HISTORY OF PREVENTIVE MEDICINE DIVISION GROUND MEDICAL SECTION HEADQUARTERS, ARMY GROUND FORCES This history is being made available in manuscript form pending the completion of the official History of the Medical Department in World War II, and must be considered as a draft subject to final editing and revision0 Persons finding errors in facts or important omissions should communicate with the Historical Division, Amy Medical Library, Washington 25, DoCo It is emphasized that all statistical data in this monograph are tentative and subject to revision when tabulation of individual sick and wounded report cards has been completedo PREVENTIVE MEDICINE IN MEDICAL SECTION GHQ PRIOR TO ORGANIZATION OF ARMY GROUND FORCES For approximately 10 months prior to the dissolution of General Headquarters by virtue of the reorganization of the War Department under Circular 59 the Medical Section had been primarily concerned with the femulation of plans for various potential operations, each of which contained a medical annex,, The purpose of these plans was to place in the hands of the commanders (to be selected) an appreciation to include a medical appreciation of the area selected for operations0 To make proper prevision for the units and supplies required and the necessary logistical preparation for their arrival at the required place at the proper time detailed information necessary for an evaluation of these requirements was requiredo Information was assembled relative to health protection and the medical care of troops„ Serious consideration was given to the health of the civilian communities in which our troops might be stationed or pass through since our military forces would be vitally affected by the health of these civilianso Orientation and training relative to health hazards were made a part of the troop training programs in order that troops would bee erne properly indoctrinated with the necessity for maintaining a high standard in sanitation and personnel hygiene,, Surveys of the areas with which we were con- cerned had not been completed in each instance and resort was made to information from all possible sources, especially library research,, Much valuable information was also received from commercial air line sources. Military Attache® reports, and from surveys made by medical officers assigned to the Engineer Divisions who were responsible for the preparation of Various U„ Bo Amy baseso In the fall of 1841 with the establishment of the Medical Intelligence Division in The Surgeon General’s Office more and more epidemiological information was made available by that section,, These enlightening summaries of health conditions and specific precautions to be taken in certain theaters supplied a large part of the information During this period a standard form for a Medical Plan as an annex to an operations plan containing a section on disease control, special sanitary precautions and a form for sanitary surveys was prepared for the War Departmento (Ss© Tab A) 1 PREVENTIVE MEDICAL SECTION AiMY GROUND FORCE MEDICAL SECTION Army Ground Forces Headquarters became operational 9 March 1942 under War Department Circular 59© The Medical Section was included as a special staff section organized as indicated in Tab Bo While the operational phase of preventive medicine greatly increased, considerable planning was also necessary and this section was occupied chiefly with the fol- lowing tasks: X e Preparation of courses of instruction and recom- mendations relative to policy for training in personal hygiene* sanitation* and VoD© control in Ground Force schools (infantry School* Artillery School* etc)© 2© VoDo control in Ground Force Units© (In this con- nection close liaison was maintained with the V©D© Section of the Preventive Medical Service* Surgeon General*s Office* in order to insure uniformity in presenting information* control and proper cooper- ation of Ground Forces with ASF commands in meeting their common problemo) 3o Preparation of Records* Reports and Returns© Close liaison was maintained with the Medical Statistics Division* Surgeon General*s Office* and recom- mendations were submitted relative to changes in type of records* reports* and returns© Every effort was made to properly indoctrinate Ground Force unite with the necessity of rendering complete and correct reports© Information needed by The Surgeon General’s Office relating to Ground Fore© units was obtained for the Medical Statistics Division* SGO* and corrective action taken from time to time to insure compliance with the directives of that office relative to these reports© 4© Statistics relative to the health of the Ground Forces were maintained in the Medical Section in order that the Commanding General* Army Ground Forces* could be kept