Iowa Medical Profession in the Great War

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THE IOWA MEDICAL PROFESSION IN THE GREAT WAR



        The medical profession of Iowa furnished 835 medical officers for the war in many lines of service, in many camps in the United States, in many overseas camps and in combat service, with credit to the state, with honor to the profession and many with great personal distinction which has been recognized by the War Department and by the Nation. It has been the purpose of this Journal to follow the activities of the Iowa medical officers as far as possible not so much in the way of extolling the individual merits, as in showing how by cooperation of the different medical units a condition of service was obtained that practically eliminated the ordinary infectious diseases that has so often in the past followed armies in the field and rendered so many soldiers unfit.
       We are also able to point with pride and satisfaction to the skill with which wounded men were evacuated to dressing stations and hospitals notwithstanding the inadequate provision which our unpreparedness compelled us to rely upon. We shall begin our account of Iowa medical officers in the war with an introductory abstract from the medical history of the 42nd Division (Rainbow) and the medical history of the 168th Regiment (Iowa) which with the 167th Regiment (Alabama) rendered the most distinguished services of the war.
      "The purpose of this paper is to relate experiences of the Medical Detachments of the 42nd Division in such a way that the future may profit from the past. And, with this in mind, it seems

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only fair that we discuss, first, in a brief way, the personnel of these detachments, for the credit that redounds to the medical department of the front line must go to those brave lads whose magnificent courage and intelligence made possible the efficient care of the wounded under most adverse conditions.
      "In the service of the state from which these medical detachments came, as a part of that particular infantry, artillery or engineer unit which went to make up the Rainbow Division, there was a peculiar attraction about the medical branch of the service that drew to it, for enlistment, men of the highest type. In fact, it was possible for the commanding officers to take only the cream, as it were, of the preferred enlistments. This apparently had been done without exception with the result that these medical detach-ments were made up of men who were peculiarly fitted by temperament and physique for the work that they were later to do.
      "In one detachment, of which the writer has intimate knowledge (and there is no reason to suppose that this detachment was other than an average one of the whole Division), the percentage of men who had a grade school education was 100, the graduates of a high school were 90 per cent of the total and the percentage of those who had had some college training was 80. In addition, almost half of these men had acquired some little medical or surgical training in civil life. In sharp contrast to this type of men, were the poorly chosen replacements that came to the Division on several occasions - an appreciable percentage of whom were illiterate, with little practical experience in life, and some of whom could not speak

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the English language intelligently. Though the work of these men, in most instances, was creditable, it was obviously hampered.
     "The fact that an organization has in it a certain number of college men, a given number of trained men, a proportion of men who are physically strong, does not, perhaps, insure its efficiency, but the fact is sub-mitted that where these qualities, as have been suggested, have been possessed, the result has been most gratifying. The medical detachment man is more often thrown on his own resources than the man of any other branch, when, on his exhibition of courage, intelligence and endurance, depends the safety and life of others, and it is with this fact in mind that the plea is made for the man of these qualities.
     "Equipment, too, has played a prominent part in the successful functioning of the medical detachments, as it has with every other branch of the service. The various types of warfare brought about a development of combat equipment. This development includes improvements, modifications, reductions and the addition of many new articles and types. As in other branches of service, problems were met at every turn and, while many of them were to be solved when encountered, yet foresight enabled the medical department to handle many emergencies with credit. Both the English and the French contributed to our medical needs and schooled our officers in their methods, but no perfect equipment or set of rules was provided in advance for the successive campaigns and, after all, experience proved the greatest factor in perfecting and balancing this important item. Transportation, too, effected

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equipment in no small degree, especially in the last months of the war."



MEDICAL SERVICE OF THE 168TH INFANTRY



     1. Baccarat Area - The medical service on a stationary, and more or less quiet front consists mainly of sanitation and prevention of disease, rather than the evacuation of wounded. Consequently, the details of litter-bearing, getting the wounded from the field to the aid station, were not very thoroughly worked out during tIie first few weeks in this sector. This made very little difference in the service, on account of the nature of the action, which consisted wholly of patrolling and raids, and when the affair was over, the soldier laid down his rifle, took hold of a litter and helped bring his wounded comrade in. And how well they did this is evident by the remarkably swift time of evacuation established in this area.
     Major Conkling, the regimental surgeon was away at school when we first entered the trenches, and the sanitary detachment was under command of Capt. Wm. B. Hudson. The 1st Battalion took the trenches in front of Badonviller, with Lieut. Harris and Lieut. Williams as surgeons. The aid station was in Badonviller, and about fifteen hundred yards from the farthest outpost of our troops. The enlisted personnel consisted of a sergeant, a pharmacist, a clerk and ten first aid men. Two of the latter were detailed with each of the two companies in the tront line trenches. They had with them litters, splints and a plentiful supply of dressings.
     All of the trenches in this area were narrow, and had many sharp angles, so it was apparent

