of whole blood, acted as scrub nurses and surgical assis-
and to assist on the shock wards. The hos- tants, and an enlisted technician admin-
pitals alone utilized 14,000 pints of whole istered a spinal anesthetic, open drop
blood, and more than 40,000 were trans- ether, or Pentothal under the supervi-
fused in the course of the campaign.38 sion of a commissioned nurse anesthetist
The casualty arriving at a field hospital or anesthesiologist. Operations were car-
entered a medical assembly line. He went ried out by general surgeons or by spe-
cialists, depending on the type of injury.
The six hard-working orthopedists on
sub: Orthopedic Surgery on Okinawa, Historians files; Okinawa accomplished an exhausting
Surg, XXIV Corps, Daily Journal (copy), 21 Apr 45, file
319.1. All in HUMEDS, RG 112, NARA. It should be task in dealing ably with some 15,000
noted that Colonel Potter remained a strong supporter injuries, many resulting from artillery.
of the role of the portables, writing that “the value of The presence of neurosurgeons on
the Portable Surgical Hospitals cannot be over-empha-
sized especially in the administering of definitive treat- detached service from general hospitals
ment to severe non-transportable battle casualties.” See made early treatment of brain and spinal
Rpt, Surg, XXIV Corps, n.d., sub: Iceberg Operation, p. cord injuries possible, almost from the
17, file 319.1–2, HUMEDS, RG 112, NARA.
38
OofSurg, USAFPAC, ETMD, 28 Sep 45, THU Note first day of severe fighting.39
Cards, Historians files; Whitehill, “Medical Activities in
Middle Pacific,” block 18f, 1:148–50, file 314.7. Both in
39
HUMEDS, RG 112, NARA. See also Interv, Mary Ellen 31st Field Hosp AAR (copy), Okinawa, 1945, pp.
Condon-Rall with Douglas B. Kendrick, 7 Oct 80, CMH; 9–10, 23–31, file 319.1; Ltr (copy), Sofield to Peterson,
Douglas B. Kendrick, “The Blood Program,” in B. 20 Jul 45, Historians files. Both in HUMEDS, RG 112,
Noland Carter, ed., Activities of Surgical Consultants, NARA. Full use of air evacuation and the establishment
Medical Department, United States Army in World War of a separate neurosurgical chain of evacuation to
II, 2 vols. (Washington, D.C.: Office of the Surgeon speed movement and minimize injury in transit, how-
General, Department of the Army, 1962–64), 1:160–61. ever, were not attained until the Korean war.
ADMINISTERING WHOLE BLOOD AND ETHER in tented operating rooms
LARGE-UNIT WAR: OKINAWA 403
It is said that the Japanese artillery on men in the neuropsychiatric wards. The
Okinawa has been the heaviest and most number of casualties continued to grow
accurate that we have encountered. This so that on 25 April the 82d Field
surprising and violent change in the
Japanese tactics caused a remarkable reac- Hospital opened specifically to care for
tion among the front line [sic] troops. Many NPs, both soldiers and marines. Here
psychoneurotic patients were brought in the most difficult cases received more
during the days of the heaviest Japanese complex treatment, including group
shelling. Our troops, though veterans, had therapy and hypnosis.
no way of personally combating this artillery.
Having no choice but to get into a hole and Eventually, because psychiatrists from
“sweat it out,” many developed severe anxi- other hospitals were assigned to the 82d,
ety and fear neuroses. These “battle it became the best staffed facility of its
fatigues” were brought to the aid stations kind in the Pacific war. Deliberately
trembling violently, glassy-eyed, crouched operating closer to the front line than
and flinching, and many were crying hyster-
ically. Old, hardened soldiers broke up the other field hospitals, the 82d embodied
same as new troops.43 Kaufman’s conviction that NPs must be
held in the danger zone and continue to
About 1 in every 7 hospital admissions make their cots, to stand in chow lines,
was for causes loosely termed psychiatric. and to hear the “shells whiz over their
Attached to the Tenth Army for the heads” if they were to recover and
Okinawa operation was Col. M. Ralph return to duty. For the same reason, four
Kaufman, MC, the USAFPAO neuropsy- rest camps—where soldiers recovering
chiatric consultant, who brought to bear from combat fatigue finished their recu-
the accumulated experience of past peration on duty status—were set up for-
years in the South Pacific Area and the ward of the field hospitals, rather than
Pacific Ocean Areas. Active therapy at to the rear. In some units the results
the earliest possible time and at the most were as good as any in World War II. The
forward possible echelon was Kaufman’s 77th Division, for example, reported
aim. Those suffering only from exhaus- that 76 percent of all neuropsychiatric
tion and mild anxiety received sedation cases returned to full duty and that less
and rest at aid stations and were than 10 percent of those returned to
returned to duty after twenty-four hours, combat failed to hold up under renewed
while more serious cases went to a divi- stress.44
sion clearing station to be seen by the As a whole, however, the Tenth Army
division psychiatrist. Here treatment for had less satisfactory results, for reasons
most consisted of reassurance, rest, hot that had nothing to do with the scheme
meals, sleep, and a change of clothes. of forward treatment in itself. More than
However, as the clearing stations became half of the 3,118 Army and Marine neu-
overcrowded, the overflow went to the ropsychiatric cases had to be evacuated,
field hospitals, each of which had a psy- many going untreated to the rear
chiatrist on its staff and trained enlisted because the wounded had priority for
43 44
Ltr, Bloodhart, thru CO, 18th Med Gen Lab, to Quotation from Markey, “Tenth U.S. Army,” in
CSurg, USAFPOA, 5 May 45, p. 3 (quotation), Encl 3 to Glass, ed., Overseas Theaters, p. 672. See also 77th Inf Div
Ltr, Willis to Kirk, 7 May 45, file 312.1 Kirk-Willis AAR, Okinawa, 25 Apr–30 Jun 45, p. 76, THU Note
Correspondence (SWPA), HUMEDS, RG 112, NARA. Cards, Historians files, HUMEDS, RG 112, NARA.
LARGE-UNIT WAR: OKINAWA 405
invasion began. Throughout the cam- redoubt progressed, the contrast grew.
paign, noneffective rates from disease The onset of torrential rains soon com-
remained low and total nonbattle casu- pounded the work of division medics.
alties, both sick and injured, numbered The valleys became bogs, and tanks had
only two-thirds of those killed, wound- to be employed as evacuation vehicles,
ed, and missing in action. In no other dragging out ambulances and jeep
respect did the last battle of the Pacific ambulances that were hopelessly stuck.
war so completely depart from past Sometimes tank crews came to the aid of
norms. casualties pinned down by enemy fire,
straddling the victim and pulling him to
Evacuation safety through the escape hatch. At
other times tanks, moving at low speed,
Evacuation of all casualties was diffi- ran interference for litter teams that
cult along the fighting line but funda- were unable to reach the wounded.
mentally well-organized and efficient Weapons carriers (3⁄4-ton trucks), trac-
further to the rear. As the battles against tors, and Weasels likewise served as
the Shuri lines and the southern ambulances.
LARGE-UNIT WAR: OKINAWA 407
Victims of War
50 52
“Disaster Relief Administration: Public Health,” pp. Quotation from Appleman et al., Okinawa, p. 415.
1–6, Historians files, HUMEDS, RG 112, NARA. See also ASF Monthly Progress Rpt, 30 Sep 45, sec. 7, p.
51
Ibid., p. 5, Historians files, HUMEDS, RG 112, 10, THU Note Cards, Historians files, HUMEDS, RG
NARA; Arnold G. Fisch, Jr., Military Government in the 112, NARA. The subsequent course of events on
Ryukyu Islands, 1945–1950 (Washington, D.C.: U.S. Okinawa is detailed in Fisch, Military Government in
Army Center of Military History, 1988), pp. 42, 45. Ryukyu Islands.
410 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
The effort to treat civilians and pro- and care similar to that given American
vide the basics of public health appears soldiers, except in three particulars:
to have been one of the success stories they were not given American blood,
of the Okinawa campaign. The mere plasma, or penicillin. At the end of the
fact that humanity should have been fighting Army hospitals on Okinawa
shown at all astonished those who came held 1,065 Japanese prisoners—“an
trembling into American lines, in expec- unprecedented number for the Pacific,”
tation of torture and death. The provi- as the surgeon general reported. They
sion of food and its transportation over responded well to food and medical
long distances, when space was at a pre- treatment and answered questions
mium, marked the depth of the com- freely. Those who were ambulatory car-
mitment by Nimitz’ headquarters to a ried litters and water if able, as well as
wise and successful policy.53 assisted in the care of bed patients.54
The full weight of responsibility for
caring for Japanese prisoners of war fell Reviewing the Campaign
upon the Army. During most of the cam-
paign, in line with past experience, few The joint headquarters that planned
enemy soldiers surrendered; many of medical support and the officers who
those who did were unconscious or oth- directed it in the field had cause for sat-
erwise helpless. Suicide remained com- isfaction in the record of Okinawa. As
mon. Some Japanese soldiers would fire ever, courage and endurance at the line
a last shot and then wait in plain view to were the foundations of success. But
be killed, while others would hold sound planning had incorporated the
grenades against their bellies and pull hard-learned lessons of past opera-
the pins. But at the end of the fighting tions, giving the troops some advan-
7,401 preferred surrender to death— tage. Better intelligence, more surgical
though 3,339 of those who gave them- teams, more abundant and earlier use
selves up were laborers, rather than of light planes, and the presence of a
fighters. few helicopters could have improved
Hard used during the terrible cam- the situation further, as could an Army
paign, most Japanese prisoners were in evacuation hospital, had one been
poor condition from the effects of star- available. But in surgery, bed strength,
vation and stress. Many were wounded and evacuation, the three essentials for
as well. They entered Army hospitals in such a campaign, the theater achieved
a state of acute anxiety that reflected the an impressive record under difficult
atrocity stories spread by anti-American conditions.
propaganda. The 96th Medical As a whole, the Tenth Army sustained
Battalion’s holding station was the first 65,631 casualties, about 2,000 more
unit to receive them, and the 88th Field than on Luzon, and roughly 1 in 9 died.
Hospital was later dedicated to their Its four divisions suffered 34,736 casual-
care. They received nourishment, beds,
54
ASF Monthly Progress Rpt, 30 Sep 45, p. 9 (quota-
tion), THU Note Cards, Historians files; Whitehill,
53
Appleman et al., Okinawa, pp. 415–19; ASF Monthly “Medical Activities in Middle Pacific,” block 18f, 1:135,
Progress Rpt, 30 Sep 45, sec. 7, p. 10, THU Note Cards, file 314.7. Both in HUMEDS, RG 112, NARA. See also
Historians files, HUMEDS, RG 112, NARA. Appleman et al., Okinawa, pp. 465–67.
LARGE-UNIT WAR: OKINAWA 411
ties, of whom 4,582 were killed or died and 110,000 Japanese died. Total
of wounds. The marines lost 2,792 dead, American casualties, including wound-
while the Navy, reflecting the bitterness ed and nonbattle injuries, were in excess
of the struggle at sea, lost 4,907 dead, of 75,000. Roughly speaking, 2
although many fewer wounded than the Americans either died or went to the
land forces. The intensity of the Ryukyus hospital for every 3 Japanese who were
fighting is less easy to measure. In killed killed, surrendered, or committed sui-
and wounded per 1,000 troops per day, cide. These figures were grim reading
only Iwo Jima was higher than Okinawa; for the American planners, who already
in Europe, the battle of Normandy was had begun to look ahead to the invasion
approximately equal. of Japan.55
Beginning as a series of savage
55
episodes, the campaigns in the Pacific For statistics and analysis, see Appleman et al.,
Okinawa, pp. 489–90; ASF Monthly Progress Rpt, 30 Sep
ended in a large-unit struggle for the 45, sec. 7, pp. 2–5, THU Note Cards, Historians files,
Ryukyus, in which 12,281 Americans HUMEDS, RG 112, NARA.
CHAPTER XIII
older base sections of Australia, New accounts had contributed to a new kind
Guinea, and the South Pacific, as well as of particularism: Because he was identi-
the newer ones of the Philippines. The fied with the USASOS, other commands
rapid decrease of troops in New Guinea accused him of favoritism.
as the forces shifted forward brought a The major problem, however, was
decision to close some bases there and, that of getting things done in a bureau-
on 31 July, to dissolve the local logistical cratic system that depended upon con-
commands, placing those bases that sensus far more than is customary in a
remained under the USAFWESPAC’s military organization. A mere proposal
direct control.1 to move a medical officer, according to
Even as the USAFWESPAC prepared Denit, launched a round of conferences
for its supreme test, it remained in a and requests for concurrence, which in
sense the captive of its own history. the end usually brought a refusal from
Geography had early dictated that the local commander who viewed the
decentralization should be the rule in officer in question as part of his official
the Pacific commands, and the “family”—or even as his personal prop-
Southwest Pacific had been no excep- erty. The continuing shortages of key
tion to the rule. As the explicit policy of people, both officer and enlisted, often
General Headquarters, SWPA, and of served to justify resistance to demands
USAFFE, decentralization had come to from above. But the resulting problems
mean virtual autonomy among the were many. For example, the work of
many subordinate commands, all of consultants in evaluating the ability of
which seemed to exist more or less on medical officers and the needs of partic-
the same level. USAFFE’s eight major ular units was often nullified or suffered
commands appeared to resent as endless delays. “It became,” Denit com-
unwarranted interference attempts plained, “almost a policy to avoid any
from higher headquarters to shift action which might remotely be con-
resources or personnel from one to strued as interference with lower com-
another or, as Denit had discovered, to mand activities.”2
impose technical supervision. His own The chief surgeon was not all-power-
position as both the USAFFE and the ful, and he acknowledged that he could
USASOS chief surgeon had been neither reorganize the command nor
absolutely necessary to overcome the separate the medical system from the
infighting of earlier years, yet by some rest in a “theater having such strong tra-
ditions of independent action.” Yet
1
CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 2, pp. there could be no question that Denit’s
168, 270; CSurg, USAFPAC, Semiannual Rpt, Jun–Dec position had been greatly improved by
45, pp. 4–5. Both file 319.1–2, Historical Unit Medical
Detachment (HUMEDS), Record Group (RG) 112, the creation of the USAFPAC. Only
National Archives and Records Administration those who had suffered through the
(NARA), Washington, D.C. Briefly during 1945 the confusion that had reigned in the past
three major areas under General Headquarters, SWPA,
and USAFPAC control had unified logistical com- could fully appreciate the advantages of
mands: the Philippines Base Section, the New Guinea
Base Section, and the Australia Base Section.
