United States Navy Medical department 
Administrative History 1941-45 
Volume I Chapters VII-X CHAPTER VII 
THE f.iARSHAULS 
The success of American offensive operations in the south 
and central Pacific during 1943 made possible the launching of new 
attacks early in 1944* The early months of the new year found Allied 
forces pressing a two-pronged campaign against the Japanese — in the 
> 
New Guinea theater on the one hand, and in the Marshall Islands thea- 
ter on the other. 
Medical personnel who participated in the northernmost of 
these campaigns — that in the Marshall Islands — were able to pro- 
fit from the lessons which the Navy Medical Department had learned 
in earlier amphibious operations, especially the Gilberts Islands 
campaign. The problems confronting them in these two operations were 
generally similar. 
The Marshall Islands campaign will be discussed under four 
general headings; (l) the seizure of the Kwajalein, (2) Eniwetok, 
(3) Majuro Atolls, and (4) the reconnaissance of the lesser Marshalls 
and the elimination of the Japanese occupying these atolls. 
Kwajalein 
Kwajalein Atoll, the largest of the Marshalls, lies on a 
northwest - southeast axis and surrounds a lagoon nearly 65 miles 
long. The maximum width at the center is about 18 miles and the cir- 
cumference is approximately 154 miles. There are three principal is- 
# 
lands: Hoi, Namur and Kwajalein, Intelligence had estimated that there 
1 were approximately 24,000 enemy troops in the Marshalls’ area, the bulk 
of the Japanese being on Kwajalein, Wotje, Maloelap and Mille Atolls, 
with an estimated 2,700 to 3,100 on Roi and Namur and 7,100 on Kwaj- 
alein and the surrounding islands. 
The operations involved complete cooperation by the Army, Navy, 
and the Marines, As this work has as its primary function the narra- 
tion of the activities of the Medical Corps of the United States Navy 
in the Marshalls campaign, particular emphasis will he placed on the 
part played by the Navy and by the Marines, 
Kwajalein Atoll was assaulted by two separate forces under 
the Commanding General of the Fifth Amphibious Corps: the Northern 
Landing Forces and the Southern Landing Forces, 
The Fourth Marine Division, which was to play such an im- 
portant part in this campaign, was activated at Camp Joseph M. Pendleton 
on 14 August 1943. Four Camp Pendleton dispensaries were taken over in 
their entirety for the care of the division troops. These dispensaries 
were manned by the medical company personnel, and in retrospect, proved 
to be a favorable factor in their training. Each medical company ro- 
tated in dispensary and field training. In the field they were obliged 
to utilize all materiel and personnel attached to the company, and they 
were encouraged to experiment with new ideas in the evacuation of casual- 
ties and in the employment of materiel. 
During this period the major portion of the Fourth Marine 
Division supplies and equipment were received and distributed with particular emphasis on the requirement that each member of the medical 
organization become familiar with his equipment and supplies. The 
entire personnel, with the exception of a minority who possessed a 
history of Fleet Marine Forces experience, had received essential train- 
ing at medical field schools. This training was continued under the 
supervision of the commanding officer of the medical battalion and 
the regimental surgeon, and by medical participation in all field train- 
ing. At the end of the training period of the basic medical personnel 
allowed, at least 20 percent were lost through transfers due to ill- 
ness, disciplinanyyaGtldtir* and Navy bureau orders. Malaria and filar- 
iasis accounted for the greatest loss of personnel with campaign ex- 
perience. 
The actual organization of medical units of the Fourth Marine 
Division was in accordance with the Marine Corps Table of Organization, 
1 
with complements as authorized by the Bureau of Naval Personnel. 
Based upon the experiences at Tarawa, it was determined that 
greater bombing strikes and naval bombardment would be employed prior 
to the actual assault of the several atolls in the Marshalls. During 
the approach and final operations, carrier striking forces totalling 
12 heavy and light cruisers, 8 new battleships, 3 heavy cruisers, 3 AA 
cruisers and 36 destroyers operated offensively throughout the Marshall 
Islands area, neutralized all enemy bases in the area, and covered the 
2 
northern and southern forces from attack by superior enemy forces. 
1. Distribution of Commanding General, Northern Landing Force ltr. of 
17 Mar. 1944, p. 168, 
2. Distribution of CTU 53.5.5, 25 Feb. 1944, p. 18, In the bombardment of Wotje, the USS ANDERSON was hit by one 
enemy projectile which burst in its combat intelligence center killing 
her commanding officer, Comdr. J. G. Tennant, III, USN, two other of- 
3 
ficers, three men, and wounding eight others. 
Typical of the foresight and care exercised by the commanders 
of the various transports was the case of the APA, USS MONROVIA. Prior 
to departure the MONROVIA had brought all supplies and materiels up to 
full requirement, which were then dispersed according to previous plans 
The litter units were placed mainly in one center area for ease in ac- 
cessibility and security from rifling. The sick bay was expanded and 
work spaces were provided so that litters with patients could be transl* 
formed easily into convenient working first-aid tables. Moreover, 
aboard the MONROVIA a small blood bank was collected on D-day plus 2 
4 
and stored in the refrigerator for use during the operation. 
The trips from the various bases to the campaign areas were 
made without incident, and the crews and embarked troops were in excel- 
lent health. The USS COLORADO found that np arrangements had been made for 
the hospitalization or transfer of patients when it arrived at Lahaina 
, 5 
Roads, T. H., anJfeitfte to the Marshalls. Also, there were cases of 
catarrhal fever noted and treated among several Marine units, and lice 
which had to be eradicated. 
3. Distribution of Commanding Officer, USS ANDERSON, 23 Feb. 1914. 
4. Distribution of the CO, USS MONROVIA, 6 Mar. 1911, p. 29. 
5. Distribution of the CO, USS COLORADO, 28 Feb. 1911, p. 5. The over-all plan of the Navy Medical Department was broken 
down into supply, evacuation, and hospitalization. With reference to 
supply: (l) the medical detachments and units of the assault forces 
and elements of other forces accompanying the assault forces were or- 
dered to carry medical supplies for 30 days, these supplies to be fur- 
nished by the normal supply agency from which the troops embarked;((2) 
resupply from ships and medical supplies ashore was to be in accordance 
with previously established practices; and (3) the emergency supplies 
of medical stores were to be from the mobile supply base located ini- 
tially at FunaFuti and, when the tactical situation permitted, from the 
Galvanic area. Insofar as evacuation TJas concerned, the medical plan 
called for: (l) the commander of the Amphibious Force to be responsible 
for the evacuation of sick and wounded by surface vessels during the 
assault phase; (*3i surface evacuation to be implemented by air evacua- 
tion as soon as practicable, with the air evacuation during the assault 
phase to be under the control of the Commander of the Air Forces of the 
Central Pacific; (3) land evacuation to be effected as transportation 
became available; (4) evacuation during the assault phase to be im- 
mediate. Upon completion of the assault phase and after establishment 
of adequate hospital facilities on each base, a 30-day evacuation policy 
was ordered with normal evacuation of the sick and wounded to be to 
6 
Army and Navy hospitals on Oahu, T. H. 
On board all ships, other than heavy units of the fleet, the 
ship’s company, except for gun crews, were ordered to administer first 
6, Distribution of Commanding General, Headquarters V Phib Corps, 
7 Apr, 1944-, p. 91. aid and notify the bridge whether the casualty was a stretcher or am- 
bulatory case. During battle conditions, the gun crews were to fight 
the ship and to consider everything else, including casualty handling, 
7 
as a secondary matter. 
From 29 January 1944- until the Army and Marines were so firmly 
established ashore that only call-fire was possible, battleships, cruis- 
ers, destroyers, LCI’s and other craft poured forth a crushing weight 
of shells upon the enemy installations. None of the islands escaped 
this rain of fire. 
Despite the fact that there ?/as some delay in landing the as- 
sault forces on D-day, 31 January 1944, and despite certain criticism 
levied by responsible personnel, it would seem that the initial land- 
ings were made in close conformity with the previously well conceived 
plans. During the first phase of the assault, the IVAN landing group, 
consisting of the 25th Marines reinforced, the 14th Marines, and at- 
tached division troops; secured the islands in the Kwajalein sector 
designated as JACOB, IVAN, ALLEN, ALBERT and ABRAHAM. The official 
action reports state that the casualties were very light. Some losses 
8 
ia personnel were sustained when tractors overturned on coral reefs. 
During these operations, medical personnel *;ent ashoife in 
support of their respective units. This plan involved landings on 
scattered beaches. The shore party medical sections and battalion aid 
7. Distribution of CO USS WILLIAM P. BIDDLE, 17 Feb. 1944, p. 51. 
8. "Marshall Islands Operation,” prepared by the Historical Division, 
U. S. Marine Corps, Feb. 1944, P* 11* stations functioned smoothly and efficiently under difficult tactical 
conditions• 
In the opinion of competent medical authorities a solution 
was demanded insofar as any future amphibious operations were concerned 
regarding the continuous operation of tractors by the same crews. -It 
was estimated that 75 percent of the personnel operating tractors did 
so from 24 to 30 of the first 48 hours of the Kwajalein invasion. Con- 
tinuous operation of tractors from 14 to 16 hours was not uncommon, and 
several Marine platoons participated in assaults on three separate is- 
lands in one day. Upon returning to their ships on the evening of 31 
January, it was necessary for the tractor crews to refuel and service 
their vehicles in preparation for assaults on D plus 1 day, 1 February 
1944* These men worked almost continuously at heavy labor during the 
period of assault. No sooner were the assaults completed than these 
same men were called upon to operate their vehicles in transportation 
of supplies and reinforcement troops. 
During the assault period these men were under fire inter- 
mittently and were subjected to the nervous strain incident to the con- 
fusion experienced in beaching supplies. Reports were received from 
several officers that men fell asleep at their tractor controls whenever 
they were not in operation, and a few reports saying men vomited from 
sheer exhaustion. Only a few of the LST's provided warm food, hot coffee, 
and brandy to the officers and men returning from the beaches. It was 
found by the medical officers that these items of comfort, particularly 
brandy, were remarkably effective in improving psychological, if not 9 
physiological, well-being. 
A great many men became sunburned about the face and other ex- 
posed areas and this condition was made worse by a constant spray of salt 
water. The clothing worn by the tractor crews was completely soaked with 
salt water during operations, and a number of the mentfieveloped severe 
cases of s]p.n irritation where their clothing was tight, particularly 
around the ankles and feet. This skin irritation was generally ac- 
companied by redness and swelling although the extremities themselves 
were cool. The suggestion was made by one of the battalion surgeons 
that this condition could be regarded as a form of immersion foot and 
given similar treatment. It is apparent that the officers and men did 
not have a sufficient appreciation of the necessity of changing cloth- 
ing, washing in warm salt water, and obtaining early medical attention. 
Conjunctivitis was an early problem, having been induced by a combina- 
tion of salt water spray and sun. 
In the earliest phases of the operation, shipboard problems 
were not as many or as varied. The commanding officer of the USS 
MASSACHUSETTS arranged to have his officers and men divided into three 
watches before going to general quarters. These watches were stood on 
a three shift basis and were not rotated, thereby enabling each man to 
adjust his schedule so that he might obtain proper rest, necessary 
nourishment, and satisfy the requirements of nature without inter- 
fering with his watch standing. The U. S. Army type K ration was 
9. Distribution of Commandant of the Marine Corps, y Apr. 1944, 
p. 13. issued for the noon meal on D-dayr and proved entirely satisfactory. 
One problem that was apparent even on heavier fleet units was the fall- 
ing of projectiles and fragments of projectiles near the supporting 
craft. In several instances men were wounded by projectiles which were 
fired from friendly ships. Such an accident occurred aboard the USS 
COLORADO during the bombardment and assault of Parry Island, Eniwetok 
Atoll. 
Battleships were required to remain at general quarters for 
long perifds and special emphasis was placed on relieving magazine crews 
at frequent ihtervals, ventilating the magazines as often as possible, 
and replacing empty powder can tops. A number of the battleships re- 
ported that intoxicating effects of powder fumes had been definitely 
noted. There were frequent burns inflicted on men who v/iped burned 
powder from the hot plugs in the turrets, and recommendations v/ere made 
that these men be furnished with asbestos gloves with long gauntlets 
attached. 
As has been previously pointed out, a great number of de- :• 
stroyers not only assisted in the usual screening activities attendant 
upon any fleet movement, but also participated in supporting fire neces- 
sary to successful landings on the many beaches. Particularly on the 
destroyers was it considered advisable for personnel, even those between 
decks, to wear steel helmets and life jackets. Those men wearing hel- 
mets and jackets received only minor wounds that otherwise would have 
been fatal, whereas those without them were either seriously wounded 
or killed by similar fragments. Throughout D-day the USS PORTERFIELD, U3S HOPEWELL, and 
USS ELLET, as well as other fleet units, kept up an intermittent bombard' 
ment of Roi and Namur. This night bombardment v/as intended to harrass 
the Japanese and to prevent any rest rather than to produce qny actual 
destructive results. It was directed against areas in which it was 
possible for concentration of personnel to be made and against those 
beaches in support of demolition parties. During the night of 31 
January, the LST’s remained at anchor in the lagoon, gassing their em- 
barked LVT!s and otherwise making preparations for the general assault 
of 1 February, At dawn of D plus 1 day the general bombardment of Roi 
and Namur was resumed, and its intensity was stepped up gradually during 
the hour immediately preceding the landing by the Americans. Roi was 
occupied in its entirety 1 February. Although little opposition was 
encountered on the beach of Namur, dogged resistance met the invader 
on the northern part of the Island, one-half of which had been secured 
by nightfall of that day. All organized resistance was overcome on 
Namur the afternoon of 2 February. 
The 23rd Marines reinforced, who had landed on Roi and Namur 
respectively, had their own attached medical units which were boated 
in accordance with the principles of dispersal, and in general landed 
in the same wave as the unit commanding officer. There was one inci- 
dent of a shore party medical section intended for support behind the 
/ 
lines, landing with the initial assault waves, owing to the confusion 
that obtained at the place of departure. As soon as landings were ef- 
fected, battalion aid stations were set up on or near the beaches, uti- 
lizing deep shell craters, pill boxes, and dugouts. 
10 During 1 February, the medical forces on Namur were subjected 
to enemy small arms fire, but according to reports, all hands performed 
well. On account of the small area involved in the operation, it was 
seldome necessary to move a battalion aid station after it had been 
initially set up. The battalion aid stations of the 23rd Marinos on 
Roi were able to evacuate all casualties with hospital corpsmen acting 
as litter bearers. On Namur the 2Ath Marines experienced a much heavier 
casualty rate and it became necessary to employ bandsmen as additional 
litter bearers. Security for litter teams was sometimes provided by 
Marines who had been detailed for malaria control, with general secu- 
rity for the medical installations effected by the shore party and divi- 
sion troops. 
A minimum amount of gear was taken ashore initially. Battal- 
ion aid stations carried sjblints, litters, plasma, morphine, sulfa drugs, 
battle dressings, tourniquets, ophthalmic ointments, stretcher bandages, 
adhesive tape, burn ointments and brandy. Supplies of everything were 
adequate. It was suggested that in future operations, in addition to 
these items, small amounts of the following should be carried ashore: 
cotton applicators, tongue blades, chromic acid, adhesive tape (2 inch 
rolls), 2 percent gentian violet, paregoric, bismuth, campho-phenique, 
10 
sulfa tablets, alcohol and tincture of merthiolate. 
The medical report of the Commanding General, Northern land- 
ing Force, noted; (l) the moulded plywood splint was superior to other 
types; (2) oxygen and an apparatus for its administration must be 
10. Distribution of Commanding General, Northern Landing Forces, 
19 May 1944, p. 171. provided; (3) more plaster was required; (4) Leven or Wangensteen 
tubes were needed; (5) tracheotomy tubes and metal air-ways were de- 
sirable; (6) a folding litter stand for a battalion aid station, im- 
provised by a Hawley orthopedic table, or some modified version, 
would prove of inestimable value; (7) large hemostats were needed 
in increasing numbers; and (8) catgut for abdominal cases would hafee 
11 
been of great value. 
Generally the evacuation of casualties was excellent. The 
wounded personnel were cleared directly from the battalion aid sta- 
tions to the ships and the average lapse of time from the firing line 
to the ship was three hours. 
In connection with the Kwajalein operation, the comments 
of Lt. Comdr. T. G. Slagle, (MC), USNR, the senior medical officer 
aboard the USS HARRY LEE, are interesting: 
The medical department personnel consisted of 5 
medical officers, one dentist and 23 hospital corps- 
men, This included the beach party which was not 
called avay from the ship as a unit and was avail- 
able rnosu of-the time. The chaplain and a yeoman 
were also assigned to register casualties and to 
stow gear as received aboard— this complement 
was found to be adequate for the number of casual- 
ties received. Experience gained in other opera- 
tions was found by the senior medical officer to 
bo invaluable in training corpsmen and suggestions 
of improvements in treatments and the handling of 
casualties. Considerable equipment was improvised 
of ?7hich one of the most valuable items was a limb 
refrigeration unit. Extra transfusion and gastric 
suction sets were made and a pool of type *0f 
11 
11. Distribution of ComGen, Northern Landing Force, 19 May 1944> P« 225. volunteer donors was prepared for immediate use by 
check typing and Kahn reactions. Twenty wounded 
were ; received— 18 Army and 2 Navy personnel— 
in general the wounds were found to be less severe 
than those sustained by the casualties at the last 
operation in whi«h this ship had participated. In 
most cases the evacuation from the beach was prompt 
and the first aid rendered there was good. None 
of the casualties was dead on arrival and only one 
was in extreme shock— suffering from gunshot 
wounds of the lower back and chest, complicated 
by fracture of 2 vertebrae with paralysis of the 
lower extremities and profuse hemorrhage into the 
abdominal cavity— man died a few hours after ad- 
mission. The wounded were brought to the ship in 
DUKW*s and boats on D plus 1, 2 and 3 days. Con- 
siderable difficulty was experienced in the re- 
moval of patients from the DUKW1s as litter handles 
extended beneath the overhang of the gunwales of 
both sides and it is difficult to hoist them from 
a rocking vehicle without dropping them on the 
other wounded in the bottom. 
All casualties received aboard were transferred 
to the hospital ship USS RELIEF on D plus 4 with the 
exception of one man who had died and another patient 
who was considered to be non-evacuable on account of 
a severed femoral artery, etc. It was recommended 
that efforts be made to further expedite casualty 
evacuation by using landing boats which are faster 
than the DUKW’s. 12 
The hospital ship US3 SOLACE arrived on 3 February, and 
departed the following day with 362 wounded aboard. Most of these 
patients were received from transports and the bulk of them had 
been wounded not less than 48 hours prior to admission aboard this 
ship. The total casualties suffered by the 4th Marine Division 
were reported to be 737, consisting of 32 officers and 705 
12. Distribution of CO USS HARRY LEE, 9 Feb. 1944, p, 25. enlisted personnel. 
The majority of the ships that were employed in the Kwajalein 
operation were of the C-2 or C-3 type which had recently been con- 
verted to APA’s. Their physical characteristics of accessibility 
■ •mimmKmmrn■. ■ i i.i—i % 
13. A more detailed picture of casualties suffered by the 4th 
Marine Division follows: 
Total Casualties of the 4th Marine Division 
Officers 
Enlisted 
Total 
Wound cd, eva cuated 
11 
Ail 
462 
Wounded, not- evacuated 
8 
77 
85 
Died of wounds 
1 
17 
18 
Killed 
12 
160 
172 
TOTAL 
it 
705 
737 
Casualties Received & Treated by the Medical Companies of the 4th 
Mar. Dlv 
A Company 
52 
B Company 
154 
C Company 
98 
D Company 
74 
E Compary 
41 
TOTAL 
419 
* Received while aboard the USS CALLAWAY 
Classification of Wounds 
Wound, gunshot, head 10 
Wound, gunshot, face 14 
Wound, gunshot, nek 7 
Wound, gunshot, thorax 24 
Wound, gunshot, abdomen 11 
Wound, gunshot, extremities 122 
Wound, fragment, head 5 
Wound, fragment, face 7 
Wound, fragment, ahdomen 1 
Wound, fragment, extremities 34 
Wbund* lacerated,.bayonets 1 
Injury, crushing 3 
Fracture, simple 20 
Fracture, compound . 21 
Burn (not sunburn) 5 
Psychosis, war 8 
Misc. 116 
Blast, injury 10 
(Distribution of the Commanding General, Northern Landing Fores, 
May 1944, p. 172.) of space to litter-borne casualties, ventilation, galleys, and messing 
facilities compared rather poorly with ships built as APA’s or those 
that had been converted earlier in the war. In certain of the ships, 
alterations had been accomplished to make troop officers’ messes and 
sick bays more accessible to litter-borne casualties. Most of the 
LST’s used had only one hospital corpsman, although the authorized 
complement was two. 
Prior to tho operation, conferences were held with the divi- 
sion surgeon of the Fourth Marine Division to discuss the over-all 
raediwal problems of coordination, training, and logistics. This of- 
ficer had been furnished with all pertinent directives and memoranda 
issued by Group Three, of the Fifth Amphibious Force. A list was 
prepared showing the amounts of all strategic supplies — including 
Stokes litters, metal pole litters, and field blankets — for use as 
a ready reference in emergency inter-ship resupply. There was a com- 
pilation of all medical officers with their specialties, together with 
the number of hospital corpsmen on each ship. Several beach battalion 
medical resupply units were placed on each LST as a reserve. Begin- 
ning on D-day the attack force medical officer worked from the flagO. 
ship of the commander of transports, which permitted him to follow 
i 
closely the problems of evacuation and care of casualties. Tho op- 
erations order assigned a boat to the attack force medical officer 
for use commencing on D-day, which vessel was identified by a small 
Red Cross flag displayed when approaching another ship. 
An unfortunate accident occurred on an LST in that two cases of accidental gonococcus infection of conjunctiva developed with the 
commanding officer and a signalman being the unfortunate victims. It 
was suggested that both cases resulted in cross-infection from use of 
i 
binoculars. 
It was found that LCVP's were better suited for transferring 
casualties from APA's to hospital ships (AH's) than the ambulance 
boats carried by the latter, inasmuch as the LCVP's had greater carry- 
ing capacity, afforded more protection from the sea, and could be 
hoisted to deck level to facilitate loading. 
All of the action reports emphasized the value and use of 
salt by personnel operating in the tropics. In the treatment of cer- 
tain wounds it was necessary to remove certain portions of the patient's 
. 
clothing and in some of these cases rather severe sunburn occurred 
from exposure, particularly with respect to extremities. 
Neither epidemics nor native diseases were encountered during 
the phase of occupation of Roi, Namur, Kwajalein and the surrounding 
islets. The majority of cases at sick call were sunburn, minor cuts 
and abrasions, and small pyrogenic infections of the skin believed to 
have resulted from the difficulty in keeping clean, hpwevor, none 
of these complaints was serious, and few were admitted for further 
treatment. One of the most painful and common causes of distress was 
the groat incidence of lip sunburn with resultant cracking, pealing, 
and often iklcoration. Those action reports which were reasonably 
complete were unanimous in the opinion that some satisfactory lip 
pomade should be issued to all personnel participating in any ; tropical•action. 
The largest sanitary problem confronting the Americans was 
the speedy and effective disposition of the dead, particularly the 
enemy dead. Some of the Japanese had been dead for several days prior 
to 31 January, Many others v/ere wholly or partially buried by debris 
in block houses and under bomb-proof shelters and were therefore very 
haidd to remove. The stench resulting from the putrification of the 
mutilated bodies made the work very obnoxious. The American dead were 
buried on a site agreed upon both by the commanding gdneral and the 
Island commander, located between Roi and Namur on a little spit of 
land knovm as Aqua Pura, The Graves Registration Section reported 
on 3 February, and by A February all the Marine and Navy dead who could 
be found had been properly buried. 
The malaria and epidemic control team had a previously pre- 
pared plan for body disposal,. Twelve 50-gallon drums of concentrated 
sodium arsonite solution and 25 knapsack sprayers assigned to the 
malaria control section were loaded prior to departure from shipboard 
and were landed on 2 February, On account of the transportation dif- 
ficulties, three large bomb craters were designated on Namur as seconds 
ary burial sites, and deep trenches between the air strips dug by an 
engineering regiment were primarily utilized. There was inadequate 
officer supervision and the combat troops employed on the working 
details assigned to dispose of the dead felt that this sort of a 
chore vra.s an imposition. 
17 On Roi and Namur, the most common error noted was in the 
construction of heads. It was necess?„ry in many instances to super- 
vise actively and forcefully the construction of closed pit latrine 
boxes to insure their being fly-proof. There was a dearth of building 
materials and shovels. The galleys were not always located in the 
most advantageousqspots, since they were frequently adjacent to the 
heads which were on porous soil. It was necessary to emphasize the 
desirability of covering the garbage dumped into shell holes as soon 
as possiMe. The Japanese sanitary facilities were notorious for 
their simplicity. No problem of sanitation presented in the Kwajalein 
14 
area was new. 
The final report on the Marshall Islands operation, dealing 
specifically ?;ith the Kwajalein phase, made a number of justifiable 
criticisms and recommendations. Morphine syrettes in paper containers 
were soaked in salt water during the flKlr--t»-*h(Qre movements, with the 
result that the cartons fell apart leaving the tubes without any pro- 
tection and causing them to become a conglomerated mess. It was sug- 
gested that the syrette containers be dipped in paraffin. The com- 
bat details landed initially with a total of 200 units of plasma for 
aid stations, and it was recommended that 20 units to each station 
would be adequate for the original supply. Plasma was found to possess 
great and definite value in cases of battle fatigue and near hysteria, 
Lyster bags were not camouflaged or set up early enough. Aid stations 
14, CTF 53, 22 Mar, 1944, pp. 124-215£*Distribution of the ComGen, 
Northern Landing Force, 19 May 1944, pp. 174-183; Distribution 
of the ComGen, Headquarters V Amphibious Corps, 7 Apt, 1944, 
P.494. 
18 were not equipped with telephones soon enough, with the result that 
runners had to be sent to the front lines to request corpsmen and 
stretcher bearers. To overcome the shortage of stretcher bearers, it 
was felt that the collection section of the medical battalion should 
be increased to 60 men divided into three teams of 20 men each. It 
was found that the water brought ashore in tins was about 60 percent 
unpotable. Recommendation was made that while in camp, the expedi- 
tionary cans and drums should be filled with water, to which would be 
added one ounce of baking soda for every five gallons, and left stand- 
ing for two weeks; the cans then should be subjected to live steam 
and refilled with the soda solution. 
The aid station doctors and hospital corpsmen were frequently 
and unnecessarily fatigued and their efficiency impaired because they 
had to bend over or work in a kneeling position when treating patients 
laid directly on the ground, and it was recommended that in the first- 
aid station, a folding stand be devised on which stretchers could be 
15 
placed. 
Majuro 
Although the occupation of Kwajalein and Eniwetok Atolls 
represented the real conclusion of the Marshalls campaign insofar as 
the Navy Medical Department is concerned, mention must be made of the 
seizure of Majuro, and the lesser a|ro!3.s. Speaking generally, there 
were few, if any, medical problems, other than routine matters. 
15• Distribution of the ComGen, Northern Landing Force, 19 May 19A4> 
pp, 112-119, Majuro Atoll, which lies in the eastern portion of the 
Marshalls, is surrounded by a number of islands which, in the initial 
planning, were to be bypassed by the invading Americans. It is about 
24 mi<|es long by 5 miles wide, extending generally east and west, with 
long stretches of reef on the north and west. Most of the south side 
of the atoll consists of Majuro Island, which curves for 21 
miles, with an average of 200 to 300 yards, except in the westernmost 
portion where it broadens considerably, Other important islands in the 
atoll, all of Yjhich are situated in the western portion of the lagoon, 
are Dalap, Uliga and Darrit. All of the islands have dense vegetation. 
Initial landings were effected on 30 January 1944? and it 
developed that the greatest resistance occurred from the sea itself, 
which was extremely rough. One Japanese ground officer was found and 
taken prisoner and a few Japanese families were taken into custody, 
but there vfas absolutely no military resistance. On D plus 2 days, 
units of the fleet began to arrive and on D plus 3 days there were about 
30 ships in the anchorage, with others duo to arrive in considerable 
numbers. Work was commenced on the air field on Dalap on 3 February, 
and on 4 February the commander of the Central Pacific Forces announced 
that the capture and occupation had been completed, with the island 
commander, E. A. Cruise, taking over at six o’clock In the morning. 
Eniwetok 
Because of the early and successful termination of the 
Kwajalein operation, it was possible to plan the capture ®f Eniwetok 
in February. All units sortied from Kwajalein on 15 February. The 
20 passage to Eniwetok was made without incident. In accordance with 
previous plans, the Japanese were subjected to the usual heavy shelling 
and bombing and there was no return fire. Silence had been ordered 
by the Japanese High Command to conceal positions. 
The operations in the Eniwetok group were extremely bloody, 
and the assault on Parry Island could properly be compared to the at- 
tack on Betio in the Tarawa Atoll of the Gilberts. 
The account by J. M. Johnson, 3rd wave guide officer, as 
reported in the Action Report of APA 25 on the LCI 442 incident in 
the assault on Parry Island speaks for itself: 
'«• lator the coxswain cf the third wave guide boat (Brien, 
Clyde T, 516-678, Sic) called attention to an LCI about 200 
yards away that was burning. This was LCI 442. The 
quarterdeck was burning. The wave guide boat was brought 
along the starboard side, forward of the deck house, where 
most of the burning ship’s crew and officers were gathered. 
One member of the crew called out that the magazine was 
on fire. The third wave guide officer went aboard and 
went to the upper deck and aft. A Ship's officer wae 
mot there and he also stated that the magazine was 
burning. Upon reaching the after part of the upper 
deck, the dead and wounded were seen lying about the 
deck. It was not known to this officer until this time 
that there were casualties aboard, 
Brien, coxswain of the third wave guide boat, had come 
aboard immediately after seeing that his boat was properly 
secured and was present when the wounded were discovered, 
A ship's officer was asked the number of wounded aboard 
but at this time the exact number was unknown. An in- 
vestigation was started. The third wave guide officer 
went aft to the quarterdeck in search of v/ounded. Brien 
went below into the deck house finding a man dazed by a 
shrapnel wound behind the oar. He was placed upon a 
table in the crew's quarters and Brien went in search 
of first aid equipment. On the quarterdeck there were 
several charred bodies lying around the magazine hatch. 
Investigation showed that no wounded remained in the 
magazine or on the quarterdeck. There was much loose ammunition lying about the deck; 
it was ordered thrown overboard. Two members of the crew 
were ordered to disconnect the ignition wires from the 
rocket projectors that were still loaded. 
In the after starboard 20 mm gunpit there were several 
mangled bodies and pieces of flesh and pools of blood 
about the deck. One man in the gun pit v/as still alive, 
with a badly lacerated leg. He was removed from the gun- 
pit and as no first aid equipment was at hand a tourniquet 
was made from a piced of line and bound above the wound. 
An officer was ASKED ABOUT FIRST AID EQUIPMENT AND HE 
STATED THAT THERE WAS NONE ABOARD. The wave guide of- 
ficer1 s first aid kit and the boat’s first aid bag were 
brought aboard dv tne engineer of the wave guide boat 
(Miller, Billy L. 588-758, Flc), The wounded man was 
then given morphine. 
Another wounded man was lying on the port side of the 
upper deck with a deep wound in the leg just back of 
the knee. Blood was spurting from the wound and it v/as 
evident that the man v/as already growing weak from the 
loss of blood. With the aid of Larsen, Howard E, 
575-044 Sic, a tourniquet was applied. This did not 
stop the flow of blood and a compress was applied di- 
rectly to the wound. The wounded men was conscious 
and stated that his leg and toes were in pain and that 
he v/as v/eak. He was given morphine. 
Stretchers were needed and after being informed by a 
ship’s officer that none were aboard, Brien was sent to 
rig something in which to carry the rounded to the boat. 
Before this was done several Stokes stretchers were 
found nearby. 
First aid v/as continued in the boat and a seaman with 
a deep wound in the arm, who was brought aboard by Larsen, 
Miller and Dichiara, v/as given morphine. Miller assisted 
in comforting the wounded. The hospital ship v/as notified 
by radio that a boat with casualties was approaching. 
They were waiting to receive them and at qpproximately 
1000 all were aboard under the care of doctors, who were 
informed as to what had been done in the way of first aid. 
The officer of the Seek of the SOLACE remarked that the 
USS ARTHUR MIDDLETON would be credited with evacuating 
the first casualties in the Parry landing. 
UPON RETURNING TO THE LGI 442 IT WAS LEARNED FROM AN 
OFFICER THAT THE SHIP HAD RECEIVED A DIRECT HIT FROM 
EITHER A CRUISER OR DESTROYER IN THE FIRE SUPPORT GROUP, 
It was also learned that the charred bodies on the quarter- 
deck had been burned at the time of the direct hit by an exploding gasoline drum situated on the quarterdeck. With 
the aid of another LCI, the fire had been extinguished. 16 
One of the difficulties involved in caring for large scale 
casualties at Eniwet»k was the handling of money and other valuables. 
Recommendations were made that troops and other personnel about to ji*o 
into a campaign area remain unpaid until the successful completion of 
the action, and that casualties be stripped on the beach of ammunition, 
hand grenades, and demolition units before being sent to hospital ships 
or other vessels. It was also found that the boat crews needed further 
training in the technique of hoisting litter cases aboard. One sug- 
gestion was made— that the ship’s laundries be instructed to accept 
soiled and bloody clothing stripped from Marine casualties which could 
be used to clothe Marine ambulatory patients, thereby relieving the 
17 
necessity of drawing Navy clothing. 
