A HISTORY OF PREVENTIVE MEDICINE 
IN THE 
WORLD WAR II 
EASTERN DEFENSE COMMAND BASES 
This monograph is being made available in manuscript form 
pending the completion of the official History of the Medical 
Department in World War II, and must be considered as a draft 
subject to final editing and revision. Persons finding errors 
in facts or important omissions should communicate with the 
Historical Division, Army Medical Library, Washington 25, D.Co 
It is emphasized that all statistical data in this monograph 
are tentative and subject to revision when tabulation of 
individual sick and wounded report cards has been completed. This document Is reproduced from unedited, unrGrieved material 
oa fils la the Historical Division, S00, and statements of opinion* 
any comments, or critic!one contained heroin do not necessarily 
represent the views of the Surgeon General, Department of the Army, or 
official policy or doctrine. Therefore, this document it not to he 
reproduced in any pert or in its entirety. TABLE OF CONTENTS 
Part. I—History of Preventive Medicine inWonld War II* 
Eastern Defense Command® Continental United States. 
Page 
Chapter I—Introductory Remarks and Maneuver Experience® • • 1 
First Army Maneuvers. .... 15 
Preparations for Hospitalization. . . • . 15 
Preliminary Water Arrangements. . . .... 19 
Plans for Extra-cantonment Sanitation 19 
Sanitation during the Maneuvers oooooooo.«o.20 
Extra-cantonment Sanitation .••••<>. ••••••• 22 
Water *,• .,. . .. ... « . © . . ... . . . © o « . . . 22 
The Health of the Command During the Maneuvers. • • • . 23 
Venereal Disease Control. . .... ...... .... 26 
Chapter IL—Sanitation © o 0 . . . ..29 
Clothing. ......... .... 29 
Housing . . o ... o «o . . . . . . ... . . . . . . . . 29 
Food & Nutrition. • 31 
Personal Hygiene. .. 32 
Water .35 
Disposal of Waste . . . .37 
Control of Insects. 39 
Chapter III—Sanitary Engineering. ............. 4-4- 
Chapter IV--Epidemiology and Communicable Disease Control. . 4-7 
Immunization. . .... ............... 4-7 
Intestinal Inx action. .... 0.0.000.0.000 4-7 
Infections of the Respiratory Tract and' Infection 
Transmitted by Discharges from the Respiratory Tract. 4-7 
Miscellaneous Infections. •••••••••••••••49 
Sulfonamide Drugs ..50 
Chapter V—Venereal Disease Control. . . • 53 
Annex to History of Preventive Medipine in World War II.6l 
Part II—History of Preventive Medicine in World War II—Eastern 
Defense Command Bases—History of Preventive Medicine• 
Bermuda Base Command ••••••••••••••••••••66 
Introductory RemarkSo . ..... . 66 
Samtatlpno ooooo*ooooo.ee...ooo«« 66 
Sanitary Engineering® • • ••••••••••68 
Epidemiology. .©.goo........ .....•• VC 
Venereal Disease Control® ••••••. •••••••■••71 Greenland Base Command, • • • 73 
Introductory Remarks . • . • . • *73 
Sanitation ..76 
Sanitary Engineering 77 
Epidemiology «77 
Venereal Disease 78 
Inclosures 
Iceland Base Command 95 
Introductory Remarks 95 
Sanitation 95 
Sanitary Engineering ••••• .98 
Epidemiology 99 
Venereal Disease Control ...... 100 
Graphic Summary and Analysis 100 
Charts • 
Newfoundland Baas Cpinny* 105 
Introductory Remarks •••••• 105 
Sanitation • ••••••••••• 105 
Sanitary Engineering •••• •••••• 126 
Epidemiology •••••••••••••••• 129 
Venereal Disease Control ••••• 135 EASTERN DEFENSE COMMAND 
Governors Island* New York 4* N<i0 
319ol 
(Surg) 
29 Octo 1945. 
Subject: of Preventive Medicine in World War II. 
To s The Surgeon General* Historical Division* Washington 2$* D0Co 
1. The following history* covering preventive medicine activities from 
the inception of this command in November 1940 to the present* is submitted in 
compliance with letter* Office of The Surgeon General* ASF* file SPMGG* subjects 
"Coordination of Medical Historical Work"* dated 2B July 1944* The evolution 
of the Eastern Defense Command throughout this period is outlined as follows* 
9 November 194.0 First Army 
24. December 194-1 Eastern Theater of Operations 
and First Army 
19 March 194-2 Eastern Defense Command and 
First Army 
10 September 194-3 Eastern Defense Command 
2. The history of preventive medicine within this command has been 
divided into two parts - Part I* Preventive Medicine Activities within the 
Continental United States| and Part II* Preventive Medicine Activities in the 
following base commands: Bermuda* Newfoundland* Greenland and Inas™ 
much €fs the geographical locations of the base commands have given rise to 
certain unique preventive medicine problems* base command histories have been 
preseAted as a separate phase of this study. All base commands* however* are 
under the jurisdiction of this headquarters and* when appropriate* receive the 
same medical directives as are issued to continental units* and specific 
instructions where indicatedo 
3o In order that the problems of preventive medicine within this command 
may be more easily understood in relation to the composition of the command* a 
review of the early organization and medical aspects thereof is includedo 
FOR THE COMMANDING GENERAL: 
/s/ William Vincent 
/t/ WILLIAM VINCENT 
Captain* A.G.D0 * 
Ass’t. Adjutant General 
3 InclSo 
Incl 1 - History* Continental U.S. 
Incl 2 - Annexo 
Incl 3 - History* EDC Bases. PART I 
HISTORY OF PREVENTIVE MEDICINE IN WORLD WAR II 
EASTERN DEFENSE COMMAND 
Continental United States CHAPTER I 
INTRODUCTORY REMARKS AND MANEUVER EXPERIENCE 
le The Office of the Surgeon* First Army* was instituted on 
9 November 194-0. For the most part* the First Army staff consisted 
of former members of the Second Corps Area staff in view of the fact 
that the First Army commander had been Commanding General of the 
Second Corps Area. At this time* the Surgeon’s section was under- 
staffed and it was not until 31 December 194-0 that an adequate staff 
was authorized. On 14- January 1941 an additional officer with 
Public Health experience was assigned to the Surgeon’s Office as 
Medical Inspector and the procurement of a medical officer late in 
the Spring of 194-1 made it possible to assign to an officer the 
supervision of vital statisticso 
20 When elements of the First Army were dispersed at various 
training centers among four corps areas* the major functions of 
the Army Surgeon’s Office comprised administration and training. 
Corps areas were charged with a large measure of responsibility 
for the sanitation* preventive medicine measures* medical care and 
hospitalization of Army units located within their boundaries. 
3o During the period when the First Army was concentrated in 
the Carolina Maneuver Area* a preventive medicine subsection was 
establishedo 
A© One of the earliest matters given consideration was the 
securing of adequate information from tactical units* First Array* 
to permit maintaining at these headquarters vital statistical 
records sufficient to present to the Army Commander a picture of 
the current state of health of the command. Accordingly* on No- 
vember 9* 1940* the Surgeons* First* Second* Third and Fourth 
Corps Areas were requested by letter* this office* to furnish a 
copy of the Weekly Statistical Report* WD MD Form 86ab* from each 
station where units of the First Army were located in the respec- 
tive Corps Areas. It was preferred that this be accomplished by 
having the surgeon of each station concerned submit an extra copy 
of this report for transmittal to this office. Prompt cooperation 
was obtained from the First* Second and Third Corps Areas* but it 
was some time before complexities which arose in the Fourth Corps 
Area were straightened out. The following copies of correspondence 
between the Office of the Surgeon* First Array* and the Office of 
the Surgeon* Fourth Corps Area are believed to be of sufficient 
historical interest to warrant their quotation in fulls December 26* 194-0 
Subjects Medical Reports® 
To g The Surgeon* First Amy* Governors Island* New York* 
lo This office has been studying the matter of various 
medical reports with the hope of arriving at some practical 
solution whereby all concerned will be able to obtain the 
data desired with a minimum of duplication and which will be 
feasible while the troops are at station and in the field* 
The reports under consideration are Sick and Wounded* Statis- 
tical* Sanitary* and Venereal Disease ReportSo 
20 Sick & Wounded Reports; 
a* This Corps Area requires a Sick and Wounded 
report from each command to which a medical officer is at- 
tachedo The reports of regiments and similar units are 
forwarded through the division surgeon to this office 
where they are checked for errors* except those pertaining 
to diagnosis and line of duty which are to be checked in 
the Office of The Surgeon General* and then forwarded to 
The Surgeon Generalo In many instances it has been found 
necessary to return these reports for resubmissiono For 
instance* fifty-three out of ninety-seven reports for 
October were returned in their entirety* This indicates 
that medical personnel of field units are not now trained 
in the preparation of Sick and Wounded ReportSo There 
should be marked improvement in this respect after study- 
ing the War Department manual on the subject* which has 
only recently been distributedo 
bo It is felt that Array surgeons have no 
particular interest in Sick and Wounded reports except 
perhaps to note as a matter of training whether the re- 
ports are being submitted as required by regulationso 
On the other hand* if found possible to do so* Array sur- 
geons might consider it desirable to extract considerable 
information from these reports* However* to require these 
reports to go from the division through the corps and Army 
surgeons and thence to the Corps Area Surgeon0s Office 
would cause considerable delay in their arrival at The 
Surgeon General’s Office* If the reports were to pass 
from the Army surgeon to The Surgeon General direct* 
this office would have no opportunity to study the amount 
and character of illness taking place among the troops in 
the Corps Area* a matter in which the Corps Area is vi- 
tally interested* Furthermore* if the unit Sick and Wounded 
report, as well as that from the hospital, pass through the 
Corps Area Surgeon0 s Office* there is an opportunity for 
checking the unit and hospital reports against each other 
for errors* 
2 3o Statistical Reports; 
aF Weekly Statistical reports first and second 
section* {Form 86ab)* are received from station hospitals* 
nondivisional units having medical personnel attached* 
and divisionso Division reports are consolidated in the 
division surgeon*s office for all units within the divi- 
sion0 These reports are used in the Corps Area Surgeon’s 
Office for the preparation of a consolidated Corps Area 
report which is forwarded to The Surgeon General• This 
section of the statistical report is the principal source 
of information upon which the Army surgeon depends for 
current data on epidemic outbreaks* It is likewise im- 
portant to the Corps Area Surgeono While at station in 
the Zone of the Interior* the Corps Area Surgeon* un- 
der the Corps Area Commander* will have more readily 
available than will the Army surgeon the necessary 
facilities for the correction of environmental and 
other influencing factors which give rise to and are 
necessary for the control of outbreaks of diseaseo It 
would therefore seem desirable to have this report ren- 
dered to the Corps Area Surgeon rather than to the Army 
Surgeon* but to also require unit surgeons to prepare 
an additional copy to be forwarded either direct to 
the Army surgeon* or through the corps surgeon* as 
may be desiredo 
bo The third section of the statistical 
report contains information which both the Army and 
Corps Area Surgeon must haveo It is believed that 
this section of the report should be submitted to 
the Corps Area Surgeon and a copy thereof sent by 
unit surgeons either direct to the Army Surgeon* 
or through the corps surgeon* as may be desiredo 
4° Sanitary Reports; 
Sanitary reports* monthly and special* are 
of much interest to the Army surgeon and Army com- 
mander as well as to the Corps Area Surgeon and the 
Corps Area Coraraander0 The Corps Area has at its 
disposal means for the correction of sanitary de- 
fects which are not ordinarily available to the 
Army commander0 On the other hand* the Army com- 
mander is directly responsible for sanitary defects 
within units of his command* especially while in 
the fieldo It is believed that both Array and Corps 
Area Commanders should have a copy of this report 
so that each may take appropriate action* the scope 
of which will depend to a great extent on whether 
the troops are at station or in the fieldo 
3 5o Venereal Disease Reports: 
There is at the present time considerable 
dissatisfaction with monthly venereal disease reports® 
Regimental and Similar units admit probable cases of 
venereal disease to sick report and transfer them to 
hospital with incomplete diagnosis. The report of the 
diagnosis made by the hospital commander, required by 
Army Regulations 4.0-235, reaches the unit surgeon too 
late to be included in the compilation of the weekly 
venereal reportSo In other words, there is consider- 
able lag in units in reporting venereal diseases® This 
report is important both to the Array surgeon and Army 
commander as well as to the Corps Area Surgeon and the 
Corps Area Coraraander0 While at station the Corps Area 
Commander perhaps has a better opportunity to take ac- 
tion necessary to bring about a reduction of venereal 
diseases® The opposite will usually pertain while 
troops are in the field. 
6® It is requested that a study be made of the 
best methods of submitting the above-mentioned reports, 
and this office be informed of your views with the 
hope that some practical solution may be found which 
will be agreeable to all concerned. In the meantime, 
it is considered that Army surgeons have the right un- 
der the provisions of Par® 2 e (2) (b), AR 4-0-1080, to 
require any additional reports which they may desire. 
December 28* 194-0 
Subject: Weekly Statistical Report® 
To g The Surgeon, First Array, Governors Island, 
New York® 
lo Reference is made to your letter of November 
28th, 194-0* concerning weekly statistical reportSo It 
is hoped that the procedure which will be outlined be- 
low will prove satisfactory for the time beingo An- 
other communication concerning the matter of medical 
reports in general has been mailed to you today. 
2. There is mailed to you herewith copies of 
the statistical reports received from Forts Bragg, 
Moultrie, Screven, and Jackson, beginning with those 
of November l6th0 Many of the First Army units in 
this Corps Area do not have attached medical person- 
nel and the information pertaining to those units is 
4 included in the reports rendered by station surgeonsc 
These reports will include data pertaining to the per-r 
sonnel of a number of units other than those of the 
First Array0 In view of the very large amount of work 
required of station surgeons at the present time it 
does not seem feasible to direct that they render sepa- 
rate reports for Army units. It is hoped that when the 
complement of medical officers is sufficiently increased 
it will be possible to prepare reports of a more satis- 
factory nature, 
3o Letters are being addressed to the surgeons 
of the stations concerned* requesting that copies of the 
statistical reports containing data as to units of the 
First Army be forwarded to your office, It is suggested 
that your office more properly than this office may re- 
quest copies of the consolidated divisional statistical 
reports and those of First Array units to which medical 
personnel is attachedo 
4.0 The following units of the First Army are now 
rendering weekly statistical reports to this office: 
8th Division* Fort Jackson* S0Co 
9th Division* Fort Bragg* No Co 
30th Division* Fort Jackson* SoCo 
10$th 0bsno Sqc* A0C0* Columbia* So Go 
January 16* 1941° 
Subject: Medical Reports, 
To % Surgeon* Headquarters Fourth Corps Area* 
Post Office Bldgo * Atlanta* Gac 
1. Reference is made to letter your office* 
December 26* 194-Oj subject as above, 
20 Sick and Wounded Reports: 
a, Information contained in the weekly 
statistical reports is of value to this office in 
the maintenance herein of an index of disease in- 
cidence among units of the First Arrayo To this 
end* Corps Area Surgeons of the corps areas in 
which First Array units are located were requested 
on November 9* 194-0* to furnish this office with a 
carbon copy of Form 86ab submitted by the surgeon of 
each station at which there are units of the First 
Aray0 bo Station reports* rather than unit reports* 
have been preferred since existent Wo Do instructions re- 
quired that there be only one Sick and Wounded register 
at unit training centers* and such register will contain 
all cases excused from duty because of sickness or in- 
jury. Furthermore* the station hospital records re- 
fleet a more nearly correct picture of illness from 
communicable diseases* than do records maintained by 
tactical units* since it not infrequently happens that 
unit surgeons do not diagnose cases admitted to station 
hospitalso The fact that a station weekly statistical 
report includes cases not belonging to tactical units 
does not materially alter the picture on a vital sta- 
tistics chart* because of the relative numbers con- 
cernedo 
Co It is appreciated that what has been 
said in the immediately preceding paragraph is appli- 
cable to a station like Fort Bragg* only with consider- 
able difficulty. Nevertheless* the undersigned is at a 
loss to state requirements otherwise so long as War De- 
partment instructions hold. In this connection* it was 
learned while on a recent visit to The Surgeon General’s 
Office* that instructions in FM 8-4.5 will be modified to 
require tactical units* while at unit training centers* 
to maintain a Sick and Wounded register* and to use 
Form MoDo 52 for quarters cases. 
do This headquarters requires the surgeon 
of each tactical unit* First Army* to prepare and for- 
ward Form 86c* in the manner indicated in instructions 
covering the rendition of the reports0 
4.0 This headquarters requires the surgeon of each 
tactical command* First Army* to render a monthly sani- 
tary reporto The rendition of the report will not pre- 
clude the Inclusion of data it contains in station sani- 
tary reports. While there is thus a duplication of data 
the requirement is essential from a training viewpoint. 
5. Request has been made by this headquarters 
that it be placed on the mailing list to receive monthly 
venereal disease reports promulgated by corps areas con- 
cerned with First Army units. It is believed this will 
satisfy all requirements* and will hold while units are 
in unit training centers. 
6 February B* 194-1° 
Subject; Weekly Statistical Report* Form 86ab«, 
To s The Surgeon, First Army, Governors Island, 
New York® 
lo Reference is made to a letter* this office* 
December 28* 194-0* concerning the Weekly Statistical 
ReportSo Through an error in this office the various 
stations concerned were not requested to forward Sta- 
tistical Reports to your officeo They have been in- 
structed to forward such reports* beginning with that 
of February B* 1941° We enclose herewith copies of 
the reports from Fort? Bragg* Moultrie* Screven and 
Jackson* December 28th to February 1st* inclusive. 
5o Monthly Sanitary Reports s aP Principally with the view 
of training medical officers of tactical units in the proper ren- 
dition of the monthly sanitary report, this headquarters on Novem- 
ber 25, 194.0, issued instructions requiring the surgeon of each 
tactical command, First Army, to render a monthly sanitary report 
and forward it with sufficient carbon copies to permit the reten- 
tion of one at this Headquarterso It was not intended that the 
rendition of this report would preclude the inclusion of such data, 
or other matter, as might be necessary in station sanitary reports 
of stations at which tactical units of the First Army might be lo- 
cated for trainingo 
bo It soon became apparent that many of the reports that 
were ordered had been prepared either perfunctorily or without re- 
course to appropriate directives® This prompted the promulgation 
of the following instructions which purposely were made so replete 
as to leave little or no excuse for a continuance of illy prepared 
reports thereafter. 
January 29* 1941° 
Subjects1 Sanitary Reports, 
To s CoS^TKTu£l*ieers of Field Force Units* First 
Army, (Copies to; Commanding Generals* 1st* 2d* 3rd* & 
4-th Corps Areas) 
1° References; Letter* Headquarters First Army* 
file number 721o5 (Surgo 0o) Subject; Monthly Sani- 
tary Reports* dated November 25* 194-0* to Commanding 
Officers of Field Force Units* First Array; AR 40-275 
7 dated November 15* 19321 MF 8-4-0 (Field Sanitation)0 A 
copy of each of these should be in the possession of 
surgeons of tactical units* First Army. 
20 Instructions; a0 In the preparation of 
sanitary reports, the surgeon of each for which a 
sanitary report is to be rendered, should bear in mind 
that the purpose of these reports is to keep commanding 
officers and higher administrative authorities in touch 
with current sanitary and health conditions of units re 
ported upon0 To this end, the report should be brief 
and concise and cover so far as practicable the subject 
matter outlined in AR 40-275 and any other information 
that the surgeon may consider of value to higher au- 
thorltieso 
bo The following form is suggested as an out- 
line for the preparation of monthly sanitary reports by 
surgeons of tactical units* First Army; 
(UNIT 
?2lo5-~ 
(Station 
(DATE 
Subjects Monthly Sanitary Reporto 
To; 
lo In compliance with letter. Headquarters, First 
Arny, file No0 721® 5 (Surge 0o) Subject: Monthly Sani- 
tary Reports, dated November 25, 194-0, and pursuant to 
the provisions of paragraph 1 c AR 4.0-275, the follow- 
ing sanitary report is submitted for the month of 
, 19 : 
(1) MEM STRENGTH OF COMMMD FOR THE MONTH, 
( ) DAYS; Military 
C ivii ian . 
(2) ENVIRONMENTAL SMITATICN; 
(3) GENERAL STATISTICS; 
Mean strength of command, (Military per™ 
sonnel) for the ( ) week period 
, 19_;_ 
admissions to sick report from all 
causes, (absolute numbers):•••••<,•• .n 
Rate per 1000 per annum for , 19 
oeeeeoeooe e Rate per 1000 per annum for , 19 : 
Rate per 10CC per annum for , 19 : 
o • « • • • • « 
Rate per 1C0C per annum for the year, 19 : 
(4) PERSONAL HYGIENE: ' . The physical 
inspection of all troops as required by AR 
615-250 was held on , 19 o . 
(5) PREVALENCE OF ACUTE COMMUNICABLE 
DISEASES: 
(6) OR IMPROVED ADMINISTRATIVE MEASURES: 
(7) SUBJECTS NOT COVERED UNDER OTHER HEADINGS: 
(8) RECOMMENDATIONS: 
(SIGNATURE) 
(RANK) 
BURGEON) 
Co If the report is an initial report a statement 
should be added in paragraph 1 showing the exact period 
covered by the report. For example: This report covers 
the period from November 18 to 30, 1940; unit activated 
on November 18, 1940° 
de Paragraph (l) Mean Strength of Command for 
the Month.! Military. By this is meant the mean strength 
for the full month, 28, 29, 30, or 31 days, as the case 
may be. For this purpose the mean strength should be 
computed by adding the strength of command for each day 
of the period and dividing the result by the number of 
days in the month for which the report is rendered, 
using the nearest whole numbero 
e. Paragraph (3) General Statistics: Mean 
strength of command (military personnel)» This mean 
strength should be computed by adding the strength for 
each week (as shown on Weekly Statistical Reports, 
Form 86ab MD) of the previous 4" or 5-week period, as 
the case may be, and dividing the result by the number 
of weeks in the period for which the report is rendered, 
using the nearest whole numbero Units not rendering a 
Weekly Statistical Report at the present time should 
9 compute this strength by adding the strength of command 
for each day of the statistical period (4 or 5 weeks) 
and dividing by the number of days in the statistucal 
period# (28 or 35 days as the case may be)o In prepare 
ing monthly sanitary reports it is noted that the sur- 
geons of some units report word for word# the phrase- 
ology used in paragraph 1 c (3) AR 40-275# in recording 
general statisticso In recording comparative rates it 
is desired that the data be recorded in a uniform man- 
ner and be so arranged as to enable one to evaluate 
them at a glanceo For examples 
Mean strength of command (military)0ooo.«.o......o500 
Admissions to sick report from all causes# 
Vabsolute numbersj(oooooo»®«®o®»eoo*«ooo»cooo» 10 
Rate per 1000 per annum for November# 194-Coo0oo• ®,208 
Rate per 1000 per annum for October 194-Coo o o o 0»* o * 
Rate per 1000 per annum for November,? 1939o ® o.. • • • - 
Rate per 1000 per annum for the year-? 1939®®®° * 
{* Other comparative rates not Available inasmuch as 
unit was activated on & 19_# and this is 
the INITIAL REPORT)Q 
BASIC FORMULAE FOR CALCULATING RATES 
For a four (4.) week period; 
Rate per 1000 per annum* Number of cases X 13 X 1000 
Strength of Command 
For a five (5) week period: 
Rate per 1000 per annum* Number of cases X 10o4. X 1000 
Strength of Command 
fo Paragraph (6) New Or Improved Administrative 
MeasureSo New sanitary devices developed by tactical, 
units? First Army? while in camp? which prove to be of 
special value? should be reported under this headingo 
This report should state the particular problem solved 
and a brief summary of the results obtainedo 
3o Special Sanitary Reports? When indicated? a 
special sanitary report may be renderedo The purpose 
of the special sanitary report is to place immediately 
before the commanding officers? information and recom- 
mendation regarding gross sanitary defects? epidemics? 
or other conditions that are seriously affecting or 
may immediately affect the health of the command® Such 
10 reports will be forwarded to unit commanders for neces- 
sary actiono Copies of speel$l sanitary reports together 
with a brief outline of action taken by the unit comman- 
der will accompany the monthly sanitary report for the 
month in which the special sanitary report was submitted® 
4® Channels of Transmission: The unit surgeon will 
forward the report to the unit commander„ The unit 
commander concerned will 'transmit each report by in- 
dorsement noting action taken* if any* to correct sani- 
tary defects and deficiencies reported* through appro- 
priate military channels to the Commanding General* 
First Array® 
60 On January 1# 1942# there were under the jurisdiction 
of this headquarters four Army Corps headquarters# eleven infan- 
try divisions# the Antiaircraft Artillery Command# ETC# the vari- 
ous coast artillery installations along the Atlantic Seaboard# and 
the many separate Army and Army Corps Stoops units0 Included were 
some forty-three medical units# numbered general hospitals# evacua- 
tion hospitals# numbered station hospitals# medical regiments# 
medical battalions# sanitary companies# a general dispensary and 
a veterinary company** Later on the Air Forces EDC and First Air 
Force# and several base commands came under this jurisdictiono 
7® During the early part of 1942 all of the army corps* 
all of the divisions but one* and all of the separate medical 
units were relieved from assignment to this command® 
Bo At the close of the year the Eastern Defense Command 
and First Army was comprised of: Air Forces EDC and First Air 
Force; the Antiaircraft Artillery Command, EDC; the Bermuda 
and Newfoundland Base Commands; the New England# New York- 
Philadelphia# Chesapeake Bay# and Southern Sectors; the Mili- 
tary District of Washington; the 26th Infantry Division# and 
Army Troops Including a number of separate units# only two of 
which were toedical units# viz0 the 671st and 672d Collecting 
Companies (Sep)* 
9o With the formation of combat teams and their dispersion 
in small units and detachments along the coast in out of the way 
and often rather inaccessible places# the problem of maintaining 
adequate supervision of the medical welfare of the personnel be- 
came considerably magnifiedo One combat team,? consisting of a 
regiment of infantry# a battalion of field artillery# a battalion 
of engineers and a company or more of quartermaster (truck) troops 
was assigned to each of the four sectors of this commando As the attached 
medical troops were obviously too few to meet the demands of the 
situation# detachments from two of the collecting companies of 
11 the 114th Medical battalion were attached (with ambulances) to two 
of the combat teams* and a collecting company (Sep) was provided by 
the War Department* upon request by this headquarters* for each of 
the other two teams. To provide coordination and correlation of 
medical activities within the team a combat team surgeon was desig- 
natedo It was recognized that a surgeon on the staff of each sec- 
tor commander was needed to fill the hiatus then existing between 
the combat team surgeon and this officeo Therefore this matter 
was taken up with the Sector commanders and their concurrence ob- 
tained*) This office reoMnmended medical officers as sector sur- 
geons only after a thorough canvass of the available personnel and 
the calling of several into this office for temporary duty where 
opportunity was given them to become acquainted with the many de- 
tails of a surgeon0s office* the staff responsibilities entailed* 
and their fitness for such a position determined. 
10o The principal problem during this period was to provide 
efficient and adequate medical care and evacuation facilities for 
the troops stationed at isolated locationso Where units were sta- 
tioned at or near a fixed post with an established station hospi- 
tal there was no problem* but where small units or detachments 
were located at points some eighty to one hundred miles from the 
nearest station hospital* evacuation therefrom presented many 
problems? the time element involved in transporting a seriously 
ill or injured patient* the mileage necessitated for transporta- 
tion* etco 
Ho By assigning a collecting company to each combat team 
sufficient ambulances were made available to furnish adequate am- 
bulance service* except in those instances where the excessive 
mileage as indicated above was concerned*) Other personnel of the 
collecting companies were detailed as aid men* thus providing at 
least one trained corps man with each small detachments 
120 The problem of dental care and treatment for troops in 
these isolated spots was met by having the dental surgeon travel 
to the unit or detachment* taking his equipment by truck thus 
avoiding any disruption of unit activities and saving the time 
that would otherwise be required to take men to the unit head- 
quarters or nearest station hospitalo 
13o The assignment of Medical Department officer personnel 
created some difficulty and confusion earlier in that yearQ With 
the release of the many Medical Department officers of the com- 
mand to units being prepared for overseas service* many of our 
units were depleted to such an extent that the rendition of 
proper medical care for the troops became a very real problemo 
Then as requisitions began to be filled by the War Department 
for medical officer replacements a new situation arose0 These 
12 officers would be assigned directly to units by the War Department 
and this office would not be cognizant of the fact until receipt of 
the next Statistical Report W.D., M©D0 Form No© 86c© This syatewr 
resulted in many administrative and other difficulties© It often 
resulted in new medical officers with no training in medico-mili- 
tary matters being ordered to units and by virtue of their high 
initial rank superseding the medical, officer who had been effi- 
ciently serving the detachment for many months© Hence The Surgeon j 
General was requested to make the assignments of these officers as a 
pool for reassignment by this office. This was approved and that 
method was inaugurated with satisfactory results© Questionnaires 
covering professional* and military qualifications were 
prepared by this office and distributed to all Medical Department 
officers within the command and to the new officers as assigned 
to the pool® In this way a complete file was built up and assign- 
ments and reassignments were made so as to enhance the value of 
these officers to the service and at the same time improve the 
morale of the Medical Department officer personnel© 
14° The need for veterinary service for units of this 
command within the continental limits of this country has been 
negligible as there are practically no animals to care for at 
present and the meat and dairy inspections are covered by the 
service commands® Hence it has never seemed necessary to ask for 
the assignment of a Veterinary officer to this headquarters© In 
the Base Commands and in the Air Forces EDO and First Air Force.. 
Veterinary officers are assigned and the service is satisfactory. 
15® With the change in the composition of this command 
there was no longer a sufficient need for a Dental officer in this 
office and therefore the Dental Surgeon was relieved for assign- 
ment where his services were more urgently needed. With the den- 
tal clinics of the various station as supplemented by 
the dental officers of this command and the travelling dental 
teams as described earlier in this the dental situation 
was generally satisfactory© 
l6o Attached medical officers were available in sufficient 
numbers to render all medical treatment and care authorized within 
the unit© Patients were evacuated to the nearest station hospital 
when indicated© Close liaiscn with the surgeons of the sectors 
and the AAA Command kept this office in touch with all medical 
matters within the command and permitted prompt action when and 
where needed to improve the service© Throughout the year the 
statistical reports from the subordinate units indicated that 
the health of the command was very satisfactory© 
13 17o The Preventive Medicine Section of the Surgeon’s Office* 
Eastern Defease Command* is organized to include supervision of all 
medical activities within this command pertaining to hygiene and 
sanitation* venereal disease control* vital statistics* sanitary 
inspections* epidemiology* dental service and veterinary serviceo 
Current information of health conditions in all organizations un- 
der Eastern Defense Command is constantly surveyed and instructions 
are issued when indicated to EDO units regarding practical measures 
to be employed for the preservation of health and the prevention of 
disease in order that military personnel of the Eastern Defense 
Command be kept at its maximum effective strength*. 
l8o In view of the fact that the Statistical Health Reports 
(WD MD Form 86ab) submitted by units of this command did not reveal 
complete statistics for SDC military personnel* inasmuch as patients 
within the continental United States are routinely hospitalized in 
service command installations* a supplemental report was instituted 
in 194-2 to account for all personnel confined in Army hospitals0 
The additional information contained in these supplemental reports 
has enabled the Surgeon* EDO to present a complete picture of the 
health of the command to the Commanding General*. The supplemental 
report is not required from base commands since all hospitals at 
the bases are under EDO control and data extracted from the regu- 
lar Statistical Health Reports from base commands presents a 
complete pictureo 
19o A summary of Weekly Statistical Health Reports and 
supplements thereto was originated from the Office of the Surgeon 
EDO and the initial publication distributed for the week ending 
October 30» 1942° The summary was prepared to afford an uncom- 
plicated comparison of admission and noneffective rates for sec- 
tors and base commands under the jurisdiction of this headquarters 
and to project graphically the health trends within this commando 
Commencing with the issue of the summary for the week ending 4- 
Febmary 1944 this publication became a command report,, thereby 
enhancing its value as an instrument for issuing pertinent in- 
structions to lower units pertaining to general medical subjects 
and preventive medicine measures* and yet retaining the compari- 
sons of admission and noneffective rates and the record of health 
trends from the former medical reporto In addition* this report 
is used to further advantage by directing attention to current 
Medical Department publications and circulars and disseminating 
medical information to commanding officers and surgeons of 
Eastern Defense Command units» For those units of this command 
located within the continental United States at permanent posts* 
camps or stations* preventive medicine activities have closely 
paralleled those of service commands*, 
14 20® In lieu of combat experience* the following account of 
the Carolina Maneuvers in the fall of 19-41 gives a comprehensive 
view of medical activity within this command during the maneuver 
period® 
First Arm ManeuverSo 
21 © ( Preparations for Hospitalization.?) 
a® Tfom the viewpoint of adequately caring for casualties 
from army medical installations* the Carolina Maneuver Area was 
happily selected® This area* straddling the interstate borders of 
North Carolina and South Carolina* and covering eight counties in 
each of the abovenamed states* had its northeastern border in the 
vicinity of Fort Bragg* and its southwestern border in the vicin- 
ity of Fort Jackson® At Fort Bragg* there was a group of hospital 
buildings affording approximately 3000 beds| at Fort Jackson* the 
Station Hospital had a bed capacity of approximately 1B00 beds® 
Furthermore* since troops at both of these places were to partici- 
pate in the maneuvers* their vacated barrack buildings would be- 
come potential expansion space for hospital beds* when and if 
such space became necessary® It so happened that the larger of 
the two opposing maneuver forces was destined to be located in 
the northeastern portion of the maneuver area where the larger 
facilities for treatment in corps area medical installations 
were available® Both of these corps area medical installations 
were approximately sixty-six (66) miles from the field medical, 
installations which were to be established in the rear areas of 
each of the two major opposing forces® It was thus apparent that 
no insuperable difficulties were to be encountered in transport- 
ing casualties from the field forces to corps area medical in- 
stallations* within a reasonable length of time* and over well- 
surfaced roads® 
b® Letter* General Headquarters* The Army War College* 
Washington* D®C®* March 18* 194-1 j Subject: Corps and Array Train- 
ing* contained the provision that the First Army was to look to 
the Fourth Corps Area to arrange for the evacuation and care of 
casualties from army medical establishments® Thus there remained 
the necessity for the First Army to arrange for the necessary medi- 
cal supplies for the field forces* field medical installations in 
the army rear areas wherein casualties could be collected and pre- 
pared for further evacuation to corps area medical installations® 
e® One of the first problems to solve was to coordinate 
the divided responsibility* with respect to means for transporting 
evacuees* between the Fourth Corps Area on the one hand and the 
First Army on the other® In this connection* the First Army was 
15 charged not only with providing for its own requirements but also 
for those of the Fourth Army Corps which was to be its opposing 
force during the second half of the maneuver periodo 
do In an effort to determine* for Fourth Corps Area 
purposes* the number of ambulances that would be required to 
transport evacuees from the two rear areas to the respective 
corps area medical installations* it was estimated that the 
strengths of the forces* from which evacuations to corps area in- 
stallations were to be made* would be as followss 
During Octobers 
At northern part of maneuver 
At southern part of maneuver 4^^400 
During Novembers 
At northern part of maneuver area5 223 600 
At southern part of maneuver area- 69^500 
6o At the time the above estimates were made* it was not 
known definitely that the 30th and 44-th Divisions would participate 
in the Carolina in view of the fact that they were Na- 
tional Guard Divisions whose one year of service would terminate in 
September 
fo For the purposes of planning* it was assumed that 
there would be a daily increment of sick of approximately 0®6 per- 
cent* two-thirds of which would remain under treatment in their 
own organizations* or la clearing stations. One-third would re- 
quire evacuation to hospital installations in the array rear areaso 
It was felt that* if an evacuation hospital of 750 bed capacity 
were established both in the rear area on the north and in. the 
rear area on the south of the maneuver area* sufficient beds 
would be available to care for the normal number of evacuees 
daily from divisional and other unitso Since there would not be 
much of a margin in the way of spare beds each day* especially in 
the evacuation hospital supporting the larger force on the north* 
it was assumed* as a safety measure* that it would not be feasible 
to do mors than prepare patients in evacuation hospitals for imme- 
diate clearance to corps area medical installations0 Consequently* 
0o2 percent was taken fes the figure* representing the number of 
patients for which ambulances would be required for evacuation 
from evacuation hospitalSo 
go On this basis* it was assumed the evacuation hospital 
on the north would have to be cleared* during the month of October* 
once every 3l/2 days* and* during November* twice every 3 days? 
the evacuation hospital on the south would have to be cleared* 
during the month of October* once every 8 days* and* during the 
month of November* once every $ dayso 
16 ♦ ho Assuming that ambulances were to be used for the 
above purpose, it was estimated that the following number of ambu- 
lances would be required daily: 
From the evacuation hospital on the norths 
During October 37 
During November 78 
From the evacuation hospital on the souths 
During October 17 
During November 25 
ie In presenting the above figures to Headquarters, 
Fourth Corps Area, it was learned that the required number of am- 
bulances would not be forthcoming from that corps area, and that 
unless both ambulances and drivers to operate them were furnished 
by the First Array, that corps area would be unable to accomplish 
the evacuation of patients, by ambulance, from medical installa- 
tions in the Army rear areas to corps area medical installations® 
It was apparent then that some means would have to be made avail- 
able by the First Army to effect the clearance of the evacuation 
hospitals that were to be established,. Army ambulances seemed to 
be out of the question, for, at the time in question, of the 678 
ambulances allowed the First Army, only 353 were on hand, leaving 
a shortage of 325*. Nor does this present the darkest side of the 
picture: there were only 20 ambulances in the two Army medical 
regiments$ for one of these regiments, 22 ambulances were promised 
on September 1$ and 30 on October 15] for the other regiment, none 
were promised until after October 15o Some consideration was 
given to the possibility of evacuating by train, but this possible 
method had the drawback of requiring the use of ambulances both 
for loading and unloading® Passenger buses held out a possible 
solution for the problem at hand provided a type in sufficient 
number and capable of being used for both sitting and litter 
patients could be obtainable« Translating ambulance loads into 
bus loads was accomplished on the basis of 1/10 of the patients 
being litter patients, each litter patient occupying the space of 
4 seatso Thus a 34=passenger bus was considered capable of carrying 
an average of 25 patients, 3 of which would be litter patients, or 
the equivalent of 4 ambulance loads® Accordingly it was estimated 
that, to clear the evacuation hospital, to be established in the 
northern part of the maneuver area, during October, with a pro- 
spective daily admission of 358 patients, fifteen 34-passenger 
buses would be required® To clear the evacuation hospital, to be 
established in the southern part of the maneuver area, during 
October, with & prospective daily admission of 130 patients, five 
34-passenger buses would be required® To clear the northern 
evacuation hospital, during November, with a prospective daily 
admission of 542 patients, would require twenty-two 34-passenger 
buses® 
17 jo The Commanding General* First Army* approved the pl%n 
of taking over from the Fourth Corps Area the evacuation of patients 
from army rear areas to corps area medical installations and of us™ 
ing commercial buses for the purpose. 
k» One might womder* without having full knowledge of the 
matter* how a commercial bus could readily be adapted to the carry™ 
ing of litter cases without extensive alterations® In fact* the 
question was asked this headquarters by Go Ho Q. The solution of 
the problem* however* was simpleo The New York Metropolitan Area 
had a bountiful supply of buses which during the summer months were 
used for trips of one sort or another and were not in great demand 
at tne close of the summer season® Through the Quartermaster* First 
Arofy* contact was gained with a contractor who would hire the type of 
bus desired® This bus had an emergency door at the rear of the left 
side* sufficiently wide to admit a loaded litter® With a sufficient 
number of the rear seats removed* three loaded litters could be 
placed on the floor of the bus* leaving the forward seats for the 
estimated number of sitting patients® 
I® Several factors influenced the kind of hospitalization 
facilities that were to be provided in the rear areas5 namely* the 
necessity for having a sufficient number of suitable beds at each 
place to care for the expected number of daily admissions together 
with adequate facilities for the care of those patients* and the 
desirability of affording opportunity to the evacuation hospital 
training units of the First Arn$r to become acquainted with the in- 
stallation with which they were expected to function in actual war™ 
fare® Since there were but two army medical regiments and one was 
to be used on one opposing side* and the second on the other* at 
least during the month of October* it would be impracticable to use 
the clearing stations of either as simulated evacuation hospitals® 
Accordingly it was planned to requisition for two evacuation hos- 
pital equipments® In the selection of the prospective sites of the 
two evacuation hospital units* that on the south presented no dif- 
ficulties* for the environs of Chester* SQ Co were on the southern 
limits of the maneuver area* and no matter what changes there might 
be in tactical situations* its location* necessarily immutable* ap- 
peared to answer the requirements of tactical correctness® The se™ 
lection of a site for the northern group could not be made to con?= 
form to orthodoxy* for it was only at the forward extremity of the 
First Army Troops area that all. of the desiderata of an evacuation 
hospital site could be obtained* that is* at Rockingham* NoC® Thus 
there was to be an inevitable back tracking in the evacuation of 
certain of the First Army Troops located in the rear of the First 
Army Troops area® 
18 Preliminary Water Arrangements. 
22o The Array Engineer having made a preliminary survey to 
determine possible municipal sources of water in the maneuver area-, 
steps were taken to determine the quality of the water from each 
sourceo A medical officer* qualified in public health work* was 
detailed as Surgeon of the maneuver area* and was charged with 
the collection of samples of water from all sourceSo These were 
examined bacteriologically at the Station Hospital* Fort Jackson* 
Sc Co Based upon examinations made* as well as upon whether the 
municipalities concerned properly treated the water at source* de- 
termination was made as to requirement for full chlorination of the 
water before use by troops* or for partial chlorination to overcome 
possible recontamination in handling by troops*. / 
Plans for Extra-cantonment Sanitation 
23% On July 1 4-# 194-1* correspondence with the State Health 
Officers of North Carolina and of South Carolina was initiated by 
this office with the view of holding conferences with these offi- 
cers to consider necessary extra-cantonment sanitary measures to 
be taken for the protection of troops and citizens in the area in- 
volved during the First Army Maneuvers* October and November* 1941® 
bo A representative of this office attended two meetings* 
held respectively on July 30* 1941* at Raleigh* NoCo* and on July 
31* 1941# at Columbia* S0Co* under the auspices of the governors 
of North Carolina and South Carolina* to consider plans as set 
forth aboveo Each meeting was formally opened with an address by 
the Governor The representative from this office outlined the 
problems* from the standpoint of the Army* presented by the sani- 
tary aspects of water supply* milk supply* food handling* sewage 
disposal* control of hotels* restaurants* camps* tourist homes* 
roadside stands* and trailers* and by necessity for the adoption 
of stringent measures to control prostitution*. Each meeting was 
thereafter conducted by the State Health Officer of North Carolina* 
and of South Carolina0 Each presented a suggested public health 
program* either personally or through a subordinate*. The North 
Carolina program was substantially identical in substance and 
wording with that of South Carolinao They covered the ground of 
extramilitary sanitation in an adequate manner* subject to ade- 
quate attention to the details enumerated in them before and dur- 
ing the maneuver period. 