2
Subcommands were called bases, with letter designa- CSurg, USAFPAC, Semiannual Rpt, Jun–Dec 45, pp.
tions—for example, Base X (Manila) and Base M (San 15–19 (quotations), file 319.1–2, HUMEDS, RG 112,
Fernando). NARA.
414 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
having a single capable hand at last on Denit’s planners developed the med-
the tiller.3 ical plans to support the three opera-
tions, giving heavy emphasis to OLYMPIC.
USAFPAC Planning They worked within the general assump-
tions of MacArthur’s staff, namely,
As the initial step in the final Pacific that the Japanese would employ
campaign, code-named DOWNFALL, 260,000–300,000 troops to defend
MacArthur’s staff prepared Operation Kyushu; that their first line of defense
OLYMPIC, an assault by the Sixth Army on would be special suicide units, air and
southern Kyushu starting 1 November sea; and that they would return to their
1945. A second plan foreshadowed an earlier practice in the war of defending
invasion of the main Japanese island, the landing beaches. Hence, to secure
Honshu, by the Eighth and Tenth an anchorage, the Americans, as at
Armies from the Pacific and by the First Okinawa, would first attack offshore
Army from Europe. But this operation, islands before landing by corps on the
code-named CORONET, remained little eastern and western sides of Kyushu.
more than a general concept. Knowing Involved were the I and XI Corps and
nothing of the atomic bomb then being the V Amphibious Corps.5
readied for use, MacArthur’s staff devot- Medical support for the invasion
ed only limited effort to planning for would benefit by the experience of
the peaceful occupation of Japan, in the more than three years of war. Although
event of a surrender. Work on such a the proportion of medics to troop
contingency plan started in May, under strength continued to decline and the
the name BLACKLIST, but was still incom- Eighth Army was short of both doctors
plete when the war ended. and nurses, the medical endowment for
OLYMPIC was a natural successor to the the Sixth Army would be even more
earlier campaigns of the Pacific war, for ample than in the past. Each division
it contemplated using amphibious tac- would have not only its organic units,
tics and large-unit operations ashore to including its medical battalion, but also
seize an enemy-held island, which in an attached separate clearing company,
turn would serve as an advanced air base a medical company from an engineer
and staging area for the later invasion of
Honshu. The medical contribution
included, as usual, casualty estimates Press, 1953), pp. 333–40; John Ray Skates, The Invasion
of Japan: Alternative to the Bomb (Columbia, S.C.:
and plans for support of the fighting University of South Carolina Press, 1994), pp. 1–7. The
forces and for the evacuation and treat- actual decision to invade was made by President Harry
ment of the wounded. The task was S Truman on 18 June. See Louis Morton, “The Decision
To Use the Atomic Bomb,” in Kent Roberts Greenfield,
familiar, but its scale dwarfed the inva- ed., Command Decisions (Washington, D.C.: Office of the
sions of the past.4 Chief of Military History, United States Army, 1960),
pp. 500–01.
5
Olympic Opn Log Instrs no. 1, OofCG, USAFWES-
3
Ibid., p. 20, file 319.1–2, HUMEDS, RG 112, NARA. PAC, 16 Jul 45, in “History of Planning Division, ASF,”
4
Department of the Army, Reports of General 11:1, Ms 3–2.2 AA 11, files of U.S. Army Center of
MacArthur, 4 vols. (1950; reprint ed., Washington, D.C.: Military History (CMH), Washington, D.C.; Warren W.
Government Printing Office, 1966), 1:27, 67–89; Walter Daboll, “From OLYMPIC to BLACKLIST,” ch. 15 of
Krueger, From Down Under to Nippon: The Story of the Sixth “Medical Service in the Asiatic-Pacific Theater,” pp.
Army in World War II (Washington, D.C.: Combat Forces 5–6, Historians files, HUMEDS, RG 112, NARA.
THE LAST ACT 415
special brigade, two portable surgical Army casualties would be sent by air or
hospitals, and an evacuation hospital. In hospital ship to the treatment centers in
addition, each corps would have five the Philippines. In either case, those
field hospitals, plus an ambulance com- whose condition required them to leave
pany, a medical supply company, malar- the theater would travel to the United
ia survey and control detachments, and States by returning transports or by the
a veterinary food inspection detach- C–54s and C–87s of the Air Transport
ment. The Sixth Army was to have two Command’s Pacific Division. In June the
medical groups to organize evacuation, USAFPAC authorized 62,250 hospital
plus an array of special units, including beds for the Philippines and Okinawa,
a medical laboratory. The commander some 37,000 of which were to be on
of the Far East Air Forces, created in Luzon alone, with more than 22,000 in
June 1944 as the higher headquarters Manila.
for the Thirteenth and Fifth Air Forces, As soon as possible, airfields to be
allocated three squadrons of L–5s to built on Kyushu would be exploited to
evacuate casualties from the forward provide direct air transport to Okinawa
areas—a clear indication that the and beyond. An array of new hospitals
lessons of air evacuation taught by would then be built on Kyushu, with
Luzon and Okinawa had been learned.6 capacity almost as great as the whole
The chief surgeon, with the objective medical establishment supporting
of controlling the movement of casual- OLYMPIC. The USAFWESPAC was
ties from the time they left the beaches assigned the responsibility for establish-
until they arrived in the rear-area hospi- ing 33,250 fixed beds on Kyushu, includ-
tals, assigned Lt. Col. Paul Taylor, MC, in ing 13,250 at Kagoshima, 15,500 at
April 1945 to be the USAFPAC medical Shibushi, and 4,500 at Miyazaki. This
regulating officer. As usual, the first stop would permit a gradually increasing
would be the eighteen hospital LSTs off- evacuation policy, as Japan’s southern-
shore, where the wounded would be most island—like Australia, New Guinea,
received, treated, sorted, and trans- the Philippines, and Okinawa before it—
ferred to other vessels. Naval assault became a base for operations beyond. It
craft would evacuate the wounded to would also prepare the way for the cli-
Okinawa, where marines would be dis- mactic blood-letting of CORONET.7
patched by air or by hospital ship to the The precise calculation of casualties
Marianas and, if necessary, to Oahu and upon which this extraordinary medical
the United States. The well-equipped establishment was predicated is not easy
naval assault transports would sail direct- to deduce from the records. Probably
ly to the Marianas or the Philippines.
7
Daboll, “From OLYMPIC to BLACKLIST,” pp.
6
An 4 (Medical) to Log Instrs no. 1, 16 Jul 45, in 14–15, 23.1, Historians files; CSurg, USAFWESPAC,
“History of Planning Division, ASF,” 11:1–6, Ms 3–2.2 Annual Rpt, 1945, pt. 2, pp. 222–23, 227, file 319.1–2.
AA 11, CMH; Daboll, “From OLYMPIC to BLACK- Both in HUMEDS, RG 112, NARA. See also App B
LIST,” pp. 10–11, Historians files, HUMEDS, RG 112, (Major Hospitalization Areas) and App C (Hospital
NARA; John H. McMinn and Max Levin, Personnel in Facilities—Tentative) of An 4 (Medical) to Log Instrs
World War II, Medical Department, United States Army no. 1, 16 Jul 45, in “History of Planning Division, ASF,”
in World War II (Washington, D.C.: Office of the 11:1 and 11:1–2, and An 5 (Engineer) to ibid., in ibid.,
Surgeon General, Department of the Army, 1963), pp. 11:15, 24, 30, Ms 3–2.2 AA 11, CMH; Crawford F. Sams,
108, 368–70. “Medic,” 1:331, 335, CMH Library (L).
416 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
basic to the confusion is the fact that The figures later reported by Medical
debate continued in the highest circles Department historians differed sharply
of the Truman administration over the from those of MacArthur. By their
advantages of an invasion, rather than a account the basis for calculating proba-
blockade and bombardment, as the ble casualties in Operation OLYMPIC was
means to induce Japan to surrender. neither Normandy nor Okinawa but
General MacArthur evidently saw high rather Luzon, which resembled Kyushu
casualty projections as likely to influ- in topography. Their breakdown of fig-
ence this debate in a direction he did ures was far more precise. Besides non-
not desire. On 18 June his headquarters battle injuries, the chief surgeon antici-
reported to the War Department that pated that the invaders would face a
battle casualties—with no breakdown as number of serious disease threats,
to dead and wounded—would number including dysentery, scrub typhus, and
50,800 for D-day to D+30, 27,150 for Japanese B encephalitis. Denit forecast-
D+30 to D+60, and 27,100 for D+60 to ed in the first 60 days after the landing a
D+90, with an additional 4,200 nonbat- total of 176,663 casualties, including
tle casualties per month. These figures 55,906 battle casualties, and in the first
appear to give a total of 117,650 for the 120 days a total of 394,859, including
first 90 days. 125,935 battle casualties. In all, about
However, MacArthur followed with a 119,000 would require evacuation from
message stating that the reported USAF- Kyushu, some 44,000 ultimately needing
PAC figures were “purely academic,” transport to the United States.9
that he had never seen them before, and
that he did “not anticipate such a high 9
Daboll, “From OLYMPIC to BLACKLIST,” pp. 14,
rate of loss.” He asserted that the esti- 18, Historians files, HUMEDS, RG 112, NARA. This
document is marked “Gen Denit,” and appears to con-
mates were based upon Normandy and tain Denit’s marginalia, including a check on the casu-
Okinawa, implying that they represent- alty figures. Estimates of 500,000 or more were cited at
ed an upper limit of possibility. In seek- the time by Secretary of War Henry L. Stimson, who was
attempting to modify the unconditional surrender doc-
ing the president’s reconfirmation of his trine, and after the war by President Truman and oth-
decision in favor of OLYMPIC, General ers, who were attempting to justify the use of the atom-
Marshall was even vaguer; he mentioned ic bombs. Such estimates presumably related to losses
anticipated for both OLYMPIC and CORONET. Some
no numbers at all. “Marshall and his col- scholars have cited much lower figures—for example,
leagues,” as a later Army study revealed, Rufus E. Miles, Jr., “Hiroshima: The Strange Myth of
“were not willing to estimate the num- Half a Million American Lives Saved,” International
Security 10 (Fall 85): 121–40. However, many of the
ber of casualties to be expected from an numbers cited by Miles are estimates of battle casualties
invasion of Kyushu, but they presented only; as USAFPAC figures indicated, disease and non-
many reasons for their belief that they battle injury would have expanded the toll over the
anticipated four months of fighting to almost 400,000
would be acceptable.”8 American casualties. These, of course, were only the
projected losses for OLYMPIC; more severe fighting
accompanied by even heavier losses would have fol-
8
Statistics from MFR, A.J.G. [Lt Col Andrew J. lowed in CORONET, as the final battles were fought in
Goodpaster, Opns Div, WDGS], 18 Jun 45, and first two one of the most heavily settled parts of Japan. If a fifth
quotations from Msg, MacArthur to Marshall, 18 Jun of American battle casualties in OLYMPIC died—not an
45, file OPD 704, box 178, Entry 419, RG 165, NARA. unreasonable assumption—and if, as in the past, 22
Remaining quotations from Henry G. Morgan, Jr., Japanese died on average for 1 American, the sum total
“Planning the Defeat of Japan: A Study of Total War of all deaths, Japanese and American, for the invasion
Strategy,” p. 167, Ms 2–3.7 AB.J, CMH. of Kyushu alone would have been 579,301.
THE LAST ACT 417
0 150
Aparri
Miles
Lingayen
S O U T H Gulf P H I L I P P I N E
Dagupan
LUZON
S E A
C H I N A San Fernando
Manila
Base M Bataan Philippine Base Section Headquarters
Cavite and Base X
Corregidor
Batangas
S E A Base R
MINDORO it
n a r d i no S t r a
Ber
n
Sibuyan
Sa
MASBATE
Sea SAMAR
Base K
Visayan
Sea
Tacloban
CUYO PANAY
IS LEYTE
Leyte
Iloilo
Gulf
Cebu
DINAGAT
CEBU
t r a it
MINDANAO SEA
S U L U S E A
M I N D A N A O
Davao
N O R T H
B O R N E O
MAP 16
420 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the floors and the stench of gangrene for the end of the war transformed the
filled in the air. On the last day of his situation again.15
tenure he revisited the hospital and The rebirth of Manila was a crucial
found the halls spotless, clean sheets on part of the logistical plan, but the whole
the beds, and children on the wards. A was a complicated puzzle. The
“Well Baby” competition had been USAFWESPAC headquarters had to carry
announced, and the courtyard of the out the customary duties of a theater
hospital was thronged with “Filipinos in logistical command: to procure supplies
their best embroidered shirts, all carry- and equipment for all soldiers in its
ing babies.”14 region of the Pacific; to transport equip-
Venereal disease (VD) required spe- ment and personnel; and to construct
cial attention, for, as medical investiga- and maintain bases, ports, and the mili-
tors remarked in June, the incidence was tary railway system. Meanwhile, its prepa-
“increasing to a level so high as to inter- rations for the invasion demanded an
fere with the military efficiency of the ever-increasing commitment of
command.” About a million men were resources. Growing numbers of troops,
stationed in the Philippines, and even including new arrivals from the United
with antibiotic therapy the prospect was States, massed at its bases in the
bleak. Overall rates for Leyte and Luzon Philippines and at the Okinawa logistical
through April reached 100 per 1,000 command, which was still under the con-
troops per annum, and small areas in the trol of the Tenth Army. The headquarters
islands saw rates of 1,000 to 2,000. organization of the old South Pacific Base
Contributing factors were the long con- Command arrived in the Philippines to
tinence of troops stationed on the support the Sixth Army under the title of
Southwest Pacific’s remote jungled the Army Service Command—OLYMPIC
islands, the free and friendly relations (ASCOM-O). Assigned to the USAFWES-
between Americans and Filipinas, the PAC early in June, ASCOM-O settled on
poverty of the civil population after years Luzon and joined the planning for the
of war and occupation, and the heavily invasion. Similarly, ASCOM-C would sup-
infected state of local prostitutes. During port CORONET from its headquarters at
the summer, at Denit’s suggestion, a full Manila. Each service command was to
program of prevention began. The com- pass to the control of the army it support-
mand propagandized, put brothels off ed when the planned operation actually
limits (despite the complaints of local began.16
politicians, who had found them a lucra-
tive investment), held commanders 15
Thomas H. Sternberg et al., “Venereal Diseases,” in
responsible for VD cases in their units, Ebbe Curtis Hoff, ed., Communicable Diseases Transmitted
Through Contact or by Unknown Means, Medical
provided prophylactic stations, and Department, United States Army in World War II
enforced curfews. Medical installations (Washington, D.C.: Office of the Surgeon General,
began a new standardized penicillin reg- Department of the Army, 1960), pp. 292–99 (quotation,
p. 292). In the Philippines as in Hawaii, breaking up
imen for gonorrhea. How far the pro- houses of prostitution apparently reduced the inci-
gram might have succeeded under dence of disease by lowering the total number of sexu-
Philippine conditions remained unclear, al contacts—that is, by making sex less convenient and
more expensive.