informed at all times on the health of the com- mand© 2 5o Sanitary Reports were processed and corrective action taken where indicatedo Special information believed to be of sufficient importance to warrant it was communicated to The Surgeon General’s Office by telephone© Reports of specified acute infectious diseases received by wire or telephone were furnished The Surgeon General’s Office immediately upon their receipt© 60 Inspections in the .field were made relative to sanitation and personal hygiene and corrective action taken where indicated© Diseases occuring in epidemic proportions were investigated on the ground and action indicated taken© 7© Recommendations were made relative to physical standards and for instructions for the physical processing, vac- cinations, etc©, in preparing troops for overseas move- ments© Organization of Preventive Medicine Division, Medical Section Two officers (Major M® W® Bass, MC, AUS and Captain F® S® Dozier, MC, AUS$ were assigned for duty in the Medical Section in early March 1942 and assigned to the Preventive Medicine Division® This assignment was terminated after less than a month due to a reduction in the strength of the Medical Section (See Tab G)and the Preventive Medicine Division with its respective responsibilities were temporarily incorporated as an additional duty of the Operations Division® This permitted the utilization of but part of the time of one officer and curtailed greatly the operative phase of this Division® However, operating procedures were promulgated which assured that routine administrative matters were performed by highly capable enlisted assistants and full use of the officers available time was accomplished® This method of operating was continued for the period March 1942 to June 1943 until Captain Fred H® Fehlmann, MC, AUS, was assigned to Headquarters, GNMED, Preventive Medicine Section, 12 June 1943® (See Tab D®) Considerable experience had been gained during the preceding period relative to the responsibilities that should be properly assigned the Preventive Medical Division® This Division was therefore charged with the following duties; lo Maintain a file of statistical records received periodically from The Surgeon General relative to disease and injury in the Army and ke$p the Chief Surgeon informed as to the health of Army Ground Forces personnel© 3 2o Review Monthly Comprehensive Sanitary Reports0 3o Make such studies relative to health of Array Ground Forces troops as special situations may require» 4o Maintain liaison with Preventive Medicine Division Office of The Surgeon General and Office of The Air Surgeono 60 Advise Chief Surgeon, Army Ground Forces, on matters of preventive medicine as it applies to Army Ground Forces troopso 60 Review and act for Chief Surgeon on all War Department publications and on directives pertaining to hygiene, sanitation, and communicable disease„ 7© Review current overseas reports for information on all matters of military health and make appropriate recom- mendations to the Chief Surgeon concerning training in medical subjects0 80 Represent Chief Surgeon on Uo So Army Committee for Insect and Rodent Control0 Physical Standards and Profiling lo Review and act for Chief Surgeon on War Department publications pertaining to physical standards, profiling and medical examinations» 2o Maintain liaison with Physical Standards Division, Office of The Surgeon General and Office of The Air Surgeon© 3© Render professional advice for the Chief Surgeon relative to questions of physical standards for training and for overseas duty.. Statistical records maintained by the following chartso Admission rate per 1000 men per annumo A0 Malaria acquired in and out Uo So 1944-1945o Bo Non-effective rat© - AGF and Uo So total from January 1943 to July 19450 Co Intestinal Diseases. Do Disease and Injury0 Eo Respiratory Disease. Fo Venereal Disease "Newo" (See Tab E). In addition to the instructions contained in AR 40-1080 relative to the rendition of (WD, MD Form 86ab) the following additional and specific instructions were published to Ground Force units. (1) Consolidated reports covering each of the following units and commands will be prepared and forwarded promptly to Headquarters Army Ground Forces (Attention: Ground Surgeon): a. Each Division (including units attached for Medical service)„ bo Bach independent Corps (including all assigned and attached units)o Co Bach Army (including all assigned and attached units)« do Each independent Army Ground Forces command except Replacement and Schoolo (2) Copies of Army Ground Forces unit and consolidated reports will include under "Remarks." a. The number of individuals actually assigned to the reporting unit who remain in any hospital (present or absent) as of 2400 of