This page needs to be proofread.
246
ARMY MEDICAL SERVICE


field. They are situated at or near the sea bases but may be estab- lished in greater or smaller hospital centres elsewhere on the lines of communication. The stationary hospitals are smaller and less fully equipped than the general hospitals and are organized for 200 or 400 beds. They are intended to act as local hospitals for the sick of large camps or other posts on the lines of communication, or as hospitals for special purposes such as the reception and treatment of infectious diseases. They are mobilized in the same proportion as general hospitals. In the United Kingdom the Territorial Force R.A.M.C. mobilize 24 general hospitals in time of war, each of 520 beds.

Convalescent Depots. These form large camps at the bases or else- where where convalescents on discharge from hospital are made physically fit to return to duty by convalescent treatment and graduated physical training. There is no fixed limit to their numbers or size. During the World War a convalescent depot could accom- modate from 1,000 to 5,000 men.

Medical and Surgical Supplies in War. Two kinds of units are organized for maintaining and distributing medical and surgical supplies, the base depots of medical stores and the advanced depots. They are in charge of quartermasters of the R.A.M.C. The base depots receive their supplies through the Army Medical Stores at Woolwich. They supply the hospitals and medical services at the base and on the lines of communication, and are placed as a rule at the sea bases. Originally the proportion was one for every two divisions, but there was no fixed proportion during the World War. As a rule there was one at each sea base or advanced base. Advanced depots of medical stores are army troops under the control of the director of medical services of the army, and are allotted in the proportion of one for each army corps. They are replenished from the base depots and supply the casualty clearing stations, the divisional medical units and other medical services of the field army. Sanitary Organization in War. In addition to the sanitary detach- ment of each regimental unit, a sanitary section of one officer and 25 men is mobilized with each division and for each base. Sanitary squads of one non-commissioned officer and four men are also mobil- ized for each railhead or railway post on the lines of communication. The personnel of sanitary sections and squads act as sanitary inspectors, supervise the construction of sanitary requirements in camps and billets, and maintain sanitary establishments.

Mobile Laboratories. For special work in the field four classes of mobile laboratories are organized. Mobile hygiene laboratories for chemical analysis of water and food supplies and for other hy- gienic investigations are allotted in the proportion of one to each army. Mobile bacteriological laboratories for medical and surgical bacteriological investigation are allotted in the proportion of two to each army. A mobile X-ray laboratory and a mobile dental unit, in the proportion of one of each to an army, are attached to one of the casualty clearing stations. All these laboratories are constructed on motor chassis and can be placed in any area as required.

Nursing Services in War. Members of the nursing services are employed in all the general and stationary hospitals, in ambulance trains and flotillas, hospital ships and casualty clearing stations.

Voluntary Organization in War. Voluntary aid detachments of men and women are organized under County Territorial Force Associations by county directors of the British Red Cross Society or St. John Ambulance Association. They have a definite composi- tion and are registered at the War Office. On mobilization they undertake the opening and staffing of auxiliary hospitals throughout the United Kingdom and the local transport of patients who are being distributed to hospitals in the United Kingdom. Members of women's Voluntary Aid Detachments (V.A.D.) may also be employed in nursing duties in military hospitals. In theatres of war the chief function of voluntary aid organizations is to maintain stores for supplementing hospital equipment and supplies by articles which may add to their comfort and appearance, and by distributing gifts. Medical units offered by voluntary services or private individuals are not recognized unless they are organized on the same lines as corresponding regular units and under the command of officers of the R.A.M.C. In addition to the voluntary aid detachments, the St. John Ambulance Brigade and the St. Andrew's Ambulance Association maintain a home hospital reserve, the personnel of which takes the place of the regular R.A.M.C. in the military hos- pitals in the United Kingdom when the latter are mobilized to form the medical units of the war establishments. At the beginning of the war in 1914 the St. John Ambulance Brigade had ready a home hospital reserve of 2,200 men and the St. Andrew's Ambulance Association 113, but these numbers increased so rapidly that by the end of 1915 over 15,000 of the St. John Ambulance Brigade were serving in the military hospitals in Great Britain; (W. G. MA.)

UNITED STATES

Functions. By Army Regulations the Medical Department in 1910 wascharged with the following duties: Investigating the san- itary conditions of the army and making recommendations with reference thereto; advising with regard to the location of per- manent stations, the selection and purification of water supplies, and the disposal of wastes; caring for the sick and wounded;

making physical examinations of officers and enlisted men; managing military hospitals; recruiting, instructing and con- trolling the enlisted force of the Medical Department and the Nurse. Corps; and furnishing all medical and hospital supplies, except for public animals. In 1921 these functions persisted.