The USS CUSTER reported that its medical department operated 
with high efficiency. It was further pointed out that during the height 
of the battle on Eniwetak, every doctor and pharmacist’s mate worked 
continuously for thirty-six hours. Typical of all ships receiving 
casualties, the CUSTER utilized its troop officers' mess room on the 
main deck as a collecting station. It was recommended that improve- 
18 
ments in the ventilating system of the sick bay be made. 
16. Distribution of CO USS ARTHUR MIDDLETON, 7 Mar. 1944. 
17. Distribution of the CO USS HAYWOOD, 18 Mar. 1944. 
18. Distribution of the CO USS CUSTER, 29 Mar, 1944, pp. 8, 9, 13, ' 
17, 20, 21. Some concern was evidenced by various medical officers con- 
cerning the loss on the beaches of litters, life jackets and blankets, 
lout no effective solution of this equipment problem was suggested. 
The hospital ship, USS SOLACE, arrived at Eniwetok 21 
February 1944* The northerly two-thirds of Eniwetok Island had been 
secured on 20 February. However, during the night of 20-21 February, 
the Japanese defenders remaining on the other one-third of the Island 
staged a counterattack. Casualties were admitted from the transports 
and i?rmm the beaches the following morning; these patients were pre- 
dominately Army and consisted of approximately 30 percent of all the 
casualties received in this location. 
Landings in Parry, adjacent to Eniwetok Island, were effected 
on 22 February, and the remaining patients from the Eniwetok theatre 
were evacuated directly from the beach. The reports indicate the ab- 
sence of cross machine gun fire at Eniwetok, with enemy resistance 
in the form of sniping and the use of mortars and grenades predomi- 
nating, There were a number of wounds inflicted by the explosion of 
land mines and a great many demolition accidents. At this point in 
the Marshalcks operations, the handling of casualties was more efficient 
and a system of segregating patients was evolved whereby only the most 
critically wounded individuals ¥/ere sent to the SOLACE and the less 
severely wounded persons were treated on board transports. It was 
noticeable that the bulk of all patients received aboard the SOLACE 
had been wounded only a few minutes or a few hours prior to admission. 
Another vessel which participated in the assault on Eniwetok, and whose medical experiences could be considered as fairly typical 
of ships similarly participating, was the APA12, the USS LEONARD WOOD, 
which arrived off the main island in time to receive its first casualty 
aboard on D-day, from which time the wounded arrived and were treated 
continuously. On 21 February 1944f the census of the LEONARD WOOD 
stood at 70 cases, of which 46 were transferred to the SOLACE. On 
25 February, this APA sailed for Roi and transferred all of its pa- 
tients to the USS RELIEF, which T/as functioning as a temporary hospital 
at Kwajalein until a dispensary could be established ashore. Jit -the 
time of transfer of these wounded persons, it was estimated that some 
90 percent would be fit for duty in 30 days. The medical officer of 
the LEONARD WOOD recommended that the sick bay of this vessel have a 
separate water circuit and that the water be properly sterilized in 
19 
ordo4 to avert the danger of epidemics or acute infections. 
The percent of persons actually killed in the action at 
20 
Eniwetok was substantially the same as at Tarawa (25 percent). 
The chief of the surgical service aboard the SOLACE hastened 
to point out the necessity for the determination, in a rather arbitrary 
fashion, of what constituted the primary woujjd, inasmuch as a number 
of cases of multiple wounds had been inflicted* The test that 
was adopted was to determine which would be more likely to endanger 
the patient's life, and in those cases where no one wound would be 
likely to be fatal, to classify as primary that wound which would 
19. Distribution of the CO USS LEONARD WOOD, 16 June 1944, PP* 7-14• 
20. Study of Battle Casualties Evacuated from Three Amphibious 
USS SOLACE (AH5), 28 Apr, 1944, p. 9. threaten the greatest period of morbidity. 
In the treatment of casualties it was necessary to adopt 
such modifications as were indicated by conditions prevailing aboard 
the hospital ship, A pertinent example cited wae the case of traction 
in the reduction and immobilization of fractures, where skeletal 
traction exerted in various directions by means of weights and pulleys 
was found not to be adaptable because of the motion of the ship, enough 
clearance between upper and lower bunks, and the possibility of having 
to hbandon ship in an emergency. It was therefore necessary, according 
to the medical officers, to reduce the fractures through traction ob- 
tained by skeletal pins and immobilize the fracture by the use of 
plaster. Sulfonamides and penicillin were utilized aboard the SOLACE, 
although the latter was not employed extensively. 
An interesting study of mortality statistics was made in con- 
si'dbrirg the amphibious operations at Betio, Kwajalein, and Eniwctok 
by the USS SOLACE. In the last named operation, the mortality rate 
was 4*5 percent. Eleven out of the IS succumbing died within 20 
minutes to 12 hours after admission. However, in connection with the 
receiving of casualties aboard ship at Eniwetok, it must be borne in 
mind that had conditions similar to those which obtained at Tarawa been 
present, this figure would have been considerably reduced as the facil- 
21 
ities for evacuation at Eniwetok wore much more favorable. 
The best estimate of casualties on Kwajalein indicated that 
21, Distribution of the 00 USS LEONARD WOOD, 16 June 194A, pp. 8-1 At Japanese casualties numbered 8,386, of whom 8,122 were killed in action. 
The Americans sustained 367 deaths. At Eniwetok, 3,466 Japanese were 
casualties — 3,400 of them being killed as compared with 299 American 
dead, Eniv/etok was declared captured on 23 February 1944, which marked 
the immediate conclusion of the greater Marshall campaign, even though 
the atolls of Wotje and Malaelap, Mille and Jaluit remained in Japanese 
hands, 
A number of surveys of conditions existing on the various 
atolls were made subsequent to the military phases of the campaign and 
the medical officers conducting such studies found that there had been 
few epidemics on the islands but that yaws and gonorrhea were prevalent 
among the native population. Apparently there was little history of 
tuberculosis, leprosy, malaria and filariasis. There was a dearth of 
medical men, although there were a foY* natives possessed of some 
familiarity with simple medical practices. 
In the occupation of the various islands, it was found that 
fft 
progress was steady, although narked by confusion, duplication and 
absence of effort on various projects. For example, on Roi and Namur 
hot meals were served to all personnel at least once a day from the 
beginning, and all hands enjoyed excellent health and were possessed 
of the basic necessities of life. By March 1944, Roi and Namur had 
progressed from a crude, frontier outpost into a well established and 
well ordered community, despite the loss of life and destruction of 
installations and materiel which were suffered when the Japanese 
made a successful air attack on Roi, In March 1944* the erection of a 200-bed hospital establish- 
ment on Japan Island, accessible to Eniwetok by boat, was planned, with 
Eniwetok to have a dispensary of about 50 beds, with two medical officers 
and one dental officer. Two other facilities in Eniwetok were to have 
dispensaries of 50 beds each. Inspection of this latter island re- 
vealed that measures for malaria control for personnel previously under 
suppression treatment for malaria had been discontinued, but this was 
corrected immediately and the men were also compelled to use salt 
tablets. The Army had a 300-bed field hospital on Engebir Island and 
the Marine Air Corps, a 50-bed dispensary. Dispensaries were set up 
on Majuro Atoll and measures were instituted to have these facilities 
enlarged in order that the RELIEF could proceed to other theaters of 
operation. It v;as the opinion of the .'inspecting party that the over- 
all situation, from a medical standpoint, could be considered good in 
view of difficulties encountered. There were adequate medical facil- 
ities and supplies. Continuous vigilance of all personnel with respect 
to sanitation was necessary at all times. By the end of March, ample 
air evacuation to Pearl Harbor from this Central Pacific Theater was 
available• 
Summary 
In summary, the Navy Medical Department in the Marshalls 
Campaign put to good use the hard lessons which had been learned on the 
bloody beaches at Tarawa. At Kwaj&lein, the handling of casualties 
did not present any particular problems because of the short-lived 
Japanese opposition, but at Eniwetok, the energies of both medical 
officers and hospital corpsmen were sorely taxed. The use of a hospital 
28 ship as a supplementary facility prior to the erection of a shore dis- 
pensary was employed to advantage at Kwajalein and this innovation was 
to be utilized again and again. THE MARSHALLS 
BIBLIOGRAPHY' 
USS ALABAMA, War Diary of January 1944, dated 4 February 1944• 
Amphibious Operations, Action Report of January-March 1944, dated 
9 August 1944. 
USS ANDERSON (DD411), “Action Report wf the Bombardment and Occupation 
of Northern Islands, Kwajalein Atoll, Marshall Islands, 30 January- 
1 February 1944«f 3 February 1944. 
USS ARTHUR MIDDLETON, Action Report of landing operations at Eniwetok 
Atoll, Marshall Islands, 7 March 1944* Serial 09 of 21 March 1944.- 
Distribution of Atoll Commander, Action Report on Occupation of Ailuk 
Atoll, Mejit Island, Jemo Island and Likiep Atoll, 21 April 1944, 
Serial 00133 of 25 April 1944. 
Distribution of Atoll Commander, Action Report on Occupation of Bikini, 
Allinginae, Rongelap, Rongerik, Utirik, Bikar and Taka Atolls, 14 April 
1944, Serial 00134 of 26 April 1944. 
Distribution of Atoll Commander, Action Report of occupation of Ebon and 
Namorik Atolls and Kili Island, 10 April 1944, Serial 00130 of 25 April 
1944. 
USS BURNS, Action Report of surface action against Japanese Convoy on 
30 January 1944, Serial 06 of 9 March 1944. 
USS COLORADO, Action Report of the bombardment of Kwajalein Atoll, Marshall 
Islands, 31 January and 1 February 1944, Serial 004 of 28 February 1944. 
USS COLORADO, Action Report of the bombardment of Eniwetok Atoll, Marshall 
Islands, 17 February to 21 February 1944, Serial 007 of 14 March 1944. 
Commandant of the Marine Corps, ltr. of 23 March 1944, Report of LVT(2) 
activities in Kwajalein Operation, Serial 0408344 of 3 April 1944. 
Commanding General, Headquarters, V Amphibious Corps, Action Report of 
Marshall Islands Operation, 6 March 1944, Serial 00695 of 7 April 1944. 
Commanding General, Northern Landing Force, ltr. of 17 March 1944, 
Report on the Marshall Islands Operation, Serial 00C07744 of 19 May 1944. 
Commander of Joint Expeditionary Force, Action Report of Amphibious 
Operations for the capture of the Marshall Islands, Serial 00180 of 
25 February 1944, of 17 March 1944. Commander Task Force 53, ltr. of 23 February 1944, Action Report, 
Amphibious operations for the capture of Roi and Namur Islands, 
Serial 002S of 22 March 1944* 
Commander Task Farce 53*5.5, Action Report on the Attack, Capture, and 
Occupation of Kwajalein Atoll, Marshall Islands, 31 January to 1 
February 1944, Serial 05 of 25 February 1944* 
USS COWPENS, Action Report during the period 29 January to 4 February 1944, 
Marshalls Islands, Serial 003 of 22 February 1944- 
USS CUSTER, Action Report of operations against the Marshall Islands, 
January and February 1944, Serial 08 of 29 March 1944. 
USS FAYETTE, "Action Report of Landing Operations 31 January to 5 
February 1944,n Serial 001 of 3 March 1944* 
USS HAGGARD, "Action Report of Bombardment of Southern Islands Kwajalein 
Atoll 1 and 2 February 1944,’* Serial 017 of 15 March 1944* 
USS HARRY LEE, action Report of operations at Kwajalein, Serial 0010 of 
1 March 1944* 
USS HEYY/00D, action Report of Assault on Eniwetok .atoll, Serial 00585 of 
18 March 1944. 
Hospital Corps Quarterly, vol. 17, No. 3, May 1944. 
Island Commander ltr. of 5 April 1944, War Diary for months of January, 
February, and March 1944, Roi and Namur Islands, Kwajalein Atoll, 
Marshalls, Serial 0018 of 2 May 1944* 
USS JOHNSTON, Action Report of Bombardment of Kwajalein .atoll on 31 
January-1 February 1944, Serial 03 of 24 February 1944* 
USS LEEDST0WN, Action Report for period 31 January 1-2-3-4- and 5 
February 1944, Kwajalein Atoll, Serial 013 of 4 March 1944* 
USS LEONARD YY00D, ltr. of 9 March 1944, Action Report of assault and 
capture of Eniwetok Atoll, Marshall Island Group, Serial 027 of 16 
June 1944. 
USS MASSACHUSETTS, Action Report of bombardment of Kwajalein and Ebeye 
Islands, 30 January 1944, Serial 004 of 7 March 1944. 
USS MONROVIA, Action Report, Marshall Islands Operation, Serial 001 of 
6 March 1944. 
USS NEW MEXICO, "Action Report of Bombardment of Kwajalein Atoll 31 
January-1 February 1944,” Serial 06 of 2 March 1944. USS SIGSBEE, Action Report of Capture of Kwajalein Atoll, 31 January - 
2 February 1944 > Serial 010 of 13 March 1944* 
USS YJILLIAM P. BIDDLE, Action Report after battle of Marshall Islands, 
8 February 1944> Serial 002 of 17 February 1944• TABLE OF CONTENTS 
THE LIAR I ANAS 
Page 
Introduction 1-5 
Section 1 Saipan 5 “44 
Embarkation 5 “ 1° 
Shore Phase-Debarkation and Assault .. 10-11 
Beach Treatment and Care of Casualties 11-17 
Evacuation 17 - 24 
Treatment in Field Hospital Facilities 24 - 28 
Casualty Statistics 28 - JO 
Burial of the Dead JO - J2 
' The Battle Afloat 32-39 
Sanitation Problems Ashore 39 “ 41 
Civilian and POW Care . 41 - 44 
Section 2 Tinian 44-58 
Debarkation and Assault 45 “ 47 
Evacuation 47 - 49 
Hospitalization 49 “ 51 
The Tinian Off-Shore Struggle 51 “ 54 
The Troblem of Sanitation 54 - 5^“ 
Island Prisoners 5^-58 
Section 3 Guam 58 - 75 
Medical Aid on the Benches 60 - 62 
Evacuation 62 - 65 
Assault Force Hospitalization 65-67 
Casualties 67 - 68 
Sanitation 68 - 72 
Problems of Civilian Care 72-74 CHAPTER VIII 
THE MARIAMS 
The second phase of the great advance moving west 
from Hawaii was the capture of a group of heavily-wooded, coral- 
reefed islands, the Marianas. These islands were an integral 
and vital unit of the Japanese Empire, and an important supply 
and staging base for their Facific activities. In the Marianas 
campaign. Levy medicine was faced with new difficulties and 
problems, on the solution of which hung much of the success or 
failure of the co-iing Pacific campaigns. 
The cluster of seventeen islands in the Marianas 
group, /ith a total area of approximately 450 square miles, had, 
with the exception of U, S.-owped Guam, been under the control 
of the Japanese military as mandates from the League, following 
the first World In December 1941, after a bitter and 
gallant defense, the American forces on Guam had been forced to 
surrender. Now, with Tinian and baipan to the north, it loomed 
as a formidable barrier to any American advance in the Pacific. 
On 1 May 1944, Expeditionary Troops, Task Force 56 was 
activated under Admiral Spruance's Fifth Fleet and assigned the 
1. Perry F. Alien, ed., Stewards Handbook of the Pacific Islands, 
p. 129 . 
1  2 
capture, occupation and defense of Saipan, Tinian, and Guam. 
This force was divided into two main units, the Northern Troops 
and Landing Force, Task Group 56.1, organized for the seizure 
of Saipan and Tinian; and the Southern Troops and Landing Force, 
Task Sroup 56.2, committed to the occupation of Guam, 100 miles 
south of Tinian and Saipan. The 27th and 77th Infantry had 
been alerted in Hawaii to ret as reserves for both forces. 
The component units of the task force were to be 
mounted from Hawaii, the Solomons and the west coast of the 
3 
United States, and the target date was set as 15 June. Trans- 
\ 
portation for this operation was furnished by the Fifth Fleet, 
the largest yet assembled in the Pacific, with control of over 
800 ships. Final decisions for the entire operation rested with 
the Commander Fifth Fleet, whose vessels were to "transport, 
land, cover and support the landing forces and garrison forces of 
Task Force 56."^ 
2. Ernest J. King, Second Official Report to the Secretary of 
the Navy, p. 13. The over-all commander of Expeditionary 
Troops, Task Force 56 was Lt. Gen. Holland M. Smith, USMC. 
The Northern Troops and Landing Force, under Lt. Gen. Smith 
and later Maj. Gen. Harry Schmidt, included the Second and 
Fourth Marine Divisions, reinforced, the Twenty-fourth Army 
Corps Artillery, corps troops and elements of the garrison units - 
all under the over-all command and staff of the Fifth Amphibious 
Corps. The Southern Troops and Landing Force, staffed and com- 
manded by the Third Amphibious Corps and led by Maj„ Gen. R. S. 
Geiger, USMC, included the Marine Division, reinforced, the 
First Provisional Marine Brigade, the Third Amphibious Corps 
Artillery, corps troops, and elements of the Third Amphibious Corps. 
3. Action Report, Commander Task Force 56, p. 3. 
4. Ibid., pp. 31-33. Several months before the target date, active pre- 
parations were initiated with the purpose of establishing a 
state of advanced readiness. Over-all training, amphibious 
training, provisions for supply and logistical support, and 
provisions for additional personnel swung into motion. Troops 
in the Hawaiian area to be used in the Marianas assault underwent 
a realistic dress rehearsal on beaches at Maalaea Bay, Maui, and 
5 
Kahoalawi. Resulting object lessons were stressed, and personnel 
given a supervised period of rehabilitation following the rehearsal. 
Replacements of personnel were needed in the Second and Fourth 
Marine Divisions, as two accidents caused by unauthorized ex- 
6 
plosions resulted in 20B casualties. 
Navy medical planning for the Marianas operation was 
thus faced with the problems of caring for a large combat force, 
for shore based naval units and advance echelons of garrison forces, 
as well as providing for anticipated civilian casualties, many of 
whom would be 'women and children. In addition to combat casual- 
ties, medical problems could be anticipated from the presence of 
such exigencies as hemolytic venomed Moray eels and poisonous 
7 
coral which inflicted slow-healing cuts. Of n- cessity, existing 
medical facilities had to be enlarged and diversified. 
5. Ibid., p. 3. 
6. Ibid., p. 230. 
7. "Medical and Sanitary Data on Guam", Har Department Technical 
Bulletin, p. 4* With the rir-tw Amphibious Corps, which was destined 
for Saipan and Tinian, were the Second and Foiu w. 
Battalions, component units of the Second and Fourth Marine 
Divisions. The substantial Fifth Corps Medical Battalion, as 
g 
adjunct, arrived from the mainland of the United States. The 
Third Amphibious Corps, looking Guamwards, added additional 
medical personnel to each of its basic medical units (the Corps 
Medical Battalion, the Third Medical Battalion, and the two medi- 
9 
cal companies of the First Provisional Marine Brigade ). The 
augmented facilities of the Third Corps Medical Battalion pro- 
vided a 750-bed field hospital for its phase of the operation. 
In reserve in Hawaii, the 77th Army Division, equipped with three 
field hospitals (the 31st, 36th and 30th), made the 31st available 
10 
to the Fifth Amphibious Corps. 
Special medical training was given during the period 
* 
of preparation and rehearsal. Units which were to be embarked 
for the expedition from the Hawaii area received training at Maui 
in field sanitation, tropical diseases, care and transportation 
of the wounded, and first Corpsmen were trained with their 
respective units, and use was made of the lessons learned at 
Tarawa and Guadalcanal. 
8. Action Report, Com Task Force 56, p. 452. 
9. Action Report, Commander III Phib Corps, p. 155. 
10. Action Report, Task Force 56, p. 452. 
11. Action Report, Commanding General 4th MarDiv, Saipan, p. 465. Collecting stations were equipped to act initially 
as battalion aid stations for the efficient handling of anticipated 
heavey casualties during the landing phase; while hospital sections were 
put under division control to establish a large division hospital for 
the care of all the wounded, in the event of the transports' being 
12 
forced to pull out. 
Section 1 Saipan 
The key to the Japanese defense of the Marianas was 
Saipan, where heavy fortifications had been systematically pre- 
pared from the time it entered Japanese control in the first World 
War. From the fall of Guam, the islands had been free of action, 
but a fast, punishing task force raid in February 1944, under Admiral 
Mark Mitscher brought the Marianas into the American naval offensive. 
It was significant that the return fire and air defense of the Japanese 
during this raid, while substantial, was not as fanatical as that 
13 
met at Kwajalein and Truk. 
Embarkation 
On 29 May 1944, the Hawaiian units, formidable in the 
gun and air power of the protecting war vessels, and heavy with troops 
and supplies, steamed westward through calm blue waters. Medical companies 
were dispersed throughout the forces prior to departure, in accordance with a 
14 - 
regular pattern based on combat experience. One company of the medical batta- 
-i * u - lion 
12. Action Report, Commanding General 2nd MarDiv, Forrager Expedition, 
_ P. 2. 
13. 0. Jensen, Carrier '.ar, p. 121. 
14. Action Report, Com Task Force 56, p. 460. 15 
accompanying each Marine division was attached to each RCT. 
A third of the collecting section, with litter units, light 
first-aid material, and a proportionate number of company jeep 
16 
ambulances, was embarked with each BLT. The remaining sections 
of the medical company wore then embarked on the ship with the 
17 
RCT headquarters. Each RCT was embarked on three to five APA*sj 
and one or two AKA’s carried their supplies. To each medical 
battalion v/cre attached nine members of the band section. The 
average medical battalion in the Saipan invastion contained 50 
18 
corpsmen, 9 bandsmen, 2 drivers and 2 medical officers. In 
addition, 27 dental officers, who were attached to the various 
units participating in the engagement, embarked to act as 
sanitation officers, anesthetists, evacuation officers, water 
supply officers, mess officers, and company mail censors and to 
19 
serve in regimental and battalion aid stations. Red Cross per- 
sonnel, although assigned to Marine regiments, were not embarked 
for combat operations. 
15. The RCT or Regimental Combat Team constitutes one third of a 
Marine division, and is the formation used in amphibious 
assault. 
16. The BLT or Battalion Landing Team constitutes one third of the 
RCT, and is the basic assault unit of the amphibious team. 
17. Action Report, Com Task Force 56, p. 460. 
18. Action Report, ComGen 4th MarDiv, Saipan, p. 465. 
19. Action Report, Com Task Force 56, p. 469 In embarking large numbers of troops for an operation 
of this size where heavy casualties were to be expected, one of 
the most important problems was that of medical supply. Three new 
departures in medical supply handling, based upon experiences of 
previous campaigns, were adopted at the outset. Supplies desired 
by battalion and regimental corpsmen for immediate use wore packed 
in waterproof carrying cases, each load containing those items 
found by past experience to be most needed in administering 
primary treatment. In contrast, heavy units including surgical 
tables, dental units, sterilizers and spot lights were loft in 
the rear echelon. Combat-loaded jeeps containing replacement 
supplies for medical sea bags, along with extra plasma, and litters, 
were to provide prompt beach resupply. 
A second innovation was the packaging of 50 percent 
of the remaining bulk supplies necessary for 30 days in a replace- 
ment unit which contained three boxes, each weighing fifty pounds. 
Battle dressings, sulfa drugs, and morphine syrettes made up the 
first; the second contained plasma; and the third, termed the 
utility box, included miscellaneous drugs and supplies for sick bay. 
A third supply feature was the provision of two LVT’s 
for medical resupply, each to be known as the Mobile Dump, one 
20 
for each of the Saipan beaches. Resupply to supplement the 
20, Action Report, ComGen 2nd MarDiv, Forrager, p. 2. 
7 supplies embarked, was to come from the Sixth Base Depot. 
It is interesting to note that a number of item 
lacking in the Marshalls campaign were included among the sup- 
plies embarked for the Marianas--intestinal clamps, atraumatic 
catgut, tracheotomy tubes, oxygen, and several dozen homostats. 
Useful also was to bo a large supply of "Band-aids" contributed 
21 
by the American Red Cross. 
Although medical suppl;r provision for civilian use 
had been recommended, it was disapproved by a higher echelon; 
thus no medical supplies, tents, cots, or equipment for civilians 
were embarked. 
Reports on the health conditions among troops carried 
by the transports varied. The Second Marine Division stated: 
"The health of the command at the time of this operation was ex- 
cellent, even though there were 4,532 known cases of malaria who 
22 
had had one or more up to ten recurrences." An effort had been 
made, however, to Yrced out the unfit before the campaign, and in 
February, 54& had been eliminated from the Second Marine Division 
as unsuitable for combat. Three weeks previous to the embarkation 
all treops were put on an atabrine suppressive therapy, and this 
v/as continued throughout the voyage. One month prior to embarka- 
21. Action Report, ComGen 4th MarDiv, Saipan, p. 195. 
22. Action Report, ComGen 2nd MarDiv, Forrager, See. VI, p. 1. 
8 tion, tetanus boosters were administered to officers and men. 
Hitherto this had been carried out aboard ship, but in the Saipan 
operation it was done in camp, with better coverage of all personnel. 
Measures instituted, aboard ship to maintain the troops 
in fighting condition met with limited success, as over ninety 
percent of the troops of the Fourth Marine Division had diarrhea 
at one time or another, varying from mild to severe cases. Attempts 
were made to control this ailment by placing five percent crcosol 
solution for hand rinsing in wash rooms aboard ships, and by 
utilizing a series of G. I. cans for washing canteen cups, with 
23 
steam piped for the final rinse. 
Another sanitation problem aboard ship was the presence 
} 
of numerous bedbugs. The commander of one vessel reported that 
all available means were tried to rid the troop compartments of 
the vermin, but while they would be retarded for an interval, 
after a. short period they reappeared in greater numbers than be- 
fore. Bad overcrowding on APA’s added to sanitation difficulties, 
and there was general criticism of poor ventilation and air condi- 
tioning, which caused temperatures frequently to reach 100° E. on 
24 
transports. Improper laundry facilities on board troopships 
caused many complaints; fungus infections thrived in varying degrees 
23. Action Report, USS PIERCE, Saipan, p. 11. 
24. Action Report, ConGen 4th MarDiv, Saipan, p. 166, 
9 of severity. Because of the employment of inexperienced men for 
collecting, narking, and distributing, a large percentage of 
clothing was lost. 
Another irksome factor in the general health and sani- 
tation of embarked troops was the absence of sufficient variety 
of foods, and the lack of fresh fruits and vegetables. This 
shortage continued throughout all the Pacific campaigns with 
little remedy. Frequent recommendations were made by medical 
officers that canned fruit juices and fruits be made more plenti- 
ful in the diet, but no action was taken to correct this deficiency. 
Shore Phase: Debarkation and Assault 
The troop novenent from the staging areas at Eniwetok 
and Kwajalein commenced on the morning of 11 June, D minus 4, and 
the afternoon of that same day Task Force 56 released a pounding 
carrier and surface fire on Saipan, Tinian, Guam, Rota, and Pagan 
Islands. Destroyers kept up harassing bombardment on Tinian 
and Saipan throughout the night. On D minus 1, underwater demoli- 
tion teams and mine sweepers went into successful action near 
Saipan, and on the morning of 15 June (D-day), at 0830, the grey 
LVT’s, carrying their assault troops, moved toward the beaches from 
a reef which blocked the closer approach of the larger ships to 
Saipan. Leading the way was a wave of armored amphibians firing 
26 
75mm howitzers and 37mn guns. 
25. Ibid., p. 473. 
26. Action Report, Con Tr.sk Force 56, p. 39. Vicious artillery and mortar fire from carefully 
hidden Japanese positions increased in volume as the second and 
third wave hit the beach. The fight for the beachhead was the 
most critical stage of the battle for Saipan, and boatload 
after boatload of Marines fell under a relentless enemy barrage. 
The battalion medical sections hit the beaches with 
the fourth v/ave of LVT's. Under the medical plan of operation 
the collecting sections were to arrive in the last v/ave of boats 
bringing in the reserve battalions, which would put them ashore 
27 
some ninety minutes after H-hour. But the collecting sections 
were not the first medical men to go ashore; accompanying every 
fighting platoon had gone company aid men carrying their vital 
scabags of medical supplies. Long before the battalion aid 
stations were set up, while assault and debarkation were still 
in progress, the injured on the beaches received first aid. 
Beach Treatment and Care of Casualties 
During the early phases of the assault at Saipan, the 
scene of sand, blood, and wreckage was intensified by an atmosphere 
28 
of "extreme confusion.” Seabees, Marine shore party detachments, 
and naval beach party personnel had dug into fox holes over the 
entire area above the high water mark, and the proximity of the 
enemy, along with the continuous shelling of the beaches, strained 
27. Action Report, ComGen 2nd MnrDiv, Saipan, p. 2. 
28. Action Report, Commander Task Units 52.34 end 52.92, Saipan, 
p» 15 • 
i -i the nerves of the officers and men. Ammunition cases vrcre 
broken open, and the contents strewn about among the thousands 
of lifebelts that littered the beaches and floated uneasily on 
the water. The dead, both Japanese and American, had been 
hastily collected to await trucks for transportation to a burial 
ground. Not until D plus 3 with the arrival of the Army shore 
party commander did the beaches operate entirely according to 
. 29 
plan. 
Into this melee of battle, Navy medical units were 
hastily landed by the LVT's and LCT’s. The first groups to 
establish medical order were the Navy medical sections of the 
beach parties, component medical units of the shore party team 
medical section. These medical beach parties were composed of 
one medical officer and eight hospital corpsmcn from each troop 
carrier, and they constituted the link between medical care afloat 
30 
and medical care ashore. They were designated by blue helmets 
31 
with red crosses painted on front, back and sides. The medical 
beach parties worked in highly exposed positions on Saipan, 
sometimes for over 4$ hours without rest. Strafing Japanese 
planes added to the hazards under which the corpsmen and doctors 
labored as they gave emergency medical treatment and set up rough 
29. Ibid., p. 11. 
30. Inasmuch as one BLT is embarked on one APA, one beach party 
medical section is available for each BLT. Training Guide 
for Amphibious Medicine, p. 15. 
31. Ibid.. p. 35. 
12 casualty evacuation stations in the trampled sand. 
The shore party medical sections were composed chiefly 
of Marine and Army personnel (Navy medical personnel served in 
Marine uniform when attached to Marine divisions). At Saipan 
they numbered four sections to each Marine division, one medi- 
32 
cal officer and six hospital corpsmen to each section. Initially, 
the shore party medical establishments served as collecting and 
evacuation points. In the latter phase of the operation, shore 
party medical personnel became reinforcements to the division 
33 
hospital staff. 
Another important part of the medical establishment 
to be found on the Saipan beaches was the battalion aid station. 
During the long hours when the invasion forces were confined to 
the beaches, these units, which acted as forward emergency and 
evacuation centers, were forced to set up their facilities on the 
beaches. From these stations the company aid men went out to 
minister to the wounded—to stop hemorrhages, apply sulfa drugs, 
dressings, splints, to administer morphine, to make out emergency 
medical tags, and carry the wounded to the boats. 
32. Action Report, ComGon 2nd MarDiv, Saipan, p. 5. 
33. Ibid. This was possible because later evacuation was made 
direct from the division hospital via DUKW’s, which elimi- 
nated the necessity for an evacuation party at the beaches. 
The shore party at Saipan did establish an evacuation 
station on D minus 4, which was used until the setting up 
of the division hospital. Heavy fire, exploding mortars, artillery shells, and 
snipers1 bullets made the functioning of separate medical groups 
on the beaches difficult. Often they were merged in the immediate 
necessity of caring for the wounded and getting them off the 
beaches. Separately functioning units could not be set up until 
a beachhead was established. Despite the disordered conditions 
prevailing on the beaches, no report of the Saipan action had 
anything but praise for the doctors, corpsmen, and other medical 
personnel who performed their individual duties with little or 
34 
no thought for their personal safety. 
Casualties during the first five days of the operation 
were very heavy, and the beach medical facilities were constantly 
overcrowded and undermanned. One shore party evacuation station 
treated and evacuated 1,009 casualties from D-day to D plus 3 
35 
under the most difficult conditions. Jeep ambulances with 
their loads of wounded were hit time and again by artillery fire. 
No provision had been made for a movable light-proof shelter 
34-. That this was not paralleled by other units in the campaign 
is evidenced by a statement of a task unit commander describ- 
ing the Saipan beaches: "Lack of initiative on the part of 
the officers, CPC’s, and lack of interest on the part of the 
officers and men was obvious. Almost without exception the 
officers could bo located in their foxholes unless individually 
routed out and put to work. This is attributed to the fact 
that the officers and men were untrained in this type of work 
and were out of their field, and also to the fact that they 
were under fire constantly for almost thirty hours and were 
fatigued,” Action Report, ComTaskUnits 52.34- and 51.92, 
Saipan, p. 16. 
35. Action Report, ComGcn 4th MarDiv, p, 196. in which the wounded would receive adequate treatment on the 
I 
beach during the long night hours. The maintenance of a 
strict blackout was essential, and yet it was almost impossible 
to diagnose and treat a wounded man in the dark by the pale gleam 
36 
of a poncho-covered flashlights. Still another hazard con- 
fronting the Medical Department was the landing of ammunition and 
gasoline on crowded beaches in proximity to casualty evacuation 
37 
centers. 
An important aspect of medical activity on the beaches 
v/as the functioning of medical supply in the early hours of the 
engagement. Corpsmen carried primary supplies in seabags. Jeep 
ambulances which had been combat-loaded were debarked fairly 
successfully during the first few days. In some instances, 
hov/ever, deck officers mistakenly ordered ambulances unloaded 
prior to debarkation of troops. Severe temporary shortages re- 
38 
suited from this. 
