UC-NHLh B ^ bn 3b3 GIFT or mr .H.L.i^euDo t » » .» •» » SANITARY TROOPS IN FOREIGN ARMIES PREPARED BY THE WAR COLLEGE DIVISION, GENERAL STAFF CORPS AS A SUPPLEMENT TO THE STATEMENT OF A PROPER MILITARY POLICY FOR THE UNITED STATES WCD 9319-1 'N ARMY WAR COLLEGE ; WASHINGTON NOVEMBER, 1915 533 WASHINGTON GOVERNMENT PRINTING OFPIOE 1916 • ••,•• • v.\- •/• :«it : •:: : '.\ • • • • •••• •*•' BIOLOGY LIBRARY War Department. Document No. 533. OSi(x of the Chief of Staff. SYNOPSIS. Introduction. Page. Duties of sanitary troops 7 General scheme of distribution 7 (a) The zone of advance 7 (6) The zone of the lines of communication ' 7 (c) The zone of the interior or home territory 7 Utilization of reserve forces 9 Organization and administration adopted by leading powers. 10 I. England. Peace establishment 10 Regular Army 10 Territorial force (military service) 10 Indian force 10 Colonial forces 10 Organization of the medical services 11 Royal Army Medical Corps 11 Distribution of personnel (Royal Army Medical Corps) 11 The Indian Medical Service 11 Territorial force (medical corps) 12 Distribution of personnel (territorial force) 12 Royal Army Reserve Corps 12 War organization 12 Service with combatant units 13 Mobile medical units 13 Motor workshop section 14 Lines of communication 14 Casualty clearing stations 14 Sanitary section 14 Stationary hospitals and base hospitals 15 Hospital trains 15 Hospital ships 15 Home territory 15 II. France. Peace establishment 15 Organization of the medical services 16 Service de sante de Tarmie de terre 16 Corps de sante rnilitaire (commissioned medical officers and pharmacists) .... 16 Officers d 'administration 17 Section d'infirmiere (hospital corps) 17 Sanitary soldiers belonging to combatant units 17 Administration and distribution of personnel 18 533 (3) i? ^ ^ o rt. A II. France — Continued. Page. The colonial medical service 18 Enlisted personnel 19 War organization 19 Eegimental service 19 Mobile field units 19 Ambulance sections 20 Sections DTiospitalization 20 Divisional bearer companies 20 Cavalry ambulances. . - 20 Corps bearer companies 20 Lines of communication 21 Evacuation hospitals 21 Auxiliary convoys. 21 Motor ambulance sections 21 Reserve medical personnel 21 Hospital trains 22 Zone of the interior 22 III Germany. Military service 22 The standing army 23 Greneral organization of the medical service 23 The sanitats korps 23 The sanitats offizier korps 23 The sanitats offizier diensttuer 23 The stanitats mannschat 24 The militar krankenwarter 24 The krankentrager 24 Apothecaries and quartermasters 25 Administration and distribution of personnel 25 "War organization 26 Medical personnel with combatant organizations 26 Sanitats bataillon 26 Field hospitals 27 Lines of communication 27 Hospital trains 29 Home territory 29 IV. Austria-Hungary. Military service 29 Organization of the medical service 30 The militar arzliches offizers' korp *. 30 The sanitats truppe 30 Sanitats hilfspersonal bei den truppen 31 Medical assistants 31 Litter bearers 32 Carriers of equipment 32 Pharmacists and supply officials 32 Nursing sisters 32 Administration and distribution of personnel 32 Regimental hospitals 33 Garrison hospitals 33 588 IV. Austria-Hungary — Continued. Page. War organization 33 Medical service in the zone of advance 34 Regimental medical service 34 The divisional medical unit 35 Other medical units 35 Field Hospitals 35 Lines of communication 36 Mobile reserve hospitals 36 Field depots for slightly sick 36 Rest stations 36 Field medical supply depot 36 Hospital trains 36 Mobile laboratories 37 Surgical detachments 37 Zone of the interior 37 V. Italy. Peace establishment 37 General organization of the medical service 38 Ufficiali medici di corps sanitario (oflicers of the medical corps) 38 Pharmacists : 39 Administration officers 39 Enlisted personnel 39 Nursing sisters 40 General distribution of personnel 40 War organization 41 Medical service with combatant units 42 Medical field units 42 Ambulance companies 42 Field hospitals 43 Lines of communication 43 Home territory , 43 VI. Russia. Peace establishment. 44 Organization of the medical service 45 Administration and distribution of personnel 46 Feldshers 47 Nadzirateli 47 War organization 48 Medical service with combatant units 48 Mobile medical units 48 The divisional lazaret 49 Field hospitals 49 Lines of communication — Transport column 49 Hospital trains 50 Sanitary detachments 50 Evacuation hospitals 50 Home territory 50 633 6 VII. Japan. Pagre. Peace establishment 51 Gueneki (the active army) 51 Yobi (first reserve) 51 Kobi (second reserve) 51 Hoju (replacement troops, reserve of recruitment) 51 Kakurnin, first part (the national army, first part) 51 Kaknrnin, second part (the national army, second part) 51 Organization of the medical department 51 Commissioned officers 51 Reserve medical officers 52 Pharmacists 52 Enlisted personnel 52 Administration and distribution of personnel 53 War organization 53 Divisional medical service 54 Medical service with combatant units 54 Enlisted personnel 54 Field medical units 54 Bearer battalions 55 Field hospitals 55 Lines of communication 55 Reserve medical personnel 55 Sick and wounded transport detachments : 56 Base hospitals 56 Home territory 56 Summary. The percentage of medical officers in permanent peace establishments 57 The percentage of medical personnel for duty directly with troops as taken from tables of organization 57 SANITARY TROOPS IN FOREIGN ARMIES, INTRODUCTION. DUTIES OF SANITARY TROOPS. A study of the sanitary troops in foreign armies shows that all the great powers have adopted practically the same principles govern- ing the employment of these troops. The organization and distribu- tion of the various units is to some extent governed by the military conditions affecting the various countries, but it is generally recog- nized that the duties of sanitary troops are (a) the care and treat- ment of sick and wounded; (b) their prompt removal out of the zone of combat; (c) the maintenance of the health of troops by the insti- gation of proper sanitary measures; (d) the maintenance of an adequate supply of medical and surgical materiel; (e) the prepara- tion and preservation of records of sick and wounded. GENERAL SCHEME OF DISTRIBUTION. For the proper performance of these duties all countries make a more or less uniform distribution of their medical personnel in (a) the zone of advance; (h) the zone of the lines of communication; {c) the zone of the interior or home territory. The general scheme of medical service in the zone of advance is to provide a medical detachment for each regiment or similar unit to render service directly to that unit, and to provide mobile medical units for service with divisions, corps, and field armies. The service on lines of communication is organized so as to provide *neans for (a) evacuation of sick and wounded; (h) the replenish- iQg of supplies expended at the front by the mobile field units; (c) the transportation of wounded to those points where definite and complete care and treatment can be given them; (d) the care of such wounded during transportation. In the present war extensive use has been made of motor transport to convey wounded from the dressing stations to the rail head, and of hospital trains and hospital ships to convey them to the zone of the interior or home territory. Qearmg stations or evacuation hospitals (7) 688 8 have been established at the advanced bases for the temporary care of patients until they could be transferred to hospital trains, and large semipermanent hospitals established at the base of the lines of communimation for the treatment of all wounded until permanent disposition could be made of them. Because of the limited territory in each country, the greater part of the wounded have been returned to home territory as quickly as possible. The number necessarily retained on lines of communica- tion, however, has been large. The English Army, after the first six months of war, had established at Boulogne-Sur-Mer, their port of embarkation, 22 hospitals, where an average of some 11.000 pa- tients were daily under treatment. For bringing patients to these hospitals they were employing 12 hospital trains, with an average capacity of 400 patients each. And for transporting to England such patients as it was necessary to invalid home there was a fleet of 14 hospital ships, with an average capacity of 500 patients. The French Government has maintained on its railways 90 hos- pital trains, with a carrying capacity of 36,000 patients, and recently recommendations have been made to increase this capacity to 100,000 patients. In accordance with these recommendations 250 hospital trains have now been provided. In the zone of the interior provision is made for the final disposi- tion of all sick and wounded and the preparation and shipment of all necessary sanitary material. The extent of preparation necessary in this zone can be realized when the extent of casualties is considered. The following shows the number of wounded reported in the present war up to July 1, 1915: France, 700,000; Great Britain, 229,000; Russia, 1,982,000; Germany, 852,000; Austria-Hungary, 711,000; Bel- gium, 160,000; Serbia, 112,600; Turkey, 40,000; Japan, 910; total, 4,837,510 in one year of war. Of these wounded at least 60 per cent, or approximately 3,000,000 were sent to the hospitals in home terri- tory. Recent reports from France show that she is now maintaining 5,000 territorial hospitals, with a total capacity of 600,000 beds. For the performance of their medical service, both in peace and war, all armies have maintained a permanent medical personnel, both commissioned and enlisted. In no army, however, has this perma- nent personnel been sufficient to perform all the duties required of it in the present war. A study of the war tables of foreign armies shows that an average proportion of 4 officers and 52 enlisted men of the sanitary forces per thousand of total strength are prescribed for duty directly with troops in the zone of advance. The proportion for duty in the other two zones is not prescribed definitely, but a general outline is given of the personnel required for each of the several units. Experience has shown, however, that a slightly smaller proportion is required 533 for duty on lines of communications than for duty in the zone of advance and a much greater proportion for duty in the zone of the interior. UTILIZATION OF RESERVE FORCES. All countries have therefore been obliged to utilize in large measure medical assistance from sources outside of the army. In countries having universal military service nearly every medical man has had a certain amount of military training, and there is, in consequence, a large force of partially trained medical officers available both in the reserves and in volunteer aid societies. In 1913 Germany had 34,136, France 20,809, and Austria 13,734 men so available. These men have been utilized largely on service in hospitals and with units on lines of communication and the zone of the interior and, while there has been some shortage of men for medical service in those countries, practically the whole medical profession was able to render satis- factorily some service. In England, however, where no appreciable number of reserves were available, the shortage in medical personnel has been keenly felt. Urgent appeals have been made to the entire medical profession in the United Kingdom to give some part of their time to service with the army. A statement by the war office, September 4, 1915, was to the effect that there were at that time in army medical service 5,265 officers, and that there were residing in England, Wales, and Ireland 6,555 medical men of military age not then engaged in war service : and that of these latter one-third were immediately required. Owing to her inability to secure from her own population a suffi- cient number of medical m«jn for army service, England has been compelled to draw men from Canada, Australia, and New Zealand and to make request of various medical colleges in this country to send over as many doctors as could be induced to accept commissions. By utilizing to the utmost all available medical material