19 Sanitation during the Maneuvers® 
2A&* Because of the fact that Field Manuals 8-4,0 and 21-10 
had been made available to personnel of the First Army* and of the 
further fact that the majority of the units of the First Army had 
had considerable experience in the field during the year preceding 
the Carolina maneuvers* it was felt that it was unnecessary to 
promulgate from this headquarters detailed instructions concerning 
sanitation in the fields as has been done for maneuvers previously 
held® It was a mistaken belief* however* to consider that* be- 
cause the above referred to manuals were available* the personnel 
were familiar with the contents of them® This was especially 
true of nondivisional units<> Generally speaking* base camps were 
maintained in a sanitary condition with respect to the disposal 
of wastes® 
bo Foodstuffs were required to be protected from dirt# 
heat and flies® Each organisation was required to provide the 
necessary screening or netting adequately to protect the food sup- 
ply® Mess halls# kitchens# and canteens were required to be kept 
scrupulously clean® Food hand!ers were required to be examined 
physically prior to detail and to be inspected frequently as to 
their personal cleanliness® Vehicles for transporting bread# 
fresh meat and like exposed food supplies were required to be kept 
scrupulously clean® Field ice boxes# of a type to be buried in 
the ground# were furnished by the Quartermaster® When properly 
maintained# so as to assure maximum refrigerating effect# these 
improvised ice boxes were satisfactory® In many instances# food- 
stuffs were placed on top of the ice# the fact being lost sight 
of that cool air descends and# conversely# warm air rises* Ice 
should be placed on a rack above the foodstuffs® 
Co For the base camps# units were supplied with materials 
for the construction of latrine boxes® Lack of funds prevented the 
Quartermaster from having these boxes prefabricated® The lack of 
funds also prevented the purchase of galvanized sheet metal urinal 
troughs with pipe drains® Plans for the construction of the latrine 
box and urine trough (to be made of wood) were distributed by the 
Quartermaster# First Army® In many instances these plans failed 
to reach organizations# and# in many instances# even though they had 
been Received# they were disregarded* In consequence# results 
were far from being uniformly satisfactory. One organization de- 
parted so extremely from the plan as to construct a latrine box 
that was about 2-l/2 feet in height; the seat holes were small and 
hexagonal in shape and placed too far back; the seat covers were 
hinged at the front of the box thus placing the sloping side of 
the box at the front® To see a person enthroned in an utterly 
unphysiological position on one of these boxes# with his feet six 
inches off the ground and his lower legs stuck out in front at a 
4.5 - degree angle# was startling to say the least® To go through 
the experience one8s self# forced one to realize that here was a 
diabolical instrument designed especially to produce chronic 
constipation® 
20 do While the plan for the latrine box was satisfactory* 
save for the fact that it made no reference to the necessity for a 
urine deflector* that for the field urine trough was not entirely 
soo This was due to the fact that* being made solely of wood* it 
was difficult to insure against leakage and to provide for a fly- 
proof means of conveying the urine from the trough to the latrine 
pito Furthermore* the plan called for placing the opening of the 
trough drain six inches from its lower end* thus leaving an area 
impossible of draining« 
6o As was to be expected the greatest difficulty was 
experienced in maintaining satisfactory sanitation of the base 
camps of First Army Troops0 These troops consisted in many in- 
stances of organizations9 provisionally made up* in the maneuver 
area of companies that had come from various stations and to 
which there had never been attached any medical personnelo This 
was particularly true of service organizations* such as Quarter- 
master regiments* Signal battalions* etc0 Regiments of anti- 
aircraft artillery also were especially faulty in observing 
sanitary regulations© 
fo Sanitation in bivouacs left nuch to be desiredo One 
gathered the impression that troops felt* once they were away from 
base camps* all rules for observing sanitary regulations were off0 
Rubbish* waste paper* fruit skins* discarded sandwiches and food 
scraps* and* in certain instances* freshly deposited human feces 
were noted in and around many of the bivouac areas 0 Many units 
neglected to dispose of garbage properly* and* in some instances* 
garbage pits were totally inadequate for the amount of waste they 
were to receiveo One always could tell when a unit had been fed 
on the roadside by the amount of litter left behind after the 
unit moved onG 
go Mess gear washing of maneuvering troops presented a 
difficult problem0 It was next to impossible to get sufficient 
water up to frontline troops to permit them to carry out the approved 
three-receptacle method of mess gear washing0 There was no known 
satisfactory way of adequately heating the water for sterilization 
of the eating utensils* especially in concealed bivouacs at nighto 
In consequence* the men resorted to the use of sand for removing 
remnants of food from the mess tins and knives* forks and spoonso 
This was a hazardous method because of the possibility of acquiring 
intestinal infections from the soilo Possible solutions of the 
problem included the use of paper linings for the mess tin* to be 
discarded after use* or in having available a blue gasoline flame 
in which the eating utensils could be held for a few moments until 
a tenperature destructive to pathogenic bacteria was reached^ 
21 ho The breakdown of rations for organizations* after the 
food in bulk had been transported from railhead to breakdown point* 
inevitably had to be done under circumstances that were far from 
idealo Nevertheless considerably more care should be exercised to 
protect the food at this point than was the case in the Carolina 
ManeuverSo This applies with especial force to the prevention of 
intestinal infections acquired from the soil and surrounding en~ 
vironmento 
Extra- cantonment sanitations 
25o During the greater part of October the weather was summer- 
like* and certainly sufficiently warm to foster the growth of malaria- 
bearing raosquitoeso Mosquitoes in the maneuver area* however* were 
noticeable by their absence* which might be accounted for by the 
prolonged drought that not only preceded the maneuver period but 
also continued throughout ito In all justice* however* considerable 
credit must be given to the State Department of Health of both North 
Carolina and South Carolina for the thorough job they did in spread- 
ing oil on areas that were potentially mosquito-bearing* for* though 
otherwise many cases of malaria might have developed among the per- 
sonnel of the First Army* the records of patients that passed through 
the evacuation hospitals showed that there were but 15 cases of 
malaria so diagnosedo 
Watero 
26. a? Though a preliminary survey had indicated the satisfac- 
toriness or unsatisfactoriness of available municipal water supplies 
throughout the maneuver area* weekly samples were obtained from these 
sources to assure an up-to-date record of the status of these water 
sourceso Until the arrival in the maneuver area* early in October* 
of the 3rd Medical Laboratory* these samples of water were examined 
either at Fort Bragg or at Fort Jacksono After the arrival of the 
3rd Medical Laboratory* the samples were examined by that unit. 
bo Seme of the municipalities filtered and chlorinated 
their water; the majority did not require any treatments the source 
of the water being deep* driven wellsc The water from those sources 
which did not satisfy First Array criteria was required to be chlorin- 
ated (one tube of calcium hypochlorite to one sterilizing bag of wa- 
ter); water from sources* which consistently proved to be free of 
contamination* was required to receive one-third of a sterilizing 
dose of calcium hypochlorite to one sterilizing bag of water to 
overcome possible recontamination between the water distributing 
point and the place of use. 
22 Co The 5“gallon water can was used in the majority of 
instances for transporting water. Because of the similarity of 
this and the gasoline can* it was required that the water can have 
painted on it a 3-inch white band® 
The Health of the Command during the Maneuvers0 
27. a® Instructions issued prior to the maneuvers prescribed 
that the physical examination of enlisted men provided for in AR 
6l5~250 would be completed prior to their departure from their home 
stations® The examination of food handlers was to be completed 
prior to arrival in the maneuver area® 
bo Instructions also were issued requiring that every 
individual who had not been vaccinated against smallpox during the 
immediately preceding three years was to be revaccinated. All in- 
dividuals who had received but one series of typhoid inoculations 
were to be reinoculated,;) if the one series had not been received 
during the immediately preceding three years0 
Co Syphilitic registers were required to accompany all 
persons under antisyphilitic treatments and provisions were made 
for the administration of antisyphilitic treatment at the near- 
est clearing station# following the necessary local arrangements 
therefor® It was felt that from two to three months (the length 
of time most of the troops were in the field during maneuvers) 
was entirely too long a period of time# to withhold from troops 
requiring the arsenicals® Accordingly# arrangements were made 
to have on hand adequate supplies of neoarsphenamine and double 
distilled# sterile water for injections. These supplies were 
drawn by clearing stations and thus there was no interruption 
in the prescribed routine of the treatment of syphilitics® There 
were no untoward results of this form of treatment in the field0 
do The estimated evacuation rate to clearing stations 
was about h/lOCCo The actual rate for the First Army for the 
period was 2C 3/lOOC or considerably less than the estimated 
rate0 One factor conducive to good health was the excellent 
weather during the maneuver period. There was very little 
rain and the troops were not subjected to those conditions 
which are conducive to the production of the respiratory group 
of infections®. The common diarrheas were present in moderate 
number during the month of October when the weather was warm 
and flies prevalent. With the onset of colder weather in No- 
vember the flies became inactive and the common diarrhea de- 
creased® Another factor partially responsible for the low 
evacuation rate was that the troops were fairly well seasoned® 
23 e° The evacuation rates to clearing stations for the 
three Array Corps were practically the same, that for Army troops 
was somewhat lower than those for the three Corps. The day to day 
evacuation rate to clearing stations fluctuated very little so that 
one may say that under the conditions prevailing in the Carolinas* 
and for seasoned troops, one may expect a maneuver evacuation rate 
daily of 2o3/l000 and base future plans on such figures0 
f. The evacuation rates to the 1st and 4-th Evacuation 
Hospitals were almost identical, 1.6 and 1.5/lOOD respectivelyo 
The day to day rate fluctuated very little. The estimated rate was 
2/l000, which is in close agreement with the actual figured 
go The evacuation rate to fixed station hospitals was 
estimated at 1.5 to 2o0/l000o The actual rate was 0o5 to Fort Jack~ 
son Station Hospital and 0o9 to Fort Bragg Station Hospital, an av- 
erage of 0o7/l000o The fact that this figure is lower than the 
estimated rate suggests that the evacuation hospitals were able to 
hold and treat more cases than was expected and that illnesses and 
Injuries were on the whole of minor nature and such as could be 
cared for at the evacuation hospitalSo The fact that more patients 
were treated in evacuation hospitals and fewer evacuated than ex» 
pected attests the ability of evacuation hospitals to give effective 
and definitive treatment in the field under maneuver conditionsc 
ho The total number of evacuations performed during 
the maneuver period was 52*633 or a daily average of 889» The daily 
average* patients in clearing stations and evacuation hospitals of 
the First Array* was 201 and 6o7 respectively* 
Communicable diseases reported: 
From clearing stations; 
Chancroid 
17 
Chicken Pox 
1 
Common Respiratory Diseases 
3.052 
Diarrheal Diseases 
1.898 
Fever undiagnosed 
6 
German measles 
3 
Gonorrhea 
192 
Impetigo 
1 
Influenza 
709 
Lymphogranuloma Inguinale 
1 
Malaria 
3 
Measles 
1 
Meningococcus Meningitis 
5 
Mumps 
7 
Pneumonia 
15 Poliomyelitis 
u 
Scabies 
10 
Scarlet Fever 
1 
Syphilis 
28 
Tuberculosis 
3 
Vincent's Angina 
10 
From Evacuation Hospitals; 
Bacillary Dysentary 
19 
Chancroid 
2 
Chicken Pox 
3 
Common Respiratory Diseases 
2,301 
Diarrheal Diseases 
1*794 
German Measles 
3 
Gonorrhea 
261 
Impetigo 
50 
Influenza 
505 
Malaria 
15 
Measles 
5 
Meningococcus Meningitis 
3 
Mumps 
3A 
Pneumonia 
13 
Scabies 
33 
Syphilis 
IB 
Tuberculosis 
1 
Vincent9s Angina 
Deaths s 
56 
Directly due to maneuvers; 
Motor accidents 
64. 
Airplane accidents 
U 
Electrocution (accidental) 
2 
Gunshot wound (accidental) 
1 
Total 
71 
Not directly due to maneuvers; 
Diving accident 
1 
Suicide 
1 
Poisoning (denatured alcohol) 
1 
Poisoning (Jeweler9s fluid) 
1 
Poliomyelitis 
1 
Uremia 
1 
Perforated Peptic Ulcer 
1 
Peritonitis 
1 
25 Septicemia 
1 
Lobar Pneumonia 
1 
Malaria 
1 
Coronary Heart Disease 
1 
Total 
12 
Grand Total 
83 
Venereal Disease Control; 
28® a® During the First Army Maneuvers* 1941* certain 
problems pertaining to venereal disease arose which are presented 
together with their solutions® 
b® To assist the Departments of Health of the States 
of North Carolina and South Carolina in guarding troops against 
acquiring venereal disease* it was requested that each soldier 
contracting venereal disease in the Carolina Maneuver Area be 
questioned by the medical officer attending him* use being made 
of the subjoined questionnaire® When completed* the report was to 
be mailed to the Office of the Surgeon* First Army. The reports 
were then turned over to the appropriate representative of the 
State Board of Health for further action. 
VENEREAL DISEASE QUESTIONNAIRE 
Bach soldier who has contracted venereal disease will be asked to 
answer the questions belows 
Identity of Sex Contact 
N ame o®..............';..............N ic kname oo®*®.®®®®®®®.®®®.®®©®® 
Address® o. 
Descriptions Color®.........Age........ Height®.......Weight®00® 0 
Complexion®.e®®®.®......®.Hair ®..o......Eyeso ® ®.® ®. 
Identifying scars* birthmarks* or tattoo marks®.®.® 
Where do you think she can be located®o...®*®.....®.......®.....® 
Contact Data 
Time of sex contacts Date....*.... Hour*... •.Place....«0 o 
Was woman working at a house of prostitution?..® * © o Address* •«• . * 0 o 
Was woman pickup^?oo®ooo«*>oe...oe.o.........If so* wheres 
On street® . ®... ® ...... ®..« Where? 
Automobilec ® ®....... . Where?...... * 
Bar or tavern®..........so.....®.®.Name and location®«® 
Dance Halldo.®®®.®.®®....®........®Name and location®®. 
Tourist camp®co®®..®®®*®®®®........Name and location.«. 
26 Was she working at bar or tavern* dance hall* etc.?••••••o•••••• • 
Kind of worko . ® 0 „ ®. 
Was woman a local residentso®®®®®®©Address®e®.®.®®®.®®®.®®®.*®®®® 
Was woman a transient?©0ooWhere is she staying?®.® 
Was there a "go between"?«•® ®If so* was he a taxi driver?® © ®««.. © 
Bellhop?.oo.bartender?®• «•<>«•• 
waiter?.•0••other? 
Identity of "go between"s give name or description* and place 
where he works - name of taxi company* hotel* bar* 
tavern* etc. 
Name of your organization; Company..........Regiment®c©®®.®©..©© 
Branch of Service. 
c. As a morale measure* four recreation areas were 
created by the First Armyo These areas included the principal 
cities in North and South Carolina within reasonable distances 
from the maneuver area. An area was assigned to each of the 
three army corps of -the First Array; the fourth was assigned to 
First Army Troopso Permitting soldiers to visit relatively dis- 
tant towns in these recreation areas over the weekend raised the 
question of emergency medical care for them and the prevention of 
venereal disease among them0 With respect to the army corps., the 
problem was not a great one* for divisional troops were convoyed 
to the towns in large organized groups which contained essential 
Medical Department personnel and equipmento This was not true in 
so far as First Army troops were cone erne do These troops,, number- 
ing approximately 44-jOOO* were not organized into controlled groups 
for weekend purposeso Consequently* instead of having Medical De- 
partment personnel and equipment accompanying them on weekend visits* 
independent preparations were necessary to provide emergency medi- 
cal care and venereal prophylactic measureso The principal towns 
in the First Army tpoqps recreation area comprised Burlington* 
Durham* Fayetteville* Hamlet* Laurinburg* Raleigh* Rockingham* and 
Sanford* all in the State of North Carolinao Fort Bragg maintained 
permanently established venereal prophylactic stations in Fayette- 
ville and Raleigh® To the remaining towns details from the 16th 
Medical Regiment were sent each Saturday morning* there to set up 
and maintain until Sunday night appropriate facilities for first 
aid and venereal prophylaxis for troops visiting the townso In- 
formation covering these matters was promulgated from First Army 
Headquarterso 
do The program of the State Board of Health of North 
Carolina for the suppression of prostitution in the maneuver area 
encountered an insuperable barrier in the practically complete 
failure of the law enforcement officials to prosecute prostituteso 
Justices of the peace and judges refused to hold those actually 
caught in the act of prostitution unless the man with whom they 
27 were cohabiting appeared against them and produced definite evidence 
of the transfer of money. Houses of prostitution were placed off 
limits by the military, but circumventing the countless prostitutes 
who needed only an automobile and the wide open spaces was next to 
impossibleo CHAPTER II 
SANITATION 
lo Clothing; 
a0 During 1942 clothing for all troops under the 
jurisdiction of this command consisted of the regular authorized 
issue* 
be On 15 January 1943? 45*895 sweaters* wool* Oodo* 
knitted by the ARC were allocated for issue to units of this com- 
mand by the War Department* These were distributed throughout 
the command and proved of material value to the comfort of the 
troops during the winter of 1943° 
Co Because of the tactical mission of certain troops 
assigned to this command along the North Atlantic Coast requiring 
24 hour alert status and the severity of winter weather on sen- 
tries* observers* gun crews* etc.* overcoats* Parka type were 
authorized for 50% of enlisted personnel of fixed antiaircraft 
units located north of Boston* 21 July 1943® This authorization 
was extended to include 50$ of strength of tactical units located 
in all harbor defenses north of and to include the Harbor Defenses 
of New York on 4 January 1945o 
do During April 1944* attempts were made to procure 
the new test type summer* uniform* consisting of the khaki shirt 
with sport collar and short sleeves* and khaki shorts and knee- 
length woolen olive-drab socks for troops stationed at Key West* 
Florida* This request was unfavorably considered by the Secre- 
tary of War due to unsatisfactory conditions developed during the 
experimental stage* among which were the prevalence of insect 
bites on that portion of the leg between the top of the sock and 
the bottom of the shorts* 
e* Other than the above* clothing for Eastern Defense 
Command troops consisted of those authorized by unit T/0 & Eau 
20 Housing ? 
a* Troops of Eastern Theater of Operations and First 
Army and after March 1942* Eastern Defense Command and First 
Arrays stationed at points north of the Garolinas were all housed 
in buildings* either at fixed posts or* as in the case of some 
combat team units* in leased buildings or in hutments erected at 
strategically situated locations* Some units stationed south of 
29 the Carolines were housed in tentso Housing problems during this 
period of expansion consisted principally of getting the construe-* 
tion work accomplished fast enough.. In order to speed up construc- 
tion* this command was authorized to order emergency construction 
direct from the District Engineers not to exceed $2C*000 per project®, 
bo At this time also the Antiaircraft Command expanded 
and extended their installations in small detachments all around 
industrial centers along the coasto Special combination type hut- 
ments were designed and constructed in isolated areas where build- 
ings could not be leased and where only small detachments had to 
be housed• 
Co Environmental conditions* during and immediately 
following this emergency construction* were extremely unfavorable 
due to mud* inaccessability of gun positions and hutments* loca- 
tions near swamps* dumps* etco* necessitated by strategic, position 
of the gunso Because of the above* much care was exercised locally 
by unit personnel and supervised by Medical officers in an effort 
to reduce health hazards from exposure* insects and rodents0 Water 
in many cases had to be hauled in with the rationso 
do As a result of an increase in respiratory diseases 
that occurred during the latter part of 1942 and reached a peak of 
389 per 1000 per annum during the second week in 1943* a study was 
made of the reduced floor space allowance per bed per man as set 
down in letter* WD AGO file 600ol2 (9“2l~42)0B-S-SPNC“M. subject: 
’’Reduced Space Allowances at Posts* Gamps* and/or Air Force Sta- 
tions”* dated October 21* 1942o 
e0 This study revealed that a reduction of bed space 
below 60 square feet per man inevitably resulted in an increased 
incidence and spread of respiratory diseases with consequent in- 
crease in noneffectives and deaths from disease., A directive was 
issued to units of this command to the effect that* where shortage 
of critical materials or lack of space necessitates* the provisions 
of the letter cited above would be followed® However* commanders 
would take all possible steps to relieve crowding of troops in 
sleeping quarters in order to avoid a future epidemic of respira- 
tory diseaseso 
f0 Since September 1943 when the First Army was physically 
separated from the command* there have been no particular housing 
problems. Since the above date the Eastern Defense Command has been 
periodically reduced in strength making the necessity for new con- 
struction unnecessary® Housing for; troops of the Eastern Defense 
Command consisted of permanent barracks* T/0 semipermanent barracks* 
temporary barracks* hutments and* in the case of the Antiaircraft 
Artillery Command* from Newport mansions and stables to space 
adopted in the pier towers of drawbridges®. In general* all housing 
is adequate and satisfactory,. 
30 3° Food & Nutritions 
a0 Eastern Defense Command troops in Continental United 
States have received the Army Field Ration except when on maneuvers 
or field problems at which time Cj D or K rations were used for 
training purposeso The adequacy of the diet consumed by all troops 
has been satisfactory and the nutritional state of the troops is 
excellento 
bo During First Arny Maneuvers in 1941$ an instance of 
acute food poisoning occurred in. the 9th Infantry Division which 
was considered sufficiently important to publicize to the commando 
In this case* ten officers riding in a truck drank some orangeade 
prepared in a new metal container several hours earlierc Shortly 
afterwards all officers experienced nausea* followed by vomiting 
and severe abdominal cramping painso These officers had acute* 
chemical gastroenteritis* ultimately traced to the orangeade 
made in a container labelled 5!Hot Aervoid Gold* Food or Liquid 
Carrier* Vacuum Can Company* Chicago* Illinois®,f While the inner 
pan of this item was purportedly made of nontoxic metal* the outer 
container* used in the preparation of the beverage* was plated 
with cadmium* a toxic metal readily soluble in acid fruit juiceso 
Hence while the use of the outer container violated the manufac- 
turers instructions* it was felt that the requirements of night 
feeding in blackout surroundings* the frequent changes in person- 
nel and inability to read directions in the darkness, all operated 
to prohibit the use of such containerso In addition to outlawing 
this particular item* troops were also cautioned regarding the 
danger incident to the us© of all metal containers* especially 
zinc-plated containers* for the preparation of acid beverages such 
as lemonadeo This warning was again circulated to all units of 
the command in May of this year* and a similar directive is con- 
tained in the current WD Circular 138® 
Co In January 1944* an outbreak of food poisoning 
occurred among personnel of the 540th AAA AW Bn* Quonset Point* 
Rhode Island* but this instance was traced to a violation of 
rules for proper preparation and serving of foodo The causative 
organism was staphylococcus aureus* occurring in bread pudding 
left standing overnight* unrefrigarated and uncoveredo Unit sur- 
geons were directed to make pertinent recommendations to their 
commanding officers in order that mess personnel might be kept 
currently instructed and alert to the sanitary principles of 
proper mess management® 
d® Following First Army maneuvers* the only difficulties 
that arose were in units and detachments at outposts along the 
coast and these were gradually solved® One of these problems was 
the loss of milk from damaged paraffined cardboard quart containers 
31 that were improperly handled and hauled long distances to outpostso 
This situation was corrected* where necessary* by using bottled milko 
eo At one outpost contaminated milk was found0 The milk 
at this outpost was being supplied in /fO-quart containerso Possible 
sources of the contamination werei rusty cover on the container* 
dipping utensils* carelessness and/or contamination caused by per- 
sonnel handling the milk* returning milk to the can* length of time 
from pasteurization to consumption* transportation under question- 
able refrigerationo Authority was denied to purchase bottled milk 
at that timeo Instruction in the proper handling of milk to pre- 
vent contamination was given to all personnel having occasion to 
handle this milk and the situation was correctedo 
f0 During June 194-3 this headquarters received author- 
ity from the War Department to increase specific components of the 
ration by not more than 10$ for messes of fifteen men or lesso 
With this increase it was still very difficult for battalion* regi- 
mental and battery agencies to break down the ration so as to 
supply a sufficient amount of food to small detachments located at 
outposts along the coasto As a result of the difficulty encountered* 
special short courses were established at Fort Jay* NoYo* to tra5.n 
ten (10) cooks and five (5) mess sergeants monthly in the economical 
and equitable breakdown of rations and in meat boning and trimming 
for 15-man messes0 
go Periodic Inspections of organizations under the 
jurisdiction of this headquarters disclose that much attention is 
given to the care and preparation of foodo Storage* handling and 
serving of food has been satisfactoryo Through pertinent War De- 
partment directives and instructions issued by this headquarters* 
all elements of the command have been informed concerning conserva- 
tion of foodo 
4° Personal Hygiene: 
ar In view of the tactical mission of this command* 
with many troops located in isolated outposts and undergoing physi- 
cal hardships* emphasis has been placed upon individual aspects of 
Personal Hygiene and Preventive Medicine and Physical Conditioningo 
This phase of training has received special attention through 
training directives* supervision and inspections. The following 
Training Memorandum #13* dated 20 December 1943* was initiated by 
this office and provided for a m5 nimum of 1 hour per week to be 
utilized in instruction on subjects pertaining to the health of 
the individual. 
32 M HEADQUARTERS 
EASTERN DEFENSE COMMAND 
Governors Island* New York Us N0Y0 
20 December 1943 o 
TRAINING MEMORANDUM 
NUMBER 13 
TRAINING OF ENLISTED PERSONNEL IN PERSONAL HYGIENE 
AND PREVENTIVE MEDICINE 
Reference:- Training Directive 1-A3* Par* 5a (2) 
dated 2G March 194-3° 
lo PURPOSES- In order to maintain the health of 
troops in the highest possible states it is essen- 
tial that each individual have a thorough knowledge 
and understanding of all measures available to him 
to prevent disease or injury and to alleviate the 
suffering and complications arising therefrom* Re- 
cent inspections have demonstrated deficient train- 
ing in First Aid; for example (l) methods of control 
of bleeding* and (2) the contents and use of the 
First Aid Packet* It is particularly important to 
stress the fundamentals of personal hygiene* preven- 
tive medicine* and field sanitation as pertaining to 
the individual* not only as related to the present 
situation but with a view towards future develop- 
ments o This training assumes greater importance as 
American troops* in increasing numbers* are being 
exposed to more and new diseases from all over the 
world* It is believed further that this latter 
subject* if properly handled* will vary the monotony 
of routine training programs* 
20 SCOPE:- Training shall consist of a minimum of 
one (l) hour per week* and include such personnel as 
may be designated by the commanding officerso It is 
desired that a carefully planned* coherent* and pro- 
gressive program be outlined to include all phases of 
personal hygiene* applicable phases of preventive 
medicine* field sanitation* first aid* venereal dis- 
ease control* and any other subjects pertaining to the 
health of the individual* 
33 3o GENERAL INSTRUCTIONS:” aQ The unit surgeon* through 
normal command channels* will either conduct the training 
or designate suitably qualified personnel therefore and 
exercise the necessary supervision thereofo 
bo Subjects will be repeated as necessary to 
insure that all will receive this instruction 
Co Local Medical Department personnel will be 
used as instructors wherever They will: 
(1) Exercise originality and avoid "canned” 
or '’bottled” text book lectures as far as possibleo 
(2) Make full use of training films and 
other training aids® 
(3) Utilize "demonstration and application" 
wherever feasibleo 
(4) Use layman's language0 
(5) Avoid crowding too much into one 
lecture*. It is far better to thoroughly establish 
one principle or procedure* than to mention many 
which may be immediately confused and forgotten,. 
(6) Encourage questions and allow an 
ample period for discuss 5.on at the end of each classo 
(7) Stress the care observed by the 
Army in the selection and preparation of food* to 
provide a well-balanced diet* and to insure against 
the dangers of food contamination or spoilages*. 
(8) Emphasize particularly the necessity 
for the early reporting of any illness to a medical offi- 
cer in order to avoid additional opportunities for in- 
fecting others and prolonged hospitalization of the in- 
dividualo 
Uo REFERENCES s 
PERSONAL HYGIENE 
* FIELD SANITATION 
Nature & Control 
of Communicable 
Chapter 
9 
FM 21 <=10 
FM 8-4-0 
Diseases 
Prevention of 
Respiratory Dis- 
Chapter 
2 
FM 21-10 
eases 
Chapter 
3 
FM 21-10 PERSONAL HYGIENE—FIELD SANITATION (Continued) 
Prevention of Intestinal Dis- 
eases and Sterilization of 
Water Chapter 4 FM 21-10 
Prevention of Insect Borne 
Diseases Chapter 5 FM 21-10 
FIRST AID FM 21-11 
First Aid Chapter 10 FM 21-10 
First Aid TM 8-220 
Splints* Appliances & Bandages FM 8-50 
VENEREAL DISEASE CONTROL AR 4.0-210 
Venereal Disease Control Chapter 6 FM 21-10 
Venereal Disease Control Section 6 
Chapter 5 TM 8-220 
Venereal Disease Control Pertinent WD Circulars 
and LetterSo 
By command of Lieutent General GRUNERTs” 
« 
bo The training directive for 1944 for units of this command 
provided for a minimum o£ two (2) hours weekly training for all 
personnel until individuals and units attain the standards of pro- 
ficiency set forth in WD Circular Noo 48* 3 February 1944o There-= 
after a continuing health education program insures the maintenance 
of this proficiency* 
Co On 6 September 1944 all EDC units were directed to include 
in their training programs Instructions pertaining to the preven- 
tion of Trench Foot in accordance with the provisions of Section 
IV, WD Circular Noo 312* 22 July 1944° 
do Monthly physical examinations are conducted for all 
troops of this commando 
5o Waters 
a» Water purification in the field has been discussed in 
Section I Maneuver Experienceo Just prior to this period* in 1941* 
First Army Headquarters received notice from the Office of the 
Chief of Engineers* Washington* DoC** to the effect that the stor- 
age or transportation of drinking water in containers that had 
previously contained gasoline constituted a considerable health 
hazzard due to the highly toxic residue of lead remaining in the 
35 canso Inasmuch as no reliable method of cleaning these cans was 
known, a directive was issued to all troops prohibiting the use of 
such contaminated containers for transporting water0 As a further 
precaution to differentiate between the almost identical 5-gallon 
water and gasoline cans** a system of marking the water cans with 
orange-yellow paint was adopted which proved quite satisfactory0 
bo It was also noted that when water was allowed to 
stand in the new type five gallon water cans for several days* an 
exothermic chemical reaction appeared to take place which caused a 
sediment to form in the cans* the quantity of which was considered 
detrimental to healtho Analysis conducted by the Amy Medical Center 
and the Station Hospital* Fort Bragg* NoC©* indicated that when 
water was added to the cans* a very minute amount of zinc was dis- 
solved* not only by chlorinated water but also by distilled water* 
thus causing large amounts of calcium and magnesium precipitates 
from the hard water© The chalky white coating inside the containers 
was made up of zinc carbonate and zinc oxide© Both of these condi- 
tions combined to produce a metallic zinc taste and to create a 
milky* unpalatable appearance of the water which rendered it far 
from appetizing© This problem was alleviated by advising troops to 
thoroughly rinse the cans before filling and to irrcert and drain 
the water cans when emptied© 
e0 At outposts, water has been obtained from many and 
varied sources and is chlorinated before use© Mien First Army 
troops were in the field in 1941, instructions were issued directing 
the chlorination of all water drawn from distributing points, by the 
use of ampoules of calcium hypochlorite in sterilizing bags© 
d© For Eastern Defense Command troops within Continental 
United States located on permanent posts, water supply has been a 
service command function and has presented no problem with the ex- 
ception of an incident at Fort Story, Virginia© In the summer of 
3.944, a serious health hazard existed at that post and its envi- 
rons due to inadequate water supply for summer needs, together with 
the possibility of gross contamination of water due to back siphon- 
age of sewage when the water dropped below a critical levelo This 
matter was brought to the attention of both the civilian authori- 
ties and the higher military echelons of Command, including Third 
Service Command, Southeastern Sector, and the. Fifth Naval District© 
After consultation with the Sanitation Officer, Station Hospital, 
Fort Story, Va©, it was determined that this scarcity of water was 
due to two causesg 
(1) The summer drought 
(2) The excessive number of military personnel* 
especially Naval enlisted personnel who visited Virginia Beach on 
liberty and overtaxed .its water facilities© 
36 e. Pending the completion of a new 20-inch water main# a 
number of expedient measures were adopted to temporarily solve this 
sanitary problem® It was determined to declare Virginia Beach and 
its environs off limits to all military personnel# thus building up 
a sufficient reserve to provide water pressure adequate to enable 
all latrine facilities to function properly® Close plant supervi- 
sion by the town was carried out# concurrent with the adoption of a 
water conservation program. Typhoid immunizations were offered to 
all dependents of military personnel and boiling of water was recom- 
mended as a temporary measure to all concerned. 
f0 All installations under the jurisdiction of this 
command submit specimens of drinking water to the appropriate mili- 
tary laboratory for bacteriological examination as required by Army 
Regulations and letter this headquarters* file 671 (Surg)* subjects 
"Bacteriological Examination cf Water*1’ dated 4- January 1944>» This 
procedure is required routinely each month or at more frequent in- 
tervals when indicated. 
