Offsetting War's Casualties
The Army Doctor Cannot Stop Bullets, But He Heals the Wounded and Protects Millions from Disease

By Dr. Franklin Martin
(Council of National Defense)

[Leslie's Weekly, August 30, 1917]

EDITOR'S NOTE:—As a member of the Advisory Commission of the Council of National Defense, Dr. Martin aids in the coordination of the various medical and health departments of the Government and the civilian organizations of similar character. He is, therefore, probably the best-informed man in the public service on the work that pertains to the health of the army. The losses among our soldiers will be governed to a great extent by the strength of the medical branches of the service, and Dr. Martin shows here how it is possible to give the finest medical service the soldiers of any nation have ever received if patriotic support is given the country's physicians.

The doctor in war, as in civil life, is in constant demand. At the birth of an army, as at the birth of a man, his presence is necessary. His administration is imperative in every emergency of civil and military life and he is with the priest when the last rites are performed. His relations are the same with our army, our navy and the civilians making munitions.

The recruit must be received and passed or rejected by the doctor. The new soldier on his admittance to the ranks is under his constant surveillance. He receives from the doctor the minutest instructions concerning the care of his body, the water he drinks, the food he eats, the shoes he wears, the air he breathes, and in his relations in all these respects to his fellow soldiers. He is protected by vaccination from many infectious diseases, and if sick, he is isolated to prevent the contamination of others. In the hospitals he is furnished with the same care, when he is ill or wounded, that he would receive at home. In a word the doctor stands over the soldier with a watchful eye from the swearing-in to duty, during the weary waits of camp, in the stress of battle, in the horror of retreat, and finally when the war is over, the doctor is the last to examine him, and having recorded his condition sends him back to his home.

The Needs for Doctors

We are fighting not only our own battles, but the requirements are that we should cooperate with our Allies that are fighting the common enemy. England must be aided by us, not only financially, but by man power and one of her greatest needs is for doctors. England's sanitary equipment on the western front is superb, but it has been maintained under a terrific strain because of her under-supply of medical and sanitary officers. England is in need of medical aid in caring for her sick, wounded and sanitary regulations, with but three doctors where she should have seven. So, too, is France.

England has five million troops on the various fronts, and she has less than fifteen thousand doctors. According to our standards and the best authority she should have seven doctors to the thousand or thirty-five thousand in all. Instead of which she has but three to the thousand. A committee appointed to investigate this shortage by the imperial government has just reported, through Earl Derby that England is short of medical men to supply her army and the civilian communities have been so depleted of doctors that there is no longer a source of supply. The answer to this report is that America must endeavor to supply the need. To meet the deficiency to its full would require twenty thousand men. But, of course, while aiding our Allies we must also bear in mind our own definite needs. On October first we shall have one million five hundred thousand men in our army. These will require, on the basis of the present law, seven doctors to the thousand, or ten thousand five hundred men in the medical corps.

Other calls for enlisted men will, if this war continues, bring our army by this time next year to two million five hundred thousand or possibly three million men. This will require from 17,100 to 21,000 doctors for our own actual needs in the army, and on a conservative estimate for the navy at least two thousand more, making an actual total enrollment for service in the army and navy one year from now of twenty-three thousand medical men.

Resources for Medical Supervision

There are 147,600 legalized practitioners of medicine in the United States. There are 90,000 medical men of the military age. It is estimated that fifty thousand of these could pass the mental and physical examination for military duty.

At the present time approximately 16,000 doctors have applied for commissions in the Medical Officers Reserve Corps of the Army. The present actual enrollment in the Navy; including reservists all available for service on call, is approximately 2,000. Eighteen thousand, therefore, of the 50,000 estimated as available for service, have applied for commissions and of this, number approximately 12,000 have been accepted.

There are four departments recognized by Congress to administer the medical and sanitary activities of the men comprising the fighting force of our nation: One, the War Department under Surgeon-General Gorgas; two, the Navy, under Surgeon-General Braisted; three, the Department of National Health, under Surgeon-General Blue; four, the Department of Military Relief of the American Red Cross, until recently under the direction of Colonel Kean, now in the new organization under the direction of Mr. Ryan.