she has been able to secure, approximately, 8,000 men for service as medical officers. Of this number, however, only 1,100 are men trained in medico-military duties. Because of the great similarity between our military service and that of England this shortage of trained medical officers and the difficulty being experienced in getting even untrained medical officers should be instructive to us. In all countries considerable reliance has been placed in volunteer aid societies to supplement the permanent personnel. In Austria- Hungary particularly the war plans contemplated association of the Red Cross Society with the medical service even in the zone of ad- vance. The assistance rendered by these societies has been of con- siderable value in establishments on lines of communication and the >'— No. 533—16 2 10 zone of the interior in positions not requiring military training; but they have not been of much value in actual field service nor in administrative positions. For these latter men thoroughly trained in medico-military matters have been found essential. ORGANIZATION AND ADMINISTRATION ADOPTED Br LEADING POWERS. The organization, administration, and distribution of sanitary personnel adopted by the leading powers both in peace and in war are shown in the following pages. I. ENGLAND. PEACE ESTABLISHMENT. The military services in England comprise (a) the regular army; (b) the territorial forces; (c) the Indian force; (d) militia forces in various colonies. REGULAR ARMY. The Regular Army is organized into an expeditionary force, serv- ing in the British Isles, and a colonial force, serving in the various colonies and India. The peace strength of this army is : • British Isles 134, 339 Colonies (other than India) 45,215 India 75,884 Total- 255, 438 TERRITORIAL FORCE. The Territorial Force corresponds to our militia and is organized into divisions in the same proportion of arms but in smaller num- bers than the regular army. It has a strength on paper of 315,408, but probably the actual strength does not exceed 250,000 men. INDIAN FORCE. The Indian Force is composed of native troops with English offi- cers. It is a distinct service from that part of the regular army which also serves in India. It has a strength of approximately 162,000 men. CX)L0NIAL FORCES. All colonies maintain bodies of native troops, officered by English- men. Canada, Australia, and New Zealand maintain considerable bodies of militia. Their organization is similar to that of the reg- ular army. 683 u ORGANIZATION OF THE MEDICAL SERVICES. The medical personnel for the various forces is organized along the same general lines, but there is a distinct medical force for each of the distinct combatant forces. These various medical forces are (a) the Eoyal Army Medical Corps; (h) the Indian Medical Service; (c) the Medical Corps of the Territorial Forces; (d) the Royal Army Medical Reserve Corps. ROYAL ARMY MEDICAL CORPS. This corps comprises both a commissioned and enlisted personnel. At the head of this corps is the Director General of Medical Serv- ices, with rank of lieutenant general. The other officers are 11 major generals, 29 colonels, 130 lieutenant colonels, 331 majors, 418 cap- tains, 128 lieutenants, and 42 quartermasters; total commissioned, 1,090. In addition to these officers there were on duty before the outbreak of the present war 65 medical officers from the retired list and 182 officers from the reserve corps, making a total in peace of fifty-three one-hundredths of 1 per cent of the total strength of the regular army. The enlisted personnel is composed of warrant officers, staff ser- geants, sergeants, corporals, and privates. It has a total strength of approximately 4,000. DISTRIBUTION OF PERSONNEL. Officers of the corps serve both at home and abroad. The enlisted personnel serves only in the military hospitals at home stations. In India the subordinate duties of the medical department are performed by noncommissioned officers and privates belonging to combatant units who volunteer for and are detailed to medical work. The pay of enlisted men in the Royal Army Medical Corps is slightly higher than for those of similar rank in the line. In addi- tion to their base pay all men below the rank of staff sergeant are also granted "corps pay" (extra duty pay) while on duty. This " corps pay " is further increased by 6d. per day for those men who have taken a course in and been graduated from the " Queen Alex- andria's Nursing Service." THE INDIAN MEDICAL SERVICE. Medical service for the Indian force is provided by a separate corps of British medical officers with native assistants detailed from the line for subordinate duties. The Indian Medical Corps has 4 major generals, 15 colonels, 147 lieutenant colonels, 227 majors, 318 captains, 533 18 and 75 lieutenants; total, 786. Percentage of medical officers to total strength of Indian forces, forty-eight one-hundredths of 1 per cent. TERRITORIAL FORCE. The Medical Corps for the Territorial Force is similar to that of the Eoyal Army Medical Corps. It comprises 14 colonels, 62 lieu- tenant colonels, 140 majors, 836 captains and lieutenants, 80 quarter- masters, and 57 transport officers; total commissioned, 1,189. Pro- portion to total strength forty-seven one-hundredths of 1 per cent. DISTRIBUTION OF PERSONNEL. The Territorial Force is divided into 14 divisions, and the medical service of each division is under the direction of a colonel of the Ter- ritorial Medical Corps. The other medical officers for the division are organized into either field ambulance detachments or general hos- pital detachments. With each division there are 3 field ambulances, with a staff con- sisting of 1 lieutenant colonel in command, 2 majors, 6 captains or lieutenants, 1 quartermaster, and 1 transport officer. In addition to the 42 field ambulances assigned to the infantry divisions there are 14 mounted brigade field ambulances, with a staff of 1 lieutenant colonel in command, 1 major, 4 captains or lieutenants, 1 quartermas- ter, and 1 transport officer. Twenty- three general hospitals are organized and distributed throughout the divisions. Each general hospital is under the com- mand of 1 lieutenant colonel, with 1 captain and 1 quartermaster as assistants. The medical staff consists of 4 lieutenant colonels, 8 majors, and 2 captains or lieutenants. In addition to the general hospitals and field ambulances thus pro- vided for there are two sanitary companies and a corps of special sanitary officers numbering 106. ROYAL ARMY RESERVE CORPS. There is no definite number of officers in this corps. WAR ORGANIZATION. The administrative unit in time of war is the infantry division (19,558 officers and men). The medical service of the division is under the direction of a Principal Medical Officer (colonel), with 1 captain as assistant and 5 enlisted men as clerks and messengers. 688 13 SERVICE WITH COMBATANT UNITS. In time of war each batallion of infantry, regiment of cavalry, brigade of field artillery, etc., has attached to it 1 medical officer. The enlisted personnel for sanitary duty with these units is not derived from the Royal Army Medical Corps, but from the units themselves. In each unit 30 men are specially trained in sanitary duties: 1 noncommissioned officer and 8 privates are detailed to act as sanitary police; 1 noncommissioned officer and 4 privates are detailed to insure purity of the water supply; 16 privates are de- tailed as litter bearers; and 1 lance corporal and 1 private are detailed as orderlies to the medical officer. The latter also drives the cart or pack animal carrying medical supplies with which each unit is equipped. MOBILE MEDICAL UNITS. In general the medical units prescribed in the British field-service regulations for both the zone of advance and lines of communication are fewer in number and more limited in capacity than those pre- scribed by other armies. The only mobile units are the field ambu- lances with the divisions, three of which are assigned to each division. These units are analogous to a combination of ambulance companies and field hospitals in our service. Each field ambulance is under the command of a major. Royal Army Medical Corps, and is made up of a bearer division and a tent division. The capacity of the tent division is 150 patients, and the entire ambulance is capable of being subdivided into three complete sections. The personnel of the bearer division comprises 3 medical officers, 6 noncommissioned officers, and 118 privates. Royal Army Medical Corps. That of the tent division comprises 6 medical officers, 1 warrant officer, 16 noncommissioned officers, and 41 privates. Royal Army Medical Corps. In addition to this personnel from the Royal Army Medical Corps there are 4 sergeants, 2 artificers, and 48 privates of the army service corps attached. Of the medical personnel, 3 officers may be civilian physicians specially employed, and 90 litter bearers may be recruits specially enlisted. The total personnel of each field ambulance is 10 officers and 236 men. Recently a change has been made in the transportation for field ambulances, motor ambulances being largely substituted for horse- drawn vehicles. 533 14 The present allowance of transportation consists of 4 carts, 11 wagons, 3 horse-drawn ambulances and 7 motor ambulances, 14 riding horses and 39 draft animals. MOTOR WORKSHOP SECTION. Attached to the division for service with the field ambulances is one "workshop" (army service corps). The function of this unit is to keep in repair the motor ambulances. Its personnel consists of 1 officer, 12 artificers, and 8 privates, army service corps, and 7 drivers from the transport troops. Its transportation is 3 motor trucks for stores and 1 motor car for personnel. The total sanitary personnel provided for each division in war is— commissioned, 52; enlisted, 1,244. Of the enlisted personnel 656 are drawn from the Royal Army Medical Corps, 506 from line organizations, and 182 from the army service corps. LINES or COMMUNICATION. The fixed establishments in the British service are casualty clear- ing stations, sanitary sections, stationary hospitals, base hospitals, hospital trains and hospital ships, and motor-transport convoys, the latter having been recently introduced. CASUALTY CLEARING STATIONS. These stations are located at the head of the lines of communica- tion, and are simply temporary stopping places for wounded until they can be evacuated farther to the rear by hospital trains. No beds or other conveniences are provided, as patients are usually passed through these stations in 24 hours. Their personnel com- prises 7 medical officers (4 of whom may be civilian physicians specially engaged), 1 quartermaster, 1 warrant officer, 8 noncommis- sioned officers, and 69 privates, royal army medical corps. (Of the latter 20 may be specially enlisted.) Recently motor-ambulance convoys have been organized and used very successfully in bringing the wounded from the dressing sta- tions to the clearing stations. These convoys have a varying number of ambulances and each ambulance has a driver and orderly from the royal army medical corps. SANITARY SECTION. A sanitary section includes 1 medical officer, 2 noncommissioned officers, and 25 privates, royal army medical corps. Transporta- tion for this unit is provided from the advanced mechanical trans- port depot, and consists of 1 motor truck with 2 drivers. Its duties are confined exclusively to sanitary work. 633 15 STATIONARY HOSPITALS AND BASE HOSPITALS. These hospitals are arranged at the base section of the line of communications. At present 22 of these hospitals are established at Boulogne-sur-Mer. Stationary hospitals have a capacity of 200 beds and a staff of 8 officers and 86 men, Royal Army Medical Corps. General hospitals have a capacity of 500 beds and a staff of 21 officers and 143 men of the Royal Army Medical Corps, supplemented by 43 nursing sisters. HOSPITAL TRAINS. As in other armies in the present war, the hospital train is largely utilized in the English service. A number of these trains have been provided, with an average carrying capacity of 396 cases. The med- ical personnel consists of 2 officers and 45 men, and their equipment includes operating cars, kitchen