WW II Medical Treatment

U.S. Navy hospital corpsmen evacuate wounded from a beach in France shortly after D-Day, June 1944
U.S. Navy hospital corpsmen evacuate wounded from a beach in France shortly after D-Day, June 1944.

Today in WW II: 21 Oct 1933 Germany gives notice of withdrawal from the League of Nations.  More 
21 Oct 1944 Aachen falls to American troops, the first German city to be captured.
21 Oct 1944 Allied ships experience the first kamikaze attack as a Japanese pilot suicidally flys his bomb carrying plane into the HMAS Australia off Leyte, Philippines.
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Medical Treatment in WW II

The U.S. military in World War II had an organized, structured system for evacuation and treatment of casualties that stretched from frontline foxholes to hospitals in the United States homeland, based on medical care echelons. Sick or wounded individuals would be transported from one echelon to another as rapidly and efficiently as possible, subject to conditions which often prevented optimal handling, to optimize their care and potential to return to duty. The ability of the American military system to provide medical aid and treatment to its personnel was a source of strength and increased morale, an important factor in ultimate victory.

The invasion of North Africa on 8 November 1942 (Operation Torch) was the first ground offensive for U.S. troops against the European Axis Powers, and so the beaches of Algeria and Morocco, the barren hills and dry wadies of Tunisia, became the proving grounds for equipment, for tactics, and for men. From North Africa the battle line moved up to Sicily, to Italy, and into France, but for the Medical Department the Mediterranean remained a "pilot" theater whose accumulated experience saved countless lives on other fronts. Medical units that had served well in the static warfare of World War I were modified or discarded on the basis of their performance in the Mediterranean. New techniques, such as the treatment of psychiatric casualties in the combat zone, and the use of penicillin in forward surgery, were tested. The smaller, more mobile field and evacuation hospitals became the workhorses of the theater. Jeeps fitted with litter racks served as front-line ambulances, while transport planes, their cargoes delivered at forward airfields, were pressed into service to evacuate the wounded.

The chain of casualty evacuation was built around five echelons, starting at the unit level. Sick and wounded from the unit areas of front line battalions, regiments and other units are brought to Echelon I and then evacuated from there as indicated by their medical condition and medical needs. Each echelon does only as much as necessary, either to return the casualty to duty or to safely evacuate the casualty to the next higher echelon.

Echelon Facility Brought By Responsibility
Echelon I Aid Station / Unit Dispensary Walking, manual transport or litter, ambulance or other vehicles Unit medical personnel
Echelon II Collecting Stations to Clearing Stations Walking, manual transport or litter, ambulance or other vehicles Medical Battalions, Squadrons or Regiments, Collecting, Ambulance and Clearing elements
Echelon III Mobile Hospitals: Evacuation, Surgical, Convalescent Ambulance, Rail, Airplane Army Medical Service or Indpendent Corps Medical Service
Echelon IV General Hospitals, Hospital Centers, Station Hospitals Rail, Water Transport, Airplane, Ambulance Medical Service of the Theater of Operations
Echelon V Hospitals in the Zone of the Interior (ZI) Rail, Water Transport, Airplane, Ambulance Medical Service of the GHQ or ZI

Each echelon of casualty care and treatment is further described on the pages linked from the table above. The use of litters, air evacuation, hospital trains and ships are covered here:

Doctrine of Medical Treatment in World War II

Governing all WW II medical planning were a series of general doctrinal rules, most of which remained valid long after 1945:

  1. Commanders of all echelons are responsible for the provision of adequate and proper medical care for all noneffectives [persons whose medical condition prevents them from performing their military duties] of their command;
  2. Medical service is continuous;
  3. Sick or injured individuals go no farther to the rear than their condition or the medical situation warrants;
  4. Sorting of the fit from the unfit takes place at each medical installation in the chain of evacuation;
  5. Casualties in the combat zone are collected at medical installations along the general axis of advance of the units to which they pertain;
  6. Medical units must possess and retain tactical mobility to permit them to move to positions on the battlefield and enable them to move in support of combat elements;
  7. Mobility of medical installations in the combat zone is dependent upon prompt and continuous evacuation by higher medical echelons;
  8. The size of medical installations increases and the necessity and ability to move decreases the farther from the front lines these units are located;
  9. Medical units must be disposed so as to render the greatest service to the greatest number.

Coordination of Medical Units in WW II

One problem with the medical organization used in World War II was the lack of an overall medical command and control headquarters at the third and fourth echelons of health-services support -- a problem not completely and adequately addressed by the Medical Department until well into the 1960s.

In support of a typical corps was a separate medical battalion -- under the command of the corps commander and the technical supervision of the corps surgeon -- which provided second-echelon care to non-divisional units assigned or attached to the corps. Patients were evacuated from the corps' divisions and from its attached medical battalion by a medical group of the field army -- in this case, under the command of the army commander and the technical supervision of the army surgeon. The medical group also provided second-echelon health-services support to the units of the army operating in the corps area but not attached to the corps. The group evacuated patients to the evacuation hospitals of the field army, again under the command of the army commander and the technical supervision of his surgeon.

This meant that health-services support for the corps was provided, for the most part, by units not under the control of the corps. In turn, the medical groups evacuated casualties to hospitals not under their control -- hospitals that sometimes received patients from more than one corps. Close coordination by responsible officers, through communication and conferences on a continuing basis, was required to avoid disastrous results for the wounded.

Material on this page adapted from the U.S. Army Command and General Staff College (Ft. Leavenworth, KS) publication, "From the Roer to the Elbe with the 1st Medical Group: Medical Support of the Deliberate River Crossing", by Donald E. Hall.

Recommended Books about Medical Care in World War II

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