MEDICAL SERVICE 
IN 
CAMPAIGN 
STRAUB Medical Service in Campaign 
A Handbook for Medical Officers 
in the Field 
BY 
MAJOR PAUL FREDERICK SJRAUB 
MEDICAL CORPS (GENERAL STAFF) UNITED STATES ARMY 
Prepared Under the Direction of the Surgeon-General, United States 
Army, and Published by Authority of the War Department 
ILLUSTRATED 
PHILADELPHIA 
P. BLAKISTON’S SON & CO. 
1012 WALNUT STREET 
1910 Copyright, 1910, by P. Blakiston’s Son & Co. 
Printed by 
The Maple Press 
York, Pa. PREFACE 
The following pages include the substance of a series of 
lectures delivered at the Medical Department, Camp of In- 
struction at Antietam, Md., in July of 1909. 
It seems desirable that some systematic exposition of the sub- 
ject should be formulated to serve as a ground work for the 
instruction of me iical officers in camps of maneuver, whereby 
they and the sanitary units in their charge may take an intelli- 
gent part in the exercises. 
While this little volume is primarily intended for medical 
officers of the Regular Army and the National Guard, it is 
hoped that it may be found useful by other officers, especially 
by the students at our service schools who must necessarily give 
some consideration to the disposition of sanitary troops in all of 
the larger tactical problems. 
Washington, D. C., 
June, 1910. 
Paul Frederick Straub. CONTENTS 
Introduction . . 3-9 
PAGE 
Collateral military subjects 12 
Preparation for field service 13 
Orders 14-22 
Map reading 23-27 
Weapons 28-39 
Efficiency of cover 35-50 
Casualties 41-50 
Transportation * 51-56 
Organization 57-74 
Administration 75-84 
Battle dispositions 85-96 
Regimental service and aid stations 97-112 
Dressing stations 113-126 
Field hospitals 127-136 
Station for slightly wounded ; 13 7-143 
Line of communications 145-15 7 
Bibliography 159-160 
Index 161 CHAPTER I. 
INTRODUCTION. CHAPTER I. 
INTRODUCTION 
Since the Spanish-American War the organization and effi- 
ciency of our military establishment have greatly improved by 
the placing of our service upon a strictly modern basis. Our 
organization, equipment, and tactical instruction have been 
adapted to the improved firearms in use, and our Army now 
compares favorably, except in numbers, with those of the leading 
military nations. 
The creation of a general staff marked a momentous epoch, 
and our important military problems are now solved by a selected 
body of officers, and the work of co-ordinating the various arms 
and departments to make a well-balanced organization is well 
under way. 
These changes have also given foreign military literature a 
new and increasing interest, and many instructive works on 
“sanitary tactics” or “service of the medical department in 
the field” have become doubly valuable since the adoption of 
the common system of medical aid on the battle-field. The 
model ambulance system devised by Letterman during the 
Civil War was, in its day, the most efficient ever organized; 
and his plan must not be overlooked when this subject is 
under consideration, although it would hardly suffice in the face 
of modern arms and advanced ideas of military medicine and 
sanitation. 
The new organization and improved weapons have not, 
however, so completely revolutionized military methods that the 
procedures which demonstrated their practical value in earlier 
days should be lightly thrown aside for new schemes evolved 
from the inner consciousness of theorists. Everyone who is 4 
MEDICAL SERVICE IN CAMPAIGN. 
interested in the service of the Medical Department should 
read the medical records of our Civil War, beginning, perhaps, 
with the spring campaign of 1864, when the ripe experience 
of the previous three years was made the basis of a complete 
and effective organization. Enormous numbers of sick and 
wounded were taken care of and transported by the Medical 
Department in incredibly short periods of time, without em- 
barrassing the movements of the army, and relieving it of an 
encumbrance that in the earlier years of the war would have 
paralyzed the force. Upon the foundation laid at that time 
has been built our modern system of aid on the battle-field, 
and it is important to a clear understanding of the subject, 
that' the scheme developed under the stress and strain of great 
campaigns should be well studied. The modifications made 
necessary by new conditions are then easily understood and can 
be applied without violating the fundamental principles evolved 
from practical experience. 
In the absence of opportunity to learn from actual experience 
in warfare, one must be content with a theoretical study of the 
subject, so.that all possible preparation may be made for active 
service. While theoretical knowledge cannot take the place 
of practical experience, it can, at least, serve as a foundation 
for intelligent action when the critical time arrives. 
The importance of a theoretical study of military subjects 
is fully appreciated by our military authorities, as evidenced 
by the number of service schools now in operation. There 
are still some who seem disposed to sneer at what they call the 
“present educational fad” that obtains in our service and to 
ridicule many things taught therein because they appear trivial 
to them, apparently forgetting that the details of the greatest 
undertaking may be small in themselves, but none the less 
important in finally determining the success or failure of the 
enterprise. 
The highest function of the physician is to heal the sick, 
and he who does not respond to the cry of suffering is unworthy 
of his great calling. It is therefore quite natural that the public, INTRODUCTION. 
and even some military men, should look upon the medical 
officer as simply a practitioner of medicine whose sole mission 
is to relieve pain and heal the sick, and that the one who is well 
qualified to do life-saving operations and bring patients afflicted 
with serious diseases back to health is fully able to do all that 
is required of a military surgeon. The medical officer who 
lives up to this limited conception would find himself sadly 
out of place in active service—indeed, he would be only a civilian 
torn from his quiet routine and thrust into a sphere of action 
foreign to his taste and training. 
5 
It is true that in time of peace, the reputation, character, 
and influence of the Medical Department rest almost entirely 
upon the success attained by medical officers in the treatment 
of the sick civil and military personnel at army posts. This is 
so well recognized by the Department that the greatest care 
is taken to select candidates for commission therein who are 
exceptionally well grounded and trained in the duties of the 
medical profession. The approved candidates are given a year’s 
special instruction at the Army Medical School, in the branches 
that are most useful to medical officers; and when finally ac- 
cepted into the Corps, they have much better opportunities to 
perfect themselves in their chosen profession than the average 
civilian physician. Periodical professional examinations of a 
very searching nature are prescribed, so as to make it abso- 
lutely necessary for each and every medical officer to devote 
his time to the study and practice of his profession if he desires 
to continue in the service. 
In war, however, the utilitarian view of our service must 
take precedence over the sentimental. Armies are organized 
and maintained for the purpose of fighting battles and defeating 
an enemy, and the entire strength and resources of the medical 
department must also be drawn upon to assist in bringing about 
a successful issue; and it requires but little argument to show 
that a properly organized and trained medical department 
can contribute much thereto by its efforts in maintaining the 
effective strength of an army. This object is not brought 6 
MEDICAL SERVICE IN CAMPAIGN. 
about, however, by the successful performance of difficult surg- 
ical operations nor by the treatment of serious diseases, as men 
who require such skilled treatment, from the very nature of the 
cause of their disability, are probably lost to the army. In 
time of war the military value of the medical department de- 
pends upon its efficiency in preventing disease, by sanitation and 
early treatment of minor complaints, and in relieving an army of 
its encumbrance of sick and wounded. 
Military authorities have at last realized the vital importance 
of scientific sanitation, and everyone is now fully awake to the 
fact that stringent sanitary measures have saved many lives, 
compared to which the loss through bullets seems small. It is 
impossible to overestimate the influence that sanitary conditions 
have had upon campaigns, and the lessons to be learned from a 
study of the wars of the past may well command the serious 
attention of every military student. 
Ample provision has been made for the education and training 
of the medical officers of our army for the duties that will be 
required of them in time of war, except in so far as the very 
important service of relieving an army of the encumbrance of 
sick and wounded is concerned. The presence of a large num- 
ber of sick and wounded with a command not only complicates 
the supply and transportation problem, but also has a very 
depressing effect upon the mobility of an army, and, as so much 
depends upon the latter quality, it is reasonable to believe that 
an efficient service of the medical department may have a power- 
ful influence in determining a successful result. It has often 
been remarked by experienced military men that a considerable 
percentage of sick and wounded with an army in the field, in the 
absence of a proper evacuation service, would paralyze the force. 
In the very conservative foreign armies much attention is 
given to the training of medical officers and medical department 
units in preparations for field service, and regular courses of 
instruction are provided and all are given frequent opportunities 
to make a practical application of their knowledge at periodical 
field exercises and maneuvers. INTRODUCTION. 
7 
Our foreign confreres have long realized the importance of 
such studies, as evidenced by the large and constantly increas- 
ing number of interesting publications on the subject, many of 
which contain problems illustrating the general principles which 
underlie the service of the medical department in the field. 
Some of the problems are based upon actual campaigns and 
illustrate battle tactics, the influence of time and terrain, and 
the sequence of important events, which are very instructive 
and give an insight into the subject that could otherwise only 
be obtained by actual experience in battle. 
Too little attention has been given to this matter in our 
service, although a decisive step was taken when a medico-mili- 
tary problem was included in the examination of majors for 
promotion, which serves to call the attention of all medical 
officers to the necessity of qualifying in the subject. 
There is every prospect that the study of “sanitary tactics” 
or the “service of the medical department in the field” will be 
made a requirement in the examination of every medical officer. 
The chief reason for our backwardness in this respect has been 
the lack of a sufficient number of medical officers to do the 
strictly professional work in time of peace, and it was not con- 
sidered practicable to divert the energies of the limited number 
in service to the preparation for some possible future emergency 
when the one at hand demanded their entire time and attention. 
Of all the subsidiary departments, the medical has been, 
perhaps, most affected by the change in organization and tac- 
tics made necessary by the introduction of modern weapons. 
Military authorities agree that wars of the future will consist 
of a series of decisive battles, following in rapid succession one 
upon the other, and entailing enormous numbers of sick and 
wounded. Such conditions will make the work of the medical 
department very arduous and the proper disposition of its 
organizations a matter of great importance. The longer 
range and greater penetration of the new rifle bullet have 
made the problem of the rescue and transportation of 
wounded from the battle-field much more difficult, although 8 
MEDICAL SERVICE IN CAMPAIGN. 
the same necessity exists, as heretofore, for their speedy shelter 
and treatment. 
There is every reason to believe that the very large armies 
coming in conflict in a war with one of the powers would have 
a proportionately large percentage of casualties, and, as it is 
not practicable to maintain a medical department sufficiently 
large fully to cope with such extraordinary emergencies, for the 
reason that it is too cumbersome and expensive, it is highly im- 
portant that the relatively inadequate force should be trained 
to the highest state of efficiency. This state of efficiency can 
only be brought about by the requirement that, in addition to 
professional qualifications, medical officers shall be sufficiently 
instructed in such purely military subjects as may be necessary 
to enable them to act in harmony with the troops they are 
serving. 
There is no denying the fact that it is treading on debatable 
ground to advocate the study by medical officers of the sub- 
jects taught and practised by the line of the army; but it 
requires little argument to show that a medical officer cannot 
perform all of his duties efficiently if he does not thoroughly 
understand the military situation upon which he is expected 
to base his plan for the relief of the sick and wounded. The 
sanitary regulations of all armies provide that in case of emer- 
gency, the medical officer shall act upon his own responsibility 
in matters that pertain to his department, and if he expects to 
perform his duties properly and avoid conflict with the plans 
and purposes of other troops, he must possess a clear knowl- 
edge of the special military situation that confronts him. When 
such emergencies arise, it is too late then to seek counsel and 
advice from the commander or his staff, as they are all prob- 
ably engaged in more important affairs. 
It is by no means necessary that the medical officer 
should be required to make a profound study of the military 
art, but he must have sufficient familiarity with it to know 
how to adapt his dispositions to the tactical situation, to in- 
terpret orders, and to formulate his own clearly and concisely, INTRODUCTION. 
9 
subordinating and harmonizing them with those of his com- 
mander. A working knowledge of map reading and the proper- 
ties of ground, a correct estimation of distances, of the danger 
zone, and of the range of modern firearms would all seem to be 
necessary to locate properly the medical department stations. 
Before beginning the study of sanitary tactics or attempting 
the solution of medico-military problems, it is essential to have 
a thorough understanding of the following subjects: 
1. Medical Department regulations and organization in 
peace and war. 
2. Field Service Regulations concerning the medical depart- 
ment, rate and length of marches, length of columns, and the 
capacity and efficiency of the means of transportation for 
wounded and medical supplies. 
3. Army organization in general, and especially so much as 
concerns the lines of communication. 
4. The special conditions and circumstances which attend 
the service of troops on the march, in camp, and in action. 
5. Administrative methods at the various headquarters, and 
the formulation and interpretation of orders. 
6. Map reading and terrain. 
Nearly all of the information thus required is to be found 
in the Army Regulations and the various manuals issued by 
the War Department, but it requires considerable study to bring 
the rules and regulations together in such a way as to be able to 
apply them to a concrete case. An imperfect knowledge thereof 
would only lead to confusion, and no attempt should be made 
to solve medico-military problems without the essential pre- 
liminary study. 
It is presumed that the reader of the following pages is well 
grounded in the regulations bearing upon the service of the 
medical officer in the field and is prepared for a discussion of 
the method of conducting the service during and after an 
engagement. CHAPTER II. 
COLLATERAL MILITARY SUBJECTS. 
1. Preparation for Field Service. 
2. Orders. 
3. Map Reading. 
4. Weapons. 
5. Casualties. 
6. Transportation. CHAPTER 11. 
PART I. 
PREPARATION FOR FIELD SERVICE. 
The Field Service Regulations of our Army anti, as a matter 
of fact, for nearly all other services provide that in case of 
emergency medical officers may be authorized to issue orders 
to their subordinates in the name of their commander, which 
renders it absolutely essential that medical officers should 
endeavor to fit themselves for such functions, as the emergencies 
referred to are liable to arise during the course of any battle, 
when the time and attention of the commander and his chief 
of staff are taken up with more pressing duties. 
It is quite clear that the adminstrative medical officer in 
the field cannot properly perform his full duty unless he is 
fairly familiar with certain branches of the military art, which 
are necessary to a clear understanding of the situation to which 
he is expected to adapt his plans for the succor and care of the 
sick and wounded. It might be thought that such studies would 
tend to divert medical officers from their primary function 
of the care of the sick and wounded, but it requires little argu- 
ment to show that it immensely facilitates that very purpose. 
The amount of study required to get a sufficient knowledge 
of the military topics concerned is but child’s play compared 
to any one of the numerous branches of a medical curriculum, 
yet the information that can thus be acquired may make all 
the difference between failure and sucess of the medical service 
on the field of battle. 
In the following pages are given some of the elements of 
the subjects that cannot be classified under the head of sani- 
tation or other professional headings. CHAPTER 11. 
PART II. 
ORDERS. 
Medical officers must not only be able to properly interpret 
orders, but to issue them in proper form and in accordance 
with the instructions laid down in the regulations. (Field Orders, 
Messages and Reports, by Major Eben Swift, 12th Cavalry.) 
While there is much on the subject that does not appear to have 
any special application to medical officers or the medical service, 
it is still of vital importance that every medical officer should 
have a clear understanding of all orders and instructions, so 
that he may adapt and subordinate his directions to the general 
plans prescribed therein. 
It would be unwise to attempt to introduce for the medical 
department a special system of communication with sub- 
ordinates, and therefore, authorized military methods must 
be closely followed and orders of chief surgeons and other 
administrative medical officers must of necessity conform to 
the established custom. 
In the following pages the plain and explicit directions given 
by Major Eben Swift are very largely quoted. 
A military order is an expression of the will of the chief 
conveyed to subordinates. The higher the position of the 
issuing authority the more general in character must be the 
orders. 
At the beginning of a campaign, and from time to time 
thereafter, the intentions and plans of the supreme authority 
will ordinarily be communicated to subordinates in the form of 
letters of instruction. Under similar conditions, chief surgeons 
of armies or of field armies, will, under the authority of the com- ORDERS. 
mander, instruct subordinates in matters which pertain strictly 
to their respective departments. Such letters of instruction 
will regulate movements over a large area and for a considerable 
time prescribe a general objective, or, in the case of the medical 
service,- the sanitary regulations and general plan for the care 
and evacuation of the sick and wounded and the renewal of 
supplies, etc. 
Orders are classified as; 
1. Ordinary Orders. 
2. Orders. 
3. Field Orders. 
Ordinary orders are the orders for regiments and all larger 
commands, territorial and tactical, as well as for military posts 
and permanent camps, and are denominated general or special 
orders, according to their character. 
General orders publish matters of importance to the whole 
command which are of permanent interest or are to be con- 
stantly observed, such as hours of roll calls and duties, police 
regulations and prohibition laws and regulations for the army, 
eulogies and censures and results of trial by general courts 
martial. 
Special orders are such as concern individuals or relate to 
matters that need not be made known to the whole command. 
Orders issued by chief surgeons of large commands to sub- 
ordinates are necessarily special. 
Orders of commanders of smaller units, including field hos- 
pitals and ambulance companies, are simply called “orders.” 
For field service another class of orders is needed, which 
deal entirely with the tactical and strategical details incident to a 
state of war and prospect of contact with the enemy. They 
are denominated “Field Orders” and are numbered serially 
for each command. 
All orders except “Field Orders” are numbered in series 
beginning with the year or with the establishment of an 
organization. MEDICAL SERVICE IN CAMPAIGN. 
Circulars, memoranda, and letters of instruction are some- 
times rather loosely used in place of orders. 
Explanations, apologies, and guesses are signs of weakness 
in a commander. Undue interference with subordinates is 
inadvisable as it tends to relieve them of the responsibilities of 
their positions. The local minor authority may often be in a 
better position to determine the manner of carrying out the 
details of a plan than higher officers, on account of a better 
knowledge of the local conditions. 
It is unwise to attempt to make provision in orders for all 
possible contingencies that might arise during the course of 
operations. 
During active operations the orders of chief surgeons of 
large commands should ordinarily only give general directions, 
leaving it to the medical officers directly concerned to work out 
the details; in other words, a certain amount of elasticity must 
be maintained, so that due allowance may be made by the 
authorities designated to carry the order into effect, for local or 
peculiar conditions of which higher authority may have no 
knowledge, and for sudden and unexpected changes in the 
situation. 
The use of such terms as “before,” “behind,” “in 
rear,” “this side,” or other expressions that may easily appear 
ambiguous should be avoided whenever it is possible to indicate 
the plan or position by giving its compass bearings from well- 
known points. The terms “right” and “left” should not be 
applied to inanimate objects and must be restricted to reference 
to individuals or bodies of men or to the banks of streams, in 
which case the observer is supposed to be facing down stream. 
Expressions such as “as far as possible,” “as well as you can,” 
should not be used as they tend to divide the responsibility 
between the chief and his subordinates instead of leaving it 
where it belongs. 
Orders must be brief, concise, and clearly expressed, and a 
positive form of expression invariably used. An order reading 
that “the wounded will not be evacuated via the SHARPSBURG- ORDERS. 
BOONESBORO road” is objectionable, because the gist of the 
order lies in a single word. 
It would hardly seem necessary to say that all orders and 
letters of instruction should be clearly and distinctly written, 
as they may have to be read under unfavorable conditions of 
light and weather. 
The importance of adopting an almost invariable model for 
field orders, so that omissions may easily be detected is gener- 
ally recognized. 
MODEL FIELD ORDER 
ist Division, Northern Army. 
2 July, 1909, 7 P.M. 
Field Orders 
No. 12 
1. The Blue Army from the east has halted on the line of 
the Washington County Branch of the B. & O. R. R., with its 
outposts on ANTIETAM CREEK. 
The Red Army, from the southwest, has taken up a position 
on the ridge just west of ANTIETAM CREEK. 
From the reports of patrols, spies, etc., the Blue Commander 
decides that the line SHARPSBURG-WEST WOODS is 
very strongly held. While nothing definite can be learned of 
the line to the south of SHARPSBURG, the Blue Commander 
is of the opinion that that portion of the line is but weakly held. 
Red outposts occupy the high ground all along the right 
bank of ANTIETAM CREEK. 
2. This Division will attack and envelop the enemy’s right 
flank tomorrow. 
3. (a) The Artillery Brigade will take up its first position as 
soon as the 2nd Brigade moves from bivouac, and will support 
the infantry attack. 
(b) The 1st Brigade and 2nd Brigade will compose the 
fighting line and they will move out from bivouac at 5 a.m. The 
1st Brigade will form on the Valley Road just north of SHOW- MEDICAL SERVICE IN CAMPAIGN. 
MAN’S. The 2nd Brigade will form on the north and east of 
VALLEY ROAD, connecting with the 1st Brigade. 
ANTIETAM CREEK is fordable at all points. 
(c) The 3rd Brigade will constitute the reserve and will 
follow in rear of the left flank of the 2nd Brigade. 
(d) The divisional cavalry will cross ANTIETAM CREEK 
to the left and at the same time as the 2nd Brigade, and will 
cover our left. 
(e) The Engineer Battalion will support the Artillery. 
(f) The Signal Troops will establish and maintain communi- 
cation by wire between the different Brigade Headquarters, 
the Artillery position, the trains and Division Headquarters. 
4. The ammunition and supply columns will remain in their 
present position. 
A collecting station for slightly wounded will be established 
at ROHRERSVILLE. 
A dressing station will be established at the GRUNE 
HOUSE. 
A field hospital will be established at the W. SMITH 
HOUSE. 
The remaining ambulance companies and field hospitals 
will remain in their present positions. 
5. Reports will reach the Division Commander at present 
headquarters. 
By command of Major-General A. 
B. C., 
Chief of Staff. 
The caption is the heading of the order and consists of the 
official designation of the command from which the order is 
issued. It gives the place and date, and sometimes the hour 
and minute of issue, the series and the number of the order. 
The body of the order is divided into numbered paragraphs 
which are without headings. The 1st paragraph contains 
information of the enemy and so much of the general situation 
of our troops as is deemed necessary for subordinates to know. ORDERS. 
19 
Paragraph 2 gives the object of the movement or instructions 
covering as much of the general plan as are considered to be 
necessary in order to insure proper co-ordination in the move- 
ment of all commands. 
Paragraph 3 gives the disposition of troops adopted by the 
commander to carry out the purpose indicated in the previous 
paragraph and includes the tasks assigned to each of the several 
fractions of the command, 
Paragraph 4 gives the necessary orders for ammunition 
columns, trains, and sanitary troops, and may contain directions 
as to the disposition to be made of sick and wounded and the 
reserve supplies. In battle orders this paragraph may also 
contain the necessary instructions concerning the establish- 
ment of 
Collecting stations for slightly wounded, 
Dressing stations, 
Field hospitals, 
Reserve supply depots. 
In fact, everything that may apply directly to the service of the 
medical department on the march or in battle that is deemed of 
general importance to the whole command may be included 
therein. 
The chief surgeon of a division or an independent smaller 
command would be expected to submit his recommendations 
concerning the service of the medical department in the form 
in which, they are to be included in the march, camp, or battle 
orders as follows: 
“The sick of the command will be assembled at ROHRERS- 
VILLE by 5:20 a.m. to-morrow.” 
“Collecting station for slightly wounded will be established 
at KEEDYSVILLE. ” 
“A dressing station will be established at the GRUNE 
HOUSE at the junction of the VALLEY and SHARPSBURG 
roads. ” 
“Empty supply wagons will be placed at the disposition 
of the chief surgeon for the transportation of the wounded.” 20 
MEDICAL SERVICE IN CAMPAIGN. 
However, the manner in which these orders are to be executed 
and the personnel designated to accomplish it will ordinarily 
not be given in the division orders, as such details are of no 
importance to the command as a whole, but will be communi- 
cated in special orders to those directly concerned in the exe- 
cution thereof. The necessary instructions will be given in 
special orders issued by the chief of staff or by the chief surgeon, 
under the authority of the commander. Thus the ambulance 
company that may be designated to assemble the sick or to 
establish a dressing station will receive the necessary instructions 
in the form of a special order. 
Special Orders, 
No. 15. 
ist Division, Northern Army, 
Office of the Chief Surgeon, 
2 July, 1909, 8 p.m. 
Ambulance Company No. 1 is designated to establish the 
dressing station required by paragraph 4, Field Orders, No. 12. 
A. B., 
Lt.-Colonel, Medical Corps, 
Chief Surgeon. 
Paragraph 5, with few exceptions, contains the necessary in- 
formation as to the place where the commander can be found or 
where messages may be sent. This information is of importance 
to the medical department principally as an indication of where 
the chief surgeon may be found. 
In the margin of an order the medical department units 
are designated as follows: 
ist F. Hosp. 
2d Amb. Co. 
Fractions of such and smaller organizations are designated 
thus: 
Sec. ist F. Hosp. 
Sec. 2d Amb. Co. 
Detach. Hosp. Corps, 6th Inf. 
One or more ambulance companies are usually assigned to ORDERS. 
21 
the column of troops of the division on the march, the remainder 
with the train. 
In the presence of the ememy, an ambulance company, or 
a section thereof, with complete or light (pack mules only) 
transportation, may march in rear of the advance guard. 
Under all ordinary circumstances field hospitals march with 
the field train. Regimental detachments of the Hospital Corps 
habitually march with their units. 
Ordinary abbreviations are used in the caption, margin, 
and ending. 
A road is always designated by naming several places along 
its line, as SHARPSBURG-KEEDYSVILLE-BOONESBORO 
road. 
As it is extremely important that names of persons and 
places given in the body of an order should be clearly understood, 
it is advisable that they be emphasized by writing them in 
CAPITALS. 
Messages and Reports in the field are sent on regulation 
blanks. The sender fills in the hour and minute of despatch 
and indicates the rate of travel. 
“Ordinary” means about 5 miles an hour for a mounted 
man; “rapid” necessitates trotting 7 to 8 miles per hour; “ur- 
gent ” demands the highest rate of speed consistent with safety 
and certainty of arrival at destination. 
It is customary to leave the envelope open so that com- 
manders along the line of the messenger’s route may read the 
contents. If it is desirable that the contents be unknown 
the envelope should be sealed and marked “confidential.” 
The recipient fills in the time of receipt and returns the envelope 
to the messenger. 
The heading, “sending detachment,” should be filled in 
with the name of the body of troops with which the wrriter is 
serving, as F. Hosp. No. 1, etc. 
Several messages sent during the day from the same source 
to the same person should be numbered consecutively below 
the heading, “Sending detachment.” 22 
MEDICAL SERVICE IN CAMPAIGN. 