cars, and every convenience to make them practically rolling hospitals. HOSPITAL SHIPS. Because of the necessity of sea transport to return wounded to home territory, England has equipped a number of hospital ships. Details as to the personnel and equipment of these ships are not available. HOME TERRITORY. The large military hospital at Netley has been greatly increased in capacity and is the main military hospital in England. Every other available military and civil hospital has been utilized, how- ever, and new pavilion hospitals constructed. Recent reports from the Dardanelles campaign show 112,000 wounded and 78,000 sick in that campaign alone. These men nearly all returned to England. An idea as to the amount of hospital capacity required in home territory may be gained from these figures. As mentioned in the preface of this study, England has made every effort to utilize her entire medical population and has even sought medical assistance abroad. II. FRANCE. PEACE ESTABLISHMENT. The military service in P'rance are — (a) the Metropolitan Army; (h) the Colonial Forces; (c) the Territorial Army. Service in the Metropolitan Army is compulsory. That in the Colonial Forces by voluntary enlistment. All males between the ages of 18 and 45 are liable to military service. This service is divided 533 16 into (a) that with the colors (3 years) ; (5) that in the Metropolitan Army Reserve (10 years) ; (c) that in the Territorial Army (5 years) ; and that (final service) in the Territorial Army Reserve (9 years). The Metropolitan Army is organized into the Army of the In- terior, comprising 19 army corps (472,946 officers and men), and the Algerian-Tunisian Army, comprising four infantry divisions (68,620 officers and men). The colonial forces (49,500 officers and men) are partly French and partly native troops. The portion serving in France forms a colonial army corps of three divisions of infantry and one brigade of artillery. ORGANIZATION OF THE MEDICAL SERVICES, The Metropolican Army and the Colonial Forces have separate medical services. That for the Metropolitan Army is the " Service de sante de I'armie de terre" (army medical service). That for the Colonial Forces is the " Service de sante "des troops coloniales " (colo- nial military medical service). SERVICE DE SANTE DE l'aRMIE DE TERRE. This service comprises — (a) the Corps de Sante Militaire; (h) Offi- ciers d'administration ; ((?)- Sections d'infirmieres. CORPS DE SANTE MILITAIRE. (Commissioned medical officers and pharmacists.) The titles, rank, and number of medical officers and pharmacists in this corps are: MEDICAL OFFICERS. Title. Rank. Number. M^decin inspecteur gdn^ral Mddecin inspecteur M^decin principal de premiere classe. . . M6docin principal de den xiftme classe. . M6decin major de premi&re classe M^.dccin major de deuxifeme classe M6decin aide-major de premiere classe.. M6decin aide-major de deuxi^me classe. Total. liieutenant general. Major general Colonel I>ieutenant colonel . Major Captain Lieutenant Second lieutenant . . 5 20 60 95 370 580 670 1.710 PHARMACISTS. Pharmacien, Pharmacien, Pharmacien, Pharmacien, Pharmacien, Pharmacien, Pharmacien, Total.. mspecteur principal , premiere classe . . . principal, deuxi&me classe. . major, premiftre classe major, cieuxifeme classe aide-majcr, premiere classe. . aide-major, deuxi^me classe. Major general , Colonel , Lieutenant colonel Major Captain Lieutenant Second lieutenant 4 5 30 45 20 10 115 533 17 OFFICIERS d'aDMINISTRATION. These officers form one of the four sections into which the French Quartermaster Corps is divided. Their service is, however, exclu- sively with the Medical Department, and they are under the com- mand of the senior medical officer of the command with which they are stationed. In addition to administrative duties in the matter of supply, etc., they act as company officers for the sections d'in- firmieres. Their titles, rank, and numbers are: Title. Rank. Number. Officier d'adminlstration, prmcipal Major 18 OflBcier d'administration, premiere classe CaptaiTi 175 Officier d'administration, deuxifeme classe Lieutenant } 157 Officier d'administration, troisi^me classe Second lieutenant Total 350 SECTION d'iNFIRMIERE (hOSPITAL CORPS). The army hospital corps is organized into 25 sections under regu- lations as regards discipline and interior economy similar to infantry units. One section is usually assigned to each corps. The strength of each of these sections varies according to requirements and is fixed by the minister of war. They vary in peace from 60 to 800 men. Recruits are received direct into these sections, or men may be transferred from combatant units. After a period of preliminary drill and instruction they are distributed to the various hospitals in the army corps to which their section is attached for duty as hos- pital attendants. SANITARY SOLDIERS BELONGING TO COMBATANT UNITS. In addition to the soldiers of the sections d'infirmieres whose services are confined to military hospitals, there are three classes of men belonging to combatant units, but performing medical service under the medical officers attached to those units. These sanitary soldiers are (a) soldat infirmieres (hospital attendants), (h) soldat brancardiers (litter bearers), (c) brancardiers d'ambulance (litter bearers obtained from bandsmen, mechanics, and others), (d) mede- cine auxiliares (doctors or medical students in second year of serv- ice; these men hold warrant rank). In peace two men (soldat infirmieres) are detailed from each battalion of infantry, artillery, or engineers, and four from each 30669°— No. 533—16 -3 18 regiment of cavalry or artillery for service under the medical officers attached to the organization. Their duties are assisting in caring for the sick of the organization who do not require extensive hospital treatment. Four men in each company of infantry or engineers and in each battery of field or foot artillery are designated soldat brancardieres and are trained while serving with their organization in the work of litter bearers. Their services are not utilized as litter bearers in time of peace (except during maneuvers), but upon mobilization they take up these duties. Any bandsmen, mechanics, etc., in excess of the number required as litter bearers for the regimental units are also trained in duties of litter bearers. They are designated brancardiers d'ambulance, and on mobilization they, together with reservists and unattached men from the sections d'infirmieres militaire, form the litter squads for bearer companies. ADMINISTRATION AND DISTRIBUTION OF PERSONNEIi, Each corps or district has a Principal Medical Officer with rank of major general (or colonel), with one major (corps de sante) and two officiers d'administration as assistants. The duties of these officer's comprise not only the general administration and inspection of the medical service of the standing army, but that of the reserves and territorial army also. A large proportion of the junior medical officers are assigned to regiments and smaller units for service directly with those units. Other medical officers are distributed to the large military hos- pitals and to duty with civil hospitals in which army patients are treated. THE COLONIAL. MEDICAL SERVICE. This service is similar in organization to that for the Metropolitan Army. The commissioned personnel comprises: MEDICAL OFFICERS. Title. MMecin-inspecteur general M6decin-inspecteur M(5(]ecin-principal premiere cla?se . M^decin-principal deuxi^meclasse . Mddecin-major premifere classe Medecin-major deuxifeme classe Aide-major, preraifere classe Aide-major, deuxi6me classe Total.. 633 Rank. Lieutenant general. Major general Colonel Lieutenant colonel . Major Captain Lieutenant Second lieutenant. . Number. 12 18 88 175 141 436 19 PHARMACISTS. Pharmacien principal, premiere classe . . . , Pharmacien principal, deuxifeme classe... Pharmacien major, premise classe Pharmacien major, deuxi6me classe Pharmacien aide-major, premiere classe . Pharmacien aide-major, deuxi6me classe . Total. Colonel , Lieutenant colonel . . . . Major , Captain Lieutenant Second lieutenant 46 ENLISTED PERSONNEL. The enlisted personnel comprises 1 section d'infirmieres and the personnel supplied by combatant units. Men for the section d'in- firmieres are enlisted in France and sent to the colonies after a period of instruction in the home depots. The regimental medical personnel is native. WAR ORGANIZATION. With the headquarters staff of each field army is a " Medical In- spector General " (lieutenant general) or " Medical Inspector" (major general) with a staff of 1 medical major, 1 supply officer, and 3 cooks. With each corps is a "Medical Inspector" (major general) or " Principal Medical Officer, first class " (colonel) with a staff of 1 lieutenant, medical corps; 1 supply officer and 4 enlisted men, hos- pital corps (including 1 cyclist). With each division headquarters is a "Principal Medical Officer, second class" (lieutenant colonel). His staff consists of 2 privates, hospital corps (1 being a cyclist). REGIMENTAL SERVICE. In time of war this service is increased by the incorporation of reserve officers, regimental hospital attendants, and regimental litter bearers from the reserves. The war personnel consists of 7 medical officers (3 from the reserve), 12 attendants, and 92 litter bearers (40 from the band). MOBILE FIELD UNITS. The field hospitals formerly forming part of the medical service for each corps have recently been abolished, and wounded are now removed directly from the dressing stations to the evacuation hos- pitals at the rail head. The mobile medical units attached to each division are now 4 field ambulance sections, 3 sections d'hospitaliza- tion, and 1 bearer company. Those attached to each corps are 1 cavalry ambulance section and 1 corps bearer company. 533 a? AMBULANCE SECJTIONS. Ambulance sections establish dressing stations. Each section has a personnel of 6 medical officers, 1 pharmacist, 2 supply officers, 2 noncommissioned officers, and 36 privates, hospital corps, and 1 non- commissioned officer and 9 privates, train troops. Three enlisted men are also provided as officers' orderlies. The transportation con- sists of 5 riding horses, 14 draft animals, and 6 wagons (1 for per- sonnel and 6 for supplies). SECTIONS d'hOSPITALIZATION. These sections furnish additional personnel and supplies to ambu- lance sections temporarily immobilized. The personnel of each sec- tion is 1 medical officer, 3 noncommissioned officers, and 1 private, hospital corps, and 1 noncommissioned officer and 3 privates, train troops. The transportation is 1 riding horse, 6 draft animals, and 3 wagons. DIVISIONAL BEARER COMPANIES. These sections work in conjunction with the ambulance sections. The personnel consists of 6 medical ofiicers (4 of whom are warrant officers from the reserve), 2 supply officers, 1 transport officer, 1 chaplain, 6 noncommissioned officers, and 132 privates, hospital corps ; and 4 noncommissioned officers and 58 privates, train troops ; total, 10 officers and 194 enlisted men. Transportation comprises 14 riding horses, 59 draft animals, 11 ambulances, 9 wagons, and 1 rolling kitchen. CAVALRY AMBULANCES. Personnel: 3 medical officers, 1 supply officer, 1 chaplain, 8 pri- vates, hospital corps; 9 privates, train troops; 4 officers' orderlies. Transportation : 5 riding horses, 14 draft animals, 2 carts, and 6 ambulances. CORPS BEARER COMPANIES, These companies are similar to division bearer companies but are larger. Their personnel comprises 9 medical officers (C being war- rant officers from the reserve) , 2 supply officers, 1 transport officer, 1 veterinarian, 4 chaplains, 14 noncommissioned officers, and 205 pri- vates, hospital corps; 5 noncommissioned officers and 73 privates, train troops; and 5 officers' orderlies; total, 17 officers and 298 en- listed men. Transportation consists of 19 riding horses, 79 draft animals, 11 ambulances and 17 wagons, and 1 rolling kitchen. Q38 21 LINES OF COMMUNICATION. The French system of medical service contemplates rapid evacua- tion of wounded from the zone of combat to the zone of the interior. For this reason temporary hospitals (evacuation hospitals) are estab- lished at the