Separating the Wheat from the Chaff: The Experience of the American Army Medical Department During World War I

Journal of the American College of Surgeons

Volumn 207, Issue 1, 2008, Pages

  Hanigan, William C ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH CARE ORGANIZATION; HEALTH SERVICE; MEDICAL EDUCATION; MEDICAL LITERATURE; MEDICAL SOCIETY; PRIORITY JOURNAL; WAR;

EID: 45649085272     PISSN: 10727515     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jamcollsurg.2007.12.005     Document Type: Article

References (50)

1. Munson Col E.L. The training of Medical Reserve officers. Surg Gynecol Obstet 25 (1917) 715
2. th centuries, most neutral medical services sent officers into combat areas to observe medical care, A good example of the early reports for World War I is: (1915), GPO, Washington
3. Gillett M.C. The Army Medical Department 1865-1917 (1995), Center of Military History, Washington DC 117-199
4. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War Volume 1 (1923), The Surgeon General's Office, GPO, Washington DC 47-53
5. Senn N. Medico-surgical aspects of the Spanish American War (1900), AMA Press, Chicago There are many references and a few good memoirs for the Spanish-American War. Some of the best:
6. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War, volume 1 (1923), The Surgeon General's Office, GPO, Washington DC 47
7. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War, volume 1. The extent of the increase was not defined. In the only other recommendation related to the AAMD, Maj Gen Dodge suggested the "simplification of administrative 'paper-work' so that medical officers may be able to more thoroughly discharge their sanitary and strictly medical duties." General Dodge's suggestion must have elicited much laughter within the Department (1923), The Surgeon General's Office, GPO, Washington DC 57
8. Gillett M.C. The Army Medical Department 1865-1917 (1995), Center of Military History, Washington DC 322-323
9. Gillett M.C. The Army Medical Department 1865-1917 (1995), Center of Military History, Washington DC 322-326/377-401.
10. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War, volume 1 (1923), The Surgeon General's Office, GPO, Washington DC 59-74
11. Crossland Lt Col R.B., and Currie Maj J.T. Twice the citizen: A history of the United States Army Reserve 1908-1983 (1984), Office of the Chief Army Reserve, Washington DC 17-28
12. Kreidberg Lt Col M.A., and Henry 1st Lt M.G. History of military mobilization in the United States Army 1775-1945 (1975), Greenwood Press, Westport, CT Appendix A, 706-707
13. Owen Maj (Rt) W.O. Relations of the Army Medical Corps and the Medical Reserve Corps to the Medical Corps of the organized militia. Mil Surg XXVII (1915) 523-539
14. Fisher Lt Col H.C. Preparedness of the Medical Department for war. Mil Surg XXVIII (1916) 123-130
15. Ashford Cpt M. The most practical plan. Mil Surg XL (1917) 123-155
16. Calvert W. Camps of instruction for medical officers. Mil Surg XL (1917) 722-729
17. Pearlman M. Leonard Wood, William Muldoon, and the medical profession: Public health and universal military training. New Engl Quarterly 52 (1979) 326-344
18. Mayo C.H. The Medical Reserve Corps. Mil Surg XXIII (1908) 66-69
19. Hayes1st Lt H. The camp of instruction for officers of the Medical Reserve Corps United States Army. Medical Times 43 (1915) 263-266
20. Flexner A. Medical education in the United States and Canada. Carnegie Research Foundation, Bulletin Number 4, 1910. Hospital care and administration and surgeon accountability underwent similar changes in this short but intense prewar period. See Stevens R. In sickness and in wealth. New York: Basic Books; 1989: 53-79; and Smith D. Appendicitis, appendectomy and the surgeon. Bull Hist Med 70 (1996) 414-441
21. Flexner had the interesting but annoying tendency to clarify his data with comments in the footnotes-a subtle combination of science and gossip.
22. Although "reform" was a common theme, a great many schools failed because of financial mismanagement. Data from Flexner A. Medical education in the United States and Canada. Carnegie Research Foundation, Bulletin No. 4, 1910: 167-177. Flexner castigated medical sects and Negro medical schools, but recommended greater educational opportunities for both Negroes and women. The AMA first characterized medical schools as "A, B, and C" in 1904. The classification was similar to Flexner's, but underwent constant revisions. Classification of medical colleges. JAMA 1918;71:551-553; and Medical education in the United States. JAMA 1918;71:535-544. For licensure, see Baker SL. Physician licensure laws in the United States, 1865-1915. J Hist Med Allied Sci 1984;39:173-197. The polyclinic schools: Peitzman SJ. "Thoroughly practical": America's polyclinic medical school. Bull Hist Med 54 (1970) 166-187
23. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War, volume 1 (1923), The Surgeon General's Office, GPO, Washington DC 75-84/559-573
24. Kean Brig Gen (Rt) J.R. The General Medical Board in the World War. Mil Surg 67 (1930) 203-214
25. Medical mobilization in the War. JAMA 68 (1917) 1128
26. The first annual report of the Council of National Defense (1917), GPO, Washington DC 91-95
27. Bevan A.D. The organization of the medical professional for war. JAMA 70 (1918) 1806 The Committee did not entirely reflect the growing influence of university academics, but consisted of a recognized group of respected physicians and surgeons. A list of the original 28 members is given in Martin FH. Fifty years of medicine and surgery. Chicago: Surgical Publishing Co of Chicago; 1934: Appendix 405