The signature should consist only of the surname and rank. 
The rules adopted to insure clearness and brevity in orders 
should also be followed in writing messages. 
A report is a more elaborate communication, which gives a 
complete narrative of some important action or event and there 
is not the necessity for brevity and conciseness as in the case 
of orders and messages. CHAPTER II. 
PART III. 
MAP READING. 
A knowledge of the rudiments of map reading is of importance 
to the medical officer in the field and for the solution of theo- 
retical medico-military problems. 
Only a few facts and rules are cited, as much of the matter 
given in books on the subject is important only to those who may 
be expected to make maps. It must be understood that some 
practice in the field is required and the student should take 
advantage of the opportunities afforded during practice marches 
and other field exercises. 
By map reading is meant the ability to grasp the general fea- 
tures of a map and to form a clear conception or mental picture of 
the ground represented by the map, the corresponding distances 
on the ground, the network of roads and streams, the heights, 
slopes and all forms of military cover and obstacles. These 
are all of importance to the medical officer, especially in the 
selection of medical department stations and routes for the 
evacuation of wounded from the battle-field. 
The United States Geological Survey map is the standard, 
but special military maps drawn on a larger scale are some- 
times furnished for special field exercises. Three scales are 
employed in the geological survey maps. The largest is i: 62,500, 
or very nearly one mile to the inch; that is to say, one linear mile 
on the ground is represented by one linear inch on the map. 
An intermediate scale, 1:125,000, or about two miles to one inch, 
and a third and still smaller scale of 1: 250,000, or about four 
miles to one inch are used. The features shown on these maps 
may be classed in three groups: a. Water, including seas, lakes, 24 
MEDICAL SERVICE IN CAMPAIGN. 
ponds and streams, which are shown in blue. h. Relief; includ- 
ing mountains, hills, valleys and cliffs, shown by contour lines 
in brown, c. Works of man, such as towns, cities, roads, rail- 
roads, and boundaries, shown in black. 
There are four essential points to be observed in reading a 
map: 
1. Conventional signs. 
2. Distance. 
3. Direction. 
4. Contours. 
(1) The conventional signs that are of the greatest interest 
to medical officers are indicated above and are quite obvious. 
(2) Distances are to be determined by the scale shown on 
every map, although occasionally the scale is indicated by a 
representative fraction. Thus a “mile to the inch” scale may 
be characterized by the fraction 1/62500 and “two miles to the 
inch” as 1/125000, etc. 
(3) On the geological survey maps North always corresponds 
to the top of the sheet, although in other maps it maybe indicated 
by an arrow. 
(4) Each brown contour line passes through points which 
have-the same altitude. One who follows a contour on the 
ground will neither go up hill nor down hill, but always on a 
level. The contour interval, or vertical distance in feet between 
one contour and the next is stated at the bottom of the map. 
Contours enable us to determine the relative heights of different 
points on the map. They also show the shape of the hillsides, 
whether concave or convex, and, most important of all to us, 
the cover that might be afforded for aid and dressing stations. 
Thus an elevation and a depression as indicated by contour 
lines would appear on the ground as shown in Fig. 1. It 
will be observed that contours close together indicate sudden 
rise or fall of ground, and when far apart a more gentle slope. 
To make use of a map the observer must first locate his 
exact position on the map, which may at times be quite difficult. 
By noting prominent landmarks, towns, streams, the compass MAP READING 
25 
Sec Aon on /ine A -<2 
/4s shown on the map. 
Sec Aon on /ine A--C. 
Fig. 1 26 
MEDICAL SERVICE IN CAMPAIGN. 
bearing of the road or roads, and the contour of the ground, it is 
usually possible to arrive at a proper conclusion. After the 
place occupied has been noted on the map, the sheet is to be 
turned so that the upper edge is to the north (or so that the 
arrow points in that direction). A compass is an essential 
instrument in all such exercises, although when the sun is visible 
the well-known method of determining direction by means of a 
watch may be used. When a map has thus been oriented, the 
direction of roads, etc., is at once clear. If, when traveling along 
a road, the direction, approximate rate of speed, prominent 
landmarks, cross roads, streams, and the configuration of the 
ground are noted, no great difficulty in keeping track of the posi- 
tion on the map will be encountered after a little practice. As 
suggested above, the beginner should take advantage of every 
opportunity in the field to practise the art of map reading, and 
the difficulties that he may first encounter will rapidly disappear. 
Very simple sketches showing locations of aid and dressing 
stations and evacuation routes may readily be made from a map 
with a few strokes of a pencil. These sketches can be made to 
indicate relative positions much more clearly than by written 
description; can be read quicker, and are less liable to be misin- 
terpreted. (Fig. 2.) MAP READING. 
Fig. 2. CHAPTER II 
PART IV. 
WEAPONS. 
The range and efficiency of firearms have an influence upon 
the medical service in battle that cannot be disregarded. Not 
only is the character of wounds largely determined thereby, but 
the dispositions and uses of the medical department units also 
depend very much upon the trajectory, range, and penetration 
of the projectiles in use. 
Wounds inflicted by modern rifle bullets are, generally 
speaking, less severe than those produced by the old large-caliber 
muskets, and with modern surgical methods a much larger 
proportion of those wounded in action may be expected to return 
to the ranks. However, the greater range and efficiency of 
modern weapons makes the rescue and removal of the wounded 
from the battle-field much more difficult, although the same or 
even greater necessity for their speedy rescue now exists than 
formerly, in view of the fact that by prompt surgical assistance 
a very large proportion of those injured in battle may soon 
be able to resume duty at the front. 
Very little difference exists between the military rifles adopted 
by various countries as far as concerns the medical department, 
as indicated by the following table: 
Country 
Caliber 
Sighted up to 
United States 
•3 
2850 yards 
Austria 
•3i5 
2187 yards 
Great Britain 
.303 
2786 yards 
France 
•3i5 
2187 yards 
Germany 
•311 
2187 yards 
Japan 
.256 
2187 yards 
Russia 
•3 
2096 yards 
Spain 
.275 
2187 yards WEAPONS. 
29 
The maximum range of the U. S. magazine rifle is 5465 
yards, and the angle of elevation necessary to attain this range 
is approximately 450; the time of flight being 31.36 seconds. 
The danger space caused by rifle fire is the sum of the dis- 
/ 
tances in the path of the bullet in which an object of given 
height will be struck. 
The point-blank danger space means the distance in the 
path of the bullet where the ordinates of the trajectory are not 
higher than 68 inches, which is taken to be the height of the 
average man. 
Point-blank Danger Space. 
Assumed height of 
Point-blank danger 
line of sight above 
space (computed). 
ground. 
Inches 
Yards 
Firing standing 
56 
718.6 
Firing kneeling 
3° 
629.4 
Firing lying down 
12 
589-7 
At 1000 yards fire would usually be effective at a line of 
skirmishers at five yards’ interval, and up to 1200 yards on a 
line of skirmishers at one yard interval. 
Fire upon a body of troops at close order of the width of 
12 to 15 yards will generally be effective up to 1000 or 1200 
yards; upon a body of men with a front of 20 to 25 yards, or 
upon a section of artillery up to 1200 to 1500 yards, and upon 
troops in columns of companies or compact bodies of artillery or 
cavalry at ranges from 1500 to 2000 yards. Beyond 2000 yards, 
infantry fire will not usually be effective except at very vulner- 
able targets, such as would be presented by large bodies of troops 
in mass under conditions which favor bringing the objective 
within the beaten zone. MEDICAL SERVICE IN CAMPAIGN. 
We are not, however, so much concerned with the effects 
of aimed fire as we do not propose to make our stations a target 
for the enemy’s shots, and it is the badly aimed or the shots 
fired without aim that interfere most with our arrangements. 
In severe engagements the aimed shots are comparatively few 
in number, and the badly aimed or overshots cover a deep zone 
with a rain of projectiles—the extreme limit thereof may be taken 
£'nemty’d firing Line. 
firing Lfne. 
Dangerous zone from bad/y aimed shots. 
. 2000 yards 
Fig. 3. 
to be about 3000 yards from the firing point as shown in Fig. 3. 
Some bullets will fall beyond and laterally to this zone, but 
little danger is to be apprehended therefrom. The danger 
zone does not correspond to the maximum range of the rifle, 
as it is not probable that any considerable number of men will 
fire their pieces elevated at an angle of 45 degrees, the angle 
necessary to attain the maximum range. 
The extent of the danger zone from overshots also depends 
upon the height above the ground from which the fire is de- WEAPONS. 
31 
livered; upon the flatness of trajectory, the height of object, the 
distance from the origin of the fire, and the configuration of the 
ground upon which it is situated. If the ground where the 
object is situated is not horizontal, its slope will materially 
influence the extent of the danger space. If the object is on 
rising ground, the angle will be increased and the danger space 
thereof diminished, but if it is on falling ground, the danger 
zone will be increased as the slope of the ground becomes greater. 
In studying the trajectory of missiles from modern rifles it would 
appear that in firing at a crest 1000 yards distant and 30 yards 
above the firing point, the danger zone from badly aimed shots 
Enemy's .firing line 
Dur line 
Fig. 4. 
begins about 300 yards in rear of the crest, if it is assumed that 
the ground behind it falls to the level of the firing point. In this 
zone of comparative safety the collection of wounded and the 
application of surgical dressings might go on without great 
risk during the progress of a battle. (Fig. 4.) Should the 
difference in height between the firing point and the objective 
be still greater, the extent of the zone of comparative safety 
would be correspondingly increased. On the other hand, 
there would be no zone of safety in the immediate rear of the 
lower firing point, and nothing could be done in the way of col- 
lecting wounded during the progress of the engagement unless 
some accident of terrain afforded good cover. 
A discussion of the influence of the enemy’s fire upon the 
medical service usually only takes rifle fire into consideration, 
for the reason that the element of excitement and other disturbing 
influences do not affect the laying of an artillery piece to the 32 
MEDICAL SERVICE IN CAMPAIGN. 
same extent as in the case of aiming with a rifle, and a danger 
zone from artillery overshots cannot be spoken of with the same 
significance. If stations come within the range of exploding 
shell it must be considered as a consequence of an ill-advised 
location, near batteries in action, or on ground that would be 
ranged over by the enemy’s artillery to find concealed batteries. 
As far as any influence upon the service of the medical 
department is concerned, it may safely be assumed that the 
artillery armament of different armies is practically the same, 
and by giving certain data concerning field guns and howitzers 
in use in our Army, the present purpose will be adequately 
served: 
Field Artillery. 
Shrapnel 
• Shell 
Gun 
Caliber 
Extreme 
range 
Weight 
No. 
of 
bullets 
Size and 
weight of 
bullets 
Weight 
No. of 
effec- 
tive 
frag- 
ments 
Field gun and 
howitzer. 
3 in. 
6500 
15 lb. 
262 
• 5 in. 
167 grains 
15 lb. 
1200 
Mountain gun. 
3 in. 
5800 
IS lb. 
262 
•5 in. 
167 grains 
15 lb. 
1200 
Siege gun and 
howitzer. 
4-7 in- 
8000 
60 lb. 
711 
• 54 in. 
230 grains 
60 lb. 
3000 
Heavy fi e 1 d 
howitzer. 
6 in. 
6700 
120 lb. 
871 
.6 in. 
288 grains 
120 lb 
. 6000 WEAPONS. 
33 
Area of Dispersion. 
Shrapnel 
Shell 
Gun 
Length 
Width 
Length 
Width 
At a 
Field gun and 
400 
15° 
300 
IOO 
range 
howitzer. 
Area of disper- 
less 
sion about 100 
than 
Mountain 
3° 0 
100 
250 
75 
yards wide and 
3000 
gun. 
150 yards long, 
yards 
very effective 
; x L a. 1 
At a 
Field gun and 
3 00 
125 
250 
75 
zone of about 
range 
howitzer. 
30 yards wide 
over 
and 20 yards 
3000 
Mountain 
200 
75 
150 
75 
long. 
yards. 
gun. 
As indicated above, projectiles used by modern artillery are 
of two kinds: shrapnel against animate objects—men and horses 
—and high explosive shell against material targets, such as 
batteries and defensive works. 
A shrapnel is essentially a thin cylinder or case, closed at the 
base and filled with round lead steel jacketed bullets which it is de- 
signed to carry to a point a short distance in front of the target, there 
to be expelled with increased velocity over a considerable area. 
The expulsion takes place through the action of a powder charge 
placed inside the shrapnel case in the rear of the lead balls. 
The powder is ignited by the action of a fuse carried in the head 
of the projectile, so arranged that it can be burst at any desired 
interval of time after the projectile leaves the gun. Figure 5 
indicates the area of dispersion and the danger zone produced by 
artillery projectiles. 
The fuse in the shrapnel is so set as to endeavor to explode it 
from 80 to 100 yards in front of the target, but owing to variations 34 
MEDICAL SERVICE IN CAMPAIGN. 
Danger Zone 
SHRAPNEL. 
Ddnger Zone /'minimum) 
overstock. 
Fo/nt of Hurst 
yJrca. of 3/Jferjjon /6° of medium ranges 
Diig/i G rp/osiue S/ie/f 
Point" of 3ur.it 
dlrea of D/sponsion /40o~. 
Fig. 5. WEAPONS. 
35 
in the action of fuses, the explosion may be expected to take 
place somewhere within the space extending from about 150 
yards in front to about 50 yards in rear. The danger space that 
may thus be produced extends therefore from 100 yards in front 
to about 300 yards in rear of the target. 
A shell is a thin-walled steel projectile tilled with high ex- 
plosives and provided with a sensitive fuse that acts only when 
the projectile strikes the ground or other obstacle. There is 
usually an intentional delay so that it will burst only after burying 
itself in the ground or when ricochet takes place it will explode 
a few feet above ground. The first condition is desired when 
field fortifications are to be demolished and the second when 
troops are to be reached that are protected from shrapnel by 
intrenchments. 
Efficiency of Cover against Rifle and Artillery Fire. 
Aside from the influence that penetration, range, and trajec- 
tory of projectiles have upon the number and character of wounds, 
they are also of great interest to the medical officer in the deter- 
mination of the efficiency of cover against the enemy’s fire, for 
aid and dressings stations. 
It must be distinctly understood, however, that the figures 
concerning trajectory and slope of fall of artillery projectiles 
have no reference to those fired at high angles from howitzers. 
It has also been estimated that 2.5" of soft and 1.5" of hard 
wood, and 15" of loose earth or sand will stop shrapnel bullets, 
fired at medium and long ranges and afford effective cover 
against them. 
The effect of high explosive shells is so powerful that ordinary 
cover, such as light stone walls, ordinary buildings, etc., afford 
but little protection, and it is hardly worth while to attempt to 
make an estimate of the probable resistance offered thereto by 
various materials. 
The penetrative power of the new sharp-pointed bullets is 
given below and indicates the protection that might be afforded 
by natural or artificial cover. 36 
MEDICAL SERVICE IN CAMPAIGN. 
Material 
Penetration inches 
50 feet 
100 yards 
500 yards 
1000 yards 
White-pine butts, made of i- 
inch boards placed i inch 
apart. 
33-5 
8.7 
4- 
14. 
0.446 
Through 
Through 
12.2 
46.7 
24-3 
13-4 
9.2 
18.8 
12.8 
12.5 
7-5 
18.6 
Loam practically free from 
sand. 
Mild steel plate, 0.493 inch 
thick. 
Mild steel plate, 0.3843 inch 
thick. 
Gun shield steel plate, 0.20 
inch thick. 
Thoroughly seasoned oak, 
across the grain. 
0.259 
Through 
Through 
33-6 
5-° 
The trajectory and more especially the angle of fall of projec- 
tiles as shown in (Figs. 6 and 7) must always be considered 
when the question of establishing a station within the danger 
zone from overshots arises. It is easily seen that a site for a 
station or an evacuation route might be selected, which would 
be entirely concealed from the enemy’s view, but nevertheless 
as much exposed to his overshots as the obviously exposed high 
ground in the neighborhood. 
As an illustration, let it be supposed that Fig. 8 repre- 
sents an area of a “two inches to the mile, 20 feet contour interval 
map,” and that the establishment of an aid or dressing station 
was contemplated at “A.” By measuring the distance between 
the 500 and the 440 feet contour lines, which indicate a fall of 
60 feet, it will be found that the slope of fall of a rifle bullet WEAPONS. 
37 
fired from a distance of 2000 yards, the position of the enemy’s 
line, corresponds to the slope of the ground, consequently the 
SLOPE OF FALL OF R/FLE BULLET 
VAR/ O US RANGES 
Fig. 6 
point “A” would be as much exposed to overshots as the crest 
at “B.” (The distance between the contour lines at “A” and 
“B” is approximately 500 feet, and the difference between the 38 
MEDICAL SERVICE IN CAMPAIGN. 
slope of fall of artlllery projectiles 
MAX ORD/RATE /J<)2 FEET 
VARIOUS RANGES 
6SOO YAPPS 
/■OR /.$ 
RAX ORD/RATE 3 78 FEET 
RAX ORO/RATE 2J7 FEET 
RAX 0PD/RATE 93./FEET 
RAX ORO/RATE 4S.3 FEET 
Fig. 7. WEAPONS. 
39 
S/oge of fa// of rif/e bu//et 
at 2000 yard-! range - /on 3.4203 feet 
Fig. 8. 40 
MEDICAL SERVICE IN- CAMPAIGN. 
500 feet and the 440 feet contour lines being 60 feet, the slope 
of fall of the ground is about one on eight, which practically 
represents the slope of fall of a rifle bullet fired at 2000 yards). 
By reference to the next table it may be determined how large 
a space would be protected against rifle fire at various ranges 
by obstacles of certain heights. Such information rray be of 
value when a large dressing station is to be established within 
the zone of overshots: 
Range 
Height of obstacle necessary to give cover to a soldier at the 
following distances in the rear thereof.* 
10 yards 
20 yards 
50 yards 
100 yards 
150 yards 
200 yards 
yards 
feet 
feet 
feet 
feet 
feet 
feet 
5 00 
1.000 
2.000 
3.000 
5- 
6- 
9 •1 
15.6 
6.0 
7-i 
12.6 
2S-i 
6.4 
9.2 
22 .6 
5°.6 
7.0 
12.2 
38-4 
91.7 
7-4 
14.6 
S3-1 
131.1 
7.6 
16.6 
65.8 
167.8 
* Note.—Assumed that line of sight is horizontal and height of man is 
68 inches. CHAPTER II. 
PART V. 
CASUALTIES. 
Before attempting to describe the system for the relief of the 
wounded on the battle-held it would seem to be quite necessary 
to inquire into the subject of battle casualties so that some 
estimate may be made of the losses to be expected and thus give 
an idea of the task which may confront the medical department. 
The study of battle losses is beset with many difficulties and 
yields only approximate results, for it must be based upon 
statistics seldom reliable and assume factors which are liable 
to many and unexpected variations. But in no other way can 
we obtain the information necessary for calculating the prob- 
able needs in personnel, supplies, and transportation of the 
department. 
Until very recently, the carefully prepared casualty statistics 
of our Civil War and those of the Franco-Prussian War served 
as a basis for estimating the losses to be expected in future 
campaigns, but the introduction of more efficient firearms and 
the result of the experiences in the Russo-Japanese War may 
compel some revision of our standards. Unfortunately, the 
completed statistics of the latter war are not yet available, 
but enough has been given out to indicate that no radical changes 
will have to be made in the estimates of losses in future cam- 
paigns, and it is therefore believed to be still profitable to also 
review some of the older figures: 
The average loss in individual battles was undoubtedly greater 
in the Russo-Japanese War than in the others mentioned and 
amounted to 16.7 per cent, for the Russians and 20.4 per 
cent, for the Japanese, whereas in the campaign of 1870-71 it 
was only 7 per cent. 42 
MEDICAL SERVICE IN CAMPAIGN. 
Battles 
Nation 
Strength 
Per cent. 
Ratio of 
killed and 
wounded 
Killed 
Wounded 
Shiloh, 
Union 
62682 
2.67 
13-4 
1-4.8 
April 6-7, 1862, 
Confederate 
40335 
4.27 
19.8 
1-4.6 
Antietam, 
Union 
56000 
3-749 
16.93 
i-4/5 
Sept. 17, 1862, 
Confederate 
40000 
6.7 
21.93 
1-3.2 
Gettysburg, 
Union 
88289 
3-57 
17-5 
1-4.6 
July 1-3, 1863, 
Confederate 
75000 
5-2 
24.O 
1-4.6 
Chickamauga, 
Union 
58222 
2.8 
16.7 
!-5-9 
Sept. 19-20, 1863, 
Confederate 
66366 
3-4 
22.0 
1-6.4 
Wilderness, 
Ma7 S~7> i864, 
Union 
Confederate 
101895 
61025 
2.2 
II.8 
........ 
1-5-3 
Spichern, 
German. .. . 
28000 
2.9 
I2.7 + 
!-4 -3 
Aug. 6, 1870, 
French 
20000 
1.6 
8-3 
1-5-2 
Mars-la-Tour, 
German. .. . 
66300 
4-94 
15-5 
1-3-I 
Aug. x6, 1870, 
French 
126170 
1.08 
8.0 + 
1-7.4 
Gravelotte, 
German. .. . 
146000 
3 -°4 
IO-37 
i-3-8 
Aug. 18, 1870, 
French 
125000 
0.9 
5-37 
i-5-8 
Sedan, 
German. .. . 
165400 
0.989 
3-91 
1-3-9 
Sept, x, 1870. 
French 
108000 
2.76 + 
12.97 
1-4.6 
Yalu, 
Russian .... 
2X000 
3-o 
5-6 
1-2 
Apr. 30-May 1, 1904 
Japanese . . 
40966 
o-5 
2.0 
1-4 
Liaoyang, 
Russian .... 
140000 
1.799 
9-85 
i-5-5 
Aug. 26-Sep. 4, 1904 
Japanese . . 
I25OOO 
3-837 
14.0 + 
x-4 
Mukden, 
Russian .... 
310000 
2.9 
x6.3 + 
i-5-5 
Feb. 23-March 10, 
19°S- 
Japanese . . 
340000 
4.41 
17.64 
1-4 CASUALTIES. 
43 
The percentages given for the Manchurian campaign are 
for individual battles which lasted for variable periods of time, 
from a few hours to several days and even weeks. 
For the purposes of comparison and as a basis for estimates 
of medical department requirements for the future, such battle 
percentages are not entirely satisfactory. It is of some impor- 
tance that we should know the proportion of losses for each day’s 
fighting as the wounded are not to be left on the field until the 
close of an engagement that lasts more than one day. In the 
Franco-Prussian War most of the 27 battles were fought and 
decided in one day and several of the Civil War engagements 
lasted several days, sometimes more than a week. It has been 
computed that the percentage of casualties for each fighting 
day during the campaign of 1870-71 for the Germans was 
4.7 per cent, for the Russians in Manchuria 1.7 per cent, 
and 2 per cent, for the Japanese. The percentage for each 
battle day of our Civil War was probably not far from that of 
the Germans. 
These figures have not, however, such an important bearing 
upon the medical service as supposed by some, as there is not the 
slightest foundation for belief that the casualties were evenly 
distributed throughout the course of long engagements. Some 
of the great battles in the Russo-Japanese War were fought 
over a very large space of ground and continued for many days, 
but there were always intervals in the course of the battles when 
troops were not actually engaged. 
At Mukden, where the operations extended over a period 
of nearly two weeks, there were not more than three or four 
fighting days for any one body of troops. The same state 
of affairs obtained to some extent in many of the battles of 
the Civil War. At the battle of Gettysburg, for instance, 
which lasted three days, the same troops were rarely engaged 
more than one day. 
While there is no numerical data to prove that at critical 
moments during the Manchurian battles (charges, hand to hand 
fights, etc.), that losses were so high as to equal or even exceed 44 
MEDICAL SERVICE IN CAMPAIGN. 
the rate of the average German loss of 4.7 per cent., it is believed, 
nevertheless, that such was the case, as several higher units sus- 
tained a very high per diem rate. One Japanese division had a 
daily loss during a period of two days, in infantry alone, higher 
than the Germans average per diem, and in the following two 
days the loss was four times as great. 
Some exceptionally high battles losses were sustained by 
organizations in the Manchurian War. One Russian army 
corps lost in a single battle 25 per cent, of its force, and the 
number of divisions that lost 25 per cent, or over was strikingly 
great. One Japanese brigade was practically wiped out, as 
only 10 per cent, escaped. Three Russian infantry regiments 
lost 57, 6x, and 66 per cent., respectively, at Sandepu or 
Mukden, and four Japanese regiments lost 39, 51, 62, and 68 
per cent, in an individual battle. Great losses also occurred 
on individual battle days, and the record shows that a division 
lost as much as 30 per cent, and a regiment 46 per cent, in a 
single day. 
The ratio of losses to the average fighting strength of the 
different arms for the whole war is given as follows: 
Russian 
Japanese 
Infantry 
26.6 per cent. 
32 per cent. 
Cavalry 
9.9 per cent. 
2 per cent. 
Artillery 
8.7 per cent. 
14 per cent. 
According to Matignon’s report, the proportion of loss in 
sanitary troops of the Japanese was next to that of their infantry. 
One of the most notable results of the Manchurian experience 
was the demonstration of the comparatively benign effects of the 
modern rifle bullet on the human body, as shown by the large 
proportion of comparatively slight wounds and the small pro- 
portion that subsequently died therefrom. The Russians lost CASUALTIES. 
45 
only 3.2 per cent, of their wounded by death, and the Japanese, 
6.8 per cent., whereas in 1870-71 the Germans lost n per cent, 
and in the Civil War the Union side lost 13.2 per cent. Much 
of the improvement in this respect is undoubtedly due to better 
surgical treatment, but the fact remains that the small modern 
bullet is less liable to produce a fatal result, as the wounds caused 
thereby are not so easily infected on account of the compara- 
tively small size of the openings, and also because the narrower 
track is less liable to involve contiguous vital parts. 
There is some foundation for the belief, based upon the ex- 
perience in Manchuria, that in future wars the proportion of 
wounds inflicted by artillery will be greater than was the case 
in the Civil War or the Franco-Prussian War, in which the pro- 
portion of wounds caused by shell and shrapnel amounted to 
9.9 per cent, and 8.4 per cent., respectively. Some observers 
have estimated that the proportion of artillery wounds in the 
Russo-Japanese War reached about 15 per cent. The pro- 
portion of wounds caused by weapons other than firearms 
was small, 1. 7 per cent, for the Russians and 3 per cent, for the 
Japanese. 
