14teb? Ht ih i}, v i Hae 7 iy "i ay i a THE UNIVERSITY : * OF LEA =a LIBRARY 610, Dae Un3m = 2% V.5 Return this book on or before the Latest Date stamped below. A charge is made on all overdue books. University of Illinois Library JUL 23 195 WAY 2 4963 ge 2 19% L161—H41 ' ie La a el oa aan “ atk. ry ay s Ad i ee in Che , MEDICAL DEPARTMEN OF THE UNITED STATES ARMY IN THE WORLD WAR VOLUME V MILITARY HOSPITALS IN THE UNITED STATES PREPARED UNDER THE DIRECTION OF MAJ. GEN. M. W. IRELAND, M. D., Surgeon General of the Army See = @ By LIEUT. COL. FRANK W. WEED, M.C., U.S. ARMY THE LIBRARY OF THE Dee 2% & 1925 QRIVERSITY GF WLLINUIS WASHINGTON :: GOVERNMENT PRINTING OFFICE :: 19238 é / ADDITIONAL COPIES OF THIS PUBLICATION MAY BE PROCURED FROM _ ee THE SUPERINTENDENT OF DOCUMENTS — GOVERNMENT PRINTING OFFICE roe = WASHINGTON, D. C. Ln Sa a Rui 8 ‘ $2.25 PER COPY PURCHASER AGREES NOT TO Ri COPY FOR PROFIT.—PUB, RES LETTER OF TRANSMISSION. I have the honor to submit herewith Volume V of the history of the MEDICAL DEPARTMENT OF THE UNITED STATES ARMY IN THE WORLD WAR. The volume submitted is entitled, “ Mirrrary Hosprrars IN THE UNITED STATES.” MeritTe W. IRELAND, Surgeon General, United States Army. The SECRETARY OF WAR. 3 a Sipe > 0563552 EDITORIAL BOARD.’ Col. Cuartes Lyncn, M. C., Edator in Chief. Dr. Loy McArss, C. S., Assistant Editor in Cheef. MEMBERS. Col. Barrny K. AsHrorp, M. C. Col. Frank Biiiines, M. C. Col. Tuomas R. Boaes, M. C. Col. Grorce E. Brewer, M. C. Col. W. P. CaamMBeEerR.atn, M. C. Col. C. F. Crate, M. C. Col. Haven Emerson, M. C. Brig. Gen. Joun M. T. Fruney, M. D. Colo. FPorpaMeac: Lieut. Col. Frerpive H. Garrison, M. C. Col-H. Le Guogrgier Me -C. Brig. Gen. Jerrerson Kean, M. D. Lieut. Col. A. G. Loves, M. C. Col. James F. McKernon, M. C. Col. S. J. Morris, M. C. ColeR wt LX OuryEe eDe.€: Col. CuarLtes R. Reynowps, M. C. Col. Tuomas W. Satmon, M. C. Lieut. Col. G. E. pe Scuwetnitz, M. C. Col. J. F. Strzr,: M. C. Brig. Gen. W. S. Tuayer, M. D. Colm Ay DS TurrLe, VC. Col. F. W. WreEp, M. C. Col. Witt1am H. Wetcu, M. C. Col. E. P. Worrs, M. C. Lieut. Col. Casey A. Woop, M. C. Col. Hans Zinsszer, M. C. a The highest rank held during the World War has been used in the case of each officer. 4 PREFACE.’ The purpose of this volume is twofold: to furnish a record of experiences incident not only to the actual provision of the military hospitals in the United States during the World War but to their administrative operation as well; and, in so far as it has been practicable, to record the histories of the hospitals separately in order that their individual identities might be perpetuated. The material has been arranged to deal with generalities first and then with the individual organizations. Professional activities are considered in other volumes of the history, appro- priate in each case to the particular specialty involved. The plan consistently followed here has been not to include any of these except as they intimately affected organization or administration, when, to avoid a breach in continuity or the semblance of devitalization, they have been briefly recounted. It was obviously impossible to include complete histories of all the many military hospitals in the United States, so a representative of each of the vari- ous types has been selected for description. Hospitals whose histories were most complete were chosen in each instance for this purpose. To show what each of the hospitals accomplished and the staff requirements of each, statistical tables have been prepared exhibiting, numerically, the num- ber of patients treated and the personnel provided for their treatment. These tables have been appended to the hospital concerned when that hospital has been separately considered; otherwise, they have been given in synopsis form by hospital groups. These tables are imperfect: complete data either were not furnished by the hospital during the war, or they have been misplaced since. They are not considered an end, but rather a means to an end, and for this reason it is felt that they will amply serve their purpose despite minor errors. During the earlier stages of the preparation of this volume Lieut. Col. Casey A. Wood, M. C., was in direct charge of its compilation. Colonel Wood accom- plished much valuable work on his assignment, but the exigencies of the service resulted in his separation from activities connected with the history, except as a member of the editorial board. Since Colonel Wood’s separation from the service in October, 1920, much pertinent material became available, necessitating the rearrangement of the volume. Acknowledgment is made to Col. Charles Lynch, M. C., for much of the material in Chapter XXII, on embarkation and debarkation hospitals; to Dr. Loy McAfee, for helpful advice on the general arrangement of the contents of the volume and for the condensation of a number of the individual histories of base hospitals; to Col. A. E. Truby, M. C., for the chapter on the airplane ambulance; to Lieut. Col. S. M. DeLoffre, M. C., for data on the construction of aviation hospitals; to Maj. Floyd Kramer, M. C., for the material on the construction of temporary hospitals and the procurement of hospital space in existent buildings; and to Mr. Arthur W. Hodgkins for the preparation of the illustrations from which practically all of the line cuts have been made. a For thepurposes of the Medical Department of the United States Army in the World War, the period of war activities extends from April 6, 1917, to December 31, 1919. In the professional volumes, however, in which are recorded the medi- caland surgical aspects of the conflict as applied to the actual care of the sick and wounded, this period is extended, in some instances, to the time of the completion of the history of the given service. In this way only can the results of the methods employed be followed to their logical conclusion. 5 Preface. .-. TABLE OF CONTENTS ie ainiolalclataa miaiesss aim idisieele= tistics) xi wilenlei le, wilokelst iat aes als) ol aed olin) <\ wie = sm (eee a Se ie\e) oe e 8m) © oe em Een TER NGIVM es ee en ee See he See MOREE 5S Maeva Ic ere ae ones aes Peeiutiomor the military hospitalic 4. esse ee eee ae aot ope ee em ins sm nje ee ow CHAPTER I. iii ne XIV. XV. XVI. XVII. XV ITT. XIX. XX. XXI. OX LIT XXIII. XXIV. XXV. XXVI. XXVII. 2G EWE XXIX. XXX. Srection I.—PROCUREMENT. Evolution of hospital procurement methods.........----------------+++-+-++- General factors underlying the hospitalization scheme....-...--------+-------- Cesification ot hospitals constricted a so. see 20 6. Sedgwick Hospital, Greenville, La.c....2 62. 2.4 0hc se sense los Jo ee 21 « Mower Hospital, Chestnut Hill, Pa....2.29.95-e0 2.024 -4512005) 0252. 22 8. Satterlee. Hospital, West Philadelphia, Pa........2..0... 40.2.2. 2). 23 9. General hospitals superimposed upon Bureau of Census population map, 1910.......... 36 10. Chart of normal bed capacities in larger hospitals in United States..................-- 53 11. Chart showing relation of available beds to patients in general hospitals........:..-... 54 12. Chart showing relation of available beds to patients in base hospitals.................- 55 13. Types of block plans for hospitals... o..2...2 ac. 2. gepates tan er 58 14. Floor plan‘of receiving building J=3...... -. B4..23 5-204 eee 61 15., Administration building, base hospital .........<....5.¢s.2sceee ee 62 16.. Receiving building, base hospital. +. ....5.2.52..00< >see cues pee 62 17. Floor plans of administration and receiving buildings B-9......................---e-- 63 18. Floor plan of administration and receiving building B-13.......... _-is4 hae 64 19. Floor plans of single wards K-] and K-20.................. ee 65 20. Floor plans of two-story ward barracks K-5 and K-105...................222.-22..+---- 66 21. Floor plan of two-story general ward unit K-34. 2....22..2- 5). 251.2 2352 6e ee 67 22. Floor plans of two-story ward units K-117 and K-68. .........2....4.555.20.- eee 68 23. Floor plan of isolation: wards:M and M-I_..2. 4 .ctos,.. 5202 5-.20 <2e 68 24. Floor plan of isolation wards M-3 and M-6.............. Pio ste SS ee, 69 25. Floor plan of psychiatric wards R-2 and R-4. ..4.....- 26.2 4_-.25.52-30). eee 69 26. Interior of a typical one-story ward of temporary construction.......................- iP 27; Floorplan ot tuberculosis ward K--103) 22 4. eee pes ee. 75 28. Floor plans of tuberculosis wards K-108 and K=107 ...-..... 4... 2s22224. 4.5... 2 ee 75 29. Floor plans of laboratory buildimgs 2.4. Sega ae eA (is 30: “Flor plans of surgical: payilions< 2/9. co 36 eee ee ee 2 bie Se eee 78 31. Floor plan of a surgical department for a 1,000-bed hospital.................-.....-... 79 32. Floor plan of a surgical building for a.2,000-bed hospitals. -..2 23.2 ..22- oa. se 80 33. Floor plan of of a surgical and laboratory pavilion for a 300-bed hospital...............- 81 34. Floor plan of a physical therapy building. 2..a2 G22. - See esas. See ee 82 35. Floor plan-of mess'and kitchengly 205... acs ae ea ee 84 36. Interior of a. base hospital general kitchen( 2,73. 2-5-5 ee ee ek ee 85 37. Corridor adjacent to patients’ mess, showing equipment for transporting prepared food to WATS oes Fe cu on as has a tes im So Sort ere aI ree re 85 38; Floorplan. of mess ‘and-kitchem 12 Fc eee i eee ea 86 39. Floor plan. of mess and kitchen S212 26. @.e sane nee ee ce ane 87 40). -Floor ‘plan of niess and kitchen :l=-o4 eon le ee io) ee ee ee eee Se) 88 TABLE OF CONTENTS. Figure. aie ioor plans of mess I-43 and. kitchen 1-39.22. 20-226 ssc pean waste a elne sense i aene as Pee Omreleris, CHUIDINCN EL. = coer a. nek ao dd see Kaen soe Babe ane ne rides nin tence sass == bea BEC HCCI SA UMATLCTS eu eteen ogee. fa Sere ets stne ec piece leita a ote tna tage atin Some cl a Rrme NO Gare fii Ni THOME ace sane sate. eer a ke lee wie aS oa ea alo Mes See ol ME EGCG EU UOTLOPS > ocee ae «08 ons cites Poets seals celeerinmes se « UMEEA ENO: oe eee BE meL aii TOOT, NUYSES \QUATLCES = 4-2 a cltwi = siete see 6 se ho eae ce ga ae ee PRIS OO eT ByQUALLeT Ba. as de2 se eae ate eee oe eee o'a lo he ecient Cine oes =o oe Pa ered cree inesd Halls wen .2h ce see ae eee ea. tal oe pokes neds Direct ey ewe ee 49. Typical Red Cross recreation house for nurses.........-------------------++-+--+-+e5- 50. Typical Red Cross convalescent house......--..--+--------2-+--22 +25 eee e eee ee eee 51. Typical Young Men’s Christian Association hut...........-.----------+-----+--++-+++++-- 52. Interior of Young Men’s Christian Association hut.........-.---.------------+-+--++-+-- 53. Typical medical supply buildings........-.22- 42-2222 -2-- 222s ns ee teenie eee eee Sdeivioce pian of laundry biilding Q-3...- 2... 2222-228 s 2-2 to te we eee ee Peeaitoor plan of laundry building Q—40.222 27.2722 7.220222 -252 24 1254 - pereeeeG eed see Be 56. Garage and cars at base hospital; .........--.------+- +--+ ++ 22-2 eee e eee eee eee 57. Block plan of base hospitals as originally constructed...........-----------------+-+---- fee tnelosed corridor, connecting buildings... 2025-022 2... 23.0 see sae ae oe ese 2 ee eae 59. Typical one-story ward of temporary construction.........-.------------+---+-+++++++-- 60. Portion of the isolation section of a base hospital .............-.+-.-.-------+-+-+-++-- 61. Portion of the psychiatric ward..........-..--.----------2+ 20 eee reer eee e eee eee eee Pomleterior of atypical ward-barrack.«.. (2.22222. <-. 222 3. seen iim sine fee ee Sees <2 0 ee 63. Floor plans of regimental infirmary and camp dental infirmary.........-.------------- 64. Central heating plant, National Army base hospital......-.-....-.--------------------- 65. Method of heating National Guard hospitals...:....-..-.---.----+22--5-++--2225-008-- 6h. ase hospital fire station.-.......2-.-22220t esse een ee ee ewe eee eine acess Pee Dr roumol a, bese hospital arm 2... 2 22-222 ee ws heen eels cee cane tees sede Gs. Covered, or “umbrella” walk.........-- 2. - 25s eee sens oe ee eee eee lee nace nee ee 69. A post exchange building.....-.....-.----------- +--+ 222 eee eee etree eee eee tenes 7oe Interior of a post exchanges. .......... 22.6. 2-2 cee s eee eee eens cae teres eee eee 71. A base hospital bowling alley.........------------ 2022-22 s eee eee ene ee eee eee ences 72. A swimming pool at base hospital, Camp MacArthur, Tex...............-.-.--------+--- 73. Semischematic map showing manner of distribution of sick..........----.------------- 74. Distribution of overseas patients to general and base hospitals. ....-...--------------- Pope tiospital Train No. Lore... 2. occ oo oe oe ee ee ee See eae eee eee eens "oe. A’ 16-section patient car, Train No, 1...........2.0250-.02 02 eee ee eee esse tenderer es Pe Gariiornic eo iicerss, (rain NOW Ls. ccs 6m aes as00 5 ote omen wo acon tam nels dee ela os, 78. A hospital unit car fitted with Glennan adjustable bunks, showing manner of adjust- TMA Rn sno oc coos bbor ad ose Seb SOC On Dome Gore COSI ES COS SN OSS 5 Gots Ueltic.c mo mri omer TO. Hospital unit car interiors... . - 22 ---- 2-42. 2-5-2 ne eee eee ne eee etna sree eee 80. Hospital unit car interior in use..--..-..----------2 +++ 2222202 een eee ee eee eee eee 81. Laundry, Base Hospital, Camp Grant, Ill......-.....-.----------+-----+-+----++--+-++- 82. Folders for clinical records, Base Hospital, Camp Grant..........-..------------------ 83. Receiving office, Base Hospital, Camp Grant.......--------------0+--- 5-225 ee esses eee 84. Ward class in physical reconstruction, Base Hospital, Camp Grant.......-.------------ 85. Cottage used by the hospital personnel for outings, Base Hospital, Camp Grant......-- 86. Cover design for one of the issues of the Silver Chev’, Base Hospital, Camp Grant... -..- 87. Specimen page of the Silver Chev’ .......--222--2- 22h once cece cece ence cee cece eee ees 88. Administration building, Walter Reed General Hospital............-..-----------+--+--- 89. Hospital stewards’ quarters, Walter Reed General Hospital........-.-.-.------------- 90. Detachment barracks, Walter Reed General Hospital...........--..------------+-+----- 91. Officers’ quarters, Walter Reed General Hospital.........--.--.--------------+--++--- 92. Nurses’ quarters, Walter Reed General Hospital......-.-.-.-.-------------+-+++++--- 93. Isolation building, Walter Reed General Hospital............--.---------+----+++----- 94. Aerophotograph, Walter Reed General Hospital...........-.-.-----------+-----+----- 95. Block plan, Walter Reed General Hospital......-...-.....--------------++++---e+e22++- 96. A view of temporary buildings, Walter Reed General Hospital..........-------------- 10 Figure. Page. 97. Hospital. swimming pool, Walter Reed General Hospital.................----.--.---- 315 98. Service Club No: 1, Walter Reed General Hospital...........2.-.. 2-22-32 318 99. Block plan, General Hospital No. 2, Fort McHenry, Baltimore, Md................-.-- 324 100. Old Post Hospital, Fort McHenry, used as first administration building and officer- patients’ .quarters.... 2d. 0.S.esees oui ee Jods ee ss Sein as Soe ee 325 101. Panorama of cantonment wards, the first to be erected, at General Hospital No. 2..-.- 326 102. Two-story wards, constructed of tile, General Hospital No. 2...................25..225 B20 103. Plaster models of maxillofacial patients, General Hospital No. 2.............---.----- 336 104. Orthopedic shop, General Hospital No. 2.22222. 2 22. cet Be 338 © 105.. Portion, of laboratory, General: Hospital No.2... 22.222. 95- 0. 4 ee 344 106. Work in basketry, General Hospital No, 22.2...42..2..9.205¢ 2022. 5 oe. Se 348 107. Patients at work in printing shop, General Hospital No. 2............7..2¢2. 5. see 349 108. Blind patients learning typewriting, General Hospital No. 2........................-- 351 109. Patients’ work in jewelry class, General Hospital No. 2..........:...1.-2:.-+sseeeeee 352 110. Patients’ class in photography, General Hospital No. 2.....-2./. 3.522 gee eee 306 111. A view of Camp Purnell. Patients bathing, General Hospital No. 2.................- * 358 112; Block plan of General Hospital No. 21, Denver, Colo...2.:..12...22.2. 3 364 113. Wards (under construction) General. Hospital No. 21.....2. 22123222 ee 366 114,- Open-air ward, General Hospital No, 21..2.2........-25. 0240. seers 366 115. Officers’ apartments, General Hospital No: 212. .22:2. 2::.-2: e220. eee 367 116. Block plan, General Hospital No. 3, Colonia, N. J.....2...50-4-¢ - 2520805 376 117. View of front:of General Hospital INO.3..% 2.2. = 2.2 ee i 377 118. Convalescent wards, General Hospital No. 3...:.-.1..24.-022-.--- +25) 378 119. Bakery, General Hospital No.3 22.) 00 wees actus deo aose ee ae 379 120. Chemical laboratory, General Hospital No. 8.:...2..:42. 2-2-2242. =: 252 385 121. East garrison, Fort McDowell, Calif..-<.5....2.2.0..02see002- 70-02 390 122. Post hospital, Fort McDowell....222- 4.252.340 22 4. Sot Bs 123. Hospital at Love.Field, showing additional witgs.......-..-24). -.- sees eee 399 124. Front view of a 50-bed aviation hospital:....2.s-..-52¢e6 cee 399 125. Aviation hospital, Rockwell Field, Calif... -...2.29.<..2 see ete ee 400 126. A:ward, Post Hospital, Eberts Field, Ark... .2.02:.-.¢--<-cde-9o05 =e 400 127. Nurses’ quarters, Eberts Field, Arky. ....:.2. 2ose2.2. ese nde ee 401 128.. Enlisted men’s barracks, Post Hospital, Barron Field, Tex:-.......-22.223.-. ene 402 129. Enlisted men’s barracks, Post Hospital, Wilbur Wright Field, Ohio. ................-- 403 130. Medical research laboratory, Rockwell Field, Calif. .......0.3.5...+-1.2.- eee 403 131. Operating room, aviation hospital.2..:.... 21.22.51 .220-.4.05 05s 405 132. Sterilizing room, aviation hospitals. <. 2.022.225. Sass eee ee 406 183. Dispensary, aviation hospital. .2..10.22.25-.922 «eee Geese ee a oe 406 134. Physical examining room, aviation hospital......2..2..4..2- <-. «+0 ene . Schedule of new construction (temporary except General Hospitals, Nos. 20 and 21) tuberculosis hospitals. 2.2.2 00. oe. 2. be nate berate - tela cip et ee ee eee . Schedule of hospital buildings, semipermanent (except General Hospital No. 28), of later design than buildings at hospitals of National Army and National Guard camps....... . Hospital beds available on armistice day...22......25.5.-++)- cen esses oo ee . Number of enlisted men assigned to different sized hospitals...............-----.----- . Number of overseas patients arriving at Hoboken, Newport News, and Boston.........- . Patients from American Expeditionary Forces transferred to general and base ee from ports at Hoboken and Newport News... ...2.....2. 0.00 <.Sos-cs = 0 . Revised table for ratio capacity, for troops invalided home September 5, 1918, on prin- cipal naval transports.2.4). 25. 2 ene (cee fille =) S Ie c} bf tae 1, + — ————— ee Oe Oe cm ee Nos t A fest a] ; ] [ise as a 5 ' ‘ te a> ok ' Q ' ' 1, t Heat Ar - = peop a eae ES) rs 8 ge mig ‘ he Aether aaa ' ’ Re ae 0 (eo Keer re pik ie ee i gi ak Recs, lente \tess <=00) (Ga0d Gt wee sees wees ate | Hea ey eat erate oar DY 20 Ngee te 3 ii ‘ no 2 1 we eo : * Dept SESSEE eT SEH, esse Heri eer es ee | sent H Hie see ery f 1 Oe) eg ' Mea ire te Apa nee tet [le a ate Oe” testes ee ’ ree | ee) | A ' { SP eer erie Cer -< 24 MILITARY HOSPITALS IN THE UNITED STATES. 30 patients as giving better ventilation and greater comfort and economy of labor than one of larger capacity. 5 From the foregoing progressive stages through which general hospital con- struction passed during the War of the Rebellion, it would seem that the United States Army slowly and independently arrived at conclusions similar to those drawn by the British and French. Billings, in his report on barracks and hos- pitals, states, in referring to the pavilion type of hospital recommended by the British, “The experience gained during the late war * * * contributed greatly to the recognition of its value in this country.’ ® AMERICAN MILITARY HOSPITALS IN THE INTERIM BETWEEN THE CIVIL AND WORLD WARS. Of the large especially constructed Civil War hospitals none has survived the ravages of time. Of the many post hospitals of that period —some of which were used as general hospitals—many remain, in name at least, for by altera- tion or new construction their original appearance is no longer recognizable. This alteration in the post hospitals was largely due to the publication of Billings’ ‘Report on Barracks and Hospitals,’’® which forms a classic treat- ment of military hospitals in general. During the Spanish-American War nothing in the way of general hospital construction was accomplished which would add to the developed plan of the Civil War. Of the general hospitals established, the majority were extempor- ized by the use of tents, vacant barracks or other existing buildings—hotels or school buildings—post hospitals, etc. Where increased capacity was requisite, when existing buildings were used, tent wards were erected.2° Several semipermanent general hospitals were constructed shortly after this period, three arrangements of the pavilion wards being used.24_ One con- sisted in locating the wards on the outer side of a covered way, shaped like an inverted V; in the establishment of them on two sides of a central square; and in arranging them in two parallel lines on each side of a covered passageway. The 1,000-bed hospital at Fort Monroe was built in the form of an inverted V, similar to the plans of the Lincoln and McClellan Hospitals of the Civil War, and the hospitals used by the French at Metz in 1870-71. The administrative portion of the hospital was located between two covered corridors; the entrance - standing obliquely away from the latter in such a manner as to receive the full benefit of wind and sun without interference from each other. The chicf disadvantages of this hospital were difficulty of administration and a too great size of the individual ward. The general hospital at Savannah, also having a capacity of 1,000 beds, was well planned and arranged for purposes of administration; the beds being closely placed at right angles to a long central corridor. The long axes of the pavilions, however, extended north and south—an undesirable arrangement in hospital buildings in such a southern latitude. The buildings were also too compactly placed, seriously interfering with each other in respect to air currents. The general hospital at San Francisco had 10 general wards, each with an inside length of 153 feet and, including lavatory and administrative rooms of 180 feet. The width of the ward was 25 feet; the space between wards was 35 feet. These buildings were-located in parallel lines on each side of a central square in which was placed the operating rooms and mess halls. The square INTRODUCTION, 25 was partially closed in at one end by the administrative building and was bor- dered by a covered passageway connecting all the wards, the block plan resem- bling very closely that of the Lariboisiére except that the latter had three- storied wards. This adaptation of the pavilion ward has proven, in its grouping of buildings, to be very convenient and easily administered; and, as will be seen later, materially influenced the block plans for the hospitals constructed at the large camps during the World War. HOSPITAL SITUATION AT THE TIME OF OUR ENTRANCE INTO THE WORLD WAR. In April, 1917, the number of beds in hospitals of the Army was 9,530, distributed among 131 post hospitals, 4 general hospitals, and 5 base hospitals.” The usual type of our post hospital differed materially from the military hospitals in use in foreign countries.?? In our service, the small number of troops located at: any one place made our Army hospital buildings of corre- spondingly small size. Considerations of economy also forced the building of post hospitals of such a compact nature that they naturally and unavoidably presented many defects incident to all activities being present within the same structure. Among these faults may be mentioned the crowding together and close connection of the adminstrative portion, wards, kitchen, lavatories, etc., which should be separated one from another. Exceptionally, there were large post hospitals, to which, by special and successive appropriations, additions were made until the faults mentioned above were partially eliminated. The character of the construction of the general hospitals was very similar to that of the post hospitals, the difference being mainly in size, in the aggrega- tion of buildings, and in the more elaborate installation of surgical and medical appliances for the recognized specialties in general hospitals. Though desig- nated general hospitals, but two served for general cases—the Letterman General Hospital at San Francisco, Calif., and the Walter Reed General Hospital, Takoma Park, District of Columbia. The general hospital, Fort Bayard, N. Mex., was used solely for the treatment of pulmonary tuberculosis,”* and the Army and Navy General Hospital, Hot Springs, Ark., cared for those cases for which the hot springs of Arkansas had a high reputation for benefiting.” The post and general hospitals were, usually, of permanent brick and stone construction. Some were of wood, some partly of stone, or brick and wood; a few were built of concrete. They contained central heating plants— hot-water systems usually—-had range cooking facilities, and were rarely more than two-storied. The size of their wards varied, containing from 6 to 36 beds, dependent upon the size of the hospital. As a rule, the permanent hospitals were well constructed, durable, well lighted, and had ample porches. During the concentration of troops along the Mexican border in 1916, semipermanent hospitals were erected at various places for their care and treatment.” The two existing base hospitals at Fort Sam Houston, Tex., and at Fort Bliss, Tex., of about 200 beds each, were enlarged by the addition of pavilion wards, and increased to the capacity of 750 and 900 beds, respectively. 