Shortages of litters, tetanus anti-toxin (for treatment 
of natives and prisoners of war), blankets, blackout tents, and 
penicillin were the most notable on Saipan, Litters were in 
constant demand, and there were frequent complaints that the 
ships were not sending enough of them to the beaches. Fifty more 
litters per troop transport were recommended by the senior medical 
36. Ibid., p. 512. 
37. Action Report, USS BOLIVAR, 27 June 1944, p. 10. 
38. Ibid., p. 198. 
15 officer for future engagements, where landing force evacuation 
39 
lines were as long, and casualties as heavy as at Saipan. 
Breakage and spoilage of litters in burial of the dead was another 
factor in the shortage. 
Despite inadequacies in certain items, medical supply 
and resupply functioned fairly competently on the Saipan beaches. 
There were sufficient plasma, battle dressings and splints to 
meet the needs. After the initial assault was over and the 
medical organization could be set up on the beaches, the regimental 
aid station supplied the battalions, while the regimental station 
itselt was supplied by the medical battalion of each Marine 
division. Each evening, efforts were made to supply the batta- 
lions with the necessary equipment for the anticipated casualties 
of the following day. 
Medical beach treatment, on the whole, reflected 
favorably on the Navy medical units. The hospital corpsmen of 
the collecting units exposed themselves constantly to enemy 
fire in order to reach the wounded, and their bravery is partially 
reflected in the heavy casualties among their numbers. The 
corpsmen acted independently of the doctors to meet emergency 
medical situations, and it was recommended after the operation 
that an increase in rates be allowed the medical beach parties. 
39. Action Report, Commander Joint Expeditionary Force Marianas, 
Enclosure K, p. 254* 
16 Training in primary first aid with emphasis on the use of 
plasma and whole-blood transfusions at early stages saved the 
lives of many whose names might otherwise have been added to 
the lists of "Died of Wounds Received in Action." 
Evacuation 
In the first days of beach fighting, with the 
difficulty of maintaining organization under murderous enemy 
fire, the most important factor in the over-all saving of lives 
is to get the wounded off the beaches to the ships where they 
can receive necessary and definitive treatment as promptly as 
possible. It has been said that the first six hours are the 
most important in the treatment of a wound. With this in mind 
the need for quick, competent evacuation cannot be ever-emphasized. 
The experience gained in previous campaigns, as well 
as much thought, went into the plans for evacuation of 
casualties at Saipan. In addition to the general problems of 
evacuation experienced in earlier Pacific Island campaigns, there 
were a number of other specific complications. The presence of 
coral reefs, the less of many small boats during the assault phase 
(thus decreasing the number of boats available for evacuation), the 
difficulties of evacuating against a constant flew of troops and 
supplies, the need for medical care among evacuees, and the 
pressure of combat on the beach itself—all served to derange 
organization. 
17 The general evacuation plan provided for the reception 
of initial casualties aboard the APAls, to which they were 
brought by landing craft and amphibious vessels. From D plus 3 
on, the hospital ships were- to arrive at regular intervals to 
remove the casualties to the Marshalls and from there by air to 
Pearl Harbor. The presence of jutting coral reefs made it 
necessary to bring the wounded to the reefs in amphibian tractors 
(LVT's) or amphibian trucks (DUKYPs), and then transfer them 
to LCVP’s. Three LST1s, medically and surgically equipped, were 
also designated to stand off the reefs to receive casualties from 
40 
the amphibious tractors and trucks. 
During the first week at Saipan all casualties, includ- 
ing seriously wounded civilians and prisoners of war, were 
evacuated to ships of the force, A division of APA’s was em- 
ployed to retain the less serious casualties within the area 
until they were able to be returned to hospital facilities ashore 
or directly to duty. The most critical period in evacuation 
was from D plus 11 to the time the island was secured. With the 
withdrawal of the transports on D plus 11, insufficient vessels 
and medical personnel were left to care for the streams of 
wounded averaging five hundred per day, exclusive of the increasing 
AO, Action Report, Headquarters Expeditionary Troops, Task Force 
56, Marianas, p, A56, 
18 41 
numbers taken sick with dengue, catarrhal fever, and dysentery. 
Starting on D plus 9, air evacuation was instituted 
from Saipan. A total of 860 casualties were evacuated to the 
Marshalls, but with poor medical results. No flight surgeons 
had been provided to sort the patients to determine which were 
fit for air evacuation; no medical attendants had been provided 
to accompany the patients. As a result, a number of casualties, 
unable to stand the rigours of air transport, died en route. 
In some cases patients who had been in combat with little or no 
42 
food for over 24 hours were evacuated by air without being fed. 
At Kwajalein and Eniwctok inadequate preparation had 
been made to care for the air evacuees from Saipan. No screening 
was performed during the three to four days' wait for further 
air evacuation to Pearl Harbor. 
The most serious evacuation problems, however, and 
those affecting the greatest numbers of casualties, were 
associated with sea evacuation. A major cause of difficulty was 
the coral reef which made necessary the retransfer of casualties 
resulting in delay, injury, and discomfort for the wounded. Occa 
sionally as many as five transfers were necessary--beach to LVT, 
43 
Lyi to LCVP, LCVP to LST, LST to APA, and APA to hospital ship. 
41. Action Report, Com Joint Expedit. Force, p. 253. 
42. Letter from Adm« W. Chambers to Vice Adm. Ross T Mclntire, 
10 July 1944, n. p. 
43. Action Report, USS SUMPTER, Saipan, p. 14. 
19 The LVT'Sjwhich were slow, difficult to handle, and proved 
far less desirable than the DUpMs for reef evacuation. The 
DUKW accommodated six litter casualties, and rode far more 
comfortably than the LVT. The most effective evacuation ship, 
the LCVP, could not be taken directly to the beaches of Saipan 
because of the reef. Occasionally, in the first days of the 
attack, evacuation was accomplished directly to APA*s or hospital 
ships by use of LVT’s and DUKW’s. In the latter days of the 
fighting and after the establishment of hospitals on land, 
vessels were sometimes used in direct evacuation; but throughout 
most of the operation numerous painful transfers were required. 
The transfer of patients frem vehicle to vehicl-e was compli- 
cated.by methods employed*’’ Then facilities were available, 
casualties were transferred on Stokes stretchers to APA*s by 
44 
means of a boom. Frequently, however, Stokes stretchers were 
not available. The most notable absence of proper equipment for 
transfer was found aboard the hospital ships. These ships*which 
received boatload after boatload of injured from LCVP * were 
not furnished with Welin davits with which to lift the boats to 
deck level, and the transfers had to be made over the ships* 
gangways. Boats loaded with wounded gathered off the gangways 
of the hospital ships where they were obliged to stand for hours 
in the hot sun with their unprotected loads. Following this 
44, Ibid., p. 16. 
20 operation, official recommendations were made for equipping 
AH's with better facilities for the transfer of patients, but 
even the newest hospital ships present at Saipan carried no 
45 
transfer equipment. 
Perhaps the most unsatisfactory feature of sea 
evacuation was the lack of effective coodination and regulation 
of the evacuating ships. Great inequalities in apportioning 
casualties among ships were noticeable. The result was the 
overcrowding of the medical facilities of some vessels, while 
those aboard others were only partially used or net used at all. 
Many ships failed to fly the Mike flag to indicate that they 
could take casualties. Some boats carrying casualties made 
stops cn route for purposes other than the delivery of 
LJo 
casualties. Again and again coxswains would automatically 
head for the nearest ship to get rid of the casualties as quickly 
as possible. The report of Lt. (jg) Bussc of the .uss JlfElDERICK 
FUNSTON provides an account of evacuation difficulties: 
After having led the third assault wave as far as the 
reef cn Green Beach One, I picked up four seriously wounded 
men, three from an LVT which had been knocked out just sea- 
ward of the reef, and one out of the water. I spent the 
next hour trying to find a hospital LST and never did. I 
finally came alongside an LST which did have a doctor aboard, 
3 miles to seaward of the line of departure and put my 
casualties aboard her. Since the Jap shellfire never did 
45. Letter, ComTransDiv 34, Marianas, p. 3. 
46. Action Report, ComTransDiv 32, Saipan, pp, 7-8. 
21 come out more than 2,000 or 3,000 yards to seaward of the 
reef there was no good reason why a hospital LST could not 
have been stationed $00 yards to seaward of the line of 
departure. As a matter of fact the LST 450 which I was on, 
and a designated hospital ship could have stayed in the 
same position she was when she discharged her assault 
LVT wave, instead of standing out for several hours.4-7 
The absence of the hospital LST*s was not.in accord- 
ance with the medical plan. Three had been provided and fitted 
cut for evacuation and temporary care of the wounded. They 
were to function until the beaches were safe enough for the 
48 
transports to come in and receive the wounded. However, 
when most needed - on D-day - there was no sign of the LST!s, 
and they did not arrive until the transports closed to the beach, 
at which period it was more feasible to evacuate casualties 
49 
directly to the transports. In addition, the transports which 
provided doctors and corpsmen for the hospital LST's were left 
sherthanded themselves tc moot the heavy casualty leads. 
The value of hospital-equipped LST*s should not be 
underestimated. They could, and in later campaigns did, serve 
a particular need as casualty collecting stations which could 
not be provided until later by other facilities. The inadequate 
performance of their basic function at Saipan, however, was 
recognized by over-all commands, and recommendations were made 
47. Action Report, Com USS FREDERICK FUNST01 , Saipan, Enc. A, p. 13. 
4B. Action Report, Com Group 2, Amphibious Forces, p. 80. 
49. Action Report, ComTransDiv 7, Saipan, p. 31. 
22 to improve their service. It was recommended that they fly 
Victor flaes to distinguish them from other LST's; that they 
carry identifying lights at night; that they be supplied with 
medical personnel of their own so that the transports need net be 
decimated; that an area be set aside where they could readily be 
found by boats from the beach; that the number of hospital LST's 
be augmented where heavy casualties were to be expected; and that 
a central radio communication control and centralized administration 
of all the evacuation ships be established. 
The lack of communication facilities and centralized 
control was the real cause of the confusion in the evacuation 
prccess. A control boat had been provided for in the campaign, 
but no communication existed between it and the beach medical 
50 
section. Arrangements had been made to provide a medical officer 
cf lieutenant commander's rank in the control beat to direct both 
logistical control of medical supplies and the flow of casualties 
to the ships, but for unspecified reasons this plan was abandoned. 
As the battle fer Saipan progressed, and with the 
extension of lines of communication into the interior,.the need 
for land evacuation vehicles became increasingly apparent. Tee 
few ambulance jeeps had been provided, only one ambulance jeep 
being primarily available for each medical battalion. When 
casualties were heaviest a few other jeeps were obtained through 
50, Action Report, USS ARTHUR MIDDLETON, Saipan, p, 67, 
23 requistion of the medical company, but this was a slow 
process, and frequently the requested jeeps were lost on the 
51 
way. 
An important problem in evacuation during the early 
phase was that of segregating slightly wounded and those who 
would be ready for duty in 30 days or less from the more seriously 
wounded. Sorting was extremely difficult on the beaches where 
hundreds of wounded arrived at one time and clogged transportation. 
Dust and mud vied with the enemy fire to frustrate attempts at 
system and order. 
Evacuation of the wounded at Saipan, then, functioned 
under considerable difficulties, and left much to be desired. 
More effective medical planning for evacuation of wounded in terms 
of the specific campaign was indicated. The size of the problem 
was shown by the fact that 9*546 casualties were evacuated from 
52 
Saipan by sea. It is significant that official reports recognized 
the need for improvement in the system and made specific recommendations 
to this effect. 
Treatment in Field Hospital Facilities 
Hospital facilities at Saipan functioned very well 
in view of the heavy casualty rate. The Fifth Amphibious Corps, 
51* Action Report, Com&en 4th MarDiv, Saiprn, p. 512- 
52. Total evacuation figures for the Marianas operation as a v;hole 
appear in Appendix A. with three medical companies, used two of them to set up a 
convalescent camp which had begun to function towards the end 
of the campaign. It was chiefly useful in receiving casualties 
53 
from Tinian. The third medical company took over a small 
field hospital at Charftn Kanoa, in a captured Japanese hospital. 
The Charon Kanoa facility was first operated on D plus 2 by a 
medical company from the Second Medical Battalion. The Second 
Marine Division hospital started to treat casualties on D plus 
8 in buildings cf the main Japanese radio station. 
The Charon Kanoa hospital was, in the early days of 
operation, the only facility on the Island capable of practicing 
definitive surgery. The 97th Portable Surgical Team joined the 
Charon Kanoa hospital facility shortly after its establishment. 
No records were available for the first two days, but from D plus 
3 through D plus 11, a total of 39B were admitted from the 2nd and 
54 
4th Marine Divisions and the 27th Army Division. 
The best hospital facilities at Saipan were those of 
the Second Marino Division. They were located in the former radio 
building which had been constructed of steel and concrete and were 
surrounded by ten-foot revetments. With the assistance of a 
company of Scabecs the rubble and damaged radio machinery were 
rapidly cleared out, and a hospital of 1,000 beds set up. Casualties 
53. Action Report, Com Task Force 56, p. 462, 
54. Action Report, 2nd Marl$v, Saipanp..5*• 
25 with minor wounds were housed in nearby tents. Despite rapid 
expansion, serious delays in casualty handling did not occur 
at any time. Eight asccptic operating tables functioned in 
the four surgical huts which were manned by specialized 
surgical teams for orthopedics, chest and abdominal, and head 
and eye injuries. Eleven ether tables were available for use in 
treating shock, administering transfusions and caring for minor 
debridements, dressings and castings. A major cause of the 
excellent functioning of this hospital was the strong centralized 
55 
organization of the medical battalion. 
The Second Marine Division Hospital up to D plus 35 
had a total admission list of 5,156. Of these 3,408 were dis- 
charged to duty during that period, 1,372 were evacuated and 71 
died. A mortality rate of 28 percent prevailed in cases of ab- 
dominal surgery performed in the Divisicn hospital. 
Security from enemy attacl was a necessary factor in 
the setting up of the field hospitals. Japanese infiltration had 
been responsible for many deaths in previous campaigns, and the 
rugged terrain at Saipan offered ample opportunity for the enemy 
to hide out behind American lines. Under those conditions no 
medical installation could be set up away from troop areas with- 
out prevision for heavy guard. All hospitals were furnished 
55. Ibid., p, 6. 
26 guards and security patrols. In addition, it was necessary 
to have the slightly wounded keep their weapons and ammunition 
and be organized for defense of each unit or building. Where 
necessary, foxholes and dugouts for patients were provided by 
56 
hospital company personnel. 
Hospital care ashore for combat fatigue cases was 
provided from D plus 4 on, with the use of two medical ccmpanics 
to treat fatigue, minor injuries and medical cases. There was no 
real segregation of combat fatigue from other casualties in the 
early days of the fighting, and those having combat fatigue were 
evacuated to the transports and hospital ships along with the 
seriously wounded. Over 500 were later returned to shore and 
to the special medical companies for physical checkup and re- 
57 
equipment prior to return tc combat. No figures appeared in 
the reports giving the total number of combat fatigue cases, nor 
was there information on the percentage cf recuperation after 
Saipan. 
The supply system for the field hospital facilities 
functioned on the basis cf a thirty-day medical supply plan. 
Medical supplies were packaged in blocks, each of which contained 
a 30-day supply for 3,000 men, and, in addition, individual supplies 
58 
were reasonably adequate. Some items, such as the Wagensteen 
56. Action Report, ComGen 4th MarDiv, Saipan, p. 197. 
57. Ibid. 
58. Appendix B gives the contents of the nodical unit. 
27 suction apparatus, intestinal clamps (in sufficient numbers), 
airways, and oxygen apparatus, ere net included in the block 
packaging of medical supplies, and recommendations were made 
for their inclusion in later campaigns. Especially commended 
were the portable plywood operating rooms, easily blacked out, 
and providing clean, weatherproof, insect-free rooms for surgi- 
cal purposes. As a result of their successful utilization in 
the 3aipan campaign, it was recommended that in future operations 
two be carried with each platoon of a corps hospital instead of 
59 
one. The major portion of captured Japanese medical supplies 
was set aside for care of civilians. 
Casualty Statistics 
Heavy casualties had been anticipated, but the final 
figures surpassed the most pessimistic predictions. The total 
number killed in action was 3,100; wounded in action, 13,099; 
missing in action, 326— a grand total of 16,525 casualties, 
60 
approximately an entire Marine division. Of this number, casual- 
ties in the Second Marine Division ore re 1,150 killed in action, 
4,914 wounded in action, and 106 missing in action--a total of 
6,170. The Fourth Marine Division,sustained 966 killed in action, 
5,505 wounded in action, and 141 missing in action—a total of 
6,612, Army casualties of the 27 Infantry Division totaled 3,566, 
59. Action Report, Com Task Force 56, p. 468. 
60, Action Report, Hqs. Expedit. Troops,TF 56, Marianas, p. 473, 
28 v.dth 959 killed in action, 2,532 wounded in action, and 75 missing 
in action. In the Fifth Amphibious Corps Artillery, 7 were 
killed in action and IB wounded in action—a total of 25. Fifth 
Amphibious Corps troops numbered 18 killed in action, 130 wounded 
in action, and A missing in action—a total of 152. 
Casurltics among medical personnel were proportionately 
heavy, and in many instances resulted from their being unable to 
utilize protection and cover from enemy fire. In the Fourth 
Marine Division, 161 doctors and hospital corpsmen were battle 
casualties while another 157 were admitted to hospital facilities 
as a result of dengue, dysentery, fungus infection, combat 
61 
fatigue, psyche-neurosis, and other diseases. 
Diseases, illness, and combat fatigue accounted for 
slightly less than one-third as many admissions to medical treat- 
ment as did battle casualties. In the Fourth Marine Division, for 
example, there were 409 cases of dengue fever, 680 cases of 
dysentery, 26 cases of fungus infection, 414 cases of combat 
fatigue, 169 cases of psychoneurosis, and 879 admissions from 
other sickness—a total of 2,577. Not all of those, of course, 
wore put out of action by illness, for in the process of treating 
thousands of wounded, only men with severe cases 0f dysentery, dengue 
and fungus infections were hospitalized. 
61, Action Report, ComGcn Ath MarDiv, Saipan, p, 202. 
29 A new casualty reporting system was put into effect 
62 
at Saipan, and worked with considerable success. 
Burial of the Dead 
Medical personnel in battle arc faced not only with 
the problem of the care of the wounded and sic1:, but also with 
the disposal of the dead for the protection of the living. At 
Saipan, American and enemy dead were strewn about the beaches 
and over the rugged inland terrain by the thousands; and de- 
spite careful planning, existing facilities for disposing of 
the dead were unable to keep up with the rate of the fallen. 
Burial parties had been set up before the attack and had been 
trained and equipped prior tc embarkation. While under the 
general supervision of the medical department, they were com- 
posed cf line personnel; and each battalion and H & S company had 
a burial officer with a detail of men. 
62. Ibid., p.59. 
Three by five cards with the following information provided 
a swift means of report for overworked corpsmen: 
(Surname) 
(First Name) (Middle Name/ (Rank) 
(Organization) (Serial Number) 
(Date and Place of Casualty) 
(bate and''Place of Bur laid 
(Plot) (Row) (Number) 
Evacuated to: 
Date 
KIA W&E WNE 
SK&E MIA 
Two copies of the cards were made out on every Marine prior 
to action and this system proved effective in the battalion 
aid stations and hospitals. 
30 During the early beach fighting, bodies were gathered 
and given temporary burial while the action was continuing. Those 
who died during evacuation to ships were generally returned to 
shore for burial; however, some ships accepted bodies along with 
the wounded, and their logs shortly thereafter would carry the 
laconic report, "1730 Held burial at sea on nine casualties.n 
Enemy dead were buried in common graves, but due to the 
press of battle there was often a delay of several days before this 
could be accomplished. Limited quantities of solutions of sodium 
arsenite and oil were available for spraying, and this aided in 
63 
fly control. As the American forces advanced into Saipan, the 
Marine dead were brought to roads by the battalion and company 
teams and there picked up by the division burial officer and buried 
in division cemeteries. A service for registration of graves was 
established prior to the campaign and it functioned reasonably 
well under arduous conditions. 
Despite a generally successful program, difficulties 
in the burial plan id present themselves at Saipan. Often identi- 
fication tags were not worn, so that identification of the dead 
was made difficult. During the beach phase of the campaign, before 
the burial teams could organize, there was no responsibility 
63. Ibid.. p. 197. 
31 assumed by other groups, and there were delays in during both 
American and enemy dead. It was recommended that in future 
operations, the responsibility for burial during the early phase 
64 
be given to the shore party. Turing the entire battle the 
shortage of stretchers and of transportation facilities for 
the bodies presented difficulties. It was a hard task to 
persuade units which had carried in ammunition, rations and 
water to carry back loads of dead. The lack of proper communi- 
cation between the battalion burial parties and the division 
burial officers was another difficulty. 
Disposal of the dead was, on the whole, effective from 
a medical standpoint, as bodies were either sprayed or buried 
within a reasonable time and no large sanitation problem arose 
from their neglect. 
The Battle Afloat 
TThile the battle raged on land, the ships maneuvering 
off shore formed a part of the medical plan as well. APA’s, 
AKA’s and hospital ships were an intrinsic part of the evacua- 
tion plan and also of the plan of medical treatment. The 
floating facilities were, until the establishment of the field 
hospitals, the only locations for definitive treatment of the 
wounded, 
6/. Action Report, USS SUMPTER, p. 15. The APA’s bore the brunt of the initial casualty loads 
at Saipan, anc1 by the evening of D plus 2 they had taken aboard 
3,600 wounded. The hospital ships did not arrive until D plus 3. 
About this time the transports left the area and, had all the 
hospital ships in the Pacific been at Saipan, they could net 
have handled the loads of wounded carried out by the evacuation 
. . 65 
boats. Despite the fact that the primary function of A PA’ s 
and AKA1s is the transportation and landing of combat troops, 
equipment, and supplies, the medical services they performed 
in the Saipan campaign were professionally admirable in view of 
the conditions under which many were forced to work. 
The action report of the USS CA VALISE. (APA37) gives a 
good account of the casualty handling by APA’s at Saipan. The 
CAVALIER’s normal complement of 4 medical officers, 1 dental 
officer, and 20 hospital corpsmen was supplemented before the 
t 
engagement by 2 naval medical officers and 10 corpsmen. Its 
30-bed sick bay area was expanded (by conversion of the troop 
officer quarters, troop quarters below deck, and ship’s officer 
quarters on the main deck) to the reception of 150 bed casualties 
and 325 ambulant casualties. Medical supply for the anticipated 
casualties was enlarged, surgical dressings and plaster of Paris 
bandages were prepared and arrangements for a pool of men for 
blood transfusions made. All divisions received instruction in 
65. Action Report, Com TF 56, p. /56. 
33 first aid and casualty handling from the medical department before 
sailing, and medical teams were formed to facilitate handling. 
The CAVALIER received 108 casualties in two days and 
among these there were only two deaths. Thirty-five men were 
critically wounded and required surgery; about 40 were ambulant 
or semi-ambulant. At no time v/as there lack of proper medical 
care of the wounded, and even the bunking and feeding were con- 
66 
ducted in a commendable fashion. 
The USS PIERCE (APA50) experienced difficulties in 
handling great numbers of casualties at one time because of a 
67 
lack of proper control over xhc evacuating ships. The PIERCE 
had developed, an improvement on the transfer of patients from the 
boats to her deck by keeping an LCV(P) on davits at her rail. 
One general criticism of the treatment of wounded aboard 
the APA’s at Saipan was the lack of adequate supplies of peni- 
cillin for treating certain wounds. A vigorous attack on shore 
establishments, presumably responsible for this shortage of a 
vital drug, was made in the action report of the commander 
68 
of' Transport Group A. This roused an investigation of the 
situation by the Bureau of Medicine and Surgery and by the staff 
66. Action Report, USS CAVALIER. 
67. Action Report, USS PIERCE, Saipan, p. 12. 
68. Action Report, Commander Transport Group A, Saipan, p. 31. 
34 of Admiral King; the final onus of the incident was placed on poor- 
logistic organization. "If the supply of penicillin had been 
handled as an urgent item of logistic planning, a timely and 
adequate delivery could have been made in this case,” concluded 
69 
Admiral King in his report. 
The transports performed a creditable over-all job at 
Saipan, however, and their facilities were a haven of comfort to 
the wounded. Captain F. R. Hook, while engaged in an inspection 
tour of the South Pacific, wrote Admiral Mclntire: ”1 was at 
Espiritu Santo the day the APA’s returned with their casualties 
(from the Marianas) and had the opportunity of going aboard them 
and inspecting their facilities for handling patients. They are 
70 
very well set up for such work, better in fact than our APR." 
The hospital ships SOLACE, BOUNTIFUL, and RELIEF 
treated and evacuated casualties from Saipan after D plus 3. For 
the majority of casualties these All’s ’. ere the medical agency 
which most frequently performed definitive treatment. After the 
division hospitals had been set up, the proportion of cases which 
had received only emergency treatment prior to embarking slackened; 
but in some instances evacuation continued without clearance through 
the hospital centers. In many cases definitive treatment was 
postponed on the AH’s until the patient could be brought to larger 
69. Letter from Admiral King to the Vice Chief of Naval Operations, 
6 Jan:;. 19ig, r. 
70. Letter from Capt. F. R. Hook to Vice Adm. Ross T Mclntire, 
23 Aug'., 19.44** ■ fi p. • land hospitals; but traumatic aneurysms, fraoturoc, and ner., 
forating wounds of the abdomen alrrsys received definitive care. 
Staffing and equipment aboard the hospital ships varied 
with the size and age of the ship. The RELIEF carried a comple- 
ment of 44 officers, 11 nurses and 434 enlisted men. In the 
Pacific campaigns, the SOLACE averaged 17 medical officers, 2 dental 
officers, 3 Hospital corps officers, 13 nurses, and 173 enlisted 
men. During the Saipan campaign dental officers participated 
actively on the hospital ships and were especially useful in 
giving anesthetics, wiring fractured jaws, and making prosthetic 
appliances for those patients with perforating wounds of the hard 
71 
palate. Surgical equipment in the hospital ships was adequate, 
but one general complaint stressed the definite need of air condi- 
tioning. "The most urgent need is for air-conditioning", wrote the 
captain of the USS SOLACE. "Dorking as we have done in the tropics, 
the heat and humidity of the operating rooms is debilitating to 
the patients and reduces the efficiency of the personnel. Further- 
72 
more, it is difficult to maintain good asceptic technique." 
The AH's at faipan were a necessary and integral part of 
the military campaign, but with the high rate of casualties there 
was a need for more of these floating hospitals to care for the 
71. Historical Sup] lenient to Annual Sanitary Report, USS RELIEF, 
1944# R. 12. 
72. Annual Sanitary Report, USS SOLACE, 1944> p. 12. 
36 wounded. Following the campaign, an increase in the number of 
Ah's was V7as especially emphasized that there 
should be sufficient hospital ships to permit oat *... . 
•r -".o T.Q 
remain in the area to care for the sick and slightly wounded 
until they could be returned to duty, rather than to use the 
73 
All's solely as evacuation hospitals. 
f.Q 
Uhile doctors and corrsmen on the beaches and aboard 
the transports and hos* ital ships off Saipan were striving to 
alleviate suffering and save lives, other doctors and corpsnen 
aboard the fighting ships--the battleships, carriers, cruisers 
and destroyers--were trying to core with the casualties inflicted 
upon the fleet by Japanese shore shelling and aerial bombardment. 
As in other engagements, a systematic first-aid program 
was instituted aboard the fighting ships for all non-medical 
personnel, h'hen the USS CALIFORNIA suffered a heavy explosion 
off Saipan, its doctors and surgeons commented very favorably 
on the excellent condition of casualties brought to the collecting 
74 
stations by the ship's company. The carrier, USS BUNKuR HILL, 
showered with bomb fragments from a near-miss by an enemy dive 
bomber, reported efficient first aid by the ship's crew as well 
as by the medical staff. 
Iledical facilities aboard carriers off Saipan included 
73. Action Report, Hqs Expedit. Troops TF 56, Ilarianas, p. A57. 
llr. Action Report, USS CALIFORNIA, Saipan, p. 50. 
37 approximately twelve battle-dressing and first-aid stations on 
each ship. The BUNKER HILL had three on the third deck, two' on 
the hangar deck, five on the gallery deck, and two in the island 
structure; at the Ilarianas this arrangement was found to give the 
. 75 
best medical coverage. Ventilating difficulties in the sick 
bays and dressing stations wore experienced aboard the battleships 
and as a result many patients experienced respiratory difficulties, 
i'.orcover, the temperatures of UCh and 120° Fahrenheit in which 
the medical staff ras forced to work were a source of great 
discomfort and wore believed to reduce its efficiency. 
Definitive medical treatment was occasionally performed 
on the larger ships of the line where there was adequate medical 
staffing. However, serious cases were customarily transferred 
to the hospital ships, as was the case with the wounded of the 
USS SOUTH DAKOTA and USS CALIFORNIA off Saipan. The use of 
sodium sulfathiazole for the seriously wounded, blood banks and 
plasma to combat shock and bleeding, petroleum gauze in burn 
cases, and light plaster bandages for a variety of wounds was 
\ 
general on the line vessels. 
Another feature of the "battle afloat was the enforcement 
of sanitation aboard the ships of the line, since the outbreak of an 
epidemic could disable a ship just as effectively as gunfire. 
75. Action Report, USS BUNKER KILL, Marianas, p, 5A. Enteritis and dysentery were the most frequent disturbers and 
they were present to a limited extent on a number of fighting 
vessels during the Saipan engagement. Only on the USS BIRMING- 
HAM, however, did these factors play a serious role. By 10 
June (D minus 5), bacillary dysentery had affected 244 persons 
on the cruiser. Rigid sanitary precautions—sterilisation 
of mess gear, insuring the washing of hands with antiseptic 
solutions, and inspection of food handlers — soon reduced the 
incidence. Treatment with sulfa, penicillin, intravenous 
glucose, and occasional blood transfusions, where necessary, 
made it possible for all ambulatory cases on the BIRMINGHAM 
to man their battle stations by the fourteenth of Junc.*^ 
Sanitation Problems Ashore 
The Marianas Islands were free of malaria at the time 
of the American invasion, but dengue-carrying mosquitoes hung 
in thick swarms over the western side of Saipan, and the islands 
were noted for respiratory disease. Bacillary dysentery was 
known to be present. To meet these and other threats to the 
health of the invading forces, preventive sanitary measures 
were emphasized throughout the campaign. Success, however, 
was limited. Adequate fly control was not possible because 
of heaps of crushed sugar cane and the presence of numerous 
unburied, unsprayed dead. A preparation called "Scat” was 
76. Action Report, USS BIRMINGHAM, 11 July 19AA, p. 33. 
39 was effective against mosquitoes, but screening vas still 
necessary and was not adequate to cover all »>ooS balls. Caro 
was taken with slit trenches, however, and heads, when installed, 
had box-type covers and were screened with Japanese mosquito 
netting when it was available. All garbage was either burned 
77 
or buried. 
Water supplies were plentiful on the island, and the 
early establishment of American purification units at springs 
provided adequate quantities. Japanese infiltrators frequently 
attacked the sources of water supply, however, and insufficient 
personnel were allotted the utilities sections to provide 
78 
necessary guard facilities. 
Following the Saipan operation, recommendations v/c-re 
made for the further provision of from four to six men for 
assignment to each battalion for spraying the dead, maintainancc 
of fly and insect control, and general supervision of field 
sanitation. Increased supplies of screening materials and 
79 
insecticides were also recommended. 
The effectiveness of the sanitation program in the 
Saipan invasion was difficult to measure. The percentage of 
dengue and dyscnt<ry was rather high, hut the battle conditions 
77. Action Report, ComGcn 4th I.IarDiv, Saipan, p. 383. 
78. Ibid., p. 267. 
79. Ibid., p. 384. were difficult, and the casualty rate heavy, obviating a perfect 
performance of sanitation planning. Once the military situation 
was under control, more effective sanitation was possible in the 
rear areas—the dead yjqre disposed of and screening was increased. 
Civilian and PCW Care 
The Saipan invasion provided the Navy with a serious 
new problem in caring for lasge numbers of sick and wounded enemy 
civilians and POW’s. Adequate preparation for this situation had 
not been made, and the results were proportionately chaotic. 
Writing to Admiral Mclntire three weeks after the invasion started, 
Admiral Chambers declared: 
The Saipan situation, as you know, was a much harder 
operation than anticipated but it certainly brought out 
some very important lessons for future applications. In 
Saipan, for instance, there was supposed to be a native 
population of about 20,000. These were mixed Japanese, 
Koreans, Chamorros ard Kanakas. The Civilian Affairs 
Administration went into Saipan about D plus five but 
without facilities. Before I left Saipan there were 
over 16,000 internees, about 10 percent wounded or sick. 
This Internees' camp was one of the biggest problems 
from a medical standpoint as limited medical personnel 
from field units had to be diverted to this work. All of 
this in addition to caring for our own and enemy prisoners 
of war wounded. The physical conditions of the civilians on 
arrival in canp was poor—tetanus was not uncommon with a 
high mortality rate, 
The Civilian Affairs Unit w/hich went into Saipan on D plus 5 
consisted of one surgeon from the public health service and one 
80. Letter from Adm. 17. Chambers to Vice A dm. R. T Me Intire, 
10 July 1944» n. p. 
41 pharmacist's mate first class; their equipment consisted of one 
81 
medical officer's field kit and one hospital corpsman's field kit. 