the last day of the period coveredo Vital Statistics in Major Units Under Army Ground Force Control Major units under Army Ground Force control were encouraged to maintain such general vital statistics, comparative rates and general reviews of health of their commands as their assigned personnel would 5 permito Especially stressed was the desirability and necessity for careful and accurate venereal disease rates0 Comparative venereal disease rates were maintained by all major units which proved to be of valid© in the control of these diseases<> (See Tab F) rurrent Operations of Preventive MedicInQ Division Medical Section (November 1945 to date) With redeployment and the ensuing drastic reduction in medical officers assigned to Ground Force Medical Units the Chief Surgeon Army Ground Forces was concerned relative to the proper supervision of sanitation and hygiene in these units0 In cooper- ation with The Surgeon General it was agreed that when the Medical Corps personnel assigned for duty in a tactical command became depleted to the degree that the surgeon thereof considered that there was an inadequate discharge of duties regarding s\*pervision of sanitation and hygiene that the assistance of the surgeon of the local post, camp, or station could be elicitedo In the absence of Medical Corps officers assigned for duty with tactical units where the Medical Service was being furnished by post, camp, or station medical personnel, the surgeon of the installation was charged by The Surgeon General with discharging the Medical Depart- ment's responsibility for sanitation, sanitary supervision, instruction in hygiene and sanitation and for the rendition of the proper reports, records, and returns0 The responsibility of com- manders and Medical Department personnel for investigating sanitary conditions and enforcing the necessary provisions of sanitary regulations were assumed under the following regulations: •'Commanding Officers are responsible for sanitation and for the enforcement of provisions of sanitary regu- lations within their organization and the boundaries of areas occupied by themo” (AR 40-205, Par 2a, 31 Dec 42)0 "The Medical Department is charged with the duty of investigating the sanitary conditions of the Army and making recommendations in relation theretoo” (AR 40-205, Par 2c)o To accomplish the above and to keep commanding officers and higher administrative authorities in touch with current sanitary conditions a Monthly Sanitary Report (WD AGO Form 8-140) was rendered by The Surgeon of each tactical command (AR 40-275)0 6 November 6, 1946, Headquarters Array Ground Forces published the following to Major Units under its control relative to Medical Reports to implement this plans lo Responsibility for rendition of medical reports as outlined in current War Department directives is supplemented as follows; a„ Statistical Health Report, WD AGO Form 8-122 (old WD MD Form 86ab)o (1) Consolidated reports are no longer required by this headquarterSo (2) Paragraph 26, Section II, Weekly Directive No 16, Hq AGF, 17 April 1945 is hereby rescindedo be Venereal Disease Statistical Tables» (1) Commanding officers of Army Ground Force units receiving Army Service Forces dispensary medical service will be responsible for main- taining Venereal Disease Statistical Tables required by par 24 a, AR 40-210, 25 April 1945» Data for compiling the tables will be obtained from the dispensary, and necessary information copies will be prepared and forwarded to permit maintenance of consolidated tables by head- quarters designated in par 24 a (3), AR 40-210» c« Monthly Sanitary Report, WD AGO Form 8-140o (1) A Monthly Sanitary Report will be rendered for each Army Ground Force unit and installation in accordance with par 3, AR 40a»275, 15 Sep- tember 1945 provided such unit or installation has a Medical Corps officer assigned for duty„ In those instances where the number of Medical Corps officers so assigned is insufficient to permit first-hand acquisition of all data re- quired for proper completion of the report, necessary assistance in procuring such data will be obtained from the Post Surgeono 7 (2) A Monthly Sanitary Report for each Army Ground Forces unit and installation which has no Medical Corps officer assigned for duty will be prepared by the Army Service Forces surgeon of the post upon which such unit or installation is located as of the Ihst day of the month0 The report will be forwarded to the commanding officer of the Army Ground Forces unit or installation for necessary action and transmission by indorse- ment through Army Ground Forces channels as prescribed in AH 40-275<, (3) Army Ground Forces commanding officers referred to in (2) above, are not relieved of responsibility imposed by paragraph 2, AR 