6« Disposal of Waste: 
a. Mess sanitation including waste disposal within the 
command has been continuously followed through inspections and ap- 
propriate directives* and has been satisfactory® 
b» The provisions of the following letter concerning mess 
sanitation have been complied with satisfactorily within this commando 
HEADQUARTERS 
EASTERN DEFENSE COMMAND AND FIRST ARMY 
OFFICE OF THE SURGEON 
720 x 72105 
Governors Island* N®Y0 
April 12# 190 
Subject: Common Diarrhea and Dysentery Control. 
To s Surgeons of Field Force Units* Eastern Defense 
Command and First Army. 
1® The health record cf the Eastern Defense Command 
and First Army has been relatively excellent and the ener- 
getic efforts of the unit surgeons in the field of proven- 
tive medicine have been very comendable. 
2c Unit surgeons are expected to be particularly 
watchful* in the forthcoming seasons* in order to prevent 
inexcusable outbreaks of common diarrhea* amoebic or 
bacillary dysentery* 
37 3o Alert* careful* unexpected sanitary inspections 
and prompt* corrective recommendations will insure that: 
a.» The water source is protected* periodic 
water samples are checked bacteriologically* chlorina- 
tion where needed is adequate and that water is always 
potable* 
bo The food* mess halls and latrines are 
thoroughly policed and screened at all times* and that 
the site of latrines in relation to mess halls conforms 
with Army Regulations* 
Co An adequate early fly control program will 
be initiated to eliminate or fly proof fly breeding focal 
sites such as manure and compost heaps* dumps* open pit 
latrines* etc* Screens* fly paper* fly swatters* fly 
sprays and fly traps will be used early and continuously 
during the fly seasono 
do Kitchen personnel will be held strictly 
accountable for their share of fly control responsibility0 
e« Food handlers will be trained in the impor- 
tant simple hygienic habits and will maintain proper 
cleanliness of person and dresso• Cleanliness of hands* 
nails and freedom from skin infections and acute upper 
respiratory infections will be particularly stressedo 
fo Food spoilage will be avoided by proper 
menu planning* adequate refrigeration and by not re- 
taining leftovers too long* Meats and salads will not 
be prepared more then four (4.) hours prior to serving* 
Ground meats* egg* mayonnaise and cheese spreads will 
not be used as sandwich fillers unless prepared just 
prior to consumption* Shallow pans only will be used 
for storage of these foods in the refrigerator* 
g* Dishes and mess gear will be properly 
washed* sterilized by the proper use of boiling water 
or chlorination and air dried® 
ho Proper policing and disposal of garbage 
and wastes will be attended to promptly* Garbage cans 
will have tightly fitting covers* will not be overfilled 
and* when emptied* will be thoroughly scrubbed* 
38 io Diarrhea or dysentery cases will be 
promptly segregated and studied as to type and source 
of infection or dietary indiscretion* Civilian sources 
of these conditions, if necessary, will be promptly 
recommended for posting as "off limitso" 
For the Surgeon: 
Co Sewage disposal has presented no problems and has 
been satisfactory. 
# 
d® Garbage disposal has consisted of many means® Edible 
garbage is usually handled by civilian contract, or in some in- 
stances has been disposed of along with unedible garbage by incinera- 
tion. More recently burial at a sanitary fill has replaced incinera- 
tion at some stations. 
7. Control of Insects: 
a. Flies; 
(1) The early institution of a Fly Control Program 
as directed in letter Headquarters Eastern Defense Command and 
First Army, subject: "Common Diarrhea and Dysentery Control," 
dated 12 April 194-3 and its continued prosecution made the pres- 
ence of excessive numbers of flies at installations of this command 
an infrequent occurrence. 
(2) Another fly and mosquito control program, 
inaugurated in all organizations of this, command during March 1944-, 
aided materially in eliminating excessive numbers of flies and other 
pests and disease-bearing insectso 
(3) During an inspection of units located in the 
southeastern portion of the United States in the Summer of 194-4-5 
screening was found generally to be inadequate. A campaign was 
recommended and publicized throughout the command to stimulate in- 
terest in this direction and to encourage repairs by camp personnel, 
rather than to call upon engineers for minor projects. Considerable 
improvement was noted on subsequent inspections. 
bo Mosquitoes: 
(l) During 194-2 drainage and oiling about fixed posts 
was carried out by service commands. It was not considered feasible 
to undertake extensive anticosquito measures for the protection of 
troops of the combat teams at the many small outposts along the 
shore. By virtue of the mission of the Eastern Defense Command, 
the largest proportion of the assigned troops have been stationed 
39 along the coastal waters and mosquitoes have continually constituted a 
seasonal nuisance. Although the incidence of malaria has continued to 
be low within this commands, there was one significant outbreak which 
occurred during the Summer of 194-3 in the vicinity of Georgetown* So Co 
Four cases of malaria appeared within one small unit simultaneously0 
Three of these were of the Estivo-autumnal type and one of the benign 
tertian variety. Malaria in this area is endemic (194-1 survey showed 
positive smears) and the Anopheles Quadrinacmlatus and Anopheles 
Crucians are prevalent The proximity of the military outpost tp un- 
screened negro dwellings and outhouses* where Anopheles Quadrimacpla- 
tus were trapped repeatedly* indicated a probable reservoir. Requests 
for antimalaria measures were directed to both the State Health author- 
ities and the respective service command* and individual antimalaria 
discipline was enforcedo No new cases have subsequently appeared in 
this area. The following letter was initiated and pertinent informa- 
tion obtained was forwarded to the U0 S. Public Health Service and 
respective service commands: 
HEADQUARTERS 
EASTERN DEFENSE COMMAND AND FIRST ARMY 
Governors Island* New York J+9 NoYo 
725oll 
(Surg) 
4 September 1943 
Subject: Disease Bearing Mosquitoes 
To : Commanders* All Units* EDO and First Army 
lo The disease bearing mosquitoes of malaria* y«llo* 
fever* filariasis and dengue are assuming an increasing Im- 
portance at this time of rapid transportations* widespread 
transfer of personnel* return of sick and wounded and global 
importation of prisoners of warQ 
20 In view of the above* it is desired that unit 
commanders submit recommendations with survey data and 
area maps for effective mosquito control when in their 
opinion there is need for instituting control measures. 
Information as to types of trapped mosquitoes will be 
noted and forwarded. 
command of Lieutenant General DRUM: 
/s/ Co Z. Shugart 
/t/ Ce Z0 SHUGART 
Colonel* Ao Go D.* 
Adjutant Generalo (2) During 1944- all cases of malaria which occurred 
in this command were recurrences of malaria in troops returned from 
foreign duty. Such cases were promptly hospitalized for treatment 
and assigned to organizations in localities where the anopheles 
mosquitoes are either absent or present in small numbers. 
(3) Early in 1944 an excessive number of anopheles 
mosquitoes* as well as excessive numbers of the pestiferous varie- 
ties* were discovered in the area surrounding the 21st Coast Artil- 
lery camp at Camp May Point* New Jersey. In view of the above and 
the fact that men with past histories of having had malaria were 
assigned to this camp from overseas stations* an active antimalaria 
campaign was inaugurated. The local township was cooperative and 
expended considerable effort and money in draining the swampy areas 
in the vicinity of the camp. They stated* however* that it would 
be useless to go farther with the program unless the Army was will- 
ing to ditch the camp area which included a part of the offending 
marsh. As a result* the Army engineers made a survey and recom- 
mended an appropriation of approximately $10*000 to carry out the 
Army’s obligation in this enterprise. This money was appropriated 
but by June 1945 no work had begun. This delay is explained by 
labor shortage in the vicinity® As an additional precaution from 
a public relations and epidemiological viewpoint* those individuals 
at the camp with malaria histories were promptly transferred to 
anopheles-free areas within this command. 
(4) During the Summer of 1944 a request was received 
by this headquarters from an outpost* where mosquitoes were creat- 
ing a serious pest problem to the extent that efficiency and morale 
were impaired* for additional amounts of insecticide for use in 
barracks and mess hallSo This unit was receiving only one gallon 
per battery per month* however additional amounts were authorized* 
which was sufficient for their needs. 
(5) The training program for Malaria Control and 
Malaria Discipline* as outlined in WD Training Circular No® ICS* 
dated 21 September 1943 for all personnel* and the training of 
special details as directed in paragraph 3b* WD Circular No. 223* 
dated 21 September 1943 was completed throughout the Eastern De- 
fense Command by 15 December 1943* This phase of training was 
covered during 1944 in accordance with the provisions of WD Cir- 
cular No. 48* dated 3 February 1944® 
c® Ticks: 
Ticks are prevalent in many outpost areas. One 
case of Rocky Mountain Spotted Fever with ensuing death was re- 
ported from a unit stationed in a tick-infested area in Virginia 
in 1943. The clinical course of this case Indicated a highly 
virulent strain of Rickettsia. The following directive* dated 18 June was issued to all unit surgeons as a precautionary 
measureo The same directive was reissued on 9 May 1944-° 
This office desires that all unit surgeons recommend 
the following preventive procedures; 
(1) That details working in tick-infested areas 
be instructed how to avail themselves of protection by 
wearing the trouser legs of the fatigue uniform inside of 
socks (high; thick woolen socks* if available* with tops 
to be taped to trouser legs) and by snugging in the shoe 
tops* wrists and neckbando When available* the interposi- 
tion of strips of greased felt or other absorbent material 
at the neckband* wrists and shoe tops will give added pro- 
tection 
(2) That bodies and clothes be inspected at 
morning* noon and night* and bedding at morning and night* 
when in tick-infested areas* Attached ticks should be re- 
moved at once and without crushing them* When attached to 
the skin a lighted cigarette placed close to the tick will 
stimulate its voluntary withdrawal* 
(3) That tick bites should be immediately cauterized 
by; 
(a) Phenol* followed by alcohol - 
(b) or by a silver nitrate sticko 
For the Surgeons 
do Fleas; 
(l) On 7 October 194-3 one (l) case of endemic typhus 
fever occurred within a unit of this command stationed at Stoney 
Field* Charleston* South Carolina* Since typhus fever was endemic 
in the entire Charleston area* the source of infection may not 
necessarily have been from this camp site* However* the following 
control measures were instituted; 
(a) No food was to be left in any of the hutments* 
(b) Company carpenters repaired all screen doors 
in order that they fit properly* 
(c) All coal bins* which were present in the 
floors of each hutment* were cleaned out and sealed permanently* 
(d) Dirt was banked around the edge of each 
hutment as a temporary measure® 
(e; The mattresses and bed clothing of all personnel 
in the hutment in which the case of typhus fever occurred were disinfected* A project was completed which consisted of the raising of all hutments 
from 12 to 14 inches off the ground to prevent harboring of rats® The 
immediate contacts of this disease case were examined and no further 
evidence of infection was found. 
(2) Thirty-four cases of endemic typhus occurred 
during July and August 1944 among the civilian population in 
Wilson County* North Carolina. Since troops of this command were 
stationed adjacent to this area an investigation was made from 
which it was learned that the State of North Carolina maintains a 
permanent rat-control program® In view of the number of cases in- 
volved* Wilson County ran an intensive rat-control program* using 
the services of professional exterminators and supplying poison 
and baits to private individuals. 
e0 Cockroaches and Bedbugs? 
(1) Neither cockroaches nor bedbugs have been a 
serious problem* control being accomplished by insistence upon ex- 
cellent sanitation of buildings* messes* etc.* and through the use 
of appropriate insecticides as outlined in current WD instructions. 
(2) When fumigation of buildings* occupied by Eastern 
Defense Command troops* is deemed advisable this headquarters as a 
safety precaution has directed that certificates be obtained from 
the appropriate medical officer as to the necessity for fumigation 
as well as the time it may be safely reoccupied after such fumiga- 
tion. The fumigation is done by trained personnel and a guard is 
maintained until the building being fumigated can be safely reoccu- 
pied. 
fc Control of Rodents: 
Within Continental U. S. rodents have presented no 
particular problem and their control has been a function of service 
commands where troops have been located on permanent posts* camps 
or stations. At outposts this phase of sanitation has been no 
problem primarily because of the application of strict sanitary 
measures® 
43 CHAPTER III 
SANITARY ENGINEERING 
lo Experienced Sanitary Corps engineers were made available 
for assignment to this command by WD AGO Ltr* File AG 2l0o31 (lS 
Sept 4.3) PO-A* Subject: “Assignment of Medical Department* Sani- 
tary Corps Sanitary Engineer Officers**1 dated 19 October 1943° In 
order to conserve trained Medical Department officer personnel and 
in view of the fact that the majority of EDC troops were located 
on or near service command posts* camps or stations* the following 
self-explanatory letter was sent to the commanding generals of each 
of the first four service commandso 
721 (Surg) 
4 December 1943 
Subject: Inspections by Sanitary Engineerso 
To : Commanding General* Service Command 
lo It is understood that Sanitary Corps officers* 
trained in different phases of sanitary engineering* 
have been assigned to the medical sections of the vari- 
ous service commands to furnish service as consultants in 
sanitary engineering problems to commanding officers and 
medical officers under your jurisdiction® It is further 
understood that they make routine sanitary inspections 
regarding water supplies; sewage and garbage disposal 
plants; mosquito* rodent and insect control; camp site 
surveys* and upon request* instruct officers and en- 
listed men in field sanitationo 
20 The question of assigning Sanitary Corps officers 
to this headquarters to provide this special feature for 
Eastern Defense Command troops* has been under considera- 
tion* since it is felt that troops housed in temporary 
quarters* or in the field* would be equally benefited 
such serviceSo It would appear* however* that since such 
such officers are now assigned to service commands* a du- 
plication of activities might be avoided and a conserva- 
tion of personnel effected* if Eastern Defense Command 
units were included in such inspections by your personnelo 
Further details could be arranged by the Surgeons* Eastern 
Defense Command and the Service Commando 
3o If such action appears practicable and meets your 
approval* a list of stations under the jurisdiction of this 
headquarters* within the geographical limits of your command* 
44 will be furnished you to be included in the current 
itinerary for inspections by sanitary engineers from 
your headquarters. Provided you concur* it is re- 
quested that the reports made by these inspecting 
officers be submitted to the commanding officers of 
the units concerned* to be forwarded by indorsement 
through channels to this headquarters* and that in- 
formational copies be sent direct to this headquarters 
in order that the Surgeon of this command may have 
prompt information concerning any irregularities that 
may be noted. 
4-* Routine medical Inspections of Eastern 
Defense Command units have been and will continue to 
be made by the respective unit and sector surgeons* 
the surgeon AAA command and by officers of the Office 
of the Surgeon* this commando 
For the Commanding General; 
/s/ E. Bogaski* 
/t/ E. BOGASKA, 
Captain* A0G0D. 
• Asst® Adjutant General 
The following reply was received from the First Service 
Command which is similar to the replies received from the Second* 
Third and Fourth Service Commands; 
SPBSM 333.1 1st Ind. RNC/mpc 
U Dec 43) 
Headquarters First Service Command* Boston 15* Massachusetts. 
10 December 1943® 
TO; Commanding General* Eastern Defense Command* 
Governors Island* New York 
lo A plan similar to that described in the basic 
communication is now in effect in the First Service 
Command embracing various installations of the Eastern 
Defense Command. Inspections have been made under the 
authority of paragraph 6 a(5)(b) AR 170-10 and reports 
in all cases have been made to the commanding officers 
of the installations® This work has been carried out 
in close cooperation with the New England Sector® 
2. To insure coverage of all installations* the 
First Service Command has been divided into 13 districts* 
in each of which there is at least one sanitary corps engineer. This engineer is required to inspect all Army 
installations within his district* regardless of what 
class the installation may be. He is stationed at the 
same place as the post engineer who provides utilities 
services for the identical district* so as to facilitate 
communication between the inspector and the engineer,, 
3* It is desired to cooperate fully with the 
Eastern Defense Command in such work® It is noted that 
a list of stations will be provided by Headquarters 
Eastern Defense Command* and this list will be broken 
down at this headquarters for transmittal to the post 
sanitary officers involved. It is also noted that it is 
desired that reports of inspecting officers be submitted 
to the commanding officers of units concerned* and that 
information copies be sent direct to Headquarters Eastern 
Defense Command. This practice will be put into effect 
immediately upon receipt of the list of installations. 
For the Commanding General: 
/s/ Robert N. Clark 
/t/ ROBERT N. CLARK 
Major* Sanitary Corps 
Chief* Sanitary Section* 
Medical Branch 
20 Prior to the above action* problems concerning Sanitary 
Engineering had been handled by Medical Corps personnel assigned to 
this command and these services were furnished by service commands 
by special request in a few instances® 
3® The arrangement outlined in paragraph 1 above has functioned 
satisfactorily for 2 years and remains in effect. By early 1945 all 
Eastern Defense Command troops within the continental confines of 
the United States were stationed on permanent posts* thus eliminating 
the problems relating to sanitation at outposts. It is felt that a 
duplication of activities has been avoided and a definite conserva- 
tion of personnel and travel has been effected® CHAPTER IV 
EPIDEMIOLOGY AND COMMUNICABLEDISEASE CONTROL 
1* Immunization: 
a. Immunization of Eastern Defense Command troops stationed 
within Continental United States has been routine and in accordance 
with War Department directives. 
bo Special immunizations are not required routinely and 
are only given to units alerted for overseas duty and then in ac- 
cordance with special instructions as contained in warning or move- 
ment orders. Individual replacements for overseas duty receive im- 
munizations as directed in their orders and as prescribed in POE. 
2m Intestinal Infections? 
The incidence of diarrheal diseases has always been and 
continues to be low within this command* however* an occasional out- 
break of diarrhea does occur. Strict sanitary inspections and meas- 
ures have been enforced throughout the command to the effect that 
mess personnel are kept currently instructed and alerted to the actual 
practice and use of the sanitary principles necessary for proper mess 
management. In this connection see Letter* Headquarters Eastern De- 
fense Command & First Army* File 72C X 721.5* subject: "Common Di- 
arrhea and Disentery Control*" dated 12 April 1943 which is repro- 
duced in Section I* under (paragraph 6) subject: "Disposal of 
Waste.” 
3® Infections of the Respiratory Tract and Infection Transmitted 
Discharges from the Respiratory Tract: 
a. The influenza epidemic during the early winter of 
1943* although not of serious proportion in this command* stimulated 
the publication of the following directive with the intent of empha- 
sizing preventive measures in the control of Acute Upper Respiratory 
Diseases. 
HEADQUARTERS 
EASTERN DEFENSE COMMAND 
710 
(Surg) 
Governors Island* New York X* NoY. 
18 December 19X3° 
Subject: Acute Upper Respiratory Diseases. 
To: s Antiaircraft Artillery Command* Base Commands* 
Military District of Washington* Sector* Sub-- 
sector* Harbor Defense* Brigade and Separate 
Unit CommandSo lo The need for stringent application of preventive 
measures against acute upper respiratory diseases is em- 
phasized by the present "grippe" epidemic® This epidemic 
is not the "influenza of 1918*" but its potential for 
creating noneffectives is great® Therefore the following 
preventive measures are reiterated and recommended for 
consideration at this times 
a. Early diagnosis and hospitalization. When 
hospital facilities are not available for all* the segre= 
gation of the mild quarter cases should be practicedo In 
the presence of a noteworthy increase in the incidence of 
upper respiratory diseases* a daily inspection of troops 
roster should be conductedo 
b. Any practical rearrangement to obtain maxi- 
mum bed spacing* use of head to foot sleeping* utiliza- 
tion of shelter halves to construct cubicles when indi- 
cated (Reference par® 17 a®(l)(b)* Chap® 2* FM 8-4-0)* 
proper airing of bedclothes* frequent routine checks for 
adequate ventilation* particularly at night® 
Co Daily inspection of food handlers for symp- 
toms of upper respiratory disease* their prompt removal 
when found infected* and strict compliance with proper 
sterilization and air drying of mess utensils® 
d® More widespread dissemination of knowledge 
among the troops as to how these upper respiratory dis- 
eases are spread* particularly by unmasked sneezing* 
coughing* careless spitting* the use of the common 
drinking cup* and transmission by hand contacts with 
nasal and mouth discharges® The importance of general 
sanitation and personal hygiene should be emphasized at 
this time® Attention is directed to the availability of 
training film 8-63* T®C® 116* dated 1 November 194-3* 
subject: "Housing and Control of Respiratory Diseases®" 
e® Avoidance of excessive fatigue and chilling* 
and pertinent modification* whenever feasible* of train- 
ing schedules for recruits during the current epidemic. 
f. Frequent inspections in order to insure the 
wearing of adequate clothing and footwear and the issue 
of suitable bedding. 
go Avoidance of crowding in public gatherings 
such as theaters during the presence of an epidemic of 
upper respiratory disease® h. Commissioned and noncommissioned officers 
should be delegated and held responsible for the en- 
forcement of these preventive measures. 
i. Under extreme circumstances the limiting or 
denying of passes to areas with a high incidence of res- 
piratory infectionso 
2. One of the common weaknesses of preventive 
medicine is to await actual involvement in an epidemic 
before strictly enforcing preventive measures. Prac- 
tically all of the above measures can be quietly and 
firmly enforced before such involvement* without in- 
terfering with any military objective. These measures* 
properly enforced* can be regarded as a definite bul- 
wark against the possibility of a majority of any com- 
mand becoming noneffectives at any one time due to acute 
uppfer respiratory diseases. 
command of Lieutenant General GRUNERT: 
/s/ L® V. Warner 
/t/ L® V® WARNER 
Colonel* AeG©De* 
Adjutant Generalo 
bo There was a marked reduction in the admission rate 
for the common respiratory diseases in 1944* the rate being 79 per 
1000 which represented a decrease of 85 per 1000 in the annual rate 
over 19-43o First indorsement to War Department letter* AG 710* 
Subject: "Measures to Prevent Epidemics of Respiratory Diseases*11 
dated 29 January 1944-j directed the attention of commanders of all 
grades to the fact that they are responsible for the enforcement 
of such preventive measures and that this responsibility may not 
be delegated® 
c. The admission rate for cerebrospinal fever for 1943 
was 0.750 per 1000 per annum* with a death rate of 0.043 per 1000 
per annum. They all represented sporadic cases. 
d. Four scattered cases of cerebrospinal fever occurred 
in this command during 1944 without fatality. 
4• Miscellaneous Infections: 
a. Following vaccination with yellow fever virus* an 
epidemic of jaundice occurred among the officers of this headquar- 
ters in 1942. This made an ideal group for study as regards the 
possible etiology and nature of the disease* As a result of this 
49 study* it was believed that the cause of this epidemic was due to 
Lot No. 368* yellow fever vaccine® Of the officers who received 
Lot No. 368* y.f.v. * 24*7$ developed jaundice and 32.4$ developed 
symptoms without clinical jaundice* a total of 57®1$. No officer 
who received another vaccine lot or who was unvaccinated* developed 
symptoms of jaundice. The symptoms and signs were those of ”catar- 
rhal” jaundice* and the majority of patients developed symptoms 
from 70 to 80 days following vaccination® Jaundice followed in an- 
other 11 days on the average* the incidence of both jaundice and 
symptoms being highest in the age group 51-60® There were no 
deaths and recovery was complete in all cases® 
b. In conclusion, it was felt that most likely the 
human serum used in the vaccine was responsible and that it was 
contaminated by the virus of infectious hepatitis® A detailed 
report of this study, dated 18 August 1942* was submitted to The 
Surgeon General® 
c. During April 1944* one (l) case of Weil’s disease 
occurred in a unit of this command stationed at Brunswick, Georgiac 
In view of the fact that this camp site was to be declared excess 
within a very short time, any project for the permanent rat-proof” 
ing of buildings was considered too expensive® Temporary rodent 
control measures were effected while troops remained at that 
stationo 
do Two cases of undulant fever were reported during 
194-3J a civilian source of infection was revealed in one case and 
the source of the other was undeterminedo 
e® During 1943 and 1944 technical medical activities were 
closely coordinated and correlated by the Surgeon* Eastern Defense 
Command* through liaison with Sector and Base Surgeons* to the 
respective unit surgeons® 
5® Sulfonamide Drugs; 
In order to prevent improper use of sulfonamide drugs in 
field units the following letter was issued; HEADQUARTERS 
EASTERN DEFENSE COMMAND 
OFFICE OF THE SURGEON 
Governors Islands New York 4, No Yo 
441 ol 
27 November 1943 
Subject: ( Use of Sulfonamide Drugs in Field Unitb® 
Tc i Medical and Dental All Unitsj 
Eastern Defense Command® 
lo In accord with the recommendations contained in 
Circular Letter No0 17* SoGoO®* dated 23 February 1942* 
it is desired to remind medical officers of this command 
of the limits to which the use of sulfonamide drugs in 
field installations are confinedo Indiscriminate use of 
this potentially dangerous drug must be avoidedo 
20 Every medical officer should be thoroughly 
familiar with the most recent circular letters of The 
Surgeon General’s Office relative to conditions in 
which sulfonamide drugs are used* and should be guided 
accordingly® Dehydration will be corrected before* and 
an adequate Intake of fluids assured during the thera- 
peutic administration of all sulfonamides® 
3° Without adequate laboratory control* the admin™ 
istration of sulfonamide drugs* Including topical appli- 
cations* in excessive dosage or over long periods of 
time or to individuals with previous history of diffi- 
culty in taking the drugs is contraindicated® Similarly* 
the internal use of sulfonamides in treating minor* self™ 
limiting diseases is not in accord with the policy of 
this commando When the internal use of a sulfonamide is 
indicated in dental cases* it will be given under the 
supervision of a medical officer® When the topical use 
of a sulfonamide powder is indicated* the powder should 
either be applied with an insufflator* when available* 
or lightly dusted over the cavity to avoid excessive 
caking with foreign body formation or interference with 
natural drainage® 
4® Adequate laboratory facilities for the control 
of the administration of sulfonamides is considered to 
mean having sufficient equipment for the daily perform- 
ance of blood counts* blood-level determinations of sul- 
fonamides and microscopic examination of the urine* if 
51 neededo Where adequate laboratory facilities are not 
available to the medical officer* the administration of 
sulfonamides* will be limited to the following instances! 
(a) When sulfathiazole as a preventive for 
gonorrhea is expressly authorized by this headquarters*. 
(b) When sulfadiazine is expressly authorized 
as a preventive for epidemic (meningococcic) meningitiso 
(Refer SoGoO* Circular Letter No* 170, 3C September 194-3°) 
(c) Where the treatment of gonorrhea op. a duty 
status is a policy of the service command in which the 
unit is locatedo 
(d) When indicated, in the judgment of the 
attending medical officer, pending transfer of the pa» 
tient to a hospital. 
5° Whenever the condition of a patient suffering 
from any ailment not listed under paragraph Us subpara= 
graphs a* b* c* is considered severe enough to indicate 
the internal use of sulfonamide drugs* that patient will 
be evacuated to the nearest available hospital facility 
serving the unit. 
60 Where not specifically covered in directives 
from The Surgeon General's Office or this headquarters, 
it is desired that Medical" Department officers assigned 
to EDC installations follow the general policies of the 
respective service command surgeons for the professional 
care of the sick and injuredo When any cogent reason 
arises that renders such action unwise for tactical units, 
it should be brought to the attention of this headquarters 
without delayo 
/s/ S. M. CCRBETT 
/t/ S. M. cgrbett. 
Colonel, Medical Corps, 
Surgeon* 
52 CHAPTER V 
VENEREAL DISEASE CONTROL 
1® An intensive analysis of all existing records relative to 
the incidence of venereal disease and the use of routine chemical 
prophylaxis was made during 194-2® Numerous graphs were prepared 
as indicators of current venereal disease trends for each subdivision 
of the Eastern Defense Command. Liaison was established with the 
Venereal Disease Control Officers of the service commands* the UoSo 
Public Health Service Districts* U.S® Naval Districts* and of most 
State Health Departments along the eastern seaboard® Over a score 
of regimental units within the command were visited specifically 
concerning venereal disease control. Educational data about the 
correct and incorrect techniques in using mechanical prophylaxis 
were distributed® These instructional data were amplified to in- 
elude individual chemical prophylaxis as well® Carefully con- 
trolled studies concerning the use of sulfathiazole as a prophy- 
laxis for gonorrhea were started and are being continued® A study 
was made among over ten thousand soldiers along the Atlantic sea- 
board relative to the proportion of enlisted personnel having non- 
marital sexual intercourse within a 28 day period* the use or non- 
use of each type and combination of prophylaxis* the proportion of 
time fees were paid and the correlation of these data to marital 
status and race® Following this* another more extensive survey was 
prepared to uncover additional facts and* insofar as possible* the 
motives and reasons for phenomena observed so that a more scienti- 
fic and effective program of venereal disease control might be for- 
mulated® Insofar as available data permitted* further analyses 
were made concerning the type of enlisted personnel* general and 
special environmental and other factors related to the venereal 
disease incidence rates in individual regiments and their subdivi- 
sions. Meetings were attended and assistance rendered in connec- 
tion with the special venereal disease problems existent in the 
State of Maine® A study of venereal disease problems in the coun- 
try of Newfoundland was started and certain practical remedial 
measures were instituted to help control the problem among our 
armed forces at that base® 
20 Throughout the year 194-3 the intensified program for 
control of venereal disease aided the command to maintain the slow 
but appreciable lowering of the general venereal disease rate® 
During the year 194-3 the highest monthly rate attained was 23 per 
1000 per annum* and in December 1943 the rate was 15,? 7 per 1000 per 
annum. The average rate for 1943 was 19®3 per 1000 per annum® 
This represents a decrease of 12®6% over the average rate for the 
previous year® 
53 3o New measures placed in operation during 194-3 were primarily 
designed to reach the individual rather than units as a whole® A 
training memorandum issued by this headquarters 28 September 194-3 
was forwarded to all units of this commando It provided for tn« 
training of at least one enlisted man from each detachment* platoon 
or position,? through a course of ten hours of prepared lectures 
demonstrationSo These trained venereal disease aides are to teach 
and advise all the men of their units individually or in small 
groups by encouraging discussions and correcting erroneous ideaso 
4.o In addition a directive was forwarded to units maintaining a 
higher rate than average for the commands expressing the desire that 
all men going on or returning from pass or furlough be interviewed 
with sex education in mindo 
5o A study of sulfathiazole as a prophylactic for gonorrhea 
was completed during 194-3° An analysis of over 500C cases was the 
basis of the report which proved the effectiveness of this new 
drug as a. prophylactic agent against gonorrhea® The study referred 
to above was published in The Bulletin of the U«,S0 Army Medical De-= 
partment* No0 78,? dated July 194-4* under the title "Sulfathiazole 
for the Prevention of Gonorrhea®" 
6® The problem of excessive incidence of the venereal disease 
in colored troops,® long a problem in the armed forces,? was given 
particular attention* and in several instances where the venereal 
disease rate was high* aggressive measures such as enumerated above 
were successful in reducing the rate to a satisfactory levelo 
7o The program of poster and literature distribution was 
maintained at a satisfactory level during the year 194-3 as well as 
the preparation and distribution of prophylactic station lists* sex 
education film lists* and lists of the sources of educational mate° 
rial for the control of venereal dlseaseso Frequent visits were 
made by the venereal disease control officer of this headquarters 
to 'units having excessive rates* as well as visits to communities 
adjacent to military installation of the commando The cooperation 
of civilian agencies* Federal and State Departments* and the Special 
Services Section of this headquarters* were most helpfulo Liaison 
with the various service commands* the Uo So Navy* and the Federal 
Security Agency was raaintainedo 
8o At the close of 1944- there existed two major problems in 
venereal disease control which were also problems of the entire 
Army and not confined only to the Eastern Defense Command® The 
first was the rising incidence of new syphilis cases concerning 
which much attention was given and it was hoped that the particular 
attention given to all men going on and returning from pass or fur- 
lough would help solve the problem® The second problem was the evolution of the duty status treatment of gonorrhea with sulfathia- 
zoleo It was then pointed out that the importance of this mode of 
treatment was threefold: (l) the maintenance of trained men on 
duty in the field; (2) the practical experience gained by medical 
officers who are expected to treat men for gonorrhea on a duty 
status under combat conditions in overseas theaters; and (3) in the 
freeing of hospital beds and personnel for other medical needs® 
9o During 1944 much emphasis was placed upon venereal 
disease control within the Eastern Defense Command® The average 
admission rate for venereal disease for 1944 was 16«6 per 1000 as 
compared with a rate of 19°3 per 1000 for 1943® This represents a 
decrease of approximately 14%® 
10® The venereal disease control officer was relieved from 
assignment to this headquarters by WD Special Orders No® 22* dated 
26 January at which time the Personnel* Plans and Training 
Officer was detailed as Venereal Disease Control Officer for this 
command in addition to his regular dutieSo 
11o In addition to control measures already in effect* the 
following control measures were instituted and stressed during 
1944 and 1945s 
a. Emphasis was placed upon the importance of obtaining 
complete* accurate and detailed information concerning the sources 
of venereal disease infection® A directive was issued to all units 
of this command on 10 June 1944 which required that an information 
copy of each completed WD AGO Form 8-148 (old MD Form 140) be fur- 
nished this office in order that corrections or suggestions might 
be recommended as necessary. The following detailed directive was 
issued to all unit surgeons* Eastern Defense Command* on 7 June 
1945* and offered a numbered of suggestions that should be considered 
in order that maximum results would be obtained when interviewing 
patients for contact information; 
1® Unit surgeons will be responsible for obtaining 
complete* accurate and detailed information concerning 
the sources of venereal disease infection® This infor- 
mation will be legibly recorded within twenty-four (24) 
hours of diagnosis on the contact history form (WD* AGO 
Form 8-148; old MD Form 140)» The completed form will 
be distributed according to instructions contained on 
the reverse side of the form® In addition* it is de- 
sired that copies of contact reports accompany the 
Weekly Statistical Health Report (WD* AGO Form 8-122; 
old MD Form 86ab) rendered to this office for all 
’’new” cases of venereal diseases recorded thereon® 20 Approximately 5C% of the contact reports that 
are received by state and local health department do not 
contain sufficient information upon which to trace a con- 
tact® Interviewing a patient requires diplomacy and in- 
teresto Best results are obtained if a medical officer 
conducts the interview privately in his officeo A com* 
ment should appear on every line of the contact form* in- 
cluding "Remarks'** and separate forms should be filled 
out for each contact where multiple exposures have c * 
curredo 
3« In interviewing patients for contact information* 
the following suggestions should be considered: 
a0 Stress the confidential nature of the infor~ 
mation a soldier gives; impress upon him that his name is 
never mentioned in connection with a contact; that,? as a 
matter of fact* the interviewer is not even interested 
in him at alio Do not start out by asking his serial 
number and unit. Many do not believe in the confiden- 
tial aspect of the inquiry when this question is asked* 
Do not fill out this section in his presence® The in- 
formation is on his Form 52 and can be filled out latero 
bo Stress should be laid on the importance of having 
the patient report accurately the names and addresses of 
the contacts so that they may also have the chance of 
early cure® It is a mistaken idea that giving the name 
of a woman is not "playing the game"o As a matter of 
fact* not giving the information puts the woman at a 
disadvantage* since most of them would be extremely 
anxious to get rid of a disease of which they may have 
been unaware0 Stress the point that they are wronging 
the woman by not giving her name and addresso Quite a 
few have a sudden return of memory when this is driven 
homeo 
c. Explain that the girl will be contacted so that 
no one* not even her parents* will have any idea that she 
is diseased or has been a contact of disease; that she 
will be advised as to treatment by competent medical prac- 
titioners* and assisted if she is financially unable to 
go to a private practitioner® 
do Impress upon the soldier that he may have infected 
others who need attention and assistance just as much as 
the woman who infected him. It is the Army's desire* in 
cooperation with civilian health authorities* to cure 
them all and that his information is his part in the 
crusade against venereal disease generally® 
56 4® Prior to transmission* each contact report should 
be checked carefully to make certain that the information 
contained on the report will be of value to the appropriate 
health department* 
bo Prophylactic station lists were published and kept 
currently up-to-date* 
Co Emphasis was placed upon the use and availability of 
individual mechanical and chemical prophylactic itemso 
do Sulfathiazole prophylaxis for gonorrhea was encouraged 
when rates reach or may be expected to reach 50 per 1000 per annum* 
in conjunction with a central check-in check-out system as outlined 
in the following letter: 
HEADQUARTERS 
EASTERN DEFENSE COMMAND 
Governors Islands New York Us N* Y0 
726o 1 
(Surg) 
16 August 1944® 
Subjects Sulfathiazole Prophylaxis for Goncrrheao 
To i Commanding Officers* All Units* E« Df’To 
I* Letter* file 726d* Subject: ’’Sulfathiazole 
Prophylaxis*” Office of the Surgeon* Headquarters East- 
ern Defense Command and First Army* dated January 16* 
19-43 and letter same file and subject* Office of the 
Surgeon* Headquarters Eastern Defense Command* dated 3 
September 194-3 are hereby rescindedo 
2. The adoption of sulfathiazole prophylaxis* 
when properly administered* has been proven to reduce 
venereal disease rateso However* when used* all other 
measures for Venereal Disease control should be contin- 
ued in operation and intensifiedo Attention is directed 
to letter this headquarters* file 726d (Surg)* Subjects 
"Venereal Disease Control*1’ dated 6 July 1944° 
3o Organizations of this command in which the 
gonorrhea rate reaches or may be expected to reach 50 
per 1000 per annum are encouraged to institute the use 
of sulfathiazole by mouth as a method of prophylaxis 
57 against gonorrhea as authorized in S.G.O. Cir. Ltr. No® 
146* Subjects 11 Sulfathiazole by mouth in the prophylaxis 
of gonorrhea/' dated 12 August 1943* as amended by SoG.O* 
Cir0 ltr* No0 1, 1 January 1944* page 8. 