Nearly all of the inhabitants of the island were to become charges 
of the Navy Medical Department from one cause or another. Many 
hundreds had been injured during the battle, as their homes were 
pounded to rubble by American guns and planes; and disease and 
epidemic illnesses were aggravated by invasion conditions. Adequate 
care had not been provided for these non-combatants in the planning 
and, although those who were finally faced with the problem did a 
highly commendable job, there was a death rate of over 30 per- 
cent • 
An urgent call for help brought an additional medical 
officer and seven hospital corpsmen on D plus 10, and on D plus 21, 
another medical officer and a pharmacist's mate. Scouting missions 
turned up Japanese medical supplies which were used solely for 
prisoners of war and enemy civilians. 
Tv-o months after the initiation of the Saipan invasion 
an Army military government program with Army hospitalization for 
500 had been set up in the civilian internment camp, but the first 
weeks were a most difficult period for the civilians who crowded the 
tiny military government sick bay at the rate of 950 a day. 
By 9 August 1944* Japanese military dead on Saipan totaled 
81, Alex C. Luna, "Military Government Duty", Hospital Corps 
Quarterly, Aug. 1945* P* 33 • 
42 23,811, while prisoners of war numbered 1,856. Many of those 
surrendering to *•*»<> American forces were fou«,a to be wounded. Most 
of the wounded Japanese military prisoners were evacuated to the 
ships for medical care, and as a result, they fared better than 
the civilians. Afore than half of the prisoners taken were Korean, 
while the remainder constituted about 4 percent of the total 
Japanese garrison on the island* 
The battle for Saipan was a difficult and costly one 
from a military as well as a medical viewpoint* It brought to 
light Navy medical needs and deficiencies, medical strengths and 
weaknesses. It made clear the need for more hospital facilities, 
and for a greater centralization of those facilities; for better 
organization of collecting stations, and for improvements in both 
the sea and air evacuation procedures* It highlighted the value 
of whole blood transfusion, the need for greater quantities of 
some medical supplies and smaller amounts of others, and the 
necessity of caring for large groups of enemy civilian wounded in 
future island campaigns—if only to protect our own troops from 
disease 'epidemics* 
The personnel performance of the medical staff was in 
most cases highly commendable, and personnel worked under trying 
82* Action Report, 2nd MarDiv, Saipan, p* 9* battle conditions for long periods. Saipan was to point the way 
to the later invasions, where Navy medicine was to profit by the 
experiences gained in this first battle of the Marianas* 
Section 2 - Tinian 
Then Saipan was finally secured, the American troops 
braced themselves for the next phase of the Marianas campaign - 
the conquest of Tinian, thirteen-mile-long neighbor of Saipan. 
Tinian, an island of volcanic origin, had a civilian population 
of over eleven thousand in addition to the heavy Japanese military 
garrison. 
The Fourth Marine Division, which was to spearhead the 
attack, was moved to a rest area on Magi cine Bay, Saipan, for 
seven days previous to the invasion date. Here the medical de- 
partment screened the troops as well as possible to remove 
individuals operating with hitherto undetected wounds or disease. 
Transfers were made among medical personnel to balance the depleted 
strength of the madical battalions, and the medical dumps opened 
their bales to supply drugs and bandages on the basis of a 2^-^C 
8 3 
percent casualty expectancy. 
The northern portion of the island was chosen for the 
attack, despite its narrow beaches flanked with six to eight feet 
83. Action Report, ComGen 4-th MarDiv, Tinian, p. 92* coral banks. The main Japanese defenses were concentrated around 
Tinian Town to the south, and the American artillery on Saipan 
had already pounded this area thoroughly. Supplies for the 
venture had been collected on Saipan except for petroleum pro- 
ducts and certain types of ammunition which were readily accessible 
on ships in the harbor. The greatest hazard was the weather, for 
the constant threat of the typhoon season hung over Tinian, and 
8ii 
huge breakers on the beaches might wreck the landing. Plans 
were laid to use planes for parachute delivery of supplies and 
evacuation of casualties if the necessity arose. 
Debarkation and Assault 
On the morning of 2/j. July, the boats set forth from 
Saipan carrying their tense loads over the two and one-half mile 
stretch of water to Tinian. Behind them were heard the reverberations 
of the heavy artillery pointed at Tinian Town; overhead the roar 
of American planes with '.bomb loads from Isely Field on Saipan dinned 
constantly. The troops, contrary to the Saipan experience, were 
able to gain the beachhead swiftly and progressed inland at a 
fairly rapid rate. This initial success made possible the estab- 
lishment of hospitals at an earlier date than in the previous 
campaign. The Second Marine Division which followed on the heels 
of the Fourth was advised that the beachhead was secure before it 
disembarked. 
84. Action Report, Com Task Force 52. capture of Tinian, p. 3« 
45 As at Saipan, company aid men v.ith their equipment were 
debarked directly with the attacking platoons. Battalion and 
regimental medical sections were debarked with their respective 
command posts. In the Fourth Marine Division, D Medical Company 
and a section of H and S company, Fourth Medical Battalion, landed 
on the afternoon of J-day while E Medical Company landed on J plus 
1. The companies were combined and prepared to s«t up and operate 
a division hospital by J plus 2. The hospital operated, however, 
as an emergency surgical unit only; All medical cases and 
ambulatory patients were evacuated directly to Saipan hospital 
facilities, and the surgical cases to Saipan or to hospital ships 
85 
as soon as they had convalesced sufficiently to be safe for moving. 
The Second-Marine Division set up hospital sections of 
D and E Medical Battalions on J plus 2, and the Division medical 
personnel were not called upon to man shore party evacuation 
posts. The collecting sections of both divisions functioned 
under control of the regimental surgeons, and there was a better 
organization and smoother operation of these units than at the 
Saipan beaches. This was in large part due to the relative ease 
in the securing of the beachhead and the early establishment of 
medical organization, but the disorganization of the Saipan beaches 
had taught a useful lesson as well* 
85* Action Report, ComGen 4th MarDiv, Tinian, p. 93* The landing of medical equipment functioned smoothly 
during the assault and debarkation phase. Each medical company 
had been equipped with two one-ton trucks, five jeep ambulances, 
and one reconnaissance jeep, and these, loaded with supplies, were 
landed successfully with their five-day supply. 
Evacuation 
The problem of evacuation at Tinian was much less 
difficult than that faced by the medical department at Saipan. The 
casualties were considerably lighter, and at no time were beaches 
crowded with waiting wounded. After the fourth day, the rise of 
high seas made it impossible to evacuate by water, and air 
evacuation was instituted. Another valuable asset to the medical 
department was the American hospital facilities on nearby Saipan 
to which casualties could be evacuated. This did not necessitate 
a total reliance upon transport and hog:, ital ships as had been the 
case at Saipan. 
The evacuation plant at Tinian hod provided for initial 
evacuation to the transports via LCVP's, and a transfer area was 
charted close to the beaches for the shifting of the casualties 
86 
from the amphibious vehicles to the LCVP's. The establishment 
of a pontoon causeway pier on J plus 1 to Beach White One permitted 
the embarkation of casualties directly to LCVP's without the 
necessity of further transfers in amphibious vehicles. The trans- 
86. Action Report, Com Task Force 52* Tinian, pp. 52-53* ports then shifted the more serious casualties to the USS RELIEF 
or USS TRYON which were anchored off Saipan, while the less 
serious casualties were landed on Saipan and cared for by the 
facilities of the field hospital there* During the campaign 
the plan was modified to allow the evacuation of White casualties 
directly to Saipan, thus eliminating th* intermediary step of 
the transports-. 
Little overcrowding of the transports occurred, and 
8? 
in nearly all cases prompt and efficacious treatment was possible. 
An increased number of jeep ambulances had been made .available 
for the Tinian operation, and they were able to operate with 
great success on the well organized beachhead. As the troops 
progressed inland, an excellent road net was established, and 
ambulance jeeps bumped down to the water in rapid sequence* At 
Tinian, the ambulances had been landed on the afternoon of J-day, 
a departure from the Saipan operation*. 
The outstanding feature of Tinian evacuation was the 
heavy dependence on air evacuation. It had been employed to a 
limited extent at Saipan, but with very unfavorable results, as 
no provision had been made to survey casualties for air transports 
or to care for them en route. With the advent of typhoon seas on 
I plus 2 making it impossible to evacuate by water after J plus 4 
87- Action Report, Com 1ST Flotilla 13» Tinian, pp* until the capture of Tinian Town ana. harbor on 1 August, air 
evaluation was the only practicable solution. The air evacuation 
unit was set up on Ushi Airfield, and the pregram wras put under 
the charge of a medical officer of the Second Marine Division* 
Approximately 1,580 casualties were evacuated by air to Saipan 
despite the hazardous winds hich blew over the islands. Arriving 
at Aslito Airfield on Saipan, the wounded were evacuated with 
dispatch to the corps hosital group at White Two w;here a system 
had been set up for processing the injured. They were sorted 
according to the nature and seriousness of their wounds and sent 
to either hospital ships and transports or to the corps hospitals 
88 
on land. 
A shortage of litters caused occasional delays in 
the otherwise well planned Tinian evacuation program, but the 
contrast with the evacuation melee at Saipan was marked. Better 
organization, swifter adaptation of facilities to immediate 
exigencies, and the helpful presence of a nearby friendly island 
contributed to the success of evacuation at Tinian. 
Hospitalizati on 
The hospital facilities set up on Tinian by the Second 
and Fourth Medical Battalions had a peak bed capacity of 1,250 
beds in the joint hospital. In addition, two portable LST's were 
88. Action Report, Transport Quartermaster, Tinian, p. 682* get UP ° i (’.ol -hril <a . Wn-t -tlipao cliU rxo-fc op-oiro-fc c L-Tt^er 
the fourth day because of the weather conditions. The rapid 
evacuation from Tinian prevented overcrowding of these facilities 
at any one time. The Tinian hospital, of course, was only an 
evacuation hospital and did not provide sustained core and treat- 
ment. .After the island was secured, the equipment and facilities 
of the Second and Fourth Medical Battalion hospital were turned 
over to the medical components of the garrison forces, and all 
but one company were withdrawn. Garrison hospitals served a 
primary need in the Pacific campaigns. As at Tinian, they were 
set up rapidly following island operations to prepare for the 
casualties of the next operation, which was frequently almost 
simultaneous with the last. 
Civilian hospitalization, as at Saipan, v;as inadequate 
to meet the flood of sick and wounded who came to the enclosures 
during and after the operation. A 100-bed G-6 unit for civilian 
use was scheduled os the second ship of the garrison supply. It 
was to have arrived on J plus 4 to 6 and have been completed by 
I plus 6 to 8. It arrived on J plus l6, so that the real burden 
for care of civilian casualties fell upon the medical companies 
of the assault divisions. These battalions did assume the task 
of civilian care, and with limited supply at their disposal, did 
an excellent job as far as they were able.®'* 
89. Ibid. , p. 684» A table of Tinian hospitalization appears 
in Appendix D. 
50 The nine-day struggle at Tinian resulted in 1,829 
American casualties, as opposed to 6,050 Japanese killed and 255 
captured. Of the American casualties, 290 died in action, 1,515 
90 
were wounded, and 2ip were listed as missing in action. Fifty- 
two medical personnel in the Fourth Division alone were injured. 
Persons put out of combat as a result of dengue, combat fatigue, 
dysentery, fungus infection, psychoneurosis and other illnesses 
came to well over a thousand in both divisions. In comparison 
with the total Saipan casualties of l6,525» however, casualties 
at Tinian were light. Medical planning for the Tinian operation 
had anticipated ]a rger numbers. 
The Tinian Off-Shore Struggle 
During the initial assault and bombardment of Tinian 
on 24 the enemy's shore batteries pounded the attacking 
line vessels heavily and scored a number of direct hits. The 
account of the USS COLORADO, which suffered 22 direct blows from 
the Japanese batteries, gives a vivid report of medical department 
performance in the battle afloat. The hits all landed within 
fifteen minutes, and the resulting conditions on the ship called 
forth the strenuous efforts of medical deportment personnel. 
One of the first hits Inded in the sick bay office, 
striking the senior medical officer with fragments, damaging 
90. Action Report, Com Joint Fxpedit. Forces, ComPhibForPacFlt., 
Tinian, p, 259• 
51 many facilities and putting the 32 beds temporarily out of use. 
Immediately after the first hit, all casualty collecting stations 
throughout the ship began functioning, but they were rapidly 
91 
swamped* The foundry on the galley deck level had been 
designated as a collecting station for wounded from the topside 
cress but it was so heavily damaged that it was rendered useless. 
The main galley nearby, with its ranges and large steel table, was 
quickly chosen as replacement, and to this were carried severely 
wounded stretcher cases for initial first-aid treatment and 
dressing. As casualties continued to pour in, they w:ere moved 
from collecting stations all over the ship to the large emergency 
v/ards on the second deck. Most of the injured came from the boat 
deck and other exposed parts of the ship*. 
Few intracranial injuries occurred, as most of the 
men were v/earing helmets. There were also relatively few- 
penetrating w/ounds of the abdomen. Hemorrhages, compound fractures 
of the extremities and soft tissue injuries presented the most 
numerous and severe problems. The treatment included control of 
bleeding, checking of shock, and splinting of fractures so that 
the patients could be transferred for definitive treatment. Burns 
were treated with large amounts of hc&atum and the men were left 
on stretchers or in bunks until transfer. Lacerated wounds of the 
91. Action Report, USS COLORADO, Guam-Tinicn, p. 104* 
52 soft tissues were dusted with sulfanilamide powder and bandaged.. 
No sutures could be performed, but corpsmen, dentists end doctors 
combined in the administration of plasma to control shock.. 
The account of personnel reaction to the emergency 
is interesting. "During all of the excitement of being hit, 
firing at the enemy, seeing mangled bodies and wounded shipmates", 
wrote the senior medical officer, "no one exhibited any 
hysterical reactions or maniacal tendencies, nor was there any 
unnecessary shouting at one another. Everyone seemed to rise 
to the occasion and performed his duty befitting a real Navy 
Man." Special commendation was given the hospital corpsmen 
sho behoved with "admirable calm" and were too busy aiding the 
wounded to become excited. So strong was the fighting spirit or 
sense of duty of some of the men at gun stations that cases were 
reported of critically injured personnel, with a hand or foot 
blown off, continuing to man their stations, with fatal results 
from loss of blood. 
At 1800 of that day, all serious and critical cases 
were transferred to the U3S TRYON at Saipan; the majority of the 
fifty-four severely injured were suffering with wounds of the 
lower extremities. Ninety-one moderately wounded remained. In 
all, during the fifteen minute period, the COLORADO sustained 
241 casualties, with 43 dead and missing. 
53 An analysis by the COLcoiu©©*- o* 
the lessons learned from the attack embodied the following 
conclusions; the number of expected casualties should never 
be underestimated; dispersion of medical materiel and men is 
essential; first-aid instruction is almost os important os 
gunnery drills; the importance of wearing identification tags 
should be stressed - many dead and wounded did not wear 
identification tags with resulting difficulties in identification; 
better medical records are needed; and preparation must be 
made for Alternate Casualty Collecting Stations, in case one or 
more is rendered useless* 
The Problem of Sanitation 
To a large extent the sanitary problems present at 
Tinian were a duplication of those experienced at Saipan, but 
evidence indicates that there was less sanitary control than 
92 
was exercised in the first Marianas campaign. This is 
attributed to an early reluctance of the unit commanders to 
designate sufficient personnel for on island sanitary organiza- 
tion. In addition, the sanitary supplies included in the 
original landing supply were soon exhausted, and no replacements 
were made available until eight days after the garrison forces 
arrived. The rapid advance into Tinien also hampered any program 
of early sanitation* 
92. .Action Report, Com V Phib. Corps, Tinian, p. 5* 
93* Memo from Capt. T. S. Carter to the Surgeon General, 27 
Sept. 1944* n* p* 
54 Tinian itself v;as a comparatively healthful place 
in pre-w/ar times, v;ith a moderate climate. No malaria or 
filariasis vectors v;ere present. However, many of the troops 
had been previously infected in other campaigns. Bacillary 
dysentery and dengue were endemic, with abundant carriers and 
vectors. Following the close of the Tinian campaign, increasing 
numbers of personnel were listed as ineffectives from enteric 
disease, arising basically from poor sanitary conditions. 
Mess halls went unscreened and flies, -nurtured by 
food debris, feces, and occasional corpses, made their way 
freely to the men's food. There were only ij.00 prefabricated 
flytraps on the entire island to keep them in check. Two thirty- 
gallon drums of sodium arsenite were available to the Second 
Marine Division, but the use of this had to be confined to the 
94 
heaps of enemy dead about the lake. So clouded was the 
island with insects that the commander of the USD TALLER, which 
was anchored in the harbor, reported the invasion of "vast hordes 
of local flies, of large size and amazing tenacity..(on which) 
95 
direct hits were necessary to discourage their activity." 
Eoth the planning and execution of sanitary measures 
in the Tinian campaign left something to be desired to meet 
94* Action Report, 2nd MorDiv., Tinian, Sect.VIII, p. 15? 
95* Action Report, USS TALLER, Tinian, p. 10. 
55 the high standards set by the Medical Corps as. a goal. 
Island Prisoners 
Japanese civilians and military personnel on 
Tinian hod been thoroughly drilled by Japanese propaganda to 
the belief that their surrender to the American forces would 
mean torture and death. A strong counter-propaganda movement 
was launched by American intelligence units, including the 
scattering of Japanese language leaflets by plane urging 
surrender and the use of loudspeaker trucks manned with per- 
sonnel who spoke Japanese travelling along the front lines. 
This counter-propaganda was believed to have been effective in 
96 
countermanning the Japanese indoctrination. 
A total of 10,676 civilians in various stages' of 
medical health were finally interned in the center of the island. 
Thirty-two percent of those treated died as a result of gun- 
shot rounds, while the remaining illnesses were attributed to 
tuberculosis, eye diseases, helminthic infections, tetanus, 
97 
pneumonia, gas gangrene, and malnutrition. 
The commanding general of the Fifth Amphibious Corps 
stated that "insufficient hospitalization facilities" for 
civilian wounded were present at Tinian, as at Saipan. This 
96. Action Report, 2nd MarDiv,, Tinian, Sect.V, p* 8* 
97* Memo of Captain Carter to the Surgeon General. 
56 was not due to bad planning on the part of the medical 
department, but for the most port upon exigencies of shipping 
priorities. During the critical period until civilian faci- 
lities verb "set- d i c a 1 baft aliens'"of the assault 
forces accepted the responsibility for the care of the civilians, 
and did a heroic job with the inadequate personnel and materials 
98 
at their disposal. 
It was recommended for future operations that if 
it was planned to core for the civilian populations, 0 well 
stocked dispensary unit having three times the supplies of a 
G-10 unit and staffed with two medical officers and eight 
hospital corpsmen for each 6,000 population be embarked with 
the assault forces. This should be landed as s on as the 
99 
tactical situation would allow. 
As time and additional shipping brought further 
medical supplies and personnel to Tinian, the civilian popu- 
lation began to realize that the Japanese propaganda was 
false. By the end of October 1945» dispensary treatments 
were being administered to the internees by the 0-6 dispen- 
saries. Volunteer native nurses were recruited and outfitted, 
100 
and proved quite effective. A good medical program had been 
98. Action Report, ComGen* V Phib Corps, Tinian, p. 5* 
99* Memo of Captain Carter to the Surgeon General, 
100, Excerpts from Medical Department Report, Medical Activities 
on Tinian, 1 Oct, through 31 Oct, 1944* PP* 28c-32c, 
Surgeon General's files. 
57 made available to the enemy civilians. 
The work of the Navy medical department at Tinian 
showed a marked improvement over earlier campaigns. Casualties 
were lighter than had been anticipated, so that the medical 
staff and its supplies and eouipment proved to be ample* The 
evacuation by sea, and especially by air, w.as handled more 
effectively than at Saipan and in the earlier Pacific campaigns. 
There were still shortages of litters and inadequate medical 
supplies for civilian needs. Occasionally, os a result of 
faulty distribution, there were insufficient supplies for 
101 
American wounded.* But the operation proved the effective- 
ness of the newly initiated use of a medical control vessel 
at the transfer point off the beaches. It is significant 
that in the few days between the Saipan and Tinian invasions 
the Medical Corps was able to adapt its plans to the situation 
and make valuable use of the mistakes and deficiencies of the 
Saipan campaign to improve medical core at Tinian, 
Section 3 - Guam 
The Guam campaign, although an integral part of 
the Marianas operation, was conducted on a separate basis from 
the Saipan-Tinian maneuver. Inasmuch as Guam was some hundred 
miles below Tinian and Saipan, a separate force, the Southern 
101. Action Report, ComTransDiv 7> Tinian, p. 17* 
58 Troops and Landing Force, v;as allocated the task of recapturing 
the former United States possession* 
The mounting area for the Guam attack forces was 
Guadalcanal and here were collected the units which were to 
moke up Task Group 5&*2, commanded by Maj. Gen. Roy S. Geiger, 
U3UC. W-day (invasion day) was set for 21 July, and the Guam 
102 
campaign in all was over by 10 August. Preparation for the 
assault was as careful and detailed os for Saipan and Tinian. 
Inter-ship medical conferences were held and supplies standardized 
as much as possible. The majority of the which embarked 
for Guam had participated in previous operations, and in 
general their medical departments were well indoctrinated in 
103 
Pacific island warfare. 
The Southern attack Forces had been designated as 
possible reinforcements for the Saipan campaign should events 
demand their use. Loaded on their ships, they vcited off the 
Saipan shores until 2Zj. June v.hen they were ordered to return 
to Eniwetok. On 14 July they reembarked for the Guam campaign 
and on 21 July arrived off the island in the early morning. H-hour 
was set for 0830. The Third Marine Division landed on the 
northern beaches between Adelup Point and the mouth of the Tatagua 
102. This Task Group included Corps Troops, III Phib Corps, 3 
MerDiv, Corps artillery, First provisional Marine Brigade, 
and the 9th and lipth Marine Defense Battalions. 
103* Action Report, Com Task Force 53* Guam, p. 163. 
59 River, while a second attack force stormed the southern beaches 
between ngat Village and Bangi Point. 
Relatively light beach resistance was met, largely 
because of the heavy bombardment by the assault ships previous 
to the landings, hs the American troops pushed inland, however, 
the Japanese fire took a heavier casualty toll. 
Medical hid on the Beaches 
Medical personnel ottrched to the Third Marine 
Division, First Provisional Brigade, and the other participating 
units were debarked from the transports in Higgens boats which 
carried them as as the coral reef. From there the men either 
waded ashore or clambered aboard DUKW’s and amphibian tractors 
which took them to the mainland. During the Guam campaign there 
was little delay in putting medical personnel and supplies ashore. 
The headquarters battalion of the Third Marine Division landed 
at H plus hours, complete with its he dically-locded jeep 
ambulance. The Third Medical Battalion reached the shore at 
H plus 11. Even malaria and epidemic control personnel were 
10|i 
debarked shortly after H plus 60. Individual corpsmen 
attached to each assault platoon and landing with the battle 
forces had, of course, preceded the medical units. 
Battalion aid stations were set up near the battalion 
104. hction Report, 3 MarDiv. , Guam, Enc. I, n. p. 
60 command posts end along tiie natural lines of drift, on roads 
and trails. The medical installations were forced to provide 
their own security, and in many instances this was difficult. 
ns much advantage as possible was taken of natural barriers, 
# 
trees, and bushes. To these, corpsmen added foxholes, sand- 
bag placements, and barbed wire. Guards were posted agcainst 
enemy infiltration at night. 
Of great value wrere the trained beach party 
medical sections from the ships. In many instances they acted 
as evacuation stations in conjunction i.ith the shore party 
medical sections. Others, during the early hours, established 
forward first-aid stations at the edge of the beaches. Those 
landing later on W-day, as did the USS TILLLiM P. BIDDLE 
medical beach party, found their most useful function in 
supplying already established units. The BIDDLE crev; consti- 
tuted itself a continuous supply center for aid stations near 
the line of fire and maintained a steady stream of stretchers, 
, 105 
plasma, bandages, and other medical supplies os colled for. 
Medical resupply on the beeches on the tdiole 
tves conducted efficiently. In the Third Marine Division, no 
serious shortage of essential equipment v;as reported from any 
106 
unit. The First Provisional Marine Brigade reported 
105. action Report, USS WILLI.il P. BIDDLE, Guam, p. 6. 
106. action Report, MarDiv, Guam, Enc. I. medical resupply to be satisfactory at all times, A ten-day 
supply of first-aid equipment was carried in with the early 
echelons of medical personnel. A neurosurgical unit with suction 
apparatus and coagulating machine was an itme felt desirable in 
107 
the early phases of the campaign by one medical unit. Beach 
party medical teems complained that the absence of lightproof 
dressing stations handicapped them in carrying on their work. 
Evacuation 
The evacuation story at Guam was different from that 
of either Tinian or Saipan. No air evacuation was used, entire 
reliance being placed upon sea facilities. Moreover, there 
were no serious weather hazards complicating the procedure as 
at Tinian. Guam casualties were only about two-fifths the 
number of the Saipan casualties; thus the beaches were never 
as heavily crowded as Saipan with wounded who had to wait long 
hours for evacuation and further medical attention. 
An especially valuable aspect of the evacuation at 
Guam v;as the use of specialized LST’s for medical and surgical 
evacuation. Two LST’s equipped v.ith surgical teams were set aside 
for surgical cases, while five LST's acted cs medical evacuation 
ships. Surgical ships were equipped with three sections; liaison teams, 
resuscitation teams, and surgical teams for, respectively, liaison 
107* Ibid. with the beach dressing stations, diagnosis of injuries and 
dispensing of initial shock treatment, and, finally, definitive 
surgical procedures. The medical ships were staffed with one 
medical officer and three corpsmen, and evacuated slightly 
wounded ambulatory casualties, neuropsychotic cases, those 
108 
ill with malaria, and other sick personnel. 
These emergency evacuation ships, os the LST's 
were known, proved to be of great worth in the integral scheme 
109 
of evacuation. Without the presence of a reef, the LST's 
would have been even more valuable as direct hospital evacua- 
tion ships. In many cases it was easier to take casualties 
directly out to close-lying transports in amphibious vehicles 
than to first route them via the!LST's. One of the surgical 
LST's was stationed over 6,000 yards from the beach during the 
early phases of the landing, and the coxswains of the LCVP's 
and LVP's, sometimes apprehensive of the medical condition of 
the casualty loads they carried, steered straight for the 
nearest transports. The LST was finally moved into a more 
110 
suitable position. The actual work done by the LST's in 
collecting and caring for the wounded until they could be 
transferred to transports or hospital ships, cannot be too 
highly commended. In reference to a recommendation that more 
108. Action Report, Task Unit 53?3«6, LST Group 15, Guam, p. 6. 
109. Action Report, ComTransDiv 4-* Guam, p. 31* 
110. Action Report, USS RINGOLD, Guam, p. 29- 
63 LST's, completely hospital equipped, be provided, the 
commander of the .amphibious Forces, U. S. Pacific Fleet, 
stated that troop handling and cargo capacity would be im- 
paired were this to be carried out. Admiral Turner, recogni- 
zing the injurious effects to casualties of numerous transfers, 
upheld hospital LST use in emergency only, but proposed more 
dependence upon the evacuating facilities of the for 
111 
normal evacuation purposes. Actually, the majority of the 581 
wounded who were evacuated on the USS SOLACE on W plus 5 had 
112 
been evacuated directly from the beach to the hospital ship. 
Despite orders that coxswains of unloading boats 
report to the control boat after unloading, many foiled to do 
so, and it was necessary to round up these vessels and escort 
them to the control boat so that they w;ould be available for 
113 
casualty carrying. 
Interesting observations were made during the Guam 
campaign regarding the adequacy of the various boats employed 
in the evacuation process. The DUKT's received the highest 
praise from almost all participating units, while LVT's were 
subject to criticism. Only two litter cases could be accommo- 
dated on each LVT* and no provision hod been no de for holding 
111. Second Endorsement to Action and Operation Report, 
ComTransDiv i|, Guam, pp. 2-3 • 
112. Action Report, Com Task Force 53» Guam. 
113. Report, USS LAMAR* p. 8. the litters in place. This meant that manual he ans had to 
be employed, a poor arrangement at best. Ambulatory casualties 
114 
often had to sit in precarious positions on the LVT’s. 
Some Marine units stated that although their jeep 
ambulances were not in good running condition, they were 
essentially satisfactory vehicles for land transportation of 
, . . ... " 115 
wounded, and more of them in better repcair would have been useful. 
The over-all picture of evacuation at Guam under 
battle conditions was an adequate one. Despite a rugged 
terrain over which wounded frequently had to be hand-carried 
for long distances and despite the shortages of land evacuation 
vehicles, all wounded were evacuated in a relatively short 
time, except those brought in at night. Less than an hour 
after the troops landed, casualties were being received aboard 
the APA’s* Because of the brevity of the campaign, all beach 
evacuation stations were discontinued after VJ plus 12 and all 
casualties were evacuated from the Corps Medical Battal ion in 
the southern area and from the Third Division Hospital in the 
northern area. 
Assault Force Hospitalization 
Two main hospitals for the assault forces were 
established in Guam. The Third Marine Division Field Hospital, 
114* Action Report, USS FAYETTE, Guam, p. 28, 
115. Action Report, Jrd MarDiv. , Enc. I. operated by two medical companies, was first set up two miles 
south of Agana in a narrow ravine. At Agana itself, use was made 
of the buildings of the pre-war U. S. Naval Hospital, some of which 
had been destroyed by the naval bombardment, and all' of which had 
been damaged. Forty-eight hours after the capture of Agana, bull- 
dozers were at work clearing out debris. A short time later the 
Third Division Field Hospital moved into the old tuberculosis 
building, an adjacent galley, and a portion of the hospital corpsraen 
quarters. This was safer and easier to defend than the Division's 
earlier quarters in the ravine, which had already been the object 
of one early morning Japanese infiltration. Doctors, corpsmen, and 
ambulatory patients had held off the Japanese until reinforcements 
of nearby Marines arrived and routed the enemy after a four-hour 
struggle. 
On the southern beaches the commanding officer of the 
Third Corps Medical Battalion went fcjjhore on YJ plus 2 to reconnoiter 
for a location. Although he was advised by Brigade Four not to land 
the medical battalion until a more suitable area could be provided, 
all medical personnel were landed on the narrow beachhead that 
afternoon. They were forced to dig in and establish themselves in 
a small area where a single, well-placed Japanese bomb could have 
wiped them out. For three nights medical personnel were crowded 
into this tiny area, but on W plus 5 they were able to set up a 
field hospital one mile north of Agat. Two hundred fifty beds were 
66 set up, complete with operating rooms, X-ray, laboratories, dental 
facilities, and other necessary offices. On W plus 7, the facility 
was opened and received military and civilian patients. Over 250 
additional cots were provided daily obtaining a maximum space of 
, „ ll6 
1,250 beds. 
Both hospitals operated satisfactorily during the 
campaign. A notable handicap occurred in feeding of patients due 
to a lack of mess gear. Conditions were primitive in comparison 
with a smoothly running shore establishment, but the wounded 
received definitive treatment and were adequately hospitalized 
until it was possible to move them iro more complete facilities. 
Casualties 
The preliminary heavy naval and air bombardment no 
doubt reduced the number of American casualties at Guam and materially 
increased the Japanese toll. The Third Marine Division alone 
buried 6,553 enemy dead, and it v;os estimated that another 2,000 
remained to be buried in the Division’s twenty mile zone of action. 
In return the Japanese killed 620 men of this Division and wounded 
2,924. Sixty-five were missing in action^which brought the total to 
3,609 for the Third Division. 
In all, 1,289 Americans died at Guam, 5»648 were wounded 
ll6. Action Report, Commander III Phib Corps, Marianas, p. 158. in action and 148 listed as missing action. Next to the Third 
Marines, the 77th Infantry Division, USA, lost the greatest 
numbers - 405 killed, 1,744 wounded and 51 missing. In the First 
Provisional Marine Brigade, 191 were killed in action, 704 wounded, 
and 20 missing. The Third Amphibious Corps Artillery suffered only 
4 deaths and 12 wounded, but the Corps Troops lost 69 killed, 264 
wounded and 12 missing. 
Casualties among medical personnel were rather high, 
117 
in some units, and replacements were insufficient. Medical 
personnel of other units, however, were unharmed and were able 
to function at Table of Organization strength. 
Sanitation 
The problem of sanitation in Tacific Island areas had 
necessitated much Medical Deportment research and planning. For 
the Guam campaign, however, the Navy had the advantage of an 
intimate knowledge of the island and its nealth and sanitation problems* 
All medical and sanitary care on Guam had been under the supervision 
of the Navy Medical Department before the.war, and some of those 
who returned to the island in the American invasion had formerly 
worked \ ith these problems on Guam*. 
The entire Marianas, it was known, were free of the 
malaria-bearing anopheles mosquito, but the aedes aegypti mosquito, 
117* Action Report, 3rd MarDiv, , Guam, 
68 transmitter of dengue fever and potential vector of yellow’ fever, 
was abundant. The crab louse, tick, and mite were inhabitants 
118 
of Guam, but were not known to be disease transmitting. The 
house fly, transmitter of enteric diseases, was also an unwelcome 
occupant. 
General sanitary and medical conditions on the islands 
even before the Japanese seizure were not admirable. Congested 
native quarters, especially in Agana, were rampant with fly-breeding 
119 
filth. Overcrowding favored the wide dissemination of tuber- 
culosis, the leading single cause of death in Guam. Some 
progress had been mode in reducing the incidence of yaws, leprosy, 
worms, and introduction of typhoid vaccination and courses in -' 
elementary hygiene. 