40- 205, 31 December 1942 and will fully cooperate with Army Service Forces medical inspectors in matters of health and sanitation requiring corrective action,. do Monthly Comprehensive Sanitary Reports0 (1) Armies, separate corps, and equivalent command echelons will submit a Monthly Comprehensive Sanitary Report in accordance with paragraph 4, AR 40-275o (2) As used in subparagraph (1) above, the follow- ing will be considered as equivalent command echelons: (a) Replacement and School Commando (b) Airborne Center® (c) Army Ground Forces Replacement Depots® (3) Army Ground Forces units and installations not assigned to a command listed in subparagraphs (l) and (2) above, will forward unit Monthly Sanitary Reports through military channels to Headquarters Army Ground Forces« 8 ASF Responsibilities In implementing their responsibilities ASF published Army Service Forces Circular No 413* HQ* ASF* Section IV* Part II dated 7 November 1945o "IV o HYGIENE AND SANITATION• lo Pending the publication of a War Department circular the following provisions will govern sanitation and hygiene in tactical commands« 2o When a tactical command such as a separate company, battalion, or division functioning as an administrative unit has no Medical Corps officers assigned for duty and medical service is furnished by post, camp, or other station medical complement, the surgeon or senior medical officer of such an installation will discharge Medical Department responsibility for sanitation, sanitary supervision, and instruction in hygiene and sanitation as provided in AH 40-205 and other pertinent regulations and directives<> 3o In such instances the surgeon or senior medical officer designated in paragraph 1 will be responsible for rendering a monthly sanitary report (Reports Control Symbol MCE-4) addressed to the com- manding officer of the organization as prescribed in paragraph 3, AR 40-275, 13 September 1945o 4o The surgeon assuming the duties designated in paragraphs 1 and 2 may assign officers of the Medical Department to act as his assistants and discharge these duties for himo 5o When the Medical Corps personnel assigned for duty in a tactical command have been reduced to such an extent below the authorized Table of Organization that the surgeon or senior medical officer of the organization considers there is inadequate discharge of the duties regarding supervision of sanitation and hygiene he should request assistance from the surgeon of the local post, camp or stationoM Major Fred Ho Fehlmann, MC, AUS, Chief of the Preventive Medicine Division, Medical Section, departed this headquarters November 9,"1945 and his replacement, Lto Colonel Co Bo Henry, MC, AUS, arrived at this headquarters January 19460 As now constituted the Preventive Medicine is subdivision of the Professional Service Division, Medical Section, but only one officer is available assignment to the Division (See Tab G)o 9 LIST OF TABS TAB "A” - Annex to Operation Plan (Medical) TAB T*B,! - Organization Chart, Medical Section, Army Ground Forces (Preventive Medicine Branch) March 1942 TAB "C" - Organization Chart, Medical Section, Army Ground Forces (Preventive Medicine Branch) April 1942 TAB *M3,! - Organization Chart, Medical Section, Army Ground Forces (Preventive Medicine Branch) 1944 TAB f,E” - Amy Ground Forces Quarterly Statistical Summaries (Cannot Locate) TAB "F” - Monthly Health Summaries (Armored Force) (Cannot Locate) TAB MG" - Organization Chart, Medical Section, Amy Ground Forces (Professional Service - Preventive Medicine Branch) \ 1946 1 ANNEX TO OPERATIONS PLAN OF MEDICAL PLAN TAB "A" 3 ANNEX TO OPERATIONS PLAN OF ' MEDICAL PLAN TABLE OF CONTENTS Paragraph Subject Page SECTION I - GENERAL PI,AN OF OPERATION 1 Initial Strength and Distribution 13 2 List of Medical Units, Dets», & Base and/or Sector Headquarters required to operate Medical Plan 13 SECTION II - SUPPLY 3 Medical Supplies 14 4 Other Supplies 17 SECTION III - TRANSPORTATION 5 Water 18 6 Rail 18 7 Air . 18 8 Motor ' 18 SECTION IV - CONSTRUCTION 9 General Policy and Responsibility 18 10 Facilities to be Constructed 18 SECTION V - PLAN OF EVACUATION 11 Policies 18 12 Evacuation to Fixed Hospitals 19 13 Evacuation to Zone of Interior 19 SECTION VI - HOSPITALIZATION 14 Location of Fixed Hospitals 19 15 Estimates of Bed Requirements 19 Paragraph Subject Page SECTION VII - MISCELLANEOUS 16 Labor 17 Captured Material -*-9 18 Water 19 Burials 20 Hospital Diets 21 Finance 20 SECTION VIII - DISEASE CONTROL 22 Responsibility 20 23 Hygiene 20 24 Water 20 25 Waste Disposal 26 Control of Respiratory Disease 20 27 Intestinal Diseases 21 28 Treatment of Gas Casualties 21 29 Venereal Diseases 21 30 Insects 21 31 Rodents - ; 32 Immunization 21 33 Injuries 21 34 Food 22 35 Physical Examinations • 22 36 Sanitary Surveys 22 SECTION IX - SPECIAL SANITARY PRECAUTIONS 37 22 ANNEXES 6a Sanitary Survey of „ 23 6b Theatreo Estimation of Bed Requirements_, Evacuations and Replacements0 25 6c Suggested precautions against yellow fever,, 26 5 AMEX TO OPERATIONS PLAN MEDICAL PLAN SECTION I GENERAL PLAN 01' OPERATION 1o Initial Strength and Distribution0 (Reference only to Annex No., , G-l Plan) 2o List of Medical Units, Detachments and Base and/or Sector Headquarters required to operate Medical Plano SECTION II SUPPLY 3o Medical Supplies«. aTe Availability 0 TTJ "Local Resourceso (Should include - (a) Local supplies available initially (b) Supplies to be taken over from relieved units (c) Statement on reduction in items required from Z of I when they become available locally b° Unit Equipmento (1) AlT"medical supplies and complete hospital equip- ment will be shipped from the U0S0 or from (2) All medical units will have equipment and medical supplies (a) as prescribed in T B A (b) any additions or subtractions from (a) 6 For allotment of motor vehicles see Annex ? quartermaster plan<> c° Basic Planning data medical componentso (1) Ship-tons required for initial shipment (including , days maintenance and days reserve for all classes of medical supplies) 0 EXAMPLE Organo 60 Day- 30 Day- Equipo Reserve Reserve 1st Echelon "A" Sector 742 244 o 8 122o4 ,rB" Sector 370c6 12208 6104 2d Echelon "A" Sector 737o37 23204 16602 "B" Sector 368o 2 120o6 60 o 3 NOTE: - Weights of organic equipment of various medical units may be obtained from So Go Oo (2) Medical Maintenance Requirements of all classes other than those included in organic equipment Qo2Q IbSo* per man per day (*as prescribed in G-4 plan)o It may be desirable to prescribe an initial maintenance requirement with a subsequent main- tenance requirement after a certain period somewhat highero This recommendation should be forwarded to G-4 in order that it be prescribed in G-4 Annex do Scheme of Supplyo (1) General Outline0 (a) Information available in Annex , G-4 Plan and reference may be made to this Section0 (b) Location of supply points where initial supplies and subsequent maintenance will be shippedo (c) Method by which supplies will be moved from base depot to various sectors0 (By intra- island shipping? - organic motor transporta- tion? - or how?)0 7 e o Stockageso (1) Organic equipment plus day current main- tenance and ( ) day reserve will ac- company medical units or as prescribed in G-4 Annex 0 (2) Initial stockages will form the basis of reserve supply and levels will be maintained thereafter as follows: (Prescribed in G-4 Annex)» At "A" For all Troops of ’DC1* Sector 60 days At "B" For all Troops of "Z” Sector 60 days At "C" For all Troops of Force 30 days (3) Medical Department Blank Formso Medical Department Blank Forms are included with the organic equipment of medical units as shown in Basic Equipment Lists of these various units„ If this amount is deemed insufficient for a particular theatre or it is intended to provide extra forms for a reserve or for the use of the Medical Sections of Sector or Theatre Headquarters they may be listed in this paragraph0 Below are listed some of the forms that would probably be desirable in most theatres« Form Hoc Form Name Amount 25 Public Voucher for Medical Attendance 25a Public Voucher for Medical Attendance Memo 27 Public Voucher for Hospital Care & Treatment 27a Public Voucher for Hospital Care & Treatment Memorandum 28 Public Voucher for Personal Services Nursing 28a Public Voucher for Personal Services Nursing Memorandum 60 Certificate of Proficiency, General Enlisted Men 60a Certificate of Proficiency, Enlisted Men, MoD» Deto 86F Report of Casualties 110 Report of Veterinary, Meat & Dairy Hygiene and Forage Inspections0 (4) Drugs and BiologicalSo J&T Sufficient vaccines and sera to complete all innoculations, immunizations and blood typing will be included in the initial supply of each medical unit to insure the completion of all immunization and blood typing with the least practical delay0 (See paragraph on im- munization (Disease control section)0 8 (b) Additional biologicals should be provided as follows: Product51, Units Amount Biologicals required due to incidence of certain diseases in the par- ticular sector or theatre„ (c) Additional drugs should be provided as follows; NOTE: - For tropical areas - Those drugs not otherwise provided recom- mended for treatment of tropical diseases per S0 Go Oo Co Lo $56 (6-19-41)o For frigid areas - additional supply of sulfapyridine, sulfathiasole, and sulfadiazine® Also drugs necessitated by certain diseases peculiar to the areao fo Relief from Property Accountability0 (Prescribed in G~4 AnnelcJ (Current instructions - 3-10-42 - as provided in letter A0 