26 MILITARY HOSPITALS IN THE UNITED STATES. REFERENCES. (1) Eleventh Thad. (2) Withington, E. T.: Medical History from the Earliest Times. The Scientific Press, (Ltd.), London, 1894, 69-70. (3) Garrison, F. H.: Notes on the History of Military Medicine. The Military Surgeon, Wash- ington, D. Cr, 1921) 1 Now ty 22: (4) Withington: Gn: Cites ti: (5) Garrison, F. H.: An Introduction to the History of Medien W. B. Saunders & Co. Philadelphia., 1913, 120. (6) Withington: Op. cit., 224. (7) Heizman, C. L.: Military Sanitation in the Sixteenth, Seventeenth, and Eighteenth Cen- turies. Journal of the Military Service Institution of the United States, Governors Island, NEEY., 1893s civse Non O4sa Male (8) Garrison, F. H.: An Introduction to the History of Medicine, 332. (9) Circular No. 4, War Department, Surgeon General’s Office, Washington, Dec. 5, 1870. A Report on Barracks and Hospitals. (10) Wylie, W. G.: Hospitals: History of Their Origin. New York Academy of Medicine Trans- actions, 1874-1876, 264. (11) Wylie: Op. cit., 266. (12)' Wylie: Opicits, 272. (13) Brown, H. E.: Medical Department of the United States Army, 1775-1873. Washington, D. C., Surgeon General’s Office, 1873, 52-53. (14) Brown: Op. cit., 89-90-91. (15) Report: Hospitals of the British Army in Crimea and Scutari. Eyre and Spottiswoode, London, 1855. (16) Wylie: Op. cit., 278. (17) Report of the Basen aus of the Sanitary Commission Dispatched to the Seat of War in bie East. Harrison & Sons, London, 1855-1856. (18) Burdette, H. C.: Hospitals and Asylums of the World. J. and S. Churchill, London, Vol. IX, 34. (19) Medical and Surgical History of the War of the Rebellion, Part III. Medical volume, Chap. XII. (20) Annual Report of the Surgeon General, U. 8. Army, 1898, 128-131. (21) Munson, E. L.: Military Hygiene. Wm. Wood & Co., New York, 1901, 439-442. (22) Hospitalization Program for the United States. On file, Record Room, 8. G. O., Corre- spondence File, 632.1. (23) Munson: Op. cit., 434-436. (24) A. R. 1445, 1913. (25) A. R. 1441-42, 1913. (26) Annual Report of the Surgeon General, U. S. Army, 1917, 142. SECTION I. PROCUREMENT. CHAPTER I. EVOLUTION OF HOSPITAL PROCUREMENT METHODS. PRE-WAR PROCUREMENT. The Surgeon General personally authorized all hospital projects and approved all preliminary or sketch plans, ! often as the result of conferences in which other officers of his staff joined. Three or four clerks, draftsmen, were employed in sketching preliminary plans for new hospital buildings. These preliminary plans, with supporting data, were furnished the Quarter- master General, to be used by him as a basis for the completed plans prepared in his office.2 Frequently necessary changes were made in the preliminary plans by the Quartermaster General, in which event they were returned to the Surgeon General for his approval. Specifications were likewise prepared by collaborating with the Quartermaster General’s Office. Complete prints and specifications were finally approved by the Surgeon General and returned to the Quartermaster General, together with a request for construction.® Funds for the construction of hospitals were secured from Congress * as an appropriation specifically termed— Construction and repair of hospitals: For construction and repair of hospitals at military posts already established and occupied, including extra duty pay of enlisted men employed on the same, and including also all expenditures for construction and repairs at the Army and Navy Hospital at Hot Springs, Arkansas, and for construction and repair of general hospitals and expenses incident thereto, and for activities to meet the requirements of increased garrisons. Difficulty had been experienced in securing the complete construction of Army hospitals with money thus appropriated. This was due to the fact that several other appropriations, in addition to that for construction and repair of hospitals, were required to install electric fixtures, sewerage, cooking ranges, and, in large hospitals, the additional construction of barracks, quarters, roads, walks, etc. Even though ample funds were provided for the erection of build- ings, occupancy could not be effected unless funds existed in at least three other appropriations to cover expenditures for electric fixtures, sewers, etc. The average yearly appropriation under “ Construction and repair of hospitals,” for the 10 years prior to the war, was $400,000, of which, as a rule, 55 per cent was used for repair and 45 per cent for new construction.” Funds for the construction of hospital stewards’ quarters were secured under separate, appropriate headings.° 27 28 MILITARY HOSPITALS IN THE UNITED STATES. WARTIME ORGANIZATION FOR HOSPITAL PROCUREMENT. The preliminary study of the hospital problem, as applied to our Army after the declaration of war, was made the duty of an officer of the Medical Corps, especially detailed to the Office of the Surgeon General for that purpose because of his broad experience with the larger type of military hospitals. Early in July, 1917, a hospital division was created in the Surgeon General’s Office, under the officer mentioned, which was charged with the responsibility of producing hospital space in the United States for the cantonments of the National Army and encampments of the National Guard, and general and special hospitals for the care and treatment of sick and wounded from overseas, as well as those from numerous camps, requiring special or prolonged treatment.’ There were 32 mobilization camps each of which required a large hospital.® Inasmuch as the first divisions of the new National Army were scheduled for mobilization in the early fall of 1917, it was essential to proceed rapidly with the development of preparations for the establishment of hospitals at the various camps of these divisions. At the same time plans had to be formulated for the provision of hospitals for the sick and wounded from overseas. That these latter hospitals would be numerous became early apparent from the experiences of the British and French. It was finally decided that provision would have to be made for 5 per cent casualties and 2 per cent sickness, the percentage referring to the total number of troops overseas and indicating the number estimated to require treatment and care on their return to the United States. This would make a total of beds equal to 7 per cent of the expeditionary troops. It was assumed that a turnover could be made, on the average, every six months, and a 34 per cent basis was adopted as a required number of beds for returning sick and wounded.’ As the United States had been divided into 16 draft districts, the policy was adopted of providing in each draft district the number of hospitals and beds to be proportionate to the number of men inducted from each district. For obtaining these hospital facilities various methods were used. The Council of National Defense classified the hospitals of the United States as to size, convenience to railroad, equipment, facilities for expansion, and arrangements for handling special work. Tuberculosis sanitaria and dispensaries were inventoried and a survey was made as to hospitals for con- valescents. Offers of private houses and other larger buildings, tendered to the Surgeon General for use as military hospitals, were classified and tabulated for the Surgeon General’s use.” After due consideration, it was decided that the use of civil hospitals for the care and treatment of troops was not feasible because of the uncertainty of the supply of beds, the impracticability of taking over entirely civil hospitals in sufficient number without creating hardship on the civil population, and the difficulty in operating a military and civil organization in the same institution. The Surgeon General concluded that a program must be developed for obtaining a sufficient number of hospitals absolutely under military control, and pro- ceeded to develop that program. At the beginning of the fiscal year 1917-18, the plans prepared for the hospitals for the National Army and the National Guard divisions were being turned over to the Quartermaster Department for execution. Due to the PROCUREMENT. 29 antiquated printing apparatus in the construction branch of the Surgeon General’s Office, there was some delay incident to the printing of large numbers of plans requisite for erection purposes in the field, and it was necessary to run the printing machine 21 hours per day for weeks and demand overtime labor, on the part of the civilian employees concerned, with no increase of pay possible. Therefore a modern, motor-driven press and a motor-driven gas-heater drier were installed. The majority of the printing firms were well behind on work orders and in consequence could not be depended upon. In the preparation of these plans, medical officers, representing the various specialities, such as surgery, medicine, laboratory, were consulted, and, in so far as time, nec- essary construction, standardization, and funds permitted, plans were pre- pared to embody the essential features desired. These features were included with other usual hospital features and activities, and a general plan was evolved for the typical 1,000-bed hospital. A 500-bed hospital was planned by a similar process. In order to standardize equipment, materials, personnel, construction, and administrative requirements, it was thought best to accomplish this, and the 1,000-bed and the 500-bed hospital types were considered as more nearly approximating the majority of the proposed perfected features. The 500-bed hospital differed from the 1,000-bed hospital not only in number of wards, which were of the same type, but in the size of the administration building, receiving building, general mess hall, kitchen, and other service buildings.” During the execution of this planning work, considerable expansion occurred in the section of the Office of the Surgeon General charged with it. At the begin- ning five civilian employees were engaged in the work, under the supervision of one officer, who had other activities as well, and the section functioned directly under the officer in charge of the Hospital Division. It was necessary at this period to increase the drafting force. This was rendered difficult because the Civil Service Commission was unable to supply draftsmen, and the law did not permit the Medical Department to employ draftsmen except at a very low wage. To overcome this impediment, in a measure, architects, versed in hospital design and construction, or in military procedure, were commissioned in the Sanitary Corps, for supervisory duties. '? By considerable effort and after extended delays, the drafting and designing force was organized and the hospital plans were studied and revised as occasions demanded. The difficulty incident to securing complete construction of Army hos- pitals from congressional appropriations, as they were made previous to the war, was overcome by adding the following phrase for incorporation into the enactment: * * * and for temporary hospitals in standing camps and cantonments. For the altera- tion of permanent buildings at posts, for use as hospitals, construction and repair of temporary hospital buildings at posts for use as hospitals, construction and repair of temporary hospital buildings at permanent posts, construction and repair of temporary general hospitals, rental or purchase of grounds and rental and alteration of buildings for use for hospital purposes in the District of Columbia and elsewhere, for use during the existing emergency, including necessary temporary quarters for hospital personnel, outbuildings, heating and laundry apparatus, plumb- ing, water and sewers, and electric work, cooking apparatus, and roads and walks for the same." In the latter part of the year 1917, the necessity for closer cooperation between the Surgeon General’s Office and the Construction Division, War Department, became apparent to both bureaus, and as a result a hospital 30 MILITARY HOSPITALS IN THE UNITED STATES. section was organized in the latter. At this time about 250 hospital construc- tion projects were in the Construction Division, and the number was rapidly increasing. The creation of a hospital section in the Construction Division ™ proved to be an excellent innovation, most advantageous to all concerned, and eventually it grew to a considerable size. Upon the organization of the Hospital Division of the Surgeon General’s Office one of its sections was designated the procurement section.® Prior to that time the branch in charge of construction had not been concerned with the leasing or investigation of properties suitable for hospital purposes. Sub- sequently, however, all activities relating to the acquisition of places for hos- pital uses were initiated and followed up by the procurement section, necessitat-: ing the assignment of additional medical officers and architects to it from time to time. Its functions'® were to determine requirements for hospital space; to secure adequate congressional appropriations; to locate and procure hospital space by lease; to make preliminary plans; to make request for new construction; to pass upon the requests for hospital space from War Depart- ment representatives in the field; to authorize allotments from the appropria- tions made by Congress for the construction and repair of hospitals and quarters of hospital stewards. In June, 1918, the planning subsection was physically placed in the Con- struction Division of the War Department.!? This was done to obtain better liaison with the engineering and building activities and to economize in time. An officer from the Office of the Surgeon General was assigned to duty as haison officer and to follow up projects which had been initiated." After the necessity for hospital construction was determined in the Office of the Surgeon General, and the plans therefor completed in the Construction Division, in collaboration with the construction branch of the Surgeon Gen- eral’s Office, estimates for necessary funds, with a request that their expenditure be authorized, were made and sent to the War Industries Board,” through the Purchase, Storage, and Traffic Division, General Staff, for clearance.” After clearance by the War Industries Board, they were returned through the Purchase, Storage, and Traffic Division to the Operations Division, General Staff, for the approval of the Secretary of War,?? after which they were re- turned to the Construction Division, whence they were sent to the field for execution. PROCUREMENT OF EXISTING BUILDINGS FOR HOSPITAL PURPOSES. The spirit of patriotic service which swept the country prompted many persons to offer their properties to the War Department for hospital purposes. These offers included buildings of every conceivable kind, such as lofts, depart- ment stores, sanatoria, private establishments, hospitals, and private homes. Upon investigation, it was found that many of these could be utilized with advantage and could be obtained and converted into hospitals much more expeditiously than barrack hospitals could be constructed, and at less cost. Therefore, dependence was placed in the greatest degree upon these sources of supply, though many of the buildings offered required extensive remodeling and additional construction. PROCUREMENT. 31 When it was desired to lease a building, the Surgeon General requested the Quartermaster General to lease a specific property. Authorization was obtained from the Secretary of War, after which the approved lease was transmitted, by the Quartermaster General, to a local quartermaster, for accomplishment.” In August, 1918, this time-consuming routine was changed by the organization of a real-estate unit in the General Staff? From that time on requests emanating from the Office of the Surgeon General, for the leasing of property, were forwarded directly to the General Staff, which, within its divisions, conducted investigations, authorized expenditures, and executed leases. When it was desired to establish a hospital in a building which required leasing and then had to be altered, after the lease had been accomplished, the routine was proceeded with as though new construction were being provided. As a rule, from two to six months were consumed in the establishment of large hospitals, representing the time between that when a request for a lease was forwarded from the Surgeon General’s Office, and the completion of any alteration work and the opening of the hospital for the reception of the sick. This necessitated the initiation of projects at a date from two to six months prior to anticipated needs. It was highly desirable that the method be simplified to save time, for during 1918 there was a progressively rapid increase in troop movement overseas. The increase in the active operations at the front portended an influx of sick and wounded into the hospitals of the United States; and to hasten the acquisition of a greater amount of general hospital space, the following plan was instituted:2! Two groups of officers were formed, each consisting of a representative of the real-estate section of the Purchase, Storage, and Traffic Division of the General Staff, the Construction Division, and the Office of the Surgeon General. The duties of these groups were to investigate properties in the large cities; one for the eastern section of the country and one for the western. Upon the recommendation of the Surgeon General, the Secretary of War, on September 21, 1918, authorized the groups to close leases where rentals would not exceed $250 per bed per annum; and to authorize necessary funds for alteration purposes, provided each project would be cleared by the regional adviser of the War Industries Board and, further, that the three members of the group of officers were unanimous in their opinions.” When the described condition could not be effected the project required separate action in the War Department. Under the changed routine, hospital procurement progressed rapidly. Upon the execution of a lease and after the expenditure of funds for alterations had been authorized, the War Department was at once notified. To take up the work on projects where these groups stopped, other groups, consisting of an officer versed in Medical Department requirements, from the procurement section of the Surgeon General’s Office, together with assistants from the hospital section of the Construction Division, War Department, went to the site and, collaborating with the local quartermaster, completed the plans. Definite knowledge was at hand as to when the conversion might be expected to be completed which permitted the advanced assemblage of per- 32 MILITARY HOSPITALS IN THE UNITED STATES. sonnel for the organization of the hospital and utilization of the hospital for patients at a much earlier date. It was found that work progressed smoothly and rapidly; uncertainty was largely eliminated; and arrangements, covering many details, could be completed locally without undue loss of time. REFERENCES. (1) A. R. 1465, 1913. (2) A. R. 1000, 1913. (3) A. R. 1468, 1913. (4) Bull. No. 30, W. D., May 22, 1917. (5) Table compiled from Annual Reports, Quartermaster General, 1907 to 1916. On file, Record Room, Surgeon General’s Office, Correspondence File 632.1 (General). (6) Bull. No. 30, W. D., May 22, 1917. (7) Annual Report of the Surgeon General, U.S. Army, 1918, 304. (8) Ibid., 305. (9) Ibid., 306. (10) Report of the Chairman of the Committee on Medicine and Sanitation of the Advisory Com- mission of the Council of National Defense, Washington, April 1, 1918, 23. (11) Annual Report of the Surgeon General, U.S. Army, 1918, 317. (12) “Ibid {3ist (13) Bull. No. 43, W. D:, July 22, 1918: (14) Annual Report of the Surgeon General, U.S. Army, 1918, 319. (15) Ibid., 308. (16) Annual Report of the Surgeon General, U. 8. Army, 1919, Vol. II, 1141. (17) Annual Report of the Surgeon General, U. 8. Army, 1918, 319; and 1919, Vol. II, 1142. (18) Annual Report of the Surgeon General, U. 8. Army, 1919, Vol. II, 1142. (19) Second Annual Report of the Council of National Defense, for the Fiscal Year Ended June 30, 1918, 117. (20) G. O. No. 80, W. D., Aug. 26, 1918. (21) Annual Report of the Surgeon General, U.S. Army, 1919, Vol. JI, 1144. (22) A. R. 1046, 1913. (23) Annual Report of the Surgeon General, U.S. Army, 1919, Vol. II, 1145. CHAPTER II. GENERAL FACTORS UNDERLYING THE HOSPITALIZATION SCHEME. HOSPITAL PROVISION AT EXISTING ARMY POSTS AND TRAINING CAMPS. During the first few months after the war had been declared, Regular Army troops were being mobilized and trained at permanent military posts in numbers far in excess of those for which original hospital accommodations had been provided. At many posts, camps had been instituted in which there were being trained men who were afterwards to become officers of the new Army. The provision of additional hospital space for the sick of these troops was effected by the construction of temporary wards, mess halls, barracks, nurses’ quarters, or combinations of these or other hospital buildings adjoining the existing post hospitals at the various places. Plans were prepared and the con- struction of the buildings requested mostly in the month of May, 1917.' Rigid physical examination of the entrants to these camps excluded prac- tically all possible chronic ailments, and hospital provisions were made for only prospective acute illnesses. HOSPITAL PROCUREMENT AT CANTONMENTS AND CAMPS. Following the procurement of hospital space at the early training camps, the next necessity in point of time was the provision of hospitals for the sick of the drafted troops and the National Guard at the 32 cantonments and camps. As in the training camps, the character of the sick anticipated was the acute, and it was expected that an abnormal number of beds would be needed for con- tagious diseases and for cases under observation. In the completed plans (proposed along lines radically different from the usual Army type) it was supposed that ample provision had been made in these temporarily constructed buildings for laboratories, infectious diseases, wards for the insane, eye, ear, nose and throat patients, general medical and surgical patients, staff and nurses’ quarters, and administration. That the plans were faulty in minor respects was due to the necessity for haste and will not seem remarkable when one considers the length of time it requires to develop plans for much smaller hospitals in civil life. PROVISION OF HOSPITALS AT PORTS OF EMBARKATION. At these ports large camps were established for the temporary quartering of troops awaiting transportation abroad.? Here, the most rigid physical examinations were given troops and the provision of beds in hospitals had to be not only of sufficient number for the sick, but for communicable disease contacts and for soldiers under observation as well. As in large mobilization camps, the location of these embarkation camps determined that of the hospital. There was little or no information to serve as a guide to the amount of hospital space required in these camps. Moreover 45269°— 233 33 34 MILITARY HOSPITALS IN THE UNITED STATES, such information would have been of slight value as the size of the camps was frequently changed—usually increased—and hospital construction was forced to keep apace. As an instance to show the impossibility of foretelling the ulti- mate requirements of an embarkation hospital, the camp hospital, Newport News, Va., was originally built with a capacity of 250 beds.? Before the war had closed the capacity of this hospital had been increased to over 2,000 beds and the emergency capacity was even greater.’ It should be stated, however, that a portion of this space was used for debarking sick. PROVISION OF DEBARKATION HOSPITALS. The general scheme for caring for the sick and wounded of the United States Army abroad provided for the return to the United States of those requiring prolonged hospital treatment. This necessitated the provision, at the ports, of hospitals for their reception.” The character of sick anticipated was the nonacute. The location of the hospitals for the reception of these returned sick and wounded was fixed, in general, by the location of the port. Specifically, the actual location was fixed by the larger, local considerations of availability and suitability of space, local transportation, connection with railroad systems of the United States, and connection with the actual point of debarkation. No one site was ideal in all of the above considerations. The good and bad features of available sites or properties had to be considered and the one pos- sessing the best combination selected. The absence of outside recreation space and the presence of extraneous noises and disturbances were disregarded. While these things were undesirable, the contemplated stay of sick in these hospitals obviated the necessity of going to an undue extent in avoiding them. Prompt reception, on short notice, and the possibility of rapid evacuation were features of first and most important consideration. The requisite space in these hospitals was the subject of considerable thought, being variously estimated. All estimates were subject to adverse criticism as they contained uncertain factors in their very foundations. Ac- cording to the view of one observer an estimate could be criticized for being too high; from another viewpoint another observer would feel that the estimate was too conservative. The number of expeditionary troops was known and the monthly increments to that number were known. The battle casualties of past wars were considered and applied as far as it was possible to do so to the existing one. The incidence of injury and disease from normal causes could be foretold with a reasonable degree of accuracy. The plan to keep in France all sick and injured, returnable to duty within a period of six months, was known. It was not known until quite late, however, what the rate of return of sick and wounded from France would be. Based upon known factors estimates were made and revised as necessary, showing the number of sick and wounded that might be expected in the United States. These estimates were used in the Office of the Surgeon General as a basis for planning the capacity of the debarkation hospitals for both poris.* In applying them it was assumed that the average stay of the sick, returned from overseas, would not be for a longer period than 10 days in the port hospitals. PROCUREMENT. 35 PROVISION OF GENERAL HOSPITALS. Many unusual cases of illness or injury, for which facilities and personnel could not be provided in camp or post hospitals, necessitated the provision of general hospital care. These hospitals had to be made general in the sense in which the term is used in civil communities, equipped for the care and treatment of all varieties of injury and disease. The larger purpose of the general hospitals was, however, for the care and treatment of patients from abroad.2, The number of patients from the expedi- tionary forces precluded the possibility of retaining them at debarkation ports longer than a reasonably sufficient time for their clearance from the debarkation hospitals, and accommodations for them had to be provided elsewhere through- out the country. The question of the number of returned patients to provide for was prob- lematical. Some of the general hospitals were solely for the tuberculous, others for mental cases, yet both these kinds of hospitals were potentially general hospitals, in the accepted sense, and were operated and controlled as such. Any necessary surgical or medical requirement could be met at any of the general hospitals with one exception—General Hospital No. 7, Baltimore. To secure this general hospital space by the use of military posts seemed appropriate, and, to a certain extent, this was so directed by the War Depart- ment.’ The lease of civilian properties, hospitals, hotels, colleges, loft buildings, and the like was contemplated. This means was used to a great extent.® The provision of general hospitals by new construction was the most expensive, but could not be entirely avoided, particularly where general hospitals for the tuberculous were concerned. It was always difficult to lease desirable property for use in the treatment of tuberculous patients. The medical profession recognized certain areas as being more efficacious than others in the treatment of tuberculosis and to find suitable properties in these recognized localities for leasing purposes was extremely difficult. In accordance with prevalent opinion, the most popular sections for the treatment of the tuberculous were the mountains of New York and of North Carolina and the high and dry sections of central Colorado, New Mexico, and Arizona. It was in these locali- ties that practically all of our general hospitals for the treatment of tuberculosis were placed.’ Population centers were chosen for the location of general hospitals, other than those especially planned for the tuberculous and neuropsychiatric, the majority of them being naturally located in the East, a few scattered throughout the West in military posts. Large civilian properties, convertible into 1,000- bed hospitals, did not exist in the West. THE INFLUENCE OF THE PERCENTAGE OF AMBULATORY SICK ON HOSPITAL PLANS. The expected percentage of ambulatory sick had a large influence in the planning of hospitals. Mess halls of the hospitals of the camps, as originally constructed, provided a seating capacity of 60 per cent. Later, it was found that this estimate had been too conservative and that the number habitually able to go to the mess halls varied from 60 to 75 per cent. ‘OTT Jo deur uoretndod snsueg jo neaig uodn pesodurriodns speyidsoy TeeueH—6 “OM STV. LIASOH SISOTNINFAGAL ~ SIV.LIdSOH 1VUENID szeao puvos [MM ow GH 9 01 8T 8109 992 fF guemissoy [__] SUILNNOO AG AUN TUvnds ua NOMV1nd0a YY Gi WU MILITARY HOSPITALS IN THE UNITED STATES. PROCUREMENT. aie The use of the two-storied ward barrack—a compromise between a ward and a barrack—early in 1918, was an example of how both exterior and interior arrangements were influenced by the quantity of ambulatory sick. In preparing the hospitals designed for the overseas sick and wounded, after their return to the United States, arrangements were made for 80 per cent ambulatory patients. Acute diseases were not anticipated, but a high percentage of ambulatory injured was expected.* The number of patients able to walk proved to be larger than originally estimated, varying from 90 to 95 per cent.’ This discrepancy was attributed to the fact that, after the armistice, there was no military necessity for the retention abroad of the moderately sick and slightly wounded until cured, and these were returned to the United States from hospitals in France as patients whose convalescence, in many instances, had been completed.” HOSPITAL PROVISIONS FOR THE NEUROPSYCHIATRIC AND THE COMMUNICABLE DISEASES. During peace times, the incidence of mental diseases among troops had been about three per thousand per annum." ‘This figure was used, in a Measure, as a basis for the provision of beds for mental cases in all of the hospitals. For each 1,000-bed hospital in the camps, two special wards, of 20 beds capacity each, were provided for the observation and treatment of mental cases. In the 500-bed hospitals only one ward, of 20 beds, was constructed.” In the groups of general hospitals, special hospitals were provided for the neuropsychiatric. Three were established for the insane and one for the psychoneurotic.* As arule, 15 per cent of the space in hospitals, for the treatment of mental diseases, was especially prepared for the adequate care of the violently insane. Approximately 8 per cent of the total hospital space in camps was de- signed for the isolation of cases of communicable diseases.” This space was readily augmented by the use of cubicles in the ordinary wards. REFERENCES. (1) Annual Report of the Surgeon General, U. 8. Army, 1917, 320. (2) Annual Report of the Surgeon General, U. 8S. Army, 1918, 305. (3) Letter from the surgeon, Port of Embarkation, Newport News, Va., to commanding general, Port of Embarkation, Newport News, Va., dated Dec. 10, 1917. Subject: Embarkation hospital. On file, Record Room, Adjutant General’s Office, Correspondence File, 632-1 (Newport News, Va.) N. (4) Letter from commanding general, Port of Embarkation, Newport News, Va., to chief, Em- barkation Service, Washington, D. ©.; dated July 8, 1918. Subject: Provision for housing enlisted personnel, Medical Department. On file, Record Room, S. G. O., Correspondence File, 632 (Newport News, Va.) N. (5) Memo. from the Surgeon General to the Chief of Staff, dated Nov. 2, 1918. Subject: De- barkation hospitals. On file, Record Room, 8. G. O., Correspondence File, 721.6 (Sick and Wounded Overseas). (6) Annual Report of the Surgeon General, U. 8. Army, 1919, Vol. IT, 1148. (7) Ibid., 1167. (8) Third indorsement from the Surgeon General of the Army to Bureau of Medicine and Surgery of the Navy, dated Dec. 7, 1917. Subject: Transportation of sick and wounded from over- seas. On file, Record Room, 8. G. O., Correspondence File, 721.6 (Sick and Wounded Overseas). 38 MILITARY HOSPITALS IN THE UNITED STATES. (9) Ambulatory sick, percentage of returned from overseas: Based on ‘‘ Weekly reports of sick and wounded from overseas.’’ On file, Record Room, 8S. G. O., Correspondence File, 721.6 (Sick and Wounded Overseas). (10) Cablegram No. 2176 from Harris to Pershing, dated Noy. 12, 1918, subparagraph A. On file, Record Room, 8. G. O., Cablegram File. (11) Annual Report of the Surgeon General, U. 8S. Army, 1917, 79. (12) Semiannual Report, Division of Neurology and Psychiatry, from Maj. Pearce Bailey to the Surgeon General, dated Jan. 2, 1918. On file, Record Room, 8. G. O., Weekly Report File (Neurology and Psychiatry). (13) Memo. for the Surgeon General from Col. ©. R. Darnall, M. C., dated Nov. 13, 1918. Subject: Care of insane, epileptics, and war neuroses. On file, Record Room, 8S. G. O., Correspond- ence File 701 (Care of Insane). ~ (14) Memo. from Maj. Pearce Bailey to Hospital Division, Surgeon General’s Office, dated June 13, 1918. Subject: Alterations in psychiatric ward. On file, Record Room, 8. G. O., Correspondence File, .024-10 (Neurology and Psychiatry). (15) Letter from the Surgeon General to the Quartermaster General, dated May 26, 1917. Subject: Estimates for base hospitals for cantonments. On file, Record Room, 8. G. O., Corre- spondence File, 176796-R. (Old Files). CHAPTER, It. CLASSIFICATION OF HOSPITALS CONSTRUCTED. The following group of tables divides the new construction of war hospitals into six main classes: Additions to post hospitals which were enlarged but which never became general hospitals; hospital buildings constructed at the National Army contonments; hospital buildings constructed at the National Guard camps; hospital buildings of the cantonment type constructed at places other than at National Army and National Guard camps, buildings constructed at the general hospitals for the treatment of tuberculosis; and semipermanent hospital buildings. 39 40 MILITARY HOSPITALS IN THE UNITED STATES. TABLE 1.—Schedule showing new construc- n oF Post Hospital at— 3 is, eee tea eel eja(#| |e lele |e lg l4lels rise |e zo) ‘ a Ss |S E416 |elslaleee J2le8 (E888 | ele F.|. Aacseea |e a « (318 lo9 2/218 leslgsl 8/3 Pal 3 sl 2a] 216 la8] Slesizl els] s 2) 8 /4/a sis 15/5 |B*182/5 |4 1.8/4 |_s]/& | S/H |e SslS [esleEle 6) a | a FE ILEIEIR LEIS IESE LEIS E LE ELE lEelE Re eee o| 6 |\9 S |-o | O SWS SS eS" lcs SS S/o oO} 5 lea o 16 oOo} 9 A 4 |e) I |e |e 1s Oo I 1a] 0 |e Fe Tee Pees Le UR Oe Ul 24 Teg lessee |e ale seller Serene | ses |e eer (cree eam eee eee ee Le oot [geet &4 7 ae Dates aese SSeS |S UBS eS Rtas see ll ic | eS | | meee 25 | aot see a le 37 La ne ees Fee eee aes Select ciensaleeecis Se Nee a ae ee ssc sis al | Eeeeee (es 28 No Se epee ae [eal ee era Be oe ee ee eee saline ee ee oa Gace 6 it asa ac, 1 Sele Beal ge ae wwe fae |e ceclee bell oleae teem Reeve Peteaiea eae Be dare Del Cee we ae ae Dae eee wae Se |S cave Pace ete fe = oe aes eI See iN i OE el Bases nee Beal stele o22/siese|{se0, cosas Goa Seree eer eee emer cheese Bel ey eae Gee ole a foes BAS Sealy Sali aoa Scena nae ol LAN SS ia cee Eaeaeue Oriisea been ee uy alee a baee Selene Caen Be Lo] ic loceclee. =| LSI | eee eee eee Eee: FOR elie sel Meee all Be : eA sill soa |2ece | eece| a col ee ae leer eee eee eee eae S| eel ena |e pee A Rc eee ee 2) 0l| aie =n] Soraya ernsetn (asc rat|O olin | eee regen ere ea FP eee ile) ee eld alas eee Dalits Se lee sees ccelbecs| aeolian 10) 2a eee ae ee On|. Gir eeneeiay Sioa ee 3 Al FHORISeEAlaGSel ls a Paes i OEE pace eG") Tl eal 2 300 Sr ANSC Race Sei eyersilt. eres eres relly Ss teaveyapel levees | Pee eee SL eee |e ele A lees BA es Ree er lr laascllase 48 Big cent el el eee eae RDA ei al els i i sileoeale ‘ oc)! lee Sel coe epee eee See: 48 Oi Mine see E>) Pe Se Ibe | aa ial ea lla? Beal teers ean kira ea Mh | aes] 2.) Sep re ee le 288 |S eee etna | ae aoa Bia Meal nan Bln Or oes eel fa were ses Sl meee Gee a ere ree eee 32 Les Alse ilar Ten Pia 8 IO ed oclas de lasduloeee (ahem leee ates i ie Melee eMac 504 Tape mee Sees by eat cea ee [ene se een aioe eel tee ees i SAIS sal cen eee 252 On ielalss elie : 1 es a USNR Sl aera ees 0 | ge nace ee Df. cles Sal eee 8 leet eee ene 112 7 Ne ae aS SO Fie Oe |S ees El es i al Py Ne es oP es |e re ee ee ese ldacelsce 27 eee piel ine lee Bs ecle| Bran Hobe lees ease |e eae | Geen eae ae Bee a eka Sanctcsclosee 50 1 alec be else ule Ae Ieee Se ie rales | Sales eee lhe slats | el eee mes 364 Talaees Seles oee Sl Sokal eaealassales Salen Bee aer Meee 6) | Cee ee ene at 204 Silene San heal : Bee ace a eae eee are pe Pe (eee tet |e Be allows leis 20 lee ae 3 i ne aval a cic == ce|ese =} sims] are cieloac el esse clears eee ee eee | 24 ig (ee aoe | a é eRe eRe ie Does wafewsel) Lose 0 2 [ei eee ieee ere 200 eles eae oa A eele SNS aes Meee al ace tel cee Sete eee ae Learn eee A Raed 5 Ae. ile ee ae aae acs ll ae kat A Raab asc Sasa soul cecil ents See cleeee eee ee ol eee Lees OMe ac nals A ea at ied a Pallas deleceg|oaee|2 cecal) cose meee eee eee eee 1 ee eae Nasal a een ee albsee eee eee eel asaicemrlessalicoo 19 1 Se aioe “ Benes zee eles wile cccell Savoie sores | Cm erence PO 4,618 | 21891 <2 slectaloccclewesl|edea|osee|sces|-0callsose|Sacelaseeleeccl ene Se ec eee ake aes leeere cece eee ee oe oe BED CAPACITY. Post Hospital at— Patients. | Officers. | Nurses. HE ORG CAG AING 2 Becta. Steed misrene oe ae accel eee eee e hot O ROLE SB TUKSH em ¢ Sipe Sel ae Tee aI SUN erates ty ce MN en Oe REE CL te ae Port: Barrancas sic oh Sos cee eee eee eee eee, Site atl ean Me oa Forti@as well. 2298 See sat oe Repertory pee Ort CAS Gy. Fac, pee no Soe Bai Coe Seer Ne Sa ee ee ees Mort. Clank on ist. Se IR Rye a ny. tal ee pe eee Reh ee eTea VE Pee at eel en eee Colum Bus INE Mex ie. yore tee Nee ee ree ee ee a ep Mort: COnStititlonies ccs e a sees oie set ra cee aes ree en eee eee ea HOP: Cr OCK CE bs ico ein ars ee eee Tee te Sr RN i oun ae 3 B OK0) sire BC aerate et RAE es ee > URE he mae ely Re eon uate Oye Sl Ret Camp PD OUs as ee eee se es ee a ne rea ee ae a Se eee 0) a oiel BAG 240) al eaters Nem eines Tn een a Toe as 7 ea yg ge ks Pa the ad Mort: Bt hanwAdll eric see jas aes Sey aye ee rer open IR OnG Ela glen Sees nem evs hia. ie ee oe ree eae Forte amad] Con 25 Ao raion Ss oe a ee Sa er ee Port Elan Cocke. fae oc ce ho aie a orc eerste Cree ake Te ator thes ase ES Ont EOWA distves oe Soles ees ean eo aT SEN er ae Bort Vays cme arca sae rae nee ee ae eee oe ee eer Sea Se er ants KOMELSOM AB ALVACKS ser ces sey ee NS Aer oy eed Rae re aca sn Fort Mace Ar tia Se ees ce my ree ee Rey Re ena nan ee ee a Data compiled from plans for temporary construction at post hospitals. General’s Office. Plans on file, Hospital Division, Surgeon PROCUREMENT. tion (temporary) erected at post hospitals.@ 4] Post Hospital at— 3 Ae ae en ee e119 12 | 6 io a [= a = q 4 8 . oO Slealsis.jJel|e| s 5 a pla| s aie ae lessee Description. ; Seely a} S| o]ole Bolten lits Sie SIPS = 5 o|/ Pls Mala) s/s} els6l 8/4] losleg| & toe) o :S SISI4Z| gla lalaln psa lala loblege lal » ES Pree le eye le | ele (Te |e] esas! £ IEF] Ss Bi | jo) [o) ° So o a ies fee hee ise is ee le ee ee ele | Ss) saclidelboeslaees|sss4 Base] Saar | Seae ace Sees Bees else Soe D-8..] Officers’ quarters, 1-story.....--.-- 24 a iy loeslege| baer ieee Sebel Patse Bec] Pere Et esa | eres nae E....| Nurses’ quarters, l-story...-..--.--- 42 a alipesel aan leas eel | | (eo) WR Fe asaya eee E-4..| Nurses’ quarters and mess........-- 37 . 55) | See | ee ee el Set al ae ls 4 ee E-6..| Female servants’ quarters. .......-- 11 2 S eellenee eal sere (ie! | See ae E-7..| Nurses’ quarters and mess........-- 14 x 68 aa Sele erie aa. oalseetaleics 1 HESeeheNULSes: InfinMaryies veces seecee cee e 6 3 nae pL ae eee Saleen ae H-9ee | Nurses? quartersee-aeceee cee secs ce 26 : ae mallSace Saee eae. E-12-.| Nurses’ quarters and mess.-......-. 14 é ones alee S| Bees ecllierere Z Hale | Garave tien .ceccudclas a ee cie==cee cee. 6276 " x tl ee Bee Beallace 1 13 eee pecs GO jee occ otse oe ae ee ae to an tals es 2 al lsiseees | iael nelese J222-2|| Detachmentimess ssc >see co eelcases Boers é eA oe eel Apalleer ne 1-3 Detachment mess and kitchen... -. aoe ! 5 bal eee = 1 I-4 iDetachinentanessaene see 2 soca ee 3 : Stina = = I-7...| General mess and kitchen......-..-. eae eetllsbos| Soe eee felines oe : ae ator. 1-9---| Detachment mess! o.keecescce qtecee |= 2 a V4 sat 2 pee (ae: Ales 8 Saale cele Behn LeStOLy Wardeon sas ace cicc cetiece cass 34 2 Bel ans eae eee Seid eens - ope ..-|----| K-8..| 2-story ward barracks..........-..-| 60 Jleeee| Boge eee eee agile eee B leerneel loestare ....|----| K-17.] 1-story ward 16 sae tse 586 eee teeta) Asche ls sere dose aeas 24 3 aoe Se ee De ors A ee re ae SB alevsecel| a0) eee © Gosoneeee 32 A Se eae | eel eell Sewell <'c Pree aeeeleeee lee clenee|| hess | erisonaward 32 A Bilao meee woke) socal sac erate etosee ..| L-1..| Double ward and lavatory, 1-story.| 72 lees an al] aly Spee leeoale --/ M....] Isolation ward, l-story..-......--.. 28 Sdllnceg Bsee GaSe mele pee terete ec Mia IM SOlatiOn saesetcta acca ten co oon totes 28 atic ee eae bee palaaralscate| arte Be Bea ee aces Pee Mio el P LSOLALION WATG = cece eee siececem eee 27 Brae lates! (ae evs eyaleteare |e w= te Sod Beds hoodonos |sece .---| N....| Detachment barracks, 1-story...... 50 Sealbeeelaene Ae | Osee eee ne Semele suk Ge oelooseleeee ..--| N-2..| Detachment barracks............-- 52 eeelleccicloce s Sie o{lSarer=| staves: P fee geses letesere Salers! PW N=3ioeie cme (CORA ae Ne aor Goa et ee eee oee 68 Sel eeelsaeelae sc jaealeced beat 5 Bese leaeal eaeia ieeke Gal Cee 2 See] UN=4 5 leosee CO diva tion me crcek ceecee cases 20 el eee ase eer Saat |e se see eee f Se eee Seb Boel NSO ee eat OE BS once ace SS CBee ane ernoas 24 Salioe Neale sachets. ; Sal eel ect Baer he ...| N-9..| Detachment barracks, 1l-story...... 200 aedle sacl (oois aoe sen Poel eee Z Se ol 1 Pe POR ree POtorehouseaepeneesecesee see ee sae |cces Selle Sek Sac ese Cae (Pee eee 3 ar Pee 2 ae ae ..| O-3..] Patients’ effects building.......-...|/.-.-- 6 sara eae ~All eel erset eteee eesal e S erece ese pe Brille Peewee | MODbUar ys. ceciomec = ote nee a eetestete alee eats Sc: earl Pore | Sane eee eal Se |e Pee R-oael esy chiatricnwarde. -cnccrs-maacee aa 19 BED CAPACITY. Post Hospital at— Patients. | Officers. |} Nurses. pees Taya, INUCTD YOR We bs SER Se — AS ee oie en eileen a oe oe ie earn eee TF Opie ere ei ateteecls cise a crotiake lat eiem omnes TENG MIO. 2s Oe CBE ih A as i Scene ea ol See et ge ee eye ore Gy [eee eee See Rae (Spa eee DFE WA ONSG Sy S ego cbc, SOD RK As ie SME sO aes PAROS ae mae ny a got ee mg (ita E baciseawe 14 52 STC YOU Eom e meee mem ns oe, ee Seer iees Ce we op ee tet Ue ot ON a he dee wha oe GYM Bees, baie Banh Soe BA Ce oo eee ORG MDG 6 copem eed Space GReees qOGee Be SESS eiee Se ae Sees Sete Me eee ae eee 136) Seen ee AD: || Pere ee MOTE LOOSE a oe ae thn US SERIE Pac lem Gr te aor ts en an LS) | See eee | Sears creer. || Sen tee eereer EE BEC OSCOU TS reer nnenee ree pee te ceet ee sagt eS Ne, POL ee aioe tee nice am wate lot EEoeeeece 14 200 ontipelmiyleneeiss eee esek s-O seen naa ecke ee asco Nite lhe se ees ee Sos DE | ee ainaue| ase dacs oo |sacersastes TOTES STEEN, 5 os BS SS cS Seo Et ae ee ee pT Eo 28 LEG SIRO Elta = = Boa OBE OR See See EOE Ae ate Ee nA ic eee ee eee ae TRO i SENEINS oc 555, cos Seog a SIRI GE IE MIR once I ne me ty Sel Fort St. Philip Fort Terry..... Fort Thomas. . FLORPR OL CCU Meant Merwe UE R ET is i eae eee Gens oe eT eee eS Vancouver Barracks Watertown Arsenal LORORNNOLCLC Heenan rte taper fon sew Sey NC Ne ee ee eae eo Fort H. G. Wright 42 MILITARY HOSPITALS IN THE UNITED STATES. Tapur 2.