While sanitary conditions had been bettered under 
U. S. naval administration before the war, there had been a need 
for larger appropriations and trained personnel to bring adequate 
sanitation to Guam, In 1939 the commandant of the naval station 
had reported: 
Except for inadequate and piecemeal expenditures of 
local government funds, no general approach has been 
cade in preventive measures in safeguarding health 
of naval personnel stationed in Guam. Such semblance 
to modern living conditions as do exist today in the 
housing of naval personnel has been brought about by 
improvements in living quarters made at the expense 
of the individual. 121 
118. War Department Bulletin, 23 June 1944* P* 3« 
119. Annual Sanitary Report, U. S. Naval Station, Guam, 1939* P« 19- 
120. Annual Sanitary Report, U. S. Naval Station, Guam, 1940* P« 
121. Action Report, U. S. Naval Station, Guam, 1939* 
69 One of the most important sanitation factors on the 
island was that of providing a safe water supply. Troops going 
into Guam were warned that all water was unsafe until proved 
otherwise. No natural purification of the island's water supply 
could be provided by the thin soil cover, the permeable lime- 
122 
stone and the volcanic rock formation. What sewerage there 
was did not operate satisfactorily because many of the systems 
were below' sea level, preventing adequate flushing into the sea. 
This was especially true of interior regions. As early as W plus 
2, purification units were placed in operation. These were 
increased in number, as conditions permitted, at all accessable 
water points. Sufficient water supply equipment had been provided 
for the operation, but because of a lack of spare parts and 
extensive use of the equipment aboard ship before the landings, 
123 
much of the gear was in poor condition. 
General sanitary measures were carried out as well as 
possible under battle conditions. Especial attention was paid 
to the cleaning away of debris around comp areas and to the 
location and proper construction of heads. Fly-proofed, and screened 
latrines in the Third Amphibious Corps were not supplied os early 
as in the Third Marine Division. Scarcity of water made bathing 
"difficult if not impossible for the mea" except when rain 
water was available. 
122. War Department Bulletin, 23 June 1944* 
123* Action Report, 3rc* MarDiv. , Guam, Enc. F, p. 7. 
I24. Ibid., Enc. I. 
70 Galleys were supervised at all times, although combat diffi- 
culties hampered the sterilization of mess gear. It was 
possible, however, for the commanding officer of the Third 
Marine Division to report that "sanitation was basic and in 
125 
general good." 
Related to sanitation was the problem of burial of 
the dead. American dead received burial in the Third Marine 
Division cemetery commencing on 17 plus 2, with few lags in 
the burial program. Enemy dead handled by this unit were sprayed 
with 2 percent sodium arsenite and buried as rapidly as possible - 
for the most part in shell holes. Native labor proved valuable in 
this task after the early combat stage was over. The First 
Provisional Marine Brigade did not have a supply of sodium 
arsenite available until after the need for it has passed, but 
the brigade buried the dead as ouickly as the military situation 
... , 126 
permitted. 
It is interesting to note that medical and sanitation 
factors were not felt to have had much effect upon the outcome 
of the operation as far as the enemy was concerned. Tropical 
attrition, enteritis, and dengue seemed to have had far less 
effect upon the Japanese forces than in the Bismarks, Solomons, 
]25. Ibid. 
126. Action Report, First provisional Marine Brigade, Marianas, 
P* 34* 
71 127 
and New Guinea, where medical factors operated in our favor. 
Neither were sanitary factors so significant as to affect 
American: Porees seriously during the relatively brief course of 
the campaign. Once the island was secured, it was a much 
easier matter to effect the proper establishment of sanitary 
conditions on Guam. 
problems of Civilian Care 
In 194° * the total native population of Guam was 23,348. 
The people were of mixed blood, largely Chamorro, with some 
Spanish. Following the conquest of their island by the Japanese, 
the natives were reasonably well treated at first, but from the 
spring of 1944 on, Japanese treatment had become harsher. Many 
were driven from their homes to provide shelter for the reinforce- 
ments augumenting the island garrison, and then were obliged to 
live in caves and in the woods. They were made to provide forced 
labor for the Japanese, and food was withheld from them if they 
refused to work. With this background of inadequate food, in- 
sufficient shelter, bad water and sanitation, and overwork, the 
health of the native population had greatly deteriorated by the 
time of the American reoccupation. ” Moreover, the heavy bombard- 
ment of the island had destroyed a large percentage of native 
dwellings, especially in Agana, and wounded many hundreds of the 
natives. Navy medicine had a serious problem on its hands to care 
127. Action Report, Com III Phib Corps, Marianas, p. 78. 
128. Ibid., p. 77. 
72 for Guam's civilians. 
As at Saipan the provision of medical 
_lVriTo lor civilians through the medical staffs of combat 
ou.|. J 
units had been disapproved, and none were embarked for the 
campaign. Unfortunately no medical supplies for civilians hod 
been provided for by Civilian Affairs, the Garrison Force, or 
the Island Command during the assault phase, and thus the 
medical personnel v;ere forced to makeshift with whatever they could 
obtain. The USS BOUNTIFUL was able to supply the essential items 
of a 101.-bed hospital, and the 77th Army Division loanded several 
wall tents to the Third Amphibious Corps to set up some facility 
129 
for the civilian injured and seriously ill. 
Large dependence was placed upon the use of captured 
Japanese medical supplies in treating the Guam civilians, but this 
was hampered by the widespread "pilfering" of valuable Japanese 
medicines, supplies, and instruments by Navy medical officers 
130 
from ships. Much unnecessary ruination and spoilage of 
bandages and medicines was incurred by the wholesale looting. 
Another medical facility for civilians was set up by 
two medical officers of the Civilian Affairs group and seven 
hospital corpsmen furnished by the Garrison Force commander. 
129. Ibid., p. 55- 
130. Action Report, Con III Phib Corps, Marianas, p. 6l. 
73 Twenty volunteer native nurses assisted in the work. A native 
doctor also operated a civilian camp at Yona, performing very 
creditable service under the most primitive conditions. 
The "comments and recommendations" sections of the 
Guam action reports reveal the strengths and weaknesses of the 
campaign. Commander Task Force 53 noted the failure of many 
ships to fly the Mike flag to indicate their ability to receive 
1 
casualties. As a result, the numbers of wounded evacuated to 
the individual ships were disproportionate. The use of additional 
temporary medical personnel in the assault operation was praised, 
131 
however. A need for posting guards, preferably medical 
personnel, over medical property was expressed by the commander 
of the Third Amphibious Corps. In future campaigns, it was 
recommended that field hospitals be retained aboard ships until 
"sufficient beachhead has been secured and a suitable location 
132 
for their installations been determined.0 Sufficient cots, 
tents, blankets and medical supplies, it was felt, should be 
provided during the assault phase to care for civilian patients. 
The Third Marine Division received commendation for the excellent 
sanitary control measures it had put into operation,, and the 
133 
resulting low incidence of dysentery in this unit. 
131- Action Report, USS ILLIAM P» BIDDLE, Guam; Action Report, 
ComTransDiv 8, Saipan-Guom. 
132. Action Report, III Phib Corps, Marianos, p. l6l. 
133« Ibid. 
74 The entire Marianas campaign represented a medical 
improvement over earlier Pacific campaigns. In view of the 
staggering problems of supply and organization, fanatical enemy 
resistance, and the character of the islands on which the 
fighting took place, the Navy Medical Department's work 
in the Marianas theatre was commendable. Uhereos the individual 
phases of the campaign left something to be desired, the over-all 
picture was a satisfactory one. Reports on the Marianas 
campaign indicated ways of improving conditions and achieving 
better medical core for personnel participating in amphibious 
warfare. Unit commanders, group commanders, medical personnel 
and line officers offered frequent criticism in their reports,but 
only with the wish of eliminating as much suffering as possible 
from the horrors of war. Later campaigns were to prove the 
value of experience in the Marianos, 
75 APPENDIX A 
MR LANAS EVACUATION FIGURES 
Action Report Headquarters 
Expeditionary Troops, Task 
Force 56, Marianas, 2 
October 1944, p. 474- 
A. Saipan and Tinian: 
1. Hospital Ships. 
Bountiful (1st trip) 526 
(2nd trip) 522 
Solace (1st trip) 570 
(2nd trip) 543 
Samaritan (1st trip) 705 
(2nd trip) 505 
Relief (1st trip) 601 
(2nd trip) 680 
(3rd trip) _ 384 _ 
TOTAL 5,036 
2. Transports. 5,110 
3. Air. _ i,Q53 _ 
TOTAL 11,199 
B. Guam: 
1. Hospital Ships. 
Solace (1st trip) 531 
(2nd trip) 500 (approximate) 
Bountiful (1st trip) _ 551 
TOTAL. r,632 
2. Transports. 2,552 
3. Air. _ _ _0_ 
TOTAL....................4,184 APPENDIX A 
MARIANAS EVACUATION FIGURES 
Action Report Headquarters 
Expeditionary Troops, Task 
Force 56, Marianas, 2 
October 1944> P« 474. 
C. Mr. rianas Sunr.ia ry: 
Hosp. Ships 
Transports 
Air 
TOTAL 
Saipan and Tinian 5,036 
5,110 
1,053 
11,199, 
Guam 1,632 
2,552 
0 
4,184 
GRAND TOTAL 6,668 
7,662 
1,053 
15,383 APPENDIX B 
STANDARD BLOCK MEDICAL SUPPLIES 
(3,000 Men for 30 Days) 
Action Report Headquarters 
Expeditionary Troops Task 
Force 56, Marianas, 2 Octo- 
ber 1944* p. 476. 
Item 
Stock 
No. 
No. 
Item 
Unit 
Required 
CUSS 1 - SUPPLIES (EXPENDABLE 
DRUGS, CHEMICALS AND BIOLCGICAIS). 
1 
1-110 
ALCOHOL, i - ga. tin 
tin 
30 
'2 
1-170 
BISMUTH SUBCARBONATE, 1-lb. 
ctn 
7 
carton 
3 
1-175 
BISMUTH SUB NITRATE, i-lb. 
bottle 
bot 
30 
4 
1-185 
CALAMINE, PREPARED, i-lb. 
carton 
ctn 
10 
5 
1-325 
ETHER, i-lb. tin 
tin 
60 
6 
1-495 
MORPHINE TARTRATE, 0.032, gm., 
lice tube u/stcrilc needle, 
t in pkg. 
syrette 
500 
7 
1-575 
PETROLATUM, LIQUID, 1-qt., tin 
tin 
75 
8 
1-585 
PETROUTUM, WHITE. 1-qt., can 
SODIUM CITRATE, 2ffo SOLUTION, 
can 
60 
9 
1-775 
50 cc ampul, 6 in box 
box 
30 
10 
1-930 
EMETINE HYDROCHLORIDE, 0.021 
gm. 20 in tube 
tube 
18 
11 
1-980 
ACID, ACETYLSALICYLIC, 0.324 
gm. 1000 in bottle 
bot 
30 
12 
1-995 
CODEINE SULFATE, 0.0162 gm. 
100 in bottle 
bot 
30 
13 
1-1064 
QUININE, 1000 in bottle 
bot 
36 
14 
1-1085 
SODIUM CHLORIDE, O.648 gm. 
5000 in bottle 
bot 
30 
15 
1-1200 
TINCTURE OF OPIUM, CAMPHORATED, 
1-pt.' bottlo 
bot 
60 ' IWl I v 
(Coni *d) 
APPENDIX B 
STANDARD BLOCK MEDICAL SUPPLIES 
(3,000 Men for 30 Days) 
Action Report Headquarters 
Expeditionary Troops Task 
Force 56 Marianas, 2 
October 1944, p. 476. 
CLASS 2 - SUPPLIES (EXPENDABLE) SURGICAL 
16 
2-090 
BANDAGE, gauze-, 2-inch 
doz 
60 
17 
2-095 
BANDAGE, gauze, 3-inch 
doz 
60 
18 
2-105 
BANDAGE, gauze, compressed, 
2-inch one 
one 
300 
19 
2-110 
BANDAGE, gauze, compressed, 
3-inch, one 
one 
900 
20 
2-345 
COTTON, absorbent, 1-lb. roll 
roll 
30 
21 
2-350 
COTTON, absorbent, compressed, 
1-oz. pkg. 
Pkg 
210 
22 
2-355 
CRINOLINE, 36-inches wide, 
100 yd bolt 
bolt 
3 
23 
2-390 
DRESSING, battle, large, one 
one 
600 
24 
2-395 
DRESSING, battle, ran11, one 
one 
900 
25 
2-425 
GAUZE, plain, 26 yd. roll 
roll 
30 
26 
2-545 
MUSLIN, yard 
yd 
300 
27 
2-835 
PLASTER, ADHESIVE, 2-in. by 
5 yds., spool 
spl 
12 
28 
2-840 
PLASTER, ADHESIVE, 12-in. by 
- 
5yds., roll 
roll 
30 
29 
2-845 
PIASTER OF PARIS, 25-lb tin 
tin 
3 
30 
2-925 
SPLINT, arm, hinged ring 
one 
10 
31 
2-940 
SPLINT, log, ha.If ring 
one 
30 
32 
2-950 
SPLINT, strap, adjustable, 
traction 
one 
40 
33 
2-955 
SPLINT, strap and buckle 
one 
40 
34 
2-960 
SPLINT, SUPPORT AND FOOT REST, 
combination 
one 
60 
CLASS 6 - EQUIPMENT (NON-EXPENDABLE) 
HOSPITAL AND NURSING 
35 
6-145 
LITTER, metal pole 
one 
20 (Cont'd) 
APPENDIX B 
STANDARD BLOCK LEDIGAL SUPPLIES 
(3,000 Men for 30 Days) 
Action Report Headquarters 
Expeditonory Troops Task 
Force 56 Marianas, 2 
October 19AA, p. A76. 
CUSS 13 - SUPPLIES (EXPENDABLE) FIELD 
36 
13-095 
FOOT POWDER, in 4-oz. sifter top 
tin 
tin 
300 
37 
13-175 
SOAP, hand, cake 
cake 
60 
38 
13-200 
TAG, diagnosis, 25 in book 
book 
30 
39 
13-215 
TINCTURE GREEN SOAP, 3-oz, bottle 
in cont. 
cont 
30 
40 
13-225 
ZINC OXIDE OINTMENT, 1-oz. tube 
tube 
60 
CUSS SI - SUPPLIES (EXPENDABLE) DRUGS 
CHEMICALS AND BIOLCGICALS 
41 
S1-070 
ATABRINE, DIHYDROCHLCRIDE 
amp 
500 
42 
Sl-1000 
GAS GANGRENE ANTITOXIN, conbines 
syringe 
60 
43 
S1-2080 
TETANUS GAS GANGRENE ANTITOXIN, 
combine 
syringe 
30 
74 
Sl-2650 
HYDROGEN PEROXIDE, S% 
bot 
15 
45 
Sl-3260 
NEO-SYNEFHRIN HYDROCHLORIDE 1% 
sol. NNR 4oz* bottle 
bot 
6 
46 
Sl-3280 
NLO-SYNEPHRIN HYDROCHLORIDE 1R sol. 
vial 
7 
47 
Sl-3361 
OINTIIENT, BAL 
tube 
300 
48 
Sl-3365 
OINTMENT, Butyn Ophthalmic, 2% 
tube 
60* 
49 
Sl-3375 
OINTMENT , PROTECTIVE, 3oz. tube 
tube 
300 
50 
Sl-3440 
PENT?. OB A RB IT A L SODIUM, 500 in 
bottle 
bot 
1 
51 
Sl-3450 
PENTOTHAL SODIUM 
amp 
150 
52 
Sl-3530 
PUSMA, normal human, dried, 250cc 
Pkg 
720 
OR 
Sl-3531 
PLASMA, normal human, dried, 500cc 
Pkg 
360 
53 
Sl-3670 
QUININE DIHYDROCHLCRIDE 
amp 
150 
54 
Sl-3733 
SODIUM SULFADIZINE 
vial 
25 
55 
Sl-3790 
SOLUTION, dextrose, 5% in Normal 
Saline, 1000 cc container, 
6 in pkg 
case 
24 
56 
Sl-3810 
SULFANILZMIDE, PONDERED, i-lb 
bot 
30 
57 
Sl-3813 
SULFANILZMIDE, POWDERED, 5 gm.25- 
Pkg. 
Pkg 
120 
58 
Sl-3991 
BENZIDRINE SULPHATE, 6 in pkg 
Pkg 
200 (Coni’d) 
APPENDIX B 
i 
STANDARD BLOCK MEDICAL SUPPLIES 
(3,000 Men for 30 Days) 
Action Report Headquarters 
Expeditionary Troops Task 
Force 56 Marianas, 2 October 
1944, p. 476. 
59 
SI-4011 
APC - 100 in bottle 
• 
bot 
30 
60 
Sl-4021 
ATABRINE - 1000 in bottle 
bot 
30 
61 
Sl-4060 
CAREASONE 0.25 gm. 20 in bottle 
bot 
ISO 
62 
Sl-4335 
SULFADIZINE, 0.5 g% 500 in 
bottle 
bot 
30 
63 
Sl-4337 
SULFAGUANADINE, 0.5 gm. 1000 in 
bottle 
bot 
30 
64 
S1-4340 
SULFANILAMIDE, 0.324 gm. 1000 in 
bottle 
bot 
10 
65 
SI-43^0 
SULFATHIAZ0LE, 0.5 gm. 500 in 
bottle 
bot 
60 
66 
Sl-4633 
VITAMINS, multiple 100 in bottle 
bot 
300 
CLASS S2 - SUPPLIES (EXPENDABLE) SURGICA 
L 
67 
S2-1550 
SHEET WADDING 32" x 6 yds piece 
24 pkg 
2 
CLASS S13 - SUPPLIES (EXPENDABLE) FIELD 
68 
S13-450 
INSECT REPELLENT, liquid 
2-oz bot 
6000 
69 
S13-451 
INSECTICIDE POWDER 
11 
1500 APPENDIX C 
TINIAN HOSPITALIZATION ASHORE 
Action Report Transport 
Quartermaster's Report, 
Tinian, 10 August 1944, 
p. 686. 
2nd 
MARDIV 
4th MARDIV 
DATE 
(2 Med Co. »s) 
(2 lied 
Co. ’s) 
TOTALS 
Cap. 
Occ. 
Cap. 
Occ. 
Cap. 
Occ. 
JIG-Day) 
July 24) 
j/i - 25 
Date 
x not 
Data 
not 
Data 
not 
2-26 
available 
aval 
.lable 
available 
3-27 
for 
this 
for 
this 
for 
this 
4 - 28 
period. 
period. 
period. 
5-29 
6-30 
280 
133 
60 
20 
340 
153 
7-31 
325 
201 
76 
9 
401 
210 
Aug. 1 
336 
276* 
76* 
76* 
412* 
352* 
J/9 - 2 
337* 
181 
66 
14 
403 
195 
10-3 
325 
76 
35 
14 
360 
90 
11-4 
162 
76 
35 
10 
197 
86 
12-5 
155 
80 
50 
46 
200 
126 
13 - 6 
155 
92 
50 
42 
205 
134 
14-7 
155 
71 
50 
25 
205 
96 
15-8 
155 
S3 
155 
S3 
16-9 
155 
87 
155 
87 
17 - 10 
155 
107 
155 
107 
18 - 11 
155 
137 
155 
137 
* Denotes peaks. 
NOTE: Control of 
' 2nd 
MarDiv passed to 
IsCon on 10 August 1944. THE MARIANAS 
BIBLIOGRAPHY 
Action Reports - Ships 
USS ALI.IAACK, Participation in Invasion of Saipan, 27 Juno 1944. 
USS APPALACHIAN, Amphibious Operation for the Capture of Guam, 19 
August 1944. 
USS BILOXI, Covering the Period 16-17 February 1944? dated 23 
February 1944. 
USS BIRMINGHAM, Saipan, 14-17 June 1944, n. d. 
USS BIRMINGHAM, Bombardment of Tinian and Aguijan Islands, 26 June- 
6 July 1944, dated 22 July 1944* 
USS BOLIVAR, Saipan 15-22 June 1944, dated 2 July 1944. 
USS BOLIVAR, Guam, 22 July-29 July 1944, dated 2 August 1944. 
USS BUNKER HILL, Covering the Period 6-27 June 1944, Marianas Action, 
13 July 1944. 
USS CALIFORNIA, Participation in Operations off Saipan, 14-22 June 
1944, dated 30 June 1944. 
USS CAVALIER, Saipan-Tinian Operation, 14 August 1944. 
USS CENTAURUS, Guam, 10 May-26 July 1944, dated 12 August 1944- 
USS COLORADO, Tinian Operation, 23-24 July 1944, dated 12 August 1944. 
USS COMET, Saipan Operation, 24 August 1944* 
USS DICKERSON, 14-21 July 1944, Guam, dated 28 July 1944. 
USS DOYAN, Guam 7-28 July 1944, dated 9 August 1944. 
USS DOYAN, Saipan Operation, 1 August 1944. 
USS ELECTRA, Marianas Operation, Saipan Phase, 20 August 1944. 
USS FAYETTE, Guam, 21-25 July 1944, dated 27 July 1944. 
1 USS FREDERICK FUNSTON, Guam Operation, 22-28 July 1944, dated 6 
August 1944. 
USS FREDERICK FUNSTON, Saipan Operations, 26 June 1944. 
USS GEORGE CLYMER, Assault Landing on Guam, 9 August 1944. 
USS HARRIS, Saipan Operation, 23 July 1944. 
USS JOHNSTON, Guam Operations, 12 August 1944. 
USS LAMAR, Amphibious Operation, Guam, 21 July 1944, dated 12 August 
1944. 
USS JOHN LAND, Tinian Operation, 24-25 July 1944, n. d. 
USS ARTHUR MIDDLETON, Report of Landing Phase Operation on Saipan 
Island, 30 June 1944. 
USS MONROVIA, Amphibious Assault on Guam, 7 August 1944. 
USS PIERCE, Saipan Operation, 17 July 1944* 
USS PRESIDENT ADAMS, Guam, 21-26 July 1944, dated 27 August 1944. 
USS RINGOLD, Guam Operations, 1 August 1944. 
USS SHERIDAN, Guam Operation, 1 August 1944. 
USS SOUTH DAKOTA, Anti-Aircraft Actions of 12, 15 and 19 June 1944, 
Operations in Support of Marianas Invasion, 26 June 1944* 
USS SUMPTER, Occupation Saipan, 28 June 1944* 
USS TENNESSEE, Report of Fire Support Delivered During Saipan Opera- 
tion, 30 June 1944. 
USS VIRGO, Guam, 10 May-26 July 1944, dated 30 July 1944. 
USS WALLER, Tinian Occupation, 24 July-1 August 1944, dated 10 August 
1944. 
USS WHARTON, Guam, 20--29 July 1944, dated 14 August 1944. 
USS WILLIAM P. BIDDLE, Guam Operations, 28 July 1944. 
USS WINDSOR, Guam, 12 June-23 July 1944, dated 26 July 1944. USS WINGED ARROW, Tinian, 15 July-20 July 1944, dated 1 August 19/4. 
Action Reports - Naval Task Organizations 
Commander LCT Flotilla 13, Tinian Operation, 17 September 1944. 
Commander LST Flotilla 13, Amphibious Report on Tinian, 7 August 1944* 
Commander Task Force 53 (Commander C-roup Three Amphibious Forces 
Pacific), Amphibious Operations for the Capture of Guam, 10 August 
1944. 
Commander Task Force 53, Guam Operations, 10 August 1944. 
Commander Task Force 58, Marianas, 11 Junc-10 August 1944, dated 11 
September 1944. 
Commander Task Force 52, Pictorial History of Capture and Occupation 
Tinian Island, Marianas, 24 July-1 August 1944. 
Commander Task Units 52.4.3- and 52.9.2., Occupation Saipan, 10 July 
1944. 
Commander Task Unit 53.3.6 (LST Group 15), Seizure of Guam, 30 July 
1944. 
Commander Transport Division 2, Guam, 8 May-30 July 1944, 3 August 
1944. 
Operation Report Commander Transport Division 4, Guam Attack, 8 
September 1944. 
Second Endorsement from Commander Amphibious Forces, U. S. Pacific on 
Action and Operation Report, Guam, of Commander Transport Division 
Four, 25 November 1944. 
Commander Transport Division Seven, Amphibious Operations, Tinian, 
1 August 1944. 
Commander Transport Division Eight, Comments, Observations and Recom- 
mendations, Guam Operation, 20 August 1944. 
Commander Transport Division Eight, Saipan-Guam Operations, 4 June- 
28 July 1944, dated 5 August 1944. 
Commander Transport Division 20 (CTG 52.1), Operation Against Saipan, 
30 June 1944. Commander Transport Division 32, Amphibious Forces, U. S. Pacific Fleet, 
Saipan Operations, 9 July 1944. 
Commander Transport Division 34, Observations, Comments and Recommen- 
dations, Marianas Operation, 3 August 1944. 
Commander Transport Group nAn (CTG 52.3), Saipan Operation During 
Period 15-22 June 1944, dated 1 July 1944. 
Action Reports - Land Forces 
Commander Amphibious Forces, U. S. Pacific Fleet, Occupation Saipan, 
1 October 1944. 
Comments and Remarks on Marianas Operation, Commander Amphibious Forces, 
U. S. Pacific Fleet, 5 March 1945. 
Commanding General Fifth Amphibious Corps, Marianas, Phase III, Tinian, 
12 August 1944. 
First Endorsement on Action Report Commander Fifth Amphibious Corps, 
Tinian Operation, 2 November 1944. 
First Provisional Marine Brigade, Operations and Special Action, 
Marianas Islands, 19 August 194-4. 
Commanding General Fourth Marine Division, Fleet Marine Force, Opera- 
tions Saipan, 18 September 1944• 
Commanding General Fourth Marine Division, Operations Tinian, 25 Septem- 
ber 1944. 
Commander Group One, Amphibious Forces, Pacific Fleet on Operations for 
the Capture of Saipan, 21 July 1944» 
Commander Group Tv/o, Amphibious Forces, U. S. Pacific Fleet, Saipan 
Operation, 23 August 1944. 
Commanding General Island Command Navy 3247, Marianas Island, Phase III, 
7 August 1944. 
Commander Joint Expeditionary Force, Commander Amphibious Forces, 
Pacific Fleet, Marianas Operations, 25 August 1944i 
Commanding General Northern Troops and Landing Force, Marianas Operation, 
Phase I, Saipan, 12 August 1944. 
Report of Transport Quartermaster to Commanding General Northern 
Troops and Landing Force, Marianas, Plia.se III, Tinian, 10 August 
1944. Operations Report Second Marine Division, Marianas Phase I, Saipan, 
11 October 1944- 
Second Marine Division, Marianas Phase III, Tinian, 7 September 1944. 
The Commanding General Third Amphibious Corps, Marianas Operations, 
3 September 1944. 
Special Action Report Third Marine Division, Fleet Marine Force in the 
Field, Forager (Marianas), 21 August 1944. 
Annual Sanitary Reports and Historial Supplements 
Historical Supplement to the Annual Sanitary Report, U. S. Naval Hos- 
pital Navy No. 10, Aioa Heights, Hawaii, 1944. 
Annual Sanitary Repor t- of the U. S. Naval Hospital, Guam, 1939. 
Annual Sanitary Report of th_ U. S. Naval Hospital, Guam, 1940. 
Annual Sanitary Report of the U. S. Naval Station, Guam, 1939. 
Annual Sanitary Report of the U. S. Naval Station, Guam, 1940. 
Historical Supplement to the Annual Sanitary Report, USS BOUNTIFUL, 
1944. 
Historical Supplement to the Annual Sanitary Report, USS RELIEF, 1944. 
Annual Sanitary Report of She USS RELIEF, 1944. 
Annual Sanitary Report cf 4no USS SAMARITAN, 1944. 
Annual Sanitary Repo-.a of no USS SOLACE, 1944. 
Historical Supplement to the Sanitary Report, USS SOLACE, 1944. 
Annual Sanitary Report for the Second Marine Division, Fleet Marine 
Force, 1944. 
Annual Sanitary Repo;:’: for the Fourth Marine Division, 1944. 
Materials from the Caa:t led Files of the Bureau of Medicine and 
Surgery 
Letter from Rear Admiral Sheldon to Fleet Medical Officer, U. S. 
Pacific Fleet, 10 August 1944. Letter from Fleet Medical Officer, U. S. Pacific Fleet, to Chief, 
of the Bureau of Medicine and Surgery, 6 September 1944. 
Letter from Vice Admiral Ross T Mcintire to Commander in Chief* of 
Naval Operations, United States Navy, 19 September 1944. 
Letter from Commander in Chief, U. S. Pacific Fleet, to Chief of 
Naval Operations, 21 December 1944. 
Letter from Admiral King to Vice Chief of Naval Operations, 6 January 
1945. 
Materials from the Private Files of the Surgeon General 
Letter from Admiral Chambers to Vico Admiral R. T Mcintire, 10 July 
1944. 
Letter from Capt. F. R. Hook to Vice Admiral R. T Mcintire, 23 August 
1944. 
Medical Department Report, Medical Activities on Tinian, 1 October 
through 31 October 1944. 
Memorandum from Vico Admiral R. T Mcintire to Captain LeGroen, 24 
August 1944. 
Memorandum to Vice Admiral R. T Mcintire from Capt. T. J. Carter, 
27 September 1944. 
Report to Vice Admiral Mcintire from Office of Commanding General, 
Headquarters United States Army Air Forces, Pacific Ocean 
Area, 28 November 1944. 
Published Materials - Books 
Allen, Percy F., od., Stcuartrs Handbook of the Pacific Islands: A 
Reliable Guide to All the Inhabited Islands of the Pacific Ocean, 
Australia: McCarron Steward and Co., Ltd., 1921. 
Jensen, Lt. Oliver, USNR, Carrier War. New York: Simon and Schuster, 
1945. Pamphlets 
Catalog of Amphibious Training. U, S. Atlantic Fleet. Washington, D.C.: 
Bureau of Naval Personnel Standards and Curriculum Division, 1944. 
* * 
King, Brnost j., Second Official Report to the Secretary of the Navy, 
Covering Combat Operations 1 March 1944-1 March 1945. Washington, 
D.C.: The United States News, 1945. 
Operation and Engagement Stars, Washington, D. C.: Bureau of Naval 
Personnel, NavPers 15632, 1945. 
Training Guide for Amphibious Medicine. Force Surgeonfs News Letter 
No. 4. Washington, D.C.: Bureau of Medicine and Surgery, 1944* 
Zimmerman, Captain J, L., The Second Marino Division. Washington, D.C.: 
USMC Historical Division, 24 September 1945. 
Articles 
Richards, Major Guy, USmCR, "Pacific Briefing", United States Naval 
Institute Proceedings, vol. 71, No. 504, February 1945. 
f ■* t 
\ 
"Medical and Sanitary Data on Guam", War Department Technical 
Bulletin, p. 4. 
7 TABLE OF CONTENTS 
THE CAROLINES 
Pages 
Section 1* The Southern Palaus 1-22 
Over-all Military Operations 2-3 
Medical Planning and Organization 3-4 
The Landings 4-5 
Evacuation 5-12 
Hospitalization 12-13 
Casualties 13-14 
Medical Supply 14-16 
The Medical Department and Civil Affairs 16-17 
Sanitation ■■ 17-22 
Section 2. The Ulithi Islands 22-23 
Section 3* The Caroline Battle Afloat 23-26 CHAPTER IX 
THE CAROLINES 
South of the Marianas there is spread over the Pacific a 
widely disseminated group of islands known as the Carolines, These, 
formerly called Spanish Micronesia, had been secured by Germany in 
1885, and had passed as mandates to Japan following the first World 
War. Largest and most heavily fortified of the Carolines, the great 
Japanese naval base of Truk, was by-passed in assault landings — 
though its striking power was nullified by air and carrier raids. 
The Carolines as a group, however, were a necessary step in the Navy’s 
stride across the Pacific to the Philippines and, eventually, to 
Japan. 
Section .1. The Southern Palaus / 
The first objective of the Caroline campaign was the Palau 
group, almost 1,200 miles west of Truk. Of these islands, Peleliu 
and Angaur in the southern section were selected for the major landings. 
In March of 1944 a heavy task force raid had delivered a powerful 
bombardment at the Palaus with material damage to the Japanese instal- 
1 
lations. September 15th was set as the invasion date for the first 
attack. Peleliu was the object, and the Third Amphibious Corps, with 
the First Marine Division and the 81st Army Infantry, was prepared 
1, Lt. Oliver Jensen, U3NR, Carrier War. p, 122, 
1 in Hawaii and the Russell Islands for the assault operation. 
Over-all Military Operations 
The conquest of the Carolines was considered with care, 
as the Japanese had had six months in which to strengthen their 
fortifications. Peleliu with its narrow coral reefed beaches had 
no harbor or even a suitable anchorage. In addition, the logistic 
support for any campaign against the Palaus presented great diffi- 
3 
culties. As scheduled, however, on the morning of the fifteenth, 
the assault troops of the First Marine Division landed on the 
Peleliu beaches. They had been immediately preceded by a heavy 
naval and air bombardment. A beachhead was secured fairly rapidly, 
although the Japanese had mined the approaches. In the beginning, 
little opposition was met, and by the night of 16 September the 
4 
American forces had captured the Peleliu airfield. In view of the 
sv/ift initial progress, the 81st Infantry Division, which had sup- 
ported the First Marines, was released for the capture of nearby 
Angaur. On 17 September the 81st Infantry landed on Angatfr,bomber 
airfield site of the Palaus. Calm seas permitted the landing of 
troops and supplies "with the precision approaching that of a 
training exercise." Opposition was light and organized resistance 
2. The Third Amphibious Corps was commanded by Maj. Gen. R. S. 
Geiger, USMC; The First Marine Division, by Maj. Gen. W. H. 