Go 140 o 2 (2-10-42) MO-D-Mj Feb0 21* 1942* Policy governing property accounting in Theatres of Operations)* ge Method of Supply0 Information given in G-4 Annex usually notes - (1) where supplies are to be shipped from - how loaded and to what pointy (2) Procurement - Local procurement - development of local resourceso ho ■ Classification of Medical Supplies0 ’(as per instructions in G-4 Plan) or reference PM 100-10* December 9* 1940)„ io Markingo _ TIT Ahen equipment and supplies are procured for shipment overseas or are shipped overseas from home stations of troops or depots, the system of marking will be prescribed in the G-4 Annex for both organizational and main- tenance equipmento EXAMPLE: TO: Port Quartermaster (name) Port of Embarkation (place) FOR: (Shipment number and letter of Unit). NOTE: - The shipment number and letter of each unit will be furnished in the War Department Movement Order„ A0 Shippingo (Instructions are given in the 6-4 Annex) (information should cover use of code names, instructions to insure that shipments made direct to Ports of Embarkation by- contractors are marked in accordance with the provisions in the G-4 Annex)« ko Salvage, (any information relative to medical equipment - usually prescribed in G-4 Annex)0 L Captured Materialo As prescribed in G-4 Annex0 m° Flexibilityo As prescribed in G-4 Annexe 4o Other Supplies0 a0 Supplies in hands of troops <, (l) Supplies to come ashore with troops (Rations - individual clothing and equipment, field ranges, gas, etco) bo Supplies to come ashore immediately after troops0 (Rations, organizational equipment, remainder of vehicles, etc<>) Co Special instructions - do Fuelo (information from G-4 Annex) Reference should be made to Engineer Plan0 Note: - Fuel requirements for medi- cal units must be submitted to the Engineer Section for inclusion in their Annex« eo Laundryo Note who will furnish laundry service for medical units0 fo Mosquito and Insect Control - equipment and supply for all sanitation projects will be furnished 10 fc (continued) engineerso Requirements estimates must be submitted to Engineer Section for inclusion in their Annex® SECTION III TRANSPORTATION 5o Watero Reference G-4 Annex - water transportation for evacuation sick and wounded0 6o Railo Reference G-4 Annex - data effecting evacuation„ 7o Airo Same as for Railo 8. Motoro aQ Refer to Qj!vl Annex for motor transportation for medical units and installations0 (When other than T/0 trans- portation is to be furnished or for medical units, sector and theatre headquarters, etc0 where transportation is not prescribed by T/0 requirements must be furnished the QM for inclusion in the £$i Annex) 0 b. Maintenance and Repair - as prescribed in G-4 Annex0 SECTION IV CONSTRUCT!ON 90 General Policy and Responsibility0 Who is responsible? (prescribed in G-4 Plan)0 10- Facilities to be constructed,. til Type 'of construetion for medical installations - in tentage to be used initially? bo Reference to Engineer Annex for details. SECTION V PLAN OF EVACUATION llo Policieso 11 a*, Personnel „ (1) Evacuation policy- bo Animal So 12o Evacuation to Fixed Hospitals<> eu By what”means -"(Mobile Medical Units, plane, or boat)* 13» Evacuation to Zone of Interior*, eu Who will provide facilities - Army or Navy? b*, Number for which facilities must be provided* Reference Annex of Medical Plan which shows evacuations to Zone of""interioro Par„ D (2), G-4 Reference Data Ao Wo Co (1939 - 1940) SECTION VI HOSPITALIZATION 14o Location of Fixed Hospitals0 Note locations*, 15° Estimates of Bed Requirements*, Percentage of Force for which beds will be provided,, Reference to Annex of Medical Plan which shows actual bed requirements*, SECTION VII MISCELLANEOUS 16o Laboro Use of local labor (Reference to Annex , G-4 Plan)• 17« Captured Material (Reference to Annex , G-4 Plan)o 18o Water - (Reference to Annex Engineer Plan any special instructionso 19o Burials - as per instructions in Annex , G-4 PlanD 20o Hospital Diets0 NOTEs - The Surgeon General's Office prepared studies of diets furnished by the Quartermaster and determines additions required for patients' diets for the various theatreso These requirements must be furnished to the Quartermaster for inclusion in the Annex QM Plan and reference only need be made in the Medical Annex*, If menus utilizing the patients5 ration are available - copies should be furnished the Force Surgeon and reference made under this paragraph,, 12 21. Finance. a. Reference to Annex Finance Plan b. Purpose numbers under which expenditures in connection with the operation of medical activities may be expended as outlined in Finance Circular Letters. c. Estimates for: (1) , M lc H D ) as prescribed in policies of (2) C & R of H ) S. G. 0. or estimated. Any special provisions as to basis funds will be set up under (quarterly or annually) unexpended balance, etc.) SECTION VIII DISEASE CONTROL (The following wiTT rycfutl'tr mddification in various areas) 22. Responsibility. Responsibility for sanitation should be definedo (AR 40-205, "Military Hygiene" - PM 8-40, "Field Sanitation" - and FM 21-10, "Military Sanitation and P'irst Aid" should be used as reference texts). 