4o To increase the effectiveness of administering 
sulfathiazole prophylaxis* a central check-in check-out 
system should be established. The following plan is one 
which past experience has proven to be effective: 
a. Enlisted men,, leaving the post on pass obtain 
their pass from the Charge of Quarters who offers each man 
sufficient mechanical and chemical prophylactic materials 
to meet his anticipated needs* The Charge of Quarters 
keeps a roster of all men leaving the post on pass. 
b. Immediately upon returning to the post* all 
men report to the Charge of Quarters who instructs them 
to complete Part I of the Prophylactic Form (See sample 
below)o Part II will be filled in by a dispensary or 
Prophylactic Station attendant* and returned by the sol- 
dier to the Charge of Quarters who forwards all completed 
"Prophylactic Forms" marked CONFIDENTIAL* to the command- 
ing officer for filing in a locked cabinet* Prophylactic 
Forms are retained for the three (3) succeeding months 
and then they may be properly destroyedo 
CONFIDENTIAL (when completed) 
PROPHYLACTIC FORM 
FART I 
DATE 
NAME. ASN_ 
Did you have sexual intercourse with anyone but your 
wife ? __________ 
Time anS. date of exposure or exposures? 
Did you use a condom for every sexual exposure? . 
T 
Did the condom break? __Did you use chemical prophylaxis? 
Station or self-administered? _How long after each exposure? 
58 PART II 
(To be filled in by dispensary attendant) 
Sulfathiazole prophylaxis (2 grams) given at 
(Hour & date) 
Calomel ointment prophylaxis given at 
(Hour & date) 
NOTE: Accuracy in filling out this form is of utmost 
importance for the welfare of the individual*) 
Co If the soldier admits extra-marital sexual 
exposure without the use of prophylaxis or with inade- 
quate prophylaxis (administered more than two hours 
after exposure)* the following procedure is instituted: 
(l) The soldier will report to the dis- 
pensary or prophylactic station where a trained at- 
tendant gives the man two (2) grams of sulfathiazole 
which is taken by mouth in his presence.. (Sulfathia- 
zole should be available already made up in individual 
packageso Each package should contain four (4) l/2 
gram tablets of sulfathiazoleo Directions printed on 
the package shopld reads s,Gonorrhea Prophylactic Tab- 
lets - Take four tablets with a full tumbler of water)0 
The trained attendant will also make certain that the 
soldier thoroughly cleanses himself with soap and 
water and applies the calomel ointment in the manner 
now prescribed for station prophylactic treatment as a 
protection against syphiliso 
(2) Sulfathiazole prophylaxis will not be 
administered to individuals: 
(a) Leaving on furlougho 
(b) Whole duties involve aerial flightso 
(c) If an approved routine intraurethral 
chemical prophylaxis was used with- 
in two (2) hours. 
(d) If the soldier has a history or 
record of sensitization to the 
drug. 
59 $o This headquarters will be notified (Attention 
Surgeon) by organizations as to the date on which sulfa- 
thiazole prophylaxis is inaugurated and again when ter- 
minatedo 
command of Lieutenant General GRUNERTs 
/s/ Fo Jo Cunningham 
/t/ Fo Jo CUNNINGHAM* 
Colonel,? AoG.Do* 
Adjutant General0 
DISTRIBUTION; 
"B" 
(Less APO 100 & 860) 
eo Current regulations* circulars* and other pertinent 
instructions were published by this headquarters and forwarded to 
unit commanders as a ready reference and guide for all officers 
charged with the responsibility for the control of venereal dis- 
eases* by Ltr this headquarters* file 726.1 (Surg)* Subjects 
“Venereal Disease Control*" dated 6 July 19AA® 
f. Particular emphasis was placed upon four phases of 
control namely: 
(1) Developing an aggressive educational programo 
(2) To encourage the use of the single tube (individual) 
chemical prophylaxis* 
(3) Reporting of contacts by medical officerso 
(4.) Cooperation and coordination with civilian health 
agencies toward the suppression of prostitution and allied conditionso 
12o In the Sanitary Report under the heading "Subjects Not 
Covered Under Other Headings*" unit surgeons of this command are re- 
quired to make a statement of pertinent information pertaining to 
venereal disease control activities and the venereal disease rate 
per 1000 per annum for the month based upon either a four or five- 
week period*. When venereal disease rates exceed 25 per 1000 per 
annum* unit commanders are required to state causes of the excess 
sive rates and action taken in order to reduce thenio 
60 MORBIDITY FROM ALL CAUSES. 
ABOVE INCLUSIVE OF BASE COMMANDS 
Form 85a 
Mzdicii. Difaatmint, U. S. Abut 
(Authorized March 9, 1928} 
VITAL STATISTICS CHART (SMALL) 
GRAPH NO. I MORBIDITY FROM DISEASE ONLY 
ABOVE INCLUSIVE OF BASE COMMANDS 
Form 85a 
Mkdical Dbpaetmsnt, XT. S. Abut 
(Authorized March 9, 1928) 
VITAL STATISTICS CHART (small) 
GRAPH NO. II MORBIDITY FROM COLDS, INFLUENZA. ETC. MORBIDITY FROM INJURIES 
ABOVE- INCLUSIVE OF BASE COMMANDS 
Form 85a 
Mxdical Department, U. S. Army 
(Authorized March 9, 1928) 
VITAL STATISTICS CHART (»MAU.) 
GRAPH NO. IV NON - EFFECTIVE RATE 
ABOVE INCLUSIVE OF BASE COMMANDS 
Form 8Sa 
Mxnui Dcfastiumt, IT. S. Abut 
(Authorized March 9, 1928) 
VITAL STATISTICS CHART («MMX) 
GRAPH NO. V : 5 (1) : 
-“organization 
Weekly Hospital and Quarters Admissions & Rates Per 1000 Per Annum 
Average Daily Non-effectives Per 1000 
Men Per Day (Man Days Lost & Rates i 
(2) 
Injuris s 
Only 
Diseases Oily 
(5) 
Statistics on Certain Disease Groups 
(11) 
Injuries 
Oily 
; Diseases Only 
(3) 
Less 
Neuro psy- 
chiatric 
(4) 
Neuropsy- 
chiatric 
(6) 
Cannon 
Respiratory 
Diseases# 
(7) 
Pneu- 
monias 
(AH) 
(8) 
Diarrheal 
Diseases 
Venereal Diseases 
(12)' 
All : 
Venereal 
Diseases 
(13) 
Neuropsy- 
chiatric 
(14) 
All Other 
.Diseases 
All C 
Tot 
(2) (3^ 
auses 
al 
&(4) 
C9) 
"New" Cases 
(F-xol E?TS) 
(10) 
All 
Cases 
1 
No. (Rate 
No. 
Fate 
No. 
Rate 
No. 
Rate 
N.0* 
Rgte 
No. 
No. 
Rate 
No. 
Rate 
No. 
Rate 
Days 
Rate 
Days 
Rate 
Days 
Rate 
Days 
Rate 
EDC Troops 
‘ 3 
169 
; 2 
112 
0 
-“H 
0 
5 
281 
0 
0 
0 
0.0 
0 
0.0 
1 
56.2 
1 
56.2 
4.8 
0.4 
' 1 
1.1 
15.7 
Northeastern 
Sector 
8 
47 
29 
169 
2 
11 
39 
227 
8 
47 
1 
5.8 
0 
0.0 
0 
0.0 
0 
0.0 
27 
3.0 
2 
0.2 
0.8 
102 
11.4 
Southeastern 
Sector 
6 
69 
32 
367 
0 
0 
38 
436 
11 
126 
0 
0.0 
0 
0.0 
3 
34.4 
3 
34.4 
21 
4.7 
-A 
0.7 
3 
0.6 
70 
15.4 
i Newfoundland 
Base* Command 
X 
87 
X 
522 
X 
. 0 
X 
609 
X 
174 
X 
7.9 
X 
7.9 
X 
7.9 
X 
7.9 
X 
3.1 
X 
0.0 
X 
0.1 
X 
10.8 
- Bermuda 
Base Command 
X 
■108 
X 
216 
X 
36 
X 
360 
X 
18 
X 
0.0 
X 
0.0 
X 
0.0 
X 
0.0 
X 
2.8 
X 
0.3 
X 
0.5 
X 
5-9 
'1 Greenland 
Base Command 
X 
104 
X 
539 
X 
41 
X 
684 
X 
a 
X 
0.0 
X 
0,0 
X 
0.0 
X 
0.0 
X 
2.9 
X 
0.0 
X 
0.8 
X 
12.2 
' Iceland 
. Base Command 
X 
60 
X 
158 
X 
0 
X 
218 
X 
38 
X 
0.0 
, X 
0.0 
X 
0.0 
X 
0.0 
X 
2.1 
X 
0.1 
X 
1.0 
X 
4.2 
( /■pT<t Personnel at 
)0#100&#/)06 
X 
90 
X 
225 
X 
. 0 
X 
315 
X 
45 
X 
0.0 
X 
0.0 
X 
45.0 
X 
45.0 
X 
0.9 
X 
0.0 
X 
0.0 
X 
2.8 
Total E.D.C. 
Current Week 
52 
73 
201 
282 
X 
8 I x 
363 
52 
73 
X 
2.8 
I X 
1.4 
X 
8.4 
X 
8.4 
110 
3.0 
X 
0.2 
24 
0.6 
349 
9.4 
Total U.S.Army> 
i Current Week 
53 
461 | 514 
112 
11. 
1 7. 
37. 
38.8* 
56.7 
i Total E.D.C. 
Year to Date 
6? 
337 
10 
414 
79 
2.2 
3.7 
16.6 
22.2 
4.1 
0.5 
0.6 
13.0 
; Total U.S .Array* 
s Year to Date 
■ 67 
563 
630 
147 
11. 
9. 
. 34. 
38.8-f 
40.9 
* Continental United States only. $ Includes Influenza. -J- Average Rate for. U.S .Army (1929-38). x Figures omitted for security reasons 
* NOTES; See reverse side. ' 
! Base Commands include ATG personnel. 
18 Jan 45 
' V — * 
Summary of Weekly Statistical Health Reports, Form No. 86ab MD and Supplements week ending 29 December 1944. 
HEADQUARTERS 
EASTERN DEFENSE COUMfflffll: 
Governors Island, New York 4$ 
319.1 
(Surg) Summary for week ending 29 Dec 44 (Contd); 
1, The number of absent sick from all causes averaged 1.324 of the strength 
of the compand daily.. This is a decrease of 0,094 compared with the rate for the 
previous week. 
2, The distribution of all illness in the Eastern Defense Command as of the 
clos'e of the weekly period is illustrated below: 
Injury 
21.894 
Common Respiratory Diseases 9.814 
— Afanar-na.1 ,D.i,cAj.<!na Jl_!5X4 
Other Communicable Diseases 2.454 
Neuropsychiatric 4. 34% 
Non-Communicable ; 
Diseases, (less NP) 
60.00/6 
'% The admission rate for the comnon respiratory diseases has increased 15 
per thousand per annum compared with the rate for the previous week. 
4. The EDC admission rate for all cases of yehereal diseases shows a decrease 
of 6,9 per thousand per annum. The EDC venereal:.disease rate for "new" cases was 
8,4 per thousand per annum for the current week,'which is a decrease of 5.5 per 
thousand per annum compared with the rate fop the previous week. No excessive 
venereal disease rates for "new" cases were reported for the five-week period end? 
ing 29 Dec 44. ‘ 
5. The EDC admission rate for injuries was 73 pep thousand per annum for the 
current week, which is an increase of 31 per.thousand- per annum compared with the 
rate for the previous week. F6r the five-week period ending 29 Dec 44> excessive 
injury rates were reported for'Southeastern Sector, Newfoundland Base Cpnmand and 
Greenland Base Command. 
6. Venereal Disease: The 1944 EDC venereal disease rate for "new." cases was 
16.6 per thousand, representing a decrease of approximately 144 from the 1943 rate 
of 19.3. per thousand. The decrease is accounted for by the average drop of 194 in 
the 1944 rates at Base Commands compared with rates for the previous year. Conti- 
nental Units registered an increase of 1,54 in 1,944 rates over those of 1943, 
7. One (l) death was reported during the wejpk, as follows: Pneumonia, primary 
(not atypical) - 1 (Newfoundland Base Command). Report of!investigation of the 
one (1) injury death reported during the week ending 3 Nov 44 (Newfoundland Base 
Command) has not yet been completed inasmuch as the body has not been identified 
duo to decomposition. ... !: 
8. Average admission rates (all causes). average non-effective rates (all 
causes), and average venereal disease admission-rates (excluding "old" cases) for 
the fifty-two ?;eeks' period (seventeen weeks' period for IBC and APO #100 & #406, 
ten -weeks' period'for QBC) ending'29 Dec 44 reveal the following among commands v 
under the jurisdiction of this headquarters: 
ADMISSION RATES 
. (ALL CAUSES) 
ICELAND BC 282 
BERMUDA B C 348 
("AVERAGE EDC 4141 
NORTHEASTERN 415 
APO #IDQ&#406 417 
SOUTHEASTERN . -427- 
EDC TROOPS 486 
GREENLAND B C ,504 
NFLD BASE G 527 
CONTINENTAL 
U.S, ARMY 630 
(sane period) 
NON-EFFECTIVE RATES. 
(ALL CAUSES) ■ 
APO #100 & #406' 11.0 
ICELAND B C 11.7 
BERMUDA B C 12,0 
GREENLAND 3 C 14.7 
NFLD BASE C l6.6 
I AVERAGE EDC lB.2 \ 
NORTHEASfffej 
SOUTHEASTERN 20,9 
EDC TROOPS 30.1 
CONTINENTAL 
U.S. ARMY 40.9 
(same period) j 
V.D. ADMISSION RATES 
(EXCL "OLD11 CASES) 
GREEN LAI® B C 0.0 
ICELAND B C 9.8 
BERMUDA B C 10.6 
I AVERAGE EDC 16.'61 
NFLD base' c 1773 
NORTHEASTERN 17.9 
SOUTHEASTERN 18.*5 
EDC TROOPS 18.9 
APO #100&#4-06 34.0 
’CONTINENTAL 
U.S. ARMY 34. 
(same period) 
BY COMMAND OF LIEUTENANT GENERAL GRUNERT: /' 
fj F. J. 
v , Colonel, A.G.D., 
Adjutant General. 
i msmmm-- 
"B" ' 
1 cy ea Hq, Unit CO & 10 Oct. 45 
Weekly Hospital and Quarters Admissions & Rates 
Per 
1000 
Per Annum 
Average Dany Non- 
Men Per Dav (Man 
effectives Per 1000 
Days Lost & Rates) 
Diseases Only 
r 
Statistics on Certain 
Disease Groups 
Diseases Only 
d) 
(2) 
r (3) 
(5) 
(7) 
(8). 
•Venereal Diseases 
(11) 
(12) 
(13) 
(14) 
Organization 
Injuries 
Less 
Neuropsy- 
chiatric 
Neurcpsy- 
chiatric 
All Causes 
Total 
(2)(3)&(4)| 
Cornu on 
Respiratory 
, Diseases)) 
Pneu- 
monias 
(AH) 
Diarrheal 
Diseases 
"New" Cases 
(Excl EPTS) 
(10) 
An 
Cases 
Injuries 
! Only 
All 
Venereal 
Diseases 
Neuropsy- 
chiatric 
All Other 
Diseases 
No. 
Rcttc 
No. 
Rate 1 
No. 
Rate 
No. IRate.; 
: no.. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
Days 
Rate 
Days 
Rate 
Days 
Rate Bays 
Rate 
HD Portland 
134 
8 
535 
0 
0 
10 669 ! 
1 
67 
1 
66.9 
0 
0.0 
0 
0.0 
0 
0.0 
1 
1.6 
0 
0.0 
1 
1.3 
9 
n.7 
HD Portsmouth 
0 
0 
2_, 
404 
0 
0 
3 
404' ; 
1 0 
0 
0 
0.0 
0 
0.0 
1 
134.7 
1 
134.7 i 
1 
2.6 
1/7 
"oX1 
0 
0.0 
8 
19.9 
.HD Boston 
1 
69 
5_ 
347 
0 
0 
6 
416 
i 1 
• 69 
0 
0.0 
0 
0.0 
1 
69.4 
1 
Htl 
' 4 
4.9 
2 
2.1 
1 
1.9 
21 
27.8 
HD New Bedford 
0 
0 
3 
520 
0 
0 
3 
520 
0 
0 
0 
0.0 
0 
0.0 
0 
0.0 
0 
0.0! 
2 
6.6 
0 
0.0 
0 
0.0 
n 
35.1 
HD Namagansebt Baa 
0 
0 
3 
272 
4 
'3^3 
0 
0 
0 
0.0 
0 
0.0 
0 
0.0 
0 
xxi 
2 
3.5 
0 
0.0 
4/7 1.0 
10 
HD. Lcnglaland Scunc 
_Q, 
0 
4 
349 
0 
0 
4 
349 
0 
0 
0 
0.0 
0 
0.0 
2 174.7 
2- 
P4l"f 
1 
"T7T 
1 
1.2 
0 
0.0 
8 
UJ 
1 
HD New York 
i 
60 
5 
298 
0 
6 
358 
1 
60 
0 
0.0 
. 0 
0.0 
0 
0.0 
0 
0.0 j 
T^T 
0 
0.0 
1 
1.1 
18 
20.3 
> 
(HD Delaware 
0 
0 
8 
600 
0 
0 
8 
600 
5 
375 
0 
0.0 
0 
0.0 
0 
-0^ 
0 
0.0 j 
0 
0.0 
0 
0.0 
0 
0.0 
20 
29.0 
HD Chesapeake Baa 
2 
in 
i_nL 
"IBS’ 
0 
0 
9 
499 
0 
0 
0 
0.0 
0 
0.0 
0 
0.0 
0 
0.0 1 
1 7 
7.1 
0.0 
1 
1.1 
21 
22.3 
HD Charleston 
1 
19? 
3 
579 
I_0_| 
u_2_| 
4_h 
772 
0 
0 
0 
0.0 
0 
0.0 
0 
0.0 
0 
0.0 
i 2 
5.8 
0 
0.0 
H“ 
Hr 
2 
9.0 
HD Key West 
0 
0 
o 
0 
0 
0 
0 
0 1 
' ° 
0 
*0 
0.0 
0 
0.0 
0 
0.0 
0 
0.0 
r~r 
Tf 
0 
0.0 
— 
0.0 
H? 
1.6 
HD Pensacola 
0 
0^ 
o 
0 
0 
0 
0 
0 
! 0 
0 
0 
0.0 
0 
0^ 
0 
*■ 0.0 
0 
0.0 ! 
; 0 
•0.0 
H^ 
0.0 
0" 
Hr 
11.2 
HD Galveston 
0 
0 
2 
289 
0 
0 
2 
289 
1 0 
. 0 
0 
0.0 
0 
0.0 
0 
0.0 
0 
• ;o.o [ 
1 0 
0.0 
•“o-1 
0.0 
0 
0.0 
6.7 
* 
[S outhemlandftxrtier 
0 
0 
2 
367 
0 
0 
2 
"ISTt 
i 0 
0 
0 
0.0 
0 
0.0 
0 
0.0 
0 
Hr 
0.0 
0 
0.0 
0 
0.0 
8 
29-7 
*3 
\laneous Units 
0 
0 
o 
0 
0 
0 
0 
0 i 
f 0 
0 
0 
0.0 
;o 
0.0 
0 
0.0 
0.0 I 
0 
0.0 
0 
0.0 
0 
0.0 
3 
10.1 
j’j 
Nfln Base Cornd 
2 
_84, 
5 
210 
0 
0 
7 
294 ! 
0 
0 
• 0 
0.0 
0. 
0.0 
0 
0.0 
0 
0.0 ! 
3 
2.1 
"H 
0.0 
0 
0.0 
4 
3.4 
Bermuda B C i 
2 
61 
L-10. 
307 
2 
61 
14 
429 j 
; 4 
123 
0 
Hr 
0.0 
1130.6 
1 
30.6 
i 5 
3.1 
0.0 
2 
1.2 
17 
10.1 
V 
Greenland B C & 
1 
32 
61 193 
0 
0 
7 
225 
i 1 
32 
0 
0.0 
0 
0.0 
0 
0.0 
0 
0.0 
3 
2.1 
Hf 
0.2 
0 
0.0 
—r 
3.6 
Iceland B C 0 
1 
17 
,9 
150 
0 
0 
10 
167 
0 
0 
1 
16.7 
0 
0.0 
0 
0.0 
- 0 
0.0 | 
9 
2.? 
14 
0.3 
1 
~o7T1 
14 
4.3 
EDC Current Week 
13 
■ 44 
282 
10 
99 
.336 1 
Li3 
44 
2 
6*8 
0 
0.0 
5 
17.0 j 
5 
17.0 
46 
3.0 
4 
0.2 
9 
0.6 
186 
12.1 
EDC Yr to 21 Sep 
56, 
327 
/ 12 I 
395 1 
ll 701 
4.2 
3.2 
13.9 
16.1 1 
3.0 
- 0.2 
0.8 
12.4 
USA*Yr to 21 Sep 
48i 
533 ! 
581 .1 
r— 
120 
TTj 
46. i 
38.8+f 
87 .** 
Continental United States Army only. Non-effective rate includes evacuees from overseas. # Includes Influenza, t) Includes ATC personnel. 
f Average rate for U.S. Array (1929-38V. NOTES: See reverse side. 
HEADQUARTERS 
EASTERN DEFENSE COMMAND 
Island, New York k, N.Y. 
Summary of Hjstek3qpl3fetM*»ticaI Health Reports and Supplements Thereto for week ending 28 September 1945 
319.1 
(Surg) Summary far week endir " 28 Sep t.5 (Contd); ~ 
1. The number of absent sick frooj all causes averA-*«d 1.595a of the strength 
of the command daily. This is a decrease of 0.04% compared with the rate for the 
previous week. 
2. The distribution of all illness in th©:Eastern Defense Command as of the 
close of the weekly period is illustrated below: 
Injury- 
19. 1956 
Common Respiratory Diseases 6.94% 
Venereal Diseases 0.82% 
Other Communicable Diseases 5.30% 
Non-Communicable 
vDiseases (less NP) 
Neuronsyehiatric 3.67% 
3. The admission rate for the common respiratory diseases remains low and 
relatively stable. " 
4. .The admission rate for all cases of venereal diseases shows d decrease of 
5.6 per thousand per annum. The WDC venereal disease rate for Enew" cases was 
17.0 per thousand"pe'r annum for the current week', which i’s a decrease of 2.3 per 
thousand per annum compared With the rate for the previous week. Excessive vene- 
real disease rates for the four-week period ending 28 Sep 45 were reported for the 
Harbor Defenses of Portland. Portsmouth. New Bedford. Long Island Sound, New York, 
Chesapeake Bay and the Southern Land Frontier. (TEe underscored commands have 
reported excessive venereal disease rates for two consecutive monthly periods; HD 
of Portsmouth has reported excessive VD rates for three consecutive monthly periods). 
5. The EDC admission rate for injuries was 44 per thousand per annum for the 
current week, which is a decrease of 4 per thousand per annum compared with the 
rate for the previous week. The EDC admission rate for injuries for the four-week 
period ending 28 Sep 1945 was 53 per thousand per annum, which exceeds the injury 
pate for the total continental U.S. Army for the same period. 
6. No deaths were reported during the week among EDC personnel. 
7. Average admission rates (all causes), average admission rates (injuries 
only), average venereal disease admission rates (excluding "old" cases), and aver- 
age non-effective rates (all causes) for the twenty-two week period ending 28 Sep 
45 reveal the following among commands under the jurisdiction of this headquarters: 
WMF8 
HD KEY WEST 90 
ICELAND B C 276 
HD PENSACOIA 308 
HD NARR. BAY 334 
HD NEW YORK 352 
MISC. UNITS 356 
HD PORTUND • 360 
NFLD BASE COMD 36l 
fiygRAjfi&c' j'6fi 
hETOhESIbaY 39« 
HD NEW BEDFORD 401 
BERMUDA BC 402 
HD BOSTON 413 
GREENLAND B C 422 
HD GALVESTON 444 
SOUTHERN UND F 472 
HD L I SOUND 496 
HD PORTSMOUTH 501 
HD CHARLESTON 576 
HD DELAWARE 584 
CknM&rmr 
19441 J 
■ flylffl? 
KEY WEST 19 
NARR. BAY 24 
MISC. UNITS 30 
PENSACOLA 32 
CHESA BAY 42 
NEW YORK 43 
NEW BEDFORD 44 
GALVESTON 45 
BOSTON 45 
•ICELAND .BC,47 
DELAWARE, 50 
L 1 SOUND 52 
SOUTH'jN L F 52 
CHARLESTON 53 
PORTSMOUTH 55 
fI7G"ETO 
TORT™ 57 
BERMUDA BC 60 
NFID BC 67 
GREENL'D BC307 
L( s.a»e_p4 44} „ J 
KEY WEST 
NPLD BC 5.3 
GREENL'D BC 5.4 
ICELAND BC 7.3 
MISC. UNITS U.8 
PORTLAND 16.6 
, DELAWARE 16.8 
' NEW:YORK ■ 20.7 
BOSTON" 21.4 
L I SOUND 21.4 
NEW BEDFORD 21.9 
PENSACOLA 22.7 
CHESA BAY 24.8 
GALVESTON 29.9 
NARR. BAY 30.4 
SOUTH'N L F 37.5 
PORTSMOUTH 44.6 
TTLW’SSf' ~ TKTTF*' 
L( gaoe_pd 44-1 J 
175 
NFID BC 9.0 
ICELAND BC XO.8 
PORTLAND 12.5 
BERMUDA BC 13.3 
GREENL'D BC 13.5 
its 
MISC. UNITS 17.8 
SOUTH'N L F 18.2 
CHESA BAY 21.3 
NE7 BEDFORD 22.0 
GALVESTON 22.1 
PORTSMOUTH 22.4 
NARR. BAY 23.3 
NETT YORK 23.6 
L I SOUND 26.0 
BOSTON 26.9 
DELAWARE 28.6 
mmr " TLf.rS 
I_(§ame_p4 44l ! 
BY COMMAND OP BRIGADIER GENERAL LORD: 
CUNNINGHAM 
Colonel# «GD 
Adjutant General" 
ag.mM.iQNt 
"B" 
1 oy ea Hq, Unit CO & Surg. Organization 
0* ' 
Weekly Admissions & Rate Per 1000 Per Annum 
Daily Non-effectives 
Deaths 
AH 
Causes 
Injuries 
Only 
Diseases Only 
Common 
Respiratory 
Diseases# 
Pneu- 
monias 
(All) 
Diarrheal 
Diseases 
Venereal Diseases 
Diseases Only 
Injuries 
Only 
less Neuro- 
psychiatric 
Neuropsy- 
chiatric 
AH 
Cases 
"New" 
Cases 
less Neuro- 
psychiatric 
Neuropsy- 
chiatric 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
No. 
Rate 
Days 
Rate 
Days 
Rate 
Days 
Rate 
No. 
Rate 
E.D.C. Troops 
31 
686 
2 
44 
29 
642 
- 
- 
12 
266 
- 
- 
- 
- 
1 
22.2 
1 
22.2 
516 
31.3 
32 
1.9 
107 
6.5 
- 
- 
AAA Command 
242 
466 
16 
31 
220 
424 
6 
11 
129 
248 
4 
7.7 
- 
- 
17 
32.7 
14 
27.0 
2792 
14.7 
158 
0.8 
712 
3.8 
1 
1.9 
New England 
Sector 
234 
650 
27 
75 
204 
567 
3 
8 
106 
.295 
1 
2.8 
- 
- 
5 
13.9 
3 
8.3 
2049 
15.6 
73 
0.6 
429 
3>2 
- 
[New York-Rhila 
r Sector 
127 
596 
11- 
52 
113 
530 
3 
!4 
63 
295 
- 
- 
- 
- 
5 
23.4 
2 
.9.4 
1513 
19.4 
49 
0.6 
234 
3.0 
1 
4(7 
Chesapeake Bay 
Sector 
130, 
582 
10 
45 
120 
537 
- 
- 
53 
237 
1 
4.5 
- 
- 
3 
13.4 
3 
13.4 
1447 
17.-?’ 
94. 
12 
378 
4.6 
2 
9l0' 
Southern 
Sector 
132 
845 
8 
51 
121 
775 
3 
• 19 
_6l 
390 
- 
- 
- 
, 1 
6.4 
1 
6.4 
1452 
25.5 
24 
0.4 
217 
3.8 
- 
*r. 
*} Newfoundland 
_Base Command 
1036 
156 
880 
- 
660 
- 
- 
14.2 
14.2 
20.1 
0.2 
2.6 
70.9 
[irauda' 
Conmand 
276 
74 
184 
V 
18 
55 
- 
- 
18.4 
18.4 
8.8 
0.8 
3.9 
Total E.D.C, 
Current Week 
1057 
617 
100 
58 
9a 
550 
16 
■ 9 
520 
304 
6 
3.5 
- 
35 
20.4 
'27 
15.8 
10976 
17.6 
454 
0.7 
2289 
3.7 
14. 
8.2 
Total U.S.Army* 
Current Week 
858 
61 
797 
408 
19. 
9. 
38.81 
24. 
38. 
. 4.of 
Tot/Si E.D.C# 
Year to Date 
576 
64 
508 
12 
164 
4.9 
2.3 
22.8 
19.3 j 
19.4 
0.9 
3.5 
2.0 
[ Total U.S.Army* 
i Year to Date 
797 
78 
719 
2a 
16. 
12. 
38.81 
26. 
37.. 
4.01 
Continental IJ 
nited. States only, # includes Influenza. \ Average Rate f 
or U.S.Army(1529-38). NOTES; See reverse side. 
On 
rH 
u 
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I 
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(D 
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rH 
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bfl 
.3 
Tj 
§ 
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o 
cm 
o 
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5. <=> • fn 
S_ >H 05 
»' £ 
* to 
-p 
2 2ij S 
e 
3 t5 M -H 
CO O S £ & 
OS CO <U D 
MM to 
H W W 1 
25 E c| S 
i S 
S|SM -a 
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III ~ 
w §• o* 
& s 
C5 g 
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(j-l 
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I 
o 
£> Summary for week ending hi Dec 43 (Gontd 
The number of absent sick from all causes averaged 2,20$? of the strength 
of the command daily. This is a decrease-of 0,36$ compared with the rate for the 
previous week. 
The distribution of all Illness in the Eastern Defense Command as of the 
close of the weekly period is illustrated below: 
Common 
Respiratory 
A Diseases 
(leas innite&a# 
Influenza 1.85% 
Venereal Diseases A.30% 
Injury 
16.92$ 
23.4-5$ 
Other Communicable 
Diseases 2.12% 
Neuropsychiatric 3.05% 
Non-C oramunlcable 
Diseases (less NP) 
AS.31$ 
The admission rate for the common respiratory diseases inclusive of in- 
fluenza shows a continued decrease of 195 per thousand per annum compared with the 
rate of the previous week. This decline represents 351 less cases of upper respir- 
atory diseases and influenza in comparison with the number of such cases reported 
for the previous week. 
The average admission rate for the pneumonias in EDO for the month of 
December 194-3 was 3.90 per thousand per annum compared with a similar rate of 
12,30 for December 1942. The average admission rate for the pneumonias for Decem- 
ber 1943 in- the total continental U.S. Army was 19.0 per thousand per annum. It 
is interesting to note in a comparison of these three rates that an important fac- 
tor in the low rate for the pneumonias inj EDO may well be the policy of this com- 
mand to intensify efforts for the! early diagnosis and hospitalization of upper 
respiratory diseases inclusive of: influenza. In this connection it should be 
noted that the average admission rate; for upper respiratory diseases and influenza 
in EDO for the month of December 1943 was 476.6 per thousand per annum compared 
with a similar rate of only 253.4 fori December 1942. Thus, despite the fact that 
the admission rate for diseases not uncommonly precursors of certain pneumonias 
doubled, the admission rate for pneumonias decreased approximate- 
The admission rate for venereal diseases shows an increase of 0,9 per 
thousand per annum. The average EDQ venereal rate for the current week is 8.2 per 
thousand per annum lower than the average for the total continental U.S. Army for 
the same period. The AAA Command reports the only excessive venereal disease rate 
this week. 
EDG Troops report excessive daily non-effective rates due to both injury 
and disease. 
The following communicable diseases were reported in addition to those com- 
mented, upon above: Pneumonia, primary - 4}'Pneumonia, primary atypical-1; Pneu- 
monia, secondary -1; Vincent’s Angina-2,: Fourteen (14) deaths were reported during 
the week, as follows; Automobile accident - 2j Drowning, accidental - 1; Aircraft ac- 
cident -10j Peptic: ulcer »1, 
1 Average admission rates (all causes), average non-effective rates (all 
causes), ahd average venereal disease admission rates (excluding "old" cases) for 
the year 1943 reveal.the following among commands under the jurisdiction of this he: 
ADMISSION RATES 
PAUSES) , 
pERMUDAAB O' 309 
AAA 'COMMAND .378 
SOUTHERN 1 537 
NEW 'ENGLAND 550 
CHESA BAY. ' 587 
N Y-PHILA' 609 
NFLD BASE 0 7A8 
EDO TROOPS 826 
AVERAGE EDO -575 
NONtEFFECTIVE RATES 
(ALL CAUSES) 
BERMUDA B C ' 13.0 
NEW ENGLAND 19.0 
AAA COMMAND 19.0 
N Y-PHILA 21.5 
NFLD BASE C 23,0 
SOUTHERN 23.1 
EDO TROOPS 25.3 
CHESA BAY 29.9 
AVERAGE EDO 23.1 
V.D.ADMISSION RATES 
(EXCL "OLD" CASES) 
NEW ENGLAND 11.8 
AAA COMMAND 14.4 
BERMUDA B 0 15.7 
SOUTHERN 19.2 
NFLD BASE 0 19.8 
N Y-PHILA 21.0 
CHESA BAY 21.2 
EDO: TROOPS 21.3 
•AVERAGE EDO 19.3 
For the Surgeon* 
Assistant. ANNEX TO HISTORY OF PREVENTIVE MEDICINE IN WORLD WAR II 
10 a„ The data presented on the attached graphs is taken from 
a summary of the Statistical Health Reports, WD AGO Form 8=122, and 
supplements thereto rendered weekly to this office by every tactical 
continental unit (separate dispensary) assigned to this commando Data 
from the EDO base commands included on these graphs is taken from a 
summary of the consolidated Statistical Health Reports (no supplements 
required from EDO base commands)0 
bo Morbidity rates and noneffective rates are not recorded on the 
graphs for the years 1941 and 1942 due to the fact that this office did 
not have complete information on the continental personnel of this 
command hospitalized in Service Command installations until the adoption 
of the supplemental report on 30 October 19420 The supplemental report 
accounts for Army hospital days lost. Army hospital diagnoses of certain 
communicable diseases, and Army hospital deaths which are not accounted 
for on the regular Statistical Health Reports rendered by EDO continental 
units« 
Co Graph No„ I represents a comparison of the annual morbidity 
rates of admission per 1000 strength for all causes for the years 1943* 
1944, and 1945 (through 28 Sep 45) <> The highest rate experienced for 
any given weekly period during the years indicated was reported during 
the week ending 17 December 1943o The marked increase in the rate was 
due to an excessive number of admissions for the common respiratory 
diseases, as noted on Graph No0 IIIo A total number of 1371 cases of 
coiranon respiratory diseases, which included 1$6 cases of influenza, 
was reported,, Reports in general from the field to this headquarters 
indicated an alert awareness by unit surgeons and unit commanders of 
the importance of this outbreak and that preventive measures were 
being enforced0 
do Graphs Nos„ II, III and IV likewise represent a comparison 
of the annual morbidity rates of admission per 1000 strength for 
diseases only, common respiratory diseases, and injuries for the years 
1943, 1944, and 1945 (through 28 Sep 45)° 
e„ Special reports of injuries to military personnel are required 
from all base commands, EDO, whenever the average monthly morbidity 
rate (based upon either a four or five week period) exceeds 67 per 1000 
per annum,, Commanders are required to explain briefly the types of 
accidents and corrective action taken on all unsafe conditions or 
unsafe acts noted in the report* 
fo Two deaths by electrical shock occurred in a base command 
under jurisdiction of this headquarters during May 1945° This type 
of accident is considered to be in the preventable and avoidable 
61 categoryo A command directive was issued to the effect that all 
personnel who come in contact with electrical apparatus be constantly 
instructed and trained in protecting themselves and that adequate 
safety regulations be rigidly enforced through frequent inspections 
by appropriate officers and noncommissioned officers® 
go Graph No0 V shows a comparison of the average number of 
noneffectives per 1000 strength for the years indicated, 
2, The attached summaries are included to facilitate a cont- 
parison of the average admission rates for all causes, venereal 
diseases (excluding wold” cases), and average noneffective rates 
within the component elements of this command for 194-3, 1944, and 
194-5 (through 28 Sep 4-5)* as noted on the reverse side of the reports. 