It would appear that the battles in the Far East were so 
“bloody” not only because of their longer duration, but also on 
account of the high efficiency of the weapons used. 
The personal equation of the contestants must, however, be 
taken into account if the casualty figures of the Manchurian 
War are to be used as a basis for estimation of probable losses 
in future wars. It must be recognized that the Japanese were 
deliberate but most persistent assailants and the Russians were 
equally stubborn defenders. Whether or not the same tactics 
would be used by others in a future war is a subject only for 
idle speculation. 
With a full knowledge of the published results of the last 
war and from personal experience in Manchuria, competent 
observers have expressed the opinion that the proportion of 
casualties in future wars will not differ materially from those 
sustained in earlier wars, and the deductions drawn from most 46 
MEDICAL SERVICE IN CAMPAIGN. 
carefully prepared statistics of our Civil and the Franco-Prussian 
Wars may still be used as a guide. 
For the purpose at hand it is quite important to endeavor 
to determine the “ordinary maximum casualty” that troops 
are liable to sustain, to be used as a basis for calculating the 
amount of personnel and supplies needed. It must be empha- 
sized that there is no reason for the belief that in future wars the 
morale of our troops will be any different than in the past or that 
they will bear any greater proportion of losses than formerly. 
As a matter of fact, it is stated upon good authority that troops 
will not ordinarily maintain their firmness after a loss of 10 per 
cent, of their number and that anything beyond that usually 
means a local or general disaster. This perhaps, explains the 
reason that a loss of 10 per cent, is usually assumed in theoretical 
battle problems. 
Taking the casualty statistics of previous wars as a basis, 
it may be assumed that the maximum casualties to be expected 
in various sized organizations, great disasters excluded, are 
about as follows: 
For an army corps (about 40,000 men) 20 to 25 per cent. 
For an infantry division (about 20,000 men) 25 to 30 per cent. 
For a regiment (about 1,500 men) 40 to 60 per cent. 
While the loss of a division may amount to 20 per cent, or 
more, it does not follow that the casualties will be evenly dis- 
tributed among the various organizations of which it is com- 
posed, as more than one-half may be wounded in one group or 
small area of the field, so that some regiments may sustain an 
enormous loss and others very little. This is an important 
point to remember as it affects the distribution of the divisional 
medical units on the field. 
Such figures are also of importance in making estimates of 
the probable needs of personnel, supplies, transportation and 
hospital accommodations for units of various strengths for an 
impending serious engagement. 
The distribution of the total number of casualties into proper CASUALTIES. 
47 
categories is also necessary when the attempt is made to estimate 
the amount of transportation and hospital space that may be 
needed at the front. The proportion to be included in each 
class has been variously estimated and some rather extravagant 
statements have been made in reference thereto. For instance, 
it was maintained by some that the Manchurian campaign 
showed that 75 per cent, of all the wounded would be able to 
reach the dressing stations, field hospitals, or advance base 
unaided. Authorities have reached no definite agreement as 
to the probable proportion to be expected in each class in the 
future. Each has apparently modified the figures obtained 
from the Far East to meet the probable requirement of his own 
particular service. The figures here given are believed to be a 
conservative estimate from our point of view. It must not be 
forgotten that the state of discipline and training has some 
influence on the number of wounded that can be compelled to 
walk some distance. 
For working purposes those wounded in battle may be 
apportioned among four different categories: 
1. The very severely wounded that cannot stand transporta- 
tion, including abdominal wounds and other serious injuries ac- 
companied by marked symptoms of shock. The transportation 
of such cases to a distance in vehicles would in all proba- 
bility deprive many of them of their chance of recovery. From 
a service point of view, such cases are lost to the army, but 
humanity demands that they be given every possible care and 
attention, ft is questionable if special efforts should be made 
to prevent such cases from falling into the hands of the enemy. 
However, wounded must not be lightly left to fall into the 
hands of the enemy, as the effect that such action would have 
upon the morale of troops is not to be disregarded. When- 
ever practicable they should be sheltered near the place of the 
receipt of their injuries, and, when necessary, left with sufficient 
personnel and supplies, under the protection of the provisions 
of the Geneva Convention. 
2. The less severely wounded that require transportation by 48 
MEDICAL SERVICE IN CAMPAIGN. 
litter or ambulance from the field and aid stations to the dressing 
stations and field hospitals, 
3. Wounded whose injuries are such as to permit them 
to walk as far as the dressing station or field hospital. 
4. Wounded that are able to walk to the station for slightly 
wounded and to the advance base or other designated point on 
the line of communications. It is gradually becoming more 
and more appreciated that the care and treatment of the less 
severe cases is of greater importance to the army in the field 
than that of the serious ones, as a large percentage of the former 
may be expected to recover soon and resume duty at the front. 
From a strictly military standpoint it is quite necessary that 
these professionally less interesting and less important cases 
should be given great care and attention and that the 
medical department should not expend all of its energies upon 
those that cannot hope to be able to render further service in 
the campaign. 
The proportion of the various categories of battle casualties 
are estimated to be about as follows: 
20 per cent, killed. 
8 per cent, non-transportable. 
{sitting up, 20 per cent, 
recumbent, 12 per cent. 
28 per cent, able to walk to dressing station and field hospital. 
12 per cent, able to march to advance base. 
In accordance therewith, of every one hundred wounded: 
10 are non-transportable. 
15 require transportation recumbent. 
25 require transportation sitting. 
35 are able to walk to the dressing station or field hospital. 
15 are able to walk to the station for slightly wounded. 
As an illustration, let it be supposed that a division has 
sustained a loss of 10 per cent, in battle, and the strength of 
the division, taken in round numbers, is 20,000 officers and men; 
the casualties would be distributed among the various classes 
as follows: CASUALTIES. 
49 
Killed 400 
Wounded: 
Non-transportable 160 
Requiring transportation 640 
Able to walk to dressing station or field 
hospital 560 
Able to march to advance base 240 1600 
Total 2000 
Should the loss reach 25 per cent., which is by no means 
uncommon, the result would be as shown below: 
Killed xooo 
Wounded: 
Non-transportable 400 
Requiring transportation 1600 
Able to walk to dressing station or field 
hospital 1400 
Able to walk to advance base 600 4000 
Total 5000 
Casualties from Disease.—From a study of the morbidity 
statistics of great campaigns a basis has been found for making 
estimates as to the probable number of cases of sickness that 
may be expected in a given period, so that the necessary prepara- 
tion for their care and treatment may be made. It must be 
understood that the figures quoted below apply only to fairly 
well-seasoned troops operating under normal conditions of 
climate and service and in the absence of epidemics of infectious 
diseases. Experience has shown that during the first days of a 
campaign these figures are largely exceeded and reach a normal 
only after the weaklings have been weeded out and the troops 
have become hardened. In the first few hard marches the losses 
may be from 5 to 10 per cent, of the force. 
It can hardly be expected that such estimates will accurately 
apply to any specific case, yet the experience of past campaigns 
gives the only rational basis for calculation. It is reasonable 
to believe that the value of the factors given in the calculations MEDICAL SERVICE IN CAMPAIGN. 
can, after some experience in a campaign, be modified to corre- 
spond to the actual situation. 
For the present purpose the sick are classified as follows: 
„. . . , f Able to do light duty: Class (a) 
i. Sick in quarters < TT ,, . . ' 
L Unable to do any duty: Class (b) 
... Hospital cases.. (fght “ass £> 
f Severe Class (d) 
Class 
Daily 
admission 
per 1000 
Duration of 
treatment 
in class 
Average 
number of 
days in 
class 
Day when 
maximum 
number is 
reached 
(a) 
3 
3 days 
3 
4 
(b) 
3 
3 to s days 
4 
6 
(c) 
i-S 
5 to 14 days 
10 
15 
(d) 
i-S 
14 to 50 days 
32 
5i 
It would appear from the above table that the maximum 
number of cases in class (a), for instance, would be reached on 
the fourth day, and thereafter the admissions and discharges 
would balance. Discharge from a class does not necessarily 
mean that the patient was returned to duty, as it includes deaths 
and transfers to another class, and in the latter case, it would 
constitute a new admission in the category to which he was 
transferred as far as these figures are concerned. CHAPTER II. 
PART VI. 
TRANSPORTATION 
The Medical Department field service regulations remark 
upon the difficulties that may be expected in the efforts to relieve 
the troops at the front of the sick and wounded. It has often 
been stated that the success of the medical service in the field 
largely depends upon the celerity with which the command can 
be relieved of its encumbrance of non-effectives, and many 
experienced medical officers have expressed the opinion that the 
future progress of medical organization must necessarily be 
along the line of developing a more adequate transport and 
evacuation service. The Manchurian campaign illustrates this 
necessity in a marked degree and the additional transport ma- 
terial that the contestants were forced to obtain was enormous 
in comparison to what they had at the beginning. It is recorded 
that during the last year or two of our Civil War some com- 
mands were allowed ambulances at the rate of one for every 150 
men and then the supply trains often had to be largely drawn 
upon after serious engagements. By comparison, the present 
allowance—one ambulance to about 400 men—seems very small, 
but there is now authorized a transport column on the line of 
communication for each division which formerly did not obtain. 
It is a foregone conclusion that in a severe battle in which 
large bodies of troops are engaged the present authorized medi- 
cal department transportation will prove as pitifully inadequate 
as in former times, but it must be remembered that armies are 
put in the field in war time for the purpose of fighting battles and 
not to exploit humanitarian ideas or medical methods, and that a 
medical department might easily be made so cumbersome that the 
greater good that it could then accomplish in the way of better 
care of wounded would be more than offset by the hindrance 
it might be to the army in accomplishing its main purpose. 52 
MEDICAL SERVICE IN CAMPAIGN. 
The medical department of a division disposes over a variety 
of means of transportation for patients and for medical supplies, 
comprising ambulance wagons, field wagons, litters, pack trans- 
port, travois, etc., to which may be added ambulance carts, two 
mule litters, and motor vehicles. 
Means of Transport of Medical Department for Infantry Division. 
Ambu- 
lance 
wagons 
Field 
wagons 
Litter 
squads 
Pack 
mules 
Tra- 
vois 
Regimental (12 Reg) 
12 
72 
12 
Ambulance company (4) .. . 
48 
12 
64 
16 
16 
32 
Reserve medical supply. .. . 
6 
48 
62 
136 
28 
16 
Cavalry Division. 
Ambu- 
lance 
wagons 
Field 
wagons 
Litter 
squads 
Pack 
mules 
Tra- 
vels 
Regimental 
10 
60 
10 
Ambulance company (2) .. . 
24 
6 
S2 
8 
8 
Field hospital (2) 
32 
Reserve medical supply. .. . 
6 
Totals 
24 
54 
92 
18 
8 TRANSPORTATION. 
53 
Ambulances, litters, and travels may be considered as being 
always available for transporting wounded, but it is hardly to 
be expected under any circumstances that all medical depart- 
ment supply wagons can be diverted to such use. Most of 
those belonging to established field hospitals and to ambulance 
companies might be counted on for temporary use in case of 
emergency. It is also often considered to be practicable to use 
empty wagons of the supply train of the division—one section of 
about 50 wagons which must return daily to the advance base 
for renewal of supplies, provided that it would not be necessary 
for them to be diverted from their prescribed route of march. 
The general supply service of an army in the field is of such 
vital importance to its efficiency, and as it must be carried on 
with a minimum amount of transport, no serious interference 
therewith can be tolerated, even in the interest of the sick and 
wounded. 
While there are 475 field wagons allowed an infantry division, 
yet it would be unreasonable to expect to obtain more than a 
very small part thereof, and the medical department must be 
content, perhaps, with the empty supply section referred to. 
There is, however, still another source from which additional 
transportation for wounded may be drawn—vehicles belonging 
to citizens in the surrounding country, and regulations of many 
services provide for the systematic collection of wagons when- 
ever a battle is imminent, and for evacuating the sick of troops 
on the march when the usual means are not available. 
Chief surgeons are also authorized to hire transportation 
under such circumstances, and, in some countries, as was the 
case in Manchuria, it may be feasible to largely extend the 
transport by hiring litter bearers. 
The transport columns that properly belong to the line of 
communications would probably be largely augmented and 
might be called upon to assist at the front, when the special 
military situation permits. 
From the above it may be gathered that it is not possible to 
give definite figures concerning the amount of transport that 54 
MEDICAL SERVICE IN CAMPAIGN. 
might be available in a given instance, but the statements made 
afford some basis at least for making a reasonable estimate. 
For practical purposes and for the solution of medico-military 
problems it is essential that attempts should be made to deter- 
mine the capacity of the various means of transport and the 
amount of work that could.be accomplished therewith. Here, 
again, a great difficulty arises in the effort to fix upon a normal 
that is to be used as a basis for estimate. The factors concerned 
are subject to such great variations; the military situation, 
roads, cover, weather, etc., all must be considered. However, 
the figures quoted below are, perhaps, the best estimate that 
can be obtained, and in fact some of them have been practically 
confirmed by observers in the Russo-Japanese war, who gave 
special attention to the subject. 
The most important element in the plan for the medical ser- 
vice in battle is the arrangements that have to be made for the 
transportation of sick and wounded, the chief surgeons must 
make an estimate of the kind and amount of transportation that 
will probably be required in case a severe battle takes place. 
The various factors in the estimate given here would probably 
have to be given other values to meet local conditions and the 
special military situation, but a knowledge of the plans of the 
commander and of the topography of the ground would simplify 
the problem. Formulas have been devised to facilitate such 
calculations and the figures and formulas given below are quite 
generally accepted for the purpose: 
Litter Transportation. 
First aid and loading, 8 minutes 
March 1000 yards, 20 minutes 
Unloading, delays, 15 minutes 
Returning with closed litter, 10 minutes 
53 minutes 
(roughly 1 hour) TRANSPORTATION. 
55 
Ambulance Wagon. 
Four litter cases and one sitting with driver, or nine patients 
able to sit up may be carried in one load. The average load 
(recumbent and sitting) of an army field wagon may be taken to 
be five patients. 
Loading 4 recumbent and one sitting, 5 minutes 
Driving 2000 yards, 18 minutes 
Unloading and exchanging litters, 5 minutes 
Return, delays, 10 minutes 
38 minutes 
or to calculate the time required with a given amount of trans- 
portation to evacuate a certain number of wounded to a desig- 
nated point. 
. , wXxXt 
1 ime required = 
m Xx Xn 
To obtain the amount of transportation required in a given 
time to evacuate a certain number of patients, the following 
formula may be used: 
w Xx X t 
Number of units of transport required =— 
T Xx X n 
m=the number of units of transport material (ambulances, 
wagons, carts, etc.). 
T = the time allowed or required. 
w = the number of wounded. 
t = the time taken by the vehicles used for transport. 
n = the number of patients each unit carries. 
As an illustration, let it be supposed that 200 wounded are 
to be transported by the 12 ambulances of an ambulance com- 
pany from a dressing station to a field hospital located three 
miles away, and it is desired to know the time necessary for 
accomplishing the task. From the figures given in the chapter 
on casualties it would appear that 75 of the 200 wounded re- 
quiring transportation would have to be carried lying on litters 56 
MEDICAL SERVICE IN CAMPAIGN. 
and the remaining 125 sitting up. By using the second formula 
the following figures are obtained: 
75X2 
Recumbent =3 hours and 6 minutes. 
12X4 
1:25X2 
Sitting «=2 hours and 18 minutes. 
12X9 
Total time required 5 hours and 24 minutes. 
Should the problem be to ascertain the number of ambulances 
required to move that number of patients in three hours, the 
second formula would apply: 
0 , f7SXi.5 
Recumbent = 9.3 + 
3X4 
125X1.5 
Sitting =6.7 + 
3X9 
Total 16 + 
17 ambulances would therefore be needed. 
The same formulas may also be applied in the case of litter 
squads. Supposing that it is desired to ascertain the time 
necessary to move 200 litter cases to a dressing station 2000 
yards distant and that the 64 litter squads of the ambulance 
companies are available for the purpose. Using the first for- 
mula, the result would be: 
200Xi•5 , , 
= 4 hours and 40 minutes. 
64X1 
In the same manner the capacity of, or the time required by, 
trains and boats can be estimated. CHAPTER III. 
ORGANIZATION. CHAPTER III. 
ORGANIZATION. 
Although the details of army organization are fully set forth 
in the Field Service Regulations, it is nevertheless deemed ex- 
pedient to review some of the leading points thereof preliminary 
to a special consideration of medical organization. 
It is to be noted that the organization of units higher than 
the regiment is not fixed by law, but is subject to change upon 
the authority of the President and the War Department. The 
composition of the larger units varies according to the special 
necessity. The facts and figures quoted may, however, be con- 
sidered to express the average or normal organization. 
Company 
Battalion 
Regiment 
Officers 
Enlisted 
men 
Officers 
Enlisted 
men 
Officers 
Enlisted 
men 
Infantry 
3 
108 
15 
440 
Si 
1500 
Cavalry 
3 
86 
IS 
35i 
S3* 
1188 
Field artillery.. 
5 
171 
18 
53i 
44* 
1126 
Engineers 
4 
(ioo)t 
164 
IS 
(3°9)t 
S°i 
Signal troops... 
4 
100 
11 
(i5°)t 
207 
* Includes 2 veterinarians, 
t Mounted. MEDICAL SERVICE IN CAMPAIGN. 
In computing the strength of divisions and field armies the 
civilian clerks and drivers are included as they are entitled to 
the same medical care and attention in the field as the enlisted 
personnel. 
The company and regiment are both administrative and 
tactical units. Battalions and brigades are, as a rule, tactical 
only, and the staff of a brigade commander usually consists of a 
brigade adjutant and two aides only. 
A normal brigade consists of the headquarters and three 
regiments of infantry—approximately 4740 officers and men 
(sanitary troops included). 
The division comprises 19,850 officers and men, including 
sanitary troops and civilian drivers and clerks and are distributed 
among organizations as follows: ORGANIZATION. 
TABLE NO. i. 
The Division. 
Organizations 
Officers* 
Enlisted 
men 
Civilians 
Totals 
Division headquarters 
12 
9 
13 
34 
Three brigades infantry (9 reg.) 
498 
13716 
6 
14220 
1 regiment cavalry 
57 
1212 
1269 
1 brigade field artillery (2 reg.) 
95 
2291 
2 
2391 
1 pioneer battalion (3 Co.) 
18 
5io 
528 
1 field battalion signal troops (2 Co.). 
13 
213 
226 
4 ambulance companies 
21 
3i8 
339 
21 
230 
251 
Service of Supply. 
Officers and assistants 
13 
8 
35 
56 
Ammunition train 
2 
8 
180 
190 
Supply trainf 
2 
IS 
216 
233 
99 
99 
14 
14 
752 18533 
56s 
19850 
* Inclusive of medical officers, chaplains, and veterinarians. 
■)■ Inclusive of medical reserve supply. 62 
MEDICAL SERVICE IN CAMPAIGN. 
Cavalry Division. 
Organizations 
Officers* 
Enlisted 
men 
Civilians 
Totals 
Division headquarters 
12 
9 
13 
34 
3 brigades (9 reg.) 
,.6 
10908 
6 
11430 
1 reg. horse artillery 
47 
1147 
1194 
1 pioneer battalion (3 Cos. m’td) .. . 
18 
3*8 
336 
1 field battalion, signal troops (2 Co). 
13 
213 
226 
10 
158 
168 
10 
114 
124 
Service of Supply. 
Officers and assistants 
9 
8 
36 
53 
Ammunition train 
2 
8 
xo8 
118 
Supply trains "j* 
2 
IS 
108 
125 
Pack trains (2) 
28 
28 
Totals 639 
12898 
299 
13836 
A field army is the next higher field organization and is 
composed of two or more divisions, to which ordinarily may be 
added a cavalry division and an auxiliary division. This unit takes 
the place of the army corps formerly authorized. The organi- 
zation of the auxiliary division depends so much upon the special 
situation that only an estimate can be made of its probable 
strength. 
* Includes medical officers, chaplains, and veterinarians, 
■j" Includes medical reserve supply. ORGANIZATION. 
63 
An Auxiliary Division. 
For a field army composed of two infantry divisions and a 
cavalry brigade (estimated): 
Organizations 
Officers 
Enlisted 
men 
Civilians 
ii 
9 
18 
i regiment infantry 
55 
i524 
i regiment heavy artillery 
47 
1147 
540 
x ponton battalion 
18 
5io 
i aero-wireless battalion 
13 
213 
Supply service 
4 
8 
19 
i ammunition train 
1 
4 
68 
1 
4 
102 
5 
79 
x field hospital 
5 
57 
Totals 
179 
4095 
207 
4481 
Two or more field armies may, upon the authority of the 
President, be combined to form an army. The headquarters 
staff thereof will be such as may be deemed necessary by its 
commander. 64 
MEDICAL SERVICE IN CAMPAIGN. 
A field army composed of 2 divisions, a cavalry brigade and 
an auxiliary division, would constitute a force of about 47,466 
officers and men, distributed as follows: 
Organizations 
Officers 
Enlisted men 
Civilians 
Headquarters 
20 
ii 
3 
2 divisions 
IS°4 
37066 
1130 
i cavalry brigade 
172 
3636 
2 
x auxiliary division 
179 
4095 
207 
Totals 
1875 
44808 
1342 
Grand total 
48025 
The line of communications corresponds to the medical 
evacuation zone and is the route on which troops and supplies 
are sent from the base to the zone of operation and sick and 
wounded are evacuated to the rear. A line of communications 
is established for each field army or important expeditionary 
force and is under the control of their respective commanders, 
and directly under a commander who controls over the troops 
therein and such number of staff officers as may be necessary. 
Medical Department Organization. 
Important changes have been made in the organization of 
the medical department of troops in the field in the new Field 
Service Regulations. It will be observed that the number of 
medical officers attached to regiments has been increased from 
three to four, two have been added to each ambulance company, 
and the latter organization no longer constitutes a section of ORGANIZATION. 
65 
the field hospital, but is now a separate unit. The position 
of brigade surgeon has been abolished except in the case of 
brigades acting independently and a director of field hospitals 
and a director of ambulance companies have been added to 
the division organization. The latter mentioned authorities 
perform the functions of a battalion commander in a general 
way, but neither the four divisional ambulance companies 
nor the four field hospitals are to be considered as adminis- 
trative units. 
No special organization is provided to establish the station 
for slightly wounded, but the personnel therefor is to be drawn 
from the sanitary personnel of regiments or trains. 
The total number of medical officers of a division has been 
increased from 81 to ioi. 
The regimental detachment of the hospital corps of infantry 
and cavalry regiments has been increased from 3 non-commis- 
sioned officers and 9 men to 4 non-commissioned officers and 
20 men, and artillery regiments (consisting of two battalions) 
are allowed 3 non-commissioned officers and 18 men. Ambu- 
lance companies are given two additional orderlies for medical 
officers. The number of non-commissioned officers and men 
of the hospital corps of a division has been increased from 711 
to 877. 
The personnel of the medical department are collectively 
called sanitary troops. 
Field Service Regulations do not prescribe the number and 
rank of the staff officers of an army, but it is to be presumed 
that it will conform to that of a field army, except that the staff 
officers will be of higher grade. 
The sanitary personnel of the headquarters of a field army 
include: 
i Colonel, chief surgeon. 
1 Colonel inspector. 
2 Majors, assistants. 
2 Sergeants, ist class, clerks. 66 
MEDICAL SERVICE IN CAMPAIGN. 
9 Privates, 1st class and privates, orderlies and drivers. 
1 Ambulance company. 
1 Field hospital. 
Of a division: 
1 Lieut.-colonel, chief surgeon. 
1 Lieut.-colonel, inspector. 
1 Major, assistant. 
1 Captain, assistant. 
1 Sergeant, 1st class clerk. 
6 Privates, 1st class or privates, clerks and orderlies. 
The sanitary troops of a division are divided into those 
assigned to regiments or other organizations and those formed 
into independent sanitary units, such as ambulance companies 
and field hospitals as shown below: 
Sanitary Personnel with Regiments and Battalions. 
Organization 
Majors 
Captains or 
lieutenants 
Total 
commissioned 
Sergeants 
1st class 
Sergeants 
Privates 1st 
class and 
privates 
Total 
enlisted 
Infantry or cavalry regiment. . 
1 
3 
4 
-r 
3 
20 
24 
Field artillery reg 
1 
2 
3 
1 
2 
18 
21 
Engineer battalion (3 cos.) .. . 
3 
3 
3 
6 
9 
2 
6 
Medical Department Units. 
5 
5 
2 
7 
70 
79 
Field hospital 
I 
4 
5 
3 
6 
48 
57 
Reserve medical supply 
1 
I 
I 
I 
11 
Total Sanitary Personnel and Transportation of a Division 
and a Cavalry Division. (Par. 33, F. S. R.) ORGANIZATION. 
67 
(a) Division. 
Personnel 
Trans- 
porta- 
tion 
Lientenant- 
colonels 
Majors 
Captains and 
lieutenants 
Total 
commissioned 
Sergeants 
1st class 
Sergeants 
and corporals 
Pvts. i st class 
and privates 
Total enlisted 
Grand total 
Ambulances 
Wagons 
Pack animals 
Division Hq 
I 
I 
I 
I 
3 
1 
36 
4 
6 
3 
2 
2 
1 
21 
21 
1 
I 
9 
1 
2 
1 
8 
12 
1 
1 
27 
3 
4 
3 
2 
1 
1 
29 
25 
1 
6 
1 
180 
20 
36 
6 
4 
6 
3 
281 
193 
9 
7 
2 
216 
24 
42 
9 
6 
8 
4 
318 
230 
11 
IO 
3 
252 
28 
48 
12 
8 
IO 
5 
339 
251 
12 
9 
1 
2 
27 
3 
4 
3 
2 
2 
1 
20 
16 
1 
9 
1 
2 
9 
1 
2 
Cavalry, i reg 
Artillery, 2 regs 
Signal troops, 1 bn.... 