16
CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 2, pp.
14
Ibid., pp. 269–80 (quotation). 24–25, file 319.1–2, HUMEDS, RG 112, NARA.
422 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
By mid-June 1945 all the Philippine basically concerned Luzon. The usual
bases had been established. Denit knew problems promptly appeared, for exam-
that troops would stage for OLYMPIC ple, a shortage of materials and low pri-
through Manila, Tacloban, and San ority for engineer work on hospitals, and
Fernando. The development of a hospi- the command thus concentrated on
tal system to accommodate those who Mandaluyong rather than dispersing its
would return as casualties was under way limited means over the whole system. But
but far from complete. some other projects also received back-
During 1944 a new pattern in hospi- ing, including a stockaded station hospi-
talization had emerged as victory fol- tal near San Fernando for injured prison-
lowed victory in the Pacific. Early in the ers of war. Existing facilities were ordered
war, command surgeons throughout the to increase their expansion beds, and
Allied-controlled Pacific had broken medical personnel were pressed into ser-
hospitals up into smaller units, to serve vice as construction workers.18
on islands and support small garrison New means of moving casualties out
forces scattered over primitive country. of the theater made their appearance in
But as the lines of attack converged and midsummer. Until June, all water evacu-
the forces engaged grew larger, hospi- ation to the United States had been car-
tals had followed suit, small units recom- ried out by troopship, with medical care
bining into large ones. During 1945 no provided by provisional hospital ship
more units were disbanded and reorga- platoons of two officers and fifteen
nized, and the development of major enlisted men each. In the next month,
hospital centers made progress as many however, an Army hospital transport—
general hospitals were put under a sin- the Emily H. M. Weder, named for an
gle administrative headquarters to pre- Army nurse who had been killed in
vent duplication of services and to action—joined the work in the
exploit fully the talents of the few Philippines, loading 580 evacuees. Air
remaining specialists. One of the largest evacuation from the Philippines to the
was the huge 26th Hospital Center at United States began in June and eventu-
Mandaluyong near Manila, with 12,000 ally became a regular service, with the
beds. Other hospital centers were being Air Transport Command’s Pacific Wing
planned with the base surgeons and the craft flying via Guam, Kwajalein,
Corps of Engineers.17 Johnson Island, and Honolulu to San
Rapid construction was necessary to Francisco. Psychotic and suicidal
meet the anticipated invasion date for patients received the highest priority for
Kyushu. With Okinawa under the Tenth air transport, primarily because the trip
Army and the southern Philippines was comparatively short.19
under the Eighth Army, and with both
armies destined for CORONET, the
18
USAFWESPAC construction program CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 2, p.
67, file 319.1–2, HUMEDS, RG 112, NARA. See also An
4 (Medical) to Log Instrs no. 1, 16 Jul 45, in “History of
Planning Division, ASF,” 11:4–6, and App C (Hospital
17
Ibid., pp. 54–57, file 319.1–2; 26th, 27th, 28th, 29th, Facilities—Tentative) of ibid., in ibid., 11:1–2, Ms 3–2.2
30th, and 31st Hosp Centers Quarterly Rpts (copies), AA 11, CMH.
19
Jan–Mar 45, file 319.1 (SWPA). All in HUMEDS, RG CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 2, pp.
112, NARA. 251–53, file 319.1–2, HUMEDS, RG 112, NARA.
THE LAST ACT 423
Pacific distances made the obtaining 226. Apparently, more than 500 medical
and storage of biologicals a particular officers would be needed to fill the gaps
problem. Stocks of smallpox vaccine, left by the initial understrength, the
which had the shortest lifespan of all— growing troop list, and the ongoing
ninety days—were concentrated at demobilization process of readjust-
Manila for the troops in the Philippines ment—the discharge or transfer of
and at Hollandia for those still in New those with long overseas service—follow-
Guinea. Each had to be adjusted to local ing the end of the war in Europe. Yet
levels of consumption, with resupply actual replacements as yet were negligi-
based on priority. For the coming oper- ble—too few to make up for normal
ations, resupply responsibility for bio- attrition. And shortages of trained
logicals was concentrated in the 19th enlisted men—1,500 as the summer
Medical General Laboratory, which began—had to be filled by riflemen,
became the USAFWESPAC agent for many fresh from basic training. The
procurement, storage, and issue.21 question of whether they could be
trained in time for their new duties was
The Sixth Army pressing but unanswerable.23
Amid many uncertainties, prepara-
The strains in personnel and con- tions for the invasion began. The health
struction that afflicted the chief surgeon of the command improved rapidly after
also confronted the Sixth Army as it the Eighth Army took over the ongoing
made ready for future battles. The inva- combat against Yamashita’s surviving
sion forces would consist of eleven Army forces. In permanent bivouacs, area con-
and three marine divisions, organized in trol was reestablished, malaria sup-
three Army and one marine corps. pressed, and the troops’ diet enriched
Medical support was slated to include, and diversified. Adequate rest improved
beside the organic divisional units, eigh- all aspects of health. The complicated
teen evacuation hospitals, fifteen field process of reequipping began. Supplies
hospitals, and twenty-five portable surgi- necessary for the troops’ health includ-
cal hospitals. The Sixth Army was to ed not only medical materiel but also
have fixed hospitals under its com- new personal equipment and clothing
mand—twenty-five general and thirteen needed to fight in a colder climate. All
station hospitals.22 units were ordered to carry with them
A fundamental if familiar problem supplies for thirty days, with additional
was the lag between the troop list being stocks for fifteen days in division dumps
developed for the invasion and the and medical supply units. Reserve stocks
much slower influx of medical person- were built up in Okinawa and Manila
nel. Thus, the Sixth Army surgeon and packaged for rapid delivery by air-
reported that his deficit of medical offi- drop or by fast ships. Ample supplies of
cers grew over the summer from 165 to penicillin were provided, and the old
system for exchanging litters and blan-
21
CSurg, USAFWESPAC, Annual Rpt, 1945, pt. 2, p. kets—a source of annoyance in many
269, file 319.1–2, HUMEDS, RG 112, NARA.
22
Harrison J. Shull, “Experiences of the Consultant in
23
Medicine, Sixth United States Army,” p. 7A, Historians Surg, Sixth Army, Quarterly Rpt (copy), Jul–Sep 45,
files, HUMEDS, RG 112, NARA. p. 4, file 319.1, HUMEDS, RG 112, NARA.
THE LAST ACT 425
past campaigns, when these items had Commands. The South Pacific Base
tended to pile up in rear areas—was Command was the rump remaining
replaced by a system of automatic resup- from the South Pacific Area; the Central
ply to the forward depots that were to be Pacific Base Command included chiefly
established on Kyushu. the Hawaiian Islands; and the Western
Storing and distributing the newly Pacific Base Command, created on 25
available supplies of whole blood was April 1945 under the USAFPOA, orga-
especially important. Each corps took a nized the Army forces on Saipan, Guam,
mobile refrigerator with 200 pints ready Tinian, Iwo Jima, Peleliu, Ulithi, and
for the landing of the assault echelon. Angaur. The growing medical establish-
Each field and evacuation hospital took ment in the Marianas had already played
an additional 100 pints. Blood collected a key role in the Leyte, Iwo Jima, and
by the American Red Cross, air-shipped Okinawa campaigns.25
to the Navy’s Whole Blood Distribution The Western Pacific Base Command
Center on Guam, would be delivered by surgeon, Col. Elliott G. Colby, super-
plane to the fighting front in refrigerat- vised all Army medical activities in the
ed containers on a daily basis. Off region and continued carrying out the
Kyushu six hospital LSTs were to be des- same mission when the USAFMIDPAC
ignated as blood banks, storing the pre- succeeded the USAFPOA on 1 July. The
cious substance to resupply the other prospective invasion of Japan brought
LSTs and the attack transports.24 intensified activity to what had become a
major system of forward bases.
The Rear Areas Especially important were the hospitals
and the support provided to the air-
Preparations for the invasion were fields, from which much of the bombing
not confined to the western Pacific. The (including, in August, the atomic bomb-
demands of the immense undertaking ing) of Japan was launched and direct-
were felt thousands of miles to the east ed. Eighteen general hospitals worked
as well. in the command during 1945, to
Under the USAFMIDPAC the long include five from the 821st Hospital
evolution of the prewar Hawaiian Center on Tinian, where the major air
Department reached its final stage. No bases were located. Army strength,
longer involved in planning assaults on including air force personnel, reached a
enemy-held islands, the headquarters total of 183,837 in August, and the hos-
commanded a complex of logistical pital construction program expanded,
organizations. The chief surgeon’s office in anticipation of a new influx of wound-
was responsible for supervising the med- ed. Capacity was already great—the hos-
ical activities of the USAFMIDPAC’s pitals treated more than 25,000 casual-
three subordinate commands: the ties in June—and during the summer
Western, Central, and South Pacific Base bed capacity rose rapidly from just
under 12,000 to a maximum of 19,000.
Major medical supply depots were also
24
Ibid., pp. 10–11, file 319.1; Daboll, “From
OLYMPIC to BLACKLIST,” p. 23, Historians files; Col.
25
Ashley W. Oughterson, MC, Diary, 6 Aug 45, file 319.1. CSurg, USAFMIDPAC, Annual Rpt, 1945, p. 1, file
All in HUMEDS, RG 112, NARA. 319.1–2, HUMEDS, RG 112, NARA.
426 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
bungled an attempt at suicide, saving with low adjusted service rating scores
him for later trial and the gallows.32 were identified and moved into units
But the primary fact about troop destined for the USAFPAC. The end of
medical care was its superfluity. Typical the war in Asia now brought readjust-
was the experience of Maj. Gen. Innis P. ment to the Pacific. Political pressure
Swift’s I Corps, Sixth Army, which occu- for quick discharges mounted, as sol-
pied the Osaka-Kobe-Kyoto area. Unit diers and their families demanded—
dispensaries and corps collecting and and the president and Congress hastily
clearing companies were well able to conceded—that all who had served
care for ordinary medical problems, and overseas should return home as soon as
the few men who became seriously ill possible. The critical point score was
were sent offshore to Navy hospital ships adjusted downward, not once but again
or flown to the vast (and now largely and again, and on 21 September 1945
useless) hospital centers of the western the Eighth Army bade farewell to its first
Pacific. Preventive medicine was impor- group of departing veterans. By
tant. Troops infected earlier continued November the 4th Replacement Depot
to take Atabrine, while teams dusted near Yokohama was processing 25,000
with DDT the Japanese Army barracks to soldiers a month.
be used as housing. Engineers worked Meanwhile, half-trained replace-
to upgrade water purification. ments arrived—in the jaundiced view of
Meanwhile, hospitals were arriving as medical officers a poor lot, by and large,
scheduled, setting up shop, and waiting immature and susceptible to psychoneu-
for patients who never came. At the rotic disabilities and a long list of child-
beginning of 1946 at least eighteen hood and venereal diseases. The rapid
medical units—portable surgical hospi- depletion of the invasion force and the
tals, evacuation hospitals, collecting and departure of medical troops ended the
clearing companies, and the medical brief period of superfluity in Japan. In a
battalions of five divisions—were “trying few years there would again be too few
to operate hospitals of some sort in I Army medics in the Far East, as General
Corps zone of responsibility, and in MacArthur would discover in 1950,
many cases located within two blocks of when the Korean war began.34
each other.”33 Despite such rapid changes, the
This situation did not last long. The health of the troops proved to be the
process of readjustment had been least pressing of medical problems dur-
delayed in the Pacific theaters, because ing the early months of the occupation.
of the anticipated invasion of Japan. Far more serious were the conditions
The end of the fighting in Europe had that medical officers discovered among
already launched the complex process the liberated prisoners of war and the
of reshuffling personnel, and soldiers Japanese people.
32 34
OofSurg, USAFPAC, ETMD, Oct 45, pp. 19–21, file On the readjustment process, see Cowdrey, Medics’
350.05, box 72, Entry 54B, RG 112, NARA; William War, pp. 65–68; Graham A. Cosmas and Albert E.
Craig, The Fall of Japan (New York: Penguin Books, Cowdrey, Medical Department: Medical Service in the
1979), pp. 316–27; Cowdrey, Medics’ War, p. 44. European Theater of Operations, United States Army in
33
Surg, I Corps, Annual Rpt, 1946, p. 3, file 319.1–2, World War II (Washington, D.C.: U.S. Army Center of
box 565, Entry 54A, RG 112, NARA. Military History, 1992), pp. 596–602.