COMPOSITION

Medical Department. In. 1911 the Medical Department com- prised the Medical Corps, Medical Reserve Corps, Dental Corps, Hospital Corps (male), and Nurse Corps (female), to which could be added contract surgeons and other civilians. The National Defense Act of 1916 provided that the Department should consist of " one surgeon-general, . . . who shall be chief of said department, a Medical Corps, a Medical Reserve Corps, ... a Dental Corps, a Veterinary Corps, an Enlisted Force, the Nurse Corps, and contract surgeons . . ." Subject to the appointment of great numbers of officers in temporary grades up to and including that of major- general, as authorized by war legislation, this Act covered the organization of the medical service during the World War, with the exception that a new temporary body was formed which was known as the Sanitary Corps and consisted of officers and enlisted men, not graduates in medicine, who possessed knowledge or experience of value to the Medical Department. The Act approved June 4 1920 stipulated that the surgeon-general should have the rank of major- general and should have two assistants with the rank of brigadier- general; it added a new branch, the Medical Administrative Corps; under this Act the enlisted strength of the Medical Department could not exceed 5% of the actual commissioned and enlisted strength of the army; the number of officers in the Medical Corps was fixed at 6-5 for every 1,000 of " authorized " (virtually actual) enlisted strength of the regular army.

As provided by Act of April 23 1908, the Medical Corps of the army consisted of one surgeon-general with rank of brigadier-general, 14 colonels, 24 lieutenant-colonels, 105 majors and 300 captains or first lieutenants, advancement being by seniority except in the case of lieutenants, who were promoted after three years' service. The scheme for promotion was modified by the Act approved June 4 1920, to provide that officers of the Dental and Medical Corps should be promoted to the grade of captain after three years' service, to the grade of major after 12 years' service, to the grade of lieutenant- colonel after 20 years' service, and to the grade of colonel after 26 years' service, all subject to the satisfactory passing of the required examinations. On Oct. I 1921 there were 43 colonels, 87 lieutenant- colonels, 483 majors, 474 captains, and 52 first lieutenants.

Beginning with 1901 the Medical Department employed civilian dentists under contract. The Act of March 3 1911 established a Dental Corps, consisting of lieutenants in the proportion of one to each 1,000 of actual enlisted strength of the army, but in no event to exceed 60. By an Act approved Oct. 6 1917 the Corps was made to consist of officers of the same grades and proportionate distribution of grades as were then, or as might thereafter, be provided by law for the Medical Corps. On Oct. I 1921, there were m the Dental Corps eight colonels, 15 lieutenant-colonels, 62 majors, 132 captains and 25 first lieutenants. The Veterinary Corps was established by the National Defense Act and took over the veterinarians formerly assigned to mounted regiments and to the Quartermaster Depart- ment. On Oct. I 1921 there were in the Veterinary Corps four Colonels, six lieutenant-colonels, 17 majors, 25 captains,. 97 first lieutenants and six second lieutenants. The Medical Reserve Corps was established by Act of April 23 1908 for the purpose of securing a supply of medical officers available in emergency. The National Defense Act abolished the Medical Reserve Corps, as such, and established an Officers' Reserve Corps, with sections corresponding

o the various arms, staff corps and departments of the regular army.

Under this law a medical section of the Officers' Reserve Corps, containing approximately 1,256 physicians, existed at the outbreak of the World War. On Oct. 14 1921 there were 5,816 officers enrolled in the medical section of the Officers' Reserve Corps, 3,747 in the dental section, 390 in the veterinary section, 264 in the sanitary section, and 491 in the medical administrative section. A Hospital Dorps, composed of hospital stewards and privates, was established >y Act of March I 1887, which directed that all necessary hospital services in garrison, camp or field, including ambulance service, should be performed by members of this corps, which was perma- nently attached to the Medical Department. The National Defense Act abolished the designation " Hospital Corps " and substituted therefor an Enlisted Force, consisting of non-commissioned officers, privates first class, and privates. The Army Nurse Corps (female) came into existence in 1901. No appreciable change in its organiza- ion was made until the Act of June 4 1920, when the members of the ^urse Corps were given relative rank, the superintendent having hat of major, the assistant superintendents that of captain, chief nurses that of first lieutenant, and head nurses and nurses that of second lieutenant. In respect of matters within the line of their duties, nurses were given authority, in and about military hospitals, next after officers of the Medical Department. Nurses in 1921 continued to be employed under contract for a period of three years, and did not receive the pay of their relative rank. The Medical