Ammunition train 
Supply train 
1 
5 
48 
12 
32 
6 
16* 
Filed hosp. (4) 
supplies 
Total 
2 
19 
80 
IOI 
35 
97 
745 
877 
978 
48 62 28 
(b) Cavalry Division. 
I 
I 
I 
2 
I 
6 
7 
IO 
I 
I 
I 
2 
2 
Cavalry, 9 regs 
9 
27 
36 
9 
27 
180 
216 
252 
9 
9 
Horse Artillery, 1 reg.. 
I 
2 
3 
1 
2 
18 
21 
24 
1 
1 
Engineers bn. (m’nted) 
3 
3 
3 
6 
9 
12 
2 
2 
2 
4 
6 
8 
2 
I 
I 
6 
8 
IO 
I 
I 
I 
2 
4 
5 
IO 
IO 
4 
14 
140 
158 
168 
24 
6 
8 
Field hosps. (2) 
2 
8 
IO 
6 
12 
96 
114 
124 
16 
* Reserve supplies 
1 
I 
1 
1 
9 
11 
12 
6 
Total 
2 
*3 
57 
72 
23 
64 
469 
556 
628 
24 
38 
18 
* With supply train. 68 
MEDICAL SERVICE IN CAMPAIGN. 
SANITARY TROOPS AND TRANSPORTATION OF A FIELD ARMY. 
(Approximately 48,025 officers and men.) 
Totals 
Headquarters 
2 divisions 
i cavalry brigade. 
Auxiliary division. 
Organizations 
to 
. . . to 
Colonels 
• • -f* • 
Lt.-colonels 
4^ 
00 
Co 
cn Co oo to 
Majors 
vO 
Co 
w • 
M On • 
4- NO O • 
Captains or 
lieutenants 
to 
4^ 
to 
to H o 
nO to to 4- 
Total 
commissioned 
00 
4^ 
VO Co O to 
Sergeants 
i st class 
to 
Co 
O 
M • 
to NO • 
NO • 
Sergeants 
M 
4^ 
VO 
to 
o 
C/l 
4^ 
H 
H 4* 
NO O O NO 
o o o 
Pvts. i st class 
and privates 
to *<r m 
M 'vj CTI M 
to 4^ 
Total enlisted 
M 
s 
H • vO 
to • On h 
Ambulances 
M 
M 
M 
M tO 
Co Co 4*. m 
Wagons 
Qv 
Cn 
Cn • 
ON Co On • 
Pack mules 
No attempt is made to give a detailed organization and 
strength of the troops to be employed on the line of communica- 
tion and it is impracticable to even attempt to make an estimate 
as the length and character of the line, as the military situation 
determines the organization and force to be used, nor is it a matter 
of great importance, as far as the medical service is concerned, 
because the medical organization is largely based upon the 
strength of the field army or large expeditionary force which 
the line of communications is to serve. 
The medical department of the line of communications is 
headed by a chief surgeon with one or more medical officers 
as assistants and a number of non-commissioned officers and 
privates of the hospital corps as clerks and orderlies. A 
sanitary inspector is also assigned to the headquarters staff. One 
or more consulting surgeons and sanitarians, specially qualified 
volunteer medical officers of high rank, but who have no adminis- 
trative responsibility, may be added as professional consultants 
and advisers. 
The medical organization comprises: 
Transport columns 
Evacuation hospitals. 
Base hospitals. ORGANIZATION. 
69 
Supply depot. 
Hospital trains. 
Hospital boats. 
Red Cross relief columns. 
One transport column, two evacuation hospitals, one base 
hospital, and one supply depot is allowed for each division 
comprising the field army served by the line of communications, 
and hospital trains and boats may be added whenever desirable 
and practicable. 
The Red Cross organizations are used to supplement the 
regular institution and to assist in the care and transportation of 
sick and wounded on the line of communications and at home 
and are not usually called upon for service in the zone of opera- 
tions. They also establish rest and food stations whenever 
necessary on the line of communications or further in rear. 
Personnel and Transportation of Sanitary Organizations on 
Line of Communications. 
Organization 
Colonels 
Lt.-colonels 
Majors 
Captains and 
lieutenants 
Total 
commissioned 
Sergeants 
1 st class 
Sergeants 
Pvts. i st class 
and privates 
Total enlisted 
Female nurses 
Ambulances 
Wagons 
Cars 
No. of beds 
Transport column. 
I 
I 
2 
2 
8 
32 
42 
12 
1 
Evacuation hospital 
i 
13 
14 
8 
16 
129 
*53 
3 
2 
324 
Base hospital 
i 
i 
18 
20* 
8 
16 
129 
I53 
46 
3 
2 
5°° 
Supply depot 
2 
2 
1 
2 
12 
iS 
Hospital train 
3 
3 
1 
2 
24 
27 
10 
200 
Hospital ship 
I 
4 
5 
1 
4 
35 
40 
200 
Red Cross 
Not 
fixed 
* Including i dentist. MEDICAL SERVICE IN CAMPAIGN. 
TRAINS. 
The means of transportation for the materials and supplies 
of an entire division comprises 1009 vehicles and 408 pack 
mules, which are distributed among the combat, field, and 
supply trains. 
Combat trains consist mainly of those wagons and other 
vehicles assigned ordinarily to battalions and squadrons for 
the purpose of supplying troops with extra ammunition, in- 
trenching tools, etc., needed in actual combat; they also include 
the special vehicles provided for engineer and signal troops. 
As a rule, combat trains march immediately in rear of the 
battalion unit to which they are assigned, although when an 
engagement is probable they may be assembled in rear of their 
regiments or sent to join the ammunition trains. 
The field train of a division consists of about 313 wagons 
carrying baggage and at least two days’ subsistence and three 
days’ forage for the entire command. 
When wagons of the field train are emptied they are avail- 
able for use in obtaining additional supplies, and, in case of 
emergency, for the transportation of wounded. 
The field train is ordinarily divided into brigade sections 
which follow their respective brigades. However, when there 
is a probability of contact with the enemy, the entire train may 
be assembled in rear of the column of troops of the division. 
The supply train of a division consists of 162 wagons. The 
subsistence and forage wagons of the train are grouped in 
three sections, each section carrying one day’s supply for the 
entire division. 
When it becomes necessary to draw upon the supply train, 
one section moves up and turns supplies over to the field trains 
or makes issues direct. 
When a supply section is emptied it proceeds to the supply 
depot as rapidly as possible. A train of about 50 wagons would 
thus often become available for use in evacuating sick and 
wounded from the front to the advance base, and the division PLATE I 
Road Space of an fiMFAlMTKY SIWiiSM on a single road. 
Advance Cavafry. 
Oara/ryt /ess,one troop 
Detachment Fny/neerj. 
Point. 
Vi Troop Cora/ry. 
I Bn. Inf. 
Support. 
loss I Bn. 
Tno CoS. fnpneers, 
Reserve. 
2* Inf. an* D/v. t/Ugrs. 
One Bfy. F/e/st Art/‘//ery 
3* Inf. 
TnO CosFnyineers ftnc/utt/n? Fan Toon CoJ 
One sect* on 3/gnp/ Corps 
One AmAotance Co. 
Main Body. 
/» Troop Cara try 
2*Brig,, less 6 9Inf 
T»vo Bty. F/e/tt Art/t/ery. 
6a Inf. 
3eBr/f., /ess 9f-/n/\ 
Ft'c/d Arfi//ery Br/yatie 
/ess one &*■ 
9* Inf. 
Co. A, 3/<?na/ Corps, 
lot* one section. 
One Ambu/anco Co. 
One secf/on ftA. Ammun/ton Tram 
f2/ trcHfonsJ 
One sect/on FA.A/nmun/ton Train 
/2f nayonsj 
FacH Tra/'n. 
Ttvo Amdu/once Compom 
Y/jrf sec tons Amman/ton Truin' 
ys /rayons 
Four F/e/et ttosp'ta/j. 
22 u/afons, 
F/'e/ct Trains. 
(J2<? nrafonsj 
Supp/y Tr& in.—* 
ft92 tVoyons.J 
(Face p. 71.) ORGANIZATION. 
surgeon must endeavor to make the necessary arrangements 
for such service whenever at all practicable. 
The regimental medical supply wagon and pack mule, the 
ambulances and wagons of the ambulance company, and the 
medical supply wagons of the field hospital bear the same rela- 
tion to their units as the combat trains. The regimental medical 
supply wagon, as a rule, will be assigned to the field trains when 
troops are on the march. 
When marching in the presence of the enemy, the ambulance 
companies with their ambulances may be incorporated in the 
column of troops or when they are required to proceed with 
light transportation only (pack mules), the ambulances march 
ordinarily in advance of the field trains. Ambulances may 
also be distributed among the various regiments in the column, 
but when contact with the enemy is imminent they will be 
again assembled. 
Ambulance companies and field hospitals generally march 
in rear of the division field train, but if an engagement is in 
prospect they will usually precede it. 
The six reserve medical supply wagons formerly referred to 
in regulations as the advance medical supply depot, march with 
the supply train. 
Plate I shows the order of march and the road space occu- 
pied by a division with its trains, marching on a single road in 
the presence of the enemy. CHAPTER IV. 
ADMINISTRATION. CHAPTER IV. 
ADMINISTRATION 
The medical department of an army in the field has four 
functions, viz.; 
1. Sanitation. 
2. Professional care and treatment of sick and wounded. 
3. Providing medical and hospital supplies. 
4. Collection and evacuation of sick and wounded. 
This discussion will be largely confined to the service indi- 
cated in the fourth heading—-the collection and evacuation of 
the sick and wounded from the zone of operations; in other 
words, to such duties as cannot properly be classed under the 
head of sanitation or other strictly professional subjects. It 
relates almost exclusively to administrative functions which 
have as their ultimate object to bring the patient, the facilities for 
his treatment, and the surgeon in conjunction under the most 
favorable possible circumstances. That and the supervision 
of sanitation is what is largely implied when the administrative 
duties of medical officers are mentioned. From a strictly mili- 
tary point of view, such duties are of the greatest importance, and 
an efficient service of this kind not only enhances the mobility 
of troops by relieving them of the encumbrance of sick and 
wounded, but incidentally increases the effectiveness of a force 
by preventing spread of infectious disease at the front and also 
by the good effect the removal of the sick and wounded has upon 
the morale of troops. 
Baron von Schellendorf, in his “Duties of the General Staff,” 
pointedly remarks that “the system of evacuating sick (and 
wounded) forms the basis of the entire medical service in the 
field.” In practice, it will not be possible, however, to separate 76 
MEDICAL SERVICE IN CAMPAIGN. 
this service from that given under the second and third head, 
as patients will need care and treatment and certain medical 
supplies while in process of being taken to the institutions in the 
rear. 
The service of the evacuation of the sick and wounded natur- 
ally falls into three well-marked zones: 
(a) Collecting. 
(b) Evacuating. 
(c) Distributing. 
The first, or collecting zone, corresponds to the zone of active 
operations; the second, or evacuating zone, to the lines of com- 
munication, and the third to the home territory. No very 
distinct line of demarcation can, however, be drawn between the 
different zones as they are bound to overlap more or less. Con- 
sequently an article of this kind, which purports to deal with 
the service at the front, must also give some consideration to 
that of the line of communications. 
The various organizations of sanitary troops that are provided 
for the purposes noted above in the three zones are as follows: 
Collecting Zone: 
1. Regimental detachments. 
2. Ambulance companies. 
3. Field hospitals. 
4. Reserve medical supply trains. 
Evacuation Zone: 
1. Transport columns. 
2. Evacuation hospitals. 
3. Sanitary supply depots. 
4. Hospital trains and boats. 
5. Base hospitals. 
6. Base supply depots. 
Distributing Zone: 
1. Hospital ships and trains. 
2. General hospitals. 
3. Supply depots. ADMINISTRATION. 
77 
The service of the three zones is supervised and co-ordinated 
by the surgeon-general of the armies in the field under the 
superior direction of the Surgeon-General of the army. 
Chief surgeons exercise general supervision and control over 
the entire medical service of their respective commands, includ- 
ing sanitation, care and treatment of sick and wounded, proper 
supply of all medical department units, and relieving the army 
of non-effectives. 
The responsibility for the evacuation service rests with the 
chief surgeon of the army who gives general instructions to chief 
surgeons of field armies, who, in turn convey them as a whole 
or in part to division surgeons, and to chief surgeons of lines 
of communication. Chief surgeons of field armies and division 
surgeons are the two authorities more directly concerned in devis- 
ing the detailed plans or schemes for use of medical department 
units at the front. Chief surgeons are members of the staffs of 
their respective commanders and are expected to advise the 
latter upon all matters pertaining to their particular service, and 
under par. 291 F. S. R. may be authorized to issue orders to their 
subordinates in the name of the commander. They must keep 
themselves constantly informed of the military situation and 
of the plans and intentions of their commanders in order that 
timely preparation may be made for projected movements and 
operations. 
The Division Surgeon. 
The division is the great administrative and tactical unit and 
forms the basis of army organization. It follows that the division 
surgeon is in a corresponding position of great responsibility, 
and under the direction of his commander and of the chief 
surgeon of the field army, supervises and controls the entire 
sanitary service of his division, in camp, on the march, and in 
battle. Based upon the instructions received from the chief 
surgeon of the field army and a knowledge of the situation as 
communicated to him by his commander or chief of staff, he 
must devise and carry out a plan for a systematic evacuation of 78 
MEDICAL SERVICE IN CAMPAIGN. 
non-effectives and for the proper use of medical department 
units. To assist him in administering the medical affairs of the 
division, he disposes over the services of the inspector, directors 
of field hospitals and ambulance companies, and two medical 
officers specially detailed for duty in his office. 
The division surgeon must arrange a systematic and orderly 
service for the care and disposal of the sick on the march and 
must be prepared to give definite instructions to accomplish this 
result. 
The place or places where the sick are to be assembled and 
whence they are to be sent to a hospital for treatment should be 
designated, upon the recommendation of the division surgeon, 
in par. 4 of march and camp orders. The details of the method 
to be pursued, the designation of the personnel and transporta- 
tion, the time and place when the latter are to rejoin the column, 
etc., must be provided for in special orders and instructions. 
Unless the entire division is compactly camped, it is usually 
advisable to fix upon an assembly point for each brigade to 
which patients are brought by ambulance or litters. As these 
collecting places are not usually expected to continue in function 
more than a few hours at the most, no considerable personnel is 
needed to serve them, and one medical officer, a non-commis- 
sioned officer, and a few men are amply sufficient for each place. 
The personnel may be taken from a field hospital or ambulance 
company or from a regiment marching near the head of the 
column so that a place may be prepared for such patients as may 
fall out during the day’s march. 
The division surgeon, being in constant touch with the chief 
surgeon of the line of communications, would at once notify 
him of the number of cases that will require transportation to the 
rear so that immediate steps may be taken to remove them. 
In the attempt to maintain the highest possible effective 
strength, much work and responsibility is thrown upon the 
medical department and the division surgeon must impress upon 
the regimental medical officers the urgent necessity of pursuing 
a rigorous policy in the selection of cases for evacuation. ADMINISTRATION. 
79 
Patients falling out during the march and those reporting at 
sick call are to be classified in three categories: 
1. Trivial cases that may be expected to recover in a few 
days. 
2. Severer cases that must be sent to the rear. 
3. Non-transportable cases that must be provided for at the 
place. 
(1) To prevent undue depletion of the ranks, it is important 
that patients whose disability will probably only be of very short 
duration should be kept with the command, except when troops 
are marching into action. It is a matter of common experience 
that much is lost in effective strength of a marching command 
if trivial cases are sent to institutions in the rear, especially in 
the case of raw troops, many of whom find the hardships and 
restraints of active service irksome and are inclined to take 
advantage of every pretext to escape therefrom. 
Some of the lighter cases may well be able to march, if relieved 
of their packs, and the others can be carried in ambulances and 
on the wagons of the trains. 
(2) The severer cases and such others as cannot be expected 
to recover soon must be directly or indirectly turned over to 
the medical department on the line of communications. They 
are to be assembled and taken care of until they can be turned 
over to a transport column or other line of communication 
organization, or they may be sent to the rear in the empty 
supply wagons returning to the advance base and by hired 
transportation. 
Ambulance companies should not be called upon for such 
service if the command is in the proximity of the enemy. 
(3) The non-transportable cases, which might include 
infectious cases, are to be directly turned over to the sanitary 
troops of the line of communication. Should it be impracticable 
to thus dispose of them at once, it may be necessary to leave a 
medical officer and the necessary attendants for their temporary 
care or it may be advisable to turn them over to a neighboring 
civil institution. MEDICAL SERVICE IN CAMPAIGN. 
Daily orders and instructions must be issued, not only to 
fix the assembly points, the details of men and transportation, 
but also when the latter may rejoin their commands if there is 
delay in transferring the patients. 
Like any other extensive operations, the medical service of a 
division in battle must be conducted in accordance with a well- 
defined plan which is to be formulated by the division surgeon 
and approved by the commander. This plan must also be 
thoroughly understood by all that are concerned in its execution. 
The division surgeon being the highest medical authority 
that directly supervises the medical service of a division in 
battle, would undoubtedly be called upon to submit his recom- 
mendation to the commander or chief of staff when the battle 
order is to be issued. Some of these recommendations may 
be included in the body of the order, others would be formulated 
as special orders for the guidance of the medical department 
alone. 
The division surgeon’s plans for the battle service are based 
upon the information and instructions received from the com- 
mander of the field army or his chief surgeon, including the 
reports from the authorities on the line of communications 
concerning the preparations made for the transportation and 
reception of the sick and wounded, and the quantity and avail- 
ability of the supplies on hand. Furthermore, he must have 
informed himself of the character of the ground upon which 
the engagement is to take place, either by personal inspection or 
by a careful study of the map. He must select, at least, tentative 
locations for the stations and routes for the evacuation to the 
rear, and the routes and means by which additional medical 
and surgical supplies may be sent to stations when needed. 
The instruction that he expects to receive from the chief 
surgeon of the field army would probably cover the following 
points: 
i. The evacuation of the sick that may have accumulated 
up to the time when the troops go into action, their destination 
and the route by which they are to be sent. ADMINISTRATION. 
2. Th,e location and capacity of the hospitals that may have 
been designated to receive the wounded of the division and the 
route thereto. The number of evacuation hospitals that could 
be advanced to the vicinity of the battle-field for the relief of the 
field hospitals. 
3. The kind and amount of transportation that can be 
furnished from the line of communications for the evacuation 
of the wounded of the division. 
4. The place to which the slightly wounded that are able 
to march are to be directed. 
5. The places along the line of evacuation where it is proposed 
to establish rest stations. 
6. The location of the supply depots and the arrangements 
made to furnish additional hospital supplies and renewal of 
materials expended during action. 
When a battle is imminent it becomes necessary that the 
troops who are to participate therein should be relieved of all 
non-effectives and that the medical institutions that may have 
been established in the zone of operations or on the line of 
communications be cleared of patients in anticipation of the 
large number of wounded that would in all probability soon 
require care and attention. 
In addition to the daily quota (page 50) of severer cases 
that would ordinarily have to be sent to the rear, a large pro- 
portion of those usually treated in “quarters” would also have 
to be evacuated, as their presence under such circumstances 
would be a hindrance to the mobility of troops and also place 
additional burden upon the medical and supply departments. 
The division surgeon would designate an ambulance com- 
pany to perform the duty of collecting them, but some other 
means of transportation to the rear would have to be provided, 
as the ambulance com .anies would probably soon be needed 
on the field. In the absence of any special arrangements made 
by the chief surgeon of the line of communications, the empty 
supply section returning to the advance base might very properly 
transport such patients. 
6 82 
MEDICAL SERVICE IN CAMPAIGN. 
In making his plans for the battle service, the division surgeon 
must know where the wounded will be sent, the route thereto, 
and when the designated institutions will be ready to receive 
them. Presumably evacuation hospitals will be established 
at the advance base or some still more convenient point, or 
arrangements may have been made to transport the wounded by 
train or boat from some station easily accessible from the battle- 
field. The military situation and the means of transportation 
at the disposal of the chief surgeon of the line of communication 
may permit him to advance hospitals to the vicinity of the 
battle-field. 
Although the responsibility for the evacuation of field hospi- 
tals and the transportation of patients to the rear rests with the 
latter-named authority, it is still necessary for the division 
surgeon to be fully informed of the preparations made, as he 
would then be able to give the necessary directions to guide the 
convoys of slightly wounded and to take advantage of any avail- 
able transportation to relieve the field hospital from too much 
overcrowding. Such information would also be useful to him 
in determining the location of field hospitals, which should be 
convenient to the evacuation route. 
In case of emergency the chief surgeon of the line of com- 
munication would be expected to provide transporta ion from 
that furnished for other purposes or by hiring vehicles from 
civilians, in addition to the transportation allowed by regulations 
to transport columns. Should there be a convenient rail- or 
waterway, trains or boats would be used and this would make 
the transport problem very much simpler than when only wagon 
transportation to the advance base was to be relied upon. 
The destination of the “sick in quarters” that may have to 
be sent to the rear and of the slightly wounded must also be 
specially designated, as it is undesirable that such cases should 
be sent far back with the severe cases that cannot reasonably 
be expected to return to the ranks soon. 
A knowledge of the location of the proposed rest stations is 
of assistance to the division surgeon in formulating his instruc- ADMINISTRATION. 
83 
tions for the service and the evacuation of the collecting station 
for slightly wounded. 
The sanitary supply depot, usually located at the advance 
supply depot, would be expected to renew the supplies expended 
during action and such additional material as may be necessary 
for the wounded that may have to remain some days in field 
hospitals, and the reserve medical supply wagons from the train 
would be sent there as soon as emptied. 
Upon this information and a knowledge of the intentions of 
the commander, the division surgeon may formulate a scheme 
for the speedy rescue of the wounded and for relieving the force 
of its encumbrance of sick and wounded that might seriously 
interfere with the subsequent movements of the army. He 
submits to the chief of staff recommendations concerning the 
following points, which he desires to have included in para- 
graph 4 of the division field orders: 
1. The time and place where the sick of the command are 
to be assembled for transportation to the rear. 
2. The location of the collecting station for slightly wounded. 
3. The location of dressing stations and field hospitals 
whenever it is possible to fix them in advance. 
4. The assignment of additional transportation for the 
wounded from the field train. 
5. The disposition of the remaining medical department 
divisional units until they may be needed on the field. 
It is believed to be quite essential that the above-mentioned 
points should be covered in the division field orders, for the 
reason that they are not only of importance to the medical de- 
partment, but to every member of the command. 
The great advantage of a systematic and co-ordinated ser- 
vice appeals to everyone, and that it may rest upon a firm 
foundation the plan should be confirmed in the orders that give 
the greatest assurance that every organization will be reached. 
The medical department possesses no such rapid and reliable 
means of communication as that afforded by field orders from 
division headquarters. 84 
MEDICAL SERVICE IN CAMPAIGN. 
Some central point or points should be designated, as the 
place where the sick are to be assembled, which place or places 
should be convenient to the evacuation route and where the 
empty train wagons may conveniently pick them up. It is 
suggested that the site selected for the slightly wounded station 
might serve as the assembly point for the sick, as it would, in all 
probability, be possible to get rid of the sick before the influx 
of wounded began. 
If the collecting station for slightly wounded is known to 
the entire command, the straggling of wounded over the country 
in rear of the line would be largely prevented, and the desire 
to accompany wounded comrades to the rear restrained, if it 
was definitely known where proper assistance might be had. 
While it is not generally considered advisable to direct the 
definite establishment of dressing stations and field hospitals 
before an engagement begins, except perhaps, in defense of 
strong positions, it may often be expedient to order the establish- 
ment of one of each of these institutions early in the action so as 
to provide for those wounded in the development thereof, and, as 
suggested above, to prevent the wounded from straggling over 
the field in search of assistance. 
The additional transportation assigned to the medical de- 
partment from trains, etc., should also be provided for in 
field orders so that there may be no difficulty or misunder- 
standing between medical officers and those in charge of the 
vehicles. 
The place where the divisional medical units are held until 
the necessity arises for their use is also considered to be of suffi- 
cient importance to the entire command to warrant mention in 
the order. 
The additional steps that are to be taken may be made the 
subject of special orders and will be indicated in the discussion 
of the medical department stations and lines of assistance. CHAPTER V. 
BATTLE DISPOSITIONS. CHAPTER V. 
BATTLE DISPOSITIONS. 
Every improvement in firearms has brought about a corre- 
sponding change in the style of tactics used by fighting troops, 
and every modification of tactics has had its influence upon the 
sanitary service in battle, which has for its object the speedy 
rescue and care of the unfortunate victims of the enemy’s bullets. 
Many years ago, during the time of Frederick the Great, 
troops advanced into battle, shoulder to shoulder, to within 
200 yards of the enemy and sought to overcome him by superi- 
ority of fire, and the contestant that could fire most rapidly had 
the best chance of being successful. Open ground was chosen 
by preference and the rescue of the wounded during the progress 
of the engagement was out of the question. “Flying field hos- 
pitals” were provided which remained with the baggage until 
the conclusion of the action, when by the aid of troops detailed 
as bearers, the wounded were collected and cared for. If the 
action lasted until late in the day the wounded were often left 
on the field until the following morning. 
As a result of an improvement in firearms and the experience 
gained therewith in our War of Independence, the so-called 
“linear tactics” were abandoned and troops were not massed 
as formerly and were taught to take advantage of the cover 
afforded by the ground. It then became practicable to establish 
stations for the relief of the wounded somewhere near the battle 
lines, and the sanitary service in the field assumed greater im- 
portance, and surgeons and their assistants were thereafter 
expected to remain in closer touch. 
As the range and efficiency of weapons increased and armies 
became larger, the difficulties of the medical service increased 88 
MEDICAL SERVICE IN CAMPAIGN. 
in proportion to the number of wounded to be cared for and the 
extent of ground to be covered in assembling them. 
Until after the Civil War and the Franco-Prussian War it 
was the universal practice to put the first line of assistance well 
beyond rifle range. In the campaign of 1864 it was often pro- 
vided in orders that the “ambulance depots,” which performed 
the functions of our present aid and dressing stations, should be 
placed 500 yards in rear of the line. In the Franco-Prussian 
War the aid stations were often placed as far as 3000 yards in 
rear of the line, but it was observed that very few wounded 
made their way to the distant stations as most of them preferred 
to conceal themselves in safe places nearer the line. 