Rupertus, USMC; and the 81st Infantry Division, by Maj. Gen. 
Paul J. Meuller, USA. 
3, Action Report, Commander Amphibious Group V, Peleliu, p. 11. 
4-* Action Report, Commander Third Fleet, Seizure of the Southern 
Palaus, p. 8. had ceased by 20 September, 
Meanwhile the Peleliu operations had run into difficulties. 
To the rear of the beaches, on the north-south ’’backbone” of the 
■ 
island, were a series of tunnelled cave positions which the Japanese 
defended with tenacity. It was found virtually impossible to place 
artillery fire or direct bomb hits on these sites, and harassing 
sniper activities and infiltration moves hampered all movements of 
the American forces. On 23 September it became necessary to return 
a regimental combat team of the 81st Infantry Division to support 
the attack on the rooky, wooded, cave fortress. Flamethrowers, dem- 
olition teams and infantry assault gradully cleaned the area cave 
by cave, and on 30 September the Commander Task Force 32 announced 
the capture and occupation of the southern Palaus. Marine and in- 
fantry forces had secured adjacent small islands in the group, and 
although considerable mopping up of isolated units on both Peleliu 
5 
and Angaur remained to be done, the campaign was officially concluded. 
Medical Planning and Organization 
’’Medical planning”, stated the records, ’’was in accordance 
with directions from higher authority and with S.O.P., and based 
• 6 
upon experience gained in previous operations.” Medical companies 
were increased three to five percent above Table of Organization 
strength, Corpsmen for the infantry battalions were increased from 
32 to 40 per battalion, permitting the use of two men per platoon. 
5* Some resistance on Peleliu continued until 27 November* 
6. Action Report, 1st MarDiv, Palau Occupation, p. 112. In the First Marine Division, 32 men were assigned to each battalion 
as stretcher bearers. Such advanced assignment, it was found, had 
materially improved the morale of the fighting forces. 
With the First Marine Division were its regimental and 
battalion medical units supplemented by its medical battalion and 
a malaria control unit and sanitary organization. The 81st Infantry 
Division carried its own organic medical units to which were added 
7 
the 17th Field Hospital and the 41st Portable Surgical Hospital. 
The Landings 
The approaches and beaches to both Peleliu and Angaur had 
been heavily mined. In addition, at Angaur,, the Japanese had wedged 
projecting railroad ties into the coral bottom to prevent vehicular 
passage* Shortly before the landing, underwater demolition teams 
succeeded in clearing many of the mines. Other mines on both 
v 
Peleliu and Angaur fortunately proved to be inert. Bulldozers 
8 
landed early and successfully cleared away the remaining obstructions. 
It proved impossible to land the medical companies early, 
and casualties were treated in the beach evacuation centers manned 
chiefly by the medical beach parties from the transports. As in 
earlier operations, treatment consisted of emergency first aid, no 
7. Action Report, Commander III Phib Corps, Palaus, p, 125. 
8. An interesting medical aspect of the underwater demolition team 
was the successful use of three drops of 2 percent salicylic acid 
in tincture of merthiolate to prevent fungus infections in the 
ears of the swimmerr.. (Action Report, Commander Underwater 
Demolition Team. Augaur, p. 8.) definitive procedures being employed. On D plus 5, medical companies 
were able to land at Peleliu and sot up more extensive facilities. 
At Angaur, on Blue Beach, for example, medical beach 
parties from the USS SUMTER and the USS CALLOWAY divided the care 
and evacuation of casualties from 17 September to 21 September, when 
they were relieved by the Army shore party. During this period medi- 
cal personnel of the SUMTER and CALLOWAY operated two stations on 
the beach, and to these were brought the wounded from the more 
advanced areas. Close liaison was maintained between the two sta- 
tions , and temporary shortages of supplies at one were remedied 
by the other. Of the patients treated by the medical party of the 
SUMTER, less than half were incapacitated by direct enemy action. 
Accidental wound fragment cases, minor coral cuts, sunburn, chafed 
skin, sore feet, and other illnesses made up the remainder. The 
practice of setting up a can of water, cooled by burlap wet with 
sea water, and a bottle of salt tablets for the use of all persons 
9 
passing the station was found to be desirable. 
Evacuation 
During the early hours of both the Peleliu and .Angaur 
campaigns, the real arbiter of the efficiency of any "beach treatment" 
is the speed and skill with which casualties are evacuated. Angaur' 
evacuations were conducted more smoothly than those at Peleliu, but 
both were advancements on earlier campaigns. There were, of course, 
9, Action Report, USS SUMTER, -Angaur1, pp, 23-26f fovjor casualties at Angaur, permitting more time and individual care 
per casualty, in to-w* c-amoaignSj the medica nad improved 
its chain of evacuation to include the benefits of the Marianas ex- 
periences. 
The combination of Army and Marine forces provided another 
opportunity to observe the effectiveness of the various land evacua- 
tion vehicles used by the medical personnel of both organizations. 
The Army quarter-ton truck was found valuable for ambulance purposes 
10 
by both Army and Navy personnel. It was said to supply maximum 
comfort and least transportation shock to the patients. Similar con- 
sideration of the Army M29C semi-amphibious tracked vehicle resulted 
in the belief that mechanical imperfections and rough riding qualities 
minimized its value. The Dodge ambulance, however, had proved con- 
sistently to be the best all-round field ambulance. 
Land evacuation on both Angaur and Peleliu was rendered 
especially difficult by the rough terrain of the main combat zones. 
Rocky cliffs sometimes as high as one hundred feet necessitated the 
lowering of casualties in Stokes litters by means of ropes and pulleys. 
On the beaches, DUKW’s again were praised as the best am- 
phibious evacuation vehicle. A storm arose on Peleiu as the cam- 
paign progressed, and it was noted that when all other boats were 
unable to reach the beaches, DUKW’s ploughed through with supplies 
10, Action Report, Commanding General 81st Infantry Division, Angaur, 
p. 14-6; Action Report, Commander III Phib Corps, Palau, p, 126, and, on return trips, with casualties. Recommendations mnA* 
the Commander Third Fleet increased supplies of these vehicles 
be? made available for future operations in similar terrains. 
The amphibious vehicles were met at the reef by both LST’s 
and LCVP's for further transport to the APA’s and hospital ships. The 
LST’s were staffed with medical personnel. During the calm weather, 
use of a ramp at the Peleliu reef permitted LVT’s and LCVP’s to trans- 
fer casualties to the LST’s with a minimum of discomfort to the 
wounded. During the day, first aid was rendered aboard the LST’s 
after which the casualties were transferred to the transports for 
more definitive care. This, stated the commander of LST Flotilla 13 
at Peleliu, was the ’’most efficient (system of handling casualties) 
11 
yet seen in which LST’s were involved.” It would not have been 
practicable , however, he admitted, in any other than a smooth sea. 
During the night of the seventeenth LST 225 was designated as a 
casualty transfer ship for one of the beaches, and it was stationed 
1500 yards off the Peleliu shore- Over the bow was hung a blue light 
to identify the ship for the small boats bringing the casualties from 
the beach. This feature worked well at the Peleliu beaches, and 
12 
eliminated much confusion. 
11. Action Report, Com LST Flotilla 13, Peleliu, p. 5. 
12. Action Report, USS LST 225, Peleliu, p. 2. 
During the day transports and LST’s flew the Mike flag when they 
were able to take casualties aboard. Not all one LST’s were blue- 
lighted at night, and there are indications in the reports that 
considerable confusion in evacuation resulted off some beaches 
because of this absence of properly identified aid ships. 
USS MAINE, Peleliu p. 17. 
7 wriS achieved by establishing a medical 
officer at the reefls edge to determine the severity of injuries, 
furnish medical attention, and facilitate handling. These officers 
with their staffs were known as "Reef Beaeh Medical Sections" and 
13 
wore a new and valuable feature of the chain of evacuation. 
One of the most valuable vessels for the evacuation of 
casualties at Peleliu v/as the transport. Hospital ships were available 
on D plus 3, D plus 6, D plus 7 and D plus 9, but the transports 
played a major role in giving definitive treatment and evacuating 
during the periods the AH's were not present at the beaches. At 
Peleliu, less than an hour.after the troops made the initial landing, 
casualties were being received aboard the transports. The USS 
FAYETTE1s senior medical officer made an interesting survey to de- 
termine the time lapse between injury and receipt aboard the APA. 
One hundred casualty histories of those aboard the FAYETTE were 
picked at random and the time computed. Of these, four-fifths were 
wounded in the day time. Taking the interval between 0700 - 1900, 
the average length of time between the period of injury and receipt 
on board was 2 hours and 53 minutes; the shortest, 30 minutes; the 
longest, 13 hours. At night, the average lapse of time was 7 hours 
14 
and 17 minutes. 
Over-all statistics on the typos of casualties evacuated 
13* Action Report, USS FAYETTE, Caroline Campaign-Peleliu, p. 10; 
ComTransDiv 6, Pcleliu, p. 11. 
14. Action Report, USS FAYETTE, Pcleliu, p. 14. 
8 during the Peleliu or Angaur operations have not been compiled. 
Samplings, however, can be secured from the individual reports of 
APA*s present at the operations. The FAYETTE, classified its 302 
casualties as follows: 
Missile Wound 6Ltfo 
Blast 13% 
Other Injury 6% 
Heat Exhaustion 6% 
Neurosis 6% 
Sick 5% 
The majority of the missile wounds affected the upper extremities, 
14 percent being head wounds. 
Treatment aboard the evacuating transports was carried 
out by specialized teams. The use of whole blood transfusions was 
recorded again and again on board the transports. The USS LEONARD 
WOOD at Angaur, the USS WAYNE at Peleliu, the USS LEON at Angaur, the 
FAYETTE at Peleliu, and many other APA's cited the value of the whole 
blood transfusions. The FAYETTE had established a blood bank of 28 
quarts from volunteer "0" type donors, and drew over nine quarts more 
in cases where time permitted of cross matching. Supplies of penicillin 
were more ample then during the Marianas campaign and the transports 
15 
reported that it Y/as used in all "desirable1’ cases. 
In most instances, facilities of the transports seemed 
adequate except for the feature of poor ventilation of sick bay 
quarters. On the USS ORMSBY the temperature of the operating room 
varied from 98 to 102 degrees Fahrenheit. Medical officers on the 
15. Ibid.,p. 15. Also seo USS LEONARD WOOD, Angaur, p, 8; USS WAYNE, 
Peloliu, p. 25; USS ORMSBY, Peleliu, p. S. LEONARD WOOD found the samo difficulty. With the average temperature 
over 100 degrees the FAYETTE reported, "It is the opinion of the medi- 
cal officer that such temperatures are definitely detrimental to the 
progress of the patients confined, particularly when it is borne in 
mind that casualties are brought aboard in a state of extreme de- 
16 
hydration and fatigue." 
In addition to the evacuation facilities of the transports, 
four hospital ships were used in the Pcleliu-Angaur campaigns - the 
SAMARITAN, BOUNTIFUL, SOLACE and RELIEF. Despite the recommendations 
of the staff medical officer and surgeon of the Third Amphibious 
Corps that the ships arrive on D plus 2, D plus 4* D plus 5 and D plus 
7 respectively, the over-all plan provided for their arrival from one 
17 
to two days later. Post operation comments on the Palaus by the 
Commander Third Fleet contained the statement, "The early arrival of 
hospital ships is important to furnish better care of the wounded 
than can be provided on the AP’s, and they should be brought in at 
18 
the earliest practicable date." 
It is true that the majority of cases carried by the hos- 
pital ships had already been processed by the transports and other 
agencies. This limited the excellent facilities provided by the 
16. Action Report, USS FAYETTE, Poleliu, p. 16. 
17. Action Report, ComPhibGrp 5* Caroline Invasion, p. 227. 
18. Action Report, Commander Third Fleet, Palau Operation, p. 3. 
This was emphasized even more firmly by Com III Phib Corps who 
recommended that the AH’s arrive the afternoon of D-day. 
ao. AH* s and cast then primarily in the role of evacuation vessels and 
floating ambulances. On D plus 3 the USS SAMARITAN was loaded with 
607 processed cases from the transports, and she departed within 
seven hours of her arrival. The USS BOUNTIFUL, on D plus 6, picked 
up 550 processed cases in five hours and sailed out again. The 
USS SOLACE and USS RELIEF remained outside the Peleliu reef for 
19 
several days. On D plus 15 the RELIEF departed carrying 685 pa* 
tients, some of whom were fresh battle casualties. 
In the ten-day period before the medical companies were 
able to set up facilities on land, a total of 3,756 casualties were 
evacuated from Peleliu* Most of these had been carried by the trans- 
ports. At Angaur, the hospital facilities were set up earlier, on 
F plus 2, and much of the work done on the Peleliu transports v/as 
accomplished by the hospitals on Angaur before evacuation. A total 
of 5>554 casualties was evacuated from the Palau Islands via water 
and 258 more by air during the period 15 September to 14 October 
20 
1944. 
Reef conditions off the beaches of Peleliu had been as 
difficult a natural barrier to evacuation as any hitherto found. 
Yet the Commander of the Third Amphibious Corps was able to state 
in his report on the Palau campaign that "on the whole the evacuation 
19. D-day was the designation used for the Peleliu invasion, F-day 
for the Angaur invasion date. 
20. Action Report, III Phib Corps, Palau, p. 127. 
11 oTcasu'aTties was carried on in a highly satisfactory and efficient 
21 
mannerMedical officers and line officers had combined to elimi- 
nate as far as possible the defects and weaknesses of previous campaigns. 
Hospitalization 
On Poleliu, the severe Japanese mortar and artillery fire 
from Bloody Nose Ridge commanded any location where hospital facil- 
ities could be set up. Not until D plus 8 had this factor been suf- 
ficiently eliminated by the assault forces to permit the general sot- 
ting up of field hospital facilities. As a consequence, in the early 
phases of the campaign, personnel of the medical companies were used 
for collecting casualties on the island and for replacement of medical 
22 
personnel of the combat teams. By D plus 5, Medical Company A had 
installed some facilities on White Beach. 
At Hngaur, the situation was somewhat better. Here the 
17th Field Hospital and 41st Portable Surgical Hospital set up opera- 
tion by F plus 2 days and began receiving patients immediately. Both 
the Angaur and Peleliu hospitals during the assault phase were operated 
chiefly as evacuation hospitals, and were especially valuable during 
the night when it was impossible to evacuate satisfactorily to the 
ships. The 41st Portable Surgical Hospital was a 300-bed facility, 
but the 17th Field Hospital, with the requisition of 100 beds and 
equipment from the SOLACE, provided care for 600. This field hospital 
21. Ibid., p. 126. 
22. Action Report, 1st MarDiv, Palau Occupation, p. 115* QtClASfttfttAttO* WMftD 23 
was used as an air evacuation unit, at the end of the campaign. 
Other hospital facilities on both Angaur and Peleliu, which were to 
be used to receive casualties from later Pacific campaigns, were 
established after the official cessation of hostilities in the 
southern Palaus. 
An item for which there had been considerable need in 
previous campaigns was an easily-set-up, prefabricated operating room. 
These were welcomed at Peleliu and Angaur and proved ’’very satisfactory”. 
It was recommended that the windows be covered with black, instead of 
green,cellophane material, and that additional ventilation be provided 
24 
for tropical use. 
Casualties 
The new phase of warfare of withdrawing to more defensible 
25 
inland positions, as initiated by the Japanese at the Palaus, had 
no effect upon the final outcome of this and later Pacific campaigns, 
but added heavy tolls to the American casualty lists.. Commensurate 
with the amount of ground gained, the casualties were high. In the 
veteran First Marine Division, which received the brunt of the enemy’s 
powerful defense fire, 46 percent were casualties - killed, wounded 
23. Action Report, 81st Infantry Division, Palau Operation, p. 113; 
Action Report, III Phib Corps. 
24* Action Report, 1st MarDiv, Palau Occupation, p. 15. 
25. The enemy change in tactics was marked by a withdrawal of troops 
from the water’s edge, and establishment of the bulk of infantry 
in tunnels, caves, and pockets in the rocky hills. From these 
positions the previously mined beaches were defended with mortar 
and artillery lire. No longer was strength wasted on Banzai 
attacks, 26 
and missing in action. Losses among medical personnel were especially 
high, due to their continual exposure in an effort to aid the wounded. 
Frequently enemy snipers would wait until aid men reached the wounded 
before firing. The following table from the action report, Commander 
Third Fleet3lists American personnel losses in the Palaus: 
Killed 
Wounded 
Missine 
Total 
1st Marine Division 
842 
4,063 
126 
5,031 
81st Infantry Division 
233 
1,664 
114 
1,911 
Island Command, Peleliu 
22 
169 
6 
197 
' 
1,097 
5,896 
246 
7,139 
Japanese losses #f 10,449 killed on Peleliu and 1,192 on Angaur were 
also a silent testament to the cost in lives of the Palaus campaign. 
Medical Supply 
Medical supplies for a 30-day period were carried by both the 
Slst Infantry and the First Marine Division, and were found to be ade- 
quate and of good quality. Ship to shore supply in the early stages 
worked fairly well except for temporary shortages, in the shore party 
medical section, of paregoric, plaster bandages, plywood splints, sulfa- 
27 
diazine and ethyl alcohol. Transports and hospital ships furnished 
replacements of these items, although some medical officers aboard 
ships criticized the requests from the shore which asked for ’’all 
available” supplies of some item. It was felt that more specific re- 
quisitions would better have met the situation. 
No shortages of antitoxins occurred among forces ashore or 
in transports. While clothing was available for the injured aboard the 
26. Action Report, Commander Third Fleet, Palaus Invasion, p, 5* 
27, Action Report, ComPhibGrp 5, Caroline Invasion, p, 228. transports, it was felt that some clothing supplies should be available 
to the medical battalions ashore to evacuate patients in more present- 
able covering than the soiled, torn, frequently bloodsoaked uniforms. 
This was more particularly emphasized where patients were evacuated 
by air, no other stores of supplies being provided here as on the 
28 
transports. 
A variety of comments on supplies of food available to the 
medical units was reported* C and K rations were the standard supplies, 
and were available in adequate amounts. Their value}however, was im- 
paired by mold formations on the biscuits. Some of the aid stations 
were supplied by the transports with hot cooked food, and it proved 
a valuable and welcome addition to the cold rations. Special con- 
valescent rations were available in limited quantities, and were pro- 
29 
nounced "very satisfactory" where used. From the standpoint of 
health and sanitation, cold rations were far better than hot cooked 
food prepared under unsanitary conditions during the combat stages of 
the campaign. Field kitchens were not set up until sufficient facil- 
ities were available for boiling water to sterilize mess gear. A re- 
quest for an adequate supply of coffee and an apparatus for heating 
30 
it to be used in aid stations, was submitted in the Palau campaign. 
Hot coffee was felt to be almost as necessary as some medical supplies, 
especially in the forward areas. 
28. Action Report, 1st MarDiv, Palaus, p. 113* 
29* Action Report, III Phib Corps, Palau, pp. 125-126* 
30. Action Report, ComGen 81st Infantry Division. It had been believed that there were few, if any, natural 
sources of Y/ater on Peleliu and Angaur, although it was thought the 
Japanese had some v/ater storage facilities. In addition to the standard 
water trailers and water cans, the First Marine Division cleansed, steamed 
and filled 3*000 gasoline drums to provide two gallons per day per man 
31 
for five days* Similar provisions were made in the 81st Infantry and 
in both units sufficient evaporators and purification units were embarked. 
After the landings it was found that water could be drawn from shallow 
wells along the beaches. Japanese wells were also available further 
inland, and they were used following the cleaning and establishment of 
a purification unit. From these combined sources sufficient water was 
made available, a maximum output of 86,700 gallons being reached. This 
was an average of three gallons per man, per day. 
A 
The over-all medical supply situation on Angaur was a good 
one. The Commander Third Amphibious Corps reported the supplies and 
equipment to have been "of excellent quality and ... provided in ade- 
32 
quate amounts". Notable improvement had been made over medical supply 
conditions in the Marianas. 
The Medical Department and Civil Affairs 
Very few civilians were encountered on Peleliu, the Japanese 
having previously evacuated them. The thirteen civilians that the 
First Marino Division took into custody were sent to Angaur shortly 
31, Action Report, 1st MarDiv,, p, 117, 
32, Action Report, III Phib Corps, p, 11, alter tneir capture. On Angaur the bulk of the Palau civilians, over 
1,000 in number, had been collected. Contrary to previous Pacific 
island campaigns, detailed planning was drawn up for the care and medical 
attention of the civilian population during the assault period. Emer- 
gency supplies of food, water and clothing supplemented the medical 
supplies of the 81st Infantry Divisional surgeon who treated the wounded 
33 
and ill on Angaur. 
The question of medical aid to enemy civilians in the Palaus 
was simplified by the comparatively small number present. In no instance 
were the problems truly comparable to the care of civilians in the 
Marianas campaign because of the great difference in population figures. 
The work that was done among the enemy civilians in the Palaus reflects 
favorably on the Navy Medical Department. 
Sanitation 
Reports on the sanitation conditions in the Palaus tend to 
be conflicting. The commander of the Third Amphibious Corps stated 
that sanitation in both the forward and rear areas of the First Marine 
Division was "extremely poor”, while the 81st Division (largely on 
34 
Angaur) had "shown good training and discipline in regard to sanitation." 
Yet a medical officer present at Peleliu on 28 September wrote Admiral 
Mclntire, "The sanitation has been something new in the annals of tropi- 
cal island fighting or in military hygiene anywhere. At least, up to 
33. Action Report, ComGen 81st Infantry, Angaur, pp. 114-115* 
34* Action Report, III Phib Corps, Palau, p. 128, the present we have it all under control including the fly and mosquito 
35 
control," The fact that makes both statements more consonant is that 
despite widespread, poor sanitary conditions, there were negligible num- 
bers of casualties resulting from these conditions. The situation was, 
as the commander of the Third Amphibious Corps phrased it, "remarkable," 
The commander of the First Marine Division echoed the sentiment: "For 
the first time in the history of Military Operations, there has been 
practically no illness that could be attributed to flies or mosquitoes. 
This could not be the results of sanitary measures by individual or- 
36 
ganizations". 
Flies were especially abundant on Peleliu. Piles of rotting 
Japanese food bred many; others thrived in unsanitary latrine facil- 
ities, dead bodies, and waste food. Very few flies were present at 
the time of landing, but there 7/as a steady increase up to D plus 25, 
37 
when strenuous control methods finally effected a gradual reduction. 
The unsanitary factors that favored the heavy fly breeding v/ere no 
deterrent to the breeding of mosquitoes. Both Aedes aegypti and al- 
bopictus were reported on Angaur. Peleliu, however, supported no 
Anopheline or Aedes aegypti, although the swamps and wooded areas north 
of the airfield fostered the grov/th of Culicinae mosquitoes. 
The Palau Islands, like the Marianas, were relatively malaria 
free and there was a very low incidence of this disease during the 
35. Surgeon Generals Files, "Excerpt from Personal Letter of Medical 
Officer, Peleliu", 28 Sept, 1944, n.p. 
36. Action Report, 1st MarDiv, Palau Occupation, p. 115* 
37. Ibid.. p, 116, campaign. The 81st Division as a whole had never been exposed to malaria, 
and reported only seven cases - none ill enough for evacuation. Previous 
operations of the First Marine Division in the malarious regions of the • 
Pacific had heavily "seeded” the personnel with malaria. Suppressive 
treatment had been required for seven days prior to D-day, to the extent 
of three atabrine tablets per day, and this was continued in the Division 
38 
throughout the campaign as far as military exigencies permitted. 
From 24 September to 1 October, 72 persons were hospitalized from the 
First Marine Division with recurrent malaria. Only 4, however, were 
evacuated, and for the most part the other 68 required only a few days1 
of hospital care. 
Against the numerous flies, mosquitoes, and gnats was brought 
to bear a new weapon of medical sanitation - DDT. Penite (sodium 
arsenite) had been the agent used in previous campaigns to control fly 
and mosquito breeding, and considerable success had been achieved. The 
chief drawback, however, was that Penite produced many cases of arsenical 
39 
dermatitis, and necessitated great care in using. Some experiments 
with DDT had been carried out at Guadalcanal and at Pavuvu, but the 
Palaus campaign was the first in which widespread use of the new formula 
was made. 
Three sanitary squads of 15 men each were organized, trained, 
and equipped for the expedition. Each squad carried ten knapsack sprayers 
38. Action Report, III Phib Corps, Palau, p, 129, 
39, Action Report, 1st MarDiv, Palaus, Annex D, p. 30, and DDT nixed with Diesel oil. Nets and jungle hammocks were treated 
in advance with a kerosene solution of DDT, In addition, a power 
sprayer carried on a truck was installed by malaria control personnel* 
The squads landed on D-day, and despite the loss of some of their equip- 
ment, began functioning immediately, following the combat teams. They 
sprayed dead bodies, sprayed ruined food supplies, straddle trenches, 
latrines and pools, and any other sources of insect breeding* Spraying 
of DDT by airplane was instituted about D plus 12. At the same time a 
power truck for spraying was landed. The sprayers had a difficult task 
at both Peleliu and Angaur. Large areas of swamp land and mud flats left 
by receding tides made the task difficult. In addition, many sources of 
fly breeding could not be reached with the DDT spray — thousands of enemy 
dead hastily buried in shallow graves, thousands more rotting in the 
open beyond the front lines. Enemy fire prevented even plane spraying 
in many spots during the combat stage of the occupation. 
The use of DDT was effective in the long range sanitation pro- 
gram for the Palaus, but its immediate results were not too obvious. 
Adult flies were successfully destroyed by the solution, but the larvae 
were unharmed. The consequence was that the flies bred more rapidly than 
they could be destroyed. After D plus 25, however, results were notice- 
able. The factor most significant in reducing the fly population was the 
plane spraying, which according to the commander of the 81st Infantry, 
"made the largest single contribution toward the complete control of the 
40 
fly problem," 
AO, Action Report, Blst Infantry Division, Peleliu, p, 113. 
20 Seven elements were considered in the program of the medical 
and sanitation officers in the Palaus: elimination of fly breeding areas, 
initiation of over-all insect control program, establishment of adequate 
measures for garbage and trash disposal, correction of unsanitary mess 
and galley practices, coordination of medical facilities, fontrol of 
water supply and establishment of sanitary practices in heads. Many of 
these aims were not fulfilled until after the active combat stage of the 
operation had passed. Unquestionably, the climate and terrain presented 
unusual difficulties to any program of sanitation. 
The real answer to the low incidence of serious disease in an 
area where the sanitation as practiced left much to be desired was simply 
that no tropical diseases were endemic on Peleliu or Angaur. Gastro- 
enteritis and fungus infections of the skin did result from the lack 
41 
of proper sanitation. But the wave of dengue fever and malaria that 
had put thousands of American troops out of action in earlier campaigns 
never materialized. 
The commander of the III Amphibious Corps reported at the con- 
clusion of the Palau campaign that "from a medical standpoint this has 
been one of the most satisfactory and successful of any of the operations 
w 42. 
in which units under the command of this corps have participated. 
He attributed the success to careful planning and training, "to the 
41• Letter from Group Medical Officer, Marine Aircraft Group 11, to 
the Chief of the Bureau of Medicine and Surgery, 23 Nov. 1944> n.p* 
42. Action Report, III Phib Corps, Palau, p. 130. evaluation and utilization of lessons learned in previous combat opera- 
tions, and to the splendid and wholehearted spirit of cooperation and 
coordination of all Army, Navy and Marine units involved,” Profiting 
from past experiences, the Navy Medical Department made many improvements 
in planning and operation of the various medical phases of the operation 
which showed worth-while results. 
Section 2 The Ulithi Islands 
The occupation of Ulithi some 500 miles north of the Palaus 
was the third step in the invasion of the Carolines. Five main islands 
of the group in the Ulithi lagoon were the objects of the American 
landings: Sorlen, Falalop, Asor, Mogmog, and Potengeras, To this task 
one of the RCT*s of the 81st Infantry was assigned. The story of Navy 
medical activities at Ulithi is a limited one, first because the cam- 
paign was primarily an Army affair, and secondly, and most , 
because the islands were not defended by the Japanese. Mine fields had 
been extensively laid about the area, and the only casualties from the 
v;43 
campaign resulted from a minesweepers striking an enemy"mine. 
The American forces landed on the five Ulithi Islands on 23 
September. From the appearance of the islands the Japanese had left 
at least a month previously. The natives, who were friendly to the 
American forces, confirmed this belief. Gunfire from the invading 
forces accounted for a few casualties among the natives, and most of 
these were treated by medical elements of the RCT. One of the wounded 
4-3- Action Report, Com III Fleet, Seizure of the Southern Palaus, p, B, 
Nine men were killed and 13 wounded when the YMS 385 sank on 1 
October while minesweeping was in progress. was the daughter of the Chiaf of Ulithi Atoll when was severely injured 
by shrapnel % Although she was carried to the USS HARRIS for surgical 
44 
treatment by the ship’s medical officer, she expired. Feeding the 325 
natives of the atoll was also carried out by the RCT personnel. Later 
Navy Civil Affairs personnel handled the removal of the natives and 
their effects to a reallocation center on one of the islands* 
Sanitation among the natives was primitive, but no serious 
tropical diseases were endemic. Cases of ulcers, some cachexia, and 
occasional indications of anterior poliomyelitis were noticed on some 
of the islands, but there was no malaria or dengue. 
The oapture of Ulithi, in conjunction with the seizure of 
Angaur and Peleliu Islands, extended the lino of American bases which 
was to effect an isolation of Japanese holdings in the Central and South 
Pacific. 
Section 3- The Caroline Battle Afloat 
Prior to the landings on the Palaus, powerful sea and air 
strikes had been directed first at Truk, and then at the Palaus. These 
strikes constituted an important part of the Pacific battle afloat. Not 
until the Philippine campaign were the Japanese suicide planes organized 
to conduct a form of warfare that in these later operations was to con- 
stitute a serious menace to the fleet. During the Caroline campaign, 
enemy shore fire, enemy torpedo hits, and bombs from Japanese planes, 
however, were frequently of considerable effect in providing medical 
A4-. Action Report, USS HARRIS, Palau-Ulithi, p, 8, 45 
and surgical care aboard the American line vessels. 
Hospital ships and hospital equipped APA‘s did not take part 
in the raider actions of the line vessels; consequently medical care had 
to be provided on the war vessels themselves. The size of the ship, of 
course, in large part determined the extent of medical facilities and 
number of medical personnel attached to the vessel. Frequently, when 
smaller vessels sustained large numbers of personnel casualties, they 
would be transferred to battleships or aircraft carriers, where they 
could receive more adequate treatment. At Truk, in the raid of 29 April 
1944, the destroyer USS TINGEY (DD539) was struck and sustained 22 casual- 
ties. Many of these were in serious conditions and were transferred to 
46 
the nearby USS BUNKER HILL for medical treatment. A major cause of 
' / 
many of the fragment injuries, the TINGEY medical officer pointed out, 
was the failure of many of the men to wear their fcapok jackets and 
helmets• 
The increasing significance of air power in the Pacific cam- 
paigns led to an elaborate program by the Navy Medical Department for 
the care of the injured pilots and the psychological care of all pilots. 
At the Caroline strikes, these measures proved of great value. On the 
BUNKER HILL, for example, a careful arrangement was worked out by the 
45. Action Report, Commander Third Fleet, Seizure of the Southern Palaus, 
p. 19. 
Return American fire from the fleet sea and air arms, nevertheless, 
reached a new high in destructive power. Japanese losses at the 
Palaus mounted to the staggering totals of 1,901 planes hit; 222 
large vessels sunk; 333 vessels (excluding small craft) damaged or 
probably sunk, and 11,637 enemy personnel killed. 
46. Action Report, USS TINGEY, Truk, p. 21. modical department to permit prompt medical assistance to wounded 
personnel in returning planes without interfering with the landing 
operations aboard ship. Medical personnel were stationed at strategic 
points on the ship for this purpose: (l) forward on the flight deck, 
were stationed 1 dental officer and 3 hospital corpsmen; (2) in the 
status board compartment of the island structure were located 1 medical 
officer and 1 corpsman; (3) at the flight deck emergency battle station 
were to be found the flight surgeon and 2 corpsmen; (4) on the hangar 
deck 1 dental officer and 2 corpsmen were stationed at number two plane 
elevator; and (6) 2 corpsmen were located at number three elevator. 
Therefore, wherever aviation personnel in .need of medical assistance 
landed, medical assistance was immediately available. Seriously wounded 
were removed from the parked plane and $ent directly to sick bay by 
47 
stretcher bearers. This distribution of medical personnel was also 
maintained during general quarters, and was assumed upon order of the 
captain when the ship was engaged by the enemy. 
During the strikes on Truk the morale and general efficiency 
of the flight personnel were the particular concern of the medical of- 
ficers, and on the whole, excellent results were achieved. Few cases 
of nervous disorder were seen, and during the times the carriers were 
48 
under fire only a moderate degree of tenseness was evident. Flight 
surgeons and senior line officers established a policy of anticipating 
worries of the pilots. Fear of capture was more real to most of the 
47. Action Report, USS BUNKER HILL, Palau, p. 19. 
48. Action Report, USS INTREPID, Truk, Medical Report, n.p. pilots than fear of death or injury. Truk, where all of the objectives 
were well inside of the surrounding reef, held considerable possibil- 
ities of capture. Therefore, in preparing pilots for the task, the ob- 
ject of the strike was kept secret until reports of the enemy's weakened 
power at the objective had been outlined with the use of reconniassance 
photographs. Stressing of rescue facilities and excellent American 
medical facilities was a part of the program of minimizing the normal 
fears of the men who piloted the Navy planes. 