23. Hygiene. Standard should be prescribed. Instruction should be given relative to special problems presented by a particular area. 24. ?»ater. Method of purification should be noted. Directions relative to storage should be prescribed. 25. Mste Disposal. a. Human excreta - system to be used. b. Garbage - method of disposal. c. Liquid wastes - instructions for disposal. 26. Control of Respiratory Disease. To include: - a. Minimum allowable floor space in types of housing to be provided. b. Method of washing of mess kits and kitchen utensils. c. Special instructions relative to clothing not included in Annex. 13 270 Intestinal Diseases,, &T Relative to civilian population to include restrictions in use of local food and drinko b0 Fly controlo Co Food sanitation affecting intestinal diseases (Reference should be made to FM 8-40 and FM 21-10)=> 28o Treatment of Gas Casualtieso An-impro'vised chest for the treatment of gas casualties will be furnished appropriate medical units pending the development of such a chesto (Reference should be made to TM. 8-285* "Treatment of Casualties From Chemical Agents")» 29o Venereal Diseases,, To includes - &0 Responsibility for controlo bo Mechanical and chemical prophylaxis„ Co Establishment of prophylactic stations0 do Pertinent information relative to civil population 30o Insectso Recommend procedures for control and elimination of mos- quitoes* flies* and vermin (Procedures should in general be as prescribed in FM 8-40 and FM 21-10)„ 31o Rodents„ As prescribed in FM 8-40 & FM 21-10= 32o Immunization Those required should be specified and may include:- a« Small pox and triple typhoid as prescribed in Par, lb (4)* AR 40-215o bo Tetanus as prescribed by SG0 Letter No0 34, dated April 16, 1941c Co Yellow Fever as prescribed in SG0 Letter No„ 9, dated February 12, 1941o 33 0 Injuries., Should include information relative to preventing: a. Industrial injuries« b. Injuries resulting from vehicle operation Co Special instructions when applicable., 34, Food. a. Inspections (embarkation & debarkation by the Army Veterinary Inspector), b. Refrigeration - during transportation to base and within units. c. Local procurement (veterinary inspection prior to purchase). d. Unit storage - fly-proof, rat-proof when applicable, e. Food handlers. (Examination as prescribed in Par 12 AR 40-205, 35. Physical Examinations, a. Pre-embarkation. Special examination requirements for venereal diseases. Indication for chest X-rays, neuropsychiatric examinations and determination of blood groups, if not previously determined, b. Embarkation, Communicable diseases, c. Debarkation examination. To determine any condition preventing debarkation, d. Monthly and special physical examinations as prescribed in Armv Regulations, 36. Sanitary Surveys. Statement that the force commander will be at an appropriate and early time after arrival in the Theater cause a sani- tary survey to be made of each sector where troops are to be quartered, (Pertinent items listed in Par. 198, FM 8-40, "Field Sanitation,” should be included in this Survey), SECTION IX SPECIAL SANITARY PRECAUTIONS 37. Should include special sanitary precautions.necessitated by the prevalence of particular conditions in an area. For tropical countries it may include special precautions to be taken for sunburn, sunstroke, heat exhaustion, including the use of salt as prescribed in W. D. Circular 129, dated July 5, 1941, special emphasis on mosquito control and special emphasis on sanitation of food and water, etc. In frigid areas it may include treatment of frostbite, freezing, etc. 15 ANNEX 6a TO OPERATIONS PLAN Sanital^MBnrirgiy^T Index Paragraph Subject Page 1 Geography and Terrain 2 Climate 3 Pertinent Environmental Factors 4 Medical Facilities 5 Diseases of Military Importance 6 Summary Discussion of data that should be,included in the above subjects. lo Geography and Terrain0 Only those features affecting sanitation and gene rial heal th need be given 0 2o Climate* Only those special features which affect sanitation and general health need be given0 3o Pertinent Environmental Factors0 Should include pertinent data on at least the following: ac Population bo Housing Co Economic considerations lo General considerations 2o Utilities (affecting sanitation) 3o Communications (only those factors influencing medical service) (a) Roads (b) Water (c) Air (d) Cables (e) Radio* telephone Sc telegraph 4o Food and Dairy Supplies 5o Water supply 60 Sewage Disposal 4o Medical Faciiitieso Ho Public Health Organization bo Hospitals and laboratories 16 5. Diseases of Military Importance. Brief discussion of diseases peculiar to area which will affect the military. 