head of the lines of communication and wounded evac- uated directly from the front into these hospitals. EVACUATION HOSPITALS. These hospitals are established at the railhead in the proportion of one to each corps. Their personnel comprises 8 medical officers, 2 pharmacists, 2 quartermasters, 12 noncommissioned officers, and 40 privates, hospital corps. Their equipment consists of 200 litters which are used as beds. Medical and surgical supplies and cookery utensils are secured from the medical advanced supply depot. AUXILIARY CONVOYS. When occasion demands all wagons and personnel of the train troops under the commander of the line of communications are, upon request of the principal medical officer, organized into an auxiliary convoy and placed under his direction for use in quickly evacuating the wounded from the field units. These convoys consist of 720 wagons in four sections of 180 wagons each. MOTOR AMBULANCE SECTIONS. Recently motor ambulance sections have been organized in the pro- portion of one to each corps. They are employed in the daily evacua- tion of the sick from the front to the railhead and in talking up sani- tary materiel to replace that expended at the front. These sections are composed of from 18 to 24 motor cars, one of which is a repair car. Recommendation has recently been made that the number of these motor ambulances be increased to 60. The carrying capacity is about 120 patients, 40 recumbent and 80 sitting up. RESERVE MEDICAL PERSONNEL. Detachments of reserve medical personnel for the purpose of estab- lishing improvised hospitals are maintained in the proportion of 4 to each corps. These detachments consist of 1 medical officer phar- macist, 1 quartermaster, 1 warrant medical officer, 5 noncommissioned officers, and 39 privates of the hospital corps. Recent recommenda- tions of a committee appointed to investigate the French medical 633 service include one to the effect that special surgical units similar to the surgical units in the Austrian service be organized in the propor- tion of one to each corps, their duties being to perform the most serious surgical work. HOSPITAL TRAINS. Hospital trains are largely used for carrying patients direct from the zone of advance to the zone of the interior, and in this latter the permanent hospitals are established. Five of these trains were main- tained in time of peace. They were prepared by the railway com- panies who maintain and use them for ordinary traffic. The cars were specially constructed for conversion into hospital cars whenever the order for mobilization is given. The railway companies keep ready all the necessary fittings for the conversion of these cars, while the army medical department keeps ready in its storehouses addi- tional materiel necessary for forming complete rolling hospitals. Two hundred and fifty such hospital trains, with a carrying capacity of 100,000 patients, are at present in use in France. ZONE OF THE INTERIOR. France has in time of peace 40 military hospitals with a capacity of 10,192 patients, and there are many large civil hospitals available for military use. In addition to these, however, France has found it necessary to establish 5,000 territorial hospitals with a total bed capa- city of 600,000 patients. The personnel of all these permanent hos- pitals and for most of the work on lines of communication has been obtained from the reserves and from voluntary aid societies. III. GERMANY. There are two main divisions of the military service in Germany — (a) regular service; (b) service in the "Landsturm." All males between the ages of 17 and 45 are required to perform service in one or the other of these main divisions. Men selected for the regular service serve 7 years with the stand- ing army (3 with the colors and 4 in the reserve) , and are then passed into the " Landwehr," where they continue service until their thirty- ninth year. Service from the thirty-ninth to the forty-fifth year is in the " Landsturm." Men who for any reason are not required to serve in the standing army are placed in the " Ersatz " reserve (special reserve) for 12 years, and then passed to the Landsturm. Men of good education who clothe and feed themselves during their service are known as" Einjahrige Freiwillige " (one-year volunteers), stt 23 and are passed into the reserve of the standing army after one year of service with the colors. The Landsturm is composed of (a) men between the ages of 17 and 20; (h) those between the ages of 39 and 45; (c) men from the Ersatz reserve; and (d) men who are for some reason exempt from regular service. THE STANDING ARMY. The standing army, as organized in peace, consists of 25 army corps and 1 cavalry division, besides special troops, schools, etc. (Total strength, budget, 1912, 644,267 officers and men.) These corps are distributed, 19 in Prussia, 2 in Saxony, 1 in Wurt- temberg, and 3 in Bavaria. Each of these independent kingdoms has its own war office and administers its own army, but, combined, they form the army of the German Empire. GENERAL ORGANIZATION OF THE MEDICAL SERVICE. The Sanitats Korps. — The army medical department is called the Sanitats Korps and is composed of the following elements: (a) " The Sanitats offizier korps " or corps of medical officers (Prussia, Saxony, and Bavaria each have a separate corps of this character) ; {b) the "Sanitats offizier diensttuer"; {c) the "Sanitats mannschaft"; {d) the " Militarkranenwarter " ; {e) " Krankentrager " ; (/) apothecary officials; {g) quartermaster officials ; {h) army nursing sisters. The Sanitats Offizier Korps. — This is a corps of commissioned medical officers. The titles, rank, and number of these officers are : Title. Rank. Number. General stabsarzt Lieutenant general 1 4 General arzt Colonel 25 Lieutenant colonel Major 60 Oberstabsarzt ... .... 494 Stabsarzt Captain 640 Assistenarzt Lieutenant 1,143 Total 2,367 THE SANITATS OFFIZIER DIENSTTUER. This is an auxiliary corps to the corps of permanent medical officers and is a most important element in the German medical service. It is composed of («) medical men who are doing their service with the colors as one-year volunteers and who are appointed to junior positions in the medical corps (Oberarzt or Assistenarzt) and (6) medical students who have practically completed their medical studies and are doing their regular military service. These latter serve with the medical corps as warrant officers (Unterarzte). 638 24 The presence of these men in subordinate positions permits the maintenance of a permanent commissioned medical personnel very much smaller than would otherwise be required and provides a large supply of reserve medical officers for war. THE SANITATS MANN8CHAFT. The Sanitats Mannschaft is recruited entirely from men in the combatant units of all arms who have completed one year of service with their unit. They may be either men who have volunteered for service in the medical corps or men who have been transferred to that corps by command. After being transferred these men are sent for a six months' tour of instruction to the largest garrison hospital in the district where they are serving. While serving at these hos- pitals they are given a graded course of instruction in all the duties of sanitary soldiers. Upon completion of the course each man is examined and if found proficient is returned to his original organi- zation for duty with the medical service thereof. Noncommissioned officers of the Sanitats Mannschaft are not all returned to their units but many continue their service in various military hospitals. The various ranks in the Sanitats Mannschaft are : Sanitats Feld- webel (sergeant major), Sanitats Yize Feldwebel (quartermaster sergeant), Sanitats Sergeant (sergeant), Sanitats Unteroffizier (corporal), Sanitats Gefreiter (lance corporal), Sanitats Soldat (private). THE MILITAR KRANKENWARTER. These men are enlisted directly into the medical corps and perform the whole of their service with the colors as hospital attendants in the larger military hospitals. The number of men in this class is determined by the hospital requirements of each army corps accord- ing to estimates prepared yearly by the principal medical officer thereof. THE KRANKENTRAGER ( LITTER BEARERS ). Litter bearers for the army are not incorporated into the army medical service. Every combatant unit trains a certain number of its personnel in the duties of litter bearers. Each company of infantry, cavalry, foot artillery, and engineers trains annually four men, and each machine-gun battery and field artillery battery trains annually two men in these duties. Upon mobilization men so trained are assigned exclusively to bearer duty with their organizations, and men so trained who have passed into the reserve are, upon mobiliza- tion, assigned to duty with bearer companies in the medical battalion. 533 25 APOTHECARIES AND QUARTERMASTERS, The duties required of apothecaries and quartermasters are per- formed by men belonging to the class known as military officials. They are not commissioned officers, although those in the higher grades have military titles. ADMINISTRATION AND DISTRIBUTION OF PERSONNEL. The general administration of the medical department is under the Director General of Medical Services, with rank of Lieutenant Xreneral and stationed in the war office in Berlin. His personal staff consists of 1 colonel, 3 majors, and 3 captains, medical corps. Directly under him are 4 " General Arzte und Sanitats Inspecteurs," with rank of major general. One of these officers is assigned to duty with each of the four military districts into which the Prussian Army is divided. Their duties are the general inspection of medical and sanitary matters in their districts. Each has one captain, medi- cal corps, as assistant. At each army corps headquarters is a " Korps Arzt," with rank of colonel. He is in charge of all medical matters pertaining not only to the active army but also to the reserve, Landwehr, Landsturm, and voluntary aid societies within his corps. His assistants are 1 captain, 1 apothecary, and 2 clerks, medical corps. Each division has a "Division Arzt," with rank of lieutenant colonel as principal medical officer of the division. Medical officers are distributed in each corps for duty with troops or at garrison hospitals. Forty-five medical officers are on duty as professors and instructors in the army medical school in Berlin. Medical service is provided in regimental infirmaries and garrison hospitals. A garrison hospital is established in all garrisons having a strength of 600 or more men. Each combatant unit has a fixed medical personnel. A major, medical corps, is attached to the staff of each regiment and a captain, medical corps, to each battalion. In addition to the regular officers there are also attached a number of subaltern officers from the Diensttner. In many garrisons a retired medical officer is on duty as garrison surgeon for attendance on officers' families and officials not belonging to combatant units. The enlisted medical personnel comprises one noncommissioned officer and one private of the Sanitatsmannschaft with each company and the litter bearers mentioned above. The junior medical officers for duty with garrison hospitals are derived from those detailed for such service from the regiment to which they are attached. Such details are for a period of one year, '—No. 533—16 1 26 The enlisted personnel for hospitals is derived from members of the Sanitatsmannschaft and from Militar Krankenwarter. WAR ORGANIZATION. The general direction of the medical services in time of war is under a " Chef des Feld — Sanitats wesens," with rank of lieutenant general, who belongs to the staff of the Imperial Headquarters. On the headquarters staff of each field army is the " Armee-arzt" with rank of major general. His personal staff consists of two Ober arzt and one Stabsarzt. On the staff of each army corps commander is a "Korpsarzt" (colonel), with two assistants (one as major and sanitary officer). In addition to the regular medical officers at army corps head- quarters there is one " consulting surgeon " with the rank of colonel, lieutenant colonel, or major. This consulting surgeon is appointed by the Emperor, on the