With the introduction of the small-caliber magazine rifle 
and the long-range rapid-fire field-piece, it became quite evident 
that if the wounded were to receive speedy attention, the old 
plan of placing all medical department stations beyond the 
range of rifle fire was utterly impracticable, and it is now an 
accepted fact that, whenever the terrain permits, the work of 
the rescue and care of the wounded must begin within the danger 
zone and during the course of the engagement. The large size 
of modern armies, with a corresponding increase in the number 
of casualties and the longer duration of battles, makes it abso- 
lutely necessary that the business of relieving the distress of the 
wounded should begin at the earliest practical moment. 
It must be admitted, however, that a medical service in war 
is not organized and maintained with the sole object of meeting 
the humane demands of the age, that the sick and wounded 
soldier shall receive the same care and speedy medical attention 
that patients are accustomed to receive at their homes or in 
civil hospitals. The basis of the organization of the medical 
department for war is the military necessity of maintaining the 
highest possible effective strength of an army and of relieving 
it of its encumbrance of sick and wounded. The first purpose 
is accomplished, as far as battle service is concerned, by the early 
treatment of wounded, especially those who may be 'expected 
to recover and resume duty within a short period of time, and BATTLE DISPOSITION. 
89 
by sustaining the morale of troops by assuring proper care of 
the unfortunate wounded; the second, by rapidly evacuating all 
non-effectives from the zone of operations, thereby enhancing 
the mobility of the army. While all this would seem to be an 
argument for beginning relief work and establishing stations 
at the earliest possible moment, it must not be forgotten that at 
the beginning of a battle there is always more or less uncertainty 
as to the manner and direction in which the engagement will 
develop and as to where the sanitary service will be most needed. 
The division surgeon must, therefore, act with much caution 
and not order the establishment of stations until the military 
situation permits of its being done with reasonable safety and 
the number of wounded on hand justify the measure. In an 
attack, for instance, an early establishment of aid and dressing 
stations would expose them to the danger of being left so far 
in rear as to make it impossible for them to properly fulfill their 
functions. 
There is still some conflict of opinion as to the distance 
from the line of battle that stations should be established. It is 
still maintained by some that they should always be beyond the 
range of fire, but if such statements are inquired into it will 
usually appear that reference is had to some particular campaign 
which took place upon ground that afforded but little natural 
cover. Many reports from the war in Manchuria indicate that 
dressing stations and field hospitals were often located miles in 
rear of the line, but in nearly every case a special reason therefor 
can be discovered, such as the fact that the engagement took 
place on flat ground or a retreat was anticipated, etc. 
It is sound in principle to establish the stations as near the 
front as the terrain and the military situation will permit. It is a 
mistake to endeavor to fix a definite distance from the line for 
the location of stations and it must necessarily be determined 
in each case by the division surgeon, whose knowledge of the 
situation obtained at division headquarters enables him to 
act with judgment and proper discretion. 
The increased range and efficiency of modern weapons MEDICAL SERVICE IN CAMPAIGN. 
has also made the work of the sanitary department much more 
difficult and arduous, the danger zone behind the line having 
become so extended that the collection and evacuation of the 
wounded from the field has become a great problem. It is 
manifestly impossible under ordinary conditions of terrain to 
traverse the length of the danger zone to bring surgical assistance 
and to carry away the wounded without being exposed to even 
greater risk than that of the combatants, consequently if the 
wounded are not to be allowed to remain a long time on the field 
without surgical assistance, advantage must be taken of cover 
within the danger zone. 
The experience in recent wars has illustrated both the impor- 
tance and the difficulties of the sanitary service and an increase 
in personnel and transportation facilities has recently been pro- 
vided for our own and most foreign armies. The value of this 
service as a military factor is also being recognized, since it has 
become known how large a proportion of wounded will recover 
quickly and be able to return to the ranks, and that prompt and 
convenient surgical assistance restrains men from leaving the 
firing line to assist wounded comrades. 
The chief surgeon of a field army can only outline a general 
scheme for the sanitary service on the field of battle and it falls 
within the province of the division surgeon to regulate the details 
of the service within his particular sphere of action. While 
centralization of authority is one of the fundamental principles 
of the military institution, it has its limitations, beyond which 
it is not safe to proceed. It might be added, however, that 
the limits of centralization are, in a general way, measured 
by the executive ability of the chief. The chief surgeon of an 
army cannot supervise the details of a service that may be spread 
over a large area, and some latitude must be allowed minor 
authorities. The division surgeon is, therefore, made directly 
responsible for the way in which the service within his division 
is carried on, and he must obtain or, when properly authorized, 
issue the necessary orders concerning the establishment of 
stations and field hospitals and the routes to be used for evacu- BATTLE DISPOSITION. 
91 
ating the wounded from the field. Concerted action of all the 
divisional units is essential to a successful service, and it remains 
with the division surgeon to effect the necessary co-ordination. 
It is to be strongly emphasized that it is not possible to for- 
mulate fixed rules for the disposition and location of the sanitary 
organization on the battle-field anymore than it is practicable 
to reduce battle tactics to hard and fast lines. 
The type of the engagement, the character of the terrain, 
and the evacuation facilities, all have an important bearing upon 
the sanitary service on the battle-field, and the division surgeon 
must give them due consideration in formulating his plan for the 
relief of the wounded. 
It is easily understood that the scheme must correspond in a 
general way to the tactical movements of troops as employed in a 
rencounter, planned attack, or defense. 
Rencounter (collision of two hostile forces in movement) 
may develop suddenly and unexpectedly. The enemy’s strength, 
the extent of his lines, and the ground which he occupies are 
probably not definitely knowm, and troops are put into action as 
they arrive on the field and no well-defined plan of action can be 
determined upon until the strength, position, and purposes of 
the enemy are developed. 
In a planned attack the conditions are much different, the 
enemy’s position, his probable strength, and the extent of his 
lines have already been determined. The weakest point or 
points in his line may have been discovered and the place where 
the main attack is to be made has been decided upon and orders 
issued accordingly. 
Owing to the increased efficiency of modern firearms, troops 
will not be able to approach each other as quickly and closely as 
was formerly the case, and a decision may be reached at longer 
ranges. Even though it were possible for a part of the line at 
least to get near the enemy’s position by taking advantage of 
cover afforded by the ground, it would sooner or later become 
exposed to a very effective fire, as the troops on the defensive 
would certainly choose a position that would at least afford MEDICAL SERVICE IN CAMPAIGN. 
92 
several hundred yards of open ground on its front. It would 
be a rash commander who would attempt to cross such a space 
against anything like an equal force, for if his advance was 
checked, his force would be in danger of annihilation whether 
he held his ground or retreated. In any event, even if success- 
ful, the losses would be enormous. In fact, a large open space 
in front of a strong defensive position is generally considered 
to be an almost insuperable tactical obstruction. 
If the terrain and the military situation is unfavorable 
to a frontal attack, the line may be held by a weaker force 
and the attempt made to flank or envelop one or both wings 
of the enemy. The latter course would involve extensive 
tactical movements that require much time for their execution, 
which probably explains the long duration of some of the 
battles in the recent war in Manchuria. It requires much 
time to move a large force, as not only the troops, but the ammu- 
nition, supply, and sanitary trains must be taken along. Nor 
can a frontal attack be carried out so rapidly as was the case 
when shorter-ranged weapons were used or as is usually done 
in maneuvers. The assailants, as soon as they arrive within 
the range of the enemy’s guns, can only advance in rushes by 
taking advantage of the cover afforded by the ground, and only 
after a certain superiority of fire has been attained by the aid, 
perhaps, of artillery. After the line has arrived within five or 
six hundred yards of the enemy’s position, a delay of some 
hours may still be occasioned until it may be determined if the 
enemy has been sufficiently overcome to permit of the final 
advance. 
The defender has the advantage of position and can begin 
an effective fire at a greater distance than the aggressor, as he 
is able to accurately determine the range of any point visible 
from his position. The difference in the size of the respective 
targets afforded by the contestants becomes more and more ac- 
centuated as the lines approach and the aggressors expect to 
sustain much greater losses. Nothwithstanding, the defensive 
is the less favorable position, as it must be prepared for a variety BATTLE DISPOSITION. 
93 
of contingencies. The attacking force determines the time and 
the part of the line where the brunt of the action is to fall, and 
the larger the forces engaged and the longer the line the more 
difficult it will be for the defensive to bring their reserves to the 
proper place at the right time. 
The difference in the tactics employed in the various types of 
engagements have a corresponding influence upon the disposi- 
tions of sanitary troops, as the character of their service is so 
dependent upon, and so intimately connected with the move- 
ments and operations of fighting troops. 
In a rencounter the uncertain situation makes it imprac- 
ticable to make any but the most general preparations for the 
rescue and care of the wounded, and definite steps toward es- 
tablishing stations and lines of evacuation cannot be taken until 
the engagement has progressed to the extent that the further 
course or final outcome becomes apparent. It is inadvisable 
to even attempt, at the beginning, to indicate locations of dressing 
stations or field hospitals as long as it cannot be foreseen whether 
the position can be maintained and where the severe action 
will develop. The divisional sanitary units are to be kept in 
hand at a safe and convenient place until clear indications arise 
for their use. 
In a planned attack, however, the situation is much clearer, 
and from the formation of troops and the orders given it may 
be determined where and when the greatest need for surgical 
assistance will probably arise, and arrangements may be made ac- 
cordingly. It may not often be advisable to make complete de- 
tailed arrangements for the establishment of stations and evacua- 
tion routes as it is not possible to predict with certainty the 
manner the action will develop, and it follows that the prepara- 
tions for battle should not be strictly limited to a single course 
of events. This is especially true of the medical department, 
which, from its relative lack of mobility is more easily enveloped 
or overwhelmed. Sanitary units, however, can be placed so as 
to be within convenient reach of prospective locations, and in 
readiness to establish as soon as the necessity therefore arises. 94 
MEDICAL SERVICE IN CAMPAIGN. 
The extra transportation can also be assembled at suitable places 
and a location for the station for slightly wounded fixed upon. 
The arrangements made for a division making a frontal 
attack must also differ from those made for one that has been 
assigned to make a flank movement. 
It is quite evident that the relief service during an attack 
presents most difficult problems and the division surgeon must 
exercise much judgment and caution. The continual advance 
of the line, the sudden variations in the military situation, and 
the necessity of maintaining constant touch therewith, all com- 
plicate the sanitary service. 
In planned defensive actions the situation is much simpler. 
The ground being well known, sites for stations can be selected 
and prepared and the sanitary organizations can be so placed 
as to be ready for immediate service when the emergency arises. 
Practical experience in war has often demonstrated the fact 
that a successful medical service in war does not so much depend 
upon the excellence of the surgical service as upon the efficiency 
of the medical department administration. 
It must also be emphasized that if a large number of wounded 
are to be taken in and cared for in a very short period of time, 
the transportation of the institution to the patients, rather than 
the patients to the institution, is a sound principle to follow when- 
ever circumstances permit. 
There is some diversity of opinion among experienced 
medical officers as to the number and variety of stations that 
should be established on the battle-field for the collection and 
care of the wounded, but the consensus of opinion seems to 
be in favor of as few, within limits, as possible. It is true that 
the more the sanitary personnel of a division is broken up 
into small detachments, the less will be the sum of work that 
they will be able to accomplish, but it would be foolish to ignore 
the experience of years and break away entirely from the methods 
evolved by our predecessors from practical experience, and make 
radical changes based upon theoretical considerations alone. 
The idea, however, that a fixed succession of stations should be PLATE II 
3rd Inf. Brigade 
2nd Inf. Brigade 
1 st Inf. Brigade 
Lines of Assistance. 
(Face p. 95.) BATTLE DISPOSITION. 
95 
always carried out, must be emphatically combated, as it might 
often happen that a combination of at least two stations would 
offer a decided advantage. 
In addition to the influence that the type of engagement and 
the character of the terrain have upon the disposition of the 
sanitary units, the transportation facilities for the removal of 
wounded must be taken into consideration in formulating a 
plan of action. The proximity of available rail or water- 
ways would facilitate the execution of this most important 
problem connected with the battle service, and instead of 
providing for the care and shelter of all the more severely 
wounded at or near the field, steps could be taken at the very 
beginning of the battle to provide for the evacuation of patients 
as soon as they fall into the hands of the medical department. 
The burden of the field hospital at least would be much lightened 
and their capacity could be largely reserved for the the non- 
transportable cases. The line of communication authorities 
could also be expected to take the latter mentioned class over 
without much delay and thus again free the institutions for 
further emergencies. 
The medical department of a division is presumably complete 
in itself and sufficient to meet the needs of the command in battle. 
It comprises, as noted in Chapter III, the regimental medical 
officers and detachments of the hospital corps, four ambulance 
companies, four field hospitals, the administrative staff, and the 
reserve supplies carried in the supply train. 
The organization is primarily provided for the service in the 
zone of active operations, and its most important function from 
a military standpoint is to supervise sanitation and to rid the 
force of its non-effectives. It establishes the following stations 
on the battle-field and the evacuation routes leading therefrom 
(Plate II): 
1. Regimental aid stations. 
2. Dressing stations. 
3. Field hospitals. 
4. Station for slightly wounded. 96 
MEDICAL SERVICE IN CAMPAIGN. 
With the exception, perhaps, of the aid stations, they are 
established by direction of the division surgeon and supervised 
by the directors of field hospitals and ambulance companies. 
Regulations make no pretense of providing specific rules and 
directions for the use of the various sanitary organizations on the 
battle-field and only indicate a few broad general principles. 
The most that can be accomplished in the following discus- 
sion of the time of establishment and the location of stations 
on the field is to indicate the various conditions and influences 
which must be taken into consideration in coming to a decision, 
and it must in each specific case be left to the judgment of 
authority familiar with the local conditions to formulate a plan 
that will fully meet the requirements. 
The division surgeon remains at division headquarters where 
he may keep himself informed of the situation from the reports 
received and the orders issued, and thus be prepared to take 
timely steps to adapt his schemes for the rescue of the wounded 
to the variable phases of battle. Always keeping the main 
purpose of the army in mind, he must not permit any of his 
measures to interfere in any way with the movements of troops or 
ammunition or to occupy positions that may become of tactical 
importance or to use roads that should be kept open for the 
ammunition supply service. 
It is reiterated that the success of the relief service depends 
very much upon the rapidity with which the wounded can be 
evacuated to the rear. The division surgeon must, therefore, 
make all his arrangements and dispositions to attain that object. CHAFFER VI. 
REGIMENTAL SERVICE AND AID STATIONS. CHAPTER VI 
REGIMENTAL SERVICE AND AID STATIONS. 
The sanitary personnel allowed to an infantry or cavalry 
regiment in active service comprises a major, three captains and 
lieutenants, a sergeant first-class, three sergeants, and 20 privates 
of the hospital corps. (Among these privates, the four medical 
officers’ orderlies are included.) Artillery regiments which are 
two battalion organizations are allowed only three medical officers, 
three non-commissioned officers, and 18 privates. This detach- 
ment is directly under the orders of the regimental commander, 
who, in theory at least, directs all their movements on the march 
and in battle. The technical duties of the regimental detach- 
ment are, however, performed under the general direction of the 
division surgeon, who must co-ordinate and systematize the ser- 
vice of the entire medical department of the division, as other- 
wise it would not be possible to attain that concerted action 
which is so essential to success. 
It is utterly impracticable for the division surgeon to direct 
the details of the regimental sanitary service and he can only 
indicate the general plan that has been determined upon for 
the relief of the wounded of the division, and the regimental 
surgeon must work out the details of the service within his sphere 
so as to fit in with the general scheme. 
In practice, the senior medical officer, as a staff officer of the 
regimental commander, is held responsible for the proper care 
of the wounded at the front and supervises and directs the work 
of the detachment. 
During the development of an engagement, the senior medi- 
cal officer must remain in constant touch with the regimental 
headquarters and keep himself informed of the military situation MEDICAL SERVICE IN CAMPAIGN. 
in so far as the regiment is concerned, so that he may adapt his 
scheme for the relief of the wounded thereto. He should consult 
with the commander as to the time and plan of establishing a 
provisional or definite aid station and as to the disposal of 
wounded should it become necessary to leave them behind. 
If communication with division headquarters is to be had, 
reports of the establishment and breaking up of stations would 
be sent to the division surgeon or the director of ambulance 
companies; also the number and character of the cases on hand 
and the location and number of wounded left behind or sent 
to the rear. 
The location of stations or groups of wounded may often be 
conveniently indicated by simple sketches on report blanks (page 
27). Such reports are of special importance when collections 
of wounded have to be abandoned in order to maintain contact 
with the regiment. 
On the march the surgeon rides with the regimental staff and 
the junior medical officers in rear of their respective battalions. 
The detachment of the hospital corps, orderlies excepted, is 
with battalions or in rear of the regiment leading the pack mule. 
In battle, the senior medical officer with one assistant, the 
sergeant first-class, and several privates, take station at the 
regimental aid station, and the remaining members of the hos- 
pital corps under the supervision of the medical officers endeavor 
to give assistance to the wounded on or near the firing line and 
direct or transport wounded to the designated place. The 
members of the regimental band are also supposed to be available 
for bearer service during and after battles. Ordinarily not 
more than six litter squads can be turned out from the regimental 
detachment—two squads under a non-commissioned officer 
for each battalion. The remaining enlisted men serve at the 
aid station and as orderlies. 
The regulation regimental medical supplies for the regi- 
mental dispensary and for the aid stations are carried on the 
supply wagon and by the pack mule, the wagon ordinarily ac- 
companying the field train. The pack mule is provided for the REGIMENTAL SERVICE AND AID STATIONS. 
special purpose of transporting supplies needed in battle, as it 
may often be impracticable to follow along with a heavy field 
wagon which will probably only be on hand at the conclusion 
of the engagement or after nightfall, when the aid station is es- 
tablished on or near the field of losses. While only a very 
limited supply can be carried on one animal, it is presumed 
that it may often be possible to send the mule back to the sup- 
ply wagon or to the reserve supply train for additional material. 
The regimental supplies include, in addition to various 
utensils and appliances, first-aid packages, antiseptic gauze, ab- 
sorbent cotton, bandages, wire and wood splints, antiseptics, etc. 
The regimental aid service has become of much greater 
importance under modern conditions of warfare, not only 
because it is now more difficult to approach the line of battle 
from far in rear, owing to the increased range of weapons, 
but also in view of the greater good that can be accomplished by 
modern surgical methods of preventing infection by prompt 
protective dressings, which ultimately results in saving a large 
proportion of the trained men for further duty at the front. 
The experience in the Russo-Japanese War has conclusively 
demonstrated the efficiency of proper first-aid dressings, and it is 
stated upon good authority that the. ultimate results were better 
in those cases in which it had been applied by medical officers. 
It must be admitted that, unless the terrain is particularly 
favorable, but little real surgical work can be done at or near the 
firing line, but it is quite generally accepted that the presence of 
sanitary personnel at the front gives an assurance of speedy 
professional assistance that has a powerful effect in sustaining 
the morale of troops and relieves them of the temptation to accom- 
pany wounded comrades to the rear. The history of our own 
wars indicate that the absence of such assurance has often had a 
depressing influence upon the morale of troops. 
The benefits to be derived from prompt and proper wound 
treatment, both from a military and a surgical standpoint, are 
now considered to be of sufficient importance to warrant the 
sacrifice of some sanitary personnel and casualties are bound 102 
MEDICAL SERVICE IN CAMPAIGN. 
to occur among them if they perform the full duty now demanded 
of sanitary soldiers. 
It is neither desirable nor practicable to give extensive sur- 
gical treatment to the wounded at or near the firing line, and 
the primary function of the regimental sanitary detachment is 
to assemble and prepare them for further transportation to 
the rear. The assistance given in front of the aid station is 
limited to the application of dressings contained in first aid 
packages and the material carried in hospital corps and orderly 
pouches. At the aid station such dressings may be readjusted 
or replaced if soaked through with blood, or supplemented by 
additional material. Compresses are applied to bleeding 
wounds and occasionally it might become necessary to ligate 
an artery or perform some other emergency operation, as trache- 
otomy, etc. Fractures are immobilized with splints. Restora- 
tives and narcotics must be given, and morphine in convenient 
form for hypodermic use is an essential remedy. Cases attended 
with symptoms of shock will be given the usual treatment. 
Stimulating food and drinks must also be prepared. 
It is presumed that no surgical operation except those of ex- 
treme urgency will be performed at the aid station, unless the 
regiment is acting independently or is cut off from communica- 
tion with the dressing station or field hospital for a long period of 
time by accidents of terrain or other causes. 
The difficulties of applying ordinary antiseptic measures 
in the treatment of wounds at the front can in a measure be met 
by adopting methods that found much favor in the Manchurian 
campaign. The use of an iodine solution to sterilize the skin 
about wounds has been highly recommended, and if bichloride 
gauze in small packages is furnished it makes it comparatively 
easy to assure reasonable antisepsis, v. Oetlingen suggests 
the use of a solution of mastic in chloroform which leaves an 
impermeable layer of gum on the skin and prevents the bacteria 
from spreading into the wound openings. 
The regimental supplies include all that is required for ordi- 
nary emergency surgery and the life or limbs of patients should REGIMENTAL SERVICE AND AID STATIONS. 
103 
not unnecessarily be jeopardized for want of proper attention. 
It would hardly be justifiable to leave the severely wounded 
subjected to the danger of infection if it was at all possible to 
apply an occlusive antiseptic dressing. A simple first-aid 
dressing safeguards a severe wound only for a limited time, 
especially during hot weather or in the tropics. It is, however, 
to be strongly insisted upon that all needless or unnecessary 
handling of wounds is dangerous and no manipulation thereof 
should be attempted except under proper antiseptic precautions. 
It does not necessarily follow that the aid station is always 
crowded with wounded, and the surgeons should not sit with 
folded hands if it is at all possible to apply permanent dressings. 
Not only are the interests of the wounded directly conserved 
thereby, but the dressing stations and field hospitals would 
also be relieved of some of their burden. 
In severe battles when the number of casualties in a regiment 
may run into the hundreds, it is obvious that the surgical service 
at the aid station must be limited to application of first aid 
dressings, the readjustment of dressings already applied, con- 
trolling hemorrhages, fixing fractures and the administration of 
restoratives and narcotics, and only the simplest methods would 
be used. 
It is not expected that any elaborate arrangements for the 
care and treatment of wounds can be made at an aid station, 
and it may often become but little more than a place for assem- 
bling wounded. The necessity of maintaining constant contact 
with the regiment may demand a sudden abandonment of the 
station, and if too permanent arrangements are made the mo- 
bility of the institution might be seriously compromised. It is 
only after the lines have come to a standstill, a successful 
conclusion of an action, or at nightfall that the more definite 
establishment can be made. It is, however, usually worth 
while to improvise dressing or operating-tables from litters and 
to arrange the supplies, without entirely unpacking, so that they 
will be easily accessible. A water supply is always essential to 
the comfort of the wounded and some will also be needed for 104 
MEDICAL SERVICE IN CAMPAIGN. 
the preparation of restoratives and for antiseptic solutions. 
Shelter is desirable, especially in inclement weather, but some 
caution must be exercised in selecting buildings for the purpose as 
they are apt to become targets for the enemy’s artillery. Shelter 
may be improvised from tent flies and shelter halves. An 
effort should also be made to procure hay and straw for the 
severely wounded to lie upon. The regimental supplies also 
include some hospital stores, and a fire should be built, if con- 
ditions permit, for their preparation. 
Under ordinary circumstances wounded are not carried 
farther back than the aid station by the regimental detachment, 
and it is necessary for the ambulance company to take them over 
at that point. The station should not be allowed to become over- 
crowded and every opportunity should be taken to send such as 
are able to walk to the rear. 
The classification of wounded into the various categories 
must begin here; the slightly wounded are to be assembled in 
groups and directed to the station for slightly wounded; the more 
severely wounded that are able to go some distance are sent to 
the dressing station or field hospital, and those requiring trans- 
portation are to be dressed and made comfortable until the litter 
bearers and ambulances can remove them. The “non-trans- 
portable wounded,” abdominal injuries, severe wounds accom- 
panied by much shock, etc., are given proper attention until they 
can be carefully moved on litters to the nearest field hospital. 
While the sanitary detachment of the regiment must be 
prepared at all times to give first aid to the wounded, it does not 
imply that it is by any means necessary that a formal aid station 
is to be established at the beginning of an engagement or as 
soon as some casualties have occurred. It is very essential that 
the regimental sanitary personnel should not lose contact with 
their unit, and a hasty establishment while troops are moving 
forward would probably result in a separation. The first-aid 
packages carried by the soldiers and the contents of the hospital 
corps and orderly pouches would furnish sufficient dressing 
material for those wounded while troops are advancing into REGIMENTAL SERVICE AND AID STATIONS. 
battle. The wounded able to march would be directed to the 
station for slightly wounded or to a dressing station and those 
that were unable to proceed to the rear by their unaided efforts 
must be left in some protected place along the line of march to be 
picked up later by an ambulance company. Such wounded 
must be speedily attended and the sanitary personnel engaged 
in such work must rejoin as quickly as possible. It would be 
inadvisable to leave attendants with them, except under extraor- 
dinary circumstances, as they would in all probability be ur- 
gently needed after the action had fully developed. 
LONG RANGE 
SHORT RANGE 
Fig. 9. 
Protection from the enemy’s fire is the first and most impor- 
tant consideration in the selection of a location for the regi- 
mental aid station, consequently the nature of the ground and 
the cover afforded thereby is the determining element. Should 
an engagement take place on level, open country, the question 
of establishing an aid station would not arise until after its 
conclusion or when darkness had set in. Fortunately, some 
good cover can usually be found, and owing to the flatness of the 
trajectory of the modern bullet, a moderate rise of ground, a MEDICAL SERVICE IN CAMPAIGN. 
sunken road, a gully, or other natural feature of the ground 
may give the necessary protection, if the place is not too far away 
from the enemy’s firing point (Fig. 9). If the trajectory, and 
especially the slope of fall of bullets is recalled, a study of a 
contour map would furnish a reliable guide in determining the 
places that may properly be considered. 