—Schedule of hospital buildings erected at National Base Hospital at— Num- Number | ber of of beds. De Camp one Camp | Camp | Camp arp ur Camp | Camp | Camp | Camp cee 8S: | Custer. |. ous: Dix. | Dodge.) Grant. api con: Lee. | Lewis. | Meade.) Pike. | jyan. Be Ree ae 13 1 ib 1D Sees die eee eae 1 1 il 1 1 1 ee Dee Pil aed ae seers er oes se Leis ose 1 Sees Me on er mmere Conc cn |sncuse ce bassse 495 15 i il 1 1 1 ‘il 1 1 1 1 1 1 330 15 1 1 1 a ial 1 1 1 1 1 i 1 il 60 15 il 1 1 1 Ai 1 1 1 1 ib 1 1 630 15 1 1 1 1 al 1 1 1 1 1 1 1 370 10 1 1 if 1 1 1 ioe eters 1 1 Dolea aiwers 60 10 1 1 1 1 1 1 Hed) e iste cree 1 1 Pale ees 1, 456 56 AN lees atet 4 4 4 4 4 4 4 4 4 4 42 Sid sce Ne Soe cme allen stem ors 1 ee ee eel has Seal Sene Soca ose oo em odio! Ls eeeea ee il 255 By ll ee tetanic Ses [erate era a rctes atorw Deedee me sl oscars Di | ediche atest oe eat | eee 1 104 4 Oe 8 Fe ello a te enna gL eee iste | erence syecers TS Sa aeces a Wal Per ees ier acd o a aameeeere 15 1 1 1 1 1 1 1 1 i a 1 1 5. Skea ae 13 1 1 1 1 it 1 iL 1 DP is eS aoa a ees ics A J vtoeoune 15 1 th 1 1 il 1 it 1 1 1 1 1 S Saas 3 TU les hee ae Ne Pe, eee a oe eee ome Mn Se Ort ao dl eeeeees 1 Scart 15 1 1 iL 1 i 1 1 1 1 1 il 1 Se se eeee 15 1 ib 1 if 1 1 i ili 1 1 al 1 Ren eater 15 iH 1 1 a) 1 if i 1 1 1 if it einen een 15 1 1 1 1 1 1 1 1 1 i alt i PR ratte : 15 1 if 1 1 1 iL 1 1 1 1 1 1 Se ee eee 15 i 1 1 it 1 1 1 1 1 il 1 1 7, 480 220 16 16 16 8 16 4 16 16 16 16 16 16 11, 392 178 10 12 12! 12 12 12 12 12 12 12 12 12 420 Al ropes ote serene CEO en eae ene een rorta pre comes |sc amo eesla os Salts B.Jlencaesoslege ees 576 18 Op Ee eats les Aare ooeC Raa near poroucs Sono sss Diilts Soke TP \Gaeise alee ere 1, 220 10! |, sondern | eS ee ers eee TO os. on ccdloceeecsullcs seis cells Sods. c | Beer eee eee eee 9, 360 130 8 8 8 12 8 14 8 8 8 8 8 8 1, 204 43 3 3 3 2 3 2 3 3 3 3 3 3 5, 100 102 fi 7 if tb 7 7 7 5 6 7 fh ul 600 Bl ewmneee DG eaetoe sans teeter = DV avee cereale esicte Se alll nce 5 eel yee wie eke te Stew eee et ERE Ee 60 4 4 4 3 4 4 4 4 4 4 4 4 Nas eras a1 (ee ge eee ee eel Reese Sts poset ln acoecar || Soratoor Sadiecnomeao clos Lo en otads die Spates ead 15 1 i il 1 il 1 1 1 1 ih iL 1 See nee 15 1 1 1 1 if il 1 1 il 1 1 1 Bt oeaeianse 15 1 1 al 1 1 1 1 1 1 1 a 1 Shaw ak ee 15 il 1 1 1 1 1 1 il i 1 i 1 323 17 1 2 il il 1 1 1 1 1 1 1 ik 41,477 1,148 RATED CAPACITY. s : o- F Detach- Base Hospital at Patients. | Officers. | Nurses. ea Camp Custer s 5 2 see ie seas a ec pe ea eee 2,184 26 215 350 CamnpmDevienS ies af2 ee at eee et es ee ee ee ae 2, 043 26 85 550 (Chante) Dib cok Ge ebay aooe ne sot osaccne me escn eo Rea toss sees G SSS Seas sSe 2, 264 26 189 350 GamipeD Od Be ps eee ea a eee ice 2, 012 26 203 350 (@armaa on Gan bee =o sere = ere ea eee ain eas 3, 244 26 317 750 (GaimpG ord Ones meso eae a eee eee a ere oe 2,020 26 189 350 @amip TaACkSOni ss seo see ae te te ae eee ea 2,024 26 189 350 Camplin: ees a eee ee eee er eee eee ces ae 2, 088 26 274 250 Campa ewisene sos Aces Oe eee eae 2,024 26 189 300 a Data compiled from plans for base hospitals for National Army camps. Plans on file, Hospital Division, Surgeon General’s Office. PROCUREMENT. Army camps (base hospitals). All temporary construction.4 43 Base Hospital at— Normal capacity. Letter ee Description. Camp | Camp | Camp prefix. Pa- Offi- | cae Taylor.) Travis. | Upton. tients. | cers. betas ee 1 1 GU) ee chee AGiministraslom Dulles seer eeeeee et een ssa|eee sees Ap sallttewonce maou ese ee ae eae ses leccoecuc RSI a deel antl. Goes Sa 6ebn aces ston sos cdecode cd Rodenescc || Seeger —6| Beseccee Poudnsso |S pmengnc 1 1 al Comeeeer stony OficCers, waldseccacsas see ee ote cesar =e BS ile aes Aloas socecllige wace ae 1 1 ieee ices Ae 1-story Officers’ quarters Se Se ne ear ae saan ate ferall ee mie inte 22) iz aceeselascie stats 1 1 1) D=4o ew, Commissioned officers’ quarters...-....-.-------.-|------.- Ae ee A 1 1 1 Oe ae Nurses? quarters, pl-SGOryise ee seein = 2 oe ee oe cle taste ein allele le ae = = ADN eeaees ts aceenats Betas aoe Ceeeaees (Red SRN I cee 1 ae ee he Ce OL, CHEN See NN toc Mat cian tstvio ciel wise fcletns Siaieese eee = A Ua naRessee Eanes 1D anel| INDIES bab iiponin Reo peep oan cee snc Senco eoone obocd| eraracea||Gaeocecr Giltaee eee 4 4 4| E-9..... Nurses? quarters, IsstOry. 2- co e- ces oe © sit minieinial||em eee == mie = ZO Wier eete eee ea bacon |_......-| E-12....] Nurses’ quarters and mess. .....-.---------------|--+++-+-|-+++++-- Ee eee Yas ae een ee ee HO) ea) Nurses! Quarters, 2-StOGy= cm ae team me ooo chige asa SOO Ram aco OU es 1, 736 26 163 250 (GiPinie) BEGG Coos CooSqenacceebene destecegdesp'0 gander mee SEES Rien aioe G Sts 1, 732 26 151 700 Opinii) SWEDE sn ocaudgneeeoeaeas Soesode ar ee p= Beate GSR ort aie tmsmae Soa 1,652 26 137 150 (Cin) SHETIGRI, co Soe iammec ese cules Gp seabed Sea eran ae oG Dea OC oe 1,360 26 137 250 WarnipeNyaAds wort estas tense ese seme escraeen- etait aisiele fei-lomininirire cree nc 1,960 26 189 250 (Givisiay WHEGID econ gs 625 38 sone d orcas 366 IO Cece pep Dror aca eee rat Rc ai IIe 1, 152 26 11 100 24, 388 416 2, 287 4, 300 MILITARY HOSPITALS IN THE UNITED STATES. 46 Tasie 4.—Schedule of new hospital construction of the temporary type Hospital. “mo}snoH, weg woq ‘Teqyidsoy oseq “sjooy “A ueZ07, yon ‘TeyidsoH 480d "1 -ON TeqidsoH [e19euey KOT 410q ‘TeydsoH yseg “CoN “IOATY WeyLTey “Aiiog due9 {e11dsoH [R19T0y “PZ “ON je1idsoH [e19T9y *“G “ON jeqidsoH [e19Uey FL ON je1idsoW [R19u9y *[eUTULIEL, 104 -seurieqien? Y[OJION Plans on file, Hospital Division, Surgeon “YTIIOW dureg ‘Teyvidsoy, seg "9 ON jeiidsoH [B19TO4) 2 ON TeqidsoW [e197904H ‘qeqidsoH, yerouexy) ~—- WeUTI0} 907 6 ‘ON leqidsoH [vVI9TIH “moysuUyor “WY “SOL. dureg ‘Teqidsoy dured ‘sorydum Ga spiea tp dureg ‘teyidsoy due9 “GZ “ON jeqidsoH [e19ueH “Tr ON jeqidsoH [819094 “ssn dureg ‘tey1dsoy due) ‘jeuSIY Poomesp i “6 "ON jeqidsoH [e19u9y ne ec MaMa i SORE ines & H a Letter Se at me prefix. Description. ae feet || ES a q n oO Si | 48 | aA a 4 isa) a} a jaa] = HH =I no n a i) o oO o ‘S) o = dq <= 3) a a ee See iis el op ae Po Zapesete 4 lO |S Pee (Sy. to ll oN oliaitlishtag inteyele 2 2h. o sone 4 eo ea ROAee oss Seen cocegosdes Sedodel Mobadel Hosea seeene 1 | eee Bie coleeres CLO ae a ey ean een Me omits eeaen aie SE FAS ee a ee eee tlie cess| Segeee Fi ae cl (ee CR Radek eM cee rE Perec ee (Mees coral ts Net eialfsiametinl/miacine edit |e Se eee TER 5 ele CG Keene ae of UN rite ty Ea De a a Bena tee Aten Perio lr orc ere] Esai 50 | kes Gee cee B= lem. JMrplinairh shia ge hHLOIMEENG LOD AL ONES sors eeearooe cee 6 oadecce ce Bes booebha| Sudecel pee eSE posse eae 1 |.....-| B-101...] 2-story, administration and receiving...........---------|------|------|------|------ ee eras coer | Clos coe Officers” wardsmessy an dei Gchomin ses eese serearrsaal|O2|lereedam ial eeratafal ne simi Aas eealli=ncics='= (CHAN (DIES. IPE EG hae Oe GGE bau een GOBe ae sor Se DOcrconeancoce -peccenaroe ie | ee eee oS olla Be il 13. Seer 1B ie See Ofiicers sditarters esses eee eee assess ie oe res ie | lar =o De Rs Dees | (ae PA cam etule acces ase eal Oflicers? quarterss messeand ici LChene scene secins ast ccer cee |) eee) | sect -/-)/aee= | ote eee eee D=4e2e24| Commissioned officers. quartersse:.c--.-s<-25+ 2 e-em A rot Breall peeee ee Te eC ake Soe ID=3,. oo. | Sesion, Guiles? Wilnarmsbeeceoosoocoomceauuasqeesessceccde|oscce|| Eaiileoamed|san5.- er ccesel cots DEG seme © ticersa G UArterse see eee ents aces cies eeete emt icin eteaminte DNs ae eal oe | ae Soe ee eecteee aeeene De fee els Oficers?, quarters, messy amd) kitchermeseee = e-ces se eee |a eae OL geo tara || Se elie Se RD =i, s cre (De? Op einlece 2 nnet soenabea sede eases enasonersaneaae|esoccc ONPG RS rl le Se ‘eee eeeces eseeed tO ee eelmecsbOr ye Oficers: GUAllelsee ss stitee cette cee eeisee eerie BLS eer | 2 ee. ie cal eee eee D-102 (ONaa NAS COREE MATES S50 yao tec Hueeee eae sone once shoe eccetananae Dr ltteers 2522 Soe eters STENT (1 eel a ae a ae SELL VER OW Dee Re EN ace at ee MOUL nee cise a 1 1 eae Hvee erie Nurses’ quarters, mess, and kitchen ........-.-..--------|------|------ AQ) || Saees BR A eer scald cicte == Ff ane |B cli ee UNM a Aa Oe ie AEN ere SoCo OE Seal eros Alles Gael] ea oe te eee BESBee Seas E-5.....| 2-story nurses’ quarters, mess, and kitchen .......-..----|------|------ On| geet es Beale eee ac a eeeeeleNiursesn GUarterssmesss andi kitehemle: seeee see mee eens ere lee eeel fee 1) | Soe eee WaS cs = INjensecey bavibwOle he aoeeo con EAbanseeeoucmssoheceporc seece |saanocllscsoc Ou ees Ps ee eee HG ee SO NIUITS eS (UGS oer ee cee tetera ate tcta re clade ene yere le c= ate) Sate fmioleeimtell = atta 26 Rae 2 wee $ 2 |..----| E-10 Re CC) ee ae pee Pe are Sn PRE teen yatta tere cimiesataue ttacel ovay cece) | Rtas a= SO eee (a eageeo meee ipso eel PAGdiGrONS LO MUTses? QUALLCTS 2 ee nese nee eens elt ea =|mnl~ em AQ ARR Aes Fine sol eee eee ISERIES elAUN ND LASTS} AC0 RUE fifo) hoe tied Abo OSA ae oeeeor Behn biaon ac taeker et eObor secure Si eee Ue eo. eee a8 0 eee STO eV iG aes ee a ee a a eA iO Meee (emery cate at 26uleee. ee a oeeee|ooses Geeee Wo105s eu N2-SLOry, MUrses QUATUCIS: mec cniccc ae ccm elise ela ae ste ieee 50a |eeeee 9] (BRS es | Seer eee 1 cee Laboratory, head surgery and X ray....-.-.-.-----------|------|------|------]------ =. eee es Beeeese THT 2 | GEIR Rea avy n= cakenng eboneecorer sue cececesa Oe Srcel eaters anecx|rcccme| pence 5b co Beane apes Taste al) ADMateh eA Rol mys aa scme Bon Sone dobe cerca tece SopacodacecccsS=ol Phere |lecrsmt loco snl oo SSeS POS ight = 2 TIS joel Charest oj nin btn See ko hooeo Seek pee ecee SS acromcocr one Semon ec abec podemo| sages Le cons | eee ee ih, osu] LER SOIR ys) (oor eos ae nose ee aebresboor geeSas sec O8eP ed bacco) Smonon as aeor bbe Oe oe a oe eae F-11 Laboratory and operating room..........---.------------|----+-|---++-|--+-+-]----+- Eerie Meese) ELS Chemical and bacteriological laboratory.....-.----.------|------|------|------|------ Spee Th 2 2a) 7p Seyi a AIRED R Ee Bee eet noe soposcadcescer boc deep Seabed) sonst. ||aceoer |berr napa ce I) cess a F-101 2-story laboratory, head surgery and X ray....----------|------|------|------|------ aCe 1 eee =|) L022 iB TOV UREA yin epee an ee ie eo doce ave tasters sacunche.co|jecouG| ees ee accuca Sannce Oye HlthSe 6 ohn een ee Gocon Sacre aSBaems se beers hhse econ ser aqlgeuood |aogmacinr tee Operating addition|.4. 22-222 -2-s0cee += asses eee pase ecm | om = |e = Emergency and operating..........---+------------+--+----|------|----2-|-27222|--- >> GE TER A at cose oe cen eae be oeeconans co sehns He cree rie eoceca| oa s8re | aint lea SOO ae eae een oe oso a Sees ecee een ecko caMe seers tose boReS: || Perens abd looney anemic ID aly Se sce oaks saeSedacus es aeseees Sona cen saceaSeee=25))-oRcod| barren | Sone6 ob so (CS. to oongoseaHe Sods Bon ale ae ecn Sr Gas aane ab sue So Br eos sou eoo Eeeror Scots apa oo. SIND se) GhodoncMobde socbdar osc ses Bae coche eps a dadbeseHme cls qecon) bconoa|hecen in aaac IBRAGINT AV Os Pink eee pee mab eebeeeetecascntos oe oeedoer® SS eNOS cedag gc son rete oliseco Orthopedic workshop../.-.--------------------------"2-+|---=--|--e0-|----22]------ Exchange and amusement..........-------------- +--+ -2-/e 720+] ee eee fees rec} see Garaeorandistableceet ae cere eet cee aaa. ere were mier= ateger a teem =r freien ofr IDS CO esta OEe Senne aE ae Base ee denen casa n ape se areas acen||-s ooo” Sbcocolatera lesa eat Genera! eS na) [NNO atS Nas sen Sees bos qa Ae See esnnc oso lsc oso sesccd psa cca bce Been Fae ny Sn tee ty OU OS OE ed ee i ee to ces eee nie norte areri-c ay preteen mess and kitchen Sane OG ee machete st eee cee General mess and kitchen.....-..-- Detachment mess and kitchen Generalmossand: kitchenesses neste aaeee eter ee Nurses. mess aud kitchen. o.oo j2e coco sl stem eet 1c Detachment mess and kitchen Officers? mess.and kitchen...:..-.5..--.------2-<-------- Detachment mess and kitchen ener ATIOSS ATL Ki CM OTe eee sare mercies aie are aietare close aialatar wal yeas, Re aed ON 5 Pee is SYR Oe ee tyne ase alc Detachment mess and kitchen Generalimess and icitchense: sence sees cee see eles eee Detachment mess and kitchen _| Officers’ mess and kitchen.....- IRGC VINE Meee cate asia = eee Administration and receiving....-....------------------- Receiving for overseas’ patients.......-.-----------------|--+--2]oreece|ece sec |ec ree Sp Mie wataealesaeisie ye ie SE ees Oe Seite aeeiad Sacer) | Senses ekg Se eters Ce ee Se ia wig ators sire Stel si simiwiel lias. a walt nialas cin elise asin’ 48 MILITARY HOSPITALS IN THE UNITED STATES. TasLe 4,—Schedule of new hospital construction of the temporary type Hospital. ( Cel Q ee Load Q Q, Comal fe] lomal — Qy a mad tom Comm ay ; aig ~ =) 2\,F EERE EEEE EEE EE IEEE eee Num-'|@ | & © [2 | ese 12 Gf © leas |e |o (eae eels N ber ber on DB Wet SiO eS! wi Slee eos. SO {10.31 BOLO .1O se Eilean licsnesliometles wai ofbeds. | of || 2 [88 SAIS eee is Sidi? S818 esis Ae) © £ gign SMS 2 puild-| S$ | 3 |#8|_ 6] siaglar| Sab S| Siesies| sl S| S| alm eal Br os ings. | 32 | 8 (SelszleaiSeieale7lag els“ |SalClss/s-(e4[s 8] g ole be Sie e eo) 2 BEE ReRSs (ERIE 6 Poesis (s (3 ala f. is Soa 2 ein g o {ar = 1D > Sion f | @ lg {2 lo lgaigcis 1S (5 2 18 |S |8 18 |e [aie & [3-13 soiabbbs Sib b&b 8b b&b we eb & & Slee SS 782 PTs eae eee arte e 2th call 4 ae & ila e fisketece eserare 7, 208 212 HANG one oe alee Tbe ee Ne ze Vee 8) 1 Pall eae eee es) lle all 2 SIG 6, 208 97 Viste ee pe AVMeasal| ANB loccctocccleves ct LQ s/o oe ah USO. a eee ee eres ete Pee tere ee 660 vip eames ety tes A | cclococlecsclcoselonecle~o-{oce-[Seec|-cuel >= sell Sieallets aeaemee mene’ 128 AS Pala ye ral eede eat eases oe stl sllesaels aes Sees iD te sees re lineparaile aS 2, 048 Ciilacor aes 7 eee eae fbn geal ho IE Po Pa malt ele ae see 32 Tisha elle ae Beh are Bee ales He Saalaes Be oc | See te el oe 132 A | eee oe AalS cays Beran ae Beles sche Ballets) seks ese 2,944 AG | See. a il Oe seal etsahtlletae Pel Hellinemte lees 3 ae elton oS eee leees ae & 5 1, 053 Te Rieaeeeeedht aes oe Lede al amvel seal Guia hook em sera (nee a ae ec: eo, ee peacs 216 Biel eee ers he aes Red etc ees Boe Ure brseeattoeisal ees shalents tine 1,368 1) tear twa Stace Fetes 2 Pe eetalees sl es lp | AO Aso ee Sve sya Serer | Brees tS 3 756 D7 Phileas eel Nesta tla Wale seated sean OF alee seat : 112 AA toc tall sets 1 aS | ead RN ges Roe eal ts 1 Al ee Socal cise! a ers 56 2 eet 113) eee ee Be llesers DOE 2 Selecsre tee ere 3 ch ieee 600 Dil icfeeree rail seer See PO Ie 4c ceysieers 1 2 s a eo S lage ai 550 bh Be eee [es oe Osis ee Ser eee 1 4 Ae 5 2 E 5 ae 120 1 Rel eames os Se con Sealers e eral eroe a 5 we 26 al Rs: eee Se AS Ale ale _eal-o eet oe ee ee ms 400 De Ber acl tate cs . Eeaale Ba lee tel E Sse SSS acl HIRAM BS Sa beast ae 71° B lesccccl Wop 4 | deh Dil 3B | cc atwecelon@uh AsiASal Mila 07a sera cee aN call eee cee aes. ANG 2s eee ee eM eh ore Oe We ee ile see netstat Osea es ces cere at lee Bee Se eesclaeer aoe lees eas a labo ee B lnseen Ne camel testo 2 Bs ar i ee eae Aes ree 2 Serdlste eee nee Ae set Nesee = Ol Ae) iS besa Helis 8 8 1 es ‘3 as aA a core Valerie a eed eee ee hot 2 ie aaa siceie ae Bc Pea N Res a eee ee ed a a 5 ee ect ye melee sel 1 eet ajo 1 pas Taal ets sch] etal Rie ics eae CG gem ig eeceee| agi Ns BGs Dee cs 1 ue BS ase In Lees olla See eee 10 ly: | eee a eenoe an 1 1 LA eee Recity dell 1 hes Pes lems ee atl heck ee ee Lee Ane ee eet) alter eel rset lees ea Bo BE Peay ees) es are eae oe dP (Sore ek oe eos Dae heel Pale sseleess eee aes iS ajellte/ aero rere late oot ie oe Tel (ae eel oe eel ve ae 3 ae e Bae Seen Le ee Ios oes wine hemes Elites eee Soe ane BIAS See secs aae Sean ) ea Meaney | Lae 1 Poel ieee te rags aioe aes * BAe: = Beeeseses 3 Tees Naess ibaa ae aa Epes Care Ys | ee E 2 a Slee 24 De eye ee ers re cae attr 1 = Jc8 cers Uy legs 152 Co ec leteee e a i Bees 1 Dale SHE mie as 2 19 ih oes BO a i am be dee ieee. Naa ale eae rig leer ies 2 ue rele i aioe Ceaaees mre ane oe Ve eerraa lessees Soh 2 at poe Sl aresate s aes Soe eee hee Baia ROE 8 es Adee ee as ee ae aoK renee Se eet gees a ie! 2 iez SO eae Ft ee es il ae ae SAA OOE ets bs aloe R wale somes ee i paar o ee ao : ss Beas Eioes Stes eee PN a cereal liao coer. Sly ca! BSH aperals = Be eka 5 28, 331 889 RATED CAPACITY. : A Detach- Hospital. Patients.; Officers. | Nurses. | jy ent, General Hospital No. 3, Colonia, N. J.......-..--2------20- 2-2 e seen eee e eee e eee 1,727 LOST es WOH eacec ames Hdgewood Arsenal 28sec sce ese nce sees ae aici aie taiejare ci inolora alain siecle lela 364 24 26), nece eco Camp Hospital, Camp Abraham Eustis....-..--.--------------+-+--+--+++++++-- 1,040 28 84 300 General Hospital No. 41, Fox Hills, N. Y........------------------+-++-++-+++- 2, 150 48 134s oe Serge General Hospital No. 25, Fort Benjamin Harrison... .--.-...------------------ 206212 scene 37 50 Camp Hospital, Camp A.A. Humphreys .........-----------------++-+-+++++2+-- 1,897 49 129 fe RS Sees Camp Hospital, Camp Joseph E. Johnston.....-.-------------------++-+-+++++- 772 92 85 200 General Hospital, Lakewood, N.J........-.-----------2---- 22-222 eee e terre eee 32012 sacs asta aaron General Hospital, Letterman..........-..-.-.---------- ----+-2+e ree ceeereee AAD Sate eaten AD Nr trates General Hospital, Fort McHenry.......-..-.-------------++-- 22+ creer rte cee 2,241 , 104 D525 Pk eecte et General Hospital No. 6, Fort McPherson .........-.---------------+--++-+-++-- ST4y | eos Se arene 85 50 Base Hospital, Camp Merritt............-..-2--------2- 2222 e seen eerste 2,344 78 152 300 Camp Hospital, Norfolk Quartermaster Terminal. ......---------------------- 62 \i.nctsei cae) cea 50 General Hospital No. 14, Fort Oglethorpe...........-----------+-+-+-2e2eeee eee RO OOM pres ate ee rates [My || eeccanase PROCUREMENT. 49 done at points other than the National Army and National Guard camps—Continued. Hospitals. Capacity. ~ Lol Lom Bele & 3 fy 3 5 a n~ o S . am Lett 3. 3¢ cd 4g a Sree Description. ; Sa pases | sc 8 oF | Bh | M6 ] aye ; iS eas 8 Belew Pear |. 8 Or] o q B o Oo Cy 3 2 8 © alae ye |e Cel late tal beh nay Ree eee UO escape SLOP V PW Gaerne aa. eee eee a ae iceranee sc ameise see 4 19 14 Meld | A aR ae aces OO RS Bram ros SN ah Seer c GS EE Ses Ae aioe ie He en eee Sees tl istmieia o 1 Z-StOLVve Waka Darbacksees ye cases emce see oreo eee eeee se a 1 Dies 2-SLOLVeWalGsand DALraCks = msme cose ceete castes eee acess Laser Weer acalcec ASD TISONASOLAU OU ser ee ee oe aoe ee ene ene tere ni A ae ORE GSE See See Ke 20 ees tISUOLYn Ward oo scene cc shoe ae cme ete ceones co ec eseens BR eee acca closes sis 8S ee OIC PlisONelrssoeaamee ese mae jcc um anne ces con a aato oe cine oe modcde Hasete |Genoes Seeeee SOLE PSLOLVe Wal sense eee etme steerer memos omen enemas ae ae ae 7 12 oe LODE | F-SLOLY, Ward Dalracksseae sane etme: coe pemiecaa ones comes peas u Geeta eee | b= LOO | P2-SLOPVA WAT c oot cc aaace nce ost Beenie sos ech e cues aecsteees isn bese | eae Bh peeeee Picea ee leD Obie wardiand laVvatolyaneseccece cee cmec races cecwesee Salem telisisie's sia'll= 5.16 oe We eee LOE eres rateie cal hate ate occ ee ees ee eee ee ae a aise Saeee th anaes 4 alee eM eer ce I PESOLA GION: Wards sntaenen como sane asec ccke occa ces ccances ase cndlaccne GaCaee Beeeee eT eS ale oO See aec nen Rea aSE SUE GSD EI CESe p ESeRe RaGan res aemenade eric CiallaoS nee Ree ee Ao MAIO Ieee Ot aa cer cee eee cee eens see. cee ee elmer re Bee eine | cic sc|a'-2-0,< eee Detachment barracks. .020000000000IIIIIIII Nae ae Gea aes Up ease ec ENET Sc S22 SS bible Pee ee ee Sod aaeaeStoe SEeSee Een IN-Seeeee|ebarracksiand lavaboryceuncessceceuuss cneeerseseaeeeerece We eat reales sasc|is00ei:- IN-9--=-|-2-story detachment batracks:.-2.-..+---<2s+ssesesse -sese 1 Oulbeeeec|cecce = Oia se Sere Storehouse sascociooHées|! USER sre (kOe User Linen and commissary storehouse Sas sca eee Oi eeeee ebaroage storageerees em ceme re eer cote eee ce ae nero eee as sedate eases SUeeEe See O=1OL Se RStorehousesas: cate ee soe tetas oe eee aes eenes acceeceee =o0d92|sadebe Geonee Eaeeee betes chert CUS DOles om cope a neemneane dais ees ic ante ons ociacasuutaatnnsse See eealeeicet Ale cogs a |acecos Pere ep GUALOh OUSOrm ee sen cmon ctiescteseccotinnesiek s aee ceweaeee dG Pemeee le waceelaccs a Prsseses (MOT GUE y-Seereee eee ete ee ae eee: ae amen sotiee acee ee cmmae eee apacacloscede beeoee AAseee iL ee te eens LO Seen tata taicle eee ae ee ene soe ec temas cetera te JS dese Beers CASEEs Ceeee PaO eeecely CHAD Oh sane sten seme tian ee ote ce eet eR Se Sere a eee 466282 Kare Bee ee Pees. IMOLCUAT Veo cme oe crete eon ane eee cee eee Peres s eeece| acre ol esicecs Qeer er ce MUSING yacrs ose tesciwlian oct: wis calccerwctcine netiene celseceece ee eelemiteee sce cellane ac - O-3-ee-| uaundry, disinfecting and linemeeceoee s+. acces eclecee ce Reeecnlnes caclesccee| Seco. Qa Pease |PUAUNOT Yc staataas oc ccweeee ca larinses asececsse gedsees we cis Ber ee Seca 1b rice | a Res beers papohleirioeari cl ere at es ees, eee cee. Seems eo cee Me OS tum Set Saas caoa Scere acivete ec code aocwasccoun tea. = 3can|podnee Banedsa Caspase Lid cenlesey Sr SE ae Oe CO a Gor ah eeiaet eae =. oS04||bcered Baebes SEeeas lis Seeseeer VSIOUNELAD VAD UL Gin Oa ete tote rates eetctet ania eine ct cieinieeisee le Seal ere el Peo) Oleeee eee Oe momen ourince onto acon nome seictecete se tote oe metena eee wees lcece cle cse sa] Use weeas Chai coh p ee Sete yee ee eee tlcate ciahiiem else Aa leoemes| WO LOLS elec oc Oee sack cue cce sec cum cise cece ciidaed bac cases ee cc eeences ososeclosegd bosses Gaaeee) ah sSeeReee SChool seer sect cence cease en tote ctes seme ts < stimaroe seine = ee ere aaaea Ne epee oN lOLe sc leos Dale eye _...|.---| 1 | G-102...] Operating and nurses’ infirmary..-.-..-.--.- Bae CNL al octet Rene 1 peak 1 Heit. ca) SHOP. so. 52 sects can ac seein mieee sesamiae eer pelea eet ree Ene ape Sule SU les att ..-| H-1.....|) Bxchange... -..02c.c- <2 Bi Seealipsaclisnce T2327 RSA dl arelincec |= 10 | 34 |....|....|....] K-14....| Open-air tuberculosis ward....-.------------ 28: | Nae Paes ener GS ais (Gal eee ese Bae peer elas cllespscse| fl oa Rye || ee GO eee eae ka Be date ese eee eee PAT alates a Dorie olla cersiias cole 1 _..|...-| K-50....| Infirmary ward for detachment. ..----..-.-.- 23 ees 2 é A) | Seeeeall Ub le 5 1 | K-103-1.] Infirmary ward, 2-story.......-------------- 0 eS lc aeltenot PROF |) ONE aol). lle ees eet PK 0322 a eae GOs Sheet arcane see Cee ere ee Reet 116/22 Boe a ORONO Mee ap Ne oleae cl) od) | SKa103-35 Bene GOs sea te sae oe Fa eec eane omens 116 |... eee BoOnlmla ee ce leaale _...|....| K-104...| Open-air tuberculosis ward, 2-story....------ IS le Sula rlenes 26) Wo sdl alll eel lo) Se KE106 924 Recovery tuberculosis wardste > sess emer 26: [onsets eats 956 | 8 |....| 8\....|-...|-2.-]....|.-.-|----| K=107..-] Open-air tuberculosis ward, 2-story..-----.- = 82 oA eae, S28 i Ones Sale ___.|....| 1 | K-108...| Semi-infirmary tuberculosis ward ....-..-.-- De irealine es eee O30 eed las oles ae _..|....|----| K-109...| Infirmary ward for detachment. ...-.-.-.--- D3 oe ale hee aes 76 ee ey oe Nios! BG), es Pe lees hese eee acto K-110...| Infirmary, tuberculosis for nurses.....--.--- TAN etka Steal cers BW Le eee es lee alee stam elec mal) Tel Kati SS-2 | Str gical ward cre ae. ejeete ele ere 267 \ = BS cen py We WBN Fae |e a lle i Un ee Se ere Maine Tsolatione. san. Ae ese eee ee eee ee ee ec eerEere 28 ele ve eee DOn| eed lee ae SES MH 10225 solation ward’. 