62 PART II 
HISTORY OF PREVENTIVE MEDICINE IN WORLD WAR II 
EASTERN DEFENSE COMMAND BASES 
Bermuda Base Command 
Greenland Base Command 
Iceland Base Command 
Newfoundland Base Command HISTORY OF PREVENTIVE MEDICINE IN WORLD WAR II 
BERMUDA BASE COMMAND HEADQUARTERS 
EASTERN DEFENSE COMMAND 
Governors Island, New York 4■» N,I« 
314-® 7 
(Surg) 
28 July 194-5 
Subject! History of Preventive Medicine in World War IIo 
To ! Commanding General, Bermuda Base Command, A« P® 0«, 856, 
c/o PM, New York, N.Yo, (ATTN; Surgeon)* 
1. It is desired that a history of preventive medicine 
activities for Bermuda Base Command be prepared from the incep- 
tion of the command through June 194-5 and that the original and 
one (l) copy of this report be forwarded to this headquarters, 
attention Surgeon, not later than 1 September 194-5* 
2. The following form will be used as an outline in the 
preparation of the history: 
History of Preventive Medicine in the Bermuda Base Command 
I Introductory Remarks: 
II Sanitation; 
1. Clothing 
2. Housing 
3. Food & Nutrition 
4-. Personal Hygiene 
5* Water 
6. Disposal of Waste 
7. Control of Insects 
a. Flies 
b. Mosquitoes 
c. Ticks 
d. Fleas 
e. Cockroaches & Bedbugs 
f. Other Insects 
8. Control of Rodents 
III Sanitary Engineering; 
IV Epidemiology; 
1. Immunization 
2. Intestinal Infections 
3« Infections of the Respiratory Tract and Infections 
Transmitted by Discharges from the Respiratory Tract 
4.« Miscellaneous Infections 
5o Nutritional or Environmental Diseases 
63 V Venereal Disease Control: 
3. Additional sections may be added, if indicated, to 
include tropical disease control, medical laboratories, occupa- 
ticnal health, civil public health, Health Department activities 
or coordination, medical intelligence, nutrition and health 
education® 
4. Extracts of Instructions from The Surgeon General fs 
Office basic letter to this headquarters, which may be of assist- 
ance in preparing the history are as follows: 
a® As the Historical Division of The Surgeon Generalfs 
Office frequently emphasizes, proper documentation is of utmost 
importance in the preparation of a medical history® It is ear- 
nestly desired that not only will documentation be exhaustive but 
that supplementary material referable to preventive medicine in the 
field will be transmitted with the manuscript for preservation as 
future reference and teaching material. 
b. Such a report should contain an account of the problems 
of preventive medicine that have been met, the difficulties that have 
been overcome, the expedients employed, the successes achieved and 
the failures that occurred and that should be avoided in the future. 
5. It is further desired that material pertaining to preventive 
medicine activities, which would be of value in maintaining a current 
history of preventive medicine for your base, be forwarded to this 
headquarters, in duplicate, every six months as of 30 December and 
30 June® 
COMMAND OF LIEUTENANT GENERAL GRUNERT: 
/s/ W® Fo Schubert 
/t/ ?/. F. SCHUBERT, 
Major, A.G.D®, 
Asst. Adjutant General. Subject: History of Preventive Medicine in World War II. 
BBC 3U.7/1 1st Ind. 
HEADQUARTERS, BERMUDA BASE COMMAND, U. S. ARMY, APO 856, o/o 
Postmaster, New York, New York, 30 August 194-5* 
TO: Commanding General, Eastern Defense Command, Governors 
Island, New York 4-j New York. 
In compliance with basic communication there is inclosed a 
History of Preventive Medicine in World War II, for this command. 
FOR THE COMMANDING GENERAL: 
/s/ G. W. Evans 
/t/ G. W. EVANS, 
Major, Field Artillery, 
Adjutant. 
1 Incl. 
History (dup) 
65 HISTORY OF PREVENTIVE MEDICINE 
BERMUDA BASE COMMAND, Uo S® ARMY 
I Introductory Remarks; 
The Bermuda Base Command is located in the Bermuda Islands* 
a group of small islands situated in the Atlantic Ocean at 32° 15n 
north latitude and 64° 51” west longitude. The land area consists 
of about twenty square miles. The Islands are described as coral 
deposit on a series of mountain peaks of possible volcanic origino 
The main Island has been compared in formation to a fishhook lying 
in a northeast southwest direction* with the open curve of the 
hook toward the northo The Islands are 1*000 nautical miles from 
Miami*‘Florida* and 653 nautical miles from New York. They lie 
directly east of the North Carolina coasto The first United States 
Army personnel to be stationed in the Islands arrived on 20 April 1941» 
II Sanitation; 
lo Clothing: The climate of Bermuda is oceanic® 
Definite seasons occur, however extremes are not encountered® It 
has been the practice here to wear 0®Do clothing from 1 November to 
about 1 April and khaki the remainder of the year® Clothing has 
always been adequate and no special type required® During the 
summers of 1942 and 1943 the wearing of khaki shorts and sport type 
khaki shirts was authorised for troops during training periods® 
2« Housing: The Bermuda Base Command was established 
18 April 1941 and the troops arrived in Bermuda 20 April 1941 and 
occupied the Castle Harbour Hotel building, Hamilton Parish® The 
hotel was used for housing, messing and hospitalizing the troops 
in addition to being the administrative headquarters® 
As outpost and gun positions were established troops for 
these points were housed in either tents or temporary barracks® 
On April 1st, 1943, the Bermuda Base Command was moved 
from the Castle Harbour Hotel to its permanent location at Fort 
Bell, and at the same time the 221st Station Hospital was estab- 
lished in the permanent hospital building at Fort Bell. 
3c Food and Nutrition: This has been adequate except 
for a period during the summer of 1942 when due to enemy submarine 
activities balanced diets were difficult to maintaino Fresh milk 
was not available until the spring of 1945 when shipments were be- 
gun from the United States by plane® 
66 4* Personal Hygiene: This has been excellent except 
during the periods of water shortages and even then it has been 
adequate because of the fact that these shortages usually occurred 
in the summer and adequate bathing facilities at beaches were 
available• 
5* Water: The water supply of this base is from three 
sources: 
a. Rain water impounded from roofs of buildings and 
catchments at Fort Bello 
b. Water from three sea water evaporators. 
c. Water impounded by catchment at the Castle Harbour 
Hotel area and brought to the base by water barge. 
Approximately 13*500,000 gallons of rain water per year 
are collected on catchments having a total area of 648*700 square 
feet. Approximately 22,000,000 gallons of drinking water are pre- 
pared by the three sea water, evaporators each year. Also approxi- 
mately another 8,500,000 gallons per year is brought in by water 
barges from catchment and reservoirs at the Castle Harbour Hotel, 
which has a storage capacity of 5,000,000 gallons. Water in this 
reservoir in excess of 1,750,000 gallons is available for use on 
the base. 
6. Disposal of Waste: Waste disposal is from a central 
point at the Fort Bell Incinerator. Edible garbage is made available 
to local farmers while nonedible garbage and other wastes are incin- 
erated. At units not located on the base the same handling is in 
effect in general, but incineration is by the unit. 
7. Control of Insects: The only insect problem at this 
base has been the mosquito. Repeated surveys and mosquito trappings 
conducted at this base by the U.S. Army, Navy, and local health au- 
thorities have demonstrated the following: 
(1) Anopheline Mosquitoes are not present in 
Bermuda and Endemic Malaria does not exist. 
(2) Aedes Aegypti is present. No yellow fever 
has been reported in a number of years, but 
there was an epidemic of dengue fever during 
1941* with 1401 cases reported among the 
civilian population and 3 cases among U. S. 
Army personnel. Measures to eradicate this 
species have been enforced since that time. 
(3) Pest mosquitoes are prevalent. 
(4) The breeding season extends from early April 
until late November. • 
67 (5) There are no streams in Bermuda*. The 
character of the soil and underlying rock 
is such that water does not collect in 
any great quantities on the surfaceo 
Swampy areas in general have underground 
connections with the ocean rising and 
falling with the tide*, 
(6) Type of mosquitoes trapped: 
a0 Aedes Argenteus (Stegomyia) 
bo Culex Fatigans 
Co Aedes Sollicitans 
d*. Aedes Taeniorhynchus 
In May 1942 an inspection system was instituted* operating 
under the control of the Bermuda Medical and Health Department* for 
the locating of breeding places of mosquitoes*, Supervisors and in- 
spectors for the program were supplied by the United States Army* 
United States Navy* British and Bermuda Military Forces* and the 
Bermuda Medical and Health Department. In addition a well-planned 
publicity program was instituted and a marsh drainage program begun 
under a trained sanitary engineer imported by the local government. 
The control program to date has proven highly satisfactory0 Dur- 
ing the present campaign the United States Army was able to reduce 
the personnel assigned to such duties from 23 enlisted men as as- 
signed in 1942 to two enlisted men* the local health authorities 
taking over more of the areas previously policed by our men. 
S. Rodent Control: Although the Bermuda Islands have 
been noted for their excessive rat population through the years* 
rats have not been a problem at Fort Bell because of the rat- 
proofing of the warehouses and the sanitary control measures 
throughout the areao There are two types of rats prevalent on 
the Islands* Rattus norbegicus and Rattus Rattus. However* dur- 
ing the past three years the local programs for the control of 
these rodents have been considerably acceleratedo This has been 
due to stimulation of local interest as a result of their obser- 
vation of successful measures of control exercised by the United 
States Army. These measures are in the main limited to rat- 
proof ingo Local measures have included the free distribution 
of phosphide baits* phosphorus poison* rat traps and the opera- 
tion of cyanide pumpso 
III Sanitary Engineering; 
1° Sewage Disposal; The sewage system of the Castle 
Harbour Hotel building is a series of Imhoff Tanks located near 
the buildingo It functioned satisfactorily with only a slight 
odor* no flies and clear effluvium which emptied into Castle 
68 Harbour. Combustible refuse and garbage were burned in the 
hotel incinerator. 
Sewage disposal at Fort Bell is by flush system using 
sea water and by outfall sewer and pumping station to sea 150 
feet from the eastern end of the Islands. The outfall has been 
the cause of considerable annoyance as it is not located at suffi- 
cient distance from several excellent bathing beaches. There is 
at present under construction a sludge digestive system sewage 
treatment plant which is expected to be in operation within ap- 
proximately one month and will eliminate this difficulty. In 
general troops located at points other than Fort Bell are using 
pit latrines which are maintained in excellent condition. 
2. Water System: There are ten reservoirs and twenty-four 
wooden stave tanks which have a combined storage capacity of 5*026*600 
gallons on the base. Water is pumped into the main water mains from 
seven pumping stations from these reservoirs. The pumping stations 
are equipped with electrically operated hypochlorinators* the hypo- 
chlorite solution being injected into the system under pressure. 
The pumping station to operate for any one day is 
decided by the Post Engineer on the amount of water available to 
the pumps. The main pumping station for the day is designated as 
the primary station* a second set of pumps are designated as sec- 
ondary pumps for the day and are so set as to come into operation 
automatically if line pressure falls. 
Hypochlorite solution is introduced at the pumping point 
in the system and this point may be in very close approximation to 
using agencies* making it almost impossible to maintain a constant 
chlorine residual of C. 4- ppm. In addition secondary pumping sta- 
tions may come into the system at any time the pressure falls in- 
troducing additionally chlorinated water® Water samples collected 
from various points on this post revealed chlorine residuals varying 
from as much as 2.5 ppm to none. The present system of chlorination 
makes this water potable baetoriologically* but the uneven chlorine 
residuals with highs of as much as 2.5 ppm which makes the water 
objectionable from a taste standpoint and the complete absence of 
chlorine at other areas raises a question as to the potential dan- 
ger of the water supply. 
After a careful study of the present system by the Post 
Engineer and sanitary engineers of the North Atlantic Division of 
the Division of Engineers a recirculatory system has been inaugu- 
rated which has lowered chlorine residuals at the most objection- 
able points by increasing contact timie' of the chlorine with the 
water. Further improvements are planned which should correct the 
situation entirely. 
69 IV Epidemiology: 
1. Immunization: At this base tetanus toxoid* triple 
typhoid and smallpox vaccinations are all that have been required. 
Constant check has been maintained and at all times immunization 
has been complete. 
20 Intestinal Infections: During June 1944- an epidemic 
of diarrhea occurred in a unit of this command station at an out- 
post on the Islands and operating their own mess for a group of 99 
men. In the six days during which new cases were reported there 
were twenty-eight cases of gastrointestinal disease in the unit* 
with the peak being reached on the fourth day when eight cases were 
reported. The outstanding symptoms were loss of appetite* weakness* 
diarrhea and nausea. A few vomited and had temperatures above nor- 
mal* but none were seriously ill and recovery in the entire group 
was rapid. All could be considered cured in from 4& to 96 hours 
after their onset. 
A careful study of the menus and checking with all 
patients revealed that only one meal in the four day period prior 
to the onset of symptoms was common to the entire group* and this 
meal contained only one food which v/as common to the entire group 
of patients. This food was hamburger patties® In this outbreak 
the reporting of the cases was too late to secure any of the sus- 
pected food for bacterial examination. Examination of water supplies 
revealed nothing which would suggest that it had been a causative 
factor. Food handlers in the kitchen were examined but again 
nothing pointed to a causative factor. Laboratory examinations 
of all patients stools failed to find any organisms. The epidemic- 
logical investigation tended to incriminate ground meat served as 
the causative agent in this outbreak of enteritis but laboratory 
investigation failed to incriminate any specific organism. 
During April 1945 there was an outbreak of diarrhea 
among the personnel of the Station Hospital as well as one patient 
at the hospital. In all 33 persons shewed definite symptoms* 5 of 
whom required hospitalization. An epidemiological investigation 
was conducted and menu charts for the period involved were prepared 
and every person at the hospital was interviewed and food eaten 
during the period recorded. After this careful check it was 
found that on no one day did every person infected eat at the hos- 
pital and further that three persons infected ate no meals whatso- 
ever at the hospital during the period. Stool cultures were col- 
lected on the five cases hospitalized and of thirteen stools exam- 
ind eight proved positive for Pseudomonas pyocyanea. Repeat cultures 
one week after the disappearance of symptoms were negative in all 
cases. A detailed investigation of the water supply of the post 
at the time of the outbreak revealed that a sample of water col- 
lected from one of the catchments showed presence of Pseudomonas 
70 pyccyanea on culture. The unusual circumstance of finding the 
Pseudomonas pyocyanea in one of the sources of raw water and in 
excessive numbers in the stools of four of the five cases hospi- 
talized could not be correlated* however, nor was the presence of 
Pseudomonas pyocyanea demonstrated again in any of the raw water 
supplies of the base. 
3* Infection of the Respiratory Tract and Infections 
Transmitted by Discharges from the Respiratory Tract: Respiratory 
infections have been no problem at this command. Over the past 
six months rates have reached a point as low as 36 per thousand 
per annum and a high of only 96 per thousand per annum* which was 
for the month of February* or the period when respiratory infec- 
tions can be expected to reach their highest peak® 
4® Miscellaneous Infections: During December 1941 
there was a severe epidemic of Dengue Fever among the civilian 
population of the Islands* with three cases developing among the 
American military personnel. All three cases recovered spontane- 
ously with fever for two cases lasting four days and in one case 
thirteen days. 
5* Nutritional and Environmental Diseases: There has 
been no problem whatsoever with nutritional or environmental dis- 
eases® 
V Venereal Disease Control; 
A comparison of the number and types of venereal 
diseases in this command during the years of 1943-44 is shown 
below; 
Disease 
1244 
1143 
Gonorrhea* New 
27 
50 
Old 
3 
5 
Syphilis* New 
2 
15 
Old 
0 
4 
Lymphogranuloma 
0 
3 
Chancroid 
0 
Jk 
32 
81 
The venereal disease rates for 194-3* 1944 and the first 
half of 1945 are as follows; 
1st 6 mos of 1945 - 19°4 per thousand per annum 
1944 - 11.8 per thousand per annum 
1943 - l6o3 per thousand per annum 
71 Seventy percent of the clandestine relations are with women the 
names of whom are unknown to the soldier and only a few of these 
have charged a fee® It can be said that prostitution per se 
plays but a small part in our venereal disease rate0 Cur prob« 
lem is with the f,teenn age group of colored and white girls who 
are promiscuous in their relations with soldiers to the extent of 
meeting them for the first time on the street and proceeding to a 
field for sexual relations® 
In May 194-3 the Bermuda Medical and Health Department 
began an active venereal disease control program under the new 
regulations promulgated by the local governmento In addition to 
modernized regulations they increased the staff of their Central 
Health Bureau by assigning an Assistant Senior Medical Officer 
with special duties in venereal disease control. The results of 
this activity are shown by the attendance records at the venereal 
disease clinics. 
May 194,3 167 
September 194-3 4-63 
September 194-4- 1125 
The above figures do not represent numbers of persons under 
treatment but the number of treatments or checkups during the 
month. During September 1944- the lodal health authorities had 
4-99 patients under treatment and 116 persons under observation 
following a reversal of their serology. 
/s/ Milton Tc MacDonald 
/t/ MILTON To MacDONALD 
Major* Med Corps 
Surgeon 
72 HISTCEY OF PREVENTIVE MEDICINE IN WORLD WAR II 
GREENLAND BASE COMMAND OFFICE OF THE BASE SURGEON 
Greenland Base Command 
APO # 858? c/o Postmaster 
New York? N.Y. 
MJS/dfg 
314.0 7 
27 August 194-5 
SUBJECT: History of Preventive Medicine in the Greenland Base 
Commando 
TO : Commanding General? Hq Eastern Defense Command? 
Governors Island? New York? 4? N.Y. (ATTN; Surgeon). 
THRU : Commanding Officer? Greenland Base Command? APO # 858? 
c/o Postmaster, New -York? N.Y. 
In compliance with Itr. 314®7? Hq Eastern Defense 
Command? subject? "History of Preventive Medicine in World War II?" 
dated 28 July 1945? the following medical history of the Greenland 
Base Command is submitted: 
I INTRODUCTORY REMARKS 
On 6 July 1941 the USS Munargc arrived in Greenland and 
the first American troops went ashore at the present site of Nar- 
sarssuak Army Air Base, AFC #853 NYC. Among the original task 
force were two officers and fourteen enlisted men of the Medical 
Department who immediately established a dispensary which was used 
until 1C August 1941* On this date a ten bed field hospital was 
set up in tents. This hospital served until 4 October 1941 when 
it was moved into a permanent type building and began operating as 
the twenty bed 188th Station Hospital. 
A gradual increase in personnel and the need for additional 
hospital and equipment space brought about another move on 6 June 
1942. The warehouse buildings adjoining the airstrip were utilized 
for use as a hospital and the bed capacity was raised to fifty-five. 
It functioned as such until 11 December 1943 when the present build- 
ings were ready for occupancy and the 188th Station Hospital was en- 
larged to a two hundred fifty (250) bed capacity at the time. 
Due to gradual reduction of military personnel and the 
total absence of civilian personnel on this base by midsummer 1944? 
the 188th Station Hospital was reduced to two hundred (200) beds 
on 1 July of that year. Continued reduction of military personnel 
after this time resulted in a further reduction on 6 March 1945? 
this time to one hundred beds? and on 30 June 1945 the hospital 
was functioning as such although a further reduction was contem- 
plated in the near future. 
73 Medical service was established at Ivigtut Army Air 
Base, APO #615 NYC* on IB March 194-2 upon the arrival of an array 
force accompanied by one medical officer0 On 3 Sept 194-2 the 
lB9th Station Hospital was activated with a capacity of twenty- 
five (25) beds and during the year three medical officers and 
one dental officer were assigned to that installation* By May 
194-3 another medical officer was assigned and the enlisted 
strength of the medical department was raised to twenty-five*, 
Navy #26 also maintained a ba.se at Ivigtut and the Naval medical 
and dental officers of that unit helped greatly to relieve the 
strain upon the army medical officers although all navy personnel 
were still admitted to the army hospital* During August 1944 
most army units departed from APC #615, among them the lS9th Sta- 
tion Hospital which was disbanded at that timeo Personnel were 
either returned to the United States as excess or absorbed by the 
188th Station Hospital at Narsarssuak AABo 
On 7 October 1941 a contingent of army personnel arrived 
at the head of Sondrestrom Fjord, among them one medical officer* 
This is the northernmost base in Greenland, situated on the west 
coast and well above the arctic circle* The base is now known as 
Sondrestrom Fjord Army Air Base, APO #859 NYC* The 190th Station 
Hospital was established there on 10 Sept 1942 with a T/O of two 
hundred (200) beds*. On 29 Sept 1943 the T/0 was reduced to fifty 
(50) beds and a further reduction to twenty-five (2$) beds was 
accomplished on 1 July 1944® On June 1945 the 190th Station Hospi- 
tal was still operating under this T/0 although with a reduced per- 
sonnel. 
Medical service at what is new known as Ikateq Arny Air 
Base, APO #679 NYC, was established on 2 November 1941 upon the 
arrival of army personnel accompanied by one medical officer near 
Angmagssalik, Greenland* This is the only army installation of 
any size on the east coast of this island and on 26 June 1942 the 
191st Station Hospital was activated there with a bed capacity of 
one hundred fifty (l50)o During the period 2 November 1941 to 
26 June 1942 the medical service was provided by a UoSoEoDo dis- 
pensary commanded by the medical officer and manned by civilian 
personnel* On 17 July 1943 the hospital was reduced to fifty (50) 
beds since previous plans for the post had not materialized and 
there was no need for a larger hospital. On 1 July 1944 the 191st 
Station Hospital was reduced to twenty-five (25) beds and operated 
as such through 30 June 1945 with reduced strength similar to the 
policy in effect at the 190th Station'Hospital. 
The Air Corps has maintained weather stations in various 
parts of Greenland since shortly after the arrival cf the first 
troops, personnel ranging from a half dozen to fifty men at each 
station, depending on duties and location. Each outpost has a 
74 medical enlisted man at present but until the early part of 1944 
the three larger stations, Marrak, Gamatron, and Simiutak were 
served by medical officers on a rotating basis, three months out- 
post duty and three months duty at the station hospital. These 
officers were assigned to the 188th Station Hospital, therefore, 
upon reduction of medical personnel' at that installation it was 
no longer possible to furnish medical officers to these outpostso 
They were replaced with enlisted men especially trained for that 
type of duty and without exception this policy has worked out 
very well as emergency cases beyond the scope of the enlisted 
men’s ability can easily be evacuated to the nearest station hospi- 
tal. Screening and final approval of all candidates for outpost 
duty rests with the Flight Surgeon whose report on this procedure 
is added as inclcsure #1. 
The organization of the Medical Department in Greenland 
is headed by the Base Surgeon, a position created 1 June 194-2® Ex- 
cept for a short period early in 1943 the Base Surgeon has also as- 
sumed the position of Commanding Officer of the 188th Station Hos- 
pital as an additional duty. This office is responsible for formu- 
lating the medical policies followed in Greenland. 
Due to the large amounts of foods and the increasing 
number of sledge dogs in this command a Veterinary Officer was as- 
signed in October 1943® His duties are principally at the main 
base at Narsarssuak but oftentimes trips to other bases in Green- 
land are necessary for the successful discharge of his duties. In- 
closure #2 attached is a full report of veterinary activity in this 
commando 
Fifteen (15) army nurses arrived in Greenland on 17 
January 1944 and were assigned to the 188th Station Hospitalo 
Nursing service was established on 19 January 1944 and on 30 June 
1945 was still in force although the original group of nurses had 
by this time dwindled to six. The 188th Station Hospital is the 
only installation on this island to have nurses assigned at any 
time. 
The office of the Base Dental Surgeon was created in 
February 1945* Like the Base Surgeon and Base Veterinarian his 
duties are mainly at APC #858, but trips to the other bases and 
outposts are made as necessary for close contact and cooperatloii. 
Prior to the creation of this office the senior- dental officer 
acted in this capacity. The Dental Surgeon’s report is added as 
inclosure #3. 
75 II SANITATION 
1* Clothing: Ckothing has been adequate both in quality and 
quantity for the climate encountered. The Greenland winters are 
long and severe but all personnel have an ample supply of arctic 
clothing and are instructed in its use. Consequently* cases of 
frostbite or frozen limbs due to exposure have been infrequent 
2. Housing: Housing has presented no problem in Greenlando 
Most buildings are of wooden frame type with a scattering of Quon- 
set huts. All buildings are heated with oil stoves with the excep- 
tion of the l££th Station Hospital and the Greenland Base Command 
Headquarters building at AFC #S5S. 
3® Food and Nutrition; Food supply has been one oftthe 
biggest problems arising in this command. Quantity has been below 
normal on numerous occasions and fresh fruits and vegetables are 
rarely to be had. For this reason dehydrated foods have necessarily 
formed a large part of the diet but with proper preparation and 
varying menus it has proved to be both appetizing and nourishingo 
Calcium and vitamin tablets have always been available to supple- 
ment the regular diet and to -this date no serious nutritional prob- 
lems have been encountered. The veterinary report inclosed has ad- 
ditional information on this subject. 
4.0 Personal Hygiene: Personal hygiene has always been very 
satisfactory in this commando Running water is available at all 
main installations the year around and ample cleansing facilities 
for all personnel is provided. Monthly physical examinations are 
held and dental examinations are given periodically to insure high 
standards of health among the troops. At the larger bases laundry 
and dry cleaning facilities are also available at the option of the 
men. 
5° Water: Water supply in Greenland is excellent. At APO 
fjB58 and APC ft679 it is derived from reservoirs fed by streams and 
this water does not require chlorination. APC £59 is supplied from 
a lake and water is hauled daily by truck to storage tanks. This 
supply is chlorinated. All water sources receive routine weekly 
analysis and have always been pronounced pure and potable. 
Outposts obtain water from nearby lakes and streams 
which are piped to buildings during the summer months and carried 
in cans during the winter to storage- tanks where it is chlorinated 
and tested before use. 
6. Disposal of Waste: The main bases are equipped with 
sewage systems for disposal of human waste. These systems empty 
into nearby rivers or fjords. Outposts are equipped with chemical 
toilets. 
76 All food waste at the main bases and at the outposts is 
disposed of by incineration. 
7. Control of Insects; Insect control has never been a 
problem in this command. There is an overabundance of mosquitoes 
during the few summer months but satisfactory preventive measures 
are taken by covering the breeding spots with a thin oil film. In- 
sects other than mosquitoes are negligible and present no problem® 
8® Control of Rodents: Rodent control like insect control 
causes little concern in Greenland® A variety of rabbits are the 
only rodents found and these are not numerous. Mice and rats are 
unknown on this island®. 
Ill SANITARY ENGINEERING 
1. No special projects in sanitary engineering have been 
accomplished to this date. The problems of water supply and waste 
disposal were the only ones encountered and these were easily met 
in a satisfactory manner within a short period after the arrival 
of the first troops. 
IV EPIDEMIOLOGY 
1* Immunization: Special immunization is not required by 
troops serving in Greenland* as Cholera* Typhus* and Yellow Fever 
are not known in this command. Stimulating doses of typhoid vac- 
cine are given at twelve month periods and smallpox vaccinations 
are given at three year intervals as required by regulations® 
Otherwise* only perscnnel not completing a routine series of immu- 
nization in the United States are processed upon arrival in Green- 
land. 
Following completion of the initial series of Tetanus 
Toxoid vaccine and the required stimulating dose* inoculation is 
given only to persons in danger of infection from fresh cuts or 
gunshot woundso At the present time all personnel of this command 
have completed required immunizations. 
2. Intestinal Infections; There is no record of any serious 
outbreak of intestinal infections® We have never had any cases of 
amebic or bacillary dysentery* cholera* or protozoan infections® 
There have been a few isolated instances of common diarrhea result- 
ing from spoiled or improperly prepared,, food but never to any seri- 
ous extent. 
3® Infections of the Respiratory Tract and Infections 
Transmitted by Discharges from the Respiratory Tract: Infections 
of the respiratory tract are normally uncommon in Greenland. The 
weather has had a favorable effect in this regard® However* the 
incidence of upper respiratory infections would invariably increase 
77 with the arrival of casuals from outside the island in Greenland® 
Due to the isolation of our bases there is an apparent increase in 
the susceptibility of our personnel to upper respiratory organisms 
introduced by casuals® In one instance in 1944 it was necessary to 
quarantine Narsarssuak Air Base to control a mild epidemic of upper 
respiratory infection® 
4-o Miscellaneous Infections: No serious miscellaneous 
infections have occurred in Greenland which would be of any impor- 
tance® 
5° Nutritional and Environmental Diseases: In spite of 
occasional nutritional deficiencies in our diet no significant nu- 
tritional or environmental diseases have occurred. 
V VENEREAL DISEASE CONTROL 
The incidences of venereal diseases in general and 
syphilis in particular have always been extremely low in Greenland. 
The few cases of syphilis reported from here were invariably con- 
tracted outside the island,. Because of the Greenland law that no 
syphilitic cases could be treated here such cases had to be evac- 
uated to the United Stateso Gonorrhea is not particularly preva- 
lent in the island0 
Venereal disease control measures have probably not been 
sufficiently stressed here in view of the very low incidence of 
venereal diseases® However,* personnel returning to or on first 
arriving in Greenland are very carefully examined for evidence of 
venereal disease® Men leaving their bases for emergency furlough 
or temporary duty in the IRS® are provided with both mechanical 
and chemical protective devices against venereal disease* also* 
troops in this command are given sex hygiene education as a part 
of the routine training program® 
/s/ Maurice J® Specter 
/t/ MAURICE Jo SFECTOR 
Major9 MC 
Base Surgeon 
3 Inclss 
1 Flight Surgeon’s Report 
1 Base Veterinary Report 
1 Base Dental Surgeon’s Report 
78 f OFFICE OF THE FLIGHT SURGEON 
xJJarsarssuak Army Air Base 
AFC 850 c/o Postmaster 
New York* N.Y. 
MEDICAL SCREENING OF OUTPOST PERSONNEL 
It is the purpose of this paper to briefly* but it is hoped 
emphatically* set forth the problem of proper selection of outpost 
candidates. The standards set up must be rigid physically and 
mentally for reason of the complete isolation of these men in ap- 
proximate groups of ten for a period of eight to ten months® 
Despite excellent rescue equipment* Including planes equipped 
for landings on water* ice* land and snow* ice cutters* and sled 
teams* there are areas inaccessible for long periods of time® Auto- 
giros and helicopters offer only a partial solution (we do not have 
these available) because of extreme weather conditions* particularly 
high winds which often prevail in these areas® 
In view of the above general conditions* in cur physical and 
mental examinations* we have disqualified any individual whose medi- 
cal history or examination revealed any condition of sufficient 
gravity* either present* or likely to exist during that period of 
outpost duty* which required evacuation® Examples of medical his- 
tory frequently disqualifying are; 
lo History of repeated attacks of appendicitis*, 
2. Peptic ulcer® 
3. Low back pain of moderate degree with absence of 
physical signs*, 
History of arthritis more than mild in degree® 
5« Kidney stones® 
6o Asthma. 
7. Definite mental disease or abnormalityc 
In addition to above examples found in history* such conditions 
as are noted on inclosed copy of "Physical Standards for Cutpost Ex- 
amination." 
Psychiatric interview will result in the largest number of 
disqualifications* Mental breakdowns are very frequent due to the 
extreme isolation in arctic conditions for long periods* and*as a 
result* an examination* similar to "ARMA,! (Adaptability Rating for 
Military Aeronautics) given to Air Corps Flying Personnel* is con- 
ducted in which adaptability to arctic conditions is estimated*, 
Inclosure #1 - Page 1 
79 As examples of the factors considereds 
lo City or country environment and adaptability to sameo 
20 Outdoor or indoor preferences0 
3<> Dependent or independent personality typeso 
4.0 Evidences of emotional9 mental5 or vasomotor 
or other psychiatric disturbance» 
In regard to men sent to this base from the States* very few 
have been found by this office to be disqualified for overseas duty 
of either limited or general type| however* for isolated duty* well 
over 5<$ have been disqualified by this office* and in some groups 
over 90$o These high rates in themselves attest to the necessity 
of more adequate arctic isolation examinations in the States® In 
general* the facts to be kept in mind in conducting these examina- 
tions ares That the outpost men must be capable of physically and 
mentally sustaining the climatic conditions and isolation with ap- 
proximately ten men over a period of eight months to a year® 
All members subjected to outpost examination are volunteers 
to exclude as much as possible distortion of their complaints© 
They are returned to the Continental Limits of the United States 
upon completion of Outpost tour* usually approximately one year* 
as contrasted to normal overseas tour of the theater which has 
varied from 18 months to 2 years® As stated previously* men dis- 
qualified for outpost are rarely found to be disqualified for over- 
sea duty* and are then placed on duty at BE 2* BW 8* or BW 1* the 
three main bases of Greenland® 
Because of the efforts of the medical men assigned in adhering 
to rigid standards of selection* our problem has been in great part 
solved® Seldom now for causes other than traumatic do we have cases 
requiring evacuation in isolated areas where no evacuation is possi- 
ble without endangering several other lives* particularly has this 
been true of the manic psychiatric breakdowns so destructive to 
morale® Correspondence with higher echelons pointing out the neces- 
sity of more adequate selection has availed nothing® The problems 
could not be understood by others than those who had actually lived 
under arctic conditions and isolation* and seen the results of too 
poor a mental or physical examination* with an outpost soldier living 
day by day* not for a week or a month* but from nine to twelve 
months* in a monotonous existence with numbing cold* howling winds* 
and nothing but ice and snow for surroundings© 
In view of the above* it has been the opinion of all medical 
men* engaged in outpost examinations here* that Arctic Schools be 
set up to determine preliminary adaptability as well as actual 
training in some central area with physical and mental examinations 
conducted by medical officers attached who are acquainted* if possible* 
by actual experience with arctic problems® This is to prevent 
psychiatric problems as well as theater manpower situations due to 
inadequate preliminary selection© 
Inclosure #1 - Page 2 
80 PHYSICAL STANDARDS 
for 
OUTPOST EXAMINATION 
!• Tc be Class I (Outpost Physical Rating) for isolated 
duty in the Arctic* a man should be in excellent physical condition 
with only minor defects* as follows: 
a. VISION: 20/4,0 minimum either eye. 
bo HEARING; 20/20 both ears® 
c. COLOR VISION: Should be able to differentiate between 
true red and true green® 
d. TEETH: Class IV. 
e. HEART, LUNGS, BLOOD PRESSURE AND PULSE: Essentially 
normal. 
f. GASTROINTESTINAL: No chronic disease. Neurasthenia 
gastrica considered disqualifying. 
g. GENITOURINARY: Free of any diseaseo 
h. EXTREMITIES: No gross deformities or limitation of 
motion beyond 1C%0 
i. VARICOSE VEINS; No varicosities other than those 
mild in degreeo 
j. VARICOCELE: Considered disqualifying if symptomatic, 
ko HERNIA; Inguinal hernia considered disqualifying® 
lo HEMORRHOIDS; More than minimal considered disqualifying, 
m. AGE; 21 - 33 years of age® 
Such a man is qualified for any type of outpost duty. 
2. Our Class II is an individual who comes up to the requirements 
of Class I with one or two minor exceptions* such as 20/lC0 vision 
uncorrected. Such an individual would be more suited for Section I* 
Ivigtut* Marrak* or other larger outpost. However* some of the in- 
dividuals* after careful evaluation and consideration* could be 
used for isolated outposts if no Class I men were available* e®g.* 
defects in a.* b.* c.* greater in degree than noted above. 
3. Class III. Men not considered suitable for any type of 
outpost duty. 
Inclosure #1 - Page 3 OFFICE OF THE BASE VETERINARIAN 
GREENLAND BASE COMMAND 
APO 858* c/o Postmaster 
New York* N. Y. 
REPORT OF VETERINARY SERVICE 
Prior to October 194-3 > there was no veterinary service in 
Greenland. Until that time* all food inspection was conducted by 
the medical Inspectors at the various baseso Problems related to 
veterinary medical care of the sledge dogs were managed by the dog 
handlers. Because many difficulties and questions arose concerning 
subjects that properly fell under the jurisdiction of the Veterinary 
Corps* the Surgeon and the Commanding Officer of Greenland Base Com- 
mand considered it advisable to requisition a veterinary officers 
The Veterinary Department in its present form began functioning 
in December 194-3,> with the opening of the new hospital at APO #858. 
A limited but sufficient supply of Instruments* the necessary drugs 
and medicines* and other equipment were obtained from Medical Supplyc 
A crude but satisfactory pperating and examining table was con- 
structed* and the necessary Medical Department forms were mimeographed. 
An enlisted man of the Medical Detachment of the 188th Station Hos- 
pital was assigned to the Veterinary Officer to assist with the 
clerical work. Eventually additional veterinary biologies and 
drugs were received. The Veterinary Service in Greenland has had 
the dual function of care of the Army sledge dogs and inspection of 
food. 
I Care of Dogs 
The dogs used by Greenland Base Command were obtained from 
Danes and Eskimos in Greenland. Records of the Sale are incom- 
plete* but approximately one hundred and thirty-five (135) adult 
animals* all over two years of age* were purchased. They are of 
a type generally known as "Greenland Eskimo" or "Husky*" with the 
exception of four (4) dogs procured from the States. They are of a 
hardy* rugged breed* and only the toughest could survive the harsh* 
rough* and inhuman treatment they endured under the Greenlanders. 
They seldom become ill or require veterinary care. No adequate 
records were kept on the Army canines before October 1943* There 
was much indiscriminate breeding and poor management. These con- 
ditions were corrected when the responsibility of caring for them 
was assigned to the newly formed 1st Arctic Search and Rescue 
Squadron. Quartermaster Form No. 120 was completed for each of 
the dogs. 
Inclosure #2 - Page 1 
82 In view of the information available in December 1943* and 
at the advice of the Office of The Surgeon General, it was consid- 
ered unnecessary to vaccinate the sledge dogs against rabies and 
canine distemper at that time. Sanitary regulations were insti- 
tuted to prevent introducing new dogs into Greenland and thereby 
to avoid exposing Army sledge dogs to disease. A severe distemper 
epidemic broke out among the mongrel pets at Narsarssuak Army Air 
Base (BWl), APO #8$8, in September 1944* The source of the infec- 
tion could not be determined. Every dog on the Base was infected, 
a few old mongrels excepted. In order to control the disease and 
prevent its spread to the isolated Dog Camp Area, rigid veterinary 
police methods were enforced. All strays were killed, and all dogs 
manifesting definite symptoms of distemper were destroyed. Tissue 
specimens were sent to an Army laboratory in the States, and the 
diagnosis of distemper was confirmed. A large supply of serum and 
vaccine was ordered immediately, and plans were made to vaccinate 
all the Army dogs. The epidemic subsided completely and there 
were no new cases during the last two ?/eeks of October and the month 
of November 1944» It appeared that the strict veterinary police 
methods were successful in confining the disease to the Base. 