28. Gillett M.C. The Army Medical Department 1865-1917 (1995), Center of Military History, Washington DC 377-380
29. Kreidberg Lt Col MA, Henry 1st Lt MG. History of military mobilization in the United States Army 1775-1945. Westport, CT: Greenwood Press; reprint 1975:192-195.
30. Dickinson J. The building of an army (1922), Century Press, New York 29-56
31. After the declaration of war, American MOs were commissioned in the Regular Army, Medical Reserves, or National Guard. On August 7, 1918, the War Office canceled these distinctions and commissioned MOs as "permanent, temporary, or provisional." Issues of rank and promotion greatly influenced this change.
32. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War, volume 1 (1923), The Surgeon General's Office, GPO, Washington DC 155
33. All schools that were accepted by 50% or more of the state boards were classified by the AAMD as "reputable" or "well-recognized." It was a legal classification and did not correspond to Flexner's divisions or the AMA grades. During the war, an advisory board composed of William Welch, the brothers Mayo, Franklin Martin, Victor Vaughan, JMT Finney, and William Simpson were appointed to the Surgeon General's office to help sort out the qualification of the MOs. They had the same problems as the AMA's index cards. Lynch Col C, Weed Lt Col F, McAfee L. The Medical Department of the United States Army in the World War, volume 1. Washington DC: The Surgeon General's Office, GPO; 1923: 153-159. There were 55 contract surgeons, all female, hired during the war. For a brief description of the structure of the AAMD and the duties of an MO early in the war, see the Medical Officer of the Army. JAMA 191768:1180-1181/1259-1261/1322-1323/1407-1409/1478-1479/1551-1553 and 1624-1625
34. Munson Brig Gen E.L. The needs of medical education as revealed by war. AMA Bulletin 13 (1919) 204-213 Citation from p. 206
35. There were five camps planned for training MOs. One never opened and one for black MOs (Fort Des Moines, IA) closed on December 1, 1917 when the need for segregated medical care was satisfied. Fort Riley, KS, Camp Greenleaf, GA, and Fort Benjamin Harrison, IN remained open. Bispham Col WN. The Medical Department of the United States Army in the World War. Vol. VII. Training. Washington: GPO; 1927:1-16. Greenleaf was the largest and trained 5,000 to 6,000 MOs at any given period during 1918. See Memorandum for Col Munson, June 26, 1918. National Archives and Records Administration Washington DC (NARA), RG 112, Entry 29, Box 236.
36. Munson Brig Gen E.L. The needs of medical education as revealed by war. AMA Bulletin 13 (1919) 208
37. Hanigan W.C. Surgery of the head and 70-day brain surgeons. Neurosurgery 53 (2003) 713-722
38. Cushing H. From a surgeon's journal 1915-1918 (1936), Little, Brown, and Co, Boston 430-474 1.5% of MOs trained as hospital administrators! Munson Col EL. General Orders No. 54, Chickamonga Park, GA, June 4, 1918. National Archives and Records Administration Washington DC RG112, Entry 29, Box 236
39. Bispham Col W.N. The Medical Department of the United States Army in the World War. Vol. VII. Training (1927), GPO, Washington 375-376 Bispham described the difficulties in a succinct but understated section
40. Foster Lt Col N.B. Medical education as revealed by the War. JAMA 72 (1919) 1540
41. Lynch Col C., Weed Lt Col F., and McAfee L. The Medical Department of the United States Army in the World War, volume 1 (1923), The Surgeon General's Office, GPO, Washington DC 92-104 As an example of the shortage of medical personnel, there were only 42 base hospitals by July 1918 to serve 24 American infantry divisions in France; 36 of these hospitals were organized by the American Red Cross
42. Hall Lt F.P. National Archives and Records Administration Washington DC RG 120, Entry 391. Bispham Col WN. The Medical Department of the United States Army in the World War. Vol. VII Training (1927), GPO, Washington 601-660. The journal War Medicine was distributed to all MOs in the AEF and interested Allied personnel. There was a circulation of approximately 8,000
43. Munson Brig Gen E.L. The needs of medical education as revealed by war. AMA Bulletin 13 (1919) 210-212
44. Birmingham Col H.P. The relation of the civil practitioner to the Medical Corps of the Army. Mil Surg XXIv (1919) 495-514
45. Jones Maj J.I. The training of the medical student for service in the time of war. Mil Surg 54 (1924) 176-189
46. Tuttle Major A.D. The instruction and training of officers of the Medical Department. Mil Surg 48 (1921) 199-205
47. Lull Lt Col G.F. A brief history of the Army Medical School 1893-1933. Mil Surg 74 (1934) 78-86
48. By mid-1941, the affiliated "units" consisted of 41 general hospitals, 11 evacuation hospitals, and 4 surgical hospitals. Very few of these units served overseas. Engleman RC, Joy Col RJT. The historical unit US Army Medical Department. Fort Detrick, MD: 1975:20-24. Ashburn Col PM. A history of the Medical Department of the United States Army. Boston: Houghton Mifflin Co; 1929:378-38. Wiltse CH, ed. Medical Department, United States Army organization and administration in World War II. Washington DC: Office of the Surgeon General, Department of the Army; 1963:1-43.
49. Stevens R. The curious career of internal medicine: functional ambivalence, social success. In: Maulitz R.C., and Lond D.E. (Eds). Grand Rounds: One hundred years of internal medicine (1988), University of Pennsylvania Press, Philadelphia 339-351
50. State Board statistics for 1919. JAMA 74 (1920) 1100