2-2 ..cce- eee eee Pies Wolee (eee S84 alae eGu ee cee 8) [| 223 WINE? 2: | Detachment barracks 22 seoc-.nseceee eee eel eee RBS ead Vay NOs llesocl!) @lissenllbesae NGO: =. |" Detachment barracks ;.2-stonyi-<2-------- see Spee aac AO) Pees (Se bod Bl eesti 1D Ps SP Oe aT S| (Storehousesa- asec sere seie ke ore ete ere se tae rere are ieee tee taee Ne | NS ey cee OES | OK4a cles eS S © ea ssleaie vies ain mjeteleieniatel='= tase nyo siattet is ste cre ater | etoteta eaeteke eeu s ANieees i Baller (ENO al aks NSS aaceracBeaeeBeeeapandeceaosoocoods|(Soc(aseoicasajooso Oe IS ee be 1 Pee eo aal Oey oe Pak a soencounsnooecsooncsscascagnedlecs ne Renee See 3) | Meseltismnel ee 1 We fee Joss Dal ee [ero (el Ee ee Ke oth Ko lato) leo aaa ae RBA comer atpacaDoeae so -[ocdajoscd|sccallocca arenes Desc seal esas ere F 1 fee er tial EP eres (Ol Koy Hb Aenea Renee a SNaen a aoneeareinn asal soot enc lacsoljosee reese le Beale erste ee NS | SPS As ee On aoa sisters ote ) o o Cy) oD o os) 2 Aer NC IS ie: ce Ich Ie 4 al/Ool|4as/A Sie. Site 1 Lal Seve ae Bee acre alee oer | dl OD, BUM EV etrs ot eon sean eee ree ee es ceeeiaais al sie ee| See eaves eee te eee: Un |hs Sisal] eset bs ee | eee se eee TS |HQ= 103 ects eect LO Savaer te reer ee wots ote he eee ape as || tee, | raed aver A) ACB ll tel | ee ee es ee ..-| R-102...| Psychiatric tuberculosis ward............... CO ae Ae Sedle ahs mao 2 Reese pees sioccol cs Kae 1 Upsteene CULatlVe Shop we meees ceeter oe eh ets sere lan c olae selena avait =e 2 72 |e eect oA eee WSO) MA COMM ere lence a ont Son meen! scene Joe nee sels [ etalon Be rs 1 1h jee oe ae See NV LO Te IMO CHOO lene eeree eee ree eet eis cats Sete eee ol aie lieisiere tomers era i pete’ ka Senet eee im MU ViceesuCurauve suoprard school seeemeee ce aatcems asec lesiea|ctes «le cetel ere 8, 294 |293 RATED CAPACITY. 4 +. ati Detach- Hospital. Patients.) Officers. | Nurses ania ene naMEOsMLteer OG DAV Al Cee ae x, acters oacucisvctwesiee dee cis geceee oebere evecce <4 628 28 129 312 Gaovrsikeospibal No.2!) Denver, COlO...0-- 525. -24-922ba- + ociceeeere des sacra oe 1, 940 48 103 500 GEHOLaPELOS pita INO. 116 Markleton, Pair ete =teecce clears: qtnts ooieiee ne cee ne ele esessiae LOS Wea mevsenice Massececins ives cseces GeanerameospicalNos16, New Haven, Coma. 1.2... .cccceestccsenns+eeeeee+ ese 280) |lcececesos: 26 156 PenenamevoOsnmalenOn LO, Oteen;, Nie Clo: cos. satan tee Joa conecen soeeenses eden see 1, 600 62 58 416 enova MES lA OS, OTIS VIG. INe Yenc cscs cee ctic le coc c ciee.cs = ceaneiee como 1, 212 16 ASN Metcaisiastelats Gonerabelospitaluiouls, Waynesville, N.C... (otc. . cccen ccc ee cee eee cece scmee OO) Rierectacte oll ateisice taste ete ces General Hospital No. 20, Whipple Barracks, Ariz..............-....+---------- O02: Es acto ae a Ol S aceite ai 6,390 154 366 1,384 iy MILITARY HOSPITALS IN THE UNITED STATES. Tapie 6.—Schedule of hospital buildings, semipermanent (except General Hospital No. 28), of later design than buildings at hospitals of National Army and National Guard camps.% % Hospital. Capacity. 2) 5 =P = = ay 3 3 S v0 Sx Sa A J 4 = oT sey Sh Ses) Gees q Description. a oot 5 as NGI aid | ® ® 3 Sf | $4 | Se é Pa A S @ 3S qs, Zo, Ha) 324 Ss = Z on a 3 I ag | ag 8 | 8a ® ® 2 2 © a | 8 |eside/as)ae!]- = 3 g =) 5) BO | 80 sO | oO ® 8 S| | ® Be ete We Ih ces al faa} 3) Ae A Apa {sO no eS) Sashiy Swen cree tree reCeLVING -...- .0cae 2 ae e=|oeteee| eae eter et eae eelae Hi ea i ear, em een ea So Hobe ono cscloncSac as a 1 i eae ee en ere ee eos slccmas ocacor|isqoesul acess 164 TA Ie Ke .| Officers’ wing ward......-------------------- 82 (NG iateyaectes re etayel eres 4 1 Commissioned officers’ quarters...---.-------|------ PAN Se Aa es Set 51 ills rece eee Officers’ quarters.-..o.......+----------+--+-|---2-- BL | eee acs Ree 81 3 Officers’ quarters and mess...-....----------|------ QT al eae ele Meera 255 5 Nurses’ quarters, 2-story......-.------------|------|------ yey Merron 49 Ole ees Nurses’ quarters and infirmary---.-.-.-.----|------)------ AQ Sie 52 Dili a .| Nurses’ quarters and mess. .-...------------|------|------ Quizes? Bae aft ale eee Large laboratory and mortuary. .--.----.-----|------|------]--++--|------ See cy ee .| Laboratory and mortuary......-------------|------]------|------|------ en ee 1 i\2oee eae Surgical wing. .....2.---.0--cee cee 22-22 see fees eee|ece eee fensess| semen Sree VAS a dee ...| Large operating wing..--.-.---.+------------|------|------|------)------ Boat ul .| Surgery and laboratory building. .-....----.|------|-----+)------|------ Eon wall iN Ae Sa eg Exchanges: ..cdscede cas chess ses snan S522 oe) setts eee teers ete ace eerie Op ee | aN Ae Tan Garage... Ta1S11Na NOILOZS SNOlIOVLNOD SHiva J Woou oswol4JO# = WvxXa fo SHiVS NOILVNINVX4 + + + + 5yy3aNnNg9 ONISSSYONN $1934453 Seeseeens| SLNILLVd OSNINOONI AVM 4aeo VS S Vid _ S, woou YSMOHS squoosy NiVeald eG) fo) ay oe Saeed $193443 EEEEE SLN3iLVd SJOYVHOSIO ONISSaya ONISS3HG A ; $4391440 SQuvVM OL SNOISSINGY i — SWOOY NOILWAXdSSEO —-— SdNVO AWAV TVYNOILVN 4uod f ONIG TAG ONIAIGOGY NOILO3S SSOUD SdNVO Guvnd TVNOILLVN wos NOIL93S SSOWD NOILD3S SSOUD 62 MILITARY HOSPITALS IN THE UNITED STATES. Fig. 15.—Administration building, base hospital. ’ ENC SSG Fig. 16.—Receiving building, base hospital. CONSTRUCTION AND IMPROVEMENT. 63 Wi yoo VISITORS REGISTRARS CLERKS ray uot ™ \ vy, g ne ; sof Bei COMMANDING. Mw INFORMA REGISTRAR ADJUTANT | OFFICER isiTORS Pen . RECEPTION EQUIPMENT | 7 1 SLOP SINKS aye = bh OC LABORATORYO mie! L) tA fy 2 WASH SINKS 3 TROUGH URINALS 4 TROUGH LAVATORIES 5 WATER CLOSETS 6 SHOWERS 7TSWITCH BOARD BDISINFECTING MACHINE 9 COUNTERS JOSHELVING LOCKERS (2BENCH ISWATER CENTRIFUGE 4 TABLE ISICE BOX I6 CABINET DIELECTRIC LIGHTS RADIATORS al ViCEILING VENTS i 1o% &% CONNECTING M& CORRIDOR KM CONNECTING corRRIDOR DO @ROOF VENTS = 1 STORAGE ROOM (i REaeaae EP > PATIENTS EFFECTS O oOFFice lof . orbs ] T WAITING ROOM WU 3 o og OFFICE AITING ROOM INFORMATION WAITING ROOM OUTGOING CLERKS INCOMING PATIENTS PATIENTS SHECKERS DISPENSAR HALL ENTRANCE PG HS Sy ay ° 5 10 A DIMIDN 1.S°PR AT LON AND PeheO eevee NiGe tah U le UeDIIEN' GC 64 MILITARY HOSPITALS IN THE UNITED STATES. DRESSING (obo 2 bot isO Z ! Poi aoe he 7 Bar i ia t ia ry ey. Es WAITING leek vat WAITING rail REKBIES Ct eR) ke ROOM tds (visiTors ) tog jog fof tog (OUTGOING) Dal] ° — = = = H ee f COVEREO | fog PORCH MECHANICAL: EQUIPMENT MISCELLANEOUS: EQUIPMENT k ——— ——— 20 JurgeonsJink 30. Shelves fine 22 Slop /ink 31 Counter (2a b——4 23 Lavatory - 32 Open Lockers 25 enc 26 later Closet ic Nee BORTE COCHERE 10 20 30 40 a - ADMINISTRATION - AND RECEIVING BUILDING 6") Fig. 18. CLASS II. GENERAL CARE AND TREATMENT BUILDINGS. This class included the various ward units. By ward units is meant the sum total of the facilities in one ward building used in the care of the sick, including the ward room, where the beds were located, and the auxiliary rooms for utilities, office, linen, and serving. The letters for the plans or buildings represent the symbols used by the Sur- geon General’s Office, designating roughly the purpose of the building: A, block plans; B, administration buildings; C, officers’ wards; D, officers’ quar- ters; E, nurses’ quarters and wards; F, laboratory, X ray, head surgery, etc.; G, general surgical buildings; H, hospital exchange, garage, shops, etc.; I, all kitchen and mess buildings; J and K, receiving buildings; L, wards (common and tuberculosis); M, isolation wards, and N, psychiatric wards. Numerals following these letters indicate subsequent variations and new designs; * numerals above 100 further indicating a tile construction. As an example: B represents the earliest frame administration building; M-3, the third variation or newer design of frame isolation ward; and F—-102, the second variation or newer design of a tile laboratory. In ward designing, four classes of patients were provided for: * General, tuberculous, contagious, and mental. For the general cases, two variations from general designs were made: One to provide for officer patients and the other, a minor modification of the general ward unit, for prisoner patients.“ Although several types and variations of general ward units were con- structed during the war period, by far the largest number of sick were treated in but two types of wards: The one-story single ward (K—1) and its derivative, the double ward (L-1) and its final form (K-20); and the two-story ward bar- racks (K-—5). The other general ward units differed from these types in minor details with two exceptions: The ward building known as (K—105) *, a two-story CONSTRUCTION AND IMPROVEMENT. 65 adaptation of the one-story single ward (K-1); and a special and distinctly different type of building (K—58)”. The following tabulation shows the total bed capacity of the different types of wards constructed throughout the country: ” . Percentage ae aah ais Number of | Number of} ofall bed Building plan. Description. buildings. beds. construc- tion. I=ShOLVEWOLC eee meee ease eee ee neaccee emeae 491 16, 694 14 Double ward and lavatory......-..--------------- 89 6, 408 5 ASO EUOl. oo AAC e bance bean dodosedaBscceesasen ost 97 3, 104 23 MWoyAaW Wee aay Sone he eae ee ee Be eS 677 26, 206 214 joie he 53 eo See P-SUOLVAWOT Dali eC kame ter a eter aise ears er n= 395 25, 280 21 [Raion 22) Sees See PESTON YVRW ALG Auio eee eee ee ee an ee eee ee ee 13 1, 053 1 TINGE, ees cyte, ee ee ee ge eee eeente 408 26, 333 22 eae oe A DIST OL VEIT CRY al dete eiese eine ae er eet 57 8, 174 7 eos amd ell jee yoee eee DES COL VaDA Villon Wald asa eee mee eee tea ae 6 432 3 (OhAITH CN OS aee eonoe ReBReeeaee New construction........ ¥ Rae he Ny Borde oalligbc. m3 ee ae 36, 249 32 Extemporized wards in leased buildings. -....-.-.--|------------ 20, 218 17 Uren ra CLA Oc We Ft ee ae ws a em oe tora tal stems Sine ie teat 117, 612 100 The K-1 type of the one-story ward was designed in the early summer of 1917, and was built at all the National Army and National Guard camps.* The plan K-1, and its final form K-20, were also used in the construction of most of CHANGES eK! BETORE CONSTRUCTION TO: DENVR/ES TOILET Le ATOP | Enoo 4 a £ {Jo Toe ey PROVII MECHANICAL EQUIPMENT ai Flushing rim slop sink. 2 Wash sink 29 Lovatory 24 Tub 29 Shower ze Woler closet 27 Wash sink with drain board 29 Urinal 29 Dental lavatory MUCELLANEOUL EQUIPMENT ANG Godby s 2] Quit 30 Shel huTeHEN nv oh ute! 2 CHANGES toK! AFTER CONSTRUCTION Coa i, TO PROVIDE ADDITIONAL QUIET ROOMS: a4) Befrigerctor CHANGES eK? AFTER. CONSTRUCTION 1 Ceiling light. fo Wall light TO PROVIDE NURJES TOILET SRadiafo £=2Geiling ventilators LATER TYPL OF RJDGE VENTILATION: LS steal CaN ORIGINAL TYPE OF: RJDGE VENTILATION CONNECTING ‘CORRIDOR | | ) | Lxils @ steps provided,after construction, like K? 157" Oo COVERED PORCH CoveRrD 5 PORCH ——<—— =—$—$—x —<$—<$—=———= ~ = —— = SINGLE WARD K?® saecor Bedere ele]. [- i eel OoooocoG “s 0 i} m 7 0 fy n 0 Le it eee 0 {| ) Aooogcdtdtioooo é SINGLE WARD K® eee sa ae ee 32 BEDS ia —— <— 10 ‘20. 30. 40. SCALE Fie. 19. aS vyougun # b at the other camp hospitals and the general hospitals previous to the fall of 1918.° The K-20 type of one-story ward ® was a revised form of K—1 and included in its design various changes made in plan K~1, from time to time, as experi- 45269 ° —23——_5 66 MILITARY HOSPITALS IN THE UNITED STATES. ence dictated and as conditions demanded. The double ward L-1 was evolved by combining, for purposes of economy, the toilet facilities of two K-1 wards.” This type was discontinued after the completion of the hospitals at National Army and National Guard camps in the early fall of 1917.3 These constituted the one-story pavilion types of wards. The first of the two-story type wards, known as a K—5 ward-barrack, was designed in the early part of December, 1917, and was erected at many of the — hospitals ** to provide for a very considerable increase in the capacity of the hospitals at the camps which became necessary at that time. The two-story type was selected in order to concentrate the required number of beds in as small an area as possible, thus obtaining economy in first cost and facilitating = = =e CLEAR; STORY: HEIGHTS: HT-G 249; 10-8" , -TWO -STORY- WARD ‘BARRACK K2 » FIRST STORY Fj 2" TORY SIMILAR: foal — Toitler o 4 ha pep Bey aoe wane ‘Li : 1 He, oO COVERED PORCH Ure as See 5 3 o- CONNECTING CORRIDOR. = CLEARS TORY ‘HEIGHTS: Wt G 24ND, 10'-6"= covereo " porcn CE. = =) ‘TWO-STORY: WARD -K'S* > FiRsT STORY — ZNO-STORY SIMILAR OMITTING: OFFICES ERY. KITCHEN:G1-QUIET RM. Fia. 20. administration. Then, too, in many of. the hospitals already built the area available for expansion, immediately adjoining the hospital, was limited. When making the increase in bed capacity it was necessary also to increase the housing capacity for the correspondingly augmented enlisted personnel. In order to secure further economy in cost and more rapid erection of the build- ings, 1t was decided to make but one design which could serve both purposes and to use this type of building in sufficient numbers to provide increased bed capacity and, at the same time, increased housing for personnel. This building had decided advantages in its flexibility, since it could be used either as a ward for the ambulatory patients or as a barrack. The two-story ward building of the K—-105 type was designed to meet the special conditions which arose at United States Army General Hospital No. 2, CONSTRUCTION AND IMPROVEMENT. 67 Fort McHenry, Md.,” where, during its erection, a large number of the K—5 buildings were being constructed. It was found that the existing one-story wards were not sufficient in capacity to provide the number of beds desired at that place, so it was determined to substitute, for some of the K—5 buildings, a number of two-story buildings suitable for acute cases. This K—-105 building fol- lowed the general design of the one-story ward building K-1; but the second story was arranged for conyalescents; and the diet kitchen, the ward office, and one quiet room were omitted.” During July, 1918, it became necessary to design several large camp hos- pitals of about 2,500 beds each, and to make an extensive enlargement of one of the existing camp hospitals where the available space was limited.” It was : , : UU UU ° EO CELE) Cf) LE) ‘TWO-STORY: GENERAL: WARD: UNIT: K¥* “FIRST STORY - 2*°STORY-SIMILAR- “CLEAR. STORY “HEIGHTS! IW G 2ND, jI'=2" U0 KS. SUBDIVISION ‘or-K3-INTO-FOUR- WARDS Fie. 21. TYPICAL: CROUS ‘SECTION: found in the case of the new camps that the one-story ward (K-20), if built in sufficient numbers to give the required bed capacity, would cover an immense area, thus making the first cost excessive. It would also either jeopardize administration or demand more personnel than could be supplied. These con- ditions again led to the use of two-story buildings and to the further necessity for concentrating the beds into even a smaller area than was possible by the use of a K-5 ward barrack. From these requirements the K-34 type of two-story ward developed and was called the Knox type,” because it was first designed and built at Camp Knox, Ky. Just previous to the signing of the armistice a two-story ward building (K-58 in Figure 22) was in course of design, intended for use in hospitals not exceeding 1,000 beds.7_ When, due to the ending of the war, it was no longer necessary to build large camps, one of them, Camp Bragg, N.C., was so reduced in size as 68 MILITARY HOSPITALS IN THE UNITED STATES. COVERED ———== —— Bis = elivend as =—<——— eee SS PORCH ° a COVERED PORCH } nH x bof : — ae a. ounnnoTn Ai TOTTOTO { eet 6 2 4 nol | ce bee ais WARD. A ie x =e Poon! Dga F ae pet ca Ls ii Ta is) ag > 2 > : U ° UTI S i} nonttiogo Fae Pees onion t 4 . 1eT RMI Z M QUIET RN a eae! | & fs) b , KITCHEN + CLEAR;STORY HEIGTS: HF 1-1", 240 10'-9" ) 53 J < 2 Ae oO ‘Two STORY: GENERAL: WARD: UNIT- KY” - FIRST- STORY —SECOND STORY J IMILAR » WALK COVERED =) ——— oe x s om = VERED poRcH no COVERED PORCH nu eee piety o ; St quicr SP] Rm a core100Q i ] foes g COVERED COVLRLD PORCH 4 =x = x =x a — = x x = “HY al TOTAL N° of BEDS 72 oe -TWO -STORY- GENERAL WARD- UNIT K3 FIRIT STORY-2"°/TORY SIMILAR Fie. 22. DC acento Pena ye “COVERED PORCH *COVERED- PORCH UNCOVERED - PORCH “UNCOVERED PORCH: “UNCOVERED: PORCH “MECHANICAL LQUIPMENT ISOLATION WARD () -MISCELLANLOUS-CQUIPMENT- tSine 20 Shelves. adlop sink: 11. Dreeogre aWork = *SCALL: 22. Counter Awater Closet = SSS a.table. Sshower °. 10, Ao. 3A Nee Bax Gloyatory. # een ar Bar esis en 18 ight BLlectric eae Stoy Eeiling Height incleor wr Ceiling Vetilotes — Fig. 23. CONSTRUCTION AND IMPROVEMENT. 69 to make a small hospital of only 400 beds necessary, instead of the 2,500 beds previously contemplated. The K-58 ward was used at that place and at afew others where hospitals of small capacity were needed.” 4 nd QUIET RI QUIET RM QUIET RM a : 0 ‘QUIET RM sara] 2 QUIET RM ie . F el F| © [ReTinc RM KY TCHED QO yNurseay SECTION supe TR? Poorey g y BS nm RC a a Ml o [oj = a JSTAIR it " O ul KEY | | Lt | TREATY a O RD SURG 21 FLUSHING AIM SLOP SINK x a WAR oWARD d nik 4 a ao LAVATORY ; 37 ras) U i L b ae : LI bee oF lL], : ; s a Ryriuity TREATMT ESSnEiveS RM al RoM, SI TABLE * | a ee hs oo | Poa "RA ny P ‘ 8D) [| 34 REFRIGERATOR ve = eet met FIRST. FLOOR PLAN QUIET softest | ‘35 SURGEONS siKK past if = 10 SINK 36 HOT PLATE ACOUNTER FI < QUIET R pil isa 37 BEO PAN RACK Wa 3 e Pt et 38 CENTRIFUGE | 1} . ISOLATION'WARD M3 woswres =, 8. S SE on et coven | = eS eS QUIET RM QUIET RM inte ISOLATION WARD M& - TWO STORIES = Fic. 24. covearo porcn DISTURBED PATIENTS SECTION i} [ e DAY ROOM o a gl: = 0 quiet om Dy Qutt an co oe c ° epoecn 6 g 6 Gl $ ™ o re) s b ; z a =40 F =: it o ¢ — a 5 WARD WARO DAY R00Mm a q g . . . . ° SEAV-OISTURBED PATIENTS atl Tt bs DISTURBED PATIENTS SCA-DISTURBED PATIENTS o-z it ° = oe n a 0 a 8 0 a o a SEG) Ne a] . ° S v an 2 : | T=] cant sp a oa ro SPECIAL DIETS £ [| [| [ a anes waao a ii 7 20 |p a < (f suacton J} Hl ae a |e ale i) a, F a a Be > i = 31/5 (] rae | } { Fa q z 3 fey TOWET | ua re) TREATALAT f a 180-0 [apes oO ROOM * MECHANICAL: EQUIPMENT: o. 20 0 (ALICELLANLOUS EQUIPMENT * Diapers SCALE 2 Daves 5 13 Waler cent tee quer an = 18 Surgeons ies Seon rt Uapogaroay | ‘alory wink 34 Refrigeralor a 5 te Una ok wit tron bears patie x EN rt ~ Quiey on 3] 43 Levatory 97 Ournb walker 44 Continuous flow tub 7 Courter Shower * e Bm Gil ~~ — PSYCHIATRIC - WARD Scaivth ae : a ro ca FIRST TORY -2°°STORY SIMILAR ioe coor sated aed ale Fig. 25. The designs of the isolation and psychiatric ward units were not greatly changed from the original plan, except when it was necessary to conform with changes in the general ward units. Figure 23 shows the original one-story isolation wards (M and M-1) constructed as part of the early hospitals,” and 70 MILITARY HOSPITALS IN THE UNITED STATES. Figure 24 shows the two-story ward unit (M-3) used with the Camp Knox type of two-story ward,” and the latest design of isolation ward (M-6)’ corresponding with the general ward unit (K-58). Figure 25 exhibits the plan of the orig- inal one-story type of psychiatric ward (R-—2) ;* and the later, two-story type (R-4),?° corresponding with the two-story general ward unit (K-34). Some of all of the following facilities constituted the various ward units :*° FOR GENERAL CASES. (a) General ward units— J. Bed Tacilittes Suey. ase n 2 see = Seeks cit errr ere eae 1. Ward proper. II. Toilet facilities for— (a): Ded patente. c.<. Pe Se ee oe ee ee 2. Utility room. (by) Ama bulamt patients: one teecny in. or ren Cee 3. Toilet room. IIT) ‘Reereation dacilitiess tse ee ac tee) Se eee 4. Day room. IV. Service— (G) MOOG IG S's a Seisins edie ea Che eet ee Oe ee 5. Serving kitchen. ey ene k 0) 6) Odean paneer areas Pee Ree ease eas ney romeyie omer 6. Linen room. (ic) Cleaning TOOmIse. Seek ser he ioe, Dove. ee es 7. Slop sink closet. V. Administration— (a) Officers’-administrative:work: = 4.22. 525 -2eL2-.8es 8. Ward office. (b) Nurses’ administrative work..........:.-222.6e22e< 9. Nurses’ office. (c) Convenience 1ormunses. “aia ose ee eee eee 10. Nurses’ retiring room and toilet. VI. Special facilities for— (a) Care ol acutely sick ormoribund! 3-55. so. 5 oe es 11. Quiet rooms. (b) Minor medical and surgical treatment.......-...... 12. Treatment rooms. (c) Minor chemical and bacteriological work. ....-....- 13. Ward laboratory. (b) Prison ward wnits.—Contained the same facilities as in the general ward unit, with addi- tional provisions for the possible restraint of the patients, and their isolation under restraint in case of complication with contagious disease. (c) Officers’ ward unit.—This unit had the same facilities as the general ward unit, with the beds in separate rooms or in wards of two or four beds each, instead of in wards of 10 or more beds. Cooking and messing facilities were made part of the unit. FOR CONTAGIOUS CASES. Isolation ward unit.—Had facilities especially arranged for the control of infectious diseases (sterilizing and disinfecting apparatus) in addition to the facilities of the general ward units. FOR TUBERCULOSIS. Tuberculosis ward units.—Had the same facilities as in the general ward unit, but they were arranged in three types of ward, modified to give better ventilation, heating, and increased floor space per bed. FOR MENTAL CASES. Psychiatrie ward unit.—This unit, also, had the same facilities as in the general ward unit, grouped in a special manner, with the addition of facilities for minor hydrotherapy. (continuous baths). GENERAL WARD UNITS. WARD PROPER. Dimensions of the wards were determined from a study of several factors, that is, the maximum number of beds per ward, the cubic space per bed, the floor area per bed, and the number of rows of beds, whether two or four." Structural conditions, influencing the size of the ward were the timber sizes available and a limit to the length of the building, that is, the placing of it on the ground so that all buildings could be located on any terrain, however rough. CONSTRUCTION AND IMPROVEMENT. fal The number of beds in each ward in new construction varied from a mini- mum of 14 to amaximum of 100. Of all the beds provided in new construc- tion, 44 per cent were in wards of 14 or 16 beds each, 44 per cent in wards of 25 to 35 beds each, and 12 per cent in wards of over 35 beds each.” Wards first constructed were relatively small, containing from 15 to 30 beds each.?? This was believed to be the ideal size. The best size of the ward unit or of the ward wing, from an administrative standpoint, was later found to be from 50 to 100 beds.** The psychological effect of treating patients in large numbers, even as high as 100 in a ward, was determined to be negligible, since the patients had become accustomed to living “in a crowd.’’ On the other hand, in the interests of economy in first cost and operation and of satis- factory administration, it was considered desirable to make the wards larger than these limits, thus concentrating a greater number of beds in a given area and minimizing required personnel. Structurally, the large wards were cheaper in first cost, partly because of the concentration of toilet, utility, and diet serv- ices effected, and partly because of the saving in partitioning. Another argu- ment which favored their adoption was that the head house and wing type of building lent itself much more readily and economically to a large dividing unit. In a measure, also, connecting corridors were converted into active hospital space. The solution of the problem was reached by balancing the two sets of opposing factors, giving sufficient emphasis to the contagious factor, when the cases to be treated were from raw troops, as in the camps, and not quite so great emphasis when patients came from seasoned troops who had acquired some immunity, as, for instance, in cases returning from overseas. It was the rule to provide not less than 800 cubic feet of air space per bed,** and a minimum spacing between beds of three to three and a half feet.*° The floor area per bed, including the necessary aisle space, varied from 70 to 85 square feet.