Distemper broke out in the Dog Camp at the end of November 
1944* The source of the epidemic could not be discovered. The 
serum and vaccine that had been ordered from the States two months - 
previously had not yet arrived from the States, and the infection 
spread rapidly among the unprotected dogs. A total of fifty-three 
(53) dogs either died or had to be killed because of severe nervous 
symptoms. Thirty-six (36) of these animals were registered as Army 
dogs. Four dogs that had been obtained in the States and had been 
vaccinated against distemper there were not ill during the epidemic. 
The sulfa drugs did not seem to affect the course of the disease. 
One dog received 400,00C units of penicillin and made a recovery, 
but subsequently had to be killed because of a severe weakness in 
the hind legs. 
The vaccination of Army sledge dogs in Greenland was begun 
in January 1945# and with the exception of some puppies too young 
to be vaccinated and dogs at remote outposts that could not be 
reached, all the canines have been vaccinated against distemper by 
the Laidlaw-Dunkin Method. The greatest difficulty encountered 
was obtaining a viable virus. Delays in airplane traffic from the 
States and between the various bases of Greenland where the sledge 
dogs are located has caused the inoculum to become outdated before 
it could be used. To remedy this defect, the Fromm (Green) Method 
of vaccination for distemper is now being used. This distempercid 
virus will keep much better and for longer periods than the Laidlaw- 
Dunkin virus. 
Inclosure #2 - Page 2 
83 Prior to May 1945, the dogs in this Command were never 
vaccinated against rabies. Numerous inquiries were made concern- 
ing the prevalence of this disease in Greenland, and, as far as 
could be learned, there had never been an authentic case of rabies. 
Thns informat-ion was discussed with the surgeons, and it was de- 
cided that vaccination was not necessary. Advice on the subject 
was also requested from the Office of The Surgeon General, and 
that office suggested that prophylactic measures were not re- * 
quired under the circumstances. However, in January 1PA4-* forty- 
five sledge dogs were sent to the European Theater, and were 
scheduled to be returned to this Command. (Eventually sixteen 
dogs were returned.) Since these animals were returning from 
questionable areas, where rabies is endemic, it was considered 
advisable to protect the dogs in Greenland. Furthermore, the 
expected increase in shipping and airplane traffic during the sum- 
mer months strengthened the possibility of disease being introduced 
from these sources. In spite of all regulations and efforts to the 
contrary, mascots and pets from Navy, Coast Guard, and Merchant 
ships, and even from airplanes, occasionally are brought on the 
Base. At present, all the dogs in Greenland, both Array dogs and 
mongrel pets, have received rabies inoculations. 
In April 194-5 a routine monthly stool examination for every 
Army canine in Greenland was instituted, and treatment was admin- 
istered where indicated. Ascarides and hookworms are the only in- 
testinal parasites that have been discovered. Hookworm seems to be 
the more prevalent intestinal parasite. An effort is being made 
to obtain stool specimens from canines in isolated sledging districts 
of Greenland (North Greenland) for further investigation. In con- 
trast to conditions in the States, no difficulty has ever been en- 
countered with mange, so-called 11 summer itch," eczemas, or other 
skin diseases. Perhaps this can be explained partially by the fact 
that there is a complete absence of external parasites among the 
dogs. Fleas, lice, and ticks have never been seen. The absence of 
.fleas also may explain the nonexistence of the common tapeworm Dipy- 
lidium Caninura. Generally speaking, Greenland seems to be a very 
healthful country for dogs. 
II Inspection of Food 
It has not been possible for the one Veterinary Officer to 
conduct a thorough food inspection service in all of Greenlando 
Frequent trips are made to the various bases and accessible out- 
posts for routine Inspection. Occasionally, at the request of the 
Quartermaster or Surgeon at the various bases, special trips have 
been made when specific problems have arisen. A complete food in- 
spection service is conducted at Narsarssuak Army Air Base (BWl), 
APO #8$8, for the Veterinary Officer is in attendance at that base 
Inclosure #2 - Page 3 most of the time. The medical inspectors control the inspection 
of food at the other posts in the intervals between periodic visits 
of the Veterinary Officer. Important problems are always referred 
to the Veterinary Officer, and samples of foods are returned to 
APO $858 for inspection. No final disposition is made of any food 
product without the knowledge and permission of the Veterinary 
Officer. 
Since the inception of the Veterinary Service in Greenland 
in October 1943, three large shipments of perishable foods have been 
received. nThe Roche,1' a reefer ship, brought the supply each time. 
Each shipment contained about 14,000 tons, and included both frozen 
and chilled cargoo A typical "Roche" shipment contained the follow” 
ing items: 
MEAT 
Beef, Roasting and Frying 
Beef, Stewing and Boiling 
Beef, Chopped 
Beef, Liver 
Fork, Butts 
Pork, Loins 
Pork, Luncheon Meat 
Poultry, Chicken 
Poultry, Turkey 
Sausage 
Bologna 
Frankfurters 
Pork Link 
Cervelat 
Liver 
Salami 
Thuringer 
Veal, Carcass 
Ham, Overseas 
FRESH FROZEN VEGETABLES 
Asparagus 
Beans, Lima 
Beans, String 
Beans, Wax 
Beets 
Cauliflower 
Peas 
Spinach 
Broccoli 
Corn 
FRESH FROZEN FRUIT 
Blackberries 
Cherries 
Strawberries 
Huckleberries 
Peaches 
Raspberries 
Apricots 
Blueberries 
Loganberries 
Plums 
FRESH FRUIT 
Apples 
Oranges 
Lemons 
PRESH VEGETABLES 
Beets 
Onions 
Peppers 
Potatoes 
Turnips 
Cabbage 
Celery 
Carrots 
Sweet Potatoes 
Inclosure #2 - Page 4 
85 DAIRY PRODUCTS 
Butter 
Cheddar Cheese 
Processed Cheese* American 
Siwiss Cheese 
Cream Cheese 
Fresh Eggs 
Depending upon the types of fresh fruits and vegetables and 
their condition on arrival* the amount of these items was usually 
sufficient to supply the Command for six weeks to three months0 
Ihe frozen products and dairy products were usually in sufficient 
quantity to last about six months® In addition to the cargo delivered 
by a reefer ship twice a year* supplementary supplies of perishables 
were occasionally delivered in Navy Tankers* Coast Guard Cutters* 
and Army Transports which had Small reefer holds® 
There is ample chiled and frozen storage space at all the main 
baseso However* the refrigerators are not of ideal construction* 
especially in insulation* and some difficulty has been met in 
maintaining storage temperatures• In the summer the sun is 
sufficiently warm to heat the walls of storage buildings* and 
products placed adjacent to outside walls are sometimes actually 
heated® This was remedied shortly after the arrival of the Veterinary 
Officer by using more dunnage between the walls and the stored crates, 
and by allowing spac6 for greater circulation of the cold air® At 
Sondrestrom Fjord Army Air Base (BW8)* APO #859* above the Arctic 
Circle* the temperature drops so low during winter months that every 
storage room has a minus zero Fo temperature® This has required the 
storage of fresh foods in warehouses that are heated sufficiently 
to keep the product from freezing® 
The greater portion of the food arrives in good condition* 
but there have been notable exceptions® An outstanding example 
was the cargo received from the "Roche" (B®0® 394) in November 
1943o The ship encountered heavy seas* and two scuppers broke 
open* allowing nine feet of water to enter the two frozen holds® 
The ship put in at St® John's* Newfoundland* APO 862, where the 
cargo was unloaded and reinspected by the Veterinary Corps* and 
the rejected products were replaced® The cargo was reloaded in a 
disorderly fashion* and in unloading in Greenland* it was necessary 
to sort the cargo for storage® The shipment required close 
inspection* for some of the cargo had been watersoaked, large 
pieces of ice were formed on the meats* boxes and crates had been 
broken and their contents contaminated* and all the carcass meat 
was unsanitary and dirty® Almost the entire cargo was salvaged, 
but much of the food required trimming and thorough cleaning be= 
fore it could be used® On numerous other occasions fresh vegetables 
and fruits have arrived in a frozen condition® Frequently such 
products have been beyond salvage* but if it was at all possible* 
some use was made of them® A notable example was a huge supply 
of onions that arrived frozen® The onions were placed in frozen 
storage at Narsarssuak Array Air Base* since they could be 
Inclosnre #2 - Page 5 preserved only in this way* Most of this shipment was finally 
reclaimed by cooking* over a period of ten monthso 
The storage of shell eggs for long periods was finally solved 
at Narsarssuak Array Air Basec Of all the foods issued* fresh eggs 
have as high a morale value as any other item. The quantity re- 
ceived is usually large enough for six months. However* at the be- 
ginning of the Veterinary, Service in Greenland most personnel could 
enjoy the eggs only for the first two months of storage* During the 
third month only the inveterate eaters of eggs could relish them® 
In the fourth month some people could eat them scrambled and sprin- 
kled liberally with ketchup* After the fourth month they were fit 
only for the garbage dump* and had to be disposed of by survey. 
The spoiling was due to the fact that the eggs were stored at too 
high a temperature* without sufficient provisions for ventilating 
the boxes and circulating air around the crates. Engineers at Nar- 
sarssuak Army Air Base reconstructed two refrigerator units* so 
that they could hold a constant temperature of 30° F. Ventilation 
was improved* and arrangements were made to air the storage boxes 
periodically* to remove the characteristic stale odor that eggs 
acquire so early in storage* Unfortunately similar storage facili- 
ties for eggs could not be provided at the other two main bases now 
in operation* At Scndrestrom Fjord Array Air Base eggs must be 
stored in a heated warehouse to prevent freezing in winter*. Because 
the storage rooms are heated by crude oil stoves* it is difficult 
to maintain the correct temperature constantly* and they are often 
too warm* 
Milk is probably missed by more soldiers overseas than any 
other food itenio No fresh milk is available in this Command9 bat 
every effort has been made to furnish a reasonably good substitutee 
Mechanical cows were obtainedg but proved to be a complete failure* 
They repeatedly failed mechanically and required constant supervi- 
sion to make certain that the operators were producing the milk in 
a sanitary condition* Furthermore* the product resembled milk only 
in coloro Perhaps the poor quality of the product was due to the 
ingredients* Sufficent fresh butter was not available for both 
table use and the manufacture of milk,? and it was thought prefer- 
able to issue it directly* the butter was salted.? and 
required the time-consuming work of desalting before it could be 
utilized in the mechanical cow« When butter oil was substituted 
for butter fat9 the resulting milk was not satisfactory* 
It was found that a comparatively good reconstituted v/hole 
milk could be manufactured by the simple mechanical ra5xing of whole 
powdered milk and water. Various formulae and mixtures were tried. 
The following method resulted in a product superior in flavor to 
milk produced by the mechanical cow. Water is boiled* and then 
cooled to approximately 10C° F* and placed in a mixing bowlo Pow- 
dered whole milk Is distributed on the surface of the water in 
Inclosure #2 - Page 6 
87 proportions of four ounces per quart of water, and the mixture is 
stirred. It is cooled and aged in a refrigerator overnight before 
serving* Many men will drink this milk, but the failure of most 
personnel to drink reconstituted milk appears to be due largely to 
a psychological factor. This was proved in May 1944- by a sampling 
experiment. Six officers and one noncommissioned officer were 
asked to taste several samples of milk, one of which was fresh pas- 
teurized cow11 s milk* Not one of the men was able to distinguish 
the pasteurized milk from the other samples0 
Enormous stock piles of food were built up at all the bases 
in Greenland up to and through the summer of 194-3° Much of this food 
was brought into Greenland by civilian contractors while they were 
constructing the baseso Sudden and unexpected decreases in strength 
caused these huge amounts of food to become excesso The Quarter- 
master was informed that much of this surplus was being stored 
longer than the expected life of the products® However, it was 
not possible to return any of it to the States during the summer 
shipping season of 194-4- because of lack of cargo space® 
Further reductions in personnel have now created even larger 
food surpluses9 and an effort is being made to return the food to 
the Stateso Since March 1944-j the Veterinary Service has inspected 
prodigious supplies of surplus food. Much of it is no longer suit- 
able for human consumption and has been destroyed. This is espec- 
ially true of enormous amounts of canned goods that have been in 
storage in Greenland for as long as four years. During this period 
the cans have been frozen and thawed many timeso This has resulted 
in seams breaking,* contents of cans running out* and cans rusting 
through. Salvage of the food that remains is being attempted. If 
there is any doubt of the suitability of the products for food,* 
samples are submitted to the Army Veterinary School,* Array Medical 
Center* Washington* D. Co* for analysis and recommendation. 
In general, the quality and quantity of food in Greenland 
Base Command has been satisfactory* The Base has had its sieges 
of spam, C-ration, stabilized butter, and dehydrated potatoes* 
The length of periods of food shortages has varied from a few 
weeks to a few months, while a new shipment of food was awaited® 
Complete lack of perishable foods has occurred more frequently at 
outposts, although efforts have been made to supply inaccessible 
stations with food dropped by air* 
All food consumed in Greenland arrives from the Boston Port 
of Embarkation. Since the food is already Army property, there 
have been no rejections because of Type* Grade, or Class* Con- 
demnations for unsanitary conditions have been rare* If the food 
or any portion of it is edible, it is utilized, even though it- 
may require extensive trimming and washing* The greatest problem 
of the Veterinary Service in relation to food has been proper storage 
to insure preservation for extended periods® 
88 
Inclosure #2 - Page 7 OFFICE OF THE BASE DENTAL SURGEON 
GREENLAND BASE COMMAND 
AFO 858 c/o Postmaster 
New York* N. Y. 
DENTAL SERVICE IN GREENLAND 
Preventive dentistry in Greenland didn’t take any shape or 
form until October 194-3® Prior to that time* due to lack of facili- 
ties and supplies* the dental service consisted only of emergency 
treatment per se. There was a sick call each morning at which time 
any soldier or civilian who had a dental complaint presented him- 
self . At this time only the chief complaint was noted and treated 
even though other work was visible. With very few exceptions no 
future appointments were made. 
In October 1943# plans were made for moving into a new* much 
larger* and well appointed hospital. The dental staff at this time 
did a complete survey using the routine I* II* III* and IV Army 
classifications and* when the move to the new hospital was made* 
set up a plan whereby preventive measures could be instituted. Sub- 
sequently* a sick call was still held but* as each classification 
group was cleared up* the emergency sittings dropped off proportion- 
ately. 
Unfortunately* the mouths of the Army personnel were very 
bad* and there was a preponderance of class I and class III caseso 
The civilian construction employees were in much worse condition. 
The latter was understandable* but no logical explanation for the 
condition of the Army personnel has ever been put forth. 
The dental equipment at all the bases in Greenland was 
adequate* and at the main base we were set up to do a complete 
routine day’s work. The men were called in according to classi- 
fication and* as they were treated* went from class I to class II* 
III* or IV. All routine work was done by appointment* and in 
about eleven months the dental condition of the men in Greenland 
was good. Every type of work was done* including operative* pros- 
thetics* crown and bridge* root canal therapy* surgery* etc. We 
were fortunate in having a dental laboratory technician who did 
excellent work; he worked very rapidly and most of the glaring 
class III cases were cared for in about seven or eight months. 
The biggest dental problem in Greenland was the sending of 
dentally fit men to isolated outposts. There are eight or nine 
isolated and send-isolated outposts* (weather and radio stations* 
etc.)* where transportation in and out is limited to one or per- 
haps two trips a year except in an emergency when a rescue plane 
Inclosure #3 = Paee 1 
89 might attempt a water or ski landing. The personnel sent to these 
outposts were* for the most part,, men who had volunteered for such 
duty while in the States. As such, they were supposed to have had a 
complete dental examination before being sent overseas. However, in 
65$ of the cases the mouths were in very poor repair. During the 
winter 1943-44? between October and February, there were approximately 
eleven or twelve radiograms sent to the main base asking for emergency 
evacuation of dental patients. In two of these cases the Arctic 
Search and Rescue Squadron was able to effect a skiplane landing and 
successfully evacuate the men. When the outpost personnel were being 
changed the following summer, an effort was made to survey the men re- 
turning from isolated duty of from six to eleven months duration. The 
mouths of these men were found to be in a poor state of repair. 
The first preventive steps were taken in June 1944* Radiograms 
had been sent to all the schools where outpost men were selected and 
trained. These requested that full mouth X-rays, as well as complete 
minor and explorer examinations, be made. It was also requested that 
all doubtful teeth be extracted, and that missing teeth be replaced 
to whatever requirement thought practicable by the examining dental 
officer. It was felt that this would solve our problem for the follow- 
ing wintero 
In June 1944.? however, when the outpost men began to arrive in 
Greenland for duty, it was decided to check them again to make doubly 
certaino We carried out the same examination we had recommended and 
found that approximately 70$ to 75$ of the men so examined needed 
dental work. Fifty percent of the caries and abscessed teeth were 
picked up by the use of X-ray* Apparently, this had been overlooked 
in the States® It is apparent also that our problem is not under- 
stood by anyone except those of us here for, although we had sent 
out wire after wire, when 200 men arrived here in June 1945 for ex- 
amination prior to outpost duty, it was found that the same condi- 
tions prevailed. We have had, as a rule, ample time—from two to 
three months—in which to ready these men for their duties. How= 
ever, we must devote all of our time tp them with the result that 
the permanent base personnel are not, except in emergencies, given 
any treatment during the summer months. 
Our labors were not in vain for during the winter 1944-45 we 
had no emergency calls from isolated outposts for eight months® 
This was far better than our expectations because, in any event, 
we had expected there would be trouble of some kind. There were a 
few cases of pericoronitis which our medical corpsmen treated con- 
servatively with good results® A similarly good record is looked 
for during the forthcoming winter® 
Inclosure #3 - Page 2 
90 For a period of a year and a half one of our dental officers 
travelled by boat and by plane to the semi-isolated outposts* of 
which there are two or three. He took with him an enlisted as- 
sistant* and they worked from a portable chest #60. Upon arrival 
at an outpost he would make a survey after which he would do all 
types of routine work even going as far as the taking of impres- 
sions for dentures. In other words* not only was emergency treat- 
ment instituted but preventive dentistry as well. In the few 
cases that needed extensive work* the surgeon* upon the return 
of the dental officer to the main base* would make the recommenda- 
tion to the man1s organization* and* if practicable* the man was 
brought in and the necessary dental work accomplished. 
At the present writing, the dental condition of the men in 
Greenland is good. Preventive measures and routine work are 
still being accomplished. Unfortunately, new arrivals here are 
still not in good dental shape; the reason for this is worth 
investigating and, if found, should be corrected. 
Inclosure #3 - Page 3 
91 HISTORY OF PREVENTIVE MEDICINE IN WORLD WAR II 
ICELAND BASE COMMAND HEADQUARTERS ICELAND BASE COMMAND 
APO 610, c/o Postmaster 
New York, N» Yo 
4 September 1945® 
000o76 
SUBJECT? Transmittal of History of Preventive Medicine in World War II*. 
TO : Commanding General, Eastern Defense Command, Governors Island, 
New York 4, No Yo (Attn: Surgeon)« 
lo Transmitted here with is a written history of preventive 
medicine activities of the Medical Department in Iceland Base Command 
from its inception in September 1941 through August 1945 in compliance 
with letter your headquarters, file 314®7 (Surgeon), subject: Preventive 
Medicine in World War II, dated 28 July 1945® 
FOR THE COMMANDING GENERAL: 
/s/ Anson la Dreisen 
ANSON I. DREISEN, 
Lt Col, A© Go Do, 
Adjutant Generalo 
1 Incls 
History of Preventive Medicine» 
93 HISTORY OF PREVENTIVE MEDICINE IN ICELAND 
31 August 194-5 
I* Introductory Remarks0 
The history of preventive medicine in the Iceland Base Command 
must of necessity be a prosaic one* There will be no record of out- 
standing feats accomplished, of great problems solved or dynamic 
personalities whose work will go down in history. Rather it will be a 
story of routine well accomplished, the proof to those who needed 
proof that the general system of sanitation set up by the U. S* Army 
is adequate for general problems and well worth the trouble and an- 
noyance sometimes engendered by its application* 
Since the inception of the command there have been no epidemics 
of infectious disease even though many of the troops sent here were 
barely more than recruits* There have been no nutritional diseases 
even though the country can not adequately feed itself and its waters 
were alive with submarines making transportation difficult* 
Respiratory diseases have never been a problem in spite of the 
fact that the climate of Iceland has all the factors in abundance 
which generally are credited with the spread of such infections* 
Even venereal disease has been a relatively minor concern which is 
remarkable in an arny- living among a friendly civilian population* 
II. Sanitation. 
1* Clothing* 
The men have been well clothedo The climate of Iceland is 
peculiar* The winters are actually not as cold as most of the troops 
expected or had been familiar with in their homes but at the same 
time because of the high winds could be definitely classed as severe* 
The summers are never really warm and resemble fall in the north- 
eastern states* Woolen clothing was indicated for the entire year 
supplemented by that most useful and highly appreciated garment the 
parka for winter use* A man dressed in CDs and a parka was adequately 
clothed and comfortable and still able to perform his duties* 
One change was made in the original plan for clothing the 
command* It was originally contemplated that woolen underwear was 
to be worn at all times and that was the only kind issued* However, 
permission was given for the men to purchase cotton underwear and 
wear it* Many took advantage of this to avoid overheating and sub- 
sequent discomfort. In recent months cotton underwear has been an 
item of issue. 
95 One other item of clothing proved very effective and that is 
the overshoe arctic* During the time of year when snow is on the 
ground they are essential for foot comfort serving both to main* 
tain dryness and also contributing to the warmth of the feeto 
2. Housingo 
Housing is very satisfactory. From the beginning use has 
been made of corrugated iron huts. Many British camps of Nissen 
built construction were occupied by our troops and proved very sat- 
isfactory. The gradual trend has been toward Quonset huts* however* 
since they provide more available floor space and at present few 
troops are quartered in the older type. Occasional Butler huts are 
encountered but it is the general opinion that they are not as sat- 
isfactory as the Quonset type due to lack of rigidity and draft!- 
ness. Overcrowding has never been permitted and regardless of the 
amount of available space* head to foot sleeping has been the only 
accepted procedure. The huts are heated by either oil or coal 
stoves both of which have been satisfactory. As a matter of fact* 
overheating is more commonly encountered than the opposite. One of 
the difficulties in metal hut sanitation is ventilation. The typical 
hut has windows only at the ends. It is rather difficult to provide 
fresh air without creating a draught and so in the colder months de- 
liberate efforts to force ventilation are required by the responsible 
officers and NCOs. 
The huts have wooden floors which can be kept clean and a high 
standard of cleanliness has always been maintained. 
3* Food & Nutrition* 
Food from the nutritional point of view has undergone 
considerable change with the passage of time. The original diet was 
definitely C ration Monotony was the rule rather than the except 
tion. Large quantities of dehydrated food were supplied. The word 
is chosen advisedly since ranch more was supplied than ever was con- 
sumedo The gradual change from a canned to a fresh status has in- 
troduced an element of deficiency in a very interesting manner. 
The men are much more apt to drink canned orange juice or tomato 
juice than to eat fresh oranges or tomatoes due to inertia* lazi- 
ness or lack of aesthetic appeal in the type of fruit provided. 
A* Personal Hygiene. 
Personal hygiene has also made considerable progress by a 
gradual process of evolution rather than any organized program* At 
first*bathing facilities* especially in outpost camps* were quite 
limited and the personnel made use of civilian swimming pools or 
the shower facilities available in some of the larger camps. Now^ 
96 and for some time past, showers have been provided in adequate 
numbers everywhere and hot water either from boilers or hot springs 
has been available• At no time was personal hygiene so bad that 
any health menace was present* 
A parallel trend has existed with regard to clothing*, At first 
the quartermaster facilities for laundry and dry cleaning were very 
limited and for many troops nonexistent*, Laundry was done either by 
civilians or the men did their own. There are still evidences of this 
in the number of homemade washing machines found in the various re- 
maining organizations*, The problem gradually solved itself* The out- 
posts were closed and the quartermaster laundry expanded so that for 
the last two years the facilities have been adequate both for laundry 
and dry cleaning service. 
5. Water. 
The water supply of camps in Iceland has presented no health 
or engineering problems*, In Reykjavik the civilian supply has been 
utilized and while the load sometimes taxed the capacity of the sys- 
tem there has never been any evidence that its potability has been' 
endangered*, All bacteriological tests ran consistently very good 
and the taste and appearance are also up to a high standard*. 
In other locations wells have been driven and an adequate 
source of pure water found for each camp0 The question of contamina- 
tion never arises due to the sparcity of population and the geological 
structure of the country which makes it relatively easy to select a 
watershed free from sources of contamination*. Of course monthly bac- 
teriological tests are run on all water supply systems but nothing is 
ever found to cause the least question to be raised as to its safety 
or potabilityo 
6. Disposal of Waste* 
Disposal of waste is accomplished by one of three methods 
depending on environmental factorso Where practical, sewer lines 
have been constructed running either to the sea or civilian sewer sys- 
terns and flush toilets employedo In other situations flush toilets 
emptying in septic tanks have been utilized when the size of the camp 
made it practical to install such a local sewage disposal system, 
while in others which did not warrant-such expenditure or which are 
located in areas not suitable for this purpose bucket type latrines 
emptied by civilian contractors have been employed*. 
Garbage has been disposed of mainly by dumping into the sea*, 
This is accomplished without the use of scows as tidal action has been 
sufficient to remove it from the shore or shallow waters*, Otherwise, 
where sea dumping was not practical, it has been used ■p~r cattle feed 
under contract with local farmers or just buried in pits*, Garbage 
97 disposal has always been less of a problem here than usually 
encountered because of the lower mean average temperature and 
other conditions which minimize bacterial action0 
7o Control of Insects® 
a® Flies® 
The control of insects has presented no problem® The 
only insect encountered in Iceland with any frequency is a rather 
large indolent fly® As a matter of interest these flies cause no 
problem in mess halls or kitchens but are sometimes found in dwell■= 
ing huts apparently seeking warmth rather than food® They are easily 
controlled by screens and spraying® 
b® ’ Mosquitoes® 
Mosquitoes are very scarce and are not vectors of disease®- 
c.doecf® Ticks* Fleas* Cockroaches & Bedbugs* and Other Insects® 
I . 
Control of the other types of insects such as ticks* 
fleas and household vermin is very simple® Extensive inquiry re~ 
veals no one* either officer or enlisted man who has seen or heard 
of their presence® 
So Control of Rodents® < 
Rats could be a very definite problem* The two varieties 
commonly found are the' gray rat (Alexandrians) and the brown rat 
(Norvegicus)® Constant vigilance has resulted in maintenance of 
control* however* and no intensive programs have been necessary® A 
trained enlisted man* under the direction of the Base Medical Inspect 
tor* makes regular rounds of all camp sites® If reports or evidence of 
rodent activity are found poison bait is distributed in the camp® 
Barium salts are used for this purpose and have proved highly suc~ 
cessful® Traps are available and are used to a limited extent in 
certain favorable circumstances® Ho disease has ever been attributed 
to the rat population in Iceland as far as the Military are concerned® 
III* Sanitary Engineering* 
Sanitary engineering in Iceland has been fairly well covered 
in that part of the report dealing with water supply and sewage® 
This program is still going on as the situation changes due to re- 
distribution of troops® New wells are being sunk and sewage lines 
constructed at the present time in so»« of the camps in the Keflavik 
area where the center of troop concentration has moved in the past 
year® Sanitary engineering of other types*such as drainage* etc®* 
has been negligible since nature does not necessitate such a program 
here® 
98 IVo Epidemiologyo 
Epidemiology is limited principally to the study of what has 
not happened and an outline of the routine which has proved com- 
pletely adequate in this commando 
lo Imraunizationo 
All of the personnel coming to Iceland have had the routine 
basic inoculations against tetanus and typhoid and have been vac- 
cina tedo Up to very recently all personnel have had* in addition* 
typhus fever inoculation* as required for the ETOo 
2. Intestinal Infections* 
Intestinal infections have been practically nonexistent in 
this command. In fact such long periods of time elapsed between the 
isolated oases that no special records of these diseases were kepto 
No epidemics of this type of disease ever occurredo Even in the early 
days of the command and during the period of maximum troop strength 
many weeks elapsed between cases and these were isolated individual 
cases* never groups* 
3o Infections of the Respiratory Tracto 
Infections of the respiratory tract are the largest single 
cause of admission in the command* but even these are in a number 
much less than would be expected from the troop strength and the cold* 
moist cliraateo There have been the usual seasonal variations in the 
admission rateo When it is considered that all upper respiratory 
diseases are hospitalized* the rate becomes even more exceptionalo 
The average of the current year is approximately 120/1000 per annumQ 
In all probability the fact that no diseases are treated in quarters 
probably has a great deal to do with the control of the spread of 
these infections in the commando 
The incidence of pneumonia atypical is relatively high in this 
commando However* it is believed that this is due to the fact that 
all respiratory diseases are hospitalized here and given a much more 
thorough work-up than would be the case if they were treated in a 
dispensary or on quarters status. Thus many so-called severe -bron- 
chitides are found to have the diagnostic criteria of atypical pneu- 
monia and are so recorded. 
No plan for the control of upper respiratory disease has ever 
been needed except the insistence on the basic rules of sanitation* 
as prescribed* and the isolation of sick patients from contact with 
the rest of the commando 
99 4o Miscellaneous Infections. 
There are no infections indigenous to this area which have 
ever affected this command and so no programs for the control of such 
diseases were ever formulated. 
5. Nutritional or Environmental Diseases. 
Nutritional disease has never appeared among the troops in 
Iceland due undoubtably to the abundance and excellence of the diet 
provided* 
Under the heading of environmental disease a discussion of 
the neuropsychiatric admission rate might be in order* The weather 
and scenic arrangement of Iceland probably have no equal anywhere in 
the inhabited civilized world as a source of depression* The litera- 
ture of Iceland,? its music* and the character of the people* all re- 
flect its sombernesso When troops are stationed in such an area for a 
long period of time with practically no activity* and living in isolated 
camps with poor mail service and no recent newspapers* the less stable 
are very prone to develop symptoms of a neuropsychiatri© nature* The 
long periods some of the troops served here did not help the situation. 
From the point of view of preventive medicine much has been 
done to help this situation* Rotation and temporary duty in the States 
for recuperation have helped as has improvement of the mail service* 
entertainment* etc* However* the basic situation of ennui in a very 
depressing environment cannot be helped* 
V. Venereal Disease Control. 
Venereal disease has never been a serious problem in the command.. 
Among this was probably due to lack of Communication more than any 
other reascno The few cases seen were tt’aeeable to external contacts 
usually in the seaports* 
Since the occupation there has been an increase in the incidence 
of venereal disease with gonorrhea being by far the most common type* 
Each case has a report of contact filled out and excellent cooperation 
is obtained from the local authorities finding and treating the local 
sources of infection* Reinfection is introduced by transient person- 
and new arrivals* especially those arriving from European ports* 
The usual means of prophylaxis is available to all and seem to 
be adequateo No special drives or programs for the control of vene- 
real disease have ever been instituted since the cases are so spora- 
dic that this approach is not practical* 
VI« Graphic Summary and Analysis. 
Attached to this report are graphs showing the noneffective rate? 
admission rate for upper respiratory diseases? and the venereal dis- 
ease rate. 
100 All three show a rapid decline from an initial high shortly 
after the first landing of troops and all show a constant decline 
to the present. 
The high on the noneffective rate graph in June 1942 * not 
reflected in the upper respiratory rate* represents admissions for 
jaundice resulting from yellow fever injections. 
The only other peak of significance is December 1943 on both 
the upper respiratory disease graph and the admission rate graph 
which represents a rather mild upper respiratory epidemic which oc- 
curred coincident with one in the continental United States. 
The change in the venereal disease graph noted in September 
1944 and subsequently is of interest. While the troop strength 
started to decline at that time* the number of cases of venereal 
disease remained the same or even increased a little. The only 
explanation for this is that the number of local women infected by 
outside sources remained constant and each of them had the same 
number of contacts as before® These contacts were nonprofessional* 
for the most part* and the number represented satiety for the woman* 
rather than a reflection of the number of soldiers available. There- 
fore* the same number of soldiers would be infected each month as 
long as any reasonable number of troops remained. The valleys and 
peaks represent the result of the efforts of the local health au- 
thorities in removing the contacts for treatment and subsequent 
reinfection of the civilian population by the arrival of a ship 
from Europe. 
101 19hl 
ANNUAL ADMISSION RATE REPORT 
Per 100C by weeks 
Common Respiratory Diseases 
Form 85a 
Medical Department, XJ. S. Aemt 
(Authorized March 9, 1928) 19h2 
ANNUAL ADMISSION RATS REPORT 
Per 1000 by Weeks 
Common Respiratory Diseases 
Form 85a 
Medical Department, U. S. Aemt 
(Authorized March 9, 1928) 19U3.; 
ANNUAL ADMISSION RATE REPORT 
Per 1000 by Weeks 
Common Respiratory Diseases- 
Form 86a 
Medical Department, U. S. Aemt 
(Authorized March 9, 1928) i9kh 
ANNUAL ADMISSION RATE REPORT 
Per 1000 by Weeks 
Common Respiratory Diseases 
Form 85a 
Medical Department, IT. S. Abut 
(Authorized March 9, 1928) 19h5 
ANNUAL ADMISSION RATE REPORT 
Per 1000 by Weeks 
Common Respiratory Diseases 
Form 85a 
Medical Department, U. S. Arkt 
(Authorized March 9, 1928) MONTHLY VENEREAL DISEASE RATES PER 1000 PER ANNUM 19hl 
ANNUAL KEAN NON-EFFECTIVE RATE 
AID Causes 
Form 85a 
Medical Department, U. 8. Akmt 
(Authorized March 9, 1928) 19h2 
ANNUAL LEAN NON-EFFECTIVE RATL 
All Causes 
Form 85a 
Medical Department, U. S. A bmp 
(Authorized March 9, 1928) 
VITAL STATISTICS CHART (SMALL) 19h3 
ANNUAL MEAN NON-EFFECTIVE RATfi 
All Causes 
Form 85a 
Medical Department, U. S. Aemt 
(Authorized March 9, 1928) 
VITAL STATISTICS CHART (SMALL) 19UU 
ANNUAL MEAN NON-EFFECTIVE RAl*, 
All Causes 
Form 85a 
Medical Department, TJ. S. Army 
(Authorized March 9, 1928) 
VITAL STATISTICS CHART (small) 19h5 
ANNUAL MEAN NON-EFFECTIVE RaI. 
All Causes 
Form 85a 
Medical Department, XT. S. Abut 
(Authorized March 9, 1928) 
, VITAL STATISTICS CHART (small) HISTORY OF PREVENTIVE MEDICINE IN WORLD WAR II 
NEWFOUNDLAND BASE COMMAND HEADQUARTERS 
EASTERN DEFENSE COMMAND 
Governors Island, New York A, N.Y. 
314-o 7 
(Surg) 
2B July 1945* 
Subject: History of Preventive Medicine in World War 
To : Commanding General, Newfoundland Base Command, AcP.O* B62, 
c/o PM, New York N,Y., (ATTN: Surgeon)* 
1. It is desired that a history of preventive medicine activities 
for Newfoundland Base Command be prepared from the inception of the 
command through June 194-5 and that the original and one (l) copy of 
this report be forwarded to this headquarters, attention Surgeon, 
not later than 1 September 1945* 
2, The following form will be used as an outline in the 
preparation of the history: 
History of Preventive Medicine in the Newfoundland Base 
Command 
I Introductory Remarks: 
II Sanitation: 
lc Clothing 
2. Housing 
3* Food & Nutrition 
4« Personal Hygiene 
5o Water 
6. Disposal of Waste 
7c Control of Insects 
a» Flies 
bo Mosquitoes 
. c« Ticks 
dc Fleas 
ec Cockroaches & Bedbugs 
f* Other insects 
Be Control of Rodents 
III Sanitary Engineering: 
IV Epidemiology: 
lo Immunization 
2c Intestinal Infections 
3e Infections of the Respiratory Tract and Infections 
Transmitted by Discharges from the Respiratory Tract 
4.0 Miscellaneous Infections 
5o Nutritional or Environmental Diseases 
103 V Venereal Disease Control; 
3® Additional sections may be added* if indicated* to include 
medical laboratories* occupational health* civil public health* 
Health Department activities or coordination* medical intelligence* 
nutrition and health education. 
A. Extracts of instructions from The Surgeon General’s Office 
basic letter to this headquarters* which may be of assistance in 
preparing the history are as follows; 
a. As the Historical Division of The Surgeon General’s 
Office frequently emphasizes, proper documentation is of utmost im- 
portance in the preparation of a medical history® It is earnestly 
desired that not only will documentation be exhaustive but that * 
supplementary material referable to preventive medicine in the field 
will be transmitted with the manuscript for preservation as future 
reference and teaching material. 
b® Such a report should contain an account of the problems 
of preventive medicine that have been met* the difficulties that have 
been overcome* the expedients employed* the successes achieved and 
the failures that occurred and should be avoided in the future. 
5o It is further desired that material pertaining to 
preventive medicine activities, which would be of value in main- 
taining a current history of preventive medicine for your base, be 
forwarded to this headquarters, in duplicate, every six months as 
of 30 December and 30 June. 
BY COMMAND OF LIEUTENANT GENERAL GRUNERT: 
/s/ Wo F0 Schubert 
/t/ W. Fo SCHUBERT, 
Major, AoG.Do, 
Assto Adjutant General 
314-0 7 (Surg) 
85 
1st Indo 
1 AUG ENT’D 
HEADQUARTERS* NEWFOUNDLAND BASE COMMAND* U. S. ARMY* APO 862* c/o 
Postmaster* New York* N0Y0 6 SEP 1945 
TO; Commanding General* Headquarters* Eastern Defense Command* 
Governors Island* New York 4* N. Y. (ATTN; Surgeon) 
Basie communication complied with. 
1 Inel! 
Preventive Medicine NBC(dup) 
REG’D SURG. 0. 
HQ EDC 12 SEP 194-5 
FOR THE COMMANDING GENERALS 
/s/ F. J. Mathews 
/t/ F6 J. MATHEWS 
Captain* AGD 
Adjutant General. 