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from the start that all evacuations must be over the top and without cover. The support battalion was at Pexonne, and the Regimental Infantry was set up there, approximately two kilometers from Badonviller. The reserve battalion infirmary was located at Neuf Maison, and the sanitary personnel moved from one location to the other; keeping with its battalion. The medical equipment was left permanently at each infirmary, and checked by the surgeons at each relief. The ambulance came to the very door of the battalion aid stations, and when a wound was dressed, the patient was very shortly on his way to the hospital. There was one casualty prior to March 5, 1918, this being a slight wound in the back, suffered by a member of D Company who received a Croix de Guerre for shedding the first American blood in this area. On March 5 we had our first taste of war, withstanding a very severe bombardment which lasted about an hour and a half. The fire, was directed almost entirely on the front line trenches, and there the havoc wrought, appeared to our untried eyes and nerves, to be terrific. There were about forty wounded, most of them severely, as is usually the case in shell fire. In an hour and a half after the shelling ceased, the first of the wounded were in the aid station at Badonviller; they had been dressed in the trenches, and carried a distance of one kilometer over a terrain torn by shells, and crisscrossed with trenches and barbed wire.
      Not one of the wounded was brought in without a first aid dressing applied, and all fractures were splinted in the trenches, before putting the patient on a litter. When our front was lengthened on April 1, we took over an ideal dressing

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station at Village Nigre. This was a huge dugout, which the French troops had completed after two years of hard work. There were quarters for the men, an infirmary containing eight bunks, and the dressing station proper. This had an entry into a receiving room which held eight litters, then a passage leading to the dress- ing room. From the dressing room another passageway gave access to a waiting room where an ambulance load of wounded were collected, and then taken directly out by a "sortie" to the ambulance, which came with in a few yards of the door. This was only half of the station, the other end being used for walking patients, and not being divided into rooms, could accommodate about two hundred persons. The entire dugout was lighted by electricity; there were four doors and ten windows, all equipped with gas curtains. Pine trees had been set out all over the dug-out, and a small, but well kept flower garden appeared in front.
     The equipment kept in the aid stations here was very extensive; but as yet we had seen no reason for cutting it down. The period from April 1 to the middle of May was mainly devoted to sanitation. This was in charge of Capt. Bunch, who joined the regiment early in April, and from the time of his coming, the smoke of incinerators never ceased. Latrines were dug, and urinals established and in one part of our front when it was impossible to dig on account of water, bucket latrines were put in, and a man from each platoon put in charge of the sanitary work.
      In May occurred our epidemic of influenza, the so-called "three day fever," which appeared to be identical with the epidemic of influenza which

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was then raging in various places on the Continent, and in England. Ninety per cent of the command suffered from the disease but there were no fatalities. Evacuation to the hospital ran up to 50 and 60 per cent. A sergeant of H Company reported to the infirmary one evening with a temperature of 102 degrees F. When told that he should go to the hospital, he admitted that he was willing, but had to go back to his post in G. C. 9 and get his equipment. He failed to return promptly, and a runner was sent out to bring him in; then it was discovered that he had gone out on a patrol, possibly thinking that was a good way to cool his fever. It worked out, for the next morning he appeared with a normal temperature, and feeling fine. Many of these men, however, were desperately sick, and did not recover for weeks.
     On May 27 we suffered under the most deadly of all offensive measures. A projector gas attack which fell principally on village Nigre and took a fearful toll from the companies stationed there; A, C, and Machine Gun. A projector attack must be experienced to be appreciated. The stupendous noise of bursting containers is so unearthly as to be almost paralyzing and the gas is of such concentration and so all-pervading that the least hesitation means death, or at the very least, incapacitation for a varying period. There is only one defense, but that is absolute: namely, the gas mask, instantly adjusted and left in place until the gas has dispersed. In addition, work should cease, unless absolutely necessary. Many men on the morning of May 27 worked violently at litter bearing, and persisted in it after being