6, Summary. Brief summary of most pertinent features. 17 ANNEX 6b TO OPERATIONS PLAN THEATRE Estimates of Bed Requirements, Evacuations and Replacements Eequiredo Index Page Estimated Bed Requirements, Theatre of Operations Estimated Bed Requirements, Zone of Interior Estimated Monthly Evacuations * Estimated Bed Requirements - Theatre of Operations (Number) Troops Sector (Number) Troops Day Evacuation Policy Cause D&NBI GAS GUNSHOT TOTAL * Reference - Tables 1-3 G-4 Reference Data AWC (1939-1940)« Estimated Bed Requirements - Zone of Interior0 (same reference as above) Estimated Monthly Evacuations EXAMPLE: Admission Rate per 1000 per day Admission Rate per 1000 per month % Casualties to be Evacuated Number Evacuations per month per 1000 Evacuation for 10,000 Troops D&NBI 3, 5 105 2,63 2,762 27,62 GAS o15 4, 50 5,4 o 243 2,43 GSW - c3 9 27o4 2,466 24,66 3o 95 118 c 50 35o43 5,471 54,71 Reference - Page 20 - G-4 Reference Data AWC 1939-1940)o 18 ANNEX 6c TO OPERATIONS PLAN Yellow Fever. The following regulations relative to military aircraft arriving on flights from or will be enforced in order to prevent the introduction of yellow fever into o a. For the purpose of these regulations, all of and shall be considered as infected or suspected of infection with yellow fever. Jb. All military personnel and/or other persons returning to in military aircraft who have visited or sojourned in districts where yellow fever exists or is suspected of existing within six (6) days prior to embarkation for , shall be kept under surveillance for a period of nine (9) days from the day when last in such districts or until their departure from the if their period of duty or sojourn on this is not sufficient to complete the nine (9) day period. _c. The surveillance shall consist of daily reporting to the station hospital at for physical inspection and recording of temperature. _d. Any person in the military service and/or other person returning to by military aircraft from a district where yellow fever exists or is suspected of existing, who, on arrival, if afflicted with a febrile illness, shall be placed in isolation in a hospital until the nature of the illness is determined. Immediately upon discovery of a febrile illness, the person afflicted shall be covered with mosquito netting and remain so covered during transportation to the hospital. e. Military aircraft returning to from districts where yellow fever exists or is suspected of existing shall immediately upon arrival in , be adequately sprayed in all compartments with pyre- thrum spray which shall contain not less than one (1) part Pyrocide or equivalent and twenty-four (24) parts kerosene or a similar oil. Not less than five (5) cubic centimeters of this solution shall be used for every thousand (1000) cubic feet of space. All openings into the air- craft shall be closed during the period of spraying and held closed for not less than five (5) minutes after the spraying is completed. f. Sprayguns and insecticide suitable for the purpose of eradicating; mosquitoes which may be harbored in ships or airplanes arriving at will be furnished by the Corps of Engineers. The insecticide referred to in e. above will be as described in Medical Department Tentative Specification N.Y.G.D. No. 334-J, November 30, 1940. 19 ORGANIZATION MEDICAL SECTION, ARMY GROUND FORCES March 1942 CHIEF SURGEON DEPUTY SURGEON ADMINISTRATIVE DIVISION SUPPLY SECTION OPERATIONS DIVISION PREVENTIVE MEDICINE DIVISION Major JoWo Bass, MC, AUS Capt FoSo Dozier, MC, AUS TAB "B" ORGANIZATION MEDICAL SECTION, ARMY GROUND FORCES April 1942 CHIEF SURGEON DEPUTY SURGEON ADMINISTRATIVE DIVISION L SUPPLY SECTION | OPERATIONS DIVISION PLANNING TRAINING & OPERATIONS HOSP & EVAC PREVENTIVE I MEDICINE |1 Offo (Part Time) TAB "C" ORGANIZATION MEDICAL SECTION* AIMY GROUND FORCES 1944 CHIEF SURGEON DEPUTY SURGEON SUPPLY <& T/O&E SECTION OPERATIONS DIVISION PREVENTIVE MEDICINE DIV Ma.io Fo Ho Fehlmann PROFESSIONAL QUALIFICATIONS (c SERV BR ADMINISTRATION, branch TAB "D" ALLOTMENT AND ASSIGNMENT BRANCH -ADMINISTRATIVE DIVISION CLERICAL POOL OPERATIONS DIVISION TRAINING BRANCH SUPPLY BRANCH ORGANIZATION MEDICA.L SECTION* ARMY GROUND FORCES 16 January 1946 FLAMING BRANCH CHIEF SURGEON DEPUTY SURGEON )RCtANIZATION ID EQUIPMENT BRANCH SUPPLY AND REQUIREMENTS GENERAL CONSULTANTS BR, RESEARCH AND DEVELOPMENT BRANCH PUBLICATION AND STATISTICS BR PROFESSIONAL SERVICE Lt o Co 1« C o B c Henr y PREVENTIVE MED BRANCH TAB nG”