104 PREVENTIVE MEDICINE 
IN THE 
NEWFOUNDLAND BASE COMMAND r NEWFOUNDLAND BASE COMMAND 
I INTRODUCTORY REMARKS 
Newfoundland is the oldest of England's colonies. The island is 
about the size of the state of Virginia with an area of square 
miles and an estimated population of 300*000* The island consists 
of a rugged* rolling to semi-mountainous terrain. Most of its popu- 
lation is centered in two localities* the Avalon Peninsula on the 
eastern side and the lower Humber River Valley on the westo 
The well-fed* well-clothed and well-housed American soldier 
has not faired too badly through duty in Newfoundland from the 
health point of view* though he has been exposed to unsanitary con- 
ditions in the surrounding civilian communitieso Though water is 
chlorinated at all posts* such is not the case in the nearby city 
of St. John’s and communities. * Consequently a certain amount of 
unpotable water is consumed by our troops® Eating places are lim- , 
ited to only those approved restaurants* though the food served 
by these restaurants does not undergo the inspection furnished 
food provided on the post. Then there are always a number of men 
who partake of meals in private homes. Soldiers have been con- 
stantly exposed to communicable diseases of the respiratory tract 
by mingling with the local population in crowded theatres* res- 
taurants* churches* etc© Ventilation has always been poor and was 
even more so during the complete blackout® 
Tuberculosis is a major health problem in Newfoundland. A 
survey was conducted at Fort McAndrew in August 194-4> to include all 
civilian employees at that station. A total of six hundred and 
eighty-five fluoroscopic examinations was made (155 female and 530 
male). Six of the females and twenty of the males were found to 
have reinfective type of pulmonary tuberculosis® This represents 
3»B0 percent of the total number examined® The purpose of this 
survey was twofold; case finding and removal of infected civilian 
personnel from the post. All civilian employees are given a physi- 
cal examination and are x-rayed before they are employed® The physi- 
cal examination also includes vaginal smears on all females and 
smallpox and typhoid inoculations are given all food handlers. 
Very little has been done in Newfoundland toward immunization 
against communicable diseases® However* in the last few months a 
campaign to impress the Newfoundlanders of the seriousness of com- 
municable diseases* and encourage immunization* has been undertaken 
the Department of Public Health and Welfare. 
II SANITATION 
1. Clothing. The type and quantity of clothing available to 
the troops in Newfoundland has always been considered suitable and 
adequate. Temperatures seldom go below zero in the Winter or above B0 
105 degrees in the Summer* and perhaps only two or three times during 
the Winter does the temperature fall to minus two or four degrees 
Fahrenheit. July is generally the warmest month with the nights 
being cool. The winds in the Winter are normally northwest and 
over a twenty year period have averaged 11.22 miles per hour. Dur- 
ing Springs Summer and Autumn prevailing winds are southwest and 
average 8.2 miles per hour. It can be seen that Newfoundland is 
relatively a windy country. Average rainfall is about 43 inches 
which is approximately the same as in the New England States. There 
are frequent days of fog and mist and infrequent days of sunshine. 
The Summers are very short and there is little Autumn and little or 
no Spring. With such weather conditions* clothing issued has been 
of the Arctic type. Troops have been provided with Arctic field 
jackets* alpaca lined trousers* turtle-neck sweaters* Arctic over- 
shoes and blucher high top boots. Wool filled comforters are avail- 
able and in the hands of most troops* though they are not really 
necessary for troops housed in permanent barracks. 
20 Housing 
I a.-'Fort Fennerrell. for United States Army troops 
in Newfoundland were first provided on the USS Edmund B. Alexander. 
Approximately 1*000 troops were quartered from the date of sailing 
15 January 1941 to the latter part of May and the first week of June 
1941o Some overcrowding was experienced onboard ship and ventilation 
was not too good® However* they were much more comfortable than in 
their subsequent quarters* which were tents* with a capacity of six 
men per tent. Troops were so quartered from June 1941 to November 
and December 1941 at a site named Camp Alexander. These tents were 
placed over a wooden framework with wooden floor and wooden sides 
approximately 4 feet high. They were heated by wood burning stoves. 
These tents* were* however* too warm when the fire was blazing in the 
stoves* or were too cold when the fire was out and the wind was sweep- 
ing through the cracks of the floor and walls. However* the troops 
survived with little or no ill affects* and in December 1941 the ma- 
jority of the men in the Sto John's Area were comfortably housed in 
permanent barracks at Fort Pepperrell. These barracks are considered 
to be ultra-modern having more than ample washroom and latrine facili- 
ties. There was a little overcrowding at times and when this did occur 
double-deck beds were employed or beds were separated by shelter halves 
and head to foot arrangement of beds was practiced^. 
b« Fort MeAndrew. The first Army troops arrived at Fort 
McAndrew about the middle of January 1942° They were quartered in 
temporary barracks provided by the Area Engineers upon arrival. In 
March 1942 more troops were dispatched to that station and overcrowd- 
ing resulted. The usual head to foot arrangement was practiced and 
beds were separated by shelter halves. These temporary barracks were 
difficult to clean and space allowances were below the minimum standard. 
However* by the end ©f 1942 the majority of the troops at this station 
were quartered in permanent barracks. 
106 Co Harmon Field.% The troops at Harmon Field were housed 
in wooden temporary cantonment barracks which were unsuited for 
garrison use. The number of buildings available upon their arrival 
was not sufficient* but this condition was alleviated with the con» 
struction of additional barracks. For a time housing facilities 
were adequate at this station but when Harmon Field was converted 
into a stopover for the northern air route from Europe* overcrowding 
was experienced due to the arrival and delays in departure of the 
many transit personnel. The housing facilities were further compll- * 
cated when the evacuation scheme for patients of the European theatre 
was placed into effect® During the early part of 1945 billeting of 
permanent military* transit military and civilian personnel presented 
quite a problem and required constant study. Construction of H-type 
barracks for enlisted men was commenced immediately after approval 
was received but was occasionally interrupted due to the lack of ma- 
terial. Emergency billeting for large numbers of passengers .and 
crews detained at this station was made adequate by the erection of 
tentage and by the adoption of hangar space for quarters® An air 
evacuation building was provided for by the conversion of a lubri- 
cant warehouse. This provided accommodation for approximately one 
hundred patients. In May of 1945 emergency billeting for approxi- 
mately five hundred had been furnished in hangar number three which 
was then being provided with latrine facilities. In June 1945 tran- 
sit activity was still increasing and additional requirements for 
more housing facilities was being made as rapidly as labor and mate- 
rials became available for the construction of additional barracks* 
etc. As of June 1945 the following housing projects were under con- 
struction* had been finished or plans were being submitted as indicated! 
Project 
Capacity 
phase of Construction 
H-type Barracks 
24.0 
95$ Complete 
Tentage 
216 
Occupied 
Tentage 
14-4- 
Project submitted 
Hangar 3 Billeting 
500 
Occupied 
Latrina Building for 
95$ Complete 
Hangar 3 Billeting 
Air Evacuation Building 
100 
Occupied 
Stout Huts (Relocated) 
72 
25$ Complete 
3 H-type Barracks 
24.0 aa0 
Project submitted. 
Gander Field. In May of 1941 the first contingent of 
troops for the United States Airport at Gander* Newfoundland* ar- 
rived at their new base and found available for use fairly comforta- 
ble temporary barracks which were heated by force draught heaters. 
These buildings were built by the Atlas Construction Company for 
the Royal Canadian Air Force® Double-deck beds were set up Canadian 
style and were readily occupied. Overcrowding existed but according 
to Canadian standards of 116 men in double-decker bunks* which al- 
lowed 283 cubic feet of air space per man* there was no overcrowding® 
107 According to United States Army standards as set forth in Field 
Manual 21-1C, only 4.7 men should have been housed in the space 
allotted the 116 men. However, by the end of 1941 the overcrowd- 
ing was alleviated by the increase in the number of buildingSo 
3I Food and Nutrition 
a* • SnbSTSxehceo Upon arrival of United States troops 
in Newfoundland in January 194-1 the procurement of food was an 
important problem,, since the Army, so the speak, ’’travels on its 
stomach”® Sufficient supply of rations nA” and ”C" were brought 
along and arrangements were made in advance to keep the supply of 
food rolling into Newfoundland from the United States by weekly 
supply ships® After facilities for storage of food products was 
obtained locally, and temporary construction of Camp Alexander 
completed, a surplus supply of canned products was built up grad- 
ually® The inspection of the food supply here during 1941 was of a 
sanitary nature at the time of issue to troops since most of the 
food was obtained from other Government sources and had been pre- 
viously inspected® In 194-2 the amount of work in the food inspec- 
tion field was increased due to the increase in the size of the 
base and method of purchase by the Subsistence Depot® A large per- 
centage of fresh frozen meats and meat products, eggs, butter and 
some vegetables were purchased from Canadian sources through a co- 
operative agreement between the United States and Canada® The 
United States Army took possession of the products on arrival in 
Newfoundland and the Veterinary inspection therefore included a 
grade and quality inspection as well as a sanitary inspection® 
All meats purchased in this manner were inspected and passed by 
the Canadian Department of Agriculture and approved by the United 
States Department of Agriculture, Bureau of Animal Industry, for 
importation into the United States® Some foods continued to be 
furnished from supply depots in the United States, such as canned 
goods, boneless beef, hams, bacon, butter, cheese and fresh fruits 
and vegetables® The Base Subsistence Depot continued this food 
procurement setup until January 194-5 at which time the Naval Sup- 
ply Base at Argentia and the Army Subsistence Depot agreed upon 
requisitioning their supplies together from the Boston Port of 
Embarkation® At the present time a monthly supply ship unloads 
its cargo at the Navy Docks at Argentia and it is stored in the 
large storage buildings there® From here the subsistence items 
are shipued by rail, truck and boat to the other stations on the 
island® At the present time most of the supply problems have 
been overcome and the distribution of food to the troops on the 
Island, and the supply to the Naval Base and the ships in the 
North Atlantic, is operating in an efficient manner with a negli- 
gible loss and spoilage® 
108 There is an abundant source of fresh fish in this area but 
the sanitary conditions of the local processing and filleting plants 
prohibit the purchase of dressed and dried fish* and we are forced 
to obtain only fresh salmon* lobster and codfish direct from the 
boats and clean and prepare same in the messes. It would be very 
easy to have a year round supply rather than a seasonal supply if a 
sharp freezing unit and processing plant could be installed and op- 
erated under sanitary conditions by the Army or Navy here on the 
Island. Such a plant would pay for itself in a short time and save 
the Army and Navy much money. 
Early in 1941 the storage facilities were at a premium* with 
the result that much of the canned products were stored outside under 
tents and tarpaulins® Cold storage facilities were hard to find out- 
side of that on the troop ship USS Edmund B® Alexander* anchored in 
St® John’s harbour® This necessitated weekly supply ships to furnish 
sufficient fresh meats* fruits and vegetables to the troops® Later 
on two rooms were obtained at Harvey’s Cold Storage and used to the 
limit for frozen products® In 1942 the Cold Storage Plants at Fort 
Pepperrell and Fort McAndrew were put in operation and temporary 
structures constructed at Harmon Field and Gander® With said cold 
storage units in operation at the various stations* and two large 
storage rooms at Harvey’s Cold Storage in St® Joim’s* our losses from 
spoilage* due to lack of refrigeration* were held at a minimum* and a 
safe product was assured the troops® 
The outposts along the coast were furnished with large 
refrigerators and periodic shipments were made by the P-103 boat* 
which has a small refrigerator room* to the various outpostso Early 
in 19-44- one room at Harvey’s Cold Storage was released and late in 
1944- the second one. At present the enormous cold storage space at 
the Argentia Naval Base is being utilized by both the Army and Navy 
and can easily handle the existing needs of both® The post cold 
storage plants are adequate and well planned* consisting of an egg 
room* vegetable room* zero room and two chill rooms where the daily 
issues are broken down and stored. The sanitary conditions cf these 
plants are excellent and the only trouble experienced is the forma- 
tion of mold on the walls in the vegetable rooms® This is removed 
periodically with sodium hypochlorite solution* hot water and steam® 
The various barracks and messes have two large refrigerator units 
for storage after Quartermaster issue. The Commissaries have two 
refrigerator units and the Post Exchange has two zero units* one of 
which is used for storing ice cream. 
The biggest problem here on the Island is transportation® 
On receipt of the produce from the Boston Port much damage to the 
crates* etc® * has already occurred from rough handling in loading 
and unloading* and improper storage during the five to seven day 
trip to the Navy base at Argentia® This same produce must be 
109 stored again and reshipped by boat* rail or truck to the other 
stations and in turn handled again at issue and shipment to the 
various outposts* Consequently after several handlings a per- 
centage of loss is bound to occur. This is true with fruit and 
vegetables packaged in the thin wooden crates, etc* They just 
cannot stand the handling and were never packed for a long trip 
overseas* The meat products in heavy specified boxes, packed 
for overseas shipment, usually arrive in good condition. Then 
there is a group of vegetables and fruits which are called 
perishable items and are impossible to get to their destination 
without a rather large loss from natural deterioration, spoilage, 
rough handling and improper cratingo From 194-1 to the present 
time it is still a problem and little has been done to improve 
the condition. In the first place, for example, the maximum 
storage period for lettuce, tomatoes and celery is ten days, and 
by the time, said vegetables reach the various stations after 
shipment from Boston the storage period is up and by all logic 
little should still be eatable. So with this type perishable we 
have to be satisfied with what we can salvage and this is possi- 
ble only through proper crating, cautious handling and rapid 
transportstion* 
When we were receiving most of our frozen meat from 
Canada we had some trouble with the products being thawed out 
upon arrival at the docks in St* John’s. Sometimes it was the 
fault of the plant, sometimes the fault of the Canadian railway 
and storage at the docks in Canada awaiting transportation to 
Newfoundland, or still further faulty refrigeration on the com- 
mercial ships. Regardless of the responsibility all these ship- 
ments were inspected by the Veterinary Corps as soon as it was 
placed on the dock and if frozen solid it was taken to our stor- 
age and there given a thorough inspection for quality and grade* 
However, if the shipment was thawed to the point where damage 
and spoilage had or would occur with additional storage, 
the entire shipment was rejected and turned over to the packing 
company representative in St. Johnss without monetary loss to 
the United States Army. In other words the products were re- 
jected unless they were of good quality and frozen solidly® 
After the subsistence has been received from the United 
States or Canada the transportation about the Island is still a 
major problems The narrow gauge Newfoundland railway is the only 
means of transportation from St® John*s, on the east coast of the 
Island, to Port aux Basques, on the west coast, with a branch to 
Argentia, to the south, and another one north to Grand Falls, etc. 
The schedule is slow and can never be depended upon besides oper- 
ating in an independent manner® They had only a few refrigerator 
cars and few good box cars during 1942, 1943 and 1944# but obtained 
several new modern refrigerator and box cars in 1945® Many times 
we were forced to ship perishables in box cars during both Summer 
110 and Winter with the result that some loss was sustained from 
freezing in the Winter and spoiling in the Summer0 In other 
words transportation by rail was far from dependable and one 
had to take chances with the changeable weather conditions 
that exist in this area® 
In 194-2 the United States Army built a new road from 
Argentia to Hclyrood thus making motor transportation possible 
from St® John3s to Fort McAndrew and the Naval Base at Argentia® 
Much of our perishable supplies were transported back and forth 
over this road in refrigerator trucks rather than by means of 
the Newfoundland railway since it was much quicker and less ex- 
pensive® Some use is made of the P-103 boat which runs between 
St. Johnfs and the various stations and outposts on the coast® 
During late 1944 and early 1945 transportation of perishable 
items wAs attempted by air from Boston as well as some distribu- 
tion on the Island by air. This type of transportation is fast 
but expensive and is controlled entirely by weather conditions® 
Most of our food problems and rejections were the result 
of poor transportation, improper packing and lack of refrigeration® 
After the meat products were inspected and accepted by the Veterinary 
Corps and stored under ideal conditions there was little loss (503 
pounds) at Fort Pepperrell during 1944° We had on© outbreak of 
food poisoning, diagnosed as staphylococcus poisoning and caused 
by an issue of frozen chickens which the mess sergeant held in the 
refrigerator at 45 degrees for one week before serving. The result 
and responsibility was obvious. 
b. Milk Supplyo On arrival of the troops in St© John’s 
none of the dairies could pass a sanitary inspection acceptable to 
the Army’s standards and few of the cattle had beeja tuberculin or 
tested for Bang’s disease. After many conferences and discussions 
by the Army Veterinarians with the Newfoundland Government, New- 
foundland Butter Company and others, a quality of milk, meeting 
Army standards, was finally agreed upon and obtained. This milk 
was known as "National Mark11 milk and was produced by eight dairies 
in the vicinity of St. John* s® The dairymen improved their build- 
ings, purchased new equipment, tested their cattle for tuberculosis 
and Bang’s disease and cooperated to the fullest extent. In July 
1941 this "National Mark” milk was made available to the troops in 
this area. 
* Later an attempt was made to branch out and supply- 
fresh milk to Fort McAndrew* 9C miles south of St® John's® The 
Newfoundland railway was used as a means of transportation but 
this venture did not prove itself® The Department of Natural Re- 
sources and the Array Veterinarians made a survey of the milk supply 
in the Branch and Cape Shore area* tested a representative number 
of cattle for tuberculosis and Bang's disease and attempted to 
111 establish a milk supply, but this also failed* Fort McAndrew 
then purchased a "mechanical cow" and has successfully operated 
it to the present time* 
An attempt was also made to secure a fresh milk 
supply for the United States Airport at Gander. The herd of 
cattle in question was located about 50 miles distant from Grand 
Falls and owned by the Anglo-Newfoundland Development Company? a 
large paper concern® The dairy met Army sanitary requirements 
but the supply was insufficient and the only means of transporta- 
tion was the Newfoundland railway. Consequently they purchased a 
"mechanical cow” but did not gain much success in operating it® 
At the same time ’’National Mark” milk was being shipped to Gander 
for hospital use only® 
This overall setup for milk at the above-mentioned 
Army installations existed until'December of 1943* at which time 
the Commission Government of Newfoundland cut off our supply com- 
pletely. This was due to an acute feed shortage and indirectly 
to a shortage of tinned milk on the Island® It was impossible to 
buy dairy or poultry feed and dairymen even resorted to feeding 
flour to the cows® This shortage existed during the Spring of 
1944 and was due to feed shortages in the United States and Canada 
and also to transportation since most feeds are imported® 
During this time Fort Pepperrell had to resort to 
powdered milk? mixing it by hand in the messes® A ’’mechanical 
cow” for Fort Pepperrell was considered but in investigating the 
availability of the ingredients (skimmed milk powder? whole milk 
powder and unsalted butter) in sufficient quantity to supply three 
Array installations? it was not considered profitable® The Com- 
mission Government was then persuaded to permit the Newfoundland 
Butter Company to supply the United States Army with their surplus 
milk and in July 1944 we again started receiving a sufficient sup- 
ply of fresh milk for Fort Pepperrell. In the Spring of 1945 we 
again supplied Gander Airport with all they needed? making deliv- 
ery by the Newfoundland express on Monday? Wednesday and Thursday® 
Since the United States Navy at Argentia and the 
Army Subsistence depot have been cooperating in obtaining their 
supplies of frozen meats,? canned products and fresh fruits and 
vegetables from the United States? the services of the Veterinary 
Corps have been extended to the Navy® The Navy has at present a 
’’mechanical cow” and reconstitutes milk for issue at the base and 
to the ships? but they also wished to secure a sanitary fresh milk 
supply® On investigation a dairy was found about 40 miles from 
Argentia which could meet Army standards® The dairy was inspected 
and the herd? on being tested for tuberculosis? Bang’s disease and 
mastitis? was found to be negative® This raw milk is shipped by 
rail to the Navy Base and pasteurised in the ’’mechanical cow”® 
112 This source, with additions to the herd, will be available to Fort 
McAndrew if and when they decide to use fresh milk instead of re- 
constituted milk. 
The raw fresh milk in the St® John’s Area is collected 
and delivered to the Newfoundland Butter Company where it is processed* 
pasteurized and bottled separately from their ordinary grade milk| the 
milk for the Army being processed first* bottled and then delivered to 
the post. They also make delivery of this milk to the officers’ quar» 
ters and families living on the post® 
From observation and information received from local ■ 
sources the incidence of tuberculosis in cattle on the Island is not 
too great. This is especially true in the larger aggressive dairies 
since most of their cattle and their replacements are purchased in 
Canada and must be tested for tuberculosis and Bang’s disease before 
entrance into Newfoundland. Practically all the fresh butter and 
various types of cheese are received from the United States and we 
have had negligible trouble with these items. None of the ice cream 
plants in Newfoundland meet Army standards for quality and sanita- 
tion* but this necessary item is supplied to the troops by the Post 
Exchanges from ice cream mix obtained from the United States® 
4« Personal Hygiene. Hygienic conditions among troops stationed 
here has always been excellent® The Army Exchange Service has pro- 
vided adequate toilet articles at all timeso Laundry service is ex- 
cellent and hot water plentiful. All troops of this command have 
viewed personal hygiene films and in addition are repeatedly provided 
instruction by their unit commanders® 
5® Water. 
a. Fort Petmerrell® The site chosen for Fort Pepperrell is 
situated on the north shore of Quidi Vidi Lake and the water supply 
comes from the same source as that supplying the city of Sto John’s® 
This source is Winsor Lake which is located six miles west and 
slightly north of the city. This lake is springfed and also serves 
as a collecting basin for a drainage area of approximately A-l/2 
square miles® It is 510 feet above sea level and the water is taken 
from a point 60C feet out in the lake and at a depth of 18 feet® 
This is brought through a 36 inch steel pipe to a valve chamber, 
thence through 4*000 feet of 4 x 4 feet of concrete conduit to four 
wire mesh screens and thence through 8,000 feet of 36 inch and 32 
inch pipe to a venturi meter lever which automatically registers the 
flow. Two pipes, a 20 inch and a 16 inch, both castiron, bring the 
wafer to the city. The inhabitants have been moved from the lake 
area and fishing and swimming are prohibited by law as aids to pre- 
vent pollution of the water supply. A chemical analysis made Octo- 
ber 1942 is as follows: (Results expressed in ppm®) 
113 Free ammonia oooooooooooooooooooo Nil 
Albuminoid ammonia 0. «. *«0®* <>®0 * * 0®07 
Inorganic solids * o <> •. •»•. •®. • * * ® 16 
Organic solids ®»* *»«®• <> *«® ® * * * 0 * 15 
Hardness equivalent to coo.®®®®®® 14®B CaCC>2 
Chlorides ooooooooooooooooooeoooo 12 
Dissolved oxygen 0.. *»®*o®®®®*o®* 8®08 
C02 ooooodooooooooooooooooooooo®® 1 O 2 5 
pH ooooooooooooooo»oooooeoooooooo 60I (goes as low as 5°0) 
Ir on ooooooooooo®oooooo®oooooooo® 0 © 2 
The supply for Fort Pepperrell is derived by means of 
a 12 inch pipe branching off from the 16 inch main® This main fans 
out at Fort Pepperrell into a complete grid system with no dead 
ends® Gate valves are so located that in the event of operating 
difficulties comparatively small sections of the system can be shut 
off without affecting the rest of the system® The city pressure of 
115 to 120 pounds per square inch is reduced to 90 pounds per square 
inch is reduced to 90 pounds per square inch at the master meter 
houseo This reduced pressure is further reduced by valves in 
individual buildings® A pressure of 90 pounds per square inch has 
been found to be the correct operating pressure for the altitude 
valve located at the 500,000 gallon storage tanko At the present 
time there is a complete change of the water in the tank every 
four days* The Municipal water supply receives no treatment prior 
to its delivery to the post® A post chlorinator was installed 
during the early part of 1942® An initial dosage of one part per 
million of cholorine provides a residual varying from ®1 to <,6 
parts per million at points most distant from the point of appli- 
cation® The fluctuation of the residual is due to a storage tank 
which floats on the line® The contact period from the chlorination 
to the first possible consumer is be*tween 15 and 20 minutes• Medical 
Department supervision of the water supply is conducted by a bacterio- 
logical laboratory at the 30Bth Station Hospital® Daily bacteriological 
tests are made of the water before and after chlorination® In addi- 
tion daily chlorine residual tests are made at points most distant 
from the point of application of the chlorine® 
Late in the year 1943 considerable agitation by 
the residents of St® John's brought action from the city council 
to provide some method of sterilization® It was not, however, un- 
til this year that final approval for equipment and the necessary 
export papers were obtained and the equipment purchased® It was 
decided by the consulting Engineer to chlorinate the local supply 
at its source and to use Wallace and Tiernan automatic chlorination 
equipment for this purpose* The equipment was finally received by 
the city and installed, but due to an error in ordering the elec- 
tric motor, which will operate the booster pump, the equipment 
has not been used* Arrangements for the shipment of the new motor 
have recently been completed and it is expected that chlorination of the 
114 St. John*s water supply will begin in the near future. There is 
some question as to whether Fort Pepperrell will need to continue 
its present policy of water chlorination once the city chlorine- 
tion system begins to function. It is rather doubtful* consider- 
ing the condition of the St. Johnfs distribution system* that the 
required chlorine residual will be maintained by the time the water 
has reached the military reservation. It is quite probable that a 
booster dose of chlorine will be required at Fort Pepperrell to 
maintain the Co4 parts per million residual which the Array requires 
throughout its distribution system. 
In the Fort Fepperrell area there are numerous outposts 
which-are garrisoned and each outpost presented a special problem in 
the supplying of potable water to the troops* The rwater supply prob» 
lems/|of these outposts will be discussed under separate headings* 
(l) Ofed Cliffel The water for this outpost is obtained 
from a small stream which receives surface water 
from a comparatively small drainage area. The 
quantity of water in the catchment area varies 
considerably; during periods of prolonged dry 
weather it becomes necessary to institute a 
water conservation program. Since the water 
comes from such an open drainage area there is 
an ever present threat of contamination® Sev- 
eral samples of water taken from the pool be- 
hind the dam have shown the water to be con- 
taminated® Prior to April 19-43 chlorination 
was attempted with a temporary installation® 
However* during that month a heavy duty midget 
chlor-o-feeder was installed® Satisfactory re- 
sults were obtained in spite of the fact that the 
machine is working at border line pressures. In 
addition to the chlorination treatment a pressure 
filter was installed in November 19A3» This pres- 
sure filter is manufactured by Graver Tank and 
Manufacture Company and uses active charcoal for 
the infiltrating medium. The water system con- 
sists of two electrically driven pumps* each 
having a capacity of 4-0 gallons per minute. The 
water was driven from a pool behind a small dam 
and pumped through the pressure filter followed 
by chlorination to a 25*COG gallon wooden tank 
located on a high point above the outpost® The 
water enters at the top of the tank and is driven 
from the bottom of the tank* thus permitting a 
sufficient contact period for the chlorination0 
Considerable sediment collects in the stilling 
pool behind the dam after heavy rains* result- 
ing in some of this sediment being pumped into 
115 the distribution system. This has been corrected 
by cleaning the sediment out of the pool immediately 
aPtwp rain. 
(2)/ Cape Spear. One of the Air Warning Radar Stations 
was located at Cape Spear. A small stream was 
dammed to form a settling basin. The quantity 
of water has always been sufficient and at no time 
has it been necessary to inaugurate a water con- 
servation program. This water* because of the. 
source* has a reddish-brown colour and a fairly 
high chlorine demand. The water system is a joint 
installation operated by the Canadians® The origi- 
nal system was installed by the Canadians and con- 
sisted of one electrically driven horizontal cen- 
trifugal pump having a capacity of 2*500 gallons 
per hour with a gas-operated diaphragm pump as a 
standby unit. The main taking the water to the 
outpost and two 5*000 gallon wooden tanks floated 
on the line. While in use by the Canadians the 
water was not chlorinated. When American troops 
began to occupy this outpost the distribution 
system was tapped to supply them with water. A 
50*000 gallon covered concrete tank was installed 
to float on the line. However* until chlorination 
was inaugurated by the American forces this water 
system was not used for drinking and cooking pur- 
poses. All drinking water was transported from 
Fort Fepperrell® After some discussion and de- 
lays* the Canadians installed a Wallace and 
Tiernan hypochlorite feeder in March 194-3* Some 
mechanical difficulties were experienced with 
this chlorinator and it was replaced by a tempo- 
rary installation consisting of a barrel site 
glass and tubing which admirably served the pur- 
pose. In the Summer of 194-3 some piping changes 
were made to the distribution system. At the 
same time the Canadians removed their two 5*000 
gallon tanks so that the American installed con- 
crete tank served both forces. 
(3) Snelgrove. Cf the outposts which derive their 
drinking water locally the supply for this out- 
post is the best® The water is taken from New 
Found Pond which is part of the watershed in the 
St. John’s water supply. The water is clear and 
colourless with a comparatively low chlorine de- 
mand® The water system consists of two Nova elec- 
trically driven piston pumps with a temporary chlori 
nator on the suction side of the pumps* a wooden 
storage tank and distribution piping® 
116 (4) Signal Hillo A regulating reservoir of the Sto 
John’s water distribution system is located ad- 
jacent to this outpost® The main source of this 
reservoir is tapped and the water is allowed to 
fill a wet well® The water is then pumped by 
means of an electrically driven vertical centri- 
fuge having a capacity of 2*500 gallons per hour® 
A ten thousand gallon wooden tank which floats on 
the line serves as a reservoir. Until August 
1943 it was necessary to draw water from Fort 
Pepperrell because a chlorinator was not avail- 
able. Numerous tests showed the water to be 
bacteriologically impotable. A heavy duty midget 
chlor-o-feeder was installed which has provided 
potable water ever since its installation. 
(5) Other Outposts* The smaller outposts garrisoned 
by Infantry troops obtained water from dug wells 
or other sources of a questionable nature«> This 
water was used only for cleaning purposes and 
flushing out latrines0 Drinking water was carried 
in 5 gallon containers to these outposts daily 
from Fort Pepperrell® 
b. * Fort McAndrewT\. The source of water at Fort McAndrew V* 
Clarke's Pond which has an elevation of 139 feet® It is about one and 
a half miles southeast of the outer reservation. The lake is one-tenth 
of a square mile in area with a depth running to 24, feet® The water- 
shed is an estimated two square miles® There is no permanent habita- 
tion in the watershed area. Clarke's Pond drains into Karkin's Pond* 
which serves as a water supply for the village of Placentiao Routine 
chemical analyses have shown the following average characteristics of 
this waters 
pH 7® 0 ppm 
Total alkalinity .®®.19®6 ppm 
Chlorides ••«••*•..••45®8 ppm 
Total hardness ......28® 8 ppm 
Additional source of water developed by the United States Navy is 
Argentia Pond with an elevation of about 270 feet* the water from 
which flows by gravity to the Fort McAndrew distribution system 
into the northwest portion of the reservation. The water distribution 
system is as follows: 
(l) Puirrp Station. The 16-inch water intake (Elevation 
131«33f) extends 70 feet from the shore line. Two 
vertical turbine pumps of 1500 gpm capacity at 210 
head will discharge water to a 12-inch diameter 
117 discharge line* These pumps are driven by 
electric motors with one gasoline engine as 
standby for one of the pumps. A venturi- 
meter is on the discharge line to record* 
indicate and integrate the flow. The differ- 
ential pressure of the venturi-meter was used 
to control the flow of chlorine® 
(2) Storage and Distribution. A single 14-inch line 
carries water about a mile to the reservation 
at Shag Pond where a distribution loop is made 
around the pond. A covered concrete storage 
tank of 500,000 gallons capacity is designed 
to float on the distribution system (Elevation 
250*} at a point about one-half mile distant 
from the pumping station. The United States 
Navy area is served from the distribution sys- 
tem by two lines (6H and 12n; across the cause- 
way. There is a meter and check valve which may 
be by-passed in emergency, permitting the Navy 
to pump from its storage tanks into the Army 
distribution system. The Naval area has three 
booster pump stations and nine 500,000 gallon 
storage tanks below hydraulic gradient. Distri- 
bution lines have been disinfected before being 
placed into service® 
(3) Treatment. A Wallace and Tiernan automatic (MASV-M) 
vacuum type solution feed chlorinator has been in- 
stalled® This chlorinator has a maximum capacity 
of 4-0 pounds per day. Orifices of 5 and 12 pounds 
per day capacity are also available® Chlorine is 
injected into the suction line of the pumps. Wa- 
ter under pressure for operation of the chlorina- 
tor is available at the discharge side of the 
pump. A one and one-quarter inch service line 
on the discharge side of the pump, after chlorina- 
.. tion, leads to a service sink and is used for de- 
termining chlorine residual® Chlorine is provided 
in 150-pound cylinders and a scale is available 
for weighing the chlorine cylinder as chlorine is 
applied® Provision is made for an additional 
chlorinator when necessary. 
(4) A Proportioneers manual control motor driven 
hypochlorinator was installed on the Argentia 
Pond line by the' United States Navy. There is 
no meter on this line for determining the rate 
of flew of water from Argentia Pond. With suffi- 
cient water in the pond, the flow in this line is 
relatively constant® 
118 In the Summer of 1944 numerous complaints were 
received in that the water at Fort McAndrew had developed an 
odd taste and odor. It was found that a high chlorine dose 
had been necessary to maintain the residual required by War 
Department directives. In order to obtain this high dosage it 
had been necessary to increase the strength of the chlorine so- 
lution to a point which is detrimental to solution feed equip- 
ment. A 5% solution was being used for equipment which was for 
only 1$. The matter was discussed with the Base Sanitary Offi- 
cer and the Fort McAndrew Area Engineer and plans were made to 
provide for the use of chlorine gas at the intake* and a solu- 
tion feed with a weak solution as a booster to take care of 
fluctuations in the flow. This plan took care of the equip- 
ment but it did not answer the problem of taste and odor. Mi- 
croscopic examination of a sample from Argentia Pond* which as 
stated before connects with the main supply derived from Clarke’s 
Pond* revealed the presence of algae and protozoa. Copper sul- 
phate was added to the reservoir as a method of combatting this 
condition. Results obtained by the use of copper sulphate were 
excellent. Odor and taste were reduced to only a trace and a 
chlorine residual could be maintained in the distribution system. 
Several outposts in the Fort McAndrew area have 
various water supply problems and they are presented under separate 
headings: 
(l) St. Bride’s. The water supply at this station 
is derived from a small stream which flows 
rapidly from an area covered with heavy brush® 
A small regular dam diverts the water through a 
6-inch line to a concrete suction well. An 8- 
inch pipe back to the stream allows the water 
to flow through the well. A 2-inch suction 
line leads to the pump house housing gasoline 
reciprocating plunger pumps which discharge 
water to the distribution system. All sur- 
plus water flows to a covered wooden elevated 
storage tank of 5*C00-gallon capacity. 
(2) Black Point. The water supply from this 
installation is derived from a very small 
stream about 150 feet from the barracks. 
The water is diverted into a covered rock 
lime well about 10 feet in diameter and 3 
feet deep. A 2-inch line carries water by 
gravity to the barrack buildings. 
(3) Point Verdeo There is no water supply at this 
installation which will provide water fit to 
drink. A rain water cistern equipped with a 
119 pitcher pump is used to provide water for dish- 
washing. Blackish water is pumped up from a 
rather stagnant pond separated from the sea by a 
narrow strip of land and this water is used for 
flushing toilets* washing and so forth. The 
water for drinking purposes is hauled to this 
installation from Fort MeAndrew in ten gallon 
milk cans. 
Co Harmon Fieldo The source of water for Harmon Field is 
Noel*s Pond with an elevation of 72-l/2 feet® The lake is situated 
about one and a half miles northwest of the reservation. The lake* 
one square mile in area and ranging in depth to 170 feet* drains a 
watershed ringed with a high ridge consisting of many smaller ponds® 
There were a few habitations in the area but these were removed and 
the entire watershed became part of the reservation® A l6-inch water 
intake extends several feet from the bank some 12 feet below lake 
level. A permanent pumping system consists of two motor driven 
vertical turbine pumps having a rate of capacity of 1*000 gallons 
per minute* a venturi type to which is attached a flow meter with a 
recording and intergrading device and a chlorinator. Before the 
water passes through the pumps chlorine is added by means of a 
Wallace and Tiernan chlorinatori The chlorinator has a capacity 
of 4-0 pounds of chlorine per day® Tests conducted in October 
revealed that the water had a high chlorine demand which would not 
be satisfied even after two hours contact with chlorine. This was 
probably due to a high organic condition of the water. It was be- 
lieved that a dosage of from four to five parts per million* which 
would allow free chlorine intake of the water for at least one hour* 
would provide satisfactory disinfection. 
In September 1944 the surgeon at that station made a 
recommendation that the amount of chlorine injected into the water 
supply be gradually increased to provide a residual of at least *>4- 
ppm at points of consumption at all times® The Base Sanitary Corps 
Officer* having made a study of the Harmon Field water supply sys- 
tem* reported that this request could not be complied with because 
of the type of construction of the water system*, During the pump- 
ing operation the water not used by the base is stored in a covered 
concrete storage tank. As soon as the water in the tank has reached a 
prearranged elevation the pump is cut out of service. The water is 
then drawn from the tank. It has been found that whenever an attempt 
is made to add sufficient chlorine to maintain a residual of «4 ppm* 
at all times at all points throughout the system* an excessive re- 
sidual is present during pumping operation. The high residual dur- 
ing pumping periods gives the water an obnoxious chlorine taste® 
The Base Sanitary Officer recommended the installation of an ammonia- 
tor which would work in ccnjuction with the chlorinator as a solution 
to this problem. The combination of the chlorine and ammonia would 
120 give a slower acting chloramine which would hold the residual 
longer and eliminate the offensive taste of the Mgh chlorine 
residual. At the time of this writing it is not known whether 
an aramoniator has ■installed at this station. 
d. Gander Field. ' The water supply up to 31 December 
1941 was inadequate. During May 1941# upon arrival of United States 
forces, water was derived from several deep wells. At that, time no 
preparation was considered necessary by the Royal Canadian Air 
Force or their contractor who was constructing the Gander. In a 
short time this water became inadequate for the growing population 
and that which did exist became contaminated by improperly dis- 
posed feces by the Newfoundland laborers. A new source was pro- 
vided from Dead Man's Pond, which is situated about two miles from 
the Airport, during August 1941 when the original supply was defi- 
nitely inadequate and contaminated. Chlorination of this water 
was supposedly done by the Canadian contractors but no evidence 
thereof could be found and furthermore there was an inadequate 
amount of calcium hypochlorite on hand to last any time. The water 
continued to show evidence of fecal contamination. During the last 
week in September 1941# on joint pressure from both the Royal Cana- 
dian Air Force Surgeon and the United Stated Army Air Base Surgeon, a 
Wallace and Tiernan vacuum control chlorinator was installed for 
chlorination of water prior to storage in two 65#000 gallon wooden 
tanks. In this system the water was further chlorinated after 
leaving the storage tanks by 7-l/2 pounds of hypochlorite daily 
instilled with an automatic Wallace and Tiernan hypochlorite in- 
stallator. Several cases of diarrhea occurred during October and 
it was found that all chlorination had been stopped a few days 
prior to that time without proper authority. All water was then 
boiled prior to use until the chlorinator could be placed in proper 
operation again. 
