George Thompson, M.A., M.F.A.
Adjunct Associate Professor
Historian
History and Philosophy of Medicine
The University of Kansas Medical Center

The sick and wounded requiring more definitive care, as identified by the physicians of the infantry division’s field hospitals, were transported to a hospital located in the next level of the Medical Department’s system for patient care.

Corps-army Diagram

They were moved by motor ambulance to a hospital that was assigned to support the infantry divisions. When the patients left their division’s medical unit they entered a larger and more complex level of command called a corps, which was the grouping of several infantry divisions, or an army, which was the grouping of several corps.

This level is the intersection between the forward area medical units near the front line and the rear area of base hospitals that were reached by hospital trains. This level is perhaps the most complex layer of patient care in the Medical Department’s system. It is here that the wounded and sick are delivered to more sophisticated care, especially life-saving surgery that could not be as easily performed within the combat zone.

In order to mange this transition from the infantry division’s medical units to the diverse medical units at the corps and army level and subsequently on to base hospitals a detailed and comprehensive medical plan had to be prepared in advance of an offensive operation.

An illustration of such a plan was the one written by the First Army’s Chief Surgeon Colonel Alexander Stark for the St. Mihiel Operation, September 12-16, 1918 that deployed all the medical units under his control and defined each of their operations.

St. Mihiel Operation

Colonel Stark placed the following types and numbers of corps and army medical units within the St Mihiel operational area:

• Evacuation Ambulance Companies: 9
• Corps level Ambulance companies: 4
• Corps level Field Hospitals: 4
• Medical Supply Depots: 3
• Gas Hospitals: 2
• Contagious Disease Hospital: 1
• Neurological Hospitals: 2
• Mobile Hospitals: 5
• American Red Cross Hospital: 1
• Evacuation Hospitals: 10
• Base Hospitals: 2

All units were between 15 to 25 kilometers behind the front line and although out of range for most enemy artillery they were still vulnerable to attack from German aircraft.

Waiting Admission to Hospital

This list illustrates the emergence of experimentation and specialization by the Medical Department. By mid-1918 it was recognized that by designating hospitals to receive specific patients it produced better medical results for the treatment of gas casualties, contagious disease and neurological cases. These specialized hospitals permitted the concentration of scarce specialists who through treating several patients could better assess their results and thus improve on their methods of treatment.

The Mobile Hospital is an example of experimentation. This unit, based on French Auto-chir methods and equipment, was designed to deliver lifesaving surgery close to the front. Upon recognition of the value of this approach similar units were created and deployed by late summer, 1918. This small mobile hospital was a dedicated surgical unit that possessed specialized equipment and vehicles in order to rapidly deploy where needed. It was, however, not fully integrated into the medical system and by the end of the war these twelve units treated only 1% of the army’s wounded.

Mobile Hospital No. 2

What was fully integrated, as shown in the St. Mihiel plan was the reliance on the ten evacuation hospitals to receive the majority of patients who were evacuated from the infantry division’s field hospitals. These units were so essential and in short supply that the base hospitals 45 and 51 that arrived in Toul on August 24 and 27, 1918 were designated to function as evacuation hospitals.

Finally, the example shows where the corps and army level units were placed. The largest clusters were behind the I and IV Corps who were to make the major attack and were assumed would produce the majority of the expected 33,000 casualties.  And because these hospitals were not intended to retain their patients they were placed on a rail line, such as at Toul, so their patients could be evacuated within fourteen days to the next level and final stage of care at a base hospital, such as Base Hospital Number 28 at Limoges, France.

Sources

Jaffin, Colonel Jonathan H. Medical support for the American Expeditionary Forces in France during the First World War (Fort Leavenworth 1990)

Volume VIII, Field Operations, The Medical Department of the United States Army in the World War (Washington, 1925)

Volume XI, Section I, General Surgery, The Medical Department of the United States Army in the World War (Washington, 1925)