THE LAST ACT 429
For Allied prisoners, the end of the received thorough physicals, and
war brought a sudden transformation dressed in completely fresh uniforms.
from being remnants of defeated armies Stretcher cases were received by medical
to members of victorious ones, and from facilities, on- or offshore, and under-
a lifestyle resembling slavery to freedom. went a similar ritual. Intelligence offi-
Elaborate schemes for handling the for- cers questioned recovered prisoners
mer prisoners of war had formed part of about their prison experiences, includ-
the BLACKLIST planning. Responsibility ing any war crimes that they had wit-
for the more than 11,000 Americans set nessed. The interrogations revealed
free in Japan fell to the Eighth Army, ample new evidence in a grim story, the
and the treatment of hospital patients rudiments of which were already known,
was assigned to the 42d General though imperfectly, in Allied countries.
Hospital at Tokyo. The physical examinations tended to
Typically, liberated prisoners were confirm the accounts, for they revealed
moved to seaside repatriation centers, the consequences of prolonged malnu-
where an Allied port commander sepa- trition and abuse.
rated them by nationality. Americans Most Allied prisoners had been taken
discarded their prison clothing, bathed, in the earliest battles, and those who had
430 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
The primary treatment for all except nounced verdicts upon lesser defen-
the dying was food. Dieticians readied a dants. In some cases, military courts of
special ration, which was served three Allied armed forces brought charges
times a day with no limit on refills. locally against prison camp guards and
Canteens and post exchanges provided commandants. The trials disclosed no
snacks twenty-four hours a day. In the systematic program of extermination
three weeks that most remained under resembling the Nazi holocaust, but they
medical care in Japan, the average did bring to light overwhelming evi-
weight gain was twenty pounds, and thir- dence of widespread cruelty and neglect
ty to forty pounds was not uncommon. in the treatment of prisoners and cap-
By the time they left for home, few tive populations. The trials also demon-
looked like men who had undergone a strated that a few Japanese doctors had
long ordeal. But as later studies were to played roles in the wartime atrocities.37
emphasize, the effects of imprisonment No doubt much of the inadequate
were not to be easily shaken off, and life- medical treatment received by prisoners
long susceptibility to many ills would in Japanese camps reflected the fact that
mark a large proportion of the survivors. Japanese medical officers of good quali-
Former prisoners of war from the Pacific ty were unlikely to be assigned to their
theaters, in comparison to those from care. Indifference or casual brutality sec-
the European theater, suffered much onded incompetence. An American
more severely—in particular from Army doctor at Fukuoka No. 1 camp on
chronic tuberculosis, emotional distur- Kyushu, to which many survivors of the
bances, eye problems, gastrointestinal Oryoku Maru had been brought, voiced a
disorders, and heart conditions. Many common complaint when he told inter-
lived out long and essentially normal rogators after the war that “the Japanese
lives at home, but others had suffered doctors in this camp are not worthy of any
permanent impairments and met consideration whatever, that they were very
untimely deaths.36 neglectful in their duties and at times refused
to supply medicine to the American officers
Medical War Crimes who were dying of pneumonia and whose
lives could have been otherwise saved.” Cases
As the former prisoners filled out turned up in which Japanese camp
written questionnaires about their expe- physicians had falsified death certifi-
riences and responded to interrogators, cates—in one case certifying, without
evidence accumulated about war crimes. troubling to examine the body, that a
Trials of major defendants, accused of prisoner who had been beaten to death
launching the wars against China and was a victim of enteritis.38
the West, began in Tokyo in May 1946. There were, of course, exceptions.
Other trials in Yokohama, Manila, and Even reports prepared in the immediate
Rabaul examined evidence and pro-
37
Arnold C. Brackman, The Other Nuremberg: The
36
Bernard M. Cohen and Maurice Z. Cooper, A Untold Story of the Tokyo War Crimes Trials (New York:
Follow-Up Study of World War II Prisoners of War, VA William Morrow, Quill, 1987), pp. 33–44.
38
Medical Monograph (Washington, D.C.: Department John M. Gibbs, “Prisoner of War Camps in Japan and
of Medicine and Surgery, Veterans Administration, Japanese Controlled Areas, as Taken From Reports of
1954), pp. 19–23, 65. Interned American Prisoners,” p. 7, Ms 4–4.5A AA, CMH.
432 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
postwar period acknowledged that some school, with Japanese Army doctors,
Japanese physicians attached to the pris- civilian physicians, and medical students
ons were conscientious, like the one at observing. Surgeon Ishiyama Fukujiro
Fukuoka No. 22 who visited the hospital removed the healthy lung of an anes-
twice weekly, remaining all day, and thetized prisoner, who was then killed; a
spent a third day at the convalescent second victim, after losing one lung and
ward. He belonged to the staff of one of part of the other, died on the autopsy
the better camps, where treatment of table; three fliers were drugged and dis-
the prisoners was generally good and sected, also dying on the table. Sick pris-
morale, despite hard labor and cold oners who were not airmen also suf-
weather, was reported to be excellent. In fered. At Shinagawa Hospital and
several camps, however, Japanese enlist- Prisoner of War Camp, the comman-
ed orderlies made a practice of overrul- dant, Hisakichi Tokuda, was also the
ing POW doctors, making their own chief medical officer. Though he exper-
diagnoses and ordering the sick back to imented on prisoners, killing four by
work as they pleased. A medical sergeant injecting them with a soybean solution,
at Niigata, one of the worst camps in he escaped the death penalty when a
Japan, was sentenced to death for his General Headquarters, SCAP, review
contribution to the sufferings of some determined that he was not sane.40
captured Australians.39 Those responsible for some of the
Such cases reflected the unsatisfacto- most flagrant medical mistreatment of
ry conditions in the customary run of prisoners were not prosecuted in the
Japanese camps. By contrast, medical war crimes trials. At Pingfan, near
experiments on living captives were rare Harbin, Manchuria, a special unit under
but horrifying. Vivisection was carried Lt. Gen. Shiro Ishii developed bacterio-
out by Japanese military and civilian logical weapons, breeding vectors and
doctors, apparently reflecting the offi- making bombs to disseminate a variety
cial view that B–29 crews who bombed of diseases. The unit kept prisoners—
civilian targets were not prisoners of war apparently Chinese, Manchurians, and
but war criminals. Turned over to the White Russians—to use as experimental
Kempei Tai (military police), the cap- subjects, infecting, treating, and rein-
tured airmen were often tortured and fecting them until they died. The proce-
executed with or without trial. dures were comparable to those in some
Others, viewed as dead men in any Nazi concentration camps, where Jews,
case and therefore expendable, became Poles, Russians, and members of other
human guinea pigs. Between eight and unfavored groups were used in
twelve experimental operations were grotesque experiments.
performed in the autopsy room of the Yet Ishii and his accomplices escaped
Kyushu Imperial University medical prosecution. When the data they sup-
plied to American interrogators proved
39
Ibid., pp. 49–50, 118, Ms 4–4.5A AA, CMH; General
40
Headquarters (GHQ), Supreme Commander for the GHQ, SCAP, “Occupation of Japan: Trials of War
Allied Powers (SCAP), “History of the Nonmilitary Criminals,” pp. 183–201, Ms 8–5 AA 2, CMH; Saburo
Activities of the Occupation of Japan: Trials of Class “B” Ienaga, The Pacific War: World War II and the Japanese,
and “C” War Criminals,” pp. 112, 115, Ms 8–5 AA 2, 1931–1945 (New York: Random House, Pantheon
CMH. Books, 1978), pp. 189–90.
THE LAST ACT 433
vast numbers of additional civilian war food. The Navy quarantined the ports,
casualties, but in other respects had left and Army medical supplies were divert-
him still facing a most difficult situation. ed from the Philippines to Japan. In the
Now in charge of public health and fall and winter the spread of life-threat-
welfare, Sams confronted the problems ening diseases confirmed Sams’ early
of a wrecked and defeated nation. forebodings; smallpox increased and
Public health in prewar Japan had been louse-borne typhus fever appeared
combined with labor affairs in a single among Korean coal miners on Hokkaido
ministry, and on the local level had pri- and spread to Honshu as the liberated
marily been the responsibility of the workers headed for home. Smallpox was
police. Lacking medical direction, pub- rooted out by mid-1946 through the sys-
lic health had languished; despite the tematic vaccination of the entire
striking modernity of some prewar nation—some 75 million people. The
Japanese cities, most of the people had fight against typhus was more complex.
lived in comparatively primitive condi- Repatriates returning from mainland
tions. As a result, malaria, typhus, and Asia introduced typhus into port cities,
encephalitis were endemic, tuberculosis notably Osaka. An often fatal disease
was widespread, and enteric diseases spread by lice, typhus was traditionally
were common. Many years of war had associated with cold weather, when peo-
devastated the cities and left a popula- ple bathed and changed clothes less fre-
tion of homeless, ill-nourished, and quently, and had long historical associa-
exhausted people ripe for outbreaks of tions with times of hunger and the dis-
disease. As millions of Japanese were dri- ruptions of war. With many Japanese liv-
ven out of their overseas conquests, ing on 1,000–1,400 calories a day, the
exotic as well as homegrown ailments nation appeared in danger of a major
threatened the home islands.44 epidemic. Foci of the disease developed
The policy of the American occupa- wherever louse-infested people huddled
tion was to improve national health in for warmth. At railroad stations, crowds
order to prevent disease and unrest and of shivering vagrants spread the disease
to safeguard the health of Allied troops to the passengers, who traveled by the
by protecting that of the civil population. thousands every day from homes in the
In September General Headquarters, countryside to jobs in the shattered
SCAP, began a comprehensive survey of cities. The trains themselves were memo-
hospital facilities, medical supplies, and rably crowded, with people jamming the
interiors and hanging on the exteriors.
Not only did lice spread under such con-
44
GHQ, SCAP, “History of the Nonmilitary Activities ditions, but the microbes that cause
of the Occupation of Japan: Public Health, September
1945 Through December 1945,” pp. 1–7, Ms 8–5 AA typhus were inhaled by passengers from
7/5, CMH. See also Crawford F. Sams, “American dry louse feces on their neighbors’
Public Health Administration Meets the Problems of clothes and hair.45
the Orient in Japan,” American Journal of Public Health
and the Nation’s Health 42 (May 52): 557–65; Thomas B.
45
Turner, “Japan and Korea,” in Ebbe Curtis Hoff, ed., GHQ, SCAP, “Occupation of Japan: Public Health,”
Civil Affairs/Military Government Public Health Activities, pp. 8, 28–30, Ms 8–5 AA 7/5, CMH. Typhus is caused by
Medical Department, United States Army in World War rickettsiae, organisms that are larger than viruses but
II (Washington, D.C.: Office of the Surgeon General, smaller than bacteria. See Arthur Hurst et al., Medical
Department of the Army, 1976), pp. 664–65. Continued
THE LAST ACT 435
radio, press, pamphlets, and posters. By and other medical needs under strict
March 1946 the epidemic of about quality controls. Systematic collection of
30,000 cases had been contained. In the statistics on disease, which had almost
second half of 1946 only 1,202 cases ceased in 1945 under the pressure of the
were reported; in all of 1947, 1,141; in war, resumed the following year.
1948, 474; and in 1949, 121. The text- Humanitarianism and sound policy
book suppression of the disease can be coincided, and the benefits were reaped
attributed to the unique interaction of by the Japanese people. Life expectancy
military medicine, Japanese social disci- rose during 1947–50 from fifty to fifty-
pline, and the public health methods nine years for men and from fifty-four to
developed by American researchers dur- sixty-two years for women. Sams
ing World War II.46 received well-merited praise for “one of
Other contagious diseases were con- the great recent public health achieve-
trolled or stamped out in turn by ments,” which he explained as “just a
reestablishing sanitation and launching matter of organization.”47
a program of immunization that bene-
fited some 20 million people. A danger- Nuclear Warfare
ous increase in typhoid rates was
reversed, and in the spring of 1946 a Humane policy, however, could not
cholera outbreak was contained. The erase all the consequences of a struggle
reconstruction of functional water and that had been merciless even by the stan-
sewer systems in the cities enabled Sams dards of World War II. As of this writing,
to roll back a threatening wartime rise the Japanese-American war remains the
in Japan’s dysentery rate. In this case, only one in which atomic weapons have
however, cultural habits prevented long- been used. Tracing the medical conse-
term improvement. Farmers continued quences at Hiroshima and Nagasaki
to fertilize with nightsoil, many foods became the preoccupation of a number
continued to be eaten either raw or of Japanese and American scientists in
lightly cooked, and a multitude of street the postwar period, including some
stalls and tiny restaurants baffled public Army medical officers.
health control. One of the first to visit Hiroshima was
Ultimately, General Headquarters, Colonel Oughterson, Denit’s chief sur-
SCAP, accomplished a revolution in gical consultant. In civilian life
public health, building upon founda- Oughterson had been a distinguished
tions that were laid in the immediate academic physician, who entered the
postwar period. National expenditures Army from a position on the faculty of
on health and sanitation rose from Yale University’s medical school. In four
about 30 million yen in 1945 to 1,167 and a half years of service with the
million in 1950. The medical and nurs- USAFISPA, USAFPOA, and USAFPAC
ing professions were reorganized, and he had seen much of war, but nothing
Japanese manufacturers were encour-
aged to produce their own biologicals
47
Ibid., pp. 102, 134, 146, 166, Ms 8–5 AA 7/5, CMH;
“A Good Man Gone,” Newsweek, 8 Aug 55, p. 46 (quota-
46
GHQ, SCAP, “Occupation of Japan: Public Health,” tions). As in Germany, DDT and penicillin had been
pp. 27–30 (quoted words, p. 28), Ms 8–5 AA 7/5, CMH. known in wartime Japan only on an experimental basis.