recommendation of the Director General of Medical Services, from amongst civil surgeons of eminence. On the staff of each division commander is the "Division arzt" (lieutenant colonel), with one assistant. The Director of the Medical Services on lines of communication is an important position in the German service. There is one such official to each field army, and he is known as the " Etappenarzt," with rank of colonel. Under his direction are the " Krieglazaretten directoren" (directors of hospitals), one to each corps of which the field army is composed, and a " consulting sanitary officer," appointed from among eminent civilian physicians in the same manner as the consulting surgeon is appointed at corps headquarters. MEDICAL PERSONNEL WITH COMBATANT ORGANIZATIONS. There are 2 medical officers, 4 men from the Sanitatsmannschaft, and 16 litter bearers with each battalion of infantry or similar units. The litter bears, while belonging to the combatant units, are carried on the rolls of their organizations as noncombatants and therefore wear the Red Cross crosses. They are, to all intents and purposes, a part of the medical organization. SANITATS BATAILLON. One " sanitats bataillon " is attached to each corps. This unit is analogous to the sanitary train in our service and comprises 3 bearer companies and 12 field hospitals. It is commanded by a major of the line, with an adjutant and a detachment of enlisted men, also from the line. The commanding officer of the battalion directs its movement and the movement of the xmits of which it is 6S8 27 composed. He does not, however, control the administration of the field hospitals belonging to the battalion ; these being under the direction of the senior medical officer. Similarly, too, a divided authority exists in the bearer companies. These organizations are commanded by line officers and their enlisted personnel is obtained from reserve soldiers of the line, but accompany- ing each bearer company is a dressing-station section composed of eight medical officers who, while nominally attached to the bearer com- panies, are not under the authority of its commander. They are, however, dependent upon him for the enlisted personnel necessary to assist in the work of the dressing station. This divided authority in the German field medical units somewhat impairs their efficiency and has proven a frequent source of friction. The personnel of each bearer company is 4 officers, 36 noncom- missioned officers, and 208 privates from the line ; 4 noncommisioned officers and 28 privates from train troops; and 1 officer, 9 noncom- missioned officers, and 8 privates from the medical corps, composing the bearer company proper; and 8 medical officers composing the dressing-station section. Total, 13 officers, 49 noncommissioned offi- cers, and 244 privates. The transportation consists of 21 riding horses, 26 draft animals, 8 ambulances, and 5 wagons. FIELD HOSPITALS. The general direction of field hospitals is under the Korps Arzt, who controls their disposition by orders issued through the corps commander. Each field hospital has a capacity of 200 patients and is capable of expansion. Its personnel comprises 6 medical officers, 1 apothecary, 2 quartermasters, 11 noncommissioned officers, and 17 privates, medical corps; and 2 noncommissioned officers and 19 privates, train troops. Total, 6 officers, 3 officials, 13 noncommis- sioned officers, and 36 privates. The transportation consists of 9 riding horses, 18 draft animals, 1 ambulance, and 8 wagons. LINES OF COMMUNICATION. The service at the head of a line of communication is slightly dif- ferent from that in other armies. For the care of wounded two dis- tinct units are organized in the proportion of 1 of each to each corps. These units are a " war hospital detachment " and a " wounde dtrans- port detachment." These two units combined perform the work of the evacuation hospitals in our service, but they are more mobile and operate independently. 533 28 The function of the war hospital detachments is to take over from the field hospitals such wounded as can not bear further transporta- tion. In other words, they become immobilized field hospitals. Their personnel consists of 19 medical officers, 1 dentist, 3 apothe- caries, and 6 quartermaster officials, 3 clerks, 3 cooks, 27 noncom- missioned officers, and 36 privates, medical corps ; and 26 privates of train troop. Total, 19 officers, 10 officials, and 95 enlisted men. These units have no authorized equipment, but obtain it from the field hospitals they relieve (which in turn are replenished from the advanced medical-supply depot) or from local resources. The wounded transport detachment also has no fixed equipment, but obtains it as needed from local sources or from the medical- supply depot. Its personnel comprises 7 medical officers, 6 noncom- missioned officers, and 6 privates, medical corps ; and 8 privates from train troops. The duties of these detachments are to establish dressing and re- freshment stations at the railhead or other points where large num- bers of wounded are being brought for disposition. At the dressing or collecting station the wounded are classified, and those able to bear transportation are turned over to the hospital trains. Those not able to bear railroad transportation are sent to the nearest hos- pital. For this latter purpose all available transportation in the vicinity, including army transportation, is utilized by these detach- ments. Both the war hospital detachments and the wounded transport detachments are under the direction of the Etappenarzt and form freely movable units of personnel, which can be utilized to establish hospitals and collecting stations at the most convenient places. Like the other European nations, Germany has largely employed motor ambulances for evacuating wounded from the front. No de- tails of the organization of this service are available. Outside of the zone of advance Germany makes free use of her civilian population and voluntary aid societies. At frequent inter- vals along the line she establishes base hospitals. The command of these hospitals is always given to a regular medical officer of the active or retired list, but the routine hospital work is done by local civil practitioners. If no regular medical officer is available to command such a hos- pital, the control is placed under a " hospital committee " consisting of a line officer and a civil surgeon. A similar arrangement is in effect in the home territory, where each garrison hospital is sup- plemented and used as a "reserve hospital" (general hospital). Eminent physicians and surgeons from civil life are employed in these hospitals. 638 29 HOSPITAL TRAINS. Germany has in service 150 regularly equipped hospital trains. The capacity of these trains is about 250 patients each, and they are complete rolling hospitals with a fixed medical personnel. In addition to these hospital trains she uses ambulance trains consisting of cars returning from the front and temporarily equipped for patients by supplies kept for that purpose at the advanced supply depots. These trains have no fixed personnel, but as a rule are pro- vided with two medical officers, two noncommissioned officers, and 12 attendants for each 100 patients. Ordinary passenger coaches are also utilized for carrying wounded not requiring more elaborate transportation. Medical officers do not accompany these trains, but they supervise the loading and unloading. Attendance en route is furnished by voluntary aid societies. HOME TERRITORY. All garrison hospitals in time of war become " reserve hospitals " (general hospitals) . The capacity of these hospitals is increased by erecting additional buildings and by utilizing other buildings as branch hospitals. Eegular army medical officers are always in com- mand of these hospitals, but civil surgeons are largely utilized for the personnel. As with other European nations the greater part of Germany's wounded are promptly transported to well-equipped hospitals in home territory. IV. AUSTRIA-HUNGARY. The military service of the Austro-Hungarian Empire is divided into — {a) the Landwehr, or national army of Austria; (&) the Honved, or national army of Hungary; (c) the Gemeinsames Heer, or common army of both countries; {d) the Landsturm, or second reserve of Austria and Hungary. All males between the ages of 19 and 42 are liable to military service, and it is decided by lot whether such service will be in a national army or in the common army. Actual service begins at the age of 21 and lasts for 12 years. Men drawing assignment to the common army serve three years with the colors and seven years in the reserve of that army. They then serve an additional two years in the reserve of a national army, and at the expiration of this service pass to the Landsturm, where they are available to call until they reach the age of 45. Men drawing assignment to a national army serve two years with the colors of that army and ten years in its reserve. They then pass to the Landsturm. 533 30 Men not required to keep up the standing armies to required strength are given eight weeks' training and then passed into the Ersatz reserve. All men between the ages of 19 and 21 and those men who have completed service in one or the other of the armies form until their forty-second year the Landsturm or second reserve. The peace strength of the three armies is : Officers and men : Common army 370, 725 Austrian Army 55, 195 Hungarian Army 42, 800 Total 468, 720 ORGANIZATION OF THE MEDICAL SERVICE. The medical service is composed of the following elements: (a) The Militar arzliches Offiziers Korp (medical officers' corps) ; (b) the Sanitats triippe (hospital corps, officers and men) ; (c) the " Sanitats hilf personnel bei den triippen " (men belonging to com- batant units but employed in the medical service with those units) ; (d) medicamenten beamte (medical officials, pharmacists, and supply officers); (e) nursing sisters; (/) voluntary aid personnel. THE MILITAR ARZLICHES OFFICERS' KORP. Each army has a separate corps of commissioned medical officers. The titles, rank, and numbers in these corps are ; Rank. Number. Common Army. Land- wehr. Honved. Total. Generaloberstabsarzt Lieutenant General . . . Major General 1 8 50 75 154 711 229 1 Generalstabsarzt 1 6 15 19 152 10 1 8 10 22 122 15 10 Oberstabsarzt, first klasse. . Colonel 64 Oberstabsarzt, second klasse Lieutenant colonel Major 100 Stabsarzt 195 Regimentsarzt 985 Oberarzt 254 Total 1,228 203 178 1.609 ' THE SANITATS TRUPPE. This corps, while organized as a distinct corps, is in fact a sub- ordinate part of the medical officers' corps, being somewhat similar to the Hospital Corps in our service. The officers are not medical men and have no medical training. They are line officers and are commissioned directly into the corps in the same way that officers 533 31 are commissioned into the combatant branches of the army. They may subsequently exchange with officers of combatant units, and officers of combatant units may exchange with officers of this corps, especially if they are unfit, for medical reasons, for combatant duties. The officers of this corps are in direct command of the detachments of enlisted personnel and have the relative position of company officers. Their duties consist in regulating the discipline and internal economy of the detachment and training its members in military duties. They are, however, under the command of the senior medical officer of the hospital to which they are attached. In other words, the senior medical officer of the hospital commands the whole imit, including all personnel, medical or otherwise, who are on duty with it, and all officers and men who are patients in it; while the sanitats truppe detachment commander commands the detachment only. The enlisted personnel consists of warrant officers, noncommis- sioned officers and privates. They are recruited directly into the corps on the levying of each aimual contingent and are organized into companies or detachments, one for each garrison hospital. There are 27 of these detachments, varying in strength according to the size and importance of the garrison hospital to which assigned. The largest detachment consists of 5 officers and 270 men, and the smallest of 3 officers and 58 men. The total peace strength of the corps is 85 officers and 3,062 men. The duties of these detachments are those of the subordinate personnel of military hospitals, e. g., ward masters, nursing, cooking, and general duties. None of the officers and men of the " sanitats truppe " do duty with combatant units, but in the event of war they are distributed among the field sanitary units. SANITATS HILFSPERSONAL BEI DEN TRUPPEN, This division of the medical service consists of noncommissioned officers and men who belong to combatant units and who wear the uniform of their organizations. They are, however, permanently under the command of medical officers and perform only medical duties. They are of three classes: (a) Medical assistants (Sanitats unter offizieres) ; (h) litter bearers (Blassierten trager) ; (c) carriers, for medical and surgical equipment (Banda gen trager). Medical assistants are noncommissioned officers and number, in peace, 1 per battalion, and, in time of war, 1 per company, or similar unit. They perform the duties of ward masters in regi- mental hospitals. 