*° In computing air space, the excess of height from floor to ceiling above 12 feet was disregarded." Beds were arranged in two rows,” parallel to the long axis of the wards, except in the few wide wards which were built, where more than two rows were placed.*° Two rows of beds were found to be the best arrangement;* it per- mitted the making of sheet cubicles around each bed, which then had light and air directly from the outside. The three-row or four-row scheme was used in those wards which were 48 feet wide, as a matter of ecomony entirely, since this made it possible to put 100 beds in a ward without making the building exces- sively long.*° Having determined the factors most intimately concerning the patient, the actual dimensions of the ward were laid out, consideration being given to the sizes of timbers most readily available, the length of studs used for the standard 12 or 24 foot lengths, and the same for floor joists. These sizes determined the actual width and height of wards," for example, in the one-story ward the width, out to out, was 24 feet—two lengths of joists—and the height was 11.3 feet, being the 12-foot length of studs. Similarly, in the large wards the out width was 48 feet and the studs extended through the two stories, giving a story height of 11.2 feet. It was found by experience in locating buildings on the various sites that a length of from 150 to 180 feet was the maximum permissible. Greater lengths 2 MILITARY HOSPITALS IN THE UNITED STATES. usually involved excessive cost for excavation and grading, or building up of the foundations of one end of the building when placed on a sloping grade. The windows were spaced so as to come between alternate beds;” thus each bed had the advantage of a window, and the number of windows was not excessive. Since it was necessary to conserve to the utmost glass and other materials used for windows," the size of these was determined from the sizes of glass available, i. e., 10 by 15 inches, with six lights to each sash. As window sashes were not counterbalanced,?* this size was reasonably easy of operation, whereas the larger size—nine lights per sash—would have been heavy without counterbalances. Because of the nation-wide shortage of hardware* and result- ant restrictions imposed by the War Industries Board,’ the counterbalance was not used. The window area in wards was about 12 per cent of the floor Fig. 26.—Interior of typical one-story ward of temporary construction. area,*? except in ward barracks, where the percentage approximated 19,°° due to the fact that wards were short and without a solarium at the end and that the four end windows contributed to increase in ratio. In the latest ward (K-58) the percentage was 21,!7 windows being placed between each bed, as the restriction on the use of glass had passed at the time this ward was designed.* In addition to the sliding sash of windows, ventilation was arranged for by ridge ventilators.*° In the first designs a continuous louver ventilator was used,*? but this was found to be unsatisfactory, particularly in cold, windy weather, and was changed to a special type,’ as shown in Figure 19. It is interesting to note that the same conditions obtained in the Civil War hospitals.** At first, ridge louver ventilators were used and later changed to a type which CONSTRUCTION AND IMPROVEMENT. io was almost the same design as the second type shown in Figure 19. Even this method of ventilation was not entirely satisfactory, one objection being that it caused a vast amount of dust to collect in the attic space. In later buildings, such as K-34 and K-58, commercial metal ventilators were used.‘” Porches were added to all the wards ” on the long side, and, although they eliminated the direct sunlight on one side of the ward, these porches were a great advantage in permitting the wheeling of beds into the open air with a minimum of travel, and in providing a space to be used for expansion in sudden emergency. AUXILIARY ROOMS. The toilet and day rooms were placed immediately adjoining the wards;*° and the utility room was placed either adjoining the ward or near it, because of its continued use in the treatment of patients.*” The remaining rooms were grouped as near the ward as possible, but, excepting the nurses’ office, not directly adjoining.** The nurses’ office was placed immediately adjacent, usually; sometimes it consisted of a station in the ward itself, as in later designs.*° All the rooms were at the corridor end of the ward. Utility rooms were designed large enough to permit the emptying and cleansing of bedpans and urinals, as well as their storage.’ In the early design it was found that these rooms were too small, and they were consequently in- creased in size in later designs.*® In some cases an electrical outlet was added for attaching heating apparatus, and in a few cases utensil sterilizers were added, but this was not the general practice. The slop sink was of the flushing rim type, when available, and the fixture was supplied with hot and cold water with combination nozzle. Toilets were designed to give sufficient space for the needs of ambulatory patients. The number of water-closets was determined on a basis of 1 to each 15 or 20 beds.®° In all the early designs, stalls were provided, usually without doors, although in a few buildings doors were used.*” Later the stalls were omitted entirely, for purposes of cleanliness, better ventilation, easy inspection, and economy in construction and maintenance.*” Lavatories of the individual type were installed in the same ratio as that for water-closets.*° These lavatories were supplied with hot and cold water in the earlier designs,*® but in the late design a wash tray was supplied, and so arranged as to permit washing under a running, tepid stream, thus enhancing cleanliness as well as permitting economy in first cost and maintenance. The number of washing positions at each tray was in the same ratio as for individual lavatories. Showers were provided in the ratio of 1 shower head to each 20 or 30 beds.*° In the early designs a separate stall was provided for each shower head, while in later designs all shower heads were in one stall.’ They were supplied in’ some instances with hot water control,*® and in other, later in- stances, with tepid water, controlled as was water for the wash trays, by an automatic temperature regulator.*® Each shower head had a self-closing valve, operated by a pull chain. One tub with hot and cold water faucets was pro- vided for each ward.*° Urinals were provided in the ratio of 1 to each 25 beds;* the early ones were of wood, lined with galvanized iron, and later ones either an enameled iron, flushing type, or, later still, a vitreous-ware, steel type. 74 MILITARY HOSPITALS IN THE UNITED STATES. In the early buildings a dental lavatory for cleansing the mouth and teeth was installed,“ but this was omitted when the wash trays for washing in running water were adopted. Serving kitchens contained the usual equipment for serving food. Though the special diets were principally prepared in the main diet kitchen, a part of the general kitchen, and were carried to the ward serving kitchens to be distributed by trays from there to the patients, there was some preparation of minor special diets in the serving kitchens. It was in this room that the patients’ dishes were washed and sorted. In the large wards (K-34) arrangements were made for serving patients through a window opening directly into the ward.” As a large proportion of the patients were ambulatory, but at the same time not quite able to go to the main mess, they were served in cafeteria style,* and for this purpose the window proved very useful. Slop sink closets were not at first provided the wards. They were found to be necessary, however, particularly to afford a place for the storage of brooms, mops, cleaners’ pails, etc., and they were installed.“4 They were equipped with necessary racks for utensils, and an ordinary slop sink.” A ward office, especially for the use of the ward surgeon, was provided for each ward,* except in Debarkation Hospital No. 3 and in some other converted hailemes where, there being several VU on a floor, the offices were combined at one point.* A nurses’ office, or station, was sometimes placed in an immediately adjoining room, as in the early wards,*° but, in later designs, a station was established in the ward itself. This station consisted of a desk, placed near the wall, with space for the nurses’ records. Quiet rooms were provided, usually to the extent of 10 per cent of the beds in the ward.*° In the earlier wards one of the quiet rooms was frequently taken for treatment purposes, and in the later designs a special treatment room was provided. In the earlier construction no ward laboratories were provided;# but later they were, for minor or routine laboratory procedures, at the ratio of 1 to each 200 beds.” The scope of the work done in the hospital laboratory increased to such an extent that this measure was a necessity in practically every large camp.” Some of the characteristics of the general wards commonly used during the war are shown as follows: One-story. Two-story. Design. ; oe a a ra et K-58 K-1. L-1. 1k-20. K-5. K-105. K-34. (K-117). Bed capacity. of each ward: -22-+--.--ssessseeen. 32 34 28 14 { S \ 100 16 Bed capeltyson buildings ees scen ces 34 72 32 64 77 220 72 Total bed capacity ofall construction........... 16, 694 6, 408 3, 104 25, 280 1, 053 3, 174 432 ING DEOL TOW SOLD COS eames ameter eee 2 2 2 2 2 2 Clear height /ofstory (leet) wesss-e es eee eee 11.3 11.3 11.3 10. 2 10.5 M.2 10.4 Floor area per bed (square feet)..............-- 80 RE: 77 80 76 73 87 Airspace per bed (cubic feet)...-...:.........-. 900 870 870 800 800 810 880 Spacing of beds, center to center (feet).......... 6.5 6.5 6.4 6. 2 6. 2 6.3 6.5 Window area percentage of floor area........... 12 TUL 13 19 13 11 21 CONSTRUCTION AND IMPROVEMENT, 15 an on eA OO VAR nay Feb eee? PES ON0,000 0,0 Pepe pop pio retecen SOLARIUM . . n - K¥-CENTER-SECTION- riest-Froon TUBERCULOSIS WARDS (inrmmary) et \ a tn, GA My G de) if 5 le ca eg cp Go (on) gH & So o q dg a if SOLARIUM * SOLARIUM g 1-1 on a n a *K?-LEFT:-SECTION-: priest fiooa Fig. 27. x . . . . Hy . . a . LELPING SLECPING = . . . — Ou Se Rete e = x o u if a 4 Cover PoRcH DAY ROOM CoveRED poRcH a n / 4 s x =x x - TUBERCULOSIS - WARD - (Ck - (SEMI-INFIRMARY ) FIRST FLOOR-24° FLOOR SIMILAR SLECPING poRcn SLELPING poacn ri q om : a u fet UNCOVERED poRcH UNCOVERED poRcn ‘TUBERCULOSIS WARD (K®)- (AMBULATORY) “FIRST: FLOOR-2"°- FLOOR SIMILAR Fia. 28. 76 MILITARY HOSPITALS IN THE UNITED STATES. TUBERCULOSIS WARDS. The infirmary, Figure 27, was used for the cases confined to bed.* Here, provision was made for heating all parts of the building and, at the same time, for good ventilation and easy access to porches. In each hospital for the treat- ment of tuberculosis about one-third of the beds were placed in infirmaries.® This ratio was satisfactory early in the war; but later, however, nearly two- thirds of the patients, then remaining for treatment, required accommodation in the special ward.” The K-107, ambulatory, or fresh air ward, Figure 28, was constructed with an inclosed and heated central portion.*| The ward proper was without heat and was open on one whole side, the front. The central portion contained the day room, lockers for clothing, a dressing room, toilet facilities, ete. The buildings faced the south; the open side of the ward proper being fitted some- times with curtains of various designs, or with hanging frames covered with canvas swung into place from the top. None of these various arrangements for admitting the maximum of air and light and at the same time excluding rain, snow, and high winds, was satisfactory." very known variety worthy of trial was used and no one found free from serious fault. The semi-infirmary K-108 was a compromise between the infirmary and ambulatory ward. Though similar to the ambulatory ward, it was only moderately heated in the ward proper, was less open in front, and contained sometimes one, sometimes two, rows of beds. CLASS III. SPECIAL CARE AND TREATMENT BUILDINGS. The laboratory —Figure 29 (F) shows the original type of laboratory built for the National Army and National Guard hospitals.** The character of the addition which was later made to all of these laboratories is also shown. The mortuary (P), built when the hospitals were constructed, and the animal house (F-19) built later for all of these hospitals, were in the earlier days separate buildings, which, with the laboratory, made a total of three buildings for the laboratory service, including the X-ray. Later laboratory plans are shown in the same figure. In these later plans all the laboratory activities were included in one building, and the X-ray department was moved to the surgical building."* This consolidation of the laboratory activities brought the autopsy work under easier and better operation, placed the animals close at hand, and reduced cost. The undesirability of housing animals in the same building occupied by persons, particularly in summer, was known; but the open passage on the first floor, separating the animals from the remainder of the building, minimized any objectionable features. Head surgery buildings.—Two types of the original head surgery building are shown in Figure 30. The smaller type (F-6), for eye, ear, nose, throat, and dental work, was built at the smaller camp hospitals;** and the larger type (F-1), for the same work but providing greater space, was built at the larger cantonment hospitals. In later plans the activities of the head surgery building were consolidated with the general surgery in a single, larger building.*® a TION AND IMPROVEMENT. al © CONSTRU ‘IVLd/SOH-did-O0 O}-xod NWId UOOTL LAU: BOLVBIID IIA’ vr[ On “wo08 AS olay, | ONIMIJIA: : “sel | cee. , \Mics z -adyY> oF > x 2 i bs boi woos S E = ona a | a aDYD =! bx $ i > oS & : D 3 a Ki | jee 2 4 Ee i y WOOR ALA AN isl NOUV 8 yaad “daw ree ie | YO wowz201m7a a ara Be a = — rs + Ht 2 ee Tt ATT | ani NoW1osi- RUOLVUOAVT (cd): MDVD BV Wada TOV Aly Wado} Aa|1 409)> mat ot 4d8i7H Suir Ray tae as ‘ea JOFO]1PU>) Builia 3: 2 “PIQPL £04040 oly FIOOVDIHY Sulg poolsr PIGPL Ardoynyty ‘qrurg y40MEr "Youagty, “DQ>Li+ FOAPUSOr -LNIWdINDI-SNOINVTNIDIW waist Sur FO FFO|OVES mat 40pD10G OTLT ‘pavoquivig q4in Mule ysoMre 4279|D 42¢omMse vulanys KaQpoav ss muir doypie mor dose aig ext Ay Ie Piup ruceSinpor ANIWdINDI -TVYOINVHOIW - 249d ¢eHL J>II4r1G> « piosiy's APTS | FOD+ D14 422/77 “Bo Ji1442> 4P4OMT PAD]2OLNY'| ANIWAINDI ACOLVAIOUV] “6% OL -TWLId/SOH-di4d WIVM: 4722009 1. = H H wooa- woo’: woot SNIW TSW DNIWTVAW2 9 DNIMIIA: Em | a= we v ae - wood ATAOLAY = a re ee aN ee ADOIOHLVd wganqD # AVDINITO: ° OOO?-w0d RIOLVUOAY T- @) : TVYWINY JI q NV 1d-UOOTd- LSU = = —— Aah i WS DNILV3IdO = Bal lees pase a woou: W140 cs “ONILIVM- a 1 j -200 18 BO W@LNYWE XBTMIHOTW QVLFVIND fa0dya791 3178) bee se 4 1M = 2-801 -NVId-dOO11-GNOOF/: INOL rt SsLp NOLLVaVdlad Vigaw ADO10UIS F ADOTOISILIVG: ik JIvISVd -NIdO- bed bog WOO¢ 1801S =, q Ps i abvo jE WOOT-1YWINY = & v x (Aza (Ske a rr) me x= s = ee NOILVIOsI m is Serra olvacava Ny baer en $f—— —— Te aoe n th Jv21'507101771>y9- os 4. ‘AAO AOGYT 7 Or TW2IWIHD WN-LY: (Dor-Noiiaav: poee recy 70L_] =I ABOLVAOIY] 78 MILITARY HOSPITALS IN THE UNITED STATES. The surgical building.—The original surgical building (G) for the National Army and National Guard hospitals, and the addition which was made later, are also shown in Figure 30. In the later plans an effort at consolidation was made; recovery and conference rooms were provided where possible, and additional fixed equipment installed. The consolidation referred to grouped “A” IMsTRUMENT/ ¥Banvages PREPARATION INSTRUME pen oPteatiNg ETHERIZING: RM: meas I rip ae LINEN Closer. on Room: © +/URGICAL: PAVILION - ‘ADDITION “10:4 “LOCATED: AT - 1S650* tes et LYL CLINIC 1e) “DENTAL: INFIRMARY Rig a eae RE] «x [qe RtcLerion¢ercoveRy RA! -OPLRATING: ROOM: I CORRIDOR "TEMAINATION ROOM-FEWAsH- Room “OFFIC: EXAMINATION: ROOM: EYE EAR: np ¢ THROAT: By ss Tis ea Bick = ff fe levi TT: je x iat ish tt ta is mt d { Pas ~~ HEARING: TET: : ri jo reat — > MECHANICAL: EQUIPMENT: 20. Jorgeony Vink. zi. Floania Rim Slop Jinx. zz. Slop Sink. 2. Lavato 24. Showe 15. wey r se Eat rer tad > MISCELLANEOUS: EQUIPMENT so. Shelves, 21, Counter 32 Bench. 93. Locners 121 Ceiling Ventilators. -Clear- story: height. 12% (T) -HEAD -.URGICAL: PAVILION: Fia. 30. the X-ray, eye, ear, nose, throat, and dental work in the same building with the general surgery. This consolidation would not have been possible but for the use of more fire-resisting material permitting larger buildings. A combined surgical department for a 1,000-bed hospital is shown in Figure 31 (G-8), and for a 2,000-bed hospital in Figure 32 (G-12, p. 80). In general terms, under the con- 1) ENT CONSTRUCTION AND IMPROVEM “TE “OL 2 = : ‘IVLId/OH-7d-OOO1UWOL-LNINLAVdId -TwOISUNY = &D) iy bs¢ at) al “tel Need R | ‘woos LIND. xo Mpoys joirDds oF 4487 PAH 4484 CTiikge ped Or 10 . Box] gu, Ssaqiry v¢ jeuu9 yBoes ir “W20Y VE GOL 2{q o4404m © B4,DId Le “pavog vind (TWO GSOM Lt F q nm “W20q aya oc La Ty Norio asim 7 WT ava]9 aq} ur 448124 Aro I “WOOD LIND 4PHOM quing s¢ 4>mMouys sz : b 7121907 +8 £19409) yBnoiy rr 240d 42H 42402 <6 AsOLOALT st & furuinatrul & H y $241q v9 t¢ fl Su dol fz “ ADLOM € u A 424,4uU090 by Mul fe) wi Uiygsol it . “rua t | WOC-LIND- re aniauyes e LE odoa ei nee Gazi ues buena ' ANINdINODI-NOINVIIIIW LNIWdINDGI AVOINVH DIY) ININdINOIWIDAAL * : ae eee ig? pee onal Gl Ho ebes : qd i®. r q o7 i WOOF LIN0L ie LJ n* fy E Ps r bed G3YM-41g -OML- ig bef Ss 1 oid Sy] 7] 5 FS x Berea te bi : ¢ = 1, ae 4 Ey es l © pwaadus? Fr q aT Lo Le. e LNIWLYIUL ° f ny z xq mo | ma co} l fot ) g ° ql Al SZHHeESH woo 2 i=) paaaieenienaieee = Dromecrayn ° COB MECN be | Fel axe [fe] 5. [el DNILIVMW ° o d ; 4 : 4 o| 4 aN A 255 fF x 9 bd 4 as ‘og 3} 0 Je 9 > q wooa-y y n P aa a 2 18 Gs a 9 NOILOVUIIA G 23 Seca WDSc wl Cr Ss sn ee a Se 2 +y ASN el =O > am aw oa 1) a ° a Iva oes vp l oS Se os ae 0 woos =z a 2 nH i 5 | a Ieecothaney MAHAN) qihS WOOU-DNILIVA: wood I bos = WOOU- \ / nisraaa DNILIYM: i UMC SMR) Ror 1] ff DNuvaido-nv719) ayvoibaar | -Nitvaido-sad qwolpuos fh, a a = eens : \ wi A oy Roni « yn i Ho rwdow-tybnag prouathan2 g ly a 21 ‘oT 07 be yn fod it WOOS-ALITILO- : WO0% 1LIIND- P : | i Se | \yoodds a , \yooulrnin/ o| 9 Goes, a, SS et SS —= = 80 MILITARY HOSPITALS IN THE UNITED STATES. solidation effected in these activities, two large buildings permitted the ac- complishment of the work formerly done in five small ones. All of the above surgical and laboratory activities for a small hospital were consolidated,” late in the war period, in a single building (G-103, Figure 32). In addition, a dispensary was included, but no special provision was made in the building for the few animals required at such a small hospital. 2 Gasol] aap <0 BC PRED) x 3 ° Om ' AITING RO Bog ONFERENCE x mx STARE WOO DNIZIB 7 ‘raid: f ; rok -4 PLAN abyBoLsalvrd: Sp ant a TERS, > woos Alddas ? o3, P Taig J MIOM-SIFBON +5 8 cae ba a 1sa3afe Sk” bras \ SISBON peecaseioule : beg “REFRACTION ROOM: [OF Fictey we 3 BQ A] I 1 a) WA DIBGEL NID Bog al scosmAke wood plod} | gi ett = isi WeAte OF: SECOND FLOOR: bet | 4 aoon- o a [ o a : k vodk aoa! : x alii sWo0d: 1001F- lola ec WO 04a: ee ‘hATAODIB/ Ww g i Mie ee ON gO! $aaq 3) LI? =) ro) = weoe: 8 | aN DILIHLSIVNV “ : | xm FOPERATING aS F -ROOM:N%4 -RECCVERY obmy Pllc Fy slogo|es H E xy Y ae in peg OPERATING ROOMNSS- “DEPAR MENT: / | WoOO0a 4 / Dyaqnirayny “ OPERATING -ROOM:-NEZ zy = -¢ al He on eo) ae Sx WOO8 = / DALINLAYNY LENS ae i | $ bs / ROOM KSI pod OPERATING =< \ VJ ERVICE PEPARTMENT I ROpAY Rae Cam I (eette QE a. WOO R-MIOM (fa Faan- a: —P |e fea] J 5WG -DONIZINGIL SY fe x of o bod PATAINS aaah ( ANIWAB LENT 5 ie Se ears BpssscoessEe OU: dO -HSYM-8 OI Ea — Wwoo0a ALITILO n Ss [eg El BOCES T ON.) WADNIIIQ / 4 *y OdLsIINIL 7 LM Tw ie @aeccese's! — WOU y “Nol LW AI WY¥Xd - WQ 0%: I ADIADIDIA- WOO04. ALNNIIN- bu jax) / S ‘ “wooa? & I [ do ary | Lid daha aa7 i NIWABLEN) Doon? 3 3 op UP qs: a] | ~PLAN: OF : FIRST: FLOORS. re x ws = a 5, a Ps) iM es 3 28 (e) —. = x 2S Eras. : sos o*So aw S2e.8e See eyes ogee SB 358985 355 =SS8S3 22a SES “ Sans hasng re ; = V+ (e] oc = oa a a5 = 5 om a ae 3.0 ou 8 Bae ae eee <6 = SEs 336, Se RSS Zz oP oN ee = eo SUE 0 H OCSOS SO OD Xero 3 pc &9 Hs aS of Ss 0 = 5228 0cgge9 SES 5 FF 0a O-aAn+twYs 1 NAAR AA “oi re ot = = ui (a a g ore = sen bad C= £° = ae BS Ree 6 =x> §9F5Nm OD Foyeny w=s5eexe oS a 3552.59 5 > pes 20225 2 Le 5 Ane Sraash 6 new oured FOR: 2000 : BLD: HO/PITAL: Trg. 32. ° @ +/URGICAL: BUILDING Physical reconstruction buildings.—The special buildings for physical recon- struction comprised curative workshop buildings, school buildings, and physio- Effort was made to house physical reconstruction activities therapy buildings. in new buildings, constructed according to prepared plans.” few of them were constructed. The majority of the general hospitals were Comparatively CONSTRUCTION AND IMPROVEMENT. 81 being installed in buildings already existing; and as the other activities of the hospital, such as surgery, laboratory, wards, etc., were being provided for by alteration in existing buildings, this specialty was finally provided for in the CNCLOSED CORRIDOR porte, SITE MAG: iF Lael < — L <—— t2 a Last rt2 Tr | i ~ — — Oo zg |IL2 Bef [1° Aline Se atia ee | yep ee | EMBALMING [Mooruaey fl | [77 12S al 8 5] ) eRe FE Oy ey ate ae alah room | pdb Bll 1 Seat a) roa rae 3 w1 LICHEMICAL ¥ BACTERIOLOGICAL] «Oe : Sou Sera, Dots ine g 1 opm i if Al n a ee pose = | ad et . : ae rye on a ww ‘y it ee =e :, A\2e \a = Ty “LABORATORY yy =a oa gee ae = 40 fee 4 = F DIS PENSAR uprix oo, = 2] 3 = a a] es ae cae ARV sc = = 5 = ee ee a 41,40 = nH « tT tT ht 1 xf] iH CORRIDOR/ Te a / Het % wl ai H ty N = mt Te AY i = 5 2 . _ S 4 ’ = i x $ < 7 WANTING ROOM Laporatores 4i{ 7 gj190 Bolt Oo < LO c th by = i! < “lols, * Zila eet - 2) fae = O tt Zz 99 EuS a oh a srlcier wiclaiatd olewiecisicieie 39) (kitchen) eer esc ee ocean eneece 1 IDG. 3 jo SASS rk IEG i aes EE ee EIS re a aetna E=49)\(GNESS) Aas ncane enclose eee 1 1) yee NC NSE te gta ASE os Soe cite = Je secss ee ete nks se E43 GMe@SS) aos neceines cc acest arate 2 1D) eee ee es wee ae SN DN eee a ein one cases eceane = O-12 (preparation building)........... 1 Figure 35 shows the early type, I, constructed as a part of all of the large camp hospitals built during the first summer of the war, including all National Guard and National Army hospitals, as well as many others.” When the capacity of the hospital became overtaxed, the refrigeration space, which was found to be inadequate, was generally increased.® A third long table was added through the length of the mess hall; and often the food cart room was used for storage and office space, the food carts being kept in the corridors when not in use. Cement floors * was laid in many kitchens to replace one of wood.