In relation to other Pacific campaigns, the Caroline invasions 
were less costly in personnel fosses. This improvement was in part due 
to the smaller numbers of American troops employed in the engagements. 
The Caroline operations marked, however, the introduction of a new and 
tenacious form of warfare which the enemy was to perfect at Iwo Jima 
and Okinawa. In these later campaigns the use of heavily defended 
tunnels, caves, and wooded ridges was to account for thousands of 
American lives. Commensurate with the amount of territory involved, 
the Japanese were able to inflict severe personnel losses upon the 
two American divisions employed in the Palau occupation. Some medical 
aspects of the Pacific campaign had been notably improved. Evacuation 
functioned more smoothly; shortages of medical supplies were at a mini- 
mum. Sanitation during the combat stages left something to be desired, 
but, fortunately, disease incidence was low. With the occupation of 
the Palaus and Ulithi and the effective elimination of Truk as a serious 
menace, the American forces were ready for the next goal, the capture of 
the Philippines, 
26 THE CAROLINES 
BIBLIOGRAPHY 
I. Primary Sources 
1. Ship Action Reports 
USS BRADFORD (DD545), Two Day Air Strike on Truk and Sweep 
by Task Group 50*9 Against Damaged Enemy Ships, Carolines, 
24 February 1944. 
USS BUNKER HILL (CV17), for the Period 24-30 July 1944/ 
Palau, dated S August 1944. 
USS BURNS (DD588), Surface Action Against Japanese Forces 
Escaping from Truk Atoll, 16 February 1944. 
USS CABOT (CVL28), Aircraft Action Report, Attacks on Truk 
Island, 16 February 1944. 
USS CRESCENT CITY (APA21), Peleliu Island, Palaus, 27 
September 1944. 
USS FAYETTE (APA43}#. Peleliu Island 15-20 September 1944, 
dated 21 September a.^44. 
USS FREMONT (APA44), Palau Islands, 10 October 1944. 
USS FREMONT (APA44)) Stalemate Operation, Phases I & II, 
10 October 1944. 
USS HARRIS (APA2)} Palau and Ulithi Operations, 15-25 
September 1944, dated 8 October 1944* 
USS HONOLULU (CL48), Bombardment and Fire Support of Peleliu 
Island, 12 September 1944-29 September 1944, dated 1 October 
1944. 
USS INTREPID (cm), Air Operations Against Truk Atoll, 
16 February 1944 ana Operations During the Night of 16-17 
February 1944, dated 7 March 1944. 
USS INTREPID (CVll), Operations Against Palau and the 
Philippines, 6 September-30 September 1944, dated 30 September 
1944. 
USS JUPITER (AK43), Palau Operation, 27 September 1944. 
USS JEON (JIKA48), Occupation Angaur, Pilaus, 27 September 1074 USS LEONARD WOOD (APA12), Amphibious Assault upon Angaur 
Island, Palau Islands, 28 September 1944. 
USS LST 225, Peleliu Landing and Subsequent Operations, 
15 September 1944-23 January 1945, dated 24 January 1945. 
USS MARYLAND (BB46), Bombardment of Peleliu Island, 4 October 
1944, 
USS ORMSBY (APA49), Peleliu Islands, 25 September 1944* 
USS PREBLE (AG99), Report of Rescue of Survivors and Attempted 
Salvage of USS PERRY (DMS17), 13 September 1944, dated 5 
October 1944. 
USS RANDOLPH (CV15), Attack by Enemy Plane at Ulitfci, 11-12 
March 1945, dated 20 March 1945. 
USS SAVO ISLAND (CVE78), Palau Islands, 12 September 1944- 
30 September 1944, n. d. 
USS SUMTNER (APA52), Landing on Angaur Island, Palau, 17-23 
September 1944. 
USS TENNESSEE (BB43), Report of Fire Support Delivered During 
Angaur Operation, 28 September 1944. 
USS TINGEY (DD539), Report of Personnel Casualties Occurring 
at Sea as a Result of Enemy Action 29 April 1944 off Truk 
Island, Carolines, dated 1 May 1944. 
USS TRYON (APHl), Peleliu Island, 15 September 1944, dated 
24 September 1944. 
USS WAYNE (APA54), Peleliu Operation, 2 October 1944* 
2* Action Reports Naval Task Organizations 
Commander Group One, Amphibious Forces Pacific Fleet, Occupa- 
tion of Ulithi, 1 October 1944* 
Commander Amphibious Group Five (Commander Task Force 32), 
Report of Amphibious Operation to Capture Peleliu and Angaur, 
16 October 1944. 
Commander Third Fleet, Report on Seizure of Southern Palau 
Islands and Ulithi and Concurrent Operations in Support of 
the Seizure of Morotai, 14 November 1944* 
Commander Third Fleet, Comments on Operation Report, Palaus 
Operation, 28 December 1944? Commander LCl(L) Group 57, Reconnaissance of the Islands of 
the Abappaomogau Group in Palau Islands, 29 April 1945. 
Commander LST Flotilla 13, Attack on Peleliu, Palau Islands, 
17 September 1944. 
Commander LST Flotilla 14, 8 October 1944, Attack on Angaur, 
Palau Islands. 
Commander Task Group 32.8 (Commander Transport Division 20), 
Operations Against the Island of Angaur, 5 October 1944. 
Commander Transport Division 6, Assault and Occupation of 
Peleliu, 15-20 September 1944, dated 2 October 1944. 
Commander Transport Division 24, Peleliu, 30 September 1944. 
Commander Transport Division 32, Palau-Ulithi Operation, 
29 September 1944. 
Commanding Officer Underwater Demolition Team Eight, Operations 
on Angaur Island, D minus 1 to D plus 4, 14-19 September 1944, 
dated 19 September 1944. 
3, Action Reports Land Forces 
Commander Third Amphibious Corps, Palaus Operation, 24 October 
1944. 
Commanding Officer First Marine Division, Palau Operation, 
13 September 1944. 
Commanding Officer Slst Infantry Division, U.S.Army, Capture 
of Angaur Island, 17 September-22 October 1944* dated 
26 December 1944. 
Commanding Officer Slst Infantry Division, U.S.Army, Peleliu 
Island, 23 September-27 November 1944, n.d. 
Commanding General 81st Infantry Division, U.S.Army, Ulithi 
Atoll and other Western Caroline Islands, 21 September- 
4 January 19455 n.d. 
4. Sanitary Reports 
Annual Sanitary Report Western Carolines Sub Area, 14 October- 
31 December 1944. 
Historical Supplement to Fourth Quarterly Sanitary Report, 
Cumulative Report for the Period of World War II, Staff Medical 
and Sanitation Officer, Headquarters Island Command, Peloliu, 
n.d. 5. Materials from the Surgeon General* s Personal Files 
Letter from Group Medical Officer, Marine Aircraft Group 
Eleven, to Chief of the Bureau of Medicine and Surgery, 
Navy Department, 23 November 1945. 
Special Report of Capt, J. B. Logue, (MC), USN, to Admiral 
Mclntire, Peleliu , 7 November 1944. 
II. Secondary Materials 
Christian, F. W., The Caroline Islands: Travel in the Sea of 
the Little Lands. Charles Scribner’s Sons, New York, 1899. 
Jensen, Oliver, Lt., USNR, Carrier War. Simon and Schuster, 
New York, 1945. 
"Medical and Sanitary Data on the Caroline Islands", War 
Department Technical Bulletin, 31 May 1944. 
Thacker, Joel D., The First Marine Division, 1941-1945, 
Washington, D. C.„ Headquarters U. S. Marine Corps Historical 
Division, 1945. TABLE- OFvCONTENTS 
THE PHILIPPINES 
Pago 
Section 1 - Leyte .. 1 
Embarkation ••••••••..••.• 2 
The Leyte Beaches 3 
Leyte Evacuation ....... ...» 5 
Civilian Medical Care . .............. 10 
The Leyte Battle Afloat 11 
Section 2 - Luzon .... .. 18 
Lingayen Gulf 19 
Lingayen Landings 21 
Beach Treatment 22 
Evacuation . 24 
The Lingayen Battle Afloat 27 
Section 3 - Concluding Operations ..... 36 i CHAPTER X 
TH£> PHILIPPINES' 
By the fall of 1944 the American forces had succeeded in 
establishing bases for the long awaited return to the Philippines. 
For almost three years most of 7,083 islands of the archipelago had 
been controlled by the Japanese, and the original American defenses 
had been rebuilt and expanded into a formidable area of Japanese mili- 
tary strength. For the task of reoccupying the Philippines a great 
American Army and Navy force was mobilized in the largest joint opera- 
tion of the Pacific war. The Seventh Fleet was augmented by the major 
part of Pacific Fleet Task Force 31, including almost all the amphibious 
1 
craft then available in the Pacific area. Army forces under the com- 
mand of General MacArthur were readied for the firsts landings in the 
Philippines, on Leyte Island. 
Section 1 Leyte 
In September, Third Fleet carrier planes had participated in 
heavy raids against Philippine installations, at Manila, Luzon and 
the central Philippine islands. The first invasion date was set for 
20 October, and the east coast of Leyte Island was chosen for the 
attack. Leyte was especially suitable for the first Philippine opera- 
tion inasmuch as it commanded the approach to Surigao Strait, giving 
access to the central Philippines. The east c of the island was 
undefended from the east and provided good anchorage area. The chief 
1. Action Report, Com III Phib Force, Luzon, Lingayen Gulf, p. 3» 
1 disadvantage to the operation lay in the time of year—for the 
monsoon with its accompanying drenching rains lasted from October 
2 
to March, and was an obstacle to any military operation. 
Two forces were to be employed for the Leyte invasion—the 
Northern Attack Force (Seventh Amphibious Force) under Vice -Admiral 
Barbey, and the Southern Attack Force (Third Amphibious Force) under 
Vice -Admiral Wilkinson. In all, over 650 ships were employed, and 
3 
four Army divisions were to be landed on the Leyte beaches on A-day. 
Rehearsals were conducted at Maalaea Bay, Maui, and on the island 
of Kahoolawe in early September. In early October the forces under- 
went further training and logistic replenishment at Manus and Eniwetok. 
Embarkation 
On board the transports, immunization against cholera, ' , v • 
typhus, and plague was administered to Army and Navy forces under 
direct order from Cincpoa. Complete typhus and plague immunization 
4 
was not carried out because of insufficient quantities of biologicals. 
Suppressive anti-malarial therapy with atabrine was instituted on A 
minus 21. Ample supplies of atabrine were available, and all quanti- 
ties of the drug used by Army and Navy personnel were provided by 
the ships* supplies up to the time of debarkation. The therapy started 
2m Ernest J. King, Second Official Report to the Secretary of the 
-Wavy, p. 19. 
3* The Leyte invasion day was known as A or Able day. 
4* Action Report, Commander Task Group 79.1, Leyte, p. 111. The 
shortage on board ships arose because the original objective for 
ships of the attack force had been Yap Island, where cholera, typhus 
and plague were neither endemic nor epidemic. with 1/2 tablet a day for the first week, 1 tablet daily for the 
second week, 2 tablets daily for the third week, and 1 tablet daily 
* 
for the remainder of the campaign. 
Despite crowded quarters, poor ventilation, excess heat and 
lack of exercise, the health of the embarked troops remained good, 
and no serious epidemics developed. Sporadic outbreaks of diarrhea 
occurred on board various vessels, but it was the opinion of a medi- 
cal observer that on the whole nan excellent job was performed in 
5 
transporting so many officers and men this great distance," 
A conference of all medical officers, army and Navy, was 
held prior to departure from the mounting area. A% Eniwetok beach- 
masters and beach party medical officers held a conference to discuss 
possible improvements in evacuation of casualties from the beaches. 
The Leyte Beaches 
On 17 October, A minus 3, operations preliminary to the 
landings began; they resulted in the successful seizure of the small 
islands guarding the entrances to Leyte Gulf. Minesweepers cleared 
the approach channels and landing beaches, and reconnaissance of 
the main Leyte beaches was effected. The heavy preliminary bom- 
bardment successfully eliminated much shore opposition. 
On the morning of 20 October, landing craft converged on 
the beaches like myriad ants drawn irresistibly towards a pile of 
Frederick A, Smith, Commander,(MC)V(S), USKR, Report to ComGen 
5th MarDiv of Medical Observations on Invasion of Leyte, p. 4--a, 
3 sugar. Throughout the day, wave after wave of the small craft beached 
on Leyte’s shores, carrying the troops of the 10th and 20th Army Corps. 
Enemy artillery and mortar fire from hidden positions ware thrown onto 
the beaches, but there was little small arms fire. The beachheads were 
established with greater ease than in earlier island campaigns. 
During the assault landing phase, casualties wore compara- 
6 
tively light. Naval medical participation in the Leyte campaign ¥/as 
most active in two aspects-in the activities of the beach medical 
parties and during the process of evacuating the Army forces. The 
Army units, of course, carried with them their own medical personnel 
and supplies. Naval medical units of the beach parties consisted of 
1 medical officer and 8 corpsmen from each of the transports. They 
were put ashore in the sixth wave and established themselves on the 
east coast of Leyte, In addition to the naval personnel of the medi- 
cal beach parties, 1 Army medical officer, 1 Army dental officer, and 
2 Army medical coprsmen accompanied each medical beach party. These 
Army personnel were actually the medical collecting units of the land- 
ing force, and their grouping with the medical beach party was found 
to give very satisfactory results. 
First-aid treatment was administered with comparative prompt- 
ness. On the average, initial dressings were supplied within 2 to 20 
7 
minutes of the time of injury. Medical supplies on the beaches were 
6. Action Report, ComTaskGrp 79.1, Leyte, p. 122. A total of 1943 
casualties (66 stretcher, 73 ambulatory, and 4 dead) were received 
aboard the transports up to Jig plus 5 hours. 
7. Prliminary Report of Battle Casualties from K-2 Operations, from 
Surgical Consultant to Chief Surgeon, Surgeon General’s Files, n.p. adequate, and temporary shortages v/ere quickly relieved by the trans- 
ports. Some complaints were received that medical supplies did not 
reach their destination, and it was recommended, following the opera- 
tion, that hospital corpsmen accompany the supplies to the beaches 
8 
to assure delivery to the activity requesting them. 
A medical inspection of the beach medical facilities on 
Yellow and Violet Beaches on Able plus 1 disclosed an Army medical 
battalion clearing station set up about 300 yards inland. Through 
this medical activity casualties were being cleared effectively to 
Beach Yellow 2. Civilian casualties also were given medical atten- 
tion by the Army medical battalion, but only a few were sent on to 
the beaches for evacuation by naval facilities. 
Leyte Evacuation 
The work of the Navy Medical Department in evacuating 
casualties was perhaps its outstanding contribution to the Philippine 
campaign, although this also was performed in cooperation with .army 
medical facilities. Plans for evacuation during the initial phase 
provided for a flow from the front lines to the battalion aid sta- 
tions , to the beach party medical stations, and then out to APA* s 
and AKA*s. On A-day, casualties were first to be evacuated to surgi- 
cally and medically equipped LST's. By the time the transports and 
cargo ships were unloaded and ready to leave anchorage, Army division, 
station, and corps field hospitals v/ere to have begun functioning.. 
Evacuation and medical care was to revert completely to the Army 
8, Action Report, ComTaskGrp 79,1, Leyte, p, 11A. following the withdrawal of the APA's and AKA's. Hospital ships were 
scheduled to arrive off Leyte on A plus 1, A plus 3 and A plus 5« 
Actually, the USS MERCY arrived on A plus 5 days and took out 410 
casualties, while the USS COMFORT arrived on A plus 9 days and removed 
561 casualties. 
On the whole, the chain of evacuation operated in accordance 
with plans. Land evacuation was considerably hampered, however, by 
the terrain and by the exigencies fostered by the rainy season. Swampy 
terrain and roads rendered impassable by mud and water made ambulances 
useless for the first five days of the operation. Only the LVT’s, 
DUKW!s and Weasels were able to churn through with wounded. Weasels 
were able to get through where even LVT’s became mired. Considerable 
ingenuity was employed by the collecting sections. Occasionally a 
wounded man was laced to a stretcher to which two bamboo poles were 
attached to act as sled runners. The whole was then yoked behind a 
water buffalo and dragged through the swamp to a point where a Weasel 
could operate. The Weasel then evacuated the casualty to an LVT and 
» 
the LVT to the beach. The time involved in land evacuation was fre- 
quently long - fatally long in cases of wounds of the gastrointestinal 
9 
tract* 
The use of the medically and surgically staffed LST's was 
less effective than planned. Had the outline been possible to follow, 
the L3T!s would have provided the best type medical care in the 
9# F, A, Smith, Report of Medical Observations oilInvasion of Leyte, 
p« 6-a, shortest period of time from the moment of injury. However, for the 
plan to havo worked it would have been necessary for the LST’s to 
beach, and on some beaches this was not possible. On Red Beach Fox, 
LST 459 tried to land but was unable to get closer than 150 yards, 
where it grounded in six feet of water. Other LST’s were hit by artil- 
lery and mortar shells. In addition, certain types of casualties v/ere 
to be sent to designated LST’s, but in practice, this was found to be 
10 
almost impossible. Despite these operating difficulties, the use of 
increased numbers of specialized LST’s was again recommended by higher 
11 
echelons at the close of the campaign. 
Night evacuation v/as facilitated by the use of PCE(R)’s 
stationed about 3,000 yards off the beaches and marked with low lights. 
At Leyte, as in earlier campaigns, the APA’ s, and id£A’s per- 
formed valuable services in the evacuation process. Even before the 
landings, careful preparation v/as made aboard these vessels to re- 
ceive casualties. On one Coast Guard transport, on the evening of 
19 October, pharmacist’s mates converted the chief petty officer’s 
quarters into a temporary sick bay.. Wires were strung overhead, and 
from these wires strong lines were attached every few feet. Bottles 
of blood plasma could then be easily attached to this arrangement on 
10. Action Report, ComTransDiv 6, Leyte, p, 20. If, for example, four 
casualties—one orthopedic, one thoracic, one ophthalmic and one 
urological—were present at any one time, it would necessitate 
four LCVP’s to take these casualties to the correct LST, or in- 
volve four time-consuming stops for one LCVP. 
11. Endorsement of Com III Phib Corps to .action Report, 
ComLSTFlotilla 3, Leyte, p. 4* the following morning when the iasualties began to be brought aboard* 
Galleys were cleaned, scrubbed, and cots set up to handle overflow from 
12 
the sick bay. 
Prior to departure from the mounting area, the medical de- 
partment staffs of most of^tha-APA*s (3 medical officers and 20 corps- 
men) were augmented by an additional medical officer and 10 additional 
corpsmen. Specialists were distributed among the various transports, 
13 
and medical supplies stocked for the operation. At Leyte, no com- 
plaints were made regarding penicillin shortages on transports. The 
Naval Medisal Supply Depot at Pearl Harbor allowed each transport about 
150 ampules, and 'some ships carried additional supplies of the valuable 
drug. 
The transports received casualties up to the time they de- 
parted on Able plus 1. Their treatment of the wounded was highly 
commended by Army hospital facilities on Hollandia where they were dis- 
embarked. The Army surgical consultant declared: "They arrived in 
good physical condition, well fed, well bathed, in clean clothes, all 
14 
expressing gratification with the care given by the Navy.” The aver- 
age length of time between injury and arrival on a naval transport had 
been only one hour and 20 minutes. Wounds had been properly debrided, 
12. Press Release, 9 Nov. 1944# Hospital Corps Archives. 
13. The USS APPALACHIAN, USS J. FRANKLIN BELL and USS RIXEY each 
carried an eye surgeon in this engagement. 
14. ’’Preliminary Report of Battle Casualties from K-2 Operations, from 
Surgical Consultant to Chief Surgeon," n.p. dusted with sulfonamide powder, and packed lightly with vaseline gauze. 
No wounds were closed by primary suture except those of the abdomen, 
chest>and scalp. Almost all wounds were clean and healing well. All 
wounded had received sulfonamides by mouth, and those with moderately 
severe or severe wounds had received penicillin. 
An examination of the individual reports of the transports 
present at Leyte indicate less overcrowding and more equitable dis- 
tribution of casualties than in earlier Pacific campaigns. The USS 
LAMAR reported that the medical beach parties had done an excellent 
15 
job of distributing wounded among transport medical facilities. This 
finding was reiterated by the USS FREDERICK FUNSTON, USS HARRIS, USS 
DOYEN, and the USS ALMAACK. 
Preparations for evacuation of casualties at Leyte were 
16 
based on the following casualty estimates for the east coast operation; 
UNIT 
NO. TROOPS 
LITTER 
AMB. 
Is 
lo 
• 
White Beach, 1st Gal. Div. 
20*150 
7.6$ 
10% 
1,680 
Red Beach, 24th Inf. Div. 
17,250 
s% 
10% 
1,428 
Orange and Blue, 96th Inf. Div. 
Beach 
Violet and Yellow Beach, 7th 
25,600 
1% 
10% 
2,184 
Inf. Div. 
25,900 
s% 
10% 
2,154 
Actual figures obtained at White Beach and Red Beach on A plus 2 indi- 
cated only a 2 percent litter casualty rate and a 5 percent ambulatory 
rate. Both from a medical and military standpoint, the Leyte evacua- 
tion was successful. 
15. Action Report, USS LAMAY, Leyte, p. 6. 
16. F. A. Smith, Medical Observations on the Invasion of Leyte, p. 5-a. Civilian Medical Cra-e 
A third aspect of the Leyte invasion, in which the Navy 
Medical Department participated, was the field of civilian affairs. 
Prior to the landings, orders had been issued to Navy and Army medical 
personnel participating in the invasion to give medical care to natives 
wherever possible. The Filipinos in the battle area came to the aid 
17 
stations in great numbers. In addition to injuries resulting from 
battle, many chronic ailments received treatment—tropical ulcers, 
chronic coughs, gastrointestinal disturbances, coleric of infancy and 
many other complaints, a number of cases of pregnancy also came into 
the beach aid stations. One was sent out to an APA for delivery, and 
the ship*s chaplain christened the baby after the name of the ship. A 
number of wounded natives were evacuated on the transports when the 
ships left their Leyte anchorage. 
Recommendation was made, after the campaign, that the civilian 
affairs authorities (in this case Army personnel) establish aid stations 
IB 
for civilians early in the course of a campaign. It was felt that 
such a procedure would eliminate a certain natural confusion that ac- 
companied the descent of hundreds of around ed and sick natives upon a 
medical facility engaged in the treatment of injured military personnel. 
However, the methods employed by Navy and Army medical personnel in 
caring for the natives during the course of the Leyte battle were( a con- 
siderable improvement on previous Pacific campaigns. 
17. Ibid,. p. 7-a, 
18. Ibid.. p, 12-a, 
10 The Leyte Battle Afloat 
During the period of the Army landings and as General 
MacArthur*s forces pushed inland, the Japanese flung down a powerful 
naval challenge to the American invasion, in the Battle of Leyte Gulf. 
From 23-26 October the enemy's navy involved the Anerican Third and 
Seventh Fleets in a series of major surface and air engagements which 
culminated in the Battle of Surigao Strait, the Battle off Samar, and 
the Battle off Gape Engano. By the evening of 26 October, the American 
war vessels had secured a total victory, and three great Japanese naval 
forces were either destroyed or had retreated beyond the immediate range 
19 
of the American fleets. 
During this series of great sea battles, Navy Medical Depart- 
ment personnel aboard the ships of the line wore repeatedly called upon 
to care for casualties resulting from the naval and air attacks of the 
Japanese fleet. Severe losses were suffered by the American Third and 
Seventh Fleets, since the Battle for Leyte Gulf marked the initiation 
of a devastating new Japanese weapon—the "kamikazi'J or suicide plane. 
Painted in dark colors with large red balls on the wings, the "kamikazes" 
centered their attention on the big ships—the carriers and the battle- 
ships. But even LST's occasionally served as targets. As the months 
of the Philippine struggle continued, the suicide planes increased in 
number and vied with the old style torpedo bombers in the sinking and 
damaging of the American vessels. 
One of the most disastrous hits occurred when the carrier 
19. Second King Report, pp, 20-22. USS PRINCETON was bombed and the explosion on the USS BIRMINGHAM which 
had come alongside to aid in salvage work followed. On the morning of 
24 October, the PRINCETON was struck by a heavy aerial bomb carried by 
one of the suicide planes, and flames from the explosion caused terrible 
damage. Both the forward battle dressing station and the battle dress- 
ing station amidships were rendered useless by the explosion and flames. 
About a half-hour after the hit, the order "All hands topside" was given. 
At the same time the main battle dressing station in the sick bay. and 
20 
the after battle dressing station were evacuated. 
At about 1030 the USS GATLING (DD671) came alongside the fore- 
castle and all casualties were evacuated to the destroyer. Lines, lad- 
ders and nets were used to evacuate the crew from the flaming ship; 
2], 
as well as motor whale boats for the seriously wounded. Juaeng the 
PRINCETON casualties 7 deaths occurred, 92 were listed as missing, and 
191 were v/ounded. 
The toll of deaths resulting from the PRINCETON1s bombing was 
to be still higher before the episode was concluded. At 1530 the same 
day, the USS BIRMINGHAM came alongside the PRINCETON to aid in the sal- 
vage work. Two minutes later a terrific explosion from the after por- 
tion of the PRINCETON blew off the ship!s stern, throwing shrapnel and 
debris of all types onto the BIRMINGHAM. Over half of the BIRMINGHAM1s 
20. Action Report, USS PRINCETON (CVL23), Philippines, Loss of Ship, 
pp. 90-91. 
21. Action Report, USS GATLING, Philippines, p. 25. The PRINCETON, 
hopelessly damaged, was sunk under order by the USS IRVIN and 
the USS RENO, 26 Oct. 1944. ooiriMfA i p p 
personnel were wounded or killed by the PRINCETON’S explosion. 
A quick survey by the BIRMINGHAMS*s executive officer revealed 
the following situation; 
On the main deck, from 140 to 150 bodies, dead, dying and 
wounded, many of them horribly, covered the decks. The 
communication platform was no better. Blood ran freely 
down the waterways, and continued to run for some time. 
Words will never describe the maginficent manner in which 
the dying and wounded acted. Said the executive officer... 
”1 really have no words at my command that can adequately 
describe the veritable splendor of the conduct of all hands, 
wounded and unwounded. Not only was there not the slightest 
tendency towards panic, there was not a single case that 
came to my attention directly or reportedly where anything 
but praise could be given,..Men vdth legs off, ?dth arms 
off, with gaping wounds in their sides, with tops of their 
heads furrowed by fragments, would insist, ’Ifm all right. 
Take care of Joe over there*, or ’Don’t waste morphine on 
me Commander, just hit me over the head,1 ” 23 
The BIRMINGHAM* s chaplain commented on the terrible severity 
of the wounds—**case after case of compound fracture, legs and arms 
missing, abdominal contents protruding through the belly wall, blood 
gushing from huge wounds, skulls laid open, and, intermingled with 
24 
the living, many dead.” In all, 229 were killed, 4 missing, 211 
wounded seriously, and 215 suffered mild to severe wounds. Six of the 
seriously wounded died later. 
At the time of the explosion, the BIRMINGHAM*s senior medical 
officer was on the USS SANTA FE assisting in an operation. Since the 
dentist was among the first killed, the sole doctor remaining on the 
22, War Diary, USS BIRMINGHAM, for the month Oct, 1944y P» 21, 
23* Ibid.. p, 22, 
24* Ibid., p. 25, cruiser was the junior medical officer. Fourteen hospital corpsmen, how- 
ever, were available, and with the JIvIO and officers and men of the ship!s 
company, they cared for the wounded until noon, 27 October, when 211 
cases were transferred to the USS SAMARITAN. 
In the first hours only a few minutes could be given to each 
of the wounded—hemorrhages were stopped, morphine was administered, 
and wounds were sprinkled with sulfa powder and covered by battle dress- 
ings** The ship’s company had received frequent instruction in first- 
aid methods and the knowledge proved of inestimable value. The doctor 
and hospital corpsmen devoted most of their time to the treatment of 
25 
shock and severe hemorrhage, and to the application of difficult bandages. 
i. • ft.' 
j 
In all, 198 units of plasma, 20 flasks (2,000 cc.) of 5 percent dextrose 
in normal saline, and 500 cc, of ¥/hole blood were used. Open wound cases 
were given booster doses of tetanus toxoid. 
The second phase of the medical care was initiated as soon as 
medical department personnel could be spared from the treatment of shock, 
pain and hemorrhage. Perforated abdominal wound cases were separated 
from the rest for operation. At this time also, two groups were formed 
to splint fractures. Open wounds of compound fractures were sprinkled 
with sulfanilamide powder. On 26 October (two days after the explosion) 
a doctor and three corpsmen from the USS RENO were put aboard the 
BIRMINGHAM to give medical assistance to the ship’s medical personnel. 
In the third phase of emergency medical treatment, the patients 
25* Action Report, USS BIRMINGHAM, Fleet Operations 1B-2A October 19AA> 
p# 16, were segregated, the most severly wounded being moved to the sick bay 
and the wardroom. All other cases were carried down to the second and 
third decks, and the more serious cases placed near the dressing and 
treatment stations. During this period the two medical officers examined 
every patient carefully and the wounded were tagged with their name, 
rate, division, serial number and diagnosis. All bandages were renewed, 
splints checked and tractions adjusted. 
In the fourth step, with the aid of medical officers from the 
SAMARITAN, serious cases were selected for removal to the hospital ship. 
The treatment rendered aboard the BIRMINGHAM was of necessity 
primarily first aid, except in cases of perforated abdominal wounds. 
In the effort to save as many lives as possible, no other definitive 
treatment could be undertaken with the limited number of medical de- 
partment personnel in ratio to the heavy casualty numbers. Only five 
abdominal cases were operated on. Of these, two died. Among the 420 
wounded aboard the BIRMINGHAM, only eight cases (2 percent) were fatal. 
The medical officer of the BIRMINGHAM felt this record to be a strong 
argument in favor of the deferment of definitive treatment in order to 
26 
save as many lives as possible. 
Some recommendations for improving procedure were made. It 
was suggested that all fighting ships be allowed 15 units of plasma per 
100 men instead of 5 units, which had been the allowance. It was further 
recommended that Supply Corps personnel be specially trained to dispense 
26. Action Report, USS BIRMINGHAM, p. 18. and distribute medical supplies according to plan and thus release 
27 
medical department personnel for more professional tasks. Better 
care of the wounded resulted, it was found, if those administering aid 
could obtain at least three or four hours' sleep out of the twenty-four. 
Throughout the first night many of the medical staff went without any 
sleep at all, with resulting impairment of efficiency. No alternative 
was possible, however, with the great number of wounded. Larger supplies 
of penicillin were also indicated. Only 200,000 units were carried 
aboard the BIRMINGHAM because Of the shortage, and it was not possible 
28 
to administer it to ’’cases in imminent danger of infection.” 
During the closing days of October and the month of November, 
as the invading Army forces battled their way further into the Leyte 
jungle, Japanese planes kept up their attacks upon naval vessels off 
the beaches and in Leyte Gulf. Four suicide bombing attempts were made 
on the USS TICONDEROGA in Ormoc Bay during the 7 December landings* 
None succeeded here, but a month later off Formosa a ’’kamikaze” severely 
29 
damaged the carrier. 
In the Leyte landings at Ormoc the USS MARYLAND suffered a hit 
which killed 31 and injured 30. A ’’kamikaze” plane carrying a 500-pound 
bomb crashed into the port side of turret one, and the bomb exploded 
on the armored second deck, maiming and burning all in its vicinity. 
27. Ibid. 
28. Ibid. 
29. Action Report, USS TICONDEROGA, Ormoc Bay, p. 25. By December, the danger to the large ships from the suicide planes was 
well recognized and the medical department personnel and facilities had 
been reorganized with this constant threat in view. More adequate medi- 
cal supplies were widely distributed about the MARYLAND in anticipation 
of possible destruction of the sick bay area. Such destruction was 
exactly what happened as a result of the 7 December hit, and the in- 
jured were carried, according to plan, to a newly established sick bay 
in the junior officers’ and warrant officers’ wardrooms on the second 
deck aft of midships. After adequate emergency treatment had been 
administered, the more seriously injured were transferred to the 
30 
LST 171 and thence to a hospital ship fifteen hours after the crash. 
The pattern of early evacuation of "kamikaze” casualties via 
an LST to a hospital ship was repeatedly followed in the Leyte battle 
afloat. The USS MAHAN (DD364) was severely damaged in the Ormoc Bay 
landings and had to be sunk by American gunfire. Its casualties were 
31 
taken via LST 4&4 to the USS MERCY 22 hours after the action. The 
USS HUGHES (DD410), hit on 10 December, transferred its casualties first 
to the USS LAFFEY (DD724) and then on the next day via LST to a hos- 
32 
pital ship. 
30. Action Report, USS MARYLAND, Suicide Plane Attack, Leyte Gulf, p. 13. 
31. Action Report, USS MAHAN (DD364)> Ormoc Bay, pp. 22-23. 
32. Action Report, USS HUGHENS (DD410), p. 10. The part played by the Navy Medical Department in the Leyte 
invasions, as in all the Philippine campaigns, was a limited one con- 
fined mainly to the early phases of the operations—on the beaches and 
in the process of evacuation. Hospitalization and the administering 
of definitive treatment to the wounded personnel of the Army divisions 
was carried out by Army medical facilities. The cooperation betv/een 
Army and Navy medical personnel in the embarkation process and during 
the beach phase and evacuation was notable. 