533 32 Litter hearers (4 to each compajiy) are trained in time of peace as such, and in addition perform all the medical duties which, in garrison hospitals, are performed by men in the sanitats truppe. Carriers of equipment (2 to each battalion or similar unit). — These men have general charge of the regimental medical equipment and carry it when on the march. PHARMACISTS AND SUPPLY OFFICIALS. These men form a special branch of the medical service, both in the common army and the Hungarian Army. They have charge of all the medical and surgical stores in time of peace, and are assisted by a small technical personnel as well as by men of the medical corps. The number of pharmacist officials in time of peace is 108, with relative rank varying from lieutenant colonel to second lieutenant. NURSING SISTERS. There is no corps of female nurses provided in peace, but sisters of the order of St. Vincent de Paul are employed in the larger gar- rison hospitals, while in officers' wards lay nurses may be employed as required. ADMINISTRATION AND DISTRIBUTION OF PERSONNEL. All general administration of the medical service in the common army is performed in the war office in Vienna by the fourteenth division of that office. This division is under the direction of a chief (lieutenant general or major general, medical officers' corps) with 9 medical officers, 1 supply officer, and 1 pharmacist as assistants. In connection with this bureau are two auxiliary bureaus, one under the direction of a colonel of the line, for the administration of the affairs of the " sanitats truppe," and one under the direction of the senior medical officer, for administration of the medical officers' corps. The Landwehr and Honved each have separate administrative officers. That for the landwehr is under the direction of a major gen- eral, medical officers' corps, at Vienna, and that for the Honved is in charge of a similar officer at Budapest. Both, however, are subordi- nate to the kriegs ministerium. Each army corps has an administrative medical officer called the " Sanitats chef." His rank is either that of major general or colonel. (There are no brigadier generals in the Austro-Hungarian Army.) He has permanently one major and several captains as assistants. In each division a lieutenant colonel, usually the commanding officer of the garrison hospital, is appointed to carry on the administrative medical duties within the division. Each Austrian and Hungarian 688 33 territorial command has a colonel or lieutenant colonel as Chief Sur- geon (Sanitats Chef). The remaining officers of the medical officers' corps are distributed among the various garrison hospitals and other establishments or are attached to regiments for regimental medical duties. As a rule junior medical officers serve one or two years in a garrison hospital and then are assigned to regimental duty, where they remain until they reach the rank of major, when they are returned to duty in garrison hospitals in charge of the various departments in those hospitals. There are no specialist sanitary officers as there are in the British and German Armies. All sanitary services are carried out regi- mentally under the supervision of the regimental surgeon. The sick are cared for in regimental infirmaries, regimental hospi- tals, and garrison hospitals. At the regimental infirmary dispensary treatment only is given. Regimental hospitals correspond to post hospitals and their personnel is supplied from the regiment. Garrison hospitals are, in effect, large general hospitals. Their personnel is supplied by the medical officers' corps, and the sanitats truppe. There are 27 of these hospitals for the "common army." The Landwehr possesses no garrison hospitals, but there is one for the Honved in Budapest. Garrison hospitals not only care for the sick but serve as training schools for one-year volunteer medical students and the men of the sanitats truppe. In addition, they maintain a reserve store of medi- cal and surgical supplies and act as mobilization centers for the field medical units. Each garrison hospital is commanded by a medical officer with rank of colonel or lieutenant colonel, with a large staff of medical officers. In addition, there is also 1 supply officer, 1 pay- master, 1 pharmacist, and a detachment of the sanitats truppe. WAR ORGANIZATIONS. The Austro-Hungarian Army in war time is not divided into three forces as in peace, but forms one army composed of all three ele- ments. The administrative unit is the field army, consisting of from two to four corps, and these in turn of usually three divisions. Two of these divisions are drawn from the common army, and the third from the Landwehr or Honved, or from the reserves of the first line. In the field each Headquarters Staff of each field army, corps, division, and independent brigade has attached to it a Chief Medical Officer with one or more assistants. These officers are administrative officers for the medical service of their respective commands and receive their orders and instructions from the general officer com- manding either direct or through his chief of staff. They are em- 533 34 powered to issue orders direct to the medical units of their command ; but orders directing a change of position on the march or in combat must be concurred in by the chief of staff. The Chief Medical Officer of a field army is the "Armee-Chef- Arzt," with rank of major general. He has one regiments-arzt as assistant. There is an administrative medical officer also on the staff of the general commanding the lines of communication. His official title is " Sanitats Chef beim armee etappen-kommands." He has a staff of assistants consisting of 1 regiments-arzt, and 4 delegates, 4 assistant delegates, and 1 clerk from the Red Cross Society. (In the Austro-Hungarian Army, volunteer aid is intimately associated with the army medical service.) Each army corps has a Korps-Chef-Arzt with rank of colonel. He has a regiments-arzt as assistant, and a delegate from the Red Cross Society is also with him in the field. The chief medical officer of the division is the " Di vision- Chef - Arzt" with rank of major. He has no commissioned assistant, but four mounted orderlies are assigned to him for duty. MEDICAL SERVICE IN THE ZONE OF ADVANCE. Medical service in the zone of advance is performed by the regi- mental medical service, the divisional medical unit and such other medical units, e. g., field hospitals, field depots for slightly sick, mobile reserve hospitals, and mobile rest stations, as may be assigned from the line of communications to the various divisions and corps. The service of these latter medical field units differs from the service of similar units in other armies, inasmuch as they are not permanently attached to divisions and corps, but are field army units, and the Armee- Chef -Arzt of the field army determines the time, occasion, and maimer of their being brought up and distributed to the various corps. REGIMENTAL MEDICAL SERVICE. The regimental medical personnel consists of officers of the medi- cal officers' corps and a subordinate personnel consisting of noncom- missioned officers and privates detailed from the regiment itself. The general principle is to attach one medical officer to each bat- talion or similar unit and to have two or more in addition with regimental headquarters. The total personnel for an infantry regi- ment consists of 7 medical officers, 16 medical assistants, 48 litter bearers and 6 pack carriers for medical supplies; total, 7 officers and 70 men. 533 35 THE DIVISIONAL MEDICAL UNIT. One of these units is a part of each division. It is complex in character and has no counterpart in the medical service of other armies. It is intended to combine the functions of reserve medical supply, ambulance transport and the dressing-station service. It takes the place of the divisional sanitary train of our army, except there are no field hospitals and no litter-bearer sections. The personnel of the infantry divisional unit consists of 6 officers of the medical officers' corps, 2 officers and 125 men of the sanitats truppe, and 77 men of the train troops. Its transportation consists of 145 horses and 38 vehicles. Each unit is divided into the follow- ing elements: (a) A supply section, for replenishing supplies ex- pended by regimental detachments; (h) a slightly wounded section, to establish stations for slightly wounded; (c) a dressing-station sec- tion, to establish dressing stations; (d) an ambulance section, con- sisting of 15 ambulances, 4 of which are furnished by the Teutonic Order of Knighthood. 'divisional units for cavalry and for mountain warfare are gener- ally similar to infantry division units, but with less personnel and transportation. OTHER MEDICAL UNITS. In support of the regimental detachments and the divisional med- ical units there are the mobile units belonging to the field army and assigned to divisions and corps as the need may arise. These units are field hospitals, field depots for slightly sick, mobile reserve hos- pitals, and depots of medical supplies. Materiel and units are also provided for field armies by volunteer aid societies and are distrib- uted in a manner peculiar to Austria-Hungary. To nearly every medical unit of the regular army there is attached a supplemental unit furnished by organized volunteer aid. FIELD HOSPITALS. These are army units, but are mobilized in the proportion of three to each division of which the army is composed. Each field hospital has a capacity of 200 bed patients. Its personnel consists of 3 medical officers, 1 chaplain, 1 pharmacist, 1 officer and about 60 men of the hospital corps, and about 40 men of the train troops. It has 17 vehicles, including 1 rolling kitchen. Attached to each field hospital is a wounded transport column of the Eed Cross Society. This column is equipped with five two-horse ambulances and is commanded by a Red Cross Society's delegate. 