Early in 1942 the permanent water supply system, 
having Gander Lake as its source of water, had been startedo Gan- 
der Lake is situated about one and one-half miles south of the Air- 
port and 350 feet lower. The supply of this extremely large lake 
is Inexhaustible. There is very little human habitation for miles 
near its shores hor does it drain in large inhabitated areas. The 
water system is under the control of the Canadian forces. The 
water is chlorinated with liquid chlorine before it reaches a 
600,000 gallon reservoir and in addition calcium hypochlorite is 
added to the water as it leaves the reservoir« Bacteriological 
tests of the water have repeatedly been negative. Recently it 
was noted that there has been a lack of chlorine residual in the 
water when it arrives on the base® However, the water presents 
no evidence of contamination. This deficiency is at present un- 
der discussion with the United States Army Engineer and the 
Canadian forces. 
121 6. Disposal of Waste. 
a. Fort Pennerrell. The Post Incinerator is of the 
enclosed high temperature type and is located in the southeast 
section of the reservation near the sewage treatment plant. It 
is designed to handle from 4-1/2 to 7 tons of combustible trash 
and garbage during an B hour period and is equipped with heat 
coils and washing facilities so that all cans may be returned 
to their organizations properly cleaned. Sometime ago the fire 
brick in the combustion chamber became loose and the incinera- 
tor was out of service for several monthso During that time a 
temporary incinerator and a grate built by the Post Engineers 
was used. The operation of this temporary equipment was unsat- 
isfactory in that the loose burning and burned papers were car- 
ried into the air by the up draught of the burning process and 
littered the neighborhood area for several hundred yards. 
Garbage is disposed of by gift to a civilian. An 
agreement was drawn up with a Mr. David Squires., a Newfoundlander, 
which states that he will collect the garbage from the messes at a 
time and frequency of the collections. A clause in the agreement 
further states that said agreement could be terminated by either, 
party on two weeks’ notice. The contractor’s equipment consists 
an open truck in which he has about ten barrels of various sizes. 
Routine collection varies slightly in the Winter but is generally 
regular during the other seasons of the year. Several. times the 
contractor failed to appear during the Winter and the garbage was* 
transferred to the Incinerator by the Unit Messes and there burned. 
All permanent buildings have a rat proof alcove built into the 
rear of the building which accommodates an adequate number of 
cans for waste separation. This alcove is supplied with running 
hot and cold water and after the garbage is emptied the cans are 
scrubbed with hot water and soap. The care of the cans and racks 
at the various messes is excellent. 
b® Fort McAndrewc The high temperature type refuse 
incinerator has been in operation since the first of the year 194-3- 
A schedule has been worked out which satisfactorily handles all 
the combustible trash and garbage besides delivering the cans 
properly washed to the mess halls® At one time the work of the 
man burning this garbage and combustible material was difficult 
because the wastes were not properly segregated at the point of 
origin® It was found that tin cans* bottles and other noncom- 
bustible material was being mixed with the material intended for 
the incinerator® This practice was curbed by instructions through 
Post Memorandums and the refusal of collectors to take any con- 
tainers until all noncombustible trash had been removed® 
122 c° Harmon Field0 The question of garbage and its 
ultimate disposal has been a problem of much concern for some- 
time at Harmon Fieldo It had been announced that garbage was 
available for hog feeding but none of the local people were 
apparently interested,, Attempts have been made to bury it with 
unsatisfactory results„ Rats at the dump are accepted as an 
integral part of the rubbish and garbage„ As of April 1944 five 
incinerators of the inclined type were built and burned outQ An 
inspection of the last burned out incinerator revealed that it 
was not properly designedo A well designed and carefully oper- 
ated incinerator would serve the purpose provided the garbage 
be delivered in as dry a condition as possible,, Another in- 
cline plane incinerator was completed in November 1944 and is 
now in operation0 Sewage disposal at Harmon Field is by a 
regular sewer system and the outfall discharges into Sto George's 
Bay without creation of any nuisance„ 
do Gander Fieldo Sewage disposal at this air base 
upon the arrival of United States troops was found to consist 
of the following methods of disposals 
(1) Defecation on the ground promiscuously by 
Newfoundland laborers employed by the Atlas 
Construction Company,, Later this company 
used pail latrines which were emptied into 
a large open pit„ 
(2) Two inadequate septic tanks serving the 
Royal Canadian Air Force and the United 
States Area0 There was also one septic tank 
for the Canadian Army Area0 A permanent dis- 
posal plant of the Dorr Clarigister type 
accommodates a population of This 
plant was completed in late 1941« 
Refuse disposal methods were poor,. At that time there were two 
inadequate incinerators resulting in garbage lying around the 
area for the rats to eat0 The garbage dump came under the direct 
supervision of the United States Army in August 1944* However* 
it continues to be used by all the allied forces in this area 
and by this arrangement it has been possible to control the dis- 
posal activities in the dump area in a much better manner,, The 
sewage disposal plant and the water supply system at this base 
are under the control of the Royal Canadian Air Force„ 
7 o Control of Insects0 
lb File So Flies are very prevalent in Newfoundland 
during the months of August* September* October and November„ 
Howeverj all windows and doors in this command are properly 
screened with number eighteen wire screening and with the use 
of fly swatters* fly papers and sprays* all buildings are kept ■ 
fairly free of these insectso 
123 bo Mosquitoeso Experience has proven that the mosquito 
situation at the bases is merely a mild pest problem at the worst® 
The prevailing strong breezes help in reducing the presence of 
mosquitoes on the base sites® None have been identified as a disease 
bearing type* 
c* Tickso A type of tick identified in this region has 
been the Haeraaphysalis leporis-palustris* the common rabbit tick# It 
is understood that this tick is prevalent in all areas of North America 
and that it is capable of transmitting tularemia and Rocky Mountain 
spotted fever among animals<, However* it does not attack man® 
do Fleas® The flea which has appeared here has been 
identified as the European human flea (Pulex irritans)® Control measures 
applied with success have included increased cleaning of the barracks 
and sulphur fumigation® Pyrethrine powder has also been usedo 
e® Cockroaches and Bedbugs® Cockroaches and bedbugs have 
to some extent infested practically all the buildings of the various 
posts in Newfoundland® Responsible officers were informed that the 
irradication is accomplished only by persistent effort on the part 
of all concerned® Single applications of insecticides are not 
enough® The present system of control is to have two civilian employees 
of the Engineer Corps disinfect the affected areas® The program calls 
for an initial application of any of the available insecticide material 
followed by periodic applications as long as the particular infestation 
exists® When in the opinion of the Base Sanitary Corps Officer the 
infestation is under control the responsibility of routine application 
of the insecticides is passed onto the unit commander® Officers 
responsible for barracks and other installations on the post were 
provided with a list of insecticides which were available in this 
command® In addition the method of application for each type of 
insecticide was also furnished them® This command has used the 
following insecticides; 
Roach powder (insecticide powder* roach* QM Stock # 51-1-210) 
Finished spray (insecticide liquids finished spray* QM Stock 
# 51-1=169) 
Borax (borax* powder* QM Stock # 51-B-599) 
Methyl bromide (methyl bromide* 20 cc ampule* QM Stock # 51-M-888) 
Barium carbonate (barium carbonate* QM Stock # 51-B-152) 
Delousing powder (insecticide powder* del©using* QM Stock # 51~I~180) 
Freon bombs (insecticide* aerosal* 1 pound* QM Stock # 51-1-159) 
124 Fumigation* using hydrocyanide* has been resorted to several times. 
In July 1944- the Base Sanitary Corps Officer had six large civilian 
quarters at Harmon Field fumigated with this gas. The results were 
excellent. However* the responsible officer was informed that con- 
tinued efforts must be made towards keeping the barracks free of 
bedbugs and roaches by employing sprays and powder frequently. 
8. /Control of Rodents* 
a. The only species of rats observed in this command has 
been the brown rat. Rats at Fort Pepperrell have never assumed a 
proportion of infestation although occasionally they have appeared 
singly or in small groups in different sections of the post. Since 
this post is close to a seaport city it was felt that rats might 
be a cause of an outbreak of disease® To date, however, no such 
diseases have been traced to the presence of rats. Loss of Quar- 
termaster supplies because of rats has been negligible since the 
majority of warehouses being used are constructed of concrete. 
Rats were present in large numbers in some old structures which 
were located on property adjacent to the Post. When this property 
was purchased by the United States Army the buildings were burned 
because of their unsanitary condition and because they provided 
harbourages for rats® A large rat population was also found at a 
rubbish dump located approximately one mile from the post® While 
garbage is not supposed to be dumped there occasional traces are 
found. In the Autumn of 1944 a campaign was started to eliminate 
them by poisoning but freezing weather interfered. However, the 
campaign was resumed as soon as the weather permitted. Fumigation 
has never been used as a method for destroying- rats since their 
harbourages are generally underneath buildings or in adjacent 
areas. At one time a large building on the post was fumigated be- 
cause of bedbug infestation and it was found that several rats 
were killed as a result of hydrocyanide gas. Barium carbonate 
has been employed with very satisfactory results. 
b. Rats reached a proportion of infestation at Fort 
McAndrew in the early part of 194-3. As a result a Board of Offi- 
cers was appointed in September 194-3 which was composed of a rep- 
resentative from the Quartermaster Corps* Medical Corps and the 
Corps of Engineers, Their sole purpose was to make recommenda- 
tions for the control of pests and rodents. The following meas- 
ures were put into effect by the Boards 
(l) A detail of three enlisted men was 
provided consisting of one man from 
the Medical Department as poison and 
food technician* one man from the 
Engineer Corps as rodent proof tech- 
niclan and one man from the Quarter- 
master Corps .as supply technician. 
125 Their sole duty was pest and rodent extermination. 
This detail of men was under the direct supervision 
of the rodent control board and employed the use 
of traps# poisons# ratproofing measures and other 
available means until the problem was under control. 
(2) Cargo vessels which berthed at the United States 
Army Dock were required to use rat guards on all 
hausersc 
Excellent results were secured by the measures recommended by this 
Boardo Since that time only routine procedures have been necessary 
to control the routine infestations at Fort McAndrew* 
c® Rodent Control Boards were also appointed and were active 
in stations now under the control of the United States Array Air Trans- 
port Command® The same methods were used and recommended by them as 
they have been employed by the Newfoundland Base Command stations® 
III SANITARY ENGINEERING 
1. The sewage treatment plant at Fort Pepperrell was placed 
in operation in February 194-3® The plant provides for an average 
daily flow of 4-50#000 gallons# two Imhoff tanks with sludge storage 
space for a period of 9 months# chlorination of the influent and 
effluent and a closed covered sludge drying bed. The effluent is 
discharged in the outflow stream of Quidi Vidi Lake® The stream 
cascades over a rocky bed for a distance of about 300 feet before 
emptying into Wuidi Vidi Harbour. Some difficulties were experi- 
enced in getting the plant started# such as# slight foaming# which 
was overcome by the addition of hydrated lime# lack of equipment 
for running any kind of checks or tests until December 194-3* and 
nroper digested sludge was not being produced by the plant for 
quite sometime. The Base Sanitary Corps Officer reported in 
January 1944- that since the operation of the plant had begun it 
had never been possible to alter from an acid digestive stage to 
the alkaline digestive stage which provides a well-digested sludge® 
He advised the addition of hydrated lime in order to cut down the 
acidity® He further reported at the time that after extensive 
study of the temperature of the sludge its average temperature 
was not conducive to the bacteriological activity required for 
proper sludge digestion even though hydrated lime was added® 
During February 1944- discussions with the Base Engineer brought 
out the idea of cutting one tank out of service and using it as a 
separate sludge digester until some sludge would be properly di- 
gested. This sludge could then be used for seeding ‘material. A 
boiler and necessary pipe was installed in the east tank after it 
had been screened. Raw sludge was transferred from the west tank 
to the east tank* Heat and lime were applied® Temperatures of 90 
126 degrees Fahrenheit were usually maintained and pH values of 7.8 
were reached. Gradually the brown undigested sludge turned to 
grey. The offensive odor of raw sludge then took on an odor of 
digested sludge. Some digested sludge from the Canadian Sewage 
Treatment Plant was received and added as seeding material. The 
east tank was then put into service again. Contact with the 
sewage* however* brought the sludge temperature down to 58 de- 
grees Fahrenheit. A factor which would have some affect on the 
sludge temperature is the volume of storm water which finds its 
way to the sewage treatment plant. Studies are being made to 
determine points of entrance of storm water. 
2, Prior to the permanent water supply installation at 
Fort McAndrew* a temporary installation with the same source of 
water was in operation. Considerable pollution of Clarke’s Pond 
resulted during construction of the permanent pumping station. 
The turbidity of the water was greatly increased due to excava- 
tion at the site of the pumping station. The temporary pumping 
station was located just west of the station on Clarke’s Pond. 
The following report of the temporary water supply system was 
made in September 194-2 and is hereby presented: 
a. Pumping Stations* The temporary pump stations are 
located just west of the permanent station on Clarke’s Fonda The 
Army maintains two gasoline engine-driven horizontal centrifugal 
pumps* of 1*250 and 750 gpm capacity* which are now intended as 
standby or auxiliary equipment to the temporary Navy pump in- 
stallations. The Array has a 12-inch suction to its pumps with 
an 8-inch discharge line to the permanent l2»lnch discharge line. 
The Navy pump house* located adjacent to the Army station con- 
sists of two 500 gpm and one 350 gpm electrically-driven centrifu- 
gal horizontal pumps* each with its own suction line to the pondo 
Electricity is from the United Towns Power and Light Company® 
One 6-inch discharge carries water to the permanent 12-inch line 
near its junction with the Army temporary 8-inch discharge pipeQ 
Because there is very little floating storage capacity on the 
system it is the practice to operate normally the electrically- 
driven pumps to maintain a pressure of 35 to 50 pounds per square 
inch at the pump house. During the day* when the demand is high* a 
gasoline-driven pump is thrown in to maintain the pressure. At 
night part of the discharge from the Navy pumps is bypassed back 
to the pond. In cases of power failure* or breakdown of the Navy 
pumps* the Army is capable of carrying the loado 
b. Storage and Distribution. The 500*000 gallon storage 
tank* although full* is not being operated due to absence of the 
altitude valve® Water in the tank is kept as reserve for fire. 
Therefore* except for a temporary 25*£'Q0 gallon elevated storage 
tank there is little capacity available for absorbing variations 
127 in the demand for water® A temporary pupaping station was built on 
Shag Pond for the first water supply at the site. This pump station 
is still connected to the distribution system and constitutes a 
serious cross connection. The pumps are operated occasionally for 
filling sprinkling trucks* etc. 
c. Flow. There is no way of measuring the amount of 
water pumped from the temporary pump stations. The Navy uses an 
average of 600*000 gpd. It is estimated that the total daily 
consumption is about 1.3 to 1.5 mgd. However* when the gasoline- 
driven pump is operated in addition to the Navy pumps a peak flow 
of about 2*600 gpm. or 2.7 mgd. is reached. 
d. Treatment. Specifications called for the installations 
in the temporary Army pump station of a Wallace and Tiernan (MFVM) 
vacuum type* manual control* solution feed chlorinator of 1 to 4.0 
pounds per day capacity. This was not delivered* and in its place a 
similar piece of equipment of only 6 pounds per day capacity was 
installed® This was clearly inadequate and an electrically-driven 
Propertioneers hypochlorinator was added by the Navy. The gas 
chlorinator injects chlorine into the suction line of one of the 
Navy pumps while the hypochlorinator feeds into the discharge side. 
Either one can be readily tapped to the Army pump lines. Despite 
the variation in rate of pumping over a 24 hour period* the rate 
of chlorination remains fixed. Chlorine was dosed at the rate of 6 
pounds per day from the gas chlorinator plus about 26 pounds per 
day of available chlorine. It was determined in the laboratory 
that a dosage of 2o0 ppm will yield a chlorine residual of 1.0 ppm 
after ten minutes contact. On this basis and assuming a flow of 
lo5 mgd the chlorine dosage would be sufficient if applied in pro- 
portion to the flow of water. It is entirely insufficient when 
the gasoline-driven pumps are operated with all the Navy pumps as 
is frequently the case© Of 33 chlorine residual determinations 
made by the Area Engineer’s Office from September 6 through Sep- 
tember 26 at various points on the Army distribution system* the 
average reading was 0.15 ppffij all samples contained 0.05 ppm 
residual chlorine or less® Residual chlorine of at least 0©5 
ppm should be maintained on the system while the temporary in- 
stallation is in operation. During periods of power failure* 
which appear to be not infrequent* all water is pumped by the 
gasoline engines. However* the hypochlorinator* which has been 
applying 75 percent of the chlorine is not operative during this 
period and the water is underchlorinated. The Army pump station 
and chlorinators were operated by the Contractors but are now 
under the Post Utilities Office® 
128 eo Controlo The Area Engineer's Office makes three 
residual chlorine determinations on alternate days at different 
points on the distribution systenio Determinations of residual 
chlorine have not been made at the pump house to control the 
chlorination of the watero There is no tap at the pump house 
from which a sample of water being delivered to the system may 
be collected for this purposeo Bacteriological samples collected 
at the hospital are submitted to the Newfoundland Government 
Laboratory for analysis about twice monthly0 The contractor on 
the Navy side makes routine chemical analyses of water* including 
determinations of pH* alkalinity* CO2 and chlorides® 
/ 3® Prior to the construction of the permanent water supply 
system at Harmon Field a temporary installation was in use® In 
this system water from Yifarra Creek was pumped from a wet well 
through a concrete suction line by two gasoline-driven horizontal 
pumps from 800 to 1200 gallon capacity,. These engines and pumps 
operate for six one-hour periods every 24 hours but seldom at the 
same period Chlorine was drawn into the suction line through 
rubber tubing from a wooden keg with about 10 gallon capacity® 
This keg is filled with water to which one half can of HTH is 
added prior to each one hour pumping period® (This amount of 
HTH contains one and a half pounds of available chlorine®) It 
took about 35 minutes of one hour pumping to empty the keg of 
chlorine solution® Thus for 25 minutes of each hour chlorine 
was added to the raw water® Inasmuch as the water is punped 
directly into the distribution system* with all surplus over 
that being used at the time going to the storage tank* about 
50 percent of the water pumped may have been distributed without 
being chlorinated® 
IV EPIDEMIOLOGY 
1® Immunization® Only the routine immunizations* typhoid* 
smallpox and tetanus have been kept currently complete® In 1942 
all members of this command were inoculated with yellow fever 
vaccine® No other type of immunization has been required® 
2® Intestinal Infections® The number* rate and type of 
intestinal infections for each station by year is presented® The 
figures for the two stations in Newfoundland under the administrative 
control of the Air Transport Command* North Atlantic Division* are 
not included since it is felt that it might constitute a duplication 
through the submission of a similar report by the North Atlantic 
Division Command® 
129 Fort Penperrell 
Number of Cases 
Rate Per 1,000 Per Annum 
im 
Diarrhea 
1 
0.87 
12^2 
Diarrhea 
32 
20.27 
Dysentery, 
unclassified 4 
2.53 
1245 
Diarrhea 
40 
35.87 
1944 
Diarrhea 
49 
19-36 
Dysentery, 
bacillary 1 
0.40 
1945 
Diarrhea 
19 
18.26 
(To 30 Jun) 
Fort McAndrew 
Number of Cases 
Rate Per 1,000 Per Annum 
1242 
Diarrhea 
21 
25.11 
im 
Diarrhea 
' 39 
28*28 
m 
Diarrhea 
25 
13.24 
Typhoid Fever 
1 
0,53 
1945 Diarrhea 
(To 30 Jun) 
15 
18.10 
During the months of August and September 1942 there was a 
moderate epidemic of diarrhea in the city of St. John’s; an estimated 
number of ten to twelve thousand cases. During this period members 
of this command were ordered not to eat or drink in any establish- 
ment in the city. The few cases on the post demonstrated the value 
of the supervision of food, messes and water which exist in the 
military service. 
3o Infections of the Respiratory Tract and Infections Transmitted 
bv Discharges from the Respiratory Tract. 
Fort Peooerrel 
Number of Cases 
Rate Per Per Annum 
19A1 Nasopharyngitis 
190 
164.93 
Bronchitis 
32 
27.78 
Tonsillitis (All types) 
70 
60o 76 
Pharyngitis 
16 
13.89 
Laryngitis 
13 
11.28 
Influenza 
6 
5.21 
130 Fort Pepperrel 
Number of Cases 
Rate Per 1,000 Per Annum 
1941 Measles 
13 
11.28 
Measles* German 
23 
19o97 
Mumps 
8 
6o94 
Pneumonia* primary* 
not atypical 
5 
4o34 
Scarlet Fever 
1 
0o87 
Vincent’s Angina 
6 
5o21 
Meningitis* meningococcus 
1 
0o87 
1942 Nasopharyngitis 
360 
227o99 
Bronchitis 
51 
32o30 
Tonsillitis (All types) 
161 
101096 
Pharyngitis 
18 
llo40 
Laryngitis 
21 
13.30 
Influenza 
5 
3ol7 
Coryza 
1 
O063 
Measles 
7 
4o43 
Measles* German 
1 
O063 
Mumps 
17 
10.77 
Pneumonia* primary, 
not atypical 
43 
27*23 
Tuberculosis (All forms) 
4 
2of>3 
Vincent’s Angina 
21 
13o30 
I943 Nasopharyngitis 
515 
4610 88 
Bronchitis 
81 
72 065 
Tonsillitis (All types) 
241 
216014 
Pharyngitis 
13 
11066 
Laryngitis 
22 
19*73 
Coryza 
5 
4 0 80 
Measles 
13 
11066 
Measles* German 
51 
45o74 
Mumps 
23 
20o63 
Pneumonia * pri mary 
26 
23o32 
Pneumonia * pri mary* 
atypical 
3 
2 069 
Pneumonia * sec ondary 
5 
4 0 80 
Scarlet Fever 
1 
0o90 
Tuberculosis. (All forms) 
20 
17.94 
Vincent’s Angina 
7 
6028 
Meningitis* cerebrospinal 
3 
2 069 
I944 Nasopharyngitis 
142 
56dO 
Bronchitis 
30 
11085 
Tonsillitis (All types) 
152 
6O0O6 
Pharyngiti s 
17 
6,72 
Laryngitis 
9 
3.56 
Influenza 
1 
0«40 
131 Fort Perperrell 
Number 
1 of Cases 
Rate Per IjOCO Per Annum 
1944- Cory21a 
1 
Co 4-0 
Mumps 
5 
1.98 
Pneumonia, primary 
6 
2.37 
Pneumonia, primary, atypical 
3 
1.19 
Scarlet Fever 
1 
Co 40 
Tuberculosis (All forms) 
U 
1.58 
Vincent’s Angina 
16 
6.32 
Meningitis, cerebrospinal 
1 
0o-40 
194-5 Nasopharyngitis 
Tfo 30 
Jun) 
112 
107.58 
Bronchitis 
9 
8.64. 
Tonsillitis (All types) 
59 
$6.68 
Laryngitis 
12 
11.52 
Measles 
1 
0.96 
Measles, German 
1 
0.96 
Mumps 
1 
0.96 
Pneumonia, primary 
1 
0.96 
Pneumonia, primary, atypical 
1 
0c 96 
Scarlet Fever 
1 
c. 96 
Vincent’s Angina 
10 
9e60 
In March 1943 Fort Pepperrell encountered a minor epidemic of 
German measles. Inasmuch as we did not have facilities for isola- 
tion at that time one of the nearby barracks buildings was used. 
These cases were very well isolated and the outbreak was readily 
put under control. Shortly after there was an outbreak of mumps 
which was easily isolated in a section of the hospital. 
Fort MeAndrew 
Number of Cases 
Rate Per 1,000 Per Annum 
194-2 Nasopharyngitis 
213 
254.70 
Bronchitis 
29 
34.68 
Tonsillitis (All types) 
64. 
76.53 
Pharyngitis 
18 
21.52 
Laryngitis 
9 
10.76 
Influenza 
1 
* 1.19 
Measles 
4 
4.78 
Measles9 German 
6 
7c 17 
Mumps 
2 
2.39 
Pneumonia» primary 
19 
22.72 
132 Fort McAndrew 
Number of Cases 
Rate Per I*000 Per Annum 
1942 Pneumonia, primary. 
atypical 
3 
3*59 
Pneumonia, secondary 
3 
3.59 
Scarlet Fever 
5 
5.98 
Vincent1s Angina 
2 
2.39 
Meningitis, meningococcus 
4 
4» 78 
1943 Nasopharyngitis 
498 
36lol3 
Bronchitis 
54 
39.15 
Tonsillitis (All types; 
112 
81.22 
Pharyngitis 
28 
20.3D 
Laryngitis 
24 
17.40 
Measles 
5 
3.63 
Measles, German 
17 
12.32 
Mumps 
91 
65.99 
Pneumonia, primary 
4 
2.90 
Pneumonia, primary, atypical 
6 
4.35 
Pneumonia, secondary 
1 
0.72 
Scarlet Fever 
2 
1.44 
Tuberculosis (All forms; 
9 
6.53 
Vincent1s Angina 
6 
4.35 
Meningitis, meningococcus 
4 
2o90 
Influenza 
1 
0o 72 
Grippe 
2 
1.44 
1944 Nasopharyngitis 
155 
82.10 
Bronchitis 
27 
14® 30 
Tonsillitis (All forms) 
144 
76.27 
Pharyngitis 
5 
2.65 
Laryngitis 
9 
4® 77 
Measles 
1 
0o 53 
Mumps 
3 
1.59 
Pneumonia, primary 
3 
1.59 
Pneumonia, primary, atypical 
2 
1.06 
Pneumonia, secondary 
2 
I0O6 
Tuberculosis (All forms) 
5 
2.65 
Vincent’s Angina 
5 
2.65 
Meningitis, meningococcus 
1 
0.53 
1945 Nasopharyngitis 
47 
56.72 
(To 3C 
Jun; 
Bronchitis 
77 
92.92 
Tonsillitis.(All forms; 
46 
55.52 
Pharyngitis 
22 
26.57 
Laryngitis 
8 
9* 66 
Vincent’s Angina 
1 
1,20 
133 4* Miscellaneous Infections• 
Fort Perperrell 
Number 
of Cases 
Rate Per 1,000 Per Annum 
1941 Scabies 
6 
5.21 
1942 Rheumatic Fever 
4 
2.53 
Scabies 
9 
5.70 
1943 Scabies 
23 
20.63 
1944 Hepatitis, infectious 
2 
0.79 
Rheumatic Fever 
1 
0.40 
Scabies . 
24 
9. AS 
Fever of Undetermined Origin 
1 
0.40 
1945 Hepatitis, infectious 
1 
0.96 
(To 30 
Jun)Scabies 
19 
IB. 26 
Fort McAndrew 
Number of Cases 
Rate Per liOCC Per Annum 
194-2 Rheumatic Fever 
3 
3.59 
Scabies 
1 
1.19 
1943 None 
1944 Hepatitis, infectious 
1 
0.53 - 
Scabies 
1945 None 
(To 30 
Jun) 
5. Venereal Diseases 
2 
1.06 
Fort Perperrell 
Number of Gases 
Rates Per IjOOO Per Annum 
19-41 Gonorrhea 
32 
25.17 
Syphilis 
7 
6.07 
134 Fort Penoerrell 
Number of Cases 
Rate Per 1*000 Per Annum 
19-42 Gonorrhea 
42 
26.60 
Syphilis 
7 
4* 43 
1943 Gonorrhea 
27 
24.22 
Syphilis 
22 
19.73 
1944- Gonorrhea 
25 
9.88 
Syphilis 
5 
1.9S 
1945 Gonorrhea 
8 
7.68 
TTo 30 
Jun)Syphilis 
0 
0 
Fort McAndrew 
Number of Cases 
Rate Per 1*00C Per Annum 
194-2 Gonorrhea 
33 
39.^6 
Syphilis 
3 
3.59 
194-3 Gonorrhea 
49 
35*53 
Syphilis 
7 
5.08 
194-4- Gonorrhea 
40 
21,19 
Syphilis 
3 
1.59 
1945 Gonorrhea 
TTo"30 
3 
3o62 1 
Jun) SypM^^- 11 
1 
1,20 1 
V /VENEREAL DISEASE CONTROL 
1. Venereal disease conditions in Newfoundland can best be 
shown by quoting "aMpSWttWl1 'Wl,llilW"¥8pWW1 fiBViFiilg "SfDrveys on 
civil health services in Newfoundland. The first report was 
written by Assistant Surgeon General R. A. Vonderlahr and PA 
Surgeon Roger Heering, United States Public Health Service, in 
194-0, extract of which is hereby presented. 
"In the absence of morbidity reports or special survey 
data, it is impossible to estimate at present the extent of 
the venereal disease problem or to make final plans for 
venereal disease control throughout Newfoundland. Routine 
serologic tests performed in the antenatal clinic on women 
135 in the lower and middle classes show that approximately 8 
percent are infected with syphilis. On the other hand, 
routine serologic tests over the past few years on admis- 
sions to the mental hospital with an average patient popu- 
lation of 600 have been positive in only 2.6 percent of 
male and .7 percent of female patients. It is the opin- 
ion of the Secretary to the Department of Public Health 
and Welfare that the venereal diseases have only in re- 
cent years become a major problem in Newfoundland. 
•'During the past two years a venereal disease clinic 
has been conducted in St. John’s, arid this clinic will be 
described in detail when health services in St. John’s 
are presented. Treatments may also be given by the 
family doctor to any patient at the latter’s option. 
The Department of Public Health and Welfare provides 
the family physician with all the necessary supplies 
and pays him at the rate of $3*00 for each injection 
of arsphenamine or heavy metal. No special appropria- 
tion has ever been made for the payment of physicians 
for this service, the cost being met from the general 
appropriation for medical care made to the Department. 
The Secretary to the Department stated that there had 
never been any limitation on the payments made to pri- 
vate physicians for the administration of antisyphilitic 
treatments. It is the impression of the Secretary, how- 
ever, that present finances will not permit the organiza- 
tion of a complete venereal disease control service along 
modern public health lines even in the Avalon Peninsula. 
"The Public Health Laboratory at St. John’s provides 
services to the physicians of the country for the diag- 
nosis of syphilis® These services will be described 
later in the report, but the location cf the laboratory 
in St. John’s makes the use of this service difficult 
or impossible for doctors in the more remote parts of 
the Island. 
"Case-finding work in syphilis control is not done, 
and case-holding is very limited. Very little in the 
way of public education has been developed in the con- 
trol of syphilis and gonorrhea. There are no provisions 
for the public health control of gonorrhea and treatment 
methods do not seem to include the use of the sulfonamide 
compounds. 
"The laws of Newfoundland and regulations made thereunder 
should make possible an aggressive and efficient campaign 
against the venereal diseases. The development of a practical 
136 program has, however, been curtailed by lack of funds, 
shortage of trained personnel and the absence of necessary 
institutional facilities. The fulfillment of these needs 
plus the development of an aggressive public educational 
program should lessen the venereal disease problem mate- 
rially in a relatively short period." 
2. The second report was compiled by Lieutenant Colonel Leon 
A. Fox, Medical Corps, in 19-41* and he stated: 
’’The venereal diseases are certain to prove a problem in 
Newfoundland. However, this is no special indictment of the 
conditions on the Island® I know of no place between heaven 
and hell where we can station troops in proximity to a civilian 
population without being confronted with this problem. I have 
given very careful attention to the conditions in Newfoundland, 
especially in the city of St® John’s and I do not believe there 
is any special hazard in St. John’s that should cause us worry 
or alarm in spite of the alarming reports that have been ren- 
dered. If we have a high incidence of venereal diseases, it 
represents a very serious neglect on the part of the personnel 
in command of our troops. It is believed that if we take the 
ordinary approved precautions then there is no special problem 
that is inherent in the city of St. John’s or the island of 
Newfoundland." 
3. When the above reports were written venereal disease 
control by the Newfoundland Health Authorities in the civilian popu- 
lation was unsatisfactory and.almost nonexistent. Since that time 
many changes have occurred. A campaign was instituted in October 
1942 by the Surgeon of the Newfoundland Base Command in an attempt 
to reduce the increasing number of cases incurred by members of the 
United States Army. The plan included measures such as frequent 
group lectures on venereal disease by a medical officer, sex moral- 
ity lectures by the Chaplain, frequent showings of venereal disease 
films, furnishing of rubber prophylaxis to the men who desired them, 
free of charge, recommending more recreational facilities be pro- 
vided and stimulating intercompany competitive sports. In November 
1942 the surgeons of the United States Army. Royal Canadian Array, 
Navy and Air Force, jointly recommended to their commanding officers 
that an appeal be made by them to the Commission Government of New- 
foundland for a vigorous and immediate enforcement of the Newfound- 
land Public Health and Welfare Act of 1931e The provisions already 
contained in this act could with proper enforcement practically ir- 
radicate venereal disease from this country. As a result of this 
recommendation commanding officers of the various allied forces 
convened and decided upon an appeal to the Newfoundland Government. 
Major General Brooks, Commanding General of the United States Army 
in Newfoundland at that time, was chosen to represent those convened 
and write the appeal® The appeal was graciously received and action 
was instituted by the Department® 
137 4® Improvement in the methods of handling suspected female 
sources of venereal disease was rather slow in the Spring and Sum- 
mer of 194.3 but by the Autumn of that year considerable progress 
had been made and the Sydney Loch Hospital was opened for the treat- 
ment and detention of recalcitrant and delinquent venereally infected 
women. In addition two male and two female treatment clinics are 
conducted per week as well as one female clinic for the diagnosis of 
gonorrhea® It is staffed by four nursing investigators and one male 
investigator and has the assistance of forty district nurses and 
thirty medical health officers in various parts of the country® 
$0 In October 1943 a venereal disease division was added to 
the Newfoundland Department of Public Health and a full time physi- 
cian was placed in charge of this work® The health officer selected 
for this position was Dr. Jameg McGrath* a well-trained and hard- 
working Public Health Officer, who- has, since the inception of this 
venereal disease division, established an efficiently functioning 
venereal disease control program, he cooperates fully with mili- 
tary authorities and quickly places under control all suspects re- 
ported® It should be brought out that the establishment of the 
detention hospital and assignment of a full time physician in 
charge of venereal disease measures was obtained only after consid- 
erable persuasive pressure had been exacted by the Commanding Gen- 
eral of the Newfoundland Base Command, the American Consul and the 
heads of Medical Departments of all the allied forces® Complete 
harmony and cooperation now exist and results obtained in source 
follow-up and control of Newfoundland civilian population compare 
favourably with those obtained in the United States and Canada 
despite the difficulties of transportation existing in this coun- 
try. 
6c The incidence of venereal disease in Newfoundland insofar 
as location goes is extremely spotty and varies from those regions 
where there is almost no infection* to sections where the population 
is heavily infected. As examples* Dr. McGrath states that the town 
of St. Mary's* Newfoundland* where he was medical health officer for 
eleven years serving a population of 4-jGCC* had only one case of 
gonorrhea and fifteen cases of syphilis during the entire time he 
was there* and these cases appeared at about the time when a con- 
siderable part of the male population migrated towards the larger 
centres to be employed with the building of military bases. In 
contrast the area of Stephenville and St. George's on the west coast 
of Newfoundland* in the vicinity of Harmon Field* shows a high inci- 
dence of venereal disease as is indicated by forty“nine positives 
out of a total of one hundred and fifteen routine blood serology ex- 
aminations. Other figures indicate that the rate of incidence of 
venereal disease infection is low* outside of certain recognised 
places. In the case of the village of Harbour Grace where eight 
hundred men were given physical examinations for the military serv- 
ice* blood serology tests being done on all of them* only one case 
138 of syphilis and one case of gonorrhea were found in the entire 
group* Recently medical examinations were done on a total of 1949 
Newfoundlanders by medical officers of the United States Army prior 
to their employment in the United States by the War Foods Adminis- 
tration. This group came from all over Newfoundland and included a 
number of women. Blood tests were done on all applicants and vaginal 
smears for gonococci were taken on all the women. In this group one 
applicant was found to have gonorrhea and thirty to have positive 
blood tests for syphilis. 
7. The venereal disease control setup in Newfoundland 
functions exactly like the program in the continental United States. 
Commanding officers and noncommissioned officers of all organiza- 
tions manifest great interest and put considerable effort into con- 
trol measures. Each of the four Army posts has a venereal disease 
control officer who manages all activities in connection with con- 
trol. The Post Medical Officer and V-D Control Officer at Fort 
Pepperrell was designated Base V-D Control Officer and he assists 
the Base Surgeon in correlating the program of control at all posts 
in Newfoundland as well as compiling and forwarding information 
relative to venereal disease source both in Newfoundland and other 
countries® This officer maintains close liaison with the Newfound- 
land civilian V-D Control Officer and the Hygiene Officers for the 
Canadian Navy, Army and Air Force in Newfoundland. 
/s/ Francis E. Utley 
/t/ FRANCIS E. UTLEY, 
Major, Medical Corps, 
Base Surgeon. 
139