THE LAST ACT 437
that prepared him for the blasted plain Estimations of the dead were uncertain,
that had been Hiroshima. On 8 and the memories of the survivors were
September 1945, unarmed and relying unreliable. A Japanese doctor who had
entirely on the protection of the lived through the blast summed up the
Japanese, Oughterson departed from scene: “Hiroshima was no longer a city,
Tokyo with a mixed group of American but a burnt-over prairie.”50
and Japanese medical professionals. The explosion had come upon a city
Flying over Hiroshima, he viewed waking up, breakfasting, and moving to
“destruction . . . beyond words— work. Almost without warning, survivors
thought of a child building a city with found themselves transported into a
blocks and when he was thru, knocking nightmare world, surrounded by shat-
it all down. . . .”48 tered buildings and by the dead and
After landing, Oughterson and his wounded. Venturing into streets filled
party traveled on an ancient bus that with dust, smoke, and the heat of wind-
broke down twenty times on the way. driven fires, they joined processions of
Each time a small circle of curious battered people, many of whom were
Japanese gathered, their faces breaking naked. Those who had been burned
into smiles when the Americans passed walked with their arms stretched out, to
out candy and cigarettes. A ferry ride avoid the friction of one raw surface
across the Inland Sea took the group to against another.
the island of Miyajima, where the In the few surviving hospitals patients
Americans, after being wined and were packed “like the rice in sushi.”
dined, retired to their hotel rooms a lit- Showing early signs of radiation sick-
tle bemused by the reception their ness, they vomited and defecated, lay in
recent enemies had given them. “The their own filth, and turned the hospital
adaptability, flexibility of the human halls and doorways into latrines. Two
mind,” noted Oughterson in his diary, hundred and seventy of the city’s 298
“and the faith of mankind at times in doctors and 1,654 of its 1,780 nurses had
each other amazes me.”49 been injured or killed. Visitors who
The next day the group returned to entered the city found bizarre sights—
the city and entered a zone of cyclonic the nude corpse of a railroad worker
destruction, amid a plague of flies. with white lettering from the back of his
Buildings had been twisted and crushed; work uniform clearly visible on his
the rubble, finely divided; and every- burned torso; human shadows burned
thing, but for a few telephone poles, into cement; a dead man who still sat on
chimneys, and concrete structures, lev- his bicycle, propped against a bridge
eled and burned. A major from the railing. Meanwhile, refugees fled into
Imperial General Headquarters who had the hills, some sloughing their burned
seen the bombing described the “great skin so that they looked like ragged
violet bright light” and the blast and heat. scarecrows. Many died along the roads.51
48 50
Oughterson Diary, 8 Sep 45, file 319.1, HUMEDS, First quotation from ibid.; second quotation from
RG 112, NARA. Before its destruction Hiroshima had Hachiya, Hiroshima Diary, p. 8.
51
contained both the 2d Army and Western Command head- Hachiya, Hiroshima Diary, pp. 11 (quotation),
quarters, a military school, and a military hospital. 14–15; Oughterson Diary, 9 Sep 45, file 319.1,
49
Ibid. HUMEDS, RG 112, NARA.
438 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
For a time, Japanese doctors had works and a torpedo factory. But the city
been confused by the emerging symp- also had been the port through which
toms of radiation sickness, a problem Western medicine had entered Japan
compounded by the destruction of and the site of a medical school, which
microscopes and blood count devices had been completely destroyed with all
that might have enabled them to note of its faculty and students. Oughterson
the victims’ characteristic leukopenia, saw, in addition to the Japanese casual-
or low white blood cell count. Symptoms ties, several Allied prisoners of war who
of malaise, nausea, vomiting and diar- were showing symptoms of radiation
rhea, and the development of ulcers in sickness. The city government counted
the mouth were noted. Japanese sol- 35,000 confirmed deaths, and more
diers who had been ordered into the were expected, since the area devastated
city to aid the survivors became abnor- by the second atomic bomb had a popu-
mally fatigued and soon developed lation of about 120,000 residents. The
symptoms like the bomb victims. The Navy hospital ship USS Haven, at anchor
bone ash of victims “showed 100 times in the harbor, already had sent supplies,
natural radiation,” Oughterson noted, including penicillin.53
and relatives piously carrying bone frag- By the time he viewed the ruined
ments away from funeral pyres some- cities, Oughterson had already formu-
times received radiation burns. Japanese lated and presented to Denit a plan for
physicians believed at first that poison a scientific investigation of the atomic
gas or bacteriological weapons had been bombings. When the chief surgeon
used in conjunction with the bomb, mis- approved, Oughterson and Warren
led by not only the symptoms of the agreed to coordinate Army and
injured but also the city’s strong smell Manhattan Project efforts and to pre-
that had been produced by the ionizing pare a joint report. On returning to
radiation of the bomb. Oughterson’s Tokyo from Nagasaki, Oughterson put
first action when he arrived back at forward the suggestion for a cooperative
Tokyo was to send 100 million units of investigation by a Japanese-American
penicillin to Hiroshima.52 commission. In so doing, he recognized
Oughterson then departed for the efforts that the Japanese had
Nagasaki with a team of medical offi- launched in the immediate aftermath of
cers, including Col. Stafford L. Warren, the bombings at a number of medical
MC, chief of the Manhattan District’s schools and institutes. Chief among
medical section. Because of his exper- their investigators were Masao Tsuzuki,
tise on the effects of radiation, the for- professor of surgery at Tokyo Imperial
mer University of Rochester professor University and an admiral in the
was selected to join the Manhattan Japanese Navy, and Takeo Tamiya, the
Project team organized to study the Harvard-educated dean of the Imperial
atomic bombings. Before the bombing
Nagasaki had been an important mili- 53
Ibid., 20–23 Sep 45, file 319.1, HUMEDS, RG 112,
tary target, with the Mitsubishi steel NARA; Vincent C. Jones, Manhattan: The Army and the
Atomic Bomb, United States Army in World War II
(Washington, D.C.: U.S. Army Center of Military
52
Oughterson Diary, 9 Sep 45, file 319.1, HUMEDS, History, 1985), pp. 543–44. A small number of Allied
RG 112, NARA. prisoners of war also died at Hiroshima.
THE LAST ACT 439
Despite such gaps, the findings of the telling wisdom to be learned from the
various survey groups that studied the medical history of the Pacific war, even
bombs embodied the last and most as they suggested lessons for wars to
come. In the struggle against Japan,
modern medicine had overcome many
15, copy in CMH–L, which cites higher figures. A sub- problems that had seemed insuperable.
sequent study suggests that genetic effects of the bombs
are less serious than had been feared, but that certain But the comprehensive destructiveness
types of cancer—especially bone marrow, thyroid, and of nuclear weapons appeared to pose a
breast (female)—can be traced to the brief exposure of challenge to which there was no medical
the survivors to intense radiation. See John D. Boice, Jr.,
“Studies of Atomic Bomb Survivors: Understanding solution.56
Radiation Effects,” Journal of the American Medical
56
Association 264 (Aug 90): 622–23. Jones, Manhattan, pp. 543–50.
EPILOGUE
medical service, working in often dread- by the early landing of medical units
ful environments in the Southwest whose sole purpose was disease preven-
Pacific and China-Burma-India, was able tion and care of the civil population.
to exploit the well-established methods To some extent even the great Pacific
of preventive medicine plus a few recent distances yielded to the airplane. The
discoveries—notably Atabrine and rise of air evacuation was noted in
DDT—to reduce losses to historically almost all theaters where American
low levels. The two theaters provided medical personnel worked, but was
the darkest shading in what was, overall, nowhere more dramatic than in the
an extraordinarily bright picture.1 Pacific. Wherever evacuation routes
Advances that were equally notable were long, terrains almost impossible to
marked medical organization. The Army traverse on foot, and ships too slow, the
as a whole had been organized to fight air ambulance (and, far more frequent-
mass battles on land; amphibious war ly, the converted cargo plane) came into
demanded changes that were nowhere its own. In some respects, China-Burma-
more difficult to accomplish than India exaggerated the features of the
among medical support units, whose island war. Fighters in continental Asia
effectiveness depended ultimately on a lacked the ocean as the universal medi-
few skilled individuals. Dividing up med- um of transport and supply. Hence,
ical units among battalion landing deep penetration units lived longer in
teams, enhancing regimental medical the jungle, depended more upon the
support to enable combat teams to fight native peoples, and felt an even greater
alone, drawing upon an inadequate pool need for air resupply and evacuation.
of doctors to support the garrisons of During the war, however, the potential
many small islands, and devising units to of existing aircraft was not fully realized
operate in deep jungle all strained med- and exploited. The few Army heli-
ical resources and demanded the utmost copters employed in China-Burma-India
in improvisation. Amphibious medical and later in the Philippines were only a
support evolved within a framework of brief prevision of future frontline
doctrine first devised by the Marine aeromedical evacuation.
Corps and subsequently modified by Despite many common features—the
World War II experience in the Pacific great distances, the tropical climate, the
and Mediterranean theaters. By the war’s critical role of the Navy in protecting
end it had become a well-established American and interrupting Japanese sup-
technique, marked by Army-Navy coop- ply lines—the medical experience in the
eration, by the rapid and well-coordinat- Central Pacific was so different from that
ed advance of direct support units, and of the theaters to the south that it almost
seemed to belong to another war. In con-
trast to the South and Southwest Pacific
1
Frank A. Reister, ed., Medical Statistics in World War II, Areas, the Central Pacific Area was given
Medical Department, United States Army in World War
II (Washington, D.C.: Office of the Surgeon General, plenty of time to prepare. Most of the
Department of the Army, 1975), pp. 11, 32. It should be islands where marines and soldiers
noted that World War I in its time had marked epochal fought were free of malaria, and with few
progress in controlling disease in American armies.
According to Reister, death rates were reduced by about exceptions they were not so harassed by
90 percent during the century preceding World War I. other tropical diseases. On the other
THE MEDICAL SERVICE IN RETROSPECT 443
hand, the tactical situation in some Medics going ashore in Japan took on
respects was more severe because the duties of exceptional scope and difficul-
atolls were too small to permit surprise ty, against the background of a shattered
landings. Entrenched Japanese resistance nation and the results of atomic war. In
caused very high casualty rates, especially the rubble of Hiroshima and Nagasaki,
among the marines at Tarawa and later at medical officers viewed the effects of a
Iwo Jima. Army statistics lumped together kind of warfare that comprehensively
the sickly South Pacific and the compara- destroyed doctors, nurses, and hospitals
tively healthy Central Pacific. Even so, together with most of those to whom
admission rates for disease were lower in they might have given aid.
the Pacific Ocean Areas than for any the- Medical military records of the time
ater of the war except the European and placed great emphasis on the problems
the zone of interior.2 brought by the war. Those problems were
With the approach of American immense, and some were fundamentally
forces to the large islands of the western insoluble. Yet the contemporary preoccu-
Pacific, circumstances changed again. pation with obstacles reflected in part the
Struggles on land engaging one or more mindset of an era during which great
field armies became the rule in the strides in preventive and curative medi-
Philippines and Okinawa. The increas- cine—symbolized by the introduction of
ing skill of Japanese commanders in DDT and penicillin, but by no means lim-
defense and their desperation as the ited to those discoveries—bred an opti-
Allies approached the home islands mism that threw into sharp relief the dif-
made for appalling losses on both sides. ficulties that remained. From the view-
In the final campaigns the medical ser- point of the present, the terrain no
vice provided more conventional sup- longer seems divided so clearly into mon-
port, resembling that in the European umental accomplishments and frustrat-
theater. In the Philippines, however, the ing obstacles.
tropical climate continued to take its All in all, the American-Japanese war
toll. Casualty figures suggested that the presents a picture of near-miraculous
problem of adequately supporting pro- ingenuity in adapting to rapidly chang-
longed high-intensity combat in such a ing circumstances. It remains rich in
disease environment remained unsolved interest for students of military medicine
at the war’s end. for a variety of reasons—the tropical dis-
The presence of large civilian popula- eases, the logistical problems, the wide
tions—friendly to the Allies in the spectrum of settings from the most prim-
Philippines but hostile on Okinawa— itive jungles to the shattered but com-
served to complicate medical difficulties plex urban areas of the Philippines and
still further. As Army medical officers in Japan. Yet its ultimate lesson may lie in
the ruins of Manila and their Navy the flexibility of spirit and organization
brethren in the devastated towns of shown by medical personnel. Trained, by
Okinawa confronted the aftermath of and large, for work in a developed
conquest, the tasks of reconstruction nation and a temperate climate, they
began to overlap those of the war. mastered a new kind of medicine and
practiced it over a vast and varied part of
2
Ibid., p. 27. the Earth’s surface. Because they learned
444 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
and adapted so well, they were able to In those harsh times the medics suc-
save lives and improve health conditions cessfully maintained the fighting
among a kaleidoscope of peoples— strength of the Army in remote and dis-
American soldiers, New Guinea natives, ease-ridden lands. No less important was
Polynesians, Japanese, Filipinos, and their role in preserving the humane tra-
Okinawans—during the years of a most dition, which alone gave promise of a
bitter and unrelenting struggle. better future.
Bibliographical Note
The Medical Department: Medical Service College Park, Maryland, and incorporat-
in the War Against Japan represents the ed into the Historical Unit Medical
end product of a long period of Detachment (HUMEDS) collection of
research and writing, which began in Record Group (RG) 112, Records of the
The Historical Unit (THU) of the Office Office of the Surgeon General (Army).
of the Surgeon General. A large collec- As part of our Historians files, the THU
tion of THU note cards, assembled by note cards cited by us will also be added
anonymous researchers, Donald to the HUMEDS collection.