538 36 LINES OF COMMUNICATION — MOBILE RESERVE HOSPITALS. These hospitals are similar in purpose to the evacuation hospitals of the French and of our own service. They are provided in the proportion of six to each corps, and each accommodates 200 patients, with possible expansion. They are similar in equipment to field hos- pitals, but have no transport assigned them, being required to obtain locally vehicles necessary for transportation of their equipment. Three of these hospitals for each corps are organized on mobilization and the others held in storage in the advance depot until needed. The personnel for these hospitals is obtained from the reserve medical personnel held on lines of communication and is similar to that of field hospitals. FIELD DEPOTS FOR SLIGHTLY SICK. Field depots for slightly sick are provided in the proportion of three to each corps ; one is usually mobilized and two held in storage. The personnel consists of 2 medical officers and 1 officer and 30 men of the army medical corps. They usually take care of about 500 slightly sick and wounded. REST STATIONS, These stations are either mobile or stationary, and are located where required on lines of travel. They are usually under the charge of civilian personnel. FIELD MEDICAL SUPPLY DEPOT. One supply depot is organized for each field army, but it is com- posed of a number of army corps units, each with personnel and materiel enabling it to be attached to an army corps and act as an independent unit. These corps units, in addition to stores for re- plenishing medical materiel expended in the field, contain reserve materiel for three mobile reserve hospitals, two field depots for slightly sick, two mobile rest stations, and materiel for improvising two hospital trains. HOSPITAL TRAINS. Hospital trains are constructed out of ordinary freight trains on mobilization. The personnel of a hospital train is 2 medical officers, 1 pharmacist, and 34 noncommissioned officers and men of the medi- 633 37 cal corps. Six specially built hospital trains were maintained in time of peace by the Knights of the Sovereign Order of Malta. MOBILE LABORATORIES. Twenty complete laboratories, capable of being moved from place to place, have been organized and are in use in the sanitary service on lines of communication. SURGICAL DETACHMENTS. Some 50 " surgical detachments " have been organized to furnish the operating staff of corps hospitals. Each detachment consists of two or three eminent civilian surgeons and four specially trained surgical nurses and is furnished with adequate surgical instruments and supplies. The function of these detachments is to provide a freely movable unit of expert surgeons which may be readily assigned to hospitals on lines of communication or home territory when their services are needed. ZONE or THE INTERIOR. There are no distinctive features of the medical service in this zone. Austria utilizes her material and her medical personnel in the same way as other countries in Europe. V. ITALY. PEACE ESTABLISHMENT. Military service in Italy comprises (a) that in the standing army; (h) that in the mobile militia; and (c) that in the territorial militia. Every adult male between the ages of 20 and 39 years is liable to service in one of these branches. Examinations are made annually of all men reaching military age, and as the result of these examinations men are assigned as follows: {a) A sufficient number of men are assigned to the standing army to maintain it at peace strength. Men so assigned serve two years with the colors and are then placed on furlough for six years. At the end of the furlough period they pass into the mobile militia, or first reserve, where they serve for four years. At the end of this service they pass to the territorial militia, or second reserve, where they remain until their thirty-ninth year. (h) Men physically fit but in excess of the number required to fill the ranks of the standing army are not required to do service with the colors, but are placed immediately upon furlough for eight years, 533 38 at the end of which period they pass to the mobile militia and terri- torial militia in the same way as do men who have served with the colors. (c) Men who are exempt by law for family reasons from serving with the active army are enlisted directly into the territorial militia, where they remain until their thirty-ninth year. (d) Men specially qualified by reason of education and position and who volunteer for service are allowed to serve one year with the colors and are then placed on permanent furlough as underofficers, or reserve officers. From this class a number of medical officers are drawn in time of war. The standing army is divided into 12 army corps, each with a definite territorial area. The total strength of this army (budget 1912) was 252,340. GENERAL ORGANIZATION OF MEDICAL SERVICE. The medical service is composed of the following elements: (a) Officers of the army medical corps; (h) pharmacist officials; (c) ad- ministration and other officers and officials; (d) enlisted men belong- ing to combatant units; (e) enlisted men in the medical corps; (/) nursing sisters. UFFICIALI MEDICI DI CORPS SANITARIO (OFFICERS OF THE MEDICAL CORPS). Officers of the medical corps are divided into two classes: (a) Those on continuous active service (ufficiali medici di carriera) ; (b) those on permanent furlough (ufficiali medici in congedo). The latter are in turn subdivided into four classes : (a) Ufficiali medici di complemento. — These are a kind of special reserve. According to their years of service, they may be on per- manent furlough from the standing army or on the lists of the mobile militia. {h) Ufficiali medici di milizia territorials. — These are medical men who have completed their service in the mobile militia or who have been passed directly into the territorial militia. (c) Auxiliary medical officers. — These are medical officers who have been relieved from the active army but are capable of perform- ing special duties. {d) Reserve medical officers. — These are officers di complemento who have passed the age of 39 years. In these four classes of the ufficiali medici in congedo Italy is able practically to have her whole medical profession enrolled for war service. 638 39 The titles, rank, and number of medical officers in active service are ; Title. Rank. Number. Tenente general^ medico. Maggiare generale medico . Colonells medico Tenente colonells medico. . Maggiare medico Capitano medico Tenente medico Lieutenant general. Major general Colonel. Lieutenant colonel . Major Captain Lieutenant Total. 1 3 26 36 113 314 274 767 PHARMACISTS. Pharmacists are appointed from university graduates in pharmacy. They have relative but not actual rank. The grades and titles of those in permanent service are : Grade and title. Chimico iarmacista inspectore Chimico farmacista directore Farmacista capo di prima classe... Farmacista capo di seconda classe Farmacista di prima classe Farmacista di prima classe Total. Relative rank. Colonel Lieutenant colonel . Major Captain do , Lieutenant Number. 96 In addition to the above permanent personnel there are on duty at all times with the standing army about 30 " Farmacista di comple- mento di 3a classe." Men in this grade (relative rank of second lieutenant) are obtained from students of pharmacy who are doing their period of service with the colors and who have passed an exami- nation entitling them to this grade. After passing into the reserve these men form a large body of men available for pharmacist service in war. ADMINISTRATION OFFICERS. Officers and officials belonging to the services of administration, pay, and accounts are detailed for service in the medical department. Their services are similar to those of administration and supply services in other continental armies. ENLISTED PERSONNEL. The enlisted personnel for the medical service consists of two parts — (a) the regimental medical service (derived from combatant units) ; (b) the hospital medical service (men enlisted directly into the army medical corps). The regimental medical service consists of noncommissioned officers called " medical assistants " and litter bearers recruited from amongst the soldiers of the unit with which they do duty. Medical assistants 633 40 go through a course of two months' instruction in the military hos- pital of the division to which their regiment belongs and are then employed as assistants to the medical officer in the regimental in- firmary. There is one " medical assistant " to each regiment in time of peace, but the number is increased to six in time of war by utilizing men who have passed into the reserve. Each year two men per company of nonmounted units are selected to go through a course of three months' instruction as litter bearers under the medical officer of the unit. They do general duty in the regimental infirmary in peace and, after passing into the reserve, sup- ply, on mobilization, the litter bearers of field medical units in time of war. The hospital medical service is performed by the subordinate ranks of the medical corps. Its personnel consists of warrant offi- cers, noncommissioned officers, and men recruited directly into the corps at the time of the annual levies. The strength of enlisted personnel, medical corps, 1912, was 3,729. These men are organized into 12 companies, one for each army corps. The headquarters of each company is at the military hospital at army corps headquar- ters, detachments being distributed to other hospitals and medical establishments within the command. There is no fixed establish- ment for each company, the establishment depending upon the num- ber of medical units in the army corps. The number is restricted, however, as much of the general work in hospitals is done by men attached to the medical companies from combatant units. These attached men are called " aggregati." They do not remain perma- nently with the companies but are replaced by others from time to time. NURSING SISTERS. There is no recognized service of nursing sisters in the Italian Army, but sisters of the order of St. Vincent de Paul are employed in the larger military hospitals. GENERAL DISTRIBUTION OF PERSONNEL. The technical administration of the medical service is vested in an Inspectorate of Medical Services at the war office in Rome. This body has no administrative power but acts as a consultative or ad- visory medical board. The details of army medical organization as a whole are in the hands of a medical officer attached to the general staff at army headquarters, while the more direct administration and command are vested in the general officers commanding army corps and their principal medical officers. At each corps headquarters there is a Principal Medical Officer (colonel), with one captain and one official of administration as assistants. The remainder of the 41 medical officers are distributed to military hospitals and other estab- lishments and to regiments. The senior medical officer of the larger hospitals is a colonel or lieutenant colonel, and under him there are usually one or two lieutenant colonels, six majors, and seven or eight captains. Pharmacist officials are distributed to the various hospitals, the larger hospitals having usually three. Each regiment in peace has a regimental infirmary under charge of the regimental surgeon and one assistant. The enlisted personnel consists of a "medical assistant" and litter bearers from the regi- ment. Where several regiments together form a small garrison a "gar- rison hospital" is established. These hospitals correspond to the post hospitals at our larger posts. A major, medical corps, is in command, with the medical officers of the regiments as assistants. The enlisted personnel is derived from the regiments and supple- mented by men of the army medical corps. Principal hospitals, corresponding to our general hospitals, are established at each corps headquarters and with one division head- quarters, so that there are two general hospitals to each corps. The personnel for these hospitals is supplied from the medical corps and the " aggregati." A chaplain is appointed to each general hospital. WAR ORGANIZATION. The field army is the grand unit of organization in the Italian service. Each field army is composed of three corps, one division of cavalry and auxiliary troops. At each field army headquarters is a Director of Medical Services (surgeon general). For military pur- poses he belongs to the administrative staff. He has direct military as well as technical command of all medical units in the zone of field operations and lines of communication. As assistants he has 4 captains and 4 lieutenants, medical corps, 4 pharmacists, 2 clerks, 2 orderlies, and 11 servants. He has also a transport detachment of 3 noncommissioned officers and 15 men of the artillery train. He is responsible for keeping the medical service in the advance supplied with personnel and materiel and for the transportation and distri- bution of the sick and wounded. He cooperates for this purpose with the Director of transport and the Director of lines of communication. Each corps has a Principal Medical Officer (colonel) with one assistant (captain), a clerk, orderly, and two servants. He coordi- nates the medical services and directs the movements of the corps medical units. Each division has a Principal Medical Officer, with one lieutenant as assistant, and one enlisted clerk. He is directly under the chief of staff of the division. 