® With these exceptions, however, this building and its equipment withstood usage remarkably well. In construction there was little difference in these early kitchens from any of the other hospital buildings. The materials used were the same as those used in the wards; the length of the bay, the porches, the ridge ventilator, the sash size, all were built from the same detail sheet as that sent out for the wards. The plan shows the arrangement of the elements and their equipment. Ambulatory patients, figured at about 60 per cent of the total patients, were provided for in the mess hall by the system of serving them then in vogue in Army hospitals, called ‘‘set up service,’’ i. e., dishes and food were placed upon the tables in preparation for the arrival of the patients; the patients arrived at a given hour, ate, and left the mess hall. Tables were then cleared by attendants and clean dishes placed for the next meal, or for the next sitting of the same meal, if, as was more frequently the case, there were more ambu- latory patients than seats in the mess hall. Food for bed patients, figured at 40 per cent, was cooked in the main kitchen and in the diet kitchen, under the supervision of the dietitian. Food was then placed in the food carts which were rolled to the several ward diet kitchens, whence it was served under the direction of the ward nurse. In January, 1918, the first variation from the plan I was made, taking ad- vantage of the experience gained from the many camp and cantonment hospitals that had by that time been in operation for several months.” In a few steps there was developed the transitional type of general mess, represented by the plans (I-11 and I-12), for a small and a large hospital, respectively." The restriction to the 24-foot width was discontinued.’?> This was the inevitable a Cement floors had been intended primarily, but through some error wood floors were originally laid in most camp hospitals. MILITARY HOSPITALS IN THE UNITED STATES, 84. Ow vec ETABLE UNCOVERED PORCH PORCH COVERED TORAGE \ Ss z b ak pe 10) gor i lS a = < 2 1 oO } A a baee Wee it oe pias Soles BE ae| a SoG ree ae ee Snare SS Me) s nN i st ae Eno & 9 es 5 3 & x ae & 3 Os 4 0 J a Ss a aS 5 fa} ype! a Qa ° lc o B ns a 8 ) é HO | mS Oo oad fo} fo) Ww corRipoR = é s Eo) 3 ce a 4 0 3 a a a8 > eyes 3 Ee 629 2 S&S 25 3eks 2 og 2efGsR S 9255 8898 FZ 9 PF ji 2o8euss" SBo0daake H 3538388 5 e = 8 oO — DANTRY ry Soiled Dishes 2 x SES ee eee 5 5 GOON Nepean - 255 Smx90 O99 4% PZ2L Ee = = 80-6 OE Ale = a See ede elena is 358 es sess ZGSSdadcrzA = x noe iS) Gs ania ul zi 2 f Z50f E ®9—o o 58352. 2 Ee a a Ww eX 52 om € ae ee ee BOOSdo¥YGHRL Sd cg HVE EY OOO 9 =~ 0x = Vv CRORE Bree i tes MHHT SL DE OE edo tb=—6O Dv a SSF0NE>ZA o- Nan snean coeregipok KITCHEN a) CONNECTING MEPS < I@. 35. F CONSTRUCTION AND IMPROVEMENT. 85 ~ arene tic. eA RES A. Fig. 37.—Corridor adjacent to patients’ mess, showing equipment for transporting prepared food to wards. 86 MILITARY HOSPITALS IN THE UNITED STATES. result of the decision to give up the E-shaped plan in favor of the rectangular building, which was more adaptable to an uneven terrain, and more economically constructed.¥ A comparision of the perimeters and areas of plans I, I-11, and I-12 (Figs. 35, 38, and 39) is as follows: Total ex- we terior wall| Areaof | Floor area Building. of mess messand | per foot of and kit- kitchen. outside chen. wall. Square feet. 1 ee ee ae ne oe ary et ae era Meee aes MRC Ue aA Staats eae 1,190 12, 50 10 a OR i ey ac ee ey ae ieee eat ee Pees Ay SOM are Ue bin nee ia. urs th 430 6, 840 15 fa ee ay rae ees meee pete yee cae Rey etna gee ate Mt A ant See Be ey a Cys te 790 16, 400 21 The I-11 building was planned for the use of both patients and attendants, and it had a cafeteria arrangement. The set-up manner of feeding, an old cus- tom in the Army, had become an unwieldy method of feeding a really large num- ber of men. The cafeteria system was made effective to overcome the necessity of greatly increasing the seating capacity of the mess halls, or the alternative of having successive sittings for the same meal. * When intelligently operated, it | li i Ret Nee pe oa a ae Cabanas =, MECHANICAL “EQUIPMENT: MISCLLLANEOUS LQUIPMENT Nona cle peghen 10. Shelves uN aVegetable Kettle. M 21. Work Toble. 3 Work Sink . Oran EN: 228i ea () MLS eKITCH aN SMeat Block. en < Cooks Table. x Cart 7 Steam Table. enches =) ess Cel 9 Venti H Ceiling Light. FIG. 38. had the following advantages: Hot food, faster service, less waste, operable with fewer mess hall attendants, greater flexibility—adaptability to sudden increase or decrease in the number to be fed—greater construction economy, economy in dishes, etc. The large general mess and kitchen of the transitional type (I-12), capable of feeding 2,000 men, shows a rectangular kitchen 36 feet wide, directly attached to a mess hall, six 12-foot bays wide, divided into two cafeteria units. The kit- chen in construction was similar to I-11. The mess hall was a larger building consisting of a central nave of a 24-foot span with two 12-foot bays on either side. Close window spacing and a monitor provided sufficient light for this wider building. There was no ceiling over the main kitchea, scullery, and erocery storeroom. The I-12 plan should be compared with I. It was designed to meet similar requirements. Each of the two large elements, the kitchen and the mess, be- CONSTRUCTION AND IMPROVEMENT. 87 came simple rectangles. The kitchen was designed to keep orderlies, mess hall attendants, and food carts out of the cooking and preparation rooms, all serving being done over a counter. Access from the mess service corridor to all of the various rooms was obtainable without passing through the kitchen proper. A continuous service platform, in the rear of the kitchen, gave access to all of the rooms. This platform was left uncovered to afford the maximum of daylight throughout the kitchen. Directly abutting the kitchen building were the two cafeteria service rooms, each serving a unit similar to that of I-11. g s SIP ez “KIT C HEN L VeqtTaBLt sroeey 2 n nu iP coueipoe orrice H I nid MLUCHANICAL CQUIPALAT- tabece Kettler sae an hcg Roch Mi ‘ 2 las hin eching. peat SMe bailar Ie shoe Table 4tanges =, oder «coffee Urey volee Cream fragsee MVegabable Peslo mmead Shoppes 2 JUCTION THROUGH MLJ/ HALL SCALE (1)-MESS-“ KITCHEN: Fia. 39. During the summer of 1918, plans for the third and latest type of kitchen and mess were developed.” The smaller of the two representative buildings of this latest type, I-34 (Fig. 40), was designed for use either as the general mess and kitchen for a 500-bed hospital or as a mess and kitchen for the medical detachment of a very large hospital.”* It was really a sequel to I-11 with a double mess hall to make it more flexible in its usage. Because of the fire risk and the vital character of this service, buildings of this type were made of metal lath and stucco instead of the wood siding previously used; otherwise, the con- struction was similar. The washing room directly adjoined the cafeteria coun- 88 ters, thus eliminating the transportation of clean dishes, which had been found A monitor roof, over the serving MILITARY HOSPITALS IN THE UNITED STATES. quite a burden in buildings I-11 and I-12. and dish washing rooms, provided an extra amount of light and ventilation for that busy portion of the mess hall. All other sections of the building were pro- vided with metal ridge ventilators. The elements covered in the planning of the food preparing and mess preparing, cooking, serving, eating, and dish wash- It was necessary to depart from the ideal, direct contact arrangement of buildings were storing ing. - MECHANICAL EQUIPMENT - to Vegetable peeler 11 Roasting kettle 12 Vegetable boiler 13 Freezer 14 Stock kettle. 15 Po! be Veastoble sink is Sop sink 12 Coffee urns 2D Sauce pan rack £1 Bain morie* COVERED PLATFORM p--——— epee: table sink 5 Ran, ta eaneee cons 25 Drinking fountain 26 Fish box 27 Meat chopper ze Meat block 29 Bench Lavatory 31 Urinal 2 Wolter closer 35 Shower l 10 a CJ a Omeate VEG! a P E- REPARATION © Or am. =a corrgipoR TO WARDS MISCELLANEOUS EQUIPMENT 40 Shelves: Al Work table 42 Cooks table 42 Pot table 44 Steamtoble 45 Troy slide PLATFORM 48 Tableg benches 4@ Lockers 50 Cabinet 51 Dishwashing machin XX Ceiling light }o wall ight ea register Lt DATIENTS. CAFETEBIA for200 =e os Fig. 40. these elements in the feeding of large numbers of men in the military hos- pitals.* Variations and departures have been shown in the different build- ings already referred to. In the feeding of a still larger number, what were planned for and secured were: A kitchen separate from, though closely con- nected with, its storage and preparation facilities, and a dining room with its service and dish-washing arrangements in the portion proximal to the kitchen. This typical large general mess and kitchen consisted of three build- ings: Preparation building (O-12), kitchen (I-39), and double mess hall (I-43) shown in Figure 41. This group was planned to take care of the patients and the Medical Department detachment for a hospital of 2,000 beds. CONSTRUCTION AND IMPROVEMENT. 89 PLATFORM og VEGLTABLE o REFRIG. Fen = = MUCELLANEOUS EQUIPMENT 30 Shelves MECHANICAL coment © OMMISSARY -STORES- emer on rae so Vegelable rink, , fC na Past ‘Tock, 21 Sink with drain board 39 Ice cream Morage 36 Icestorage 4s Ceiling light ¥ £2 3Ceiling ventilatory Ly > 3 iJ g @, © > rs iy USARY 50000 - ; i a t - : ; OOOO, pee ‘ | = covered PORCH i UNCOVERED | (PORCH i COVERED PORCH ree PEE ae -——_——- a DIETICUAL o OFFICE t ee eS aon orrice |iy = TOILET : , Bese eo ae setters : : u Hee) it lel [] | [= 1 2 ge LOCKER RIM ( pine wn EN i PLOLELOCECO n | = —_ aes wera eel ill uo » FOOD CART PASSAGE MECHANICAL EQUIPMENT MISCELLANEOUS EQUIPMENT §4 Stock kettles 22 Cooks lable sink. 30 Shelves x Lockers 45 Pol sink 2Ronges 31 Work table s7Garbogecans # t Vegetable cookera 24 Boke oven 32 Cookslable 38 Re[ngerator 17 Work sink 25 Roasting kettles 39 Pol Table Dish washing machine. 5 1s Compartment cookers 26 Lavatory TE sa Stcamtable 40 Table benches 9 19 Coffee urns 27 Water closet 33 Bind 4) Drinking fountain 1 w Davce pan rack> za Urinal Q T.Ceiling light fo Wall light 41 Bain marie 29 Shower | CaCeiling ventilator meen oe uo ef o 19] uo 30 § a CONNECTING CORRIDOR = | Q RESERVE COUNTER COUNDTLR. COUNDTER COUND TER COUNOTLR ’ COUNTER. COUNTLe COUNTER COUNTER QESERVE RLFERVE RESERVE RESERVE SLRAMVICE SOILED DUNES SEROVICE JcRovice SOLED DINE, “ oe Ss a a e ne 3 of ° oO 3 ; _ | z — 5 ne _ 5 OO ees |) “ a MELS HALL S MESS isi ie] ° ist e = _ ¥ ce) FSCATING | CAPACITY 650 * JSCATING a 4a a LY n mo=0' T ;—H 14 JECTION THROUGH MESS ‘MESS: (9-6 - KITCHEN: ©: Fia. 41. 90 MILITARY HOSPITALS IN THE UNITED STATES. The buildings were of metal lath and plaster on wood-frame construction with a plaster-board lining, the joints plaster filled. The commissary stores building (O-12) was a simple building, 32 feet wide, with a cellar in which were a 5-ton refrigerating plant and storage rooms. The first floor was used for vegetable storage, a dairy, vegetable and meat refrigeration, and meat and vegetable prep- aration. An inclosed corridor connected it with the cooking building. The I-39 kitchen contained the cooking facilities for all regular and special diets. It was but slightly modified in construction from its predecessor, I-12, by the division of its width, 36 feet, into unequal bays, the center bay being 20 feet across in order that there might be a wide aisle for the cooking equipment. The kettles and ranges were located in a double, back-to-back line running lengthwise with the building, the ranges facing the foot cart corridor. It will be noticed that it was possible by this arrangement for the cooks’ tables, opposite the ranges, to operate as a serving counter at meal times. The I-43 mess hall was five 12-foot bays wide, the center bay running the length as a monitor. It contained two cafeteria units with the .dish-washing room adjoining the serving counters. This type of mess hall caused both patients from the wards and food from the kitchen to enter at the head of the mess hall. It effected a considerable saving of aisle trave! and, while it entailed a crossing of the food line through the in- coming patient line, this intermittent occurrence was not found to affect seri- ously the messing operation.“ Near, and in constant communication with, the kitchen was the reserve counter of the cafeteria serving room. It provided a working counter for any final preparation, make-up, or dishing out. It also pro- vided counter and shelf area on which reserve supplies of food and dishes could be stocked from the outside and kept there. In front of the reserve counter, and at a distance no greater than that required by two men working opposite one another at the two counters, was the serving counter. In all standard designs for serving counters an effort was made to use 30 feet as a minimum length and 35 whenever possible. In the middle of the length was placed the steam table with food containers varying in number, depending upon the number to be fed and the distance from the kitchen. ‘These containers were adequately high to obviate excessive stooping of those constantly working over them. Just in front of the row of containers and on a level with the main serving counter was a display shelf on which the food servers placed the plates of hot food as rapidly as they could and from which the patient could help himself as he passed by. A tray slide, slightly lower than the serving counter and display shelf, ran the length; and just near enough to make passing possible was a rail of sufficient height to make it uninviting and undesirable as a seat. In the operation and the detailed arrangement of the cafeteria, there was considerable variation due to the different needs of the hospitals and to the diverse ideas of the mess officer. Very broadly speaking, however, it was similar to the usual public cafeteria. In the planning of a cafeteria mess hall three closely related factors were considered: !* The rate of serving, the average length of time a patient devoted to eating his meal, and the required seating capacity of the tables. It was found that the serving of 20 men per minute was entirely practicable; a man would seldom stay more than 10, never more than 15 minutes at mess; and, by a computation from these two facts, that from 300 to 325 seats were suffi- cient to keep a single serving counter unit in smooth, continuous operation.¥ 91 ens for cafeterias in leased In the later desi CONSTRUCTION AND IMPROVEMENT. To permit the simplification of the service, a great deal of the equipment was later made interchangeable. “yuourdinbe emojzaej— vp “Ol S| ALIQ YAOA MIN SONIGTING LAHNIIAD ° C.) -EoN -TVILIGSOH - NOILVAAVGAC - sa Soy _ ININVZZIW-BOOU-464Is- SAO 01A-ENOIAS7 = -SWO004d -JAOLS- O-NOILVaVdadd - - SSIW + WWaINndadS _ ow} Cran IZ a= = { H a 2 a | = | v 1 = = OM fies n aovaoic avaaa Q| o = fe RO! | F 4 a 0! alee 5) } ' ce | = \ Bis ' S | Flr o U Al [| 8 Yamuna 1 ha, =z = Z WOO NOlLWwavdaad ' Ld _ Y : bt ' YG if. 7 Ny Nita V au @ x3 ae es Ll 2, O50 Vb. 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D]4242]D OF 622 }104 9)90)252,, a apres und 22n0¢ © Vy #2 -INJWdIND® - SS3W - LNIWdINOD » NJHOLIM - 4 OR \S WM My The containers It was found that four of these con were partitioned and designated for use as follows: Container No. 1, undi- tainers held sufficient dinner (the largest meal) for 160 men.* size, 15 by 12 inches by 11 inches deep. 92 MILITARY HOSPITALS IN THE UNITED STATES. vided, for soup; container No. 2, undivided, for potatoes; container No. 3, divided in center, one-half for meat and one-half for gravy; container No. 4, divided at third point, two-thirds for second vegetable, one-third for dessert. The same containers were used in the ward service food carts, and the same ward service food carts were used in the main mess hall in serving patients who were not quite active enough to serve themselves at a cafeteria. The food cart held the four containers set side to side and into an insulated box, making the dimensions of the cart 2 by 6 feet by 3 feet high. A shelf, underneath the main box, was so placed to hold extra containers. Dish trucks, the necessity for which was minimized by having the cafeteria patients carry their own dishes to the dish-washing room, were built on a framework identical with that of the food carts. Thus the food distribution equipment was made simple, flexible, and interchangeable. Simplification was also accomplished in the cooking and the cafeteria serving. Based on experience in temporary hospitals, the fixed equipment of the main kitchen, diet kitchen, and cafeteria was standardized, and a schedule of standard equipment was prepared by the Surgeon General’s Office and the Construction Division.”> This schedule had about 60 items of equipment and gave the steam, water, and electric connections required, the floor space occupied, and the number and size of each item appropriate for hospital messes ranging in capacity from 25 to 5,000. The problem of installing mess halls and kitchens in the leased buildings which were altered for hospital use was a very indefinite and variable one. Usually the feeding system was the fundamental factor of the entire assignment of space.” Sometimes there already existed an adequate kitchen and mess hall, as in the cases of some of the institutions and hotels that were leased. At other times, there would be a fair-sized kitchen that needed only some additional equip- ment. Then again, there were absolutely no facilities in a building, and the possibilities of each floor, from the basement to the roof, demanded consideration.” Housing.—In our hospitals three classes of duty personnel were provided for: Officers, nurses, and enlisted men of the Medical Department.” However, before the war was over a half dozen other classes, male and female, had been added to the operating personnel of the larger hospitals. In the beginning this housing included some recreational facilities. Soon the American Red Cross took over the housing of the recreational facilities for the nurses,” and the Young Men’s Christian Association, Knights of Columbus, Jewish Welfare Board, and others, provided facilities for recreation for the enlisted per- sonnel.*? The officers’ quarters were frame buildings, like others in the hos- pital, provided with a kitchen and mess hall and one room for each officer.* Each hospital had in addition a small staff officers’ building of four rooms for the commanding officer and his staff.** The nurses’ quarters were similar to those for the officers, containing a kitchen and mess hall; but part of the nurses only were provided for in separate rooms and the remainder had dormitory space. The dormitory was unpopular and in later construction a room was provided for each nurse.** The enlisted men of the Medical Department were provided for in simple barracks parallel to each other, each building having two or three small rooms for noncommissioned officers.” The kitchen and mess hall occupied usually a separate building in the middle of the group.” Where the hospital was small, a separate kitchen and mess building was not built, CONSTRUCTION AND IMPROVEMENT. 93 Fic. 43.—Officers’ quarters. Fia. 44.—Officers’ dining room. MILITARY HOSPITALS IN THE UNITED STATES. NZ NZNZ DEN Fic. 47.—F nlisted men’s quarters. CONSTRUCTION AND IMPROVEMENT. 95 ‘rg, 48.—nxlisted men’s mess hall Ng Fic. 49.—Typical Red Cross recreation house for nurses. 96 MILITARY HOSPITALS IN THE UNITED STATES. \ Fic. 50.—T ypical Red Cross convalescent house Fig. 51.—Typical Young Men’s Christian Association hut. CONSTRUCTION AND IMPROVEMENT. 97 Fig. 52.—Interior of Young Men’s Christian Association hut. Fig. 53.—Typical medical supply buildings. 45269 ° —23——7 98 . MILITARY HOSPITALS IN THE UNITED STATES. Supply buildings—The supply buildings were simple storehouses with a few separate rooms.*® They contained appropriate shelving for the orderly handling of small articles, and counters and loading platforms required for reception and issue work for the hospital, or for both the hospital and the camp if necessary. CLASS V. FOR UTILITIES AND PHYSICAL OPERATION. The following additional buildings were mainly used for utilities and the operation of the hospitals:7”7 Power house, shop, laundry, garage, fire house, and 000.000 in a 1ROAIAG ROOM “SECTION MECHANICAL LQUIPA CAT MISCLLLANCOUD LQUIPALAT aetecetee SNE Satven coverep Coreipor- L * erent STORAGE e Bh 4 SECTION: enn oe ConckeTe: platroeh -LINEN-STORAGE: ‘ = i 4 eee ea! | -DISINFECTING- BUILDING: LAUNDRY Q) Fig. 54 rf oto” 3 ; — ee a a jg OR NY rn taunoery t F es H IRONING ROOM 2 is is ni Sa snsisesaiies (oes SECTION: + MUCHANICAL LQUIPALNT: \Weshers ildrectors 3 Soap Tank 2 Sat i LIND N JTORAGE Water Closer IpRok Waller Heater MISCELLANEOUS ~ CQUIPALAT, ho Giazep Porck MENDING ROOM: fa tts 10 shelv. es ai Truck shelves. an Tables UMBELLLA CotRsDor - LAUNDRY -Q) Fig. 55. dry cleaning (rarely). Laundries were planned for the hospitals of National Army cantonments and National Guard camps.” The buildings were con- structed, but were not equipped;** so the hospital laundry was done either by CONSTRUCTION AND IMPROVEMENT, 99 civilian laundries or by that operated by the quartermaster of the camp. At Debarkation Hospital No. 2, Fox Hills, Staten Island, N. Y., a modification of the original laundry plan was used for the construction of a laundry;** and later, after this hospital had been built, a still further modified plan was used for laundries constructed at some of the tuberculosis hospitals and at a few large general hospitals which were isolated. These utility buildings were Fic. 56 —Garage and cars at a base hospital not closely connected with the care of the sick and in none of them were there such distinct changes in plans as occurred in the wards, the mess buildings, and the surgical pavilion, where the mushroom growth of military activity led from one readjustment to another. The early type garage constructed was changed to a wider, more economical type of greater capacity.” REFERENCES. (1) Block plan A. On file, Hospital Division, 8. G. O. (2) Block plan B. On file, Hospital Division, 8. G. O. (3) Block plan C. On file, Hospital Division, 8. G. O. (4) Block plan D. On file, Hospital Division, 8. G. O. (5) Block plan E. On file, Hospital Division, 8. G. O. (6) Letter from the Acting Surgeon General to the Chief of Staff, September 16, 1918. Subject: Hospital program. On file, Record Room, 8. G. O., Correspondence File 632 (General). (7) Construction plans, Camp Knox, Ky., Camp Jackson, 8. C., and Camp Mills, Long Island. On file, Hospital Division, 8. G. O. (8) Letter from the Surgeon General to the Construction Division, War Department, September 5, 1918. Subject: Hospital construction, Camp Bragg, N. C. On file, Hospital Division, S. G. O. (Camp Bragg, N. C.) (9) Plans of receiving buildings. On file, Hospital Division, 8S. G. O. (10) Plan B-9. On file, Hospital Division, 8. G. O. (11) Plan J-3. On file, Hospital Division, 8. G. O. (12) Original plan for hospital construction. On file, Hospital Division, 8. G. O. (13) Statement from Maj. Floyd Kramer, M. C., April 12, 1922, to the Surgeon General. Subject: Hospital construction. On file, Record Room, 8. G. O., Correspondence File 632-1. (14) Plan K-25. On file, Hospital Division, 8. G. O. (15) Based on construction reports. On file, Hospital Division, 8. G. O. (under camp). (16) Plan K-105. On file, Hospital Division, 8. G. O. (17) Plan K-58. On file, Hospital Division, 8. G. O. (18) Letter from the Surgeon General to the Quartermaster General, July 5, 1917. Subject: Cantonment hospitals. On file, Record Room, 8. G. O., Correspondence File 176796 (Old Files), 100 MILITARY HOSPITALS IN THE UNITED STATES. (19) Plan K-20. On file, Hospital Division, S. G. O. (20) Plan L-1. On file, Hospital Division, S. G. O. (21) Letter from the Surgeon General to the Quartermaster General, December 26, 1917. Subject: Hospital increase at National Army and National Guard Bae hospitals. On file, Record Room, 8. G. O., Correspondence File 632-11 (General). (22) Camrrerat nan Fort McHenry, Md. On file, Hospital Division, 8. G. O. (23) Camp