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ordered to stop, until they, themselves made the ultimate sacrifice.
     On May 29th the attack was repeated, but our dearly bought experience had been taken advantage of, and there were but two casualties, and they were unavoidable. The gas used in these two instances was a mixture of phosgene, and chlorene, with the phosgene much in excess. It is a very deadly combination, one full breath of the heavy concentration at the beginning of the attack being sufficient to cause death. The first week in June, Major Conkling was transferred to the divisional medical staff, and Captain Bunch became regimental surgeon, which position he held continuously from that time on.
       On June 17 we had our first experience with mustard gas. During a general bombardment of the area, numerous mustard gas shells were thrown into Badonviller. A recommendation was at once made that the portions of the village rendered dangerous by reason of the gas be evacuated temporarily. This was not done, and the following day the ambulances were kept busy evacuating the casualties. The shelling having occurred in the evening, and in conjunction with a bombardment by high explosives, it was impossible to locate all of the gas shell holes, and many men unwitting went to sleep in their quarters and were casualties by morning from the slow emanation of gas from unsuspected shell holes close at hand. The following night the Division was relieved and sent to the Champagne.
     2. In the Champagne we found ourselves in an active sector. The aid stations were in trenches, with no dug-out nearby, and no cover for either wounded or sanitary personnel. Here

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for the first time, litter bearers were authorized, and they had one day of training in their work before the storm broke out on July 15. But all stations were accessible to ambulances, and the first load of patients was on its way to the hospital in an hour after the shelling started. Here we learned that the combat equipment for a battalion could only consist of such material as the medical personnel could carry, as the battalion moved from place to place. Here, also, three men of the sanitary detachment wIth the third battalion were recommended for the D. S. C. by the company commanders of that battalion.
     In Lorraine, the deepest dug-out was none too safe. In Champagne, even a trench two feet deep, such as the second battalion infirmary occupied, was a God-send. The evacuations were carried on regularly, and with no hold up, from all three aid stations, as long as ambulances were available. After eight o'clock on the morning of the 15th, we had more or less trouble getting the patients to the rear. But they were finally cleared up by evening of that day. And although we remained in that position for several more days, there were no casualties.
     3. At the beginning of the counter offensive in the Chateau Thierry region we were at once relieved and sent to that area. Here we found a different problem. Open warfare, in a wooded region without roads, and most vital of all, no maps. Prompt cooperation from the Regimental Commander insured an extra detail of litter bearers, and enabled us to get the wounded to the aid stations in very good time. But as the heaviest casualties occurred in the neighborhood of Red Cross Farm, and just at dark, this field was not

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cleared until the following morning. No horse ambulances were available, but an escort wagon with two mules did wonderful work in this region. It was more than a kilometer from the front line to the nearest aid station where work could be carried on at night. And as we had had two days of rain, the paths in the woods were little canals of mud. The litter bearers here had a heart breaking task, and there was not one who did not deserve a decoration. The night following the action at Red Cross Farm, the regiment moved forward through the woods, several kilometers, taking up a position to attack across the Ourq river at dawn.
     The battalion aid stations were moved with the troops, the men carrying all the equipment, and being established in position when the attack began the next morning. Soon the wounded were pouring in, but no ambulances were there to take them to the rear. We had the unfortunate experience of seeing hundreds of patients lying in our several stations, some for more than eight hours, some even twelve, before they were moved.
     Three S. S. U. ambulances attached to our regiment made trip after trip that day, but could not make an impression on the ever increasing number of casualties. Three ammunition trucks took fifty gassed and wounded patients from Lieut. Harris stationed at La Cense Farm, and notably relieved the congestion there. And finally a train of ambulances was secured from the Division on our right, and we evacuated all of our seriously wounded shortly after midnight. On this front we ran two aid stations. One, near the firing line, handled litter cases, and two squads of ambulance litter bearers were stationed there, as it

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was not accessible to motor vehicles. The other station served as a gathering point for all wounded, and being in plain sight of the entire field, drew walking wounded from all directions.
     On the afternoon of the second day on the Ourcq, Lieut. Williams and Lieut. Green were wounded in their station at La Monte farm. Both of our stations here were under direct observation, as well as the path connecting them. Consequently the casualties among litter bearers were very high. And as the line advanced through Sergy and on to the hills beyond, it became increasingly difficult to get the wounded back.
     A good, but very dangerous road ran from Sergy, to the rear, right past our rear station, and six Ford trucks from the 149th Machine Gun Battalion took up the task of evacuating the village. Trip after trip was made, and each was a race with death; vicious Whiz-bangs and heavier Howitzers marking the trail of each little car with curling bursts of the dense black smoke of high explosive. Most of the patients were covered with dust and dirt from the shells that hurried the truck on its way. And each driver profanely ridiculed the attempts of the enemy gunners to make the way impassible. After replacements were received, a new detail of litter bearers was secured, and these were given several days of instruction in applying the first aid packet, and handling fitters and wounded men.
    4. At St. Mihiel we were better able to plan our work, as the operation was from an old prepared position. The aid station of the attacking battalion, was just in front of the jump off in an abandoned strong point. The station of the sup-