Some recent writers have maintained that the location is 
largely determined by the wounded themselves, and that the latter 
naturally drift to the most convenient place and it only remains 
for the regimental surgeon to bring up his supplies and the loca- 
tion is then fixed. However, if the ground is looked over and 
the map carefully studied, it might well be seen where the natural 
route for the wounded making their way to the rear lies, and the 
station established with reference thereto. 
As this station must necessarily be within the danger zone, it 
follows that it should be as near the firing line as good cover can 
be found, and of two equally safe places the one nearest the 
front should be chosen. Should the situation and terrain permit 
that some of the wounded at least could be collected during the 
progress of the engagement, the work of the bearers would certainly 
be much facilitated, and the mere possibility of retreat should 
not deter the establishment near the line, as the wounded would 
be at least as well off at the aid station as lying on the field. The 
beneficent provisions of the Geneva Convention would certainly 
give them the same protection there, and in addition thereto, if 
disaster occurred and a number of wounded were left behind at 
the station, some sanitary personnel could be left with them 
to assure them of the necessary care and attention. 
In addition to cover, it is desirable that the place should 
afford some convenience, such as shelter, water, and fire-wood, 
which are quite necessary for the comfort of the wounded. It 
would also be advantageous if it was located at a point affording 
convenient access to the front and to dressing stations and field 
hospitals in the rear and that at the conclusion of the action, 
ambulances could approach and remove the severely wounded, 
thereby saving much time and labor of the bearers. REGIMENTAL SERVICE AND AID STATIONS. 
In addition to the influence that the character of the ground 
has upon the selection of an aid station, the type of the engage- 
ment and the tactics employed have an important bearing upon 
the scheme to be adopted for the rescue of the wounded. 
In a planned attack the difficulties encountered in the 
effort to give prompt assistance to the wounded are much 
greater under modern conditions as a consequence of the style 
of tactics that are now being employed. The greater range 
of firearms has increased the extent of the zone that has to be 
covered under fire and the duration of battles has increased in 
like proportion. The attacking line may often be held in check 
for hours until sufficient impression has been made on the 
enemy to permit of further advance. The regimental sanitary 
detachment must maintain effective contact with their units 
as the line may be cut off from all communication with the 
rear for hours, and the wounded cannot, for reasons already 
given, be allowed to remain unattended for many hours. 
The closer the assailant gets to the enemy, the greater the 
probable number of casualties, and after he arrives near enough 
to prepare for the decisive action, it would hardly be possible, 
except under especially favorable conditions of terrain, to cross 
the entire danger zone to bring prompt aid to the wounded. 
If it is true that about 30 per cent, of all bullets fired in severe 
engagements fall within a space extending from 1000 to 2000 
yards from the firing point (Wolozkoi’s estimate), an aid station 
beyond this zone might be absolutely cut off. In their efforts 
to remain in contact with their units, the sanitary personnel 
is not necessarily exposed to the same extent as the troops of 
the line. The small detachments can take advantage of the 
best route that the particular terrain affords and of the lulls 
in the firing. Should it become necessary to cross exposed 
ground, they must advance by rushes just as other troops do. 
While a definite establishment of a regimental aid station 
early in an attack would probably be a great mistake, it is 
necessary that provision should be made for those wounded in 
the earlier stages of the action and a series of temporary stations MEDICAL SERVICE IN CAMPAIGN. 
may have to be established where wounded may be collected 
and given surgical aid. Such as are able to march would be 
sent to the rear if practicable, and the remainder left to be 
picked up later by the ambulance companies. 
A formal regimental aid station cannot be established un- 
til the advance ceases, the engagement terminates, or night 
sets in, and then the nearer it is to the field of losses the 
more rapidly and effectively the wounded will be collected and 
treated. If it is possible to approach to within a decisive range 
(600 or 700 yards) of the enemy’s position under fair cover, it 
would probably not be necessary to establish until that point 
is reached, but this would rarely be possible, and usually the 
line will come to a temporary halt a number of times before the 
decisive point is reached, and the number of wounded on hand 
will compel the establishment of a station. 
In a defensive action the conditions are much simpler 
than in an attack. The ground may be thoroughly reconnoitered 
and tentative locations may be selected for all the stations and 
evacuation routes, and the personnel and supplies placed in readi- 
ness at or near the proposed locations to establish as soon as the 
necessity arises. 
The use of the field howitzer has made this service more 
dangerous and the possibility of being reached by high-angle 
fire must be kept in mind in judging of the efficacy of cover. 
The aid station in defense must also be at or near the firing 
line if a rapid and efficient service is to be carried on. Behind 
strongly fortified positions the best location would probably be 
on the line itself where bombproofs, etc., may afford good cover. 
Some caution must, however, be exercised in fixing upon the 
place for a definite aid station, as it by no means follows that in a 
defensive action the position of the line may not be changed 
during the course of the action and a movement thereof may 
be necessary to follow the tactical movements of the enemy. 
The regimental surgeons of the regiments held in reserve 
have no means of determining where the organization may be 
called upon to go into action, but as they are presumably familiar REGIMENTAL SERVICE AND AID STATIONS. 
109 
with the terrain, no special difficulty will be encountered in 
finding the proper place when the time arrives. 
The division surgeon’s general plan for the care of the 
wounded will be known and the aid stations may often be ar- 
ranged so as to facilitate communication with the dressing 
stations and field hospital during action. 
It would be difficult or even impossible to lay down anything 
like a definite plan of action for the regimental sanitary detach- 
ment in a rencounter. The uncertainty as to the tactical situa- 
tion and probably a lack of accurate knowledge of the terrain 
complicate this service very much, and it is not until the action 
has developed and the further course or ultimate outcome be- 
come clear that any definite and systematic steps can be taken 
for the rescue and care of the wounded. It behooves the regi- 
mental surgeon to act with great caution, and special efforts 
must be made to maintain close contact with their respective 
units. After the action has developed sufficiently, they may 
proceed to carry on the service in a manner as suggested in the 
discussion concerning the aid service in attack or defense as 
may be called for by the situation. 
The greater accuracy of modern artillery fire and the massing 
of a large number of guns at artillery positions have brought 
about a change in the idea that formerly obtained concerning 
the location of artillery aid stations, and it is now quite generally 
accepted that they may be placed nearer the batteries than 
was formerly considered practicable. The danger zone from 
overshots in rear of batteries is not as deep as that from infantry 
fire and it is now considered to be advisable to endeavor to 
locate the station close thereto, and by preference near the 
inner flank which is less exposed in case the enemy attempts 
to envelop the position. To put it with the ammunition reserve 
would ordinarily be dangerous, as the enemy would endeavor 
to interfere with the ammunition supply whenever possible, 
and a station at this point might easily come within the range 
of exploding shell. 
The aid service with cavalry in attack presents its peculiar MEDICAL SERVICE IN CAMPAIGN. 
difficulties and it can hardly be compared to that with infantry 
or artillery. The greater mobility of cavalry troops and the 
extent of ground that may be covered rarely permit the estab- 
lishment of formal aid stations and the wounded are given such 
attention as circumstances may permit. Fortunately, the pro- 
portion of wounded is usually much smaller than with other 
arms of the service, and a very large percentage of those may 
be brought to a proper place in the rear on their mounts and no 
such extensive provision will have to be made for their care 
near the front. Severely wounded may have to be left in 
sheltered places along the route in the hope that they may be 
picked up by an ambulance company. 
When large bodies of cavalry are employed in attack, the 
sanitary personnel must be held back, as no good purpose can be 
accomplished by accompanying a mounted command into action, 
and an extensive aid service cannot be initiated until the conclu- 
sion of a successful engagement, when stations may be estab- 
lished at the most convenient places on the field of losses. After 
defeat, the question of sending out sanitary personnel under 
the protection of the Red Cross flag may arise. There is no 
doubt that the wounded would receive more satisfactory care 
from their own comrades than at the hands of the enemy, as 
the latter will probably be fully occupied with his own. 
But little can be laid down regarding the aid service with 
smaller bodies of cavalry in skirmishes incidental to the service 
of security and information. No extensive aid can be rendered, 
as the surgical supplies will probably be limited to those carried 
by the individuals of the sanitary detachment. The details of 
such service must be worked out at the time and place. First- 
aid dressings must be applied and every effort made to transport 
the wounded to the rear. 
Owing to the relatively small number of sanitary troops 
allowed a regiment and the large proportion of casualties that 
may be expected in any severe engagement, it is very important 
that the labor of rendering first aid and collecting the wounded 
should begin as early as possible. The amount of labor involved REGIMENTAL SERVICE AND AID STATIONS. 
will be so great that the authorized medical department person- 
nel can hardly hope to be able to clear the field within a reason- 
able time without help from other sources. 
It must not be forgotten that if the enemy is driven off the 
field, many of his severely wounded will also have to be cared for, 
although it is presumed that when regular aid and dressing 
stations are captured, the medical officers on duty there will 
continue their work and would not be allowed to depart until it 
had been completed. 
After a successful engagement, the field would have to be 
thoroughly gone over by the sanitary detachment, assisted 
perhaps by detachments from the regiment, to discover and bring 
in severely wounded that may have hidden away during the 
action. The search of the field may often have to be carried 
on after nightfall and lanterns or other means of illumination 
will have to be used, but unless the enemy has withdrawn, lights 
may draw his fire, a circumstance which occasionally happened 
in the war in Manchuria. 
No time must be lost, as the sanitary detachment may have to 
follow its regiment in case a pursuit is inaugurated or if a renewal 
of the engagement is in immediate prospect. As indicated 
above, the ground may be of such a nature as to preclude any 
systematic rescue of wounded during the progress of the action, 
and should the enemy be defeated and withdraw, the aid station 
would be established at the most convenient place on the field 
of greatest losses, where the wounded can be easily assembled 
for evacuation by the ambulance companies.' In a short, sharp 
engagement with many casualties, the same course is indicated. 
A sudden retreat would demand a hurried breaking up of the 
station, all wounded able to march would be directed to some 
designated place in rear and the severe cases for which there was 
no transportation would have to be left behind with the necessary 
attendants and supplies. 
After the field has been cleared and all the wounded turned 
over to the ambulance companies, the regimental surgeon must 
at once take the necessary steps to renew the supplies from the 112 
MEDICAL SERVICE IN CAMPAIGN. 
reserve supply train and prepare to resume his place with his 
regiment. 
In addition to the wounded, an unusually large daily incre- 
ment of sick may be expected, which will have to be treated and 
provided for before the labors of the day are concluded. 
Casualty returns and complete reports of the service per- 
formed will have to be submitted as soon as practicable. CHAPTER VII. 
DRESSING STATIONS CHAPTER VII. 
DRESSING STATIONS. 
Dressing stations are established, upon the order of the divi- 
sion surgeon or director of ambulance companies, by the ambu- 
lance companies, which, in addition thereto, are charged with 
the duty of transporting wounded from the regimental aid 
stations and, when practicable, from the field, to the dressing 
stations and field hospitals by means of litters, ambulances, 
travois, and improvised transportation. 
As noted in the chapter on Organization, the ambulance com- 
pany comprises five officers, two sergeants first-class, seven 
sergeants, and seventy privates. The transportation belonging 
thereto includes twelve ambulances, three field wagons, four 
pack mules, and four travois. Regulations only fix the personnel 
assigned to conduct the transportation, one officer, two non- 
commissioned officers, and twenty privates, including fifteen 
drivers, the horseshoer, saddler, cook, and two musicians. The 
remaining officers, non-commissioned officers, and men con- 
stitute the dressing-station party and the litter bearers. It is 
presumed that three detachments of about five litter squads each 
under a non-commissioned officer are available as litter bearers. 
It is not, however, considered practicable to definitely assign 
each and every man to some particular duty, as that can best 
be done at the time and place by the commanding officer. 
It cannot be expected that the limited force of the ambulance 
companies will be able to fully meet the emergencies of a severe 
battle attended with many casualties, and the chief surgeon 
most be prepared to augment it by details from sanitary detach- 
ments of organizations not actively participating, and possibly 
from field hospitals that are awaiting establishment. MEDICAL SERVICE IN CAMPAIGN. 
Regulations provide that one medical officer may be detached 
from each regiment for service at the dressing stations or field 
hospitals. In long drawn-out battles additional help may have 
to be brought up from the line of communications for temporary 
duty until the evacuation service is well under way. 
It will be noted that a formal ambulance station has been 
done away with in the new organization in the interests of 
simplicity, although it by no means implies that ambulances 
will not be expected to work as far to the front as the enemy’s 
fire will permit. 
The maximum capacity per trip of the ambulance company 
transportation, when working in connection with an estab- 
lished dressing station and using the twelve ambulances, sixteen 
litter squads, and four travois, would not exceed sixty-eight re- 
cumbent patients. Should the ambulances be loaded with 
wounded able to sit up, the number would be increased to 128, 
including twenty recumbent cases on litters and the travois. 
The dressing stations constitute the second line of assistance, 
and serve as points of assembly for wounded, and afford much 
better facilities for the surgical treatment of the wounded than 
the aid stations. They are also the first places in rear of the line 
where a regular classification of patients, so necessary to a sys- 
tematic service, can be properly carried out. A firm and rigor- 
ous policy must be adopted when large numbers are being 
received so that the transportation will only be used for those 
who absolutely require it. Patients who are able to walk to 
the advance base must be directed to the station for slightly 
wounded, not to the field hospitals, as the latter may not suffice 
for the severe cases. 
The omission of the dressing station and the assignment of 
its personnel to the regimental service,has been advocated on 
purely theoretical grounds, but recent experience in Manchuria 
seems to indicate that, owing to the depth of the danger zone, 
this station is even more necessary than formerly. Its omission 
might possibly be considered in a campaign carried on in a 
region that is covered by a network of available railways and DRESSING STATIONS. 
with greater transportation facilities than it has ever been pos- 
sible to get in any of the wars of the past. Patients could then be 
speedily transferred from the aid stations to hospital trains for 
transportation to semi-permanent or permanent hospitals on 
the line of communications or the home country. 
Many attempts have been made to definitely formulate rules 
for the surgical service at dressing stations, but the fact remains 
that the character and extent of the professional attention to be 
given depends very largely upon the number of cases that require 
treatment at the time and place. 
After severe engagements, attended by numerous casualties, 
the interests of the individual will have to be sacrificed to some 
extent to the necessity of giving all the wounded some attention 
on the battle-field. Should the situation permit and the force 
at work be sufficient, every wounded man should receive a per- 
manent occlusive antiseptic dressing, all hemorrhage checked, 
fractures cleaned and immobilized, and, in addition thereto, 
cases requiring urgent operations, such as ligation of bleeding 
vessels, tracheotomy, etc., etc., must be attended to in the 
operating department. 
Operations are now less frequently called for than formerly, 
owing to the character of the wounds produced by modern 
projectiles and the use of antiseptic methods of wound treatment. 
Many classes of wounds that in pre-antiseptic days required 
immediate active surgical interference to save life or limb can 
now safely be held over until the patients can be given the 
benefit of all the conveniences that a hospital affords, without 
incurring any special risk. 
A record such as made in 1862 at Fredericksburg, for instance, 
which shows that 11 per cent, of all the wounded were almost 
immediately operated upon, will never be duplicated in modern 
times, and the operations at the dressing stations will be strictly 
limited to emergency surgery, and it is believed that less than 
1 per cent, of the wounded would need such attention. 
No arguments need be advanced to show the advantages that 
are to be derived from permanent antiseptic dressings and no MEDICAL SERVICE IN CAMPAIGN. 
efforts should be spared to accomplish this result. Not only does 
it give protection against secondary infection, but patients so 
treated can be more easily transported and thus facilitate the 
most difficult problem that confronts the sanitary department in 
the field. 
Our organization provides four complete and distinct dress- 
ing-station parties to cover the line of battle of a division, which 
normally extends from 3000 to 5000 yards, depending upon the 
character of the ground and whether troops are employed in 
attack or defense, it being customary to allow about three men 
to the yard in defense and five in attack; that is to say, about 
that number are necessary to give a reasonable assurance that 
one man per yard may be put on the firing line for the decisive 
conflict. This estimate of the number of men required includes 
supports and reserves. 
Peculiarities of terrain and unexpected movements of the line 
may leave the dressing stations inaccessible from parts thereof, 
but an organization such as ours obviates some of the difficulties 
of breaking up and moving a station and permits of greater 
elasticity of the system of relief, and the division surgeon 
may exercise discretion in ordering the establishment of the 
companies. 
It is usually considered inadvisable to maintain a special 
reserve of sanitary organizations, and it is held that all should be 
put in service as soon as any occasion therefore arises. 
The number of separate stations that are to be established 
for the division line depends very much upon the terrain. The 
consensus of opinion seems to be in favor of combining dressing- 
station parties, or even uniting aid and dressing stations when- 
ever feasible, as greater and better results may be expected from 
a concentration of forces. 
The organization and internal administration of dressing 
stations is sufficiently set forth in the Manual of the Medical 
Department. All the transportation of the company is con- 
sidered available for bringing up the necessary supplies required 
at the station. DRESSING STATIONS. 
119 
In mountainous or other difficult terrain, the means of trans- 
port for battle supplies may be limited to the four pack mules. 
While the amount carried by the four animals would prove 
inadequate for even a moderate number of casualties, it is to be 
presumed that the transportation would be sent back to the 
wagons or the reserve supply train for the additional material 
needed. 
The place to be selected for the station should be large enough 
to admit of an orderly arrangement of the different departments, 
otherwise confusion would result that would seriously interfere 
with a systematic and rapid service. 
Some shelter is necessary, not only for the dressing and 
operating departments, but also for the wounded awaiting atten- 
tion, and for those who have received treatment and areawaiting 
transportation to the rear. 
The tentage ordinarily carried by the ambulance company 
would not be more than sufficient for the first-named purpose, 
and, unless buildings were at hand, efforts must be made to 
improvise shelter against the elements by the use of shelter 
halves, blankets, etc. 
Some time may elapse before field hospitals can be estab- 
lished and the transport service set in motion, and in inclement 
weather some such provision is quite essential. 
Water and fuel must be procured and a kitchen established 
so that stimulating foods can be prepared and water sterilized for 
surgical purposes. 
The dressing station and the roads leading thereto must be 
conspicuously marked so that they may be seen at some distance. 
Red Cross flags and green lanterns are used for the purpose. 
It is essential that the place selected should be well protected 
from the enemy’s fire and advantage must be taken of irregulari- 
ties of ground and the cover afforded by substantial buildings, 
etc. A comprehensive knowledge of the range, trajectory, and 
penetration of projectiles is necessary to properly estimate the 
qualifications of a proposed site. The chief surgeon and the 
director of ambulance companies must also have a practical 120 
MEDICAL SERVICE IN CAMPAIGN. 
knowledge of map reading in case it is impracticable to recon- 
noiter the ground. 
The question of convenience of access from front and rear is 
also of great moment, and if possible the station should be 
placed on or near a well-marked and well-known route leading 
to the rear. At the same time it must not be so placed as to 
occasion any obstruction to troops moving to the front or to the 
ammunition supply service, nor should a place be selected that 
is likely to become of tactical importance. It would, however, 
be unwise to establish in a deep ravine or gully, which, although 
it may afford ample protection against fire, would be so difficult 
of approach as to make the transportation of wounded to and 
from the station almost impracticable. 
It must not be thought that the selection of a site and the es- 
tablishment of a dressing-station is always an easy problem. In 
a series of rapid and decisive conflicts attended with heavy 
casualties the capability of the medical department will be 
strained to the utmost limit. Even under the most favorable 
conditions of terrain, improper locations may entail many addi- 
tional difficulties, both in the transportation of patients and in 
their care and treatment. 
Inclement weather, heavy roads, etc., all conspire to make the 
work one of great difficulty and the ambulance companies may 
have to labor night and day, with only short intervals of rest, 
and if, in addition thereto, badly located dressing stations com- 
plicate the situation, the medical department may easily be 
overwhelmed. 
Greater caution must be exercised in the establishment of the 
dressing station than in the case of aid stations on account of 
the relative lack of mobility of the former. After the stream of 
wounded is once directed to a certain location some time is re- 
quired before it can be diverted to another place, nor can the sup- 
plies all be packed until all the wounded that may have arrived 
have been attended and prepared for transportation to the rear. 
It would be unwise to omit the establishment of this sta- 
tion on account of a mere possibility of retreat. On the other DRESSING STATIONS. 
hand, it would probably be a mistake to attempt a definite 
establishment behind a position that could not be held if vigor- 
ously assaulted; not so much on account of the liability of the 
wounded falling into the hands of the enemy, but of the prob- 
ability of their becoming exposed to his fire in the pursuit. 
The same general principles mentioned in the discussion 
concerning the location of aid stations apply to the selection of 
the site for the dressing station, but better cover and more 
space is necessary, as the number of cases to be treated there 
will be very much larger than at any one of the aid stations. 
It was formerly customary to also indicate the proper 
location of the dressing station by directing that it should be 
put a certain number of yards in the rear of the line of battle 
or of the reserves, the point being always well beyond the range 
of the firearms then in use. Under modern conditions an effort 
would be made to establish somewhere within the danger zone 
from overshots, if proper cover can be found therein. 
To put the dressing station far away from the line of aid 
stations would not only enormously increase the labor of the 
bearers, but would also defeat the object of speedily assembling 
the wounded and giving them the better surgical care afforded 
by the station. Some authorities contend that the dressing 
station should not be much farther away from the line than 
the regimental stations, and that much would be gained if it 
was near enough to combine with it one or more of the aid 
stations. 
From all that has been said it may be concluded that the 
dressing station should be as near the line as the character 
of the cover afforded by the terrain would permit, and of two 
equally well protected and otherwise convenient places, the one 
nearer the front should be chosen. Always with the proviso, 
however, that the special tactical situation, as observed by the 
division surgeon or communicated to him by the commander 
will permit of its being done with reasonable safety. It must 
not be so close as to render it liable to be involved in ordinary 
fluctuations of the line of battle. 122 
MEDICAL SERVICE IN CAMPAIGN. 
Much would be gained if the location was easily accessible 
and afforded good cover from enemy’s fire. It is quite plain 
that the further the dressing station is to the rear the greater 
would be the probability of interference with the work of the 
bearers by fire-swept zones. 
It has been seriously proposed that a provision should be 
incorporated in regulations directing that dressing stations 
should not be established until after the decisive combat had 
taken place. Such a course might easily be followed in a 
short engagement lasting only a few hours. It has been shown, 
however, that modern combats are likely to extend over a period 
of several days, and as lulls and pauses occur from time to time 
the wounded will make their way to the rear and the necessity 
for the dressing station at once arises. Even during the active 
combat wounded will avail themselves of covered ways to 
proceed to the rear, and if the straggling of wounded over the 
field is to be prevented, provision must be made for assembling 
them, and the ambulance companies must be prepared to 
collect them and give them the needful attention. 
The type of the engagement and the kind of tactics must be 
taken into account in formulating a plan for the use of the 
sanitary companies and the establishment of dressing stations. 
Great difficulties may arise in connection with this service 
in an attack. The lack of accurate knowledge of the terrain, 
the constant tendency of the line to advance, and the varying 
phases of the tactical situation give rise to much uncertainty. 
Much ground may have to be traversed under fire before 
the advancing line comes within effective range of the enemy 
and the ambulance companies may have much difficulty in 
keeping within reach of the troops which they are expected to 
serve. They must push as far to the front as the enemy’s fire 
and the tactical situation permits, but not so close as to run 
the risk of being involved in the fluctuations of the line of battle. 
The terrain may often offer sufficient cover so that the ambulance 
companies may come up to within a reasonable distance and 
there await a proper opportunity to establish. DRESSING STATIONS. 
123 
The urgent necessity for dressing stations will probably not 
arise until the troops have arrived within effective range, and 
then the zone of overshots will be so well covered by flying 
projectiles that an advance over exposed ground will be utterly 
impracticable and the companies may have to wait for a lull or 
until the tide of battle temporarily shifts to some other parts of 
the field. The time lost under such conditions can easily be 
made up if the stations can finally be put near the aid stations 
and the field of losses. 
When many casualties have occurred, dressing stations must 
be established if it is at all practicable. The division surgeon 
must not act with too great caution for fear of retreat or unex- 
pected movements, nor should he allow himself to be misled 
by the experience obtained at maneuvers where tactical proced- 
ures are often carried out in a fewr minutes that might require 
hours for their accomplishment in actual engagements. 
It is, however, considered to be a great mistake to establish 
early in an attack, as the station would soon be left so far in 
rear as to preclude an effective service. It is also said to be in- 
advisable to fix the site of dressing stations in battle orders, but 
with four dressing-station parties per division it might be of 
advantage to fix the location of one of them in the orders that 
insure the greatest publicity, to serve as the objective for the 
wounded able to walk. Some of these will endeavor to make 
their way out of the danger zone, and a conspicuously located 
dressing station would do much to prevent promiscuous strag- 
gling of wounded. As soon as the other companies have 
definitely established near the field of losses, most of the per- 
sonnel of the first station may be withdrawn to reinforce them. 
The selection of definite locations during the progress of the 
engagement requires a keen insight into the military situation 
on the part of the division surgeon. He must keep himself 
thoroughly informed of all the tactical movements of troops and 
use his ambulance companies accordingly. 
The largest number of casualties are to be expected on that 
part of the field where the attempt is to be made to break the 124 
MEDICAL SERVICE IN CAMPAIGN. 
enemy’s line, and special provision must be made there for 
large numbers of wounded. Ordinarily it would seem advisable 
to await definite establishment of dressing stations until the line 
had come to a standstill and the number of casualties justified it. 
It may happen, as it often occurred in Manchuria, that no 
definite steps could be taken to establish near the line until late 
in the day or after nightfall, but if they are then put at the aid 
stations or on the field of losses, the wounded can be assem- 
bled there without loss of time in transportation and given the 
necessary attention. 
Stations should not be placed on the exposed flanks, for 
while such stations may be safe from frontal fire, they would 
be involved should the enemy make a flank attack. 
As in the case of aid stations, the establishment of dressing 
stations in a defensive engagement presents less difficulty than 
in the attack, and a systematic service is more easily inaugurated. 
More orderly arrangements can be made in advance for the 
evacuation of the wounded, and the transport service on the 
line of communications is usually prepared to take over the 
wounded sooner and thus relieve the organizations at the front. 
The ground being well known, tentative locations of stations 
and evacuation routes can be selected in advance and definite 
instructions concerning many of the details of the service can 
be given by the division surgeon. 