Mitchell’s lengthy manuscript “The U.S. Particularly useful documents were a
Army Medical Service in the War number of interviews, manuscript histo-
Against Japan,” and Warren W. Daboll’s ries, unpublished memoirs, and diaries
manuscript “Medical Service in the of medical service in the Pacific theaters
Asiatic-Pacific Theater” are products of of war, prepared as a rule by officers who
the unit’s work. Although we found were on the scene, with personal knowl-
them to be an invaluable source of mate- edge of the organizations and actions
rial, we developed the current volume they describe. Among these documents
largely from primary and printed were the following: Wibb E. Cooper,
sources. Specific attributions to records “Medical Department Activities in the
and repositories will be found in the Philippines From 1941 to 6 May 1942,
footnotes, where each source is cited in and Including Medical Activities in
full at first mention in each chapter and Japanese Prisoner of War Camps”; W. H.
subsequent references in the same chap- Waterous, “Reminiscences of Dr. W. H.
ter are shortened. Abbreviations are Waterous Pertinent to World War II in
identified in the list of abbreviations. the Philippines”; James W. Duckworth,
Many original documents, including “The Official History of General Hospital
most of those used by THU researchers, Number One, United States Army Forces
were first borrowed from and later in the Far East, at Camp Limay, Bataan,
returned to the collection of Army Little Baguio, Bataan, and Camp
records at the National Archives and O’Donnell, Tarlac, Philippine Islands,
Records Administration (NARA), From December 23, 1941 to June 30,
Suitland, Maryland, when The Historical 1943”; James O. Gillespie, “Recollections
Unit became part of the U.S. Army of the Pacific War and Japanese Prisoner
Center of Military History. We retrieved of War Camps, 1941–1945,” and “History
most of these documents from the of General Hospital Number 2”; Ruth B.
National Archives on a loan basis for the Kelly, “History of Nursing Service in the
duration of the project. Upon publica- South Pacific, World War II, 1945”;
tion of this volume, they will be returned Josephine M. Nesbit, “History of the
to the National Archives’ new facility in Army Nurse Corps in the Philippine
446 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
No less important was the series enlightening Earl Baldwin McKinley, ed.,
Medical Department, United States A Geography of Disease (Washington, D.C.:
Army in World War II, published in George Washington University Press,
Washington, D.C., by the Army’s Office 1935); George MacDonald, The
of the Surgeon General, a source that Epidemiology and Control of Malaria
provides both organizational studies and (London: Oxford University Press,
numerous physician-written accounts of 1957); James Stevens Simmons, Global
the clinical problems encountered in the Epidemiology: A Geography of Disease and
war against Japan. Using, to some Sanitation (New York: J. B. Lippincott Co.,
degree, almost all of the volumes in the 1944); and Kurt J. Isselbacher, Raymond
series, we found the following to be espe- D. Adams, Eugene Braunwald, Robert G.
cially valuable: Blanche B. Armfield, Petersdorf, and Jean D. Wilson, eds.,
Organization and Administration in World Harrison’s Principles of Internal Medicine,
War II (1963); Charles M. Wiltse, Medical 12th ed. (New York: McGraw-Hill Book
Supply in World War II (1968); John H. Company, 1991).
McMinn and Max Levin, Personnel in We also found significant aspects of
World War II (1963); Robert J. Parks, the medical story in a number of special
Medical Training in World War II (1974); studies and in corps and unit histories.
Ebbe Curtis Hoff, ed., Communicable Among the most useful were William F.
Disease: Malaria (1963), Communicable Heavey, Down Ramp!: The Story of the Army
Diseases Transmitted Through Contact or by Amphibian Engineers (Washington, D.C.:
Unknown Means (1960), Communicable Infantry Journal Press, 1947); Edward J.
Diseases: Arthropodborne Diseases Other Drea, Defending the Driniumor: Covering
Than Malaria (1960), Communicable Force Operations in New Guinea, 1944 (Fort
Diseases Transmitted Chiefly Through Leavenworth, Kans.: Combat Studies
Respiratory and Alimentary Tracts (1958), Institute, 1984); Thomas M. Huber,
and Civil Affairs/Military Government Japan’s Battle of Okinawa, April–June 1945
Public Health Activities (1976); B. Noland (Fort Leavenworth, Kans.: Combat
Carter, ed., Activities of Surgical Studies Institute, 1990); Edmund G.
Consultants (1962–64); W. Paul Havens, Love, The 27th Infantry Division in World
Jr., ed., Activities of Medical Consultants War II (Washington, D.C.: Infantry
(1961), and Infectious Diseases and General Journal Press, 1949), and The Hourglass:
Medicine (1968); Albert J. Glass, ed., A History of the 7th Infantry Division in
Overseas Theaters (1973); Douglas B. World War II (Washington, D.C.: Infantry
Kendrick, Blood Program in World War II Journal Press, 1950); William F.
(1964); Tom F. Whayne and Michael E. McCartney, The Jungleers: A History of the
DeBakey, Cold Injury, Ground Type 41st Infantry Division (Washington, D.C.:
(1958); and Frank A. Reister, Medical Infantry Journal Press, 1948); Philip A.
Statistics in World War II (1975). Also cov- Schaefer, ed., 54th in Review: A Resume of
ering topics of importance is James H. the Activities of the 54th General Hospital,
Stone, ed., Crisis Fleeting: Original Reports 1943–1945 (Tokyo: Dai Nippon Printing
on Military Medicine in India and Burma in Co., 1946); Orlando R. Davidson, J. Carl
the Second World War (1969). Willems, and Joseph A. Kahl, The
Among medical sources that are not Deadeyes: The Story of the 96th Infantry
official publications, we found especially Division (Washington, D.C.: Infantry
448 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Journal Press, 1947); Richard J. H. Krebs Corps, 1954); Frank O. Hough, Verle E.
[Jan Valtin], Children of Yesterday (New Ludwig, and Henry I. Shaw, Jr., Pearl
York: Reader’s Press, 1946); Edward M. Harbor to Guadalcanal, History of U.S.
Flanagan, The Angels: A History of the Marine Corps Operations in World War
11th Airborne Division, 1943–1946 II (Washington, D.C.: Historical Branch,
(Washington, D.C.: Infantry Journal G–3 Division, Headquarters, U.S. Marine
Press, 1948); [77th Division Association], Corps, 1958); Bennett F. Avery, ed., The
Ours To Hold It High: The History of the History of the Medical Department of the
77th Infantry Division in World War II United States Navy in World War II, 3 vols.
(Washington, D.C.: Infantry Journal (Washington, D.C.: Bureau of Medicine
Press, 1947); B[ertram] C. Wright, and Surgery, Department of the Navy,
comp., The 1st Cavalry Division in World 1950–53); and Jeter A. Isely and Philip A.
War II (Tokyo: Toppan Printing Co., Crowl, The U.S. Marines and Amphibious
1947); Stanley A. Frankel, The 37th War: Its Theory and Practice in the Pacific
Infantry Division in World War II, ed. (Princeton: Princeton University Press,
Frederick Kirker with John MacDonald 1951). Mae Mills Link and Hubert A.
(Washington, D.C.: Infantry Journal Coleman, Medical Support of the Army Air
Press, 1948); [6th] Division Public Forces in World War II (Washington, D.C.:
Relations Section, The 6th Infantry Office of the Surgeon General, USAF,
Division in World War II, 1939–1945 1955), was invaluable, as were the rele-
(Washington, D.C.: Infantry Journal vant volumes of The Army Air Forces in
Press, 1947); 33d Infantry Division World War II, edited by Wesley Frank
Historical Committee, The Golden Cross: Craven and James Lea Cate.
A History of the 33d Infantry Division in For full coverage of the medical story,
World War II (Washington, D.C.: Infantry we also consulted Allied and Japanese
Journal Press, 1948); and Francis D. histories. Essential to our understanding
Cronin, Under the Southern Cross: The Saga of the role played by America’s Allies
of the Americal Division (Washington, were Allan S. Walker’s The Island
D.C.: Combat Forces Press, 1951). Campaigns, Australia in the War of
In a war where joint and combined 1939–1945, Series 5, Medical (Canberra:
operations were the rule, the official his- Australian War Memorial, 1957); Field
tories of other American armed services Marshal Viscount William J. Slim’s Defeat
also gave essential data. Preeminent Into Victory (New York: David McKay Co.,
among these works were Samuel Eliot 1961); and Louis Allen’s Burma: The
Morison’s History of United States Naval Longest War, 1941–1945 (New York: St.
Operations in World War II, 15 vols. Martin’s Press, 1984). Providing welcome
(Boston: Little, Brown and Co., insights into the other side of the war
1947–62), and The Two-Ocean War: A were Saburo Ienage’s The Pacific War:
Short History of the United States Navy in the World War II and the Japanese, 1931–1945
Second World War (Boston: Little, Brown (New York: Pantheon Books, 1978), and
and Co., 1963). Also consulted were Michihiko Hachiya’s Hiroshima Diary: The
Robert D. Heinl, Jr., and John A. Crown, Journal of a Japanese Physician, August
The Marshalls: Increasing the Tempo 6–September 30, 1945, trans. and ed.
(Washington, D.C.: Historical Branch, Warner Wells (Chapel Hill: University of
G–3 Division, Headquarters, U.S. Marine North Carolina Press, 1955).
BIBLIOGRAPHICAL NOTE 449
Finally, the many nonofficial studies of Ogburn, Jr., The Marauders (New York:
the war proved indispensable. These Harper and Brothers, 1959); Brian
included general studies of the war, espe- Garfield, The Thousand-Mile War: World
cially Ronald H. Spector, Eagle Against the War II in Alaska and the Aleutians (New
Sun: The American War With Japan (New York: Doubleday and Co., 1969); and
York: Free Press, 1985), and John Gwenfread E. Allen, Hawaii’s War Years,
Costello, The Pacific War (New York: 1941–1945 (Honolulu: University of
Wade Rawson, 1981). Among biogra- Hawaii Press, 1950).
phies, the multivolume work by D. Memoirs supplied an essential dimen-
Clayton James, The Years of MacArthur, 3 sion to the story, notably Robert L.
vols. (Boston: Houghton Mifflin Co., Eichelberger, in collaboration with
1970–85), was notable. Studies of specif- Milton Mackaye, Our Jungle Road to Tokyo
ic topics included Eric Larrabee, (New York: Viking Press, 1950); Walter
Commander in Chief: Franklin Delano Krueger, From Down Under to Nippon: The
Roosevelt, His Lieutenants, and Their War Story of the Sixth Army in World War II
(New York: Harper and Row, 1987); (Washington, D.C.: Combat Forces
Arnold C. Brackman, The Other Press, 1953); Jay Luvaas, ed., Dear Miss
Nuremberg: The Untold Story of the Tokyo Em: General Eichelberger’s War in the
War Crimes Trials (New York: William Pacific, 1942–1945 (Westport, Conn.:
Morrow, 1987); Gordon W. Prange, in Greenwood Press, 1972); and Joseph W.
collaboration with Donald M. Goldstein Stilwell, The Stilwell Papers, arr. and ed.
and Katherine V. Dillon, At Dawn We Theodore H. White (New York: William
Slept: The Untold Story of Pearl Harbor (New Sloane Associates, 1948). Valuable
York: McGraw-Hill Book Co., 1981); insights were found in the medical
William M. Leary, ed., We Shall Return!: memoirs of the war, which include
MacArthur’s Commanders and the Defeat of Gordon S. Seagrave, Burma Surgeon
Japan, 1942–1945 (Lexington: University (New York: W. W. Norton and Co.,
Press of Kentucky, 1988); Walter Lord, 1943), and Burma Surgeon Returns (New
Day of Infamy (New York: Henry Holt and York: W. W. Norton and Co., 1946);
Co., 1957); James H. and William H. Alfred A. Weinstein, Barbed-Wire Surgeon
Belote, Corregidor: The Saga of a Fortress (New York: Macmillan Co., 1948);
(New York: Harper and Row, 1967); George Sharpe, Brothers Beyond Blood: A
Richard B. Frank, Guadalcanal: The Battalion Surgeon in the South Pacific
Definitive Account of a Landmark Battle (Austin, Tex.: Diamond Books, 1989);
(New York: Random House, 1990); Katharine R. Pincoffs, comp., Maurice C.
Stanley L. Falk, Decision at Leyte (New Pincoffs, M.D.: Letters From Two World
York: W. W. Norton, 1966); Lyda Mayo, Wars and a Sketch of His Life by His
Bloody Buna (New York: Doubleday and Wife (Baltimore: Garamond/Pridemark,
Co., 1974); S. L. A. Marshall, Island 1967); Tressa R. Cates, The Drainpipe
Victory: The Battle of Kwajalein Atoll Diary (New York: Vantage Books, 1957);
(Washington, D.C.: Infantry Journal and Juanita Redmond, I Served on Bataan
Press, Penguin Books, 1944); Barbara W. (Philadelphia: J. B. Lippincott Co., 1943).
Tuchman, Stilwell and the American On the effects of the atomic bombs, use-
Experience in China, 1911–1945 (New ful works included Ashley W. Oughterson
York: Macmillan Co., 1970); Charlton and Shields Warren, eds., Medical Effects of
450 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
the Atomic Bomb in Japan (New York: Eisei Ishikawa and David L. Swain (New
McGraw-Hill Book Co., 1956); and Com- York: Basic Books, 1981).
mittee for the Compilation of Materials Finally, we made use, as appropriate,
on Damage Caused by the Atomic Bombs of the huge literature of articles in mili-
in Hiroshima and Nagasaki, Hiroshima tary, historical, and medical journals.
and Nagasaki: The Physical, Medical, and Specific references will be found in the
Social Effects of the Atomic Bombings, trans. footnotes.
List of Abbreviations
AAA Antiaircraft artillery
AAF Army Air Forces
AAR After-action report
ACofS Assistant chief of staff
Adv Advance
AG Adjutant general
An Annex
APA Transport, attack
App Appendix
Arty Artillery
ASCOM Army Service Command
ASurg Assistant surgeon
AUS Army of the United States
Bde Brigade
BMSA Bureau of Medicine and Surgery Archives, Department of the
Navy, Washington, D.C.
Bn Battalion
Br Branch
Cav Cavalry
CBI China-Burma-India
Cdr Commander
CG Commanding general
CinC Commander-in-chief
Cmd Command
CMH U.S. Army Center of Military History, Washington, D.C.
