What America did

by Florence Finch Kelly

The developments of scientific warfare, with its new and fearful weapons of death and its new modes of attack, laid new duties upon the medical profession and new demands upon its knowledge and its methods of healing. It restores one’s faith in human nature, after realizing the devilish ingenuity of the death and wound dealing instruments of the world war, to find how incessantly the ministers of healing worked in hospital and laboratory behind the lines to evolve new agents and new methods for the mending of the wreckage from the front. Whatever else may or may not have been won out of the vast destruction of the world war, the medical profession can be assured that its devotion and its heroic labors have been rewarded by a wonderful advance in the frontiers of its knowledge.

The army medical officer found new problems facing him at every fresh development of the conflict, and to fit him for grappling with these new phases of human needs the Medical Department of the Army established numberless schools and courses of study at medical institutions, at hospitals and wherever could be brought together the factors necessary for this specialized and intensive training. Physicians and surgeons in overseas hospitals had evolved a number of new and effective methods for the treatment of casualties of various kinds and medical officers newly inducted into the service had to have instruction in these developments, while for those who had to undertake recently specialized work it was necessary to have whatever training in that specialty had become possible.

Intensive training and clinical opportunities were provided for instruction in new methods in war surgery and fractures and in the treatment of infected wounds; there were schools for the training of medical officers in the use of X-rays; of laboratory specialists; for special work with diseases of the heart; for treatment of pneumonia and of those infectious diseases that are of frequent occurrence when large bodies of men are brought together. A particularly determined effort was made along preventive lines to lessen in the American Army both at home and in France the menace of venereal disease, always feared for its power to lower the efficiency of armies. Instruction by various means, an incessant campaign of vigilance by specially trained physicians, treatment of infected men, military punishment of offenders, endeavors to control the surroundings of camps, all were among the methods with which this scourge of all armies was combated, with remarkable success. The percentage of such diseases in the Army was below what it is in civilian life and very much below that of its prevalence in the Allied Armies.

One of the schools made necessary by the new methods of training instituted in the American Army was that for the instruction of military psychologists who were needed for the work of examining the men, as they came from their local boards and were inducted into the training camps, in order to eliminate those mentally unfit for army service and grade those accepted according to their mental qualifications, for the information of their officers, as already described in the chapter on “The Making of the Army.” Under the supervision of the Medical Corps, this school trained many officers for psychological work at the cantonments, the course lasting two months. This development, an American idea, was something new in the making and training of armies, but it proved its value in the higher efficiency gained by enabling officers to select for special duties the men best fitted for them and so increasing the efficiency of the fighting units.

A new development of wartime medical science was made necessary by air warfare which soon brought into being the flight surgeon who kept under his observation the men in training at flying fields. So important did this division of the Medical Corps quickly become that special facilities were provided for the training of flight surgeons and laboratories were established for the investigation of the medical problems connected with the air service.

Until the influenza epidemic swept the country in the autumn of 1918, after devastating the populations of Europe, the disease figures of the American Army had set a new low record both at home and overseas. For the year ending with the first of September, 1918, which covered the time from the first gathering of men in the cantonments, the death rate for all troops in the United States was 6.37, which is a lower rate than that in civilian life for similar ages. But when the plague of influenza, which on its way around the world took a toll of 6,000,000 lives, descended upon the camps and cantonments in the United States the death rate rose to 32.15 per thousand. For the entire term of the war the disease death rate was 17 per thousand in the expeditionary forces and 16 per thousand in the army at home. The comparison of these figures with the rate maintained before the passage of the epidemic shows how deadly it was. During the summer months of 1918 the death rate for the troops both at home and overseas fell to 2.8 per thousand. During the Mexican war the disease death rate was 110 per thousand, during the Civil War in the Northern Armies it was 65 per thousand and during the Spanish-American war 26 per thousand. During the last named war the most important cause of death was typhoid fever, before which medical science was then as helpless as it was during this war under the influenza scourge. It had conquered that menace and typhoid, by its precautions, was almost eliminated from our army both at home and abroad. But notwithstanding the devastations of influenza the disease death rate in the American Army was cut to a lower figure than had been reached by any army in previous wars. The lowest previously recorded was that of the Japanese during the Russo-Japanese war, which was 20 per thousand.

The battle death rate of the American Expeditionary Forces was 57 per thousand, considerably higher than it had been in any of our previous wars. In the Mexican war it was 15, in the Civil war in the Northern Armies 33, and in the Spanish-American war 5 per thousand.

Overseas, during the eight months ending with mid-October, 1918, only four per cent of the admissions to hospital because of disease resulted in death. Of the wounded and injury cases treated during the same period a little less than nine per cent died and over 85 per cent were returned to duty. Of the American Expeditionary Forces 4,000 were permanently crippled and 125 were totally blinded.

The medical officers of all the armies won remarkable results in the quick healing of wounds and the reduction of death from battle casualties by establishing hospital stations immediately behind the fighting lines, regardless of danger. This brave course, together with the efforts of the enemy to annihilate them and their hospitals, caused much loss of life among them. The Medical Corps of the American Expeditionary Forces had 46 killed and 212 wounded in action, and a total of 442 casualties of all kinds.

It was a comprehensive system of caring for the physical welfare of the American troops that was devised and carried out by the Medical Department. It had the fighting man constantly under its eye from the moment of his physical examination for induction into the army until he was examined for his final discharge. It analyzed his water supply, it examined his food and inspected his kitchens, it waged war against flies and mosquitoes in his camps, it made his environment sanitary and it devoted itself to his welfare if he was ill or wounded.