Sanitary units can be held in readiness near the places tenta- 
tively choosen as the sites of the stations, to establish as soon as 
the number of wounded justify it. Supplies can be brought up 
and distributed where most needed. 
There is, however, some uncertainty about the situation that 
renders it advisable that the division surgeon should exercise 
some caution in giving final orders for the establishment of 
dressing stations, as it cannot be definitely foreseen where the 
enemy will make his strongest effort and when and where the 
brunt of the engagement will fall. A careful division surgeon 
will therefore await developments before he makes his definite 
arrangements. It is clear that the greatest casualties must be DRESSING STATIONS. 
expected at the point where the enemy attempts to break the 
line or on the flank where he endeavors to make an enveloping 
movement. 
A reserve of sanitary troops must be maintained, only to be 
put into service when the reserves are thrown into action, when 
the enemy makes his decisive attack. 
The stations must not be too near the line where the decisive 
action is-fought, as the enemy will concentrate his artillery fire 
thereon, and it would be difficult to find good cover, especially 
if howitzers were being used. Furthermore, it must not be so 
near as to become easily involved in slight fluctuations of the 
defensive line. 
Nothing definite can be laid down concerning the establish- 
ment of dressing stations in a reencounter, the situation being 
much more uncertain than in the other types of engagements, 
it behooves the chief surgeon to await developments before tak- 
ing any active steps to establish dressing stations. Usually 
the divisional sanitary units are so far in rear that the situation 
will have cleared before the ambulance companies can be brought 
within reach. They are then used as in attack or defense, ac- 
cording to the tactics employed by the troops they are serving. 
The final arrangements for the care of the wounded on the 
battle-field will have to be more elaborate, as it cannot be expected 
that the evacuation service could be initiated as speedily as in 
connection with a planned battle. Field hospitals that have been 
marching with the trains will arrive late and wounded will have 
to be sheltered and cared for at the dressing stations for hours. 
Ambulance companies serving with cavalry commands have 
an entirely different problem, unless with cavalry fighting on foot, 
when the same principles apply as in infantry. A regular estab- 
lishment of a dressing station would be required only after a 
victory and the enemy driven off the field, when it must be put 
at the most convenient place on the field of losses. 
In case of retreat the wounded that cannot be carried away 
from the dressing station are left with sufficient personnel and 
supplies. The transportation is hurried to the rear and carries 126 
MEDICAL SERVICE IN CAMPAIGN. 
away the supplies and as many wounded as possible. The trans- 
portation and extra supplies must not be allowed to fall into the 
enemy’s hands. Humanity demands that sufficient personnel and 
material be left for the care and comfort of the wounded. Not 
only such as may be absolutely essential, but everything that is 
necessary for their comfort should remain with them. War 
costs millions and the expense of a dressing-station outfit cuts 
no figure. The sanitary organizations of the troops that have 
been compelled to retire may soon be resupplied under modern 
conditions and the personnel will be allowed to rejoin their units 
in due time. The idea that the wounded who are left behind 
will be well cared for by the enemy and that actual and complete 
neutrality really exists among those engaged in each other’s 
destruction is an idle dream of the humanitarian. At a time 
when both friend and enemy need help the comrade will first be 
looked after, and it would be too much to expect that the enemy’s 
wounded would receive the prompt attention that their wounds 
require. CHAPTER VIII. 
FIELD HOSPITALS. CHAPTER VIII. 
FIELD HOSPITALS. 
In our service only four field hospitals with a normal capacity 
for 108 patients each are allowed each division, although in 
foreign services the usually accepted standard is six hospitals of 
two hundred beds each. It is, therefore, of special importance 
that the greatest prudence should be exercised in their use as their 
capacity is so much below the requirements for the wounded of 
a division after an engagement attended with only a moderate 
percentage of losses. A cavalry division is allowed two, and an 
auxiliary division, one field hospital, with the same personnel 
and equipment as those of an infantry division. 
When an engagement is at hand the division surgeon must 
always be prepared to greatly enlarge the capacity of these insti- 
tutions as soon as they are established by drawing upon the extra 
supplies carried in the reserve supply train and upon local resources. 
The need of such preparation is apparent when it is considered 
that if a division sustains an ordinary 10 per cent, casualty, each 
field hospital may be expected to temporarily shelter and care for 
at least 300 wounded, to say nothing of an extra large daily incre- 
ment of sick. The regulation field hospital organization com- 
prising five medical officers, three sergeants first-class, six ser- 
geants, forty-eight privates, and the necessary equipment, including 
21 hospital tents, are carried on eight four-mule wagons. 
It will be observed that our field hospitals are better equipped 
than those of most foreign services in that enough tentage is 
carried to comfortably shelter 108 patients in addition to that 
required for operating-room, dispensary, kitchen, etc., and, by 
using the tent flies belonging thereto, additional shelter may be 
improvised so as to increase the capacity to 162 beds. The 
9 130 
MEDICAL SERVICE IN CAMPAIGN. 
hospital is also provided with sufficient bed sacks for that 
number. 
The practical result of this more elaborate equipment is that 
field hospitals must not necessarily be established in villages or 
towns. A large farm house with good barns would probably 
offer the required shelter even though the institution had to be 
very largely expanded. The choice of locations, is, therefore, not 
so limited and a great advantage may be derived therefrom, 
especially in sparsely settled regions, and the first transport prob- 
lem may often be much simplified by the establishment of the 
hospitals at the most convenient places. 
The indiscriminate use of these institutions for the care of the 
sick on the march or in camp, which immobilize them for the time 
being, might be followed by serious consequences in case of an 
unexpected engagement in that the already insufficient provision 
for the seriously wounded would be further reduced and the 
suffering of those that merit the greatest consideration would be 
needlessly increased. 
It must be strongly insisted upon that these units are primarily 
for the use of the wounded, and to divert them, except in case of 
great emergency, to other purposes is liable to cause the most 
serious embarrassment. Emergencies may arise, however, that 
require them to be used temporarily for the shelter of the sick, 
but such use should be exceptional and only when the service 
of the line of communications is interrupted or inadequate or 
w’hen there is no possibility of contact with the enemy. There is 
no objection to the use of the personnel of these hospitals when 
there is no immediate prospect of an engagement in connection 
with collecting stations for sick or in established hospitals in the 
vicinity. 
In battle, field hospitals may also be used temporarily as 
dressing stations in case of emergency when the ambulance 
companies are fully engaged and a proper opportunity presents 
itself. Under such circumstances they need not be established as 
hospitals until the tactical situation permits of its being done with 
reasonable safety. The use of field hospitals for such purposes FIELD HOSPITALS. 
131 
might seem to be of great advantage to the wounded as it would 
spare them an additional move, but a general use of these organi- 
zations for the establishment of dressing stations cannot be relied 
upon as the trains of a division or field army must ordinarily be 
kept so far away from the zone of actual conflict that it is only 
under most exceptional circumstances, as for instance in a planned 
defense, that they could be brought on the ground early enough 
to render effective service as dressing stations. Field hospitals 
are too slow and unwieldly to be expected to maintain the close 
contact that ambulance companies are required to do in order to 
give speedy care and attention to the wounded. Opportunities 
may occur in planned battles when they may perform the dual 
function of dressing stations and field hospitals and receive 
patients directly from aid stations and from the field. 
In severe engagements when the dressing stations are liable 
to be overwhelmed by the large number of wounded, some of the 
personnel of field hospitals that have not been established may be 
hurried to their assistance, to remain until their respective insti- 
tutions are opened, when they must return with the first convey 
of wounded directed to them. 
Field hospitals that are being held in readiness near the field 
may also serve a useful purpose by improvising a dressing station 
to render assistance to wounded who may have straggled to the 
rear and to assemble them until proper disposition can be made 
of them. 
It is not intended that field hospitals should serve as permanent 
institutions for the care of wounded, and their stay therein must 
be short; only so long as it may be necessary for the chief surgeon 
of the line of communications to perfect his arrangements for 
taking them over and evacuating them to the rear or to convert 
them into evacuation hospitals. In the latter case an exchange 
of equipment is effected and the field-hospital organizations are 
released to again follow the division to which they properly belong. 
Field hospitals are divisional units and when established 
simply constitute one of the stages en route from front to rear 
for the wounded of the division. If there is any probability of 132 
MEDICAL SERVICE IN CAMPAIGN. 
another engagement, they must be speedily freed to meet the 
urgent necessity of giving the wounded shelter and that care which 
cannot be given at the aid and dressing stations. 
Field hospitals constitute the first place near the field of battle 
where the more serious surgical operations may be performed 
with reasonable safety and where all wounds may receive per- 
manent dressings. However, the facilities of these institutions 
are not to be compared with those of evacuation and base hospitals, 
and operative procedures that can be postponed until the patients 
can be transported to the latter-named institutions should not be 
attempted. 
It is quite essential that field hospitals should be very mobile 
and their equipment must be as primitive as is consistent with 
the purpose for which they are provided. The necessary facilities 
and appliances for assuring reasonably good antiseptic surgery 
in an improvised operating-room, ordinary instruments and 
dressings are all furnished. Bed sacks, which are to be stuffed 
with hay or straw, are included, and it is presumed that when 
hospitals are established in towns additional bedding and appli- 
ances may be collected. 
Every wounded man admitted must at least receive a per- 
manent occlusive dressing, if such has not already been applied 
at the dressing station. Fractures must be cleaned and immo- 
bilized so that patients may safely stand transportation to a distance 
with minimum danger and discomfort. Patients with penetrating 
abdominal wounds will rarely require operation in field hospitals. 
Experience in recent wars has quite conclusively demonstrated 
that fully as large if not a larger percentage of such cases recover 
under expectant treatment. The facilities necessary for such 
operations are found in these hospitals for the exceptional case 
that may require them. Amputation of a crushed limb may 
occasionally have to be made and other emergency operations 
performed. 
It must be recognized that the primary function of field 
hospitals is to afford speedy shelter and primitive hospital care 
for the wounded, and, as at aid and dressing stations, patients are FIELD HOSPITALS. 
prepared for further transportation. The facilities for such work 
are much better than at the other stations and, what is more 
important, more time and care may be taken to accomplish the 
desired result. 
Should it be impracticable to speedily evacuate these hospitals 
or turn them over to the line of communications, additional 
personnel would have to be drawn in from the division or from 
the service of the rear, and an opportunity would be afforded a 
large number of medical officers to do strictly professional duty. 
Such service is much desired by all earnest medical officers and 
every opportunity should be given them. 
On the march, field hospitals habitually accompany the field 
trains, and whenever there is any probability of an engagement 
they are preceded only by the ammunition columns. When 
troops are marching into action, the trains are usually kept tar in 
rear so as to be secure in case of reverse, and unless special dis- 
positions are made, the field hospitals will be many hours’ march 
away from the zone of conflict. It would not be advisable to 
bring these heavy organizations up close as long as the situation 
remained very uncertain, as they might easily be involved in 
fluctuations of the line, or at least they might prove an 
obstruction on roads used for troops and ammunition. The 
more mobile ambulance companies may have an opportunity to 
accomplish a great deal before it became practicable to bring 
field hospitals within reach. 
It would by no means always be necessary to depend upon 
the tentage carried by field hospitals for shelter for the wounded, 
as buildings in a town or village would be preferable and the 
probability of good communication to front and rear would be 
much better than in the field. The shelter and the opportunity 
to collect additional beds, utensils, etc., afforded by a town would 
also be of value. 
While a town will afford many conveniences for the establish- 
ment of hospitals, by the use of buildings for operating-rooms, 
wards, offices, etc., and the probability of finding a convenient 
water supply, fuel, and straw, there is always a possibility of a MEDICAL SERVICE IN CAMPAIGN. 
conflagration which makes it advisable to avoid closely built up 
districts. 
Access to a railroad or navigable stream would aid immensely 
in the subsequent evacuation of the hospitals. It would be a 
mistake to put them, except perhaps for wounded who cannot 
stand transportation, anywhere else than at a place that gave such 
facilities, if such a point was within convenient reach. Easy 
access from the front is not the only requirement that must be met. 
It is of decided advantage to locate field hospitals near dressing 
stations for the accommodation of the seriously injured who can- 
not stand transportation, if the military situation so permits. 
Recent war experience has clearly demonstrated the injurious 
effects of transportation on patients who have penetrating abdom- 
inal wounds and other dangerous injuries accompanied by much 
shock, and the better results obtained by treating such cases at 
or near the locality where the injuries were incurred. Further- 
more, it is hardly consistent with humane ideas to subject wounded 
with the mark of death on their brow to the painful process of 
transportation to a distance simply to assure them of safer shelter 
for the few remaining hours that they may have to live. 
A greater distance from the front is permissible for the location 
of field hospitals than for dressing stations, but it must be con- 
sidered that the further they are away from the dressing stations, 
the greater will be the labor required for the transfer of the wounded 
and the longer time it will require to get them under shelter. 
The possibility of a retreat should not prevent their being placed 
within a convenient distance and only the danger of being involved 
in the ordinary fluctuations of the line and being subjected to the 
enemy’s fire make it advisable to act with caution. 
Field hospitals should be as near to dressing stations as the 
military situation and safety permits. If conditions are such that 
they cannot be established until the conclusion of an engagement, 
there would be nothing to prevent them from being placed as 
close to the dressing station as a suitable location can be found. 
The selection of a site for field hospitals presents fewer 
difficulties than in the case of the other stations for the reason FIELD HOSPITALS. 
that they may be placed entirely beyond the danger zone from 
overshots and still be able to fulfill their proper function. Usually 
they will be so far in rear of the troops going into action that by 
the time they can be brought up the situation will have cleared 
up to some extent at least and a reasonably safe place can easily 
be found. 
In deciding upon the location of field hospitals, the probable 
number of wounded that are to be cared for, the proximity of the 
evacuation hospitals, and the transport facilities will all have to be 
taken into account. If a stubborn fight is anticipated, a large 
number of wounded may be expected, and the field hospitals will 
have to be largely expanded, which would suggest locations near 
buildings that offered the necessary facilities. If evacuation 
hospitals are at a distance and can not be advanced within a 
reasonable time, and if the transport service cannot be set in 
motion at once, the question of shelter, convenience of getting 
supplies, and local sanitary conditions become more prominent. 
The resources afforded by a town or village would then be of 
special advantage. 
Protection against enemy’s fire must be assured either by 
placing the hospitals well beyond the range of fire or behind 
natural obstructions that give safe cover. A field hospital once 
definitely established is practically immobile and no such risks 
can be taken in locating them as in the case of the lighter organ- 
izations. The division surgeon must act with caution when he 
proposes to establish them anywhere near the scene of conflict, 
and he would hardly be justified in putting them well up to the 
front unless a successful outcome was apparent and the terrain 
was particularly favorable. He must not let his desire to save 
time in getting the wounded under shelter lead him astray and go 
so far to the front as to expose the hospitals to the danger of the 
enemy’s fire. Efficient work cannot be done if the safety of the 
wounded and the hospital personnel is constantly threatened. 
After a victorious engagement and when the enemy is driven 
from the field, the hospitals that have not already been established 
should be located at the most convenient points near the dressing 136 
MEDICAL SERVICE IN CAMPAIGN. 
stations and the field of losses, paying due regard to evacaution 
facilities. 
As far as the influence of the type of engagement upon the 
location of field hospitals is concerned, the same general principles 
apply to the location of field hospitals as given in connection 
with the location of other stations. While it is desirable for 
reasons set forth above that field hospitals should be as near 
dressing stations as possible, they must not be placed so near as 
so be endangered by fluctuations of the line of battle. 
In planned defense, safe places can be tentatively selected 
beforehand and the hospitals held in readiness there or as close 
thereto as practicable, to establish as soon as the necessity for 
them arises. Additional supplies can be collected and buildings 
prepared for the reception of wounded. Places can be chosen that 
are on convenient evacuation routes and preliminary arrange- 
ments for sending wounded to the rear can be made with the chief 
surgeon of the line of communications. 
In an attack, the hospitals have to be kept far in rear and 
cannot be brought up until perhaps the further course or ultimate 
outcome of the engagement becomes clear and the hospitals can 
be placed within convenient reach of the dressing stations. 
In a rencounter, the uncertainty of the situation during the 
development of the action renders it advisable to hold them back 
until it is clear what part the division is to play therein and then 
the necessary steps can be taken to adapt this service to the 
situation as outlined above. 
As there will always be more or less uncertainty in all types of 
engagements as to the ultimate course and outcome, it is only an 
ordinary precaution to delay the definite elaborate establishment 
of field hospitals until the conclusion thereof, and until that 
time only provisional institutions should be opened so that if a 
radical change in the military situation takes place too much 
time will not be lost if it becomes necessary to move. 
If a retreat is ordered, efforts will be made to send as many 
wounded as possible to the rear and the remainder left with 
sufficient personnel and supplies. CHAPTER IX. 
STATION FOR SLIGHTLY WOUNDED. CHAPTER IX. 
STATION FOR SLIGHTLY WOUNDED. 
Stations for slightly wounded are established, usually one for 
each division, which serve as assembly points for such cases that 
do not require immediate hospital care and shelter and which are 
able to march some distance. 
This station constitutes a new feature as far as our sendee is 
concerned. The necessity for some additional provision for the 
care of the wounded in the collecting zone is apparent when the 
small number and limited capacity of field hospitals is considered. 
These places are expected to not only facilitate the rapid collection 
and removal of a troublesome class of wounded from the front, 
but also to have some influence in limiting straggling in rear of 
the line by fixing a definite place where slight cases are to be 
assembled. “Skulking and straggling” will be discouraged by 
systematic provision for the slightly ill or injured where all who 
should be excused from duty may obtain proper authorization. 
No permanent personnel or material is provided in regulations 
for this station, but it remains for the division surgeon to detail, 
in each case, medical officers and men from trains or from other 
organizations that will presumably not be actively engaged. A 
large force will not be needed as most of the wounded arriving 
there will have received at least a first-aid dressing at the aid or 
dressing stations. One medical officer and eight or ten men will 
probably prove ample for this service. The necessary food and 
surgical supplies are to be obtained from the reserve supply of the 
trains. 
This station is primarily intended to relieve field hospitals and 
dressing stations of the slighter cases and to serve as an inter- 
mediate station for such on their way to hospitals on the line of 140 
MEDICAL SERVICE IN CAMPAIGN. 
communications. It may also serve for the reception of the sick 
and exhausted who are unable to continue at the front and who 
after rest and refreshment may proceed to the rear. It is especially 
important that this class of patients should be kept away from 
the field hospitals as they would be the first to arrive, and in 
severe engagements, would fill them to overflowing before the 
severe cases could be brought. 
No surgical service of any consequence is expected to be 
performed there and no elaborate arrangements need be made. 
Some dressings may have to be replaced or readjusted and possibly 
an operation to check hemorrhage or other extremely urgent 
surgical procedures may have to be carried out. A detached 
service chest and a box of reserve dressings would suffice for the 
purpose. 
A systematic service must be assured by arranging a receiving 
and dressing section where wounded may be recorded and those 
who have not passed through the hands of medical officers at the 
front may be dressed and given diagnosis tags which may be 
considered as proper passports to the rear. A very important 
duty to be performed is the sorting of cases. Malingerers and 
slight cases that are deemed able to continue at the front in spite 
of minor illness or injury are to be sent back to their organizations. 
Patients with severe injuries who have inadvertently come there 
must be sent to the nearest field hospital. 
A kitchen must be improvised so that food may be given to all. 
Rations and hospital stores may be obtained from the supply train. 
Some shelter for wounded is also necessary, especially in inclement 
weather, and it will usually be possible to find a building or a group 
of buildings for the purpose. Shelter is of greater importance 
after engagements that continue until late in the day or after 
nightfall when patients may have to be retained until next morning. 
As soon as patients have received the necessary surgical 
attention and refreshments, they will be turned over to the for- 
warding section, and those who have been marked “duty” will 
be sent, after a rest, to their units. Others will be organized into 
detachments under a sanitary soldier or the senior among the STATION FOR SLIGHTLY WOUNDED. 
141 
wounded, and directed to the advance base or other designated 
place where arrangements for their reception have been made by 
the chief surgeon of the line of communications. Each detachment 
thus sent must have specific directions as to the route to be followed 
and the destination, also instructions must be given as to the 
course to-be pursued should any member of the detachment 
become unable to continue the march. 
When detachments are sent to the rear it would be advisable 
to send some wheeled transportation along with them, whenever 
such can be obtained in the-vicinity, to carry the men’s packs 
and for those who may fall out and become unable to continue 
the march. Empty supply wagons or vehicles picked up in the 
neighborhood may be used for the purpose. Should it be im- 
possible to procure wagons, such patients may have to be left in 
houses along the route and the line of communication authorities 
notified upon arrival at destination. 
The selection of a location and the determination of the time 
for establishment can usually be made before the engagement 
begins and published in the division battle orders. It is of special 
importance that the whole command should be accurately informed 
of its whereabouts so that the slight cases occurring early in the 
engagement may soon find their way there and thus prevent the 
straggling referred to above. Medical officers and members 
of the hospital corps especially must be ready to give specific 
directions for finding the station and give information concerning 
the routes thereto. 
As soon as troops form for battle the designated personnel 
and the supplies must be assembled there and the place prepared 
for the reception of wounded. If the assembly place for the sick 
of the command is chosen for the purpose, all that will be necessary 
will be to bring up the extra supplies that will be needed. Even 
in a rencounter there would probably be sufficient time to make 
all preparations before any wounded could be expected to arrive. 
Slightly wounded arriving at the dressing station or field hospital 
must at once be transferred and these institutions will then be 
relieved of an encumbrance and all attention can be given the more 142 
MEDICAL SERVICE IN CAMPAIGN. 
serious cases, and when the time comes to break up, the slighter 
cases will all have been disposed of and the entire energies of the 
sanitary personnel can be devoted to those who require the most 
attention. 
The question of distance from the field of losses is not of such 
importance as in the case of other stations, except perhaps in the 
case of an action that takes place late in the day or at night when 
the difficulty of finding a distant station would have to be taken 
into account. 
As the slightly wounded will be. expected to eventually march 
to the advance base or other place on the line of communications, 
it might seem to be a matter of indifference whether this station 
was one or ten miles away from the line of battle, but as a matter 
of fact it must be placed within convenient reach of the field of 
losses—just beyond the danger zone. The danger of being 
involved in wider fluctuations of the line is very small as it can be 
broken up at a moment’s notice and moved out of the way. 
The place selected must, if possible, be at some point that is 
well known to the troops, and generally on the route passed 
over by them, as slightly wounded men naturally drift back the 
way that they came. A site near some prominent land mark 
that can be seen at a distance, a town or village or crossroads 
through which troops have marched, is taken by preference. 
The station should also be at some distance from field hospitals 
to prevent as much as possible, the slightly wounded from making 
demands upon the conveniences of these institutions. It will, 
perhaps, be found easier to prevent them from going there than 
to turn them out after arrival. It is also quite desirable that the 
place selected should be easily approachable from the front and 
on a convenient evacuation route to the rear. It is usually 
recommended that it should not be located on the main line of 
retreat for fear of obstructing the movements of advancing troops 
or ammunition columns, but it must be borne in mind that 
such route is perhaps the best known and most readily followed. 
For similar reasons it is often stated that the main route should 
not be designated for the subsequent evacuation of the station STATION FOR SLIGHTLY WOUNDED. 
143 
and that some parallel road should be chosen, but the same 
objections apply as in the case of the site of the station. 
It is quite safe to estimate that only about 15 per cent, of the 
wounded will be able to march some distance to the rear. Based 
upon this estimate, from 200 to 500 or more slightly wounded may 
be expected after severe engagements, sufficient to fill from one- 
half to the entire normal capacity of the field hospital of the 
division. The wisdom of making some additional provision for 
this class of cases would seem to be abundantly justified. CHAPTER X. 
LINE OF COMMUNICATIONS. 
IO CHAPTER X. 
LINE OF COMMUNICATIONS. 
The very intimate relations which exist between the sanitary 
service of the lines of communication—the evacuating zone— 
and that of the front or collecting zone make it necessary that a 
brief sketch of the organization and function of the line of com- 
munication service should be given in connection with the discus- 
sion of the service in the collecting zone. 
The lines of communication are embraced in the territory 
immediately in rear of the zone of operations. This territory is 
divided into a number of districts corresponding to the number 
of field armies composing the force at the front. 
Each field army, as a rule, maintains its own line of communi- 
cations within the district assigned to it, even if several are united 
to form an army. 
The lines of communication may consist either of railway or 
water service or of both. In the absence of these, wagon trans- 
portation must be utilized. They include a base where depots 
of supplies and hospitals are maintained and supply or issue 
depots at the front. 
As troops advance from the base, a line of communications is 
formed and its head must not be more than two days’ march in 
rear. As the line extends, a chain of stations or intermediate 
bases is established, usually at intervals of about 15 miles, if the 
route is on a highway. These stations are protected by troops 
and may serve as convenient points for storing supplies and the 
establishment of hospitals and other sanitary institutions. 
At the head of the line of communications a temporary base 
of supplies is established where division trains may obtain the 148 
MEDICAL SERVICE IN CAMPAIGN. 
stores required by their units. This advance base may have to be 
moved from time to time to conform to the movements of the 
army. 
A regular organization is provided for the service of the line of 
communications, headed by a commander who is provided with 
the necessary troops and a staff which includes a chief surgeon. 
The function of this organization is to keep the troops at the front 
provided with ample supplies of all kinds that may be required, 
and to transport the sick and wounded who are not expected to 
recover within a reasonable period to the base as rapidly as 
possible. 
The chief surgeon, under the direction of the commander, must 
therefore co-operate not only with the service in the collecting zone, 
but also with that in rear of the base which is to relieve his insti- 
tutions of non-effectives and upon which he must rely for supplies 
for the sanitary units at the front and in the evacuating zones. 
He must, therefore, act in accordance with instructions received 
from both mentioned sources and meet the demands of the 
organizations at the front for supplies, to take over their sick and 
wounded, and to evacuate them beyond the base at such times 
and to such places as may be directed by the War Department. 
As indicated above, the relations of the sanitary service at the 
front and of the lines of communication are so intimate that it is 
quite impossible to fix a line of demarkation between them, but 
their organizations are, however, separate and distinct. 