The medical representative on the Advisory Commission of the National Defense, in charge of the medical section, acts in an advisory capacity and his duty is to aid in the coordination of the civilian doctors, and these four executive departments, and the body he directly represents, the Council of National Defense.

Things the Medical Branches Have Done

Many months before the war began it was apparent that a great army might be required from the United States. In cooperation with the Army and Navy medical officials and the National Public Health Department and the Department of General Medical Relief of the Red Cross, a group of civilian medical men, appointed by the presidents of several large medical organizations, began organizing the civilian resources of the country. They at once began to enroll men for the Medical Officers' Reserve Corps, to organize base hospital units, ambulance corps and to obtain and store all kinds of medical supplies. Every state was organized with a strong committee to cooperate with the national organization. When the Council of National Defense was provided for by Congress, and the Advisory Commission was appointed by the President, the civilian organizations that had been cooperating so efficiently with the Surgeon General and the Red Cross were made the nucleus around which the Medical Section of the Council should be built. Results have justified the action.

War was declared early in April. The War Department has, as I have pointed out, a medical corps commissioned that will care for a million and a half of men. It has supplied and stored sufficient medical equipment to supply the sixteen cantonments that are to be placed in commission on September 1st—each to accommodate forty thousand new recruits. This includes drugs, instruments, surgical dressings, blankets, bedding and all hospital supplies and field sanitary equipment of every description.

Besides equipping every regiment reporting on the fighting line abroad, with medical men to care for the camp sanitation, the sick and the wounded, the medical, hospital, hygienic and sanitary supervision and administration of the sixteen great cantonments that are being constructed here, the several large aircraft training camps, the numerous officers training camps are all under the direction of General Gorgas's department of the Army. All of the ships of the Navy and a large number of training camps and abroad for sailors, marines and officers, are under the direction of Surgeon-General Braisted of the Navy.

Cooperating with the Army and the Navy is the department of Public Health under the supervision of Surgeon-General Blue, which plays such an important part in times of peace in supervising the sanitary conditions of the country. In times of war, by law and regulations, it cooperates with the medical departments of the Army and Navy and gives valuable assistance in obtaining information about epidemics and health conditions in parts of the country from which troops are recruited, in regulating sanitary conditions in zones surrounding camps, in aiding through cooperation with civilian health officers in enforcing sanitary regulations in captured cities or other territories; and finally in protecting the civilian population engaged in large numbers in the manufacture of supplies and munitions for the government.

Sacrifices of Army Doctors

One-fifth of the total number of physicians in the United States will have to enroll for military duty if this war continues for another year. All but a small percentage of them must enroll voluntarily. All but a small percentage of them have families to support and these and others are wholly dependent on the income of the head of the house for this support. The physician from thirty-five to forty-five years of age, the age of greatest usefulness for military service, is at that critical period of his professional and financial development that two years of forced absence is liable to affect disastrously his whole career. The change means, if there is no independent income, sacrificing of insurance, lapsing of the mortgage, withdrawing of children from school, a complete change of method of living, and great risk of returning after the war with a lucrative practice divided among the stay-at-homes. A law has recently been introduced in the Senate by Senator Owen which provides an increased rank for medical officers of the Reserve Corps, that will in some small way meet the financial burden of the volunteer doctor and will furnish him a rank equal to the dignity of his civil position. This bill should be supported by every patriotic individual because the general losses outside of fatal battle casualties will depend greatly on the strength of the medical branches of the service. Great armies of wounded men will be returned to civil life only slightly handicapped in their ability to provide for themselves and their families if there are sufficient surgeons at the front to supply the skilled attention which is daily working miracles in the rebuilding of broken men.

If we would reduce our losses to the smallest possible number let us make the sacrifices demanded of the patriotic physicians of the country as light as is possible in order that our, soldiers may have perfect medical service.

© J. Fred MacDonald, 2013



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