hospitals of about 2,500 beds each, ected. Plans on file, Hospital Division, 8. G. O. (24) Memo. from Lieut. Col. Floyd Kramer, M. C., to Brig. Gen. Robert E. Noble, M. D., August 26,1918. Subject: Hospital construction. On file, Record Room, 8S. G. O., Correspondence File 632 (General). (25) Plans M and M-1. On file, Hospital Division, S. G. O. (26) Plans M-3. On file, Hospital Division, S. G. O. (27) Plan M-6. On file, Hospital Division, 8. G. O. (28) Plan R-2. On file, Hospital Division, 8S. G. O. (29) Plan R-4. On file, Hospital Division, S. G. O. (30) Based on plans of various wards. On file, Hospital Division, 8S. G. O (31) Report of the Chief of Construction Division, W. D., 1919, 59. (32) Letter from the Committee on Army Hospital Plans to the Assistant Secretary of War. No- vember 24, 1918. Subject: Report of study of plans for Army Hospitals. On file, Record Room, 8. G. O., Correspondence File 600.13 (Plans and Specifications). (33) Letter from Chief of Construction Division, W. D., to the Surgeon General, October 23, 1918. Subject: Length of hospital buildings. On file, Record Room, 8. G. O., Correspondence File 632 (General). (34) Letter from the officer in charge, cantonment construction, to the Surgeon General, Decem- ber 13, 1917. Subject: Glass for sash. On file, Hospital Division, 8. G. O. (35) Shown on detail plans of buildings. On file, Hospital Division, 8S. G. O. (36) Second Annual Report of the Council of National Defense for the Fiscal Year Ended June 30,1918. Government Printing Office, Washington. Page 171. (37) ene: from the War Industries Board, Council of National Defense, to the Seceee of War. April 8, 1918. Subject: Proposed aiky of new hospitals by the War Department. On file, Record Room, 8. G. O., Correspondence File 632 (General). (38) Medical and Surgical History of the War of the Rebellion, part third, medical volume. Gov- ernment Printing Office, Washington. Pages 934, 945, and 952. (39) Plans K-34 and K-58. On file, Hospital Division, 8. G. O. (40) Memo. from Maj. ©. W. Richardson, M. C., to Lieut. Col. E. P. Wolfe, M. C., December 17, 1917. Subject: Sterilizers. On file, Record Room, 8S. G. O., Correspondence File 414.4 (Sterilizers). (41) Plan K-1. On file, Hospital Division, S. G. O. (42) Plan K-34. On file, Hospital Division, 8. G. O. (43) Report on Study of Mess Conditions in Base Hospitals, by Capt. E. L. Scott, 8. C., April 29,1918. On file, Record Room, S. G. O., 720.1 (Food). (44) Shown on first plans of wards of base hospitals. On file, Hospital Division, 8. G. O. (45) Letter from the Surgeon General to the Quartermaster General. January 9, 1918. Subject: Slop sinks. On file, Record Room, 8. G. O., 652 (General). (46) Shown on plans K-34, K-58, K-117. On file, Hospital Division, S. G. O. (47) Letter from Chief of the Construction Division to the Surgeon General. March 18, 1918. Subject: Construction of laboratory additions at National Army base hospitals. On file, Record Room, 8. G. O., 632-1 (General). (48) Plans K192, K-482, On file, Hospital Division, S. G. O. (49) Shown on block plan of General Hospital No. 8, Otisville, N. Y. On file, Hospital Division, 5. GaO; (50) Shown on plans of General Hospital No. 21, Denver, Colo. On file, Hospital Division, 8. G. O. (51) Plan K-107. On file, Hospital Division, S. G. O. (52) Plan K-108. On file, Hospital Division, S. G. O. (53) Plan F. On file, Hospital Division, 8. G. O. (54) Plan F-6. On file, Hospital Division, 8. G. O. (55) Plan F-1. On file, Hospital Division, S. G. O. (56) Plan G-12. On file, Hospital Division, S. G. O. CONSTRUCTION AND IMPROVEMENT. 101 (57) Plan G-103. On file, Hospital Division, 8. G. O. (58) Letter from the Surgeon General to the Construction Division, November 22,1918. Subject: Buildings for physical reconstruction. On file, Record Room, §. G. O., 652 (General Hos- pitals) K. (59) Letter from the Surgeon General to the Construction Division, December 21, 1918. Subject: Allotment of funds for alterations for physical reconstruction buildings. On file, Record Room, 8. G. O., 632 (General). (60) Letter from the Surgeon General to the Construction Division, November 22, 1918. Subject: Buildings for physical reconstruction. Indorsements thereon. On file, Hall of Records, Fort Myer, Va. (Cr. 652-B.). (61) Plan I. On file, Hospital Division, 8. G. O. (62) PlanI-11. On file, Hospital Division, 8. G. O. (63) Plan I-12. On file, Hospital Division, 8. G. O. (64) Plan I-34. On file, Hospital Division, S. G. O. (65) Plans I-39, I-42, I-43, 0-12. On file, Hospital Division, 8. G. O. (66) Based on reports of authorization and construction from various hospitals. On file, Hospital Division, 8. G. O. (67) Construction reports (name of camp). On file, Hospital Division, 8. G. O. (68) Letter from the Chief of Construction Division to the Surgeon General, September 6, 1918. Subject: Allotment for refrigeration at base hospitals. On file, Hospital Division, 8. G. O. (National Army General File, Misc.). (69) Letter from the Surgeon General to the Quartermaster Corer October 1151917. Subject: Concrete or composition floors for hospital kitchens. On file, Record Rood Balt. Os, Odd. (70) Weekly report of construction branch, S. G. O., for week ending January 11, 1918. On file, Record Room, 8S. G. O., Weekly Report File (Hospitals). (71) Plans I-11, I-12. On file, Hospital Division, 8. G. O. (72) Weekly report of construction branch, 8. G. O., for week ending May 16, 1918. On file, Record Room, 8. G. O., Weekly Report File (Hospitals). (73) Plan I-34. On file, Hospital Division, S. G. O. (74) ‘Report on Mess Administration,’’ by Maj. R. G. Hoskins, S. C., October 22, 1918. On file, Record Room, 8. G. O. Food and Nutrition File (Hospital Needs). (75) Schedule of kitchen equipment. On file, Hospital Division, 8. G. O. (Kitchen Equipment). (76) Shown in floor plans of all buildings leased and used as hospitals. On file, Hospital Division, Sars O, (77) Letter from the Surgeon General to the Quartermaster General, May 26,1917. Subject: Esti- mate for base hospitals for cantonments. On file, Record Room, 8. G. O., 176796 (Old Files). (78) Shown on plans for hospital barracks and quarters. On file, Hospital Division, S. G. O. (79) Letter from the Surgeon General to Director General, Military Relief, American National Red Cross,March 22, 1918. Subject: Construction of recreation rooms for nurses’ home at military hospitals. On file, Record Room, 8. G. O., 682 (General). Letter from the Surgeon General to chairman, Operations Branch, General Staff, March 20, 1918. Subject: Rest rooms in camps, for Army nurses. On file, Record Room, 8. G. O., 632 (General). (80) G. O. No. 57, W. D., May 9, 1917; G. O. No. 82, W. D., July 5, 1917; G. O. No. 2, W. D., January 7, 1918; G. O. No. 46, W. D., May 9, 1918; Bull. No. 55, W. D., October 7, 1918. (81) Plans for officers’ quarters at hospitals. On file, Hospital Division, 8. G. O. (82) Block plans of hospitals. On file, Hospital Division, 8. G. O. (83) Plans of nurses’ quarters. On file, Hospital Division, 8. G. O. (84) Plans of nurses’ quarters in late construction. On file, Hospital Division, S. G. O. (85) Plans of supply buildings at hospitals. On file, Hospital Division, S. G. O. (86) Letter from the Acting Quartermaster General to the Chief of Staff. February 28, 1918, Subject: Laundries. On file, Record Room, 8. G. O., 633 (General). (87) Second indorsement from the Surgeon General to The Adjutant General. March 7, 1918. Subject: Laundries. On file, Record Room, 8. G. O., 633 (General). (88) Plan of laundry at Debarkation Hospital No. 2, Fox Hills, N. Y. On file, Hospital Division, 5: .Gr. 0. (89) Plan Q-4. On file, Hospital Division, 8. G. O. (90) Plan of garage at hospitals. On file, Hospital Division, S. G. O. CHAPTER: Y: HOSPITALS PROVIDED. HOSPITALS AT NATIONAL ARMY CANTONMENTS. It was contemplated as early as May, 1917, that there would be 32 camps at which the war army would be mobilized. Sixteen of these camps were later located in the North and 16 in the South. Generally speaking, those in the South were for National Guard troops, and those in the North were for the National Army. Since there were no modern hospitals of temporary construction, of a size comparable with the ones required for the camps, whose plans could be followed, the provision of hospital facilities for the camps presented a problem of considerable magnitude. The Letterman General Hospital at San Francisco was the nearest approach to the type desired, and the degree of influence it exercised has already been mentioned. As all the hospitals for the moblization camps were to be alike, one plan was designed to serve for all the 32 camps; consequently, it was necessitated that the common plan be adequate and free from serious error lest a mistake be multiplied 32 times. DELAYED CONSTRUCTION. The preliminary plans which were prepared in the Surgeon General’s Office showed the arrangement in each of the hospital buildings and their inter- relation as a group. The plans for the hospitals of the National Army camps were forwarded to the Quartermaster General’s Office and construction was requested on the following dates: On June 12, 1917, for Camps Devens, Dix, Jackson, and Lewis;? on June 13, 1917, for Camp Sherman;? on June 18, 1917, for Camps Upton, Custer, Lee, Meade, and Taylor;‘ on June 23, 1917, for Camp Grant;! on July 5, 1917, for Camps Dodge and Gordon;* and on July 9, 1917, | for Camps Pike and Travis.’ On June 22, 1917, the Quartermaster General acknowledged by letter to the Surgeon General the receipt of the plans for the first 10 camps which had been sent, and stated that the available funds for the construction of build- ings at the cantonments were not sufficient to cover the cost of the erection of hospitals. Acting promptly on this information, the Surgeon General submitted an estimate to cover the deficiency, and on June 25, 1917, forwarded the letter of the Quartermaster General to the Chief of Staff by an indorse- ment in which he stated that the deficiency estimate had been made and he requested that the Quartermaster General be authorized, in the emergency, to proceed with construction of the National Army hospitals.? In passing through The Adjutant General’s Office an indorsement was added to the letter in which The Adjutant General requested the Quartermaster General 102 CONSTRUCTION AND IMPROVEMENT. 103 to delay action for a reasonable length of time to determine if possible what the will of Congress might be.t? To this request of The Adjutant General the Quartermaster General replied on July 16, 1917, stating that the time had come when a start must be made in the construction of the hospital part of the cantonments if the whole was to be completed together.’ On the following day The Adjutant General forwarded to the Quartermaster General the instructions and authority of the Secretary of War to proceed with the construction of hospital facilities for 3 per cent of the commands,” and on July 24 and 26 the necessary plans and instructions were sent to the field by the Cantonment Division of the Quartermaster General’s Office. Under this authority of the Secretary of War the construction of the hospitals at the following National Army cantonments was begun: For hospitals of 1,000 beds each at Camps Devens, Dix, Jackson, Lewis, Sherman, Upton, Custer, Lee, Meade, Taylor, Grant, and Travis; and for 500-bed hospitals at Camps Dodge, Gordon, and Pike. The strengths of troops at the National Army camps, with the dates when the first sick were admitted to hospitals,'* were as follows: First pa- Average number of tient re- troops in camps. y ceived in Caanps. canton- ment |September,| October, hospital. 1917. 1917. 10, 000 29, 000 8, 500 19, 000 22, 000 28, 000 19, 000 37, 500 14, 500 23, 000 13, 000 32,000 13, 000 27, 000 12, 500 31, 000 23, 000 24, 000 6, 000 17, 500 17, 000 17, 500 13, 500 28, 500 13, 000 16, 000 16, 000 23, 000 9, 000 25, 000 ADDITIONS AND IMPROVEMENTS. The base hospitals, as orginally constructed at the National Army camps, were of pavilion type and all buildings were one-story, nearly all being con- nected by corridor without steps. Subsequently, 32 wards (all but the isola- tion and psychiatric wards) were connected by corridor with the administra- tion, receiving and forwarding, laboratory and X-ray, eye, ear, nose and throat, operating, mess and kitchen, and exchange buildings. The whole group covered a rectangular area of approximately 1,200 by 1,400 feet, fronting on a long side.‘! The wards were placed parallel to each other in four rows of eight wards each, running from front to rear. Between the inner two rows, and from front to rear, were the laboratory and X-ray building, the operating pavilion, the exchange, mess hall and kitchen, in the order given. In front of the center was the administration building and to its right the receiving and forwarding buildings. The nurses’ quarters were on one front corner, the officers’ ward on the other; the isolation and psychiatric wards on one rear 104 MILITARY HOSPITALS IN THE UNITED STATES. corner, and the quarters for the enlisted personnel on the other. To the rear | of the latter two were the utilities and the storage buildings. The officers’ quarters were in front, but across the street and facing the hospital. All buildings were of frame; but all had modern equipment and fixtures, plumb- ing and sewerage, steam heating, cooking, and sterilizing. There were originally about 60 or 70 buildings in each National Army base hospital group. Subsequent conditions necessitated augmenting this number to 80 or 90 and in some instances even to 100. Ki ZY“ WldddéddéeeA, : Zi KiLZYYwy = & KLKZZ“w y KEY pai Ls ERS WARD 1 : - D OFFICERS QUARTERS Ki ‘ WL MMMM E NURSES QUARTERS : WA F LABORATORY 4 G SURGICAL H POST EXCHANGE, SHOPS & GARAGE | MESS & KITCHEN J RECEIVING BUILDING KGL waRDS M ISOLATION WARD N BARRACKS O STORE HOUSES P GUARD HOUSE, CHAPEL G MORTUARY Q RY R PSYCHIATRIC WARD CAPACITY SHOWN. 1000 BEDS Fic. 57-—Block plan of base hospitals as originally constructed. The corridors connecting the buildings were 10 feet wide and in northern cantonments were inclosed. This corridor width was not essential to normal uses, but it was so constructed for expansion space for personnel and convales- cents. There was a mile of linear corridor space in the hospital, so constructed as to eliminate the necessity for steps up or down into any building.“ The administration building (B) soon proved to be too small at most places, mainly because administrative requirements had increased and extra administrative staffs had been instituted for training for other base and evacuation hospitals.1* It was also found more advantageous to have the dispensary located in the receiving building. This was done in later con- struction work, thereby necessitating an increase in floor space.’ The labor- CONSTRUCTION AND IMPROVEMENT. 105 atory and X-ray building (F) soon became inadequate in size at all the large camps;'® and it was enlarged to make possible the growing scope of work, not only in connection with the hospital, but with that in the nature of public health control in the military communities.'* Fic. 58.—Inclosed corridor, connecting buildings- The surgical pavilion (G) was enlarged at all the large camps.” The necessity for this was occasioned largely by the acceptance of men for service who had disabilities considered removable by surgical procedures. Fig. 59,—Typical one-story ward of temporary construction. The refrigerating area and the mess hall were enlarged in the larger hos- pitals; and the diet kitchen, in newer designs, was placed nearer the passage, to be of easier access to food conveyances.” The single ward (K-1) and the double ward (L-1) were the wards which cared for the great majority of the sick. The former predominated in number 106 MILITARY HOSPITALS IN THE UNITED STATES. and size. Little change was made in these wards during the war except to increase the number of quiet rooms, to provide more doors giving access to the porch, and to bring the utility room nearer to the ward proper.” The con- Fic. 60.—Portion of the isolation section of a base hospital. struction of the double ward (L-1), with common toilet and interior connection, provided because of economy in plumbing at all the camp base hospitals, was discontinued, due to the many objections incident to a detached common Z, Fic. 61.—Portion of the psychiatric ward. toilet area not under close observation. The isolation ward (M) was commonly used at the first camps. It was changed in later construction to provide smaller and a greater number of isolation rooms and to allow varied, and greater CONSTRUCTION AND IMPROVEMENT. 107 separation of, food and utensil service.” Little, if any, change was made in the original plan for the psychiatric ward (R-2). The two-story ward barrack building was developed and used in the enlarge- ment of the hospitals of the National Army early in 1918.** The interior arrangement provided four wards, two on each floor, each with a toilet room and two small rooms. On each floor, in the center of the building and between the wards, was a common day room. The plan was to have these ward barracks located as near to the hospital group as possible, to enhance their availability and to reduce the distance between them and the central mess and kitchen.” At some hospitals, however, the mistaken impression was gained that these buildings were to constitute a separate convalescent hospital and that a sepa- rate mess and kitchen would be built for the group.”* As a result, at some cantonments, they were located at a distance from the hospital proper and laid out as a separate colony rather than as an integral part of the hospital.” Fiq. 62.—Exterior ofa typical ward barrack. In addition to the provision of hospitals the appropriation for construc- tion and repair of hospitals provided certain buildings in the camp proper.” A regimental infirmary was built for each regiment in every cantonment.” The purpose of the regimental infirmary was to afford housing for the Medical Department enlisted personnel of the regiment and space for offices, for physi- éal examinations, for out-patient treatment, and a dispensary. It was not intended that sick be given hospital care here. However, in the early period of the camps, when the hospital facilities were not quite sufficient to cope with the large number of sick from the raw troops in training,'® these infirmaries, in addition to being used as it was originally intended they should be, were also extensively used at the cantonments for the hospital care of the sick. One dental infirmary was built for each National Army cantonment and was located centrally in the camp area.*t In towns or cities adjacent to the can- tonments, ar at the cantonments, early treatment stations were provided for the administration of venereal prophylactic treatment. The stations varied in number, and were either constructed or, as was usually the case, provided in 108 MILITARY HOSPITALS IN THE UNITED STATES. existent buildings. In the early period of the camps, when the hospital facilities were not quite sufficient to cope with the large number of sick from the raw troops in training,’® these infirmaries, in addition to serving the num- WORK TABLE LABORATORY Baars f sey) ae F]se-7> TINE Ry MAS Rey, fees 5 E Het s@le vs i s7@* 5 SounT ER = cS, 3 lll" « Ou Mt z z ee \ DISPENSAR® ROOM HALL fon : FIRST FLOOR PLAN FIRST FLOOR PLAN NOTE, DORMITORIES FOR PERSONNEL a ARE IN ANOTHER BUILDING. REGIMENTAL INFIRMARY (32 4tu) CAMP DENTAL INFIRMARY ((roee Grice vcan 23) Fig 63. ; bers for which they were built, were extensively used at the cantonments for the sick requiring treatment.” HOSPITALS AT NATIONAL GUARD CAMPS. HOSPITALS NOT INCLUDED IN PRELIMINARY PLANS. On May 29, 1917, when the Chief of Staff directed that the National Army cantonments be built, he stated that the National Guard housing would be made the subject of a subsequent communication. On July 13, 1917, in- structions were issued to the Quartermaster General to proceed with the con- struction of 16 camps for the National Guard, 6 to be ready for occupancy August 1, 6 August 15, and the remainder September 1.*4 No early provision was made for the construction of hospitals at the National Guard camps.** The Surgeon General, therefore, requested The Adjutant General, on June 28, 1917, to reserve adequate tentage for tent hospitals for the National Guard camps.® Because of the fact that no tentage was available in the Quartermaster Department,®* it was directed that the tentage stored in the field medical supply depots be used.*” This Medical Department tentage was a part of the equipment of sanitary units, namely, department hospitals, field hospitals, etc., equipment which had been slowly acquired after years of planning and effort and which would soon be needed in actual service at the front.** The tentage referred to was insufficient for the 16 National Guard camps,** and for this reason, as well as the disinclination to divert its use, reconsideration of the instructions was urgently requested and further representation was made by the Surgeon General that there be proper provision to shelter the sick at the camps.** A period of inactivity followed, CONSTRUCTION AND IMPROVEMENT. 109 and at the end of a month the Surgeon General stated that the question of adequate hospital provision had been delayed to the point of danger and requested the Chief of Staff to authorize the construction of frame hospitals and infirmaries for the National Guard troops.*® On July 26, 1917, the Sec- retary of War authorized the construction of temporary hospitals for the National Guard.*? Anticipating the probability of this authorization, the Surgeon General, on July 17, 1917, had provided the Quartermaster General with preliminary plans and form letters, for each camp, requesting con- struction.” The War Department authority provided for the construction of hospital facilities for 3 per cent of the original personnel allotted to each camp.*? The authorized number of hospital beds for each National Guard camp, the average strength of the commands at the camps for the first two months, and the coincident degree of hospital completion, were as follows: Per cent com ne aot oe t cent com- eyes pleted— pest ae ee “months. Giler Camps. pee ely WRF camp opening. Tea. hospital. Sept. 15. | Oct. 15. September.| October. | RETR GEIR lo 36 seonaeespas so npenUn ane oa oaenoceee 500 25 80 | Oct. 14,1917 4, 500 7,500 CUTS co Gb Renee aca SO eRe oge EOE oe eee aeaeaaaas 800 54 99 | Aug. 22,1917 15, 000 31, 000 Pa MO] oa} OB [etc aeee.| atas000 | 228000 ip oa RS 500 10 50 | Jan. 4,1918 a7, 500 611, 000 CHORE: Seo bead acne See cot Bee DEBE cneperee aoe 1,000 52 95 | Sept. 17,1917 38, 500 41, 000 [Stone eco ated See Sane ee aee aba e SEE OceneaD Semen 800 20 75 | Oct. 14,1917 27,000 28, 000 SOUT eee eee ean ctale este oe ok ciaietm = ei oial= = lessfecaimin = n= 500 10 50 | Sept. 1, 1917 5, 000 15, 500 He ripen etre ea Ree ara sth shoes A 500 80 100 | Sept. 15,1917 14,500 22, 500 Min DANG HIE Son SptQg eGo Spee ee ees Sonn aa ceraane 800 95 98 | Sept. 12,1917 5, 500 27, 500 INIQOIGNIBIIE oc be pubes bos See oH aoe Ae g ee aaaeaee 1,000 35 90 | Sept. 27,1917 15, 000 24, 000 BONIS. 0 oc bes sete oC G nnn CROP MBE ee eset 25 95 | Sept. 21,1917 12, 000 23, 500 SINSN/ s-ncisbe Coo Sedo Coe eE Capon Eee eae enone 500 83 100 | Sept. 26, 1917 16, 000 23, 000 SIPQUCHEK, 3 pea Seeeone eaABe Deemer Coe DaHeeneoeeae 800 20 603 |Octews95 1917 16, 000 21, 000 WEGEM TOM ss «sone gebcoduedce UesEOBpEaEEUsEoceaE 1,000 77 90 | Oct. 8,1917 22, 500 31, 000 RVG] OTe rene eaten ene Ba eho \iotoGinic sine