CNurse Chief nurse
CO Commanding officer
CofS Chief of staff
COMSOPAC South Pacific Command
Cong Congress
CP Command post
CPA Central Pacific Area
CPBC Central Pacific Base Command
CSurg Chief surgeon
452 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Def Defense
Dept Department
Det Detachment
Dir Director
Dist District
Div Division
Engr Engineer
ETMD Essential technical medical data
Exh Exhibit
F Fahrenheit
FA Field artillery
FSurg Flight surgeon
Inf Infantry
Insp Inspection, Inspector
Instrs Instructions
Intel Intelligence
JB Joint Board
L Library
LCI Landing craft, infantry
LCT Landing craft, tank
LST Landing ship, tank
Log Logistics
Ltr Letter
LIST OF ABBREVIATIONS 453
Off Officer
OofCSurg Office of the Chief Surgeon
OofSurg Office of the Surgeon
Opns Operations
OQMG Office of the Quartermaster General
QM Quartermaster
SC Sanitary Corps
Sec Section
Sess Session
SG Surgeon general
Sit Situation
SO Special Order
SofW Secretary of War
SPA South Pacific Area
SPBC South Pacific Base Command
Spec Special
Sta Station
Surg Surgeon, Surgical
Svc Service
SWPA Southwest Pacific Area
454 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
VD Venereal disease
WD War Department
WDGS War Department General Staff
WPBC Western Pacific Base Command
Index
Abdominal wounds: 15, 134, 164, 206, 207, 243, Air Transport Command—Continued
288, 301, 315 Pacific Wing: 96–97, 188–89, 243, 276, 422
Adak: 154, 155, 157, 159, 163, 166, 172, 174 Southwest Pacific Wing: 259–61
Admiralty Islands: 200–202 Airborne Division, 11th: 327–28, 331n22, 336, 338
Advance Base (New Guinea): 128, 144–45 Aircraft
Advance Base Surgeon, Office of the: 128–29 ambulance planes: 307, 309, 328
Aid stations: 93, 208 amphibious planes: 188, 193, 276
Alaska: 161–62 artillery liaison planes: 328, 333
Attu: 164, 166–67 B–17 bombers: 6, 201
on beaches: 203 B–25s: 201
Navy beach party: 212, 214–15 bombers: 145, 154
New Guinea: 203, 206 C–47 transports: 143, 147, 193, 201, 245,
Philippine Islands: 24 277, 289, 307, 312, 327, 334, 339, 346,
Aidmen, Navy: 238 348, 349
Air ambulances: 64, 75, 154 C–54s: 243, 260–61, 276, 277, 327, 346, 408
Air clearing stations: 302, 307, 312 C–64s: 345, 348
Air Commando, 1st: 307 cargo planes: 309
Air Commando Group, 3d: 345n45 cub planes: 328, 407
Air evacuation. See Medical evacuation, air. DC–4s: 408
Air evacuation nurses: 91 equipped for air evacuation: 276, 307
Air evacuation officers: 205–06 helicopters. See Helicopters.
Air evacuation squadrons: 97 L–1s: 307
Air Force, USAFFE: 21 L–5s: 307, 333, 339, 343, 345, 348, 350
Air forces light liaison planes: 312
Fifth: 51, 129, 131, 132, 148, 253, 415 Navy: 122, 188–89, 276, 277
Seventh: 94–95, 271, 277–78 transports used for air evacuation: 122,
Tenth: 291, 295–96 154–55, 243, 277
Eleventh: 150, 151, 158–60, 172 used for medical supply: 122, 147
Thirteenth: 415 Airmen
Fourteenth: 295–96 medical problems of: 94–95
Air Forces Training Command: 295–96 medical services for: 246, 271–72
Air holding stations: 345, 348 treated as war criminals: 432
Air Service Command: 51, 295–96 Aitape: 202, 205–08, 320
Air surgeons Aitutaki: 45, 101n39, 108
competition among in the CBI theater: 296 ALAMO Force: 178n3, 209, 210
Hawaii: 11 Alaska: 149–76
Seventh Air Force: 94 Alaska Defense Command: 150–51, 152, 154,
South Pacific Area: 102 158–59, 170–71, 172, 174
Southwest Pacific Area: 50–51 Alaskan Department: 150–51, 152
Air Transport Command Aleutian Islands: 149, 158–76
Alaska Wing: 154–55 Alimentary disorders: 292
India-China Wing: 296 Alligators (LVT): 223, 225, 227–28, 237, 242
and medical evacuation: 96–97, 188–89, Altfather, Lt. Col. Ellis M., MC: 151
259–61, 276, 277–78, 408, 415 Ambulance battalions: 88
Pacific Division: 389, 408, 415 Ambulance companies: 63, 112–13, 332–33, 348
456 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Army Corps of Engineers: 33, 56–57, 87, 253, Base sections (Australia): 61–68, 75–77
282 Bassett, Capt. John W., MC: 168
Army Garrison Force (Okinawa): 387–88 Bataan: 5, 22, 27–39, 40, 340
Army Nurse Corps: 7, 89, 284 American POWs taken from: 364–67
Army Nurse Corps, Philippine Army: 362 Death March: 364–67
Army of the United States (AUS): 4 general hospitals: 24n34, 40
Army Service Command-OLYMPIC: 421, 423 and malaria: 5, 27, 30, 31, 32, 36–37
Army Service Command, SWPA: 254, 322, medical supplies for: 49
325–26, 332, 334, 345 withdrawal to: 25–26, 27
Arnold, Harry L., Sr.: 13 Battalion aid stations
Asiatic Fleet, U.S.: 4–5, 23 Biak: 212
Assam Province: 291, 292, 294 CBI theater: 294–95
Asuncion, Juan: 360–61 Central Pacific Area: 220
Atabrine: 118, 124n16, 442 enemy attacks on: 239
and CBI theater: 293, 303, 306 Gilbert Islands: 223
used in Guadalcanal: 123–25 Guadalcanal: 118
used in New Guinea: 138, 207, 255 Hawaiian Islands: 95
used in the Philippine Islands: 36n64, 322, Mariana Islands: 238–39, 247
351, 357, 362 Marshall Islands: 232
Athlete’s foot: 125 New Georgia: 186
Atienza, Fe: 367 New Guinea: 133, 134, 179, 206–07
Atienza, Romeo: 367 Okinawa: 407
Atka: 159 Philippine Islands: 30, 31, 37, 345
Atomic bomb: 426, 436–40, 443 staffing of: 186, 294–95
Atrocities: 132, 431, 432–33 Battalion combat teams: 178–79
Attu: 149, 159–60, 162, 163–72, 173 Battalion landing groups: 173–74
Augustin, Col. Marcus V.: 358–59 Battalion landing teams: 227, 228, 238
Australia: 54–60 Battalion medical detachments: 222, 223,
Army Air Forces in: 50–51 306–07
malaria in: 58–60 Battalion medical sections: 220, 230
medical evacuation to: 26, 58, 145 Battle casualties
and operations in New Guinea: 128 Admiralty Islands: 200–201
planning for medical facilities in: 48 Biak: 212
role as Allied base: 47, 49–50, 254 forward treatment of: 134, 212–13, 220
U.S. medical facilities in: 143n59 friendly fire: 225
withdrawal of MacArthur to: 31 Gilbert Islands: 223, 224
Australian Army Guadalcanal: 117
Advanced Depot of Medical, Dental, and lack of proper treatment for: 186, 188, 242
Veterinary Supplies: 77 Mariana Islands: 242
in New Guinea: 129, 131, 132, 133, 178–79, New Georgia: 185–86
180 New Guinea: 133–34
and scrub typhus: 266 Philippine Islands: 27, 28, 33, 340–41,
training provided by: 70, 138 346–47, 350
Australian Army Medical Corps: 58–59, 179 Beach party medical sections: 388–89, 398
Australian Base Section: 255 Bed capacity
Aviation medicine: 11, 87, 94–95 Alaska: 153–54, 175
Aviation Medicine, Army School of: 21, 87 Australia: 65, 71, 251–52
Avitaminosis: 125 Biak: 214, 260
Bougainville: 192–93
Baker, Lt. Col. Benjamin M., MC: 109, 111 CBI theater: 292, 302
Baker Island: 86, 89 Central Pacific Area: 220, 279
Barbey, Rear Admiral Daniel E.: 178, 202 expandable: 88, 251, 256, 328–29, 349, 422
Barking Sands Army Air Base: 94 general hospitals: 87–88, 91
Barnes, Brig. Gen. Julian F.: 47 Hawaii: 11, 17–18, 87–88, 90, 91, 278
458 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Dengue—Continued Dispensaries—Continued
epidemics: 95, 101, 226, 244, 284 Philippine Islands: 21, 22, 332–33
Gilbert Islands: 226 POW camps: 373
in Hawaii: 91, 95 Distinguished Service Cross: 134n44
in Mariana Islands: 234, 244, 249, 284 Doe, Brig. Gen. Jens A.: 213
New Caledonia: 101 Doss, Pfc. Desmond T.: 397
New Guinea: 128, 131, 133, 138, 140, 205, Douglas, Lt. Col. Wallace I., MC: 98
255 Downs, Col. Charles McC.: 320
Okinawa: 405 Duckworth, Col. James W., MC: 26, 31–32, 367,
Philippine Islands: 329, 351 368–69
Denit, Brig. Gen. Guy B., MC: 200, 215, 261, 426 Dutch Harbor: 150, 154, 159, 174
appointed Chief Surgeon, USAFFE: 253 Dypsnea: 243
as Chief Surgeon, USAFPAC: 412–14 Dysentery: 45
as Chief Surgeon, USASOS: 253, 319 amebic: 329, 330, 427
and hospital construction: 256 Australia: 63
and Philippine Islands invasion: 319, bacillary: 101
323–24, 347 Biak: 215
and Japan: 438 on board ships: 112, 378
and medical planning for the invasion of Bougainville: 194, 196
Japan: 414, 416, 417, 422, 423 in CBI theater: 289, 306, 309
and personnel shortages: 268–69, 270 Chinese Army: 298
and public health in Manila: 418, 421 control of: 281
and scrub typhus: 266 Gilbert Islands: 226
and surgical teams: 347 Guadalcanal: 117
Dental clinics: 21, 28, 92, 374 Hawaii: 91
Dental Corps: 10 in Japan: 427, 430, 436
Dental laboratories: 66 Japanese Army: 310–11
Dental officers: 91–92, 186, 284, 361, 368 Japanese deaths from: 196
Dental technicians: 153 Mariana Islands: 249
Dentists: 16, 30, 66, 90, 91–92, 153, 272, 299, New Caledonia: 112
316, 373 New Georgia: 184, 189
Dermatologists: 195 New Guinea: 128, 131, 181
DeRosier, T. Sgt. Edwin C.: 134n44 Philippine Islands: 31, 34–35, 37, 38, 329,
DeWitt, Lt. Gen. John L.: 150–51, 159–60 330
DeWitt, Col. William F., MC: 295–96 among POWs: 364–66, 367, 369–70, 380, 430
Diarrhea: 34–35, 125, 128, 130, 140, 152, 172,
184, 189, 201, 205, 215, 294, 351, 405 Efate: 101, 107, 109, 122
Dietary deficiencies Egeberg, Roger O.: 178n3
Australia: 63 Eichelberger, Lt. Gen. Robert L.: 131–32, 133,
Bataan: 33–36, 37, 38–39 138, 202, 213, 330, 331, 348–49, 352
Chinese Army: 298 Ellice Islands: 223
Corregidor: 41 Elmendorf Field: 150
Guadalcanal: 117 Emergency medical plans
POWs: 338, 367, 370–71, 372, 373, 377, 380 Hawaii: 9–14
Dieticians: 90–91, 109, 269, 376 Philippine Islands: 19–23
Diphtheria: 194, 367, 369–70 Emergency Plan WHITE: 12
Diphtheria antitoxin: 367, 370 Emmons, Lt. Gen. Delos C.: 18n20, 82, 85, 95, 97
Dispensaries Encephalitis: 405n46, 434
Air Force: 295–96 Engebi: 232–33
Alaska: 150, 154 Engineer Boat and Shore Regiment, 532d: 179
CBI theater: 295–96 Engineer special brigades: 314–15
Far East Air Force: 21 2d: 177–78, 180, 320
Hawaii: 11, 95 3d: 178n2, 332
Japan: 428 4th: 178n2, 332
INDEX 463
Field hospital platoons: 107, 133, 142–43, 161, Field hospitals (units)—Continued
162, 166, 172, 220, 229–30, 248, 88th: 410
315–16, 317, 318 91st: 346
Field hospitals Fighter Group, 49th: 63
Alaska: 167, 175 Fiji: 45, 98, 101, 105, 108–09, 111, 122, 189–90
Australia: 65, 70–71 Filariasis: 46, 101, 405
Bougainville: 191 Filipino guerrillas: 327–28, 329, 340, 343, 344,
CBI theater: 298, 309 347, 349, 352, 353–63
Central Pacific Area: 220, 229–30 Finschhafen: 254, 255, 256, 258, 268
for Chinese Army: 315 First aid kits: 390
enemy attacks on: 240 First aid stations, Hawaii: 13, 84
Guadalcanal: 119, 120, 124 Fischer, Lt. Col. Arthur F.: 37
Iwo Jima: 385, 387 Fleas: 48
for malaria cases: 124 Flies: 128, 189, 201, 215, 226, 249, 250, 306, 322,
Mariana Islands: 234, 239, 240 330, 351, 365–66, 370, 405, 418, 420
mobile: 250 Flight medicine: 243
for neuropsychiatric cases: 404 Flight nurses: 408
New Caledonia: 112–13 Flight surgeons
New Guinea: 199–200, 256 Australia: 51
for Okinawa: 388, 390–91, 398–400, 401, Christmas Island: 89
403, 407 Hawaiian Islands: 94, 102
Philippine Islands: 30, 31, 332, 336, 345, Mariana Islands: 243
347, 349 and medical evacuation: 96–97, 243, 276
for planned invasion of Japan: 424, 425 Navy: 122
protection for: 240 Philippine Islands: 24
splitting of: 70–71, 161 squadron: 94
staff for: 124, 400 training for: 87
surgery performed at: 120 Flying Tigers: 291
Field hospitals (units) Food inspection
1st: 320 in Australia: 56, 57
1st Provisional: 223 CBI theater: 294
2d: 142–43, 147, 320 in Hawaii: 85, 92
3d: 320 in New Zealand: 98n37, 100
5th: 332, 338 Food supplies, inadequacy of
6th: 175 Bataan: 27, 31, 33–36
14th: 161 New Guinea: 131
17th: 184, 185, 188, 384–85 POW camps: 365–66, 369–71, 372, 373, 374,
20th: 161, 166, 171–72 376–77, 380, 381, 383
23d: 332 Foot injuries: 170–71, 173, 175, 325, 334
24th: 332 Formosa: 369, 378, 379–80, 384
25th: 301, 302, 307, 309, 313–14 Forts
27th: 317 Armstrong, Hawaii: 12, 92
31st: 227, 229–30, 234, 239–40, 241, 242, Brent, Philippine Islands: 21
244, 398–99, 407 De Russey, Hawaii: 12
36th: 232–33, 234, 246–47 Glenn, Alaska: 174
37th: 210–11, 332 Greeley, Alaska: 174
38th: 234, 239, 240–41, 387 John Hay, Philippine Islands: 21
41st: 332, 338 Kamehameha, Hawaii: 12
43d: 332, 345, 346 William McKinley, Philippine Islands: 21,
44th: 313–14 22, 24, 25
52d: 191, 192 Mason, Calif.: 80
69th: 328, 390–91 Mears, Alaska: 159, 174
74th: 407 Mills, Philippine Islands: 21, 22, 40, 43
82d: 404 Ord, Calif.: 92, 160–61, 172, 173
INDEX 465
Kachins: 301, 302, 309 Lae: 133, 179, 254, 255, 259
Kahuku Army Air Base: 94 Landing craft (LCI/LCT)
Kamehameha School for Boys: 17–18 used as ambulances: 160, 166, 179, 180,
Kamikazi attacks: 391–93, 396 197–98, 201, 209, 212, 223
Kamish, Lt. Col. Robert J., MC: 161, 169, 227 used to deliver medical supplies: 179
Kaneohe Bay Naval Air Station: 14, 17 used for medical evacuation: 326, 389, 398,
Kaneohe Territorial Hospital: 17, 18 407
Kapa Kapa Trail: 130 used for operation of portable surgical hos-
Kauai: 88, 90, 93, 94 pitals: 197–98, 200
Kaufman, Col. M. Ralph, MC: 284, 404 Landing ship, tank (LST)
Kempf, Maj. Peter, MC: 26 as blood supply centers: 401, 425
Kendrick, Lt. Col. Douglas B.: 401 casualty-converted: 242, 320, 323, 325,
Kennard, Lt. Col. William J., MC: 21, 178 332–33, 348, 385, 388–89, 398
Kenney, Maj. Gen. George C.: 51 hospital: 385, 390–91, 393, 415
Kerama Islands: 387, 390 Landing vehicle, tracked (LVT). See Alligators
Kilauea Military Camp: 11 (LVT).