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port was about three hundred yards in the rear of this, and the reserve station was on the road, about six hundred yards in the rear of the latter, or nine hundred yards from the advanced station. Motor ambulance could not traverse this last distance. It was necessary to bring seriously wounded to the road by stretcher bearers, but slightly wounded, unable to walk, were transported by horse ambulance. As our rear station was the loading point of the motor ambulances, it was necessary to maintain it until the field was cleared. The support station however, moved forward as soon as the enemy's line was broken, and followed the advancing line closely. Practically all casualties occurred in tlie first two hours of the attack, so the wounded were all evacuated from our original positions. This was very fortunate as it would have been almost impossible to evacuate across the area comprised in the old battle lines. The roads across the old "No Mans Land" were hastily reconstructed, and sustained an unceasing stream of traffic for forty-eight hours after the lines moved forward, but this traffic was of necessity all moving forward, and vehicles going towards the rear had little chance of getting through. The army objective was reached at ten o'clock in the morning of the second day, and at eleven o' clock we had one motor and one horse ambulance at the aid station just behind the front line.
      The advance station was located in Louisville farm. The road leading to it, as well as the farm itself, was under direct observation from the enemy lines, but was just out of machine gun range. The support and reserve stations were with their respective battalions, and three kilo-

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meters behind the outpost line. We remained two weeks in this sector, getting latrines, urinals and refuse pits established, and were transferred to the Argonne region. The entire Division camped in the woods just before Montfaucon for several days. This camp was behind the German lines as they were prior to September 26th, and the area had been under shell fire for the entire period of the war. A more devastated region would be hard to imagine. Branchless trunks of trees represented what had been once a forest, and each soldier had for his home, an individual shell hole. Here the first rumors of peace began to come, and over-enthusiastic dough boys were shouting in concert every few minutes, day and night when particularly pleasing ideas occurred to them.
     5. Shortly orders to move came, and we moved to the left of Montfaucon, on a road continually jammed with ration and ammunition trucks, ambulances, artillery and practically everything that goes on wheels. The march was particularly exasperating because the road was being intermittently shelled with H. E. and shrapnel. Under such conditions, most anyone has an almost uncontrollable desire to move right along and perhaps establish a new country record over the said bit of highway. Finally some eight inch, tractor drawn rifles, a couple of ration trucks and three caissons met the head of our column, and almost immediately afterwards, three shrapnel bursts right in the road, and settled all questions of right of way, and traffic speeded up considerably. The wounded were taken into a barn nearby an. dressed. Ambulances appeared at day break. The regiment rested that day, and

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relieved the 28th Infantry that night. The following day was spent in reconnoitering and brought a further change of position to the right before Hill 288 where the action started on October 14th.
      It was four kilometers from this position to a road; and this four kilometers was through a valley, ankle deep in mud. All communications from the Brigade sector to the rear was by this valley, and it was under nearly constant fire. Two squads of ambulance litter bearers were with the advanced aid station. They carried patients to the support aid station, about one and a half kilometers towards the rear. Here the horse ambulances could operate, and did operate, but were not sufficient to evacuate all the wounded, many of whom were borne back by the stretcher bearers the entire four kilometers.
     The aid station here was in a "fox hole" for two days. Then an abandoned hut was found, which when covered with a tarpaulin, gave good protection from the rain, and made it possible to work at night. The advance on hill 288 began about seven in the morning. At noon the leading elements had passed over the crest. and the medical personnel moved to the top of the hill, with battalion headquarters. This position soon came in for a heavy shelling by enemy howitzer, and Sergeant Burke, Pharmacist Bongers and Clerk Aschan of the sanitary detachment were all wounded by fragments from one shell. Two days later the Cote de Chattillon was taken, and ambulances could then come at night to within a few yards of the aid stations. The work in this area was probably the most severe test the medical department had during the war. The regiment

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was soon relieved here, and got a week's rest before entering the final campaign. The initial attack on the new line was on November 1 and on November 2 we marched out of our billets and followed the advancing 77th and 78th Divisions. On November 5 we took over a sector just north of St. Piermont and at midnight of the 6th our troops were overlooking the Meuse river just above Sedan. During this advance no aid stations were set up, the medical personnel moving right along at the rear of the battalion, and carrying all equip- ment. There were three casualties during the 5th and 6th; two from shell fire and one from a machine gun bullet. The men suffered a great deal from exposure and lack of food, and consequently many sick were evacuated. We were relieved from this front on November 9th and had moved back to Briquenay when the armistice was signed.

 

~source: History of Medicine in Iowa, by D.S. Fairchild, M.D., F.A.C.S., Clinton; Second Section: The Iowa Profession in the Great War; pg 1-95; Reprinted from The Journal of the Iowa State Medical Society, 1927
~ Transcribed by Sharyl Ferrall for 'Iowa in the Great War' IAGenWeb Special Project, August 2006