The organizations named on page 149 are mobilized for the 
line of communications service in such numbers as provided by 
regulations or the needs of the situation may demand. 
The number of each of these institutions that may be required, 
transport columns, evacuation and base hospitals, and supply 
depots excepted, cannot be fixed as it depends entirely upon the 
length and character of the line of communications. The person- 
nel for those which have no definite allowance will have to be 
specially provided by the War Department or perhaps by details 
from the regular organizations of the line of communications, 
re-enforced by Red Cross columns. LINE OF COMMUNICATIONS. 
149 
Organizations 
and 
Institutions 
Medical 
officers 
Sergeants 
1 st class 
Sergeants 
Privates 
Dentists 
Female 
nurses 
Ambulances 
W agons 
Bed capacity 
Transport column.... 
2 
2 
8 
32 
12 
I 
Evacuation hospital. . . 
14 
8 
16 
129 
3 
2 
324 
20 
8 
16 
129 
I 
46 
3 
2 
O 
O 
2 
I 
2 
12 
... 
3 
1 
2 
24 
200 
Hospital ship 
5 
1 
4 
35 
... 
200 
Convalescent camp.. . 
Allowance of personnel not fixed, but is 
dependent upon circumstances. 
Casual camp for sani- 
tary personnel 
Rest station 
Contagious disease 
hospital 
Receiving hospital at 
railway station o r 
boat landing 
Red Cross column . . . 
In preparation for a serious campaign a personnel and trans- 
portation reserve should be specially provided, not only for the 
service on the line of communications, but also to reinforce the 
sanitary units with the troops at the front in case of emergency. 
In every great war it has become necessary, sooner or later, 
to largely increase the sanitary personnel, especially that of the MEDICAL SERVICE IN CAMPAIGN. 
line of communications, and in the interest of economy and 
efficiency, regular provision for it should be made in our war 
organization. A systematic evacuation service cannot be carried 
on by unorganized and untrained civilians. The confusion and 
lack of co-ordination incidental to such a service has always 
proven most unsatisfactory and very expensive both as regards 
human life and treasure. 
The allowance of evacuation and base hospitals is based upon 
the estimate that hospital provision will have to be made for about 
6 per cent, of the force at the front and two of the former and one 
of the latter are mobilized for each division, affording a total 
normal capacity for 1148 patients for a division of 20,000 men. 
The chief surgeon of a line of communications serving a field 
army would dispose over at least two transport columns, four 
evacuation and two base hospitals, two supply depots and such 
other institutions and organizations as the situation may require. 
It has frequently been remarked that the success of the sanitary 
service at the front and on the line of communications depends 
very largely upon the rapidity with which non-effectives can be 
removed from the zone of operations. It must also be admitted 
that efficient service in the zones mentioned does not depend so 
much upon the quality of the professional work of individual 
medical officers as upon the systematic co-operation or “team 
work” in the matter of sanitation, removal, and incidental care 
and treatment of non-effectives by the sanitary organization. 
The service on the line of communications is of infinitely 
greater importance, from a strictly professional standpoint, than 
that of the front, as sooner or later all the more severe cases of 
sickness or injury are turned over to it for temporary or permanent 
care and treatment. Its primary function is, however, the 
removal of non-effectives from the zone of operations, where, 
from a military point of view they constitute a serious impediment, 
but it must not be forgotten that at least temporary care and 
treatment of all patients is required during the process of evacua- 
tion and all sanitary units must be organized and equipped for 
this dual function. LINE OF COMMUNICATIONS. 
151 
In the efforts of the medical department to maintain the 
highest possible effective strength of the force at the front, it is all- 
important that some relation should be maintained between the 
distance that patients are to be transported and the probable 
duration 0} their disabilities. It is desirable that the slighter 
cases should be held and treated as near as practicable to the zone 
of operations so that no unnecessary time will be lost in returning 
them to their organizations upon recovery. 
If the military situation, climatic and other conditions permit, 
no cases except such as will probably require prolonged hospital 
care and those permanently incapacitated should be sent further 
to the rear than the base of operations (base hospitals). 
No definite time can be fixed upon for the stay of the various 
classes of cases on the line of communications as in preparation 
for battle or other emergencies the institutions may have to be 
cleared in anticipation of a large influx of sick and wounded, and 
much judgment and discrimination will have to be exercised in 
determining the extent of the evacuation process. 
Transport columns are new organizations in our service and 
are to be mobilized at the rate of one for each division, for the 
purpose of connecting the front with the line of communication 
institutions and for service on the line itself. They must keep 
in touch with troops on the march and be prepared to take over 
the more serious cases for transportation to the nearest railway 
station, boat landing or hospital. This service is performed 
under the direction of the chief surgeon of the line of communi- 
cations upon the demand of the chief surgeon of the field army, 
who notifies the former whenever sick of the command are 
assembled for evacuation. 
Field hospitals will be cleared of patients by the transport 
columns whenever it is impracticable to convert them into evacu- 
ation hospitals. If there is no railway station or boat landing 
convenient to the battle-field, it may be necessary to largely 
augment these columns in preparation for battle by the addition 
of transportation provided for the line of communication for other 
purposes, by Red Cross columns or by hired vehicles, as these MEDICAL SERVICE IN CAMPAIGN. 
units are only strong enough to meet the very ordinary emer- 
gencies. They should arrive on the ground not later than the 
morning after battle, and arrangements to that end must be 
made by the chief surgeon, who will have received timely notice 
of an impending engagement from the chief surgeon of the troops 
about to engage, who will also indicate the time and place where 
they will probably be most needed. The personnel of the trans- 
port column is also available to act as escort to the detachment 
of sick and wounded that are sent to the rear in boats or trains 
and to establish rest stations along the line of evacuation. 
Evacuation hospitals are mobilized at the rate of two for a 
division. Each of these institutions has a bed capacity for 324 
patients and may be divided into three sections. A section of an 
evacuation hospital includes sufficient personnel and equipment 
to relieve an established field hospital. 
Evacuation hospitals have a more elaborate equipment than 
field hospitals, including everything required for three such units, 
transportation excepted; consequently when the latter are taken 
over by the line of communication organizations, all the materials 
and supplies in use with patients may be left with them and the 
field-hospital equipment completed from the supplies carried by 
the evacuation hospital. 
Enough tentage is provided for the number of patients indicated, 
but if it becomes necessary that more permanent arrangements 
should be made, pavilions may be constructed according to the 
plans and specifications now on file in the office of the Surgeon- 
General. These plans provide for the most simple possible 
construction from material that can usually be found in any 
market. However, it would often be practicable to establish 
these institutions in towns and villages where buildings may be 
made use of. 
Evacuation hospitals are intended for the temporary care and 
treatment of patients whose condition is such as to require them 
to be evacuated to the base or further to the rear, and when 
practicable for the definite treatment of those who may be expected 
to recover within a short period of time, and for such as cannot LINE OF COMMUNICATIONS. 
stand transportation. They constitute the central point toward 
which the collecting zone converges and from which the evacuating 
and distributing zones diverge. They are, therefore, of the 
greatest importance as far as the removal of the sick and wounded 
is concerned. The evacuation hospitals constitute the link 
between all three zones and are the units which the chief surgeon 
must employ in establishing and maintaining the flow of sick and 
wounded between the field hospitals and the railway line of 
evacuation. In connection with battle service their function is 
similar to that of field hospitals which they supplement or relieve. 
Field hospitals may be taken over on the ground by evacuation 
hospital organizations, or the patients may be transported to a con- 
veniently located evacuation hospital, so that the field hospitals 
may be free to rejoin their units if there is a possibility of another 
engagement. 
More permanent arrangements than are afforded by field 
hospitals will also have to be made at or near the battle-field for 
non-transportable wounded,and the chief surgeon must bear that 
in mind in making his plans for the use of the evacuation hospitals. 
As troops advance from the base and the line of communications 
is extended, evacuation hospitals or sections thereof will have to 
be established at suitable points along the line, and especially 
at the advance base for the sick of the command. Preference 
would naturally be given to locations in towns that offered shelter 
and other conveniences for the care of patients. 
It would be unwise to send those that only require a short 
period of treatment further back than the evacuation hospitals, 
if military and climatic conditions permit, as much time would 
unnecessary be lost in returning men to their organizations upon 
recovery, thus materially reducing the effective strength at the 
front. 
An evacuation hospital or a section thereof may have to be 
established as a hospital for contagious disease as it is hardly 
consistent with our ideas of sanitation to attempt to move such 
cases a long distance from the zone of operations if proper pro- 
vision can be made on the line of communications. MEDICAL SERVICE IN CAMPAIGN. 
Whenever an engagement is imminent, the established hospitals 
would have to be cleared as far as possible in anticipation of the 
arrival of large numbers of wounded, and those institutions 
which are available must be advanced within reach of the battle- 
field to relieve and supplement field hospitals on the ground in case 
of a successful termination of the engagement. If there is a rail- 
or waterway convenient to the field of operations these institutions 
are to be loaded on cars or boats in readiness to be forwarded 
upon telegraphic notice. One of these institutions would probably 
be at once established at the rail head or boat landing to act as 
receiving hospital for those who are in process of evacuation. 
Ordinarily it would be advisable to begin the evacuation to 
the rear at once, even in case of victory, as it is quite desirable to 
clear the zone of operations of wounded as soon as possible; as 
their presence would not only be an impediment to the move- 
ments of the troops, but they would also complicate the supply 
problem of the army. When evacuation hospitals take over 
field hospitals on the ground, a provisional establishment only 
would be contemplated and arrangements made for their speedy 
evacuation. 
Should the field of battle be a day’s march or more from the 
rail- or waterway, evacuation hospitals should be advanced to the 
nearest station in anticipation of the engagement, in readiness to 
be moved up to within reach of the field, so that in case of victory 
some of them may be established near it to relieve field hospitals 
in order that they may rejoin their units in case of an advance 
and a renewal of the engagement. 
It would be the duty of the chief surgeon of the line of com- 
munications to provide the necessary transportation for evacuation 
hospitals that are to be moved over ordinary roads, by drawing 
upon the trains belonging to the line of communications and 
Red Cross columns or by requisition upon the civilian popula- 
tion of the district. 
It is believed that the necessity of providing regular trans- 
portation for at least one of the evacuation hospitals of each 
division will at once appear in a great campaign, and provision LINE OF COMMUNICATIONS. 
155 
therefore should be made in our war organization. This necessity 
would perhaps be best met by an allowance of motor vehicles 
About thirty four-mule wagons would be required to transport 
the light equipment of one of these hospitals. A considerable 
reduction in the weight of the material will be accomplished by 
leaving out the tentage which would not be needed if the 
hospital is to be established in a town. 
A base hospital with a bed capacity for 500 patients is mobil- 
ized for each division, which is to serve as a safer and more per- 
manent institution for the treatment of patients than evacuation 
hospitals. Its equipment is much more complete than other 
hospitals near the front and approaches that of general hospitals. 
Base hospitals also constitute the link between the evacuating 
and distributing zones and serve to relieve the more temporary 
institutions of patients, especially of those who will require pro- 
longed treatment or who are permanently incapacitated. On 
account of their better equipment, safer location, and proximity 
to the source of supplies, they are better able to take care of the 
more serious cases. The definite classification of cases is also 
carried on in base hospitals, and all such as will require prolonged 
treatment and those incapacitated for further service are, under 
instructions from the War Department, promptly evacuated and 
distributed among general hospitals. 
The outflow of patients from the line of communications to 
general hospitals must keep pace with the influx from the insti- 
tutions in the collecting and evacuating zones, otherwise th$ 
service of the base and evacuating hospitals and finally that of the 
field sanitary units will become clogged. The chief surgeon of 
the line of communications must therefore not only arrange to 
meet the demands of the troops at the front, but also by timely and 
far-sighted representations to the War Department or to the chief 
surgeon of the army in the field, obtain the necessary means and 
facilities to initiate the further evacuation of non-effectives to 
general hospitals. 
In anticipation of a large influx of wounded from the battle-field, 
special efforts may have to be made to clear base hospitals as well 156 
MEDICAL SERVICE IN CAMPAIGN. 
as evacuation hospitals of sick, and a prompt and efficient evacu- 
ation service must be provided from the very beginning. 
As indicated by their name, base hospitals are usually estab- 
lished near the base of operations which corresponds to the rear 
end of the line of communications and marks the beginning of 
the general line, the sanitary service of which is directly under 
the control of the Surgeon-General and the War Department. 
Base hospitals are to be established in towns where suitable 
buildings may be made use of, but in case of necessity pavilion 
hospitals may be built in accordance with plans and specifications 
that have already been prepared in the office of the Surgeon- 
General. 
The medical supply service is of such great importance to 
the sanitary department at the front that it merits exhaustive 
consideration in a work that professes to treat of the service of the 
medical department in the field; but in view of the fact that it is so 
completely covered in the Manual for the Medical Department, 
little need be said on the subject here. 
A supply depot is mobilized for every division which follows 
its unit into the field. It remains, however, at the base of oper- 
ations or at some other convenient point on the line of com- 
munications where the necessary transportation facilities may 
be had. When divisions are united to form field armies, the depots 
may be combined or they may be established at different points 
as may be called for by the special situation. As the line of 
communications is extended by the advance of the troops, a 
depot or a section thereof must be brought up and finally estab- 
lished at the advance base for the convenience of sanitary organ- 
izations serving with troops at the front. 
The depots must be prepared to replace the materials used 
at the front and in the institutions on the line of communications, 
and to furnish the supplies necessary to improvise additional 
hospitals, hospital trains or boats, rest stations, convalescent 
camps, etc., etc. 
The personnel, organization, and capacity of hospital trains 
and boats is laid down in regulations, but thus far no definite LINE OF COMMUNICATIONS. 
157 
steps have been taken to provide hospital cars and boats for use 
in time of war, and they will have to be improvised when the 
emergency arises. 
Certain supplies and materials, including litter supports, 
necessary to fit up passenger and freight cars are contained in the 
field supply depots so that boats and trains can be hastily 
prepared to transport patients. Trains that bring supplies to the 
front may thus be prepared to bring back patients and systematic 
arrangements for such a service must be made by the chief surgeon. 
It must also be noted that hospital provision will have to be 
made at every post or station established along the line of com- 
munication, not only for the reception of the sick of the garrison of 
the place, but also for such as may be left behind by troops pass- 
ing through on their way to the front. Such improvised hospitals 
may become of great importance if near enough to the battle-field 
to be reached by wounded en route to the regular evacuation line. 
Nothing definite can be laid down concerning the organization, 
equipment, and service of those institutions mentioned in regu- 
lations for which no definite personnel is provided. Their 
organization and equipment constitute an important problem 
for the chief surgeon, which will have to be worked out at the 
time and place. They are important because of the relation to 
the evacuation service. The personnel and supplies of Red 
Cross organizations will probably have to be largely relied upon 
for service at such stations. BIBLIOGRAPHY. 
Army Regulations, 1908. 
Description and Rules for the Management of U. S. Magazine Rifle. 
Field Service Regulations, 1910. 
Firing Manual, 1909. 
Manual of the Medical Department, 1910. 
Altgelt. Der Sanitatsdienst im Felde. Berlin, 1910, Mittler und Sohn. 
Boerner. Der Einfluss der modernen Kriegsfeuerwaffen auf dem Sanitats- 
dienst. Leipzig, 1909, Georg Thieme. 
Cron. Zehn Beispiele a. d. Gebiete d. Gefechtssanitatsdienstes. Wien, 
1909, Josef Safar. 
Cron. Kriegswaffen und Feldsanitatsdienst. Wien, 1907, Josef Safar. 
Cron. Behelf zum Studium des Militarsanitatswesens. Wien, 1910, Josef 
Safar. 
Cron. Feldtaschenbuch fur den Sanitatsdienst im Kriege. Wien, 1908, 
Josef. Safar. 
Cron. Ueberblick einer Neuanlage des Gefechtssanitatsdienstes. Wien, 
1909, Josef Safar. 
Cron und Hochmann. Ueber Krankenstande im Felde. Wien, 1908, 
Josef Safar. 
Dautwiz. Ueber Sanitatstaktische Ausbildung der Sanitatsoffiziere. Berlin, 
1901, Mittler und Sohn. 
Etzel. Die Befehlsgebung der Sanitatsoffiziere im Felde. Berlin, 1904, 
Mittler und Sohn. 
Follenfant. Etudes sur le Service de Sante en Campagne. Journal des 
Sciences Militaires, 1909. 
v. Hoen. Der operative und taktische Sanitatsdienst im Rahmen des 
Korps. Wien, 1907, Josef Safar. 
v. Hoen. Vorschule zur Losung sanitatstaktische Aufgaben. Wien, 1908, 
Josef Safar. 
v. Hoen und Szarewski. Die operative und sanitatstaktische Tatigkeit des 
Armeechefarztes. Wien, 1910, Josef Safar. 
v. Hoen und Szarewski. Behelf zur Losung von Aufgaben. Wien, 1909, 
Josef Safar. 
Kroath. Beitrag zur Gefechtssanitaren Applikatorik im Gelande. Wien, 
1907, Josef Safar. MEDICAL SERVICE IN CAMPAIGN. 
Kroath. Beziehung des Feldsantitatsdienstes zum Felddienst. Wien, 1907) 
Josef Safar. 
Loeffler. Taktik des Truppen-Sanitatsdienstes auf dem Schlachtfelde 
Berlin, 1907, Mittler und Sohn. 
Lynch. Reports of Military Observers in the Russo-Japanese War. Wash- 
ington, 1907, General Staff. 
Munson. Utility of Map Problems. Military Surgeon, 1910. 
Macpherson. The Removal of Sick and Wounded from the Battle-field. 
Journal R. A. M. C., January, 1909. 
Matignon. Enseignements Medicaux de la Guerre Russo-Japonaise. 
Paris, 1907, Malone. 
Niebergall. Der Einfluss moderner Bewaffnung auf die Sanitatstaktik. 
Deutsche Militararztliche Zeitschrift, 1909. 
Nimier et Laval. Traitment des Blessures de Guerre. Paris, 1901, Alcan, 
v. Oetlingen. Studien auf dem Gebiete des Kriegs-Sanitatswesens. Berlin, 
1907, Hirschwald. 
v. Oven. Taktische Ausbildung der Sanitats Offiziere. Berlin, 1908, 
Eisenschmied. 
Shaefer. Moderne Bewaffnung und Kriegssanitatsdienst. Beiheft zum 
Militar Wochenblatt, 1907. 
Taussig. Losung von Aufgaben. Wien, 1902, Josef Safar. 
Villaret. Die Handgranate. Stuttgart, 1908, Enke. INDEX. 
Administration, 75 
Advance Base, 148 
Advance Supply Depot, 71, 156 
Aid Stations, 102 
Artillery, 109 
Cavalry, 109 
Function, 102 
Location, 105 
In attack, 107 
In defense, 108 
In rencounter, 109 
In retreat, m 
Personnel, too 
Ambulance Company, 115 
Capacity of transport, 116 
Function, 115 
On the march, 71 
Transportation, 115 
With cavalry, 125 
Ambulance Station, 116 
Ambulance Wagon, Allowance, 51 
Capacity, 55 
Angle of Fall, Artillery projectiles, 
38 
Rifle bullets, 37 
Attack, Medical Service in, 91 
Base, 147 
Base Hospitals, 155 
Allowance, 155 
Capacity, 155 
Function, 155 
Location, 156 
Personnel, 149 
Basis of Medical Organization, 
88 
Battalion, Strength of, 59 
Battle Dispositions, 87 
Battle Losses, 41 
Artillery, 44 
Cavalry, 44 
Civil War, 42 
Exceptionally high, 44 
Franco-Prussian War, 42 
Infantry, 44 
Of an army corps, 44 
Of a division, 44, 46 
Of a regiment, 44 
Per battle day, 43 
Russo-Japanese War, 41, 42 
Sanitary troops, 44 
Bearer Squads, Ambulance Com- 
pany, 115 
Regimental, 100 
Boats, Hospital, 156 
Brigade, Strength of, 60 
Caliber of Rifles, 28 
Casualties, 41 
Average, 44 
Classification, 48 
From artillery, 45 
From Disease, 49 
Ordinary maximum, 46 
Chief Surgeon of an Army, 77 
Of a field army, 77, 90 
Of a division, 75 
Of line of communications, 148 
II 162 
INDEX 
Classification of Sick, 50 
Classification of Wounded, 47 
Collecting Place for Sick, 84 
Companies, Strength of, 59 
Contagious Disease Hospitals, 
i49. *53 
Contour Lines, 24 
Conventional Signs, 24 
Cover, Efficiency of, 35 
Against artillery fire, 35 
Against rifle fire, 36 
Danger Space, 29, 30 
From artillery fire, 32, 34 
Point blank, 29 
Danger Zone from Overshots, 30 
Deaths from Wounds, 45 
Defensive Engagements, 94 
Director, Ambulance Companies, 
65 
Field hospitals, 65 
Distance of Stations from 
Battle Line, 89 
Division, Strength of, 61 
Division, Auxiliary, Strength of, 
63 
Division, Cavalry, Strength of, 
62 
Dressing Stations, 115 
Cavalry, 125 
Function, 117 
In attack, 122 
In defense, 124 
In rencounter, 125 
In retreat, 125 
Location, 121 
Number, 118 
Personnel, 115 
Time of establishment, 122 
Effective Ranges, Infantry Fire, 
29 
Efficiency of Cover, 35 
Against artillery fire, 35 
Against infantry fire, 36 
Evacuation Hospitals, 152 
Allowance, 152 
Capacity, 152 
Function, 152 
Location, 154 
Personnel, 149 
Field Army, Medical Organiza- 
tion of, 62, 64, 65, 68 
Field Artillery, 32 
Field Hospitals, 129 
Allowance, 129 
Capacity, 129 
Function, 130 
Location, 134 
In planned attack, 136 
In planned defense, 136 
In rencounter, 136 
On the march, 133 
Personnel, 129 
Formulas, Ambulance Transport, 
55 
Litter transport, 54 
Function of Medical Depart- 
ment, 75 
Hospitals, Base, 155 
Contagious disease, 153 
Evacuation, 152 
Field, 127 
Line of communications, 150 
Line of communication stations, 
157 
Influence of range on Sanitary 
Service, 87 
Influence of Terrain on Sani- 
tary Service, 95 INDEX. 
163 
Influence of Type of Engage- 
ment on Sanitary Ser- 
vice, 91 
Instructions, Chief Surgeon of 
Field Army, 80 
Killed, Proportion of, 42, 45 
Letters of Instruction, 14, 80 
Line of Battle of Division, 
Extent of, 118 
Line of Communications, 147 
Chief surgeon, 148 
Functions, 148 
Hospitals, 150 
Stations, 147 
Lines of Assistance, 95 
Litter Squads, Ambulance Com- 
pany, 115 
Litter Squads, Regimental, ioo 
Litter Transportation, 54 
Map Reading, 23 
Maps, 23 
Map Scales, 23 
Medical Supply, 156 
Reserve, 71 
Messages, 21 
Military Rifles, 28 
Orders, 14 
Field, 15 
For additional transportation, 83 
For assembly of sick, 78 
For battle, 83 
For dressing stations, 83 
For field hospitals, 83 
For station for slightly wounded, 
84 
General, 15 
Model, 17 
Special, 15, 20 
Organization, 59 
Auxiliary division, 63 
Cavalry division, 62 
Field army, 62 
Infantry division, 61 
Organization, Medical, 64 
Army headquarters, 65 
Auxiliary division, 63 
Cavalry division, 62 
Division, 61 
Headquarters, 66 
Field army headquarters, 65 
Line of communications head- 
quarters, 68, 149 
Organizations, Medical, Ambu- 
lance Company, 66, 115 
Base hospital, 149, 155 
Evacuation hospital, 149, 152 
Field hospital, 129 
Hospital train, 149 
Hospital ship, 149 
In collecting zone, 76 
In evacuating zone, 76 
In distributing zone, 76 
Line of communications, 149 
Regimental detachment, 65 
Supply depot, 149 
Transport column, 149, 151 
Pack Mules with Ambulance 
Company, 119 
With regiment, 100 
Plans for Battle, 80, 83 
Point Blank Danger Space, 29 
Preparation for Battle, 81 
Preparation for Field Service, 13 
Protection against artillery 
fire, 35 
Against rifle fire, 39 
Range, Artillery, 32 
Range of U. S. Rifle, 29 164 
INDEX, 
Road Space, Division, 72 
Red Cross, 151, 157 
Regimental Service, 99 
Regimental Supples, ioo 
Rencounter, 93 
Reports, ioo 
Reserve Medical Supply, 71 
Sanitary Personnel, Ambulance 
Company, 66 
Ammunition train, 67 
Auxiliary division, 68 
Base hospital, 149 
Battalion, 66 
Cavalry division, 67 
Division, 67 
Engineer battalion, 67 
Evacuation hospital, 149 
Field army, 68 
Hospital, 66 
Headquarters, army, 65 
Division, 66 
Field army, 65 
Hospital boat, 149- 
Train, 149 
Line of communications, 69, 149 
Position on the march, 71, 100 
Regimental, 66, 99 
Reserve supply train, 61, 
Signal battalion, 66 
Supply depot, 149 
Train, 61 
Transport column, 149 
Service on the March, 78 
Shell, high Explosive, 35 
Shrapnel, 33 
Sick Classification, 49, 79 
Estimate of probable number, 
49 
Sketches, 27 
Slope of Fall, Artillery Projec- 
tiles, 38 
Rifle projectiles, 37 
Station for Slightly Wounded, 
i39 
Function, 139 
Location, 141 
Orders for, 83 
Personnel, 139 
Strength, Auxiliary Division, 63 
Brigade, 60 
Cavalry division, 62 
Division, 61 
Field army, 64 
Supply Depot, 156 
Supply Train, 70 
Temporary Base, 147 
Trains, 70 
Combat, 70 
Field, 70 
Hospital, 156 
Supply, 70 
Transportation, 51 
Ambulance, 51, 55 
Of a division, 70 
Litter, 54 
Transportation of Medical De 
partment, Cavalry divis- 
ion, 52 
Division, 52 
Line of communications, 149 
Transport Columns, 149, 151 
Travois, 52 
Weapons, 28 
Wounded, Classification of, 48 
Proportion of, 48 
Wounds, Deaths from, 45