King, Lt. Col. Arthur G., MC: 103–04 Landrum, Maj. Gen. Eugene M.: 166
King, Brig. Gen. Edgar, MC LaRoche, Col. Laurant L., MC: 274–75
as anti-biological warfare officer: 85–86 Larsen, Nils P.: 13
and Central Pacific Area: 222, 226 Leach, Charles: 376
as Chief Surgeon, Hawaiian Department: Ledo Road: 291–92, 294, 297, 300, 302–03,
83–84 311–12, 313
as Chief Surgeon, USAFICPA: 222, 271–72 Lee, Lt. Henry G.: 378
as Chief Surgeon, USASOS: 83–84 Legions of Merit: 190
and emergency medical planning for Lend-lease for China: 296
Hawaii: 9–13, 15, 18–19, 83–84 Leyte: 319–31, 340, 347, 348, 349, 352, 359
and hospital facilities: 86–90 Libasci, Col. Alfonso M., MC: 49, 147, 267–68
and medical evacuation: 96–97 Limay: 22, 26, 27, 28, 40
and medical personnel shortages: 90–92 Littell, Lt. Col. George S., MC: 47, 48, 49, 68
and medical planning for offensives: 86, Litter hauls
281–82 Attu: 164, 166–67
and medical supplies: 281–82 Biak: 213, 214
and portable surgical hospitals: 222 CBI theater: 300, 306–07, 315–16
and preventive medicine: 280 Guadalcanal: 118–19
and VD control: 84–85 in jungles: 185, 315, 325, 328, 333–34, 345
King, Maj. Gen. Edward P., Jr.: 31, 38 in mountainous areas: 164, 166–67, 210–11,
King, Lt. Col. Everett, MC: 258 328, 333–34, 345, 348, 396–97, 407
Kinkaid, Vice Admiral Thomas C.: 166 New Caledonia: 112–13
Kirk, Brig. Gen. Norman T.: 71–72, 140–41, 175, New Guinea: 141–42, 179, 180–81
252, 253, 256, 261, 282–83, 417, 426 Okinawa: 396–97
Kiska: 159, 172–76 in the Philippine Islands: 325, 328, 333–34,
Kodiak: 150, 154 340, 343, 345, 348
Kokoda Trail: 127, 128, 130, 265 Litterbearers
Koontz, Lt. Col. Amos R., MC: 98, 275 Admiralty Islands: 200, 201
Korea: 378, 380, 426–27 Angaur: 384–85
Krueger, Lt. Gen. Walter: 201–03, 204, 210, Biak: 213, 214
211–12, 213, 330, 331, 333, 343 CBI theater: 300, 301, 307, 315–16
Kwajalein: 227, 228–32, 242–43, 277, 278, 279 Chinese: 300, 307, 315–16
Kyushu: 384, 385, 414, 415, 416, 422, 424–25, Filipinos: 333–34, 343
426–27 Guadalcanal: 118–20, 122
infantrymen used as: 118–19, 164, 396–97
Labor camps: 378–83 Japanese attacks on: 164, 207, 214, 385,
Laboratories: 21, 28, 213, 403 396–97
Laboratory technicians: 153, 191, 272 Mariana Islands: 239, 241–42
470 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Malaria control detachments: 194–95, 220, 320, Medals of Honor: 190, 397
322 Medical Administrative Corps: 112, 373
Malaria Control School: 255 Medical Administrative Corps officers: 151, 186,
Malaria control teams: 59, 117, 124, 138, 191, 268–69, 272
194, 200, 206, 207–08 Medical Air Evacuation Transport Squadron,
Malaria control units: 129, 292–93, 320, 322, 803d: 301–02, 307, 312
332–33, 388, 418, 420 Medical battalion commanders: 93
Malaria control units, Navy: 124, 185, 189, 201, Medical battalions
388 augmented: 347
Malaria discipline: 194–95, 201, 207, 255–56, for guerrillas in the Philippine Islands: 360
303, 306, 322, 351, 362 split: 129, 173–74
Malaria survey detachments: 194–95, 220, 320, Medical battalions (units)
322 6th: 210, 217
Malaria survey teams: 59, 138, 191, 199–200, 7th: 161, 163, 169, 227–28, 229, 326–27
201, 206, 207–08 12th: 20–21
Malaria survey units: 332–33, 420 13th: 301–02, 307, 311–12
Malariologists: 137, 138, 280 24th: 11, 202, 258
Malinta Tunnel: 22, 39–43 25th: 11, 121, 185
Malnutrition 59th: 173
Guadalcanal: 117 70th: 332, 346, 348
Japanese forces: 117–18, 120, 310–11 71st: 94, 322, 388, 390, 398
Philippine Islands: 33–36, 37, 38–39, 351 96th: 399–400, 410
among POWs: 369–70, 372, 373, 374, 102d: 94, 221–22, 234, 239–40, 243
429–30 107th: 129, 130, 141–42
Manchuria: 378, 379–80, 381 112th: 185, 191, 192, 336–37
Manila: 5, 6, 22, 24, 25, 331, 334, 336–39, 418, 116th: 129, 178, 203, 214
420–21 118th: 184, 190, 358–59
Manila Hospital Center: 24, 25–26 121st: 117n5
Mann, Capt. William L., Jr., MC, USN: 151 135th: 320, 323–24, 332, 334, 343, 348
Manus: 200–201, 320 151st: 294, 299–300, 302, 307, 312
Mariana Islands: 233–50, 271, 276–77, 278–79, 262d: 177–78, 179, 180, 203, 320, 322
282, 389, 398, 403 263d: 332, 348, 349
Marine Amphibious Corps, I: 191, 192, 233 264th: 332, 339, 348
Marine divisions 302d: 234, 246–47, 248
1st: 115–17, 124, 145n65, 198, 385, 395, 407 Medical clearing companies
2d: 117, 196, 221, 233, 245 394th: 330
3d: 192, 233, 246 893d: 330, 338
4th: 227, 233, 236–37, 238, 245 Medical collecting companies
6th: 395 409th: 339
Marine Provisional Brigade, 1st: 233, 246 506th: 209
Marines, 4th: 19, 41 644th: 330
Marines Regimental Combat Team, 22d: 232 645th: 328
Mariveles: 5 Medical command problems: 103–04
Marking (Col. Marcus V. Augustin): 358–59 Medical companies (Navy): 191
Marquesas Islands: 98, 101 Medical consultants: 191, 284, 319, 403
Marshall, General George C.: 47, 138, 196, 416 Medical control officers, amphibious operations:
Marshall, Brig. Gen. Richard J.: 50 227–28
Marshall Islands: 227–33, 271, 274, 278–79 Medical corpsmen, Filipino: 30
Martin, Maj. Gen. Frederick L.: 11 Medical corpsmen, Navy: 122
Martin, Brig. Gen. Joseph I., MC: 412, 426 Medical detachments
Martin, Col. Walter B.: 403n41 Alaska: 153
Maxwell, Maj. Gen. Earl, MC: 102–03, 107–08, Australia: 63–64
109, 111, 114, 116, 119, 184, 191, Christmas Island: 89
274–75, 387–88, 394, 426 Hawaii: 11
472 MEDICAL SERVICE IN THE WAR AGAINST JAPAN
Tongareva: 101n39, 108 United States Army Forces, Far East (USAFFE):
Tongatabu: 101n39, 108, 111 51
Training chief surgeon: 51, 253
for ambulance personnel: 113 problems of medical policy in: 51, 54, 253,
in amphibious warfare: 160–61, 172, 272 413
of anit-malaria details: 138 United States Army Forces, Middle Pacific
on board ships: 112 (USAFMIDPAC): 412, 425
cadres for medical detachments: 20 United States Army Forces, Pacific (USAFPAC):
for Chinese Army medical personnel: 288, 412, 413–17, 426–27, 428, 433
291, 299, 314–15, 316, 317 United States Army Forces, Pacific Ocean Areas
for cold weather operations: 170–71 (USAFPOA): 273
in island warfare: 116 bed capacity: 279
in jungle warfare: 93, 116, 129, 130, 272 medical planning: 387
lack of: 28 Office of the Chief Surgeon: 273–74, 280,
of medics: 112, 116, 129, 172, 272 283, 284
of medics in arms: 112, 173, 272 and preventive medicine: 279–81
for nurses: 272 United States Army Forces, Western Pacific
Philippine Army medics: 28 (USAFWESPAC): 412–13, 415, 418,
sanitation: 228 421, 422, 423–24
tropical medicine: 70, 100, 112, 272 United States Army Forces in Australia
Trains used for medical evacuation: 24, (USAFIA): 48
288–89 chief nurse: 66
Transportation Corps: 259 Committee on the Adaptation of Australian
Transportation problems: 22, 112–13, 150, Materials and Supplies: 68
155–58 Office of the Chief Surgeon: 48–49, 50
Trench foot: 171, 175, 325 United States Army Forces in the Central Pacific
Triage: 242, 343, 401, 415 Area (USAFICPA): 86, 270, 273, 279,
Tripler General Hospital: 11, 12, 14–15, 18, 283
86–87, 88, 89, 91 United States Army Forces in the Far East
Trombiculid mite: 46 (USAFFE): 19–20, 23, 26, 31, 39
Tsutsugamushi fever. See Scrub typhus. United States Army Forces in New Zealand: 98
Tsuzuki, Masao: 438–39 United States Army Forces in the Philippines,
Tuberculosis: 57, 87, 100, 357, 382, 409, 430–31, Northern Luzon (USAFIP-NL): 360
434 United States Army Forces in the South Pacific
Tulagi: 101, 115 Area (USAFISPA): 97–98
Turner, Rear Admiral Richmond Kelly: 221, chief surgeon: 102, 274
227 Office of the Chief Surgeon: 193–94
Typhoid: 92, 100, 294, 376, 436 United States Army Services of Supply, CBI: 291,
Typhus: 46, 294, 434–36 292, 296, 313
Typhus Commission, U.S.A. See United States of United States Army Services of Supply, SPA: 102,
America Typhus Commission. 111
United States Army Services of Supply, SWPA:
Umnak Island, Alaska: 154 50, 51, 254–55, 323, 418
Unalaska Island: 159 Australian Base Section: 255, 418
Underwood, M. Sgt. James B.: 337 base sections: 254–56, 338, 412–13, 418
Unit Jungle Training Center: 272 Intermediate Section: 254–55
United China Relief: 296 Luzon Base Section: 338, 343
United States Army Forces, China, Burma and and medical support for Philippine Islands
India (USAFCBI): 286–87 invasion: 322, 332–33, 338
chief surgeon: 291, 313 New Guinea Base Section: 255
cooperation with British medical service: Office of the Chief Surgeon: 51, 54, 61, 178,
312 253, 319, 413
medical missions: 287, 291 U.S.-Australian Hospitals Subcommittee: 68
Office of the Chief Surgeon: 294n15 United States Forces in Australia (USFIA): 47–48
484 MEDICAL SERVICE IN THE WAR AGAINST JAPAN