The new emphasis upon care of the wounded aboard ships of the 
line was a direct result of the "kamikaze” phase of warfare. It was 
during the Philippines operations that this ne?j form of warfare, which 
was to constitute the most serious menace to the Pacific fleets in the 
later stages of the v/ar, was initiated. All medical personnel were re- 
quired to put forth oheir utmost efforts to bring medical order out of 
the flaming chaos created by the ’’kamikaze” hits. Their work is de- 
serving of the highest praise* 
, Section 2 - The Luzon Invasion 
With the occupation of Leyte well underway, attention was 
centered on the largest of the Philippine Islands, Luzon. On 15 
December, Army forces had been put ashore in Mindoro Island, 300 miles 
northwest of Leyte, without shore opposition. Twenty-four hours later, 
American planes and PT boats were operating off the southern coast of 
Luzon from this island. Three weeks later came the Luzon invasion, a 
campaign on a considerably larger scale. Lingayen Gulf 
The attack at Lingayen Gulf had as its object the "prompt 
seizure of the Central Luzon area, the destruction of the principal 
garrisons, the command of organizations and hostile defense forces in 
the Philippines, the denial to the enemy of the northern entrance to 
the South China Sea, and the provision of bases for the support of 
33 
further operations against the Japanese." 
Command status was similar to that carried out at the Leyte 
operation—the Commander Seventh Fleet in over-all charge of the ex- 
pedition under the Commander-in-Chief, Southwest Pacific area. Im- 
mediately upon the landing of the troops, command reverted to the Com- 
34 
manding General Sixth Army. 
Lingayen Gulf stretched 20 miles wide and 30 miles deep, and, 
with its shallow sand beaches at the foot of the gulf offered good 
landing sites for amphibious operations. Behind the beaches rolled a 
flat plain interspersed by marshes. Bordering the plain to the east 
33# Action Report, ComTaskForco 78, Lingayen, p. 3* 
34• Action Report, Com III Phib Forces, Luzon-Lingayen Gulf, pp. 5-6, 
The naval organization for the invasion was as follows: Vice 
Admiral Kinkaid, Commander Seventh Fleet, in command of amphibious 
operations as Commander Task Force 77, the Luzon Attack Force; Vice 
Admiral Wilkinson, Commander Third amphibious Force in command of 
Task Force 79, designated as the Lingayen Attack Force,, and Vice 
Admiral Barbey, Commander Seventh Amphibious Force, in command of 
Task Force 78, designated as the San Fabian Attack Force. Task 
Force 79 had as its mission the transportation, protection and land- 
ing of the XIV Army Corps at Lingayen Gulf in the vicinity of 
Lingayen. Task Force 78 was to perform similar service for the 
1st Army Corps, in the vicinity of San Fabian. The day of the 
initial assaults was designated as S-day, and the hour of the 
initial landing of TF 78 as How hour, that of TF 79 as Jig hour. and west were ranges of hills and mountains, A highly favorable feature 
for the invading forces was the January season which offered the driest 
35 
condition of low ground during the entire year. 
Those concerned with medical planning had several factors to 
consider - the number of Army and Navy personnel involved, length of the 
lines of communication, the relation of the various designated landing 
beaches to each other and their hydrographic conditions, the enemy's 
capabilities which had led to the assumption that casualties would be 
heavy, especially on S-day, and the number of ships available.for care 
36 
of casualties. 
Especial attention was paid to the problem of medical supply. 
Medical Storehouse Number 6 at Manus and the Army Medical Supply Depot 
at Hollandia were the sources of medical supplies to be used by ships 
of the task force. Adequate provisions were obtained prior to the de- 
parture for the objective. At Hollandia, however, considerable incon- 
venience was encountered at the Army Medical Supply Depot, and it v/as 
felt that much of this difficulty could have been spared had there been 
37 
a Navy source of medical supply afloat or at the naval base at Hollandia. 
Additional medical personnel were ordered to each APA partici- 
pating in the invasion, bringing the average medical department comple- 
ment of each transport to 4 medical officers and 27 hospital corpsmen. 
35• Action Report, Com Luzon Attack Force, Lingayen, p, A, 
36« Action Report, ComTaskForce 78, Lingayen-San Fabian, p. 33* 
37, Action Report, Com III Phib Forces, Luzon-Lingayen, p, 68. As at Leyte, Army medical personnel were to carry the real burden of 
caring for troops of the invasion forces throughout the campaign. 
Prior to embarking, all troops had been given the prescribed 
immunization aboard ship. In addition, under the supervision of the 
commanding officer of the troops, atabrine was administered in regular 
doses. Despite this, sporadic cases of clinical malaria developed en 
route to Lingayen, and were treated by the ships’ medical officers. No 
epidemics broke out on the voyage. One case of scarlet fever which de- 
veloped aboard an APA caused a slight flurry, but sulfadiazine was im- 
mediately administered to all personnel aboard the vessel and no further 
38 
outbreak occurred.. 
Lingayen Landings 
S-day was set for the morning of 9 January, and during the 
first week of the month the American force gathered east of Leyte, 
Over the sunken wrecks of the Japanese warships in Surigao Strait the 
ships steamed, and on into Mindanao and Sulu Seas. As the assault 
force came closer to the west coast of Luzon, noisy guerrilla demon- 
strations were raised in soutern Luzon under General MacArthur’s 
direction to divert Japanese attention. Navy minesweepers swept the 
south coast bays of Balayan,, .Batangas and Taybas, and Amy transport 
39 
planes dropped dummies to simulate a parachute invasion in the south. 
38. Action Report, Com Reenforcement Group, Luzon, p. 51. 
39. Biennial Report of the Chief of Staff of the U. S. Army to the 
Secretary of War, p. 75. The results of this carefully contrived plan of diversion 
were excellent. On Luzon Japanese forces, harassed by guerrillas and 
plane fire, drove in all directions throughout the island and became 
tangled in a hopeless web of confusion. Bridges and roads were blown 
up by guerrilla bands, causing endless traffic jams. When the attack 
came at Lingayen Gulf, the Japanese had dissipated their real chances of 
repulsing the American forces. 
Bombardment of the Lingayen beaches began on S minus 2 and 
continued until immediately before the landings were effected. Just 
prior to H-hour, over 7,500-4*5 inch rockets tore into the Japanese 
defense installations. Once again the pattern of myriad little am- 
phibious craft was spawned from the transports off a Philippine beach, 
as the Sixth Army moved ashore along Lingayen Gulf. By nightfall the 
American forces were in control of a 15 mile beachhead 6,000 yards deep, 
40 
and 68,000 troops had been landed. 
The effectiveness of the preliminary bombardment was visible 
in the slight opposition met by the landing forces. Mortar fire and 
a light artillery fire were raised by the enemy at night, but only slight 
damage and few casualties resulted. 
Beach Treatment 
Naval medical participation in the Luzon-Lingayen landings, 
as at Leyte, v/as limited largely to treating and evacuating casualties 
40. Ibid. 
22 on the beaches in the early phase of the invasion. The greatest medical 
problem confronting the Navy at Lingayen was to arise not in the shore 
battle, but in the battle afloat, where casualties were to be the 
41 
heaviest yet experienced afloat in previous Pacific campaigns. 
On the Lingayen beaches, Navy medical personnel from the APA’s 
formed the medical beach parties. Army medical personnel collected the 
wounded and brought them to the beach aid stations. Here, Navy medical 
officers administered any further necessary first aid and screened the 
casualties. Those requiring immediate surgery were sent to the surgical 
teams aboard surgical LST’s beached on the shore. Patients with minor 
wounds, and ambulatory cases were sent directly to the APA’s for treat- 
42 
ment. 
At the beach aid stations, especial attention was paid to 
the degree of shock and loss of blood suffered by the wounded. Vs/hole 
blood was administered as a part of the first-aid routine wherever it 
was indicated. Blood supplies were ample, provision for this vital 
medical weapon having been made both by Sixth army medical personnel 
and the Navy medical officers from the transports. 
One aspect of medical beach treatment which functioned well 
was the use of the surgical LST. Several of these were ordered to both 
the Lingayen and San Fabian beachheads, where they were beached to pro- 
vide early definitive treatment for those cases in which time was a 
41. Action Report, Com III Phib Forces, Luzon-Lingayen, p. 68, 
42, Action Report, ComTaskForce Lingayen-San Fabian, p, 34* 
23 vital medical factor in recovery. Each LST had approximately 50 bunks 
available for litter patients in addition to emergency operating facil:-\. 
ities. The surgical LST’s operated not only as a part of the evacuation 
plan, but also as an integral unit of the Luzon beach treatment. 
The'relatively smooth functioning of the Lingayen beach treat- 
ment was due in part to the light casualties. So few were the casual- 
ties on White Beaches One and Two that it was possible for the hospital 
43 
corpsmen of the USS CAVALIER beach party to assist in unloading cargo. 
Evacuation 
Careful attention had been given to the problem of evacuation 
at Lingayen Gulf. In the background was the expectation of a heavy 
casualty load - proportionately worse than in previous Pacific cam- 
paigns. The careful military strategy which preceded the invasions, 
however, was responsible in large degree for the small number of wounded 
in the initial invasion. 
Under the evacuation plan, surgical LST’s were to unload 
supplies and then to remain at the beaches indefinitely, or until iermy 
medical and evacuation facilities had been set up ashore. They were 
equipped with two additional surgeons and five additional hospital 
corpsmen so that they could give treatment day and night. When they 
were ready to reduce their casualty load, they retracted and unloaded 
onto an APA or APH. At Lingayen, five LST's were anchored at the beaches 
and one was kept near the force commander’s AGC, so that it could be 
43. Action Report, USS CAVALIER (APA37', Lingayen Gulf, p. 7, sent to the shore to relieve a withdrawing LST, or be sent alongside 
44 
some ship that had been badly hit. In addition, three PCE(R)!s 
were supplied with a supplementary medical officer, and were anchored 
near the force commander’s ship to be used for emergencies. 
Many of the APA’s word scheduled to depart on the night of 
S-day, and these were loaded with easily evacuable casualties that 
afternoon. APH's were ordered to remain in the assault area after un- 
loading, to receive casualties for evacuation. No hospital ships ar- 
rived at the Lingayen beaches, but they received casualties from the 
45 
transports on the return to the Leyte anchorage. 
At the staging area the surgical LST’s were supplied with 
4& pints of blood by the They also received 20,000,000 units 
of penicillin and additional gas gangrene anti-toxin. Four hundred 
pints of blood for the transports were supplied by the Navy blood bank 
aboard an LST at Leyte. Resupply echelons arriving on S plus 2 and 
S plus 4 brought further whole blood supplies which had been flown from 
the United States, Light casualties and extensive blood supplies re- 
sulted in more than adequate amounts for medical facilities both afloat 
and ashore. 
Control of the evacuation of casualties was in charge of a 
casualty evacuation control officer on each of the beaches. This 
44» Unsigned Report on Lingayen Medical activities, Personal Files 
of the Surgeon General, n.p. 
45. Action Report, Com Luzon Attack Force, Lingayen, p. 79. 
25 officer kept all available data on the location of specialists aboard 
tho transports and the capacities of the transports acting as evalua- 
tion ships from his particular beach. The plan provided the best 
evacuation control seen in any of the Pacific campaigns. However, a 
real test of its efficiency was not possible because of the light 
46 
casualty rate* 
The shore casualties were surprisingly light. Between S-day 
and S plus 4> approximately 720 wounded were evacuated in transport 
47 
echelons. Between S minus 3 and S Plus 30, total casualties were 
1,909 an average of 39 per day. An approximation of the number of 
casualties cared for by evacuating transports in the first days of tho 
invasion can be obtained from the following figure’s of personnel casual- 
ties handled by Task Group 79*2 at Lingayen: 
Ship 
Navy 
-urmv 
Total 
9 January 19A 5 
ROCKY MOUNT 
6 
1 
7 
MONROVIA 
16 
11 
27 
KNOX 
3 
0 
3 
CUSTER 
4 
0 
4 
CHARA 
4 
0 
4 
ASHLAND 
2 
0 
2 
LINDENWALD 
7 
9 
7 
CLAY 
4 
0 
4 
ARTHUR MIDDLETON 
12 
1 
13 
WILLIAM P. BIDDLE 
2 
0 
2 
GEORGE F. ELLIOT 
0 
3 
3 
CALVERT 
5 
0 
5 
46, Action Report, ComTransDiv 2, Reinforcement Lingayen, p, 14. 
47, Action Report, Com III Phib Forces, Luzon-Lingayen, p* 68, 
26 Ship 
10 January 194.5 
Navy 
jirmy 
s 
Total 
YfAR HAM 
47 
23 
70 
ALCYONE 
6 
0 
6 
MONROVIA 
46 
16 
62 
FREDERICK FUNSTON 
12 
0 
12 
4B 
TOTAL 
219 
72 
291 
No now casualties were handled up to S plus 3. Many of the Navy casual- 
ties were transfers from ships hit by ’•kamikaze” attacks. 
The majority of serious casualties at Lingayen came from the 
badly damaged ships. High percentages of burns from the "kamikaze" 
explosions were responsible for a number of deaths. Flash burn cream 
had not as yet begun to be used on a widespread basis, and there were 
many burns of the face, neck, throat, and exposed parts of the arms and 
49 
ankles* 
The Lingayen Battle Afloat 
Destruction wrought by Japanese "kamikaze" planes at Lingayen 
Gulf was heavy. Ship after ship of the task force shuddered under the 
impact of a Japanese plane carrying a 500 pound bomb crashing into the 
50 
decks or the superstructures. By the time of the Lingayen operation 
48• Action Report, ComTaskGroup 79.2, Lingayen Gulf, p. 41. 
The total are given exactly as found in the source. When the 
figures given are added they show: Navy, 176; Army, 55; and 
joint totals, 231. 
49. Action Report, ComTaskGroup 79.4, Lingayen, p. 35. 
50. Action Report, Com Luzon Attack Force, Lingayen, pp. 64-73. 
The following gives a list of ships with their casualties resulting 
from '’kamikaze'* hits in the Philippine area during the month of 
January. In addition to those cited twenty other ships were hit, the suicide planes had become a major part of the Japanese plan of 
defence, American forces were now operating in areas adjacent to many 
Japanese airfields. In addition, the "kamikazes'1 were maneuvering 
more successfully than before. Full utilization was made by the Japanese 
of the heavy cloud coverage which persists in the Philippine area, and 
the planes would hop from cloud to cloud until a good opportunity for 
striking presented itself. Despite the increase in "kamikaze" hits, 
the American vessels put up strong antiaircraft defenses, and instituted 
on which casualty figures are not included in the list. 
USS COWANESQUE (A079) 2 killed 2 wounded 
SS DYCKE sunk with all hands 
USS OIvlMANEY BAY (CVE79) 6 killed 65 wounded 
87 missing - sunk 
USS HELM (DD388) 6 wounded 
USS LOUISVILLE (CA28) 1 killed 75 wounded 
USS ORCA (AVP49) 4 wounded 
HMAS AUSTRALIA 25 killed 30 wounded 
USS MANILA BAY (CVE61) 10 killed 75 wounded 
USS WALKE (DD723) 15 killed 32 wounded 
USS R. P. LEARY (DD664) 1 wounded 
USS NEWCOMB (DD586) 2 killed 11 wounded 
USS NEW MEXICO (BB40) 30 killed 87 wounded 
USS BROOKS (APD10) 3 killed 10 wounded 
ship put out of action 
USS MINNEAPOLIS (CA36) . 2 wounded 
USS CALIFORNIA (BB44) 41 killed 155 wounded 
3 missing 
HMAS AU3TRALIZ (second hit) 14 killed 26 wounded 
USS SOUTHARD (DMS10) 6 wounded 
USS COLUMBIA (CL56) 20 killed 35 wounded 
USS LOUISVILLE (CA28) 28 killed 6 wounded 
10 missing 
USS LONG (DMS12) sunk 7 wounded 
USS LST 918 4 killed 4 wounded 
USS LST 912 4 killed 3 wounded 
USS CALLAWAY (APA35) 30 killed 20 wounded 
USS K2TXUN BAY (CVE71) 16 killed 15 wounded 
USS COLUMBIA (CL56) 17 killed 7 missing 
USS MISSISSIPPI (BB41) 8 wounded 
USS LERAY WILSON (DE414) 7 killed 3 wounded 
3 missing IT D 
HFICATHX 
51 
improved damage control programs. 
Navy medical facilities were frequently severely hampered in 
the attacks. Time and again bombs would crash into sick bay areas des- 
troying personnel and supplied. The account of a hit on the U3S 
MANILA BAY (CVE6) in Lingayen Gulf on S minus U days illustrates how 
medical department personnel met such a situation. The suicide plane 
with its bomb crashed into the flight deck of the carrier, directly above 
the sick bay. All medical personnel in the sick bay area? although in- 
jured, continued functioning. Light and ventilation of the area were com- 
pletely shut off, and shortly after, the rooms were flooded with oil, 
water, gasoline and foamite from above. Rallying its forces, the medical 
department staff directed the setting up of a substitute sick bay in the 
forward battle dressing station on the upper deck, and the wounded were 
carried to this station. In addition to the damage to the sick bay, the 
hangar deck battle dressing station had been completely demolished. 
Throughout the night the wounded were treated in the forward 
battle dressing station, while repair crews worked continuotisly to re- 
pair the sick bay area. Forty-eight hours after the hit the MANILA BAY 
was again operating its sick bay. In all, V+ were killed, 51 wounded 
USS DUPAGE (APA41) 35 killed 157 wounded 
USS GILLIGAN (DE508) 2 killed 6 wounded 
USS BELKNAP (APD34) 19 killed 37 wounded 
USS DICKERSON (APD37) 13 wounded 
USS LST 77B 7 killed 12 wounded 
USS ZEILEN (APA3) 5 killed 32 wounded 
3 missing 
USS SALAMAUA (CVE96) 5 missing 10 killed B7 wounded 
51* Action Report, Com Luzon Attack Force, Lingayen, p. 84* and 1 missing. 
As a result of the large percentage of burn injuries from 
the explosion, the carrier’s medical officer requested that improve- 
ments in flash proof clothing be initiated. The three piece head pro- 
tector was felt to be the most vulnerable to loss, and in addition it 
was difficult to wear. A further recommendation for improved stowage 
52 
facilities for protective clothing at battle stations was made. 
Another victim of a Japanese suicide attack during the Lingayen 
Gulf operation was the USS NEW MEXICO (BB40). In this case, the ’’kamikaze” 
landed in the superstructure of the battleship killing 30 and wounding 
87 seriously and 42 lightly. Many of the casualties were caught among 
the wreckage in almost inaccessible areas. Post-operation reports re- 
commended increased numbers of assigned stretcher bearers as well as a 
greater coordination of medical and volunteer aid in meeting such emer- 
gencies in the future. 
It was mot possible to evacuate the wounded from the NEW MEXICO 
until 13 days after the hit. For four days immediately following the 
explosion the battleship was almost continuously at general quarters 
under repeated air attacks. This situation had unfavorable results on 
the wounded, and placed medical department personnel under a serious 
strain. Battle dressing stations had to be manned during the day to 
care for subsequent casualties. Definitive treatment could not, for 
the most part, be administered until the night. Critically wounded were 
52, Action Report, USS MANILA BAY (CVE61), Lingayen, p, 79# 
30 hospitalized in an air conditioned ward, but many seriously wounded and 
neuropsychotic cases had to be quartered in cramped, non-ventilated areas 
with detrimental effects. The continual salvos of gunfire produced a 
state of anxiety among the wounded which was not conducive to good re- 
covery. In addition, the retention of the wounded aboard the battle- 
ship had an adverse effect upon the moralo of the crew. Those not yet 
v/ounded were made constantly aware of the plight of their comrades. 
cognizing the overtaxed conditions under which the medical department 
was already working, they feared that if their turn came they might not 
receive adequate care. "Too much emphasis cannot be brought to bear 
upon the importance of early evacuation of the wounded from a combatant 
ship", reported the NEW MEXICO’S senior medical officer. "This factor 
is considered as essential as rearming and refueling. The later, inci- 
53 
dentally, was accomplished while the casualties were still aboard." 
The need for improvement in first-aid instruction aboard the 
NEW MEXICO was indicated after the January hit. Despite the fact that 
first-aid lectures and demonstrations had been given to officers and men 
a few weeks before the engagement, insufficient first aid was rendered 
54 
by non-medical personnel in the emergency. While ample medical sup- 
plies were available, in many cases only morphine was given and battle 
dressings were not applied to wounds. Delay in first-aid treatment, 
until medical personnel could reach the scene, in some instances contri- 
buted to increased severity of shock. 
53. Action Report, USS NEW MEXICO, Lingayen Gulf, Kamikaze Attack, 
p'p. 105-106. 
54. Ibid.. p. 108. Requests were made by medical officers aboard the NEW L2XIC0 
for further equipment with which to meet the increased medical hazards 
caused by the nkamakaze" attacks. A refrigerated processing tank for 
X-ray work, sternal puncture needles for administering plasma, a modern 
fracture table, more adequate ventilation in the sick bay, and a better 
supply of water in suitable containers for gun crews were all felt to 
be necessary for proper medical care aboard a battleship. 
The problem of a sudden incidence of great numbers of severely 
wounded men ro«e again and again on the capital ships at Lingayen Gulf. 
To meet this situation adequately Navy Medical Department personnel 
worked day and night. On 6 January the USS CALIFORNIA experienced a 
hit by an enemy crash diving plane and a simulataneous explosion of one 
55 
of its own five inch shells. Two hundred three casualties resulted. 
Doctors and corpsmen worked for the two succeeding days and nights 
without rest to bring medical aid to the wounded. It finally became 
possible to transfer 67 cases to the USS BOLIVAR (APA34), and 13 other 
patients to the PCE 5S2 for further transfer to a naval hospital. At 
noon of 7 January 1945, 130 survivors were brought to the CALIFORNIA 
from the USS LONG, USS BROOKS and USS HOVEY. Fifty-two of these sur- 
vivors needed medical care, and were added to the CALIFORNIA1s own long 
casualty list of the preceding day. 
The most notable factor resulting from the attacks of the 
suicide planes was the severity of wounds and multiple compounded 
55, Action Report, USS CALIFORNIA, Bombardment of Luzon Island, 
Lingayen Gulf Area, p, 9, injuries. The USS LEXINGTON, struck by a "kamikaze" early in the 
Philippine campaign, suffered 182 casualties, 50 dead and 132 injured. 
Almost all of these patients suffered from burns of varying degrees of 
intensity, along with combinations of blast concussion, fractures and 
56 
shrapnel wounds. The USS COLORADO with 69 casualties, on 6 January had 
to deal with similar conditions, as did also the USS MISSISSIPPI on 
9 January, The COLORADO, recognizing the increasing danger of the 
"kamikaze" planes, requested a large increase in Hospital Corps per- 
sonnel for ships of the line engaged in "the present, unusually hazardous 
57 
duty." 
Treatment of battle wounds had become fairly standardized by 
the time of the Lingayen campaign. Following the application of first- 
aid measures, wounds were debrided, and sulfanilamide powder and sterile 
dressings applied. Tetanus booster shots were given in most cases. 
Liberal reliance on transfusions was made- not ohly of plasma, but more 
and more frequently of "0" type blood. Severe burn cases were debrided 
under pentothal anesthesia, and sterile petrolatum and sulfanilamide 
dressings were applied under pressure bandages. In some instances, by 
the time of the third day after treatment, burn dressings had become 
so foul smelling due to escaping serum, rising temperatures and poor 
ventilation, that further treatment became necessary for the morale of 
most of the patients. In such instances, the dressings were removed, 
broken blisters debrided, all burned areas sprayed with Pendleton1s 
56, Action Report, USS LEXINGTON, Attacks on Luzon, p, 33« 
57. Action Report, USS COLORADO (BBA5), Lingayen Gulf, p, 1^8. mixture of parrafin, cod liver oil, sulfadiazine, camphor, and menthol 
oil or eucalyptol. In most cases morphine was used "generously" and 
58 
sulfathiazole given orally. 
As a direct result of the increased "kamikaze” program, ner- 
vous tension on ships of the line ran high throughout the Philippine 
invasion. Increasingly it was noted by medical officers that numbers 
59 
of men reported to sick call for "vague mental complaints." Irrita- 
bility, depression, anxiety, and fatigue marked the strain under which 
the men and officers were required to perform their duties in the battle 
afloat. The senior medical officer of the aircraft carrier USS CABOT 
stated that time for the execution of various jobs had increased by as 
much as 50 percent. Continuous action, especially under the threat of 
suicide bombers, lack of recreation and rest, and lack of replacement 
, 60 
of personnel were the major causes for nervous fatigue. On the mine- 
sweeper USS SOUTHARD (DMS10) signs of nervous strain were especially 
marked. "The action in Lingayen Gulf," wrote the commanding officer, 
"was the severest that the present ship’s crew had ever experienced. 
The numerous calls to general quarters on route, the sight of numerous 
suicide attacks on ships in company, the necessity of staying at, general 
quarters during daylight hours for three days prior to S-day, and a 
suicide dive on ’own ship’, all contributed to a severe nervous strain. 
61 
As a result a few members of the crew ’cracked up’." Those who were 
5?r Action Report, USS MISSISSIPPI, Lingayen Gulf, pp. 36-37. 
59h A.oion Report, USS CABOT, Luzon Strike, p. 14. 
60. Ibid. 
61. Action Report, USS SOUTHARD (DMS10), Lingayen Gulf, p. 15. unable to continue under the nervous pressure were not "green” and un- 
tried personnel, but men who had been on the ship for a long time. 
Everything possible was done by medical department personnel 
aboard the ships to assure the crew of the best possible medical care 
following a suicide attack. Medical supplies were packed in large metal 
cases and dispersed widely throughout the ships. On the USS TIGOBDEROGA 
(GV14) individual first-aid kits containing battle dressings, tourniquets, 
iodine, bandages, and morphine syrettes were issued to every officer and 
chief petty officer, and training in their use given. Medical officers, 
dental officers, and corpsmen were organized into fracture teams, burn 
teams, surgery teams, plaster cast teams, and plasma teams. Specialized 
personnel wore trained as sorting teams to designate the casualties for 
proper treatment. 
Over-all recommendations were made to improve conditions 
aboard the ships of the line to meet the "kamikaze” menace. Extra 
folding cots for the medical department were indicated, as well as in- 
62 
creased plasma allowances. Especial emphasis was placed on the wear- 
ing of protective clothing by all personnel. Even a recommendation 
against shaving the head or clipping the hair short was mado, since 
63 
hair of normal length provided more protection against burns and injury. 
The commander of Battleship Division Four proposed the discontinuance 
of the use of glass wool insulating material on bulkheads and over heads, 
62, Action Report, USS COLUMBIA, Lingayen Gulf, p, 74, 
63. Action Report, USS STANLEY (DD478), p, 17. 64 
for this, under explosion, caused harmful personnel damage. 
The operations at Lingayen Gulf high lighted the medical pro- 
blems posed by the new Japanese weapon, the "kamikaze” plane. As at 
Leyte emphasis for the Navy Medical Department was shifted from land to 
sea. Marine personnel were not involved in the Philippine landings, 
and even the problem of evacuation from the invasion beaches was taken 
over by the Army after the early days of fighting. This energy of Navy 
medical staffs had to be turned to combatting the MbakaH planes and to 
bringing about medical order from the crippling blows levied against 
personnel and materiel in the battle afloat at Lingayen Gulf. 
Section 3 - Concluding Operations 
As the Army forces pushed down tov/ards Manila from Lingayen 
and San Fabian, other tenacles of the American offensive tightened about 
the remaining.Japanese strongholds in the Philippines. On 29 January 
the XI Army Corps went ashore at Subic Bay; two days later troops hit 
at Nasughu. Marinduque, Samar, Mindanao, Caballo, Palawan, Panay, Cebu, 
and Negros came into the .American military orbit as the winter of 1945 
passed into the spring. Throughout the Philippine campaigns, Navy 
Medical Department facilities and personnel functioned as an adjunct 
to Army medical activities with the invading forces. The over-all cam- 
paign was, of course, a joint endeavor, a jxx>ling of effort. Certain 
aspects of the Philippine campaigns (other than Leyte and Luzon) are of 
interest in an account of the Navy Medical Department in the Pacific War. 
64, Action Report, Com Luzon Attack Force, p, 79* 
36 The increased use of medically and surgically equipped LST!s, 
for both evacuation and early definitive treatment, was a characteristic 
of all the later Philippine campaigns. At Panay, where only 19 casualties 
were removed from the beaches in the landing phase of the campaign, three 
LST’s were equipped to furnish surgical and medical treatment at the beach 
65 
edge. One of those ships, the LST 613, acted as the main hospital ship 
for the invasion. It was staffed with 4 doctors, 1 dental officer and 20 
hospital corpsmen. At Zamboanga, opposition was also light and casual- 
ties were few. Hero the LST 459 acted as the chief evacuation and medical 
aid ship. It was equipped with 174 beds. Only 16 were occupied. The 
existence of a reef at Zamboanga prevented the beaching of the LST 459, 
66 
and patients were brought out to the ship in LCM’s. At the invasion of 
Caballo Island in Manila Bay, LST 206 treated 35 casualties in two days. 
Four medical officers aboard rotated in the tasks of caring for newly 
arrived cases, operating, and administering anaesthesia in operative 
eases. It was felt that this plan of rotation and the factor of quick 
evacuation to the ship from the Army battalion aid station were highly 
67 
significant in preventing fatalities among the more seriously wounded. 
At the Mariveles-Corregidor landings in the middle of February, 
Navy medical planning was geared to the provision of emergency and defin- 
itive major surgical care for all casualties until Army medical facilities 
65. Action Report, ComTask Group 78.3, Panay, p, 26. 
66. Action Report, ComTask.Groups 76,10, p. 19. 
67. Action Report, USS CONWAY (DD507), Caballo Bay, p. 10* 
(Medical Officer’s memorandum to the commanding officer). were set up on shore. In addition, the Navy provided medical and nursing 
care for the wounded on the evacuation voyage back to Subic Bay. Once 
again, major dependence was placed on hospital LST's, and two of these 
were provided. Surgical teams aboard each of the vessels consisted of 
4 doctors and approximately 15 corpsmen. Complete operating room facili- 
ties were provided in the troop compartment spaces on the port side. 
From 15 to 27 February the two ships alternated in providing daily ferry 
service to the Corregidor area. On 27 February Army facilities ashore 
were set up to provide for air evacuation. In all, 1,087 casualties 
were evacuated to Subic Bay by the two LST's, 80 Navy and 1,007 army 
personnel. In the post operation reports, special comment was made on 
the effectiveness of the hospital LST's in rendering immediate aid to 
v/ounded, providing adequate shock and antiseptic treatment, and perform- 
68 
ing major operative procedures. Similar service was rendered by LST's 
69 
at Negros. 
Following the Zamboanga campaign, Admiral Kinkaid commented 
on the increased use of hospital-evacuation LST's in the Philippine 
/campaigns: "It is not contemplated", he said, "that surgically converted 
LST's should provide hospital ship standards in handling casualties 
during amphibious operations. HoT/ever, they are of groat service, and 
70 
their potentialities should be utilized to the fullest extent," 
68. Action Report, ComTask Group 78.3, Mariveles-Corregidor Landings, 
p. 32. 
69. Action Report, ComTask Group 78.3, Negros, p. 16. 
70. Endorsement to Action Report, Group 78.1, Zamboanga, p. 2. A second aspect of Philippine campaigns in which the Navy 
Medical Department had a vital interest was that of dealing with the con- 
tinuing "kamikaze" hits. All possible measures were taken to save lives 
and prevent injury. Aboard the USS COLORADO, during an action at Mindoro, 
the sick bay area was abandoned because of its extreme vulnerability to 
71 
plane hits, forward under the forecastle deck. The USS COLUMBIA also 
recommended a change in the position of the sick bay aboard shins of 
72 
its type. Increased emphasis was placed upon the use of protective 
and flash proof clothing. This action was a direct result of the high 
incidence of burn cases in the Philippines area. Recommendations for 
improved clothing to provide greater burn protection were submitted by 
ship after ship. Larger amounts of Vaseline gauze were prepared for 
treatment of burns. A major emphasis was laid on the decentralization 
of medical supplies aboard vessels of all types. 
With the heavy increase in casualties on ships of the line, 
requests were made for greater numbers of medical personnel. This was 
especially emphasized aboard destroyer escorts. The DE’s were not only 
vulnerable to "kamikaze" attacks themselves, but they were also fre- 
quently used in the rescue of wounded survivors from other ships. No 
doctor was included in the regular complement of a DE, and the need for 
73 
a medical officer was easily recognized under these conditions. 
71. Action Report, USS COLORADO, Mindoro, p. 25. 
72. Action Report, USS COLUMBIA, Mindoro, p. 13. 
73. Action Report, USS JOHN C. CUTLER (DE339), Lamar, p. 15. 
39 The role of the Navy Medical Department in the campaign for 
the Philippines differed greatly from the action at the Marianas and 
Carolines. The main functions at the Philippines were to provide care 
on the beaches and evacuate casualties in the early hours of the opera- 
tions. The problems of hospitalization and later evacuation were handled 
by Army personnel. The work called, however, for a close cooperation 
between the medical staffs of the two services. 
In the Philippine battle afloat, line and medical personnel 
of the Navy were confronted with one of the greatest problems of the 
war - how to combat the ’’kamikazes1’ and provide adequate care for their 
victims. No over-all solution was found during the Philippine campaign, 
but every effort was expended to meet the danger with the facilities at 
hand. PHILIPPINES 
BIBLIOGRAPHY 
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