033 42 MEDICAL SERVICE WITH COMBATANT UNITS. The medical personnel for each combatant unit is augmented in time of war by officers from the " complement " and men from the reserve. That for an infantry regiment is 7 medical officers (1 cap- tain, 6 lieutenants) and 30 enlisted men from the regiment (6 medi- cal assistants and 24 litter bearers). That for a cavalry regiment consists of 3 medical officers and 2 enlisted " assistants." Smaller imits, such as engineer companies, batteries of artillery, etc., have 1 medical officer and 1 enlisted man. MEDICAL FIELD UNITS. The medical field units consist of ambulance companies, assigned to both divisions and corps; and field hospitals, assigned to corps. There are also reserve field hospitals, assigned to the field armies. AMBULANCE COMPANIES. Ambulance companies establish dressing stations and send out litter squads to evacuate wounded from the combatant units. Their organization is in general the same, with slight modifications to fit them for service with infantry, with cavalry, and with mountain troops. The personnel of an ambulance company for duty with infantry is 6 medical officers, a quartermaster, chaplain, and 228 noncommissioned officers and privates, medical corps, with a trans- port personnel attached from the artillery train of 1 officer and 31 noncommissioned officers and privates. Its transportation consists of 3 carts, 2 wagons, and 8 ambulances. The mountain ambulance company has the same medical per- sonnel, with 1 officer and 60 enlisted men for transport. It has 30 pack mules in addition to the transportation provided for the in- fantry ambulance company. The cavalry ambulance company is a smaller unit, with only 3 medical officers, a quartermaster, chaplain, 32 noncommissioned officers and privates, medical corps, and 13 enlisted men for trans- port. Its transportation consists of 1 cart, 1 wagon, and 4 ambu- lances. Ambulance companies are not organized in peace. Materiel for them is kept in storage at each corps headquarters, and in time of war they are mobilized under the direction of the Principal Medical Officer of the Qorps. Officers are secured from the various classes of officers, and enlisted men for these units are drawn from those avail- able within the corps. One infantry ambulance company is organ- ized for each division, and one reserve infantry ambulance company for each corps. A cavalry ambulance company is assigned to each 633 43 cavalry division, and a mountain ambulance company to each moun- tain force (7 Alpine battalions). FIELD HOSPITALS. Field hospitals are of three kinds : (a) 50-bed hospitals on wheeled transport; (6) 50-bed hospitals on pack transport; (c) 100-bed hos- pitals. Fifty-bed hospitals are army corps units in the proportion of 8 to each corps. One hundred-bed hospitals are field army units. Each field army has 12 hospitals. The personnel of a 50-bed hospital con- sists of 3 medical officers, 1 quartermaster, 1 pharmacist, 1 chaplain, 29 noncommissioned officers and privates, medical corps, and 1 non- commissioned officer and 6 privates for transport personnel. Its transportation consists of 3 wagons. The 50-bed hospitals Avith pack transportation have an additional sergeant and 35 additional privates in the transport section. Its transportaion ife 30 pack mules. The personnel of the field army hospital (100 beds) consists of 6 medical officers, 1 quartermaster, 1 pharmacist, 1 chaplain, 26 enlisted men, medical corps, and 7 enlisted men for transport. Its transportation consists of 4 carts and 1 wagon. LINES OF COMMUNICATION. The medical service on lines of communication is under the direc- tion of the Director of Medical Services for the field army. There is no Principal Medical Officer for lines of communication as in other armies. Aside from the medical supply depots and the field hos- pitals belonging to the field army, there are no fixed medical for- mations, the general scheme being to establish hospitals and rest stations as occasion demands. For the evacuation hospitals or clear- ing stations at the railhead common to other armies, the Italian medi- cal service utilizes the field hospitals held in reserve. There is also no definite transport unit for evacuation of the wounded to the rail- Lead. This work is done by the intendence department as required. Nearly all medical work on lines of communication and in home terri- tory is performed by personnel from the territorial militia and from that furnished by volunteer aid societies. Of these latter, two are officially recognized as part of the Italian Army. They are the Italian Red Cress So2iety and the Military Sovcjreign Order of Malta. These societies, and especially the Red Cross, are organized to supply an appreciable part of the medical personnel and supplies required by war. The Red Cross keeps read}^ and is prepared to furnish 64 mountain ambulance companies, 47 war hospitals, 14 hospital trains, 2 equipments for hospital ships, and 65 rest stations. In addition 533 44 to these units on hand, similar units may be organized in unlimited numbers, and it is upon these units that entire dependence is placed in time of war for service on the line of communication. They all come under the control of the field army Medical Director, but each unit is commanded and operated by Red Cross personnel. HOME TERRITORY. For patients sent to home territory, the military hospitals and con- valescent depots maintained in peace are utilized, and, if necessary, enlarged. Many convalescent patients are also sent to their homes and paid 20 cents daily in lieu of rations. In addition to the regular military hospitals, civil hospitals are placed at the disposal of the military authorities and new hospitals are organized by voluntary aid societies. VI. RUSSIA. PEACE ESTABLISHMENT. All male Russian subjects, with the exception of the Mohammedan native Caucasian population and the population of a few Provinces, are liable to military service from the twenty-first to the forty-fourth year of age. This service is divided into (a) that in the standing army and reserves, and (h) that in the Imperial Militia. At the annual levy the class of service to which a man is assigned is determined by lot. Service in the standing army comprises 3 years with the colors and 15 years in the reserve for the infantry, and 4 years with the colors and 13 years in the reserve for the other arms. The reserve is divided into two classes. Service in the first class is for 7 years,' and that in the second class for the remaining period of reserve serv- ice. Upon completion of service in the reserve men pass to the Im- perial Militia, where they remain until they reach the age of 44. All men not required in the standing army, and men who have completed their service in that army, form the Imperial Militia. Men engaged in certain occupations are exempt from service with the colors in time of peace and may, if they draw a number for the standing army, be passed immediately into the reserve. Medical men are so exempt. Men may also volunteer for service with the colors, in which case they serve for one year and then pass to the reserve. Medical men, pharmacists, and veterinarians who so volunteer, if accepted, are allowed to serve as such. The standing army is divided into 37 corps located in 13 military districts. The total peace strength of this army in 1912 was 1,284,000 officers and men. G88 45 ORGANIZATION OF THE MEDICAL SERVICE. The medical organization for the Russian Army, while following the same general lines, differs materially from those of other armies. From top to bottom there exists a system of dual control, the duties of medical officers being of a purely technical character, while the administrative duties are in the hands of line officers. In her field medical units, too, Russia, while providing a large enlisted personnel, has a commissioned personnel much smaller in proportion than that provided for similar units in other armies. Apparently this system of dual control and divided responsibility, together with an insuffi- cient number of medical officers, has not proved satisfactory. A committee was appointed r.fter the Russo-Japanese War, under the presidency of Gen. Trekov, of the line, who was Director of Hospitals in Kuropatkin's army, to consider questions of improving the medi- cal service, and as a result of the recommendations of that committee, more authority has now been given medical officers in the matter of command, but there is still a great portion of the medical service in which this complicated system exists and the medical field units are still underofficered. Another improvement in the medical service resulting from the recommendations of this committee was the passing of a law in 1913 giving military rank to medical officers. Heretofore they had been merely military officials in various grades, but without actual rank. The actual rank they now hold is the same as that of officers of the line. There are no brigadier generals and no majors in the Russian Army, and hence medical officers are commissioned in the medical corps in the various grades of lieutenant general, major general, colonel, lieutenant colonel, captain, and lieutenant. The law authorizing the giving of commissioned rank is very broad and does not specify any definite numbers for each rank nor for the whole corps. It provides generally that certain positions shall carry with them certain ranks and that medical officers occupy- ing these positions shall be given rank commensurate with the posi- tion irrespective of the number of medical officers holding similar rank. Promotion is entirely by selection and is largely in the hands of the Director General of the army medical department. Appoint- ments of officers to positions carrying with them the higher ranks are made by the Minister of War upon the recommendation of the Director General, but in positions carrying with them lower rank, the Director General has the power to appoint or transfer officers. He also has the authority to retire at will officers occupying such positions. 533 46 ADMINISTRATION AND DISTRIBUTION OF PERSONNEL. The whole of the strictly medical service is under the direction of the Director General of the medical department, which is a bureau of the war department. He has the rank of lieutenant general and is ex officio a member of the chief military sanitary committee of the war office. This committee, besides the Director General of the medical services, consists of the Chief of Staff, Chief of Engineers, and Chief of the Intendance. The committee supervises the entire operation of the medical department. To each military district there is assigned a District Medical In- spector with rank of lieutenant general and an Assistant District Medical Inspector with rank of major general. When troops in the district are mobilized the District Medical Inspector becomes the Principal Medical Officer of the field army formed from the troops in the district and the Assistant District Inspector takes over his duties in the district. On the headquarters staff of each corps, division, or separate brigade there is a Chief Surgeon. The new law provides that one- third of the total number of Corps Surgeons shall have the rank of lieutenant general and two-thirds of those surgeons shall have the rank of major general. It also provides that one-third of the Divi- sion Surgeons shall be major generals and two-thirds colonels. The rank of the Chief Surgeon of a separate brigade is also that of colonel. Fortress troops are distinct from troops of the mobile army, and with each fortress there is also a Chief Surgeon with rank of major general or colonel. With each infantry regiment there is one regimental surgeon, and with each infantry battalion or similar unit there is one junior medi- cal officer. The new law provides that one-third of the senior regi- mental surgeons shall have the rank of colonel and that two-thirds of them shall have the rank of lieutenant colonel. The junior regi- mental medical officers rank as captains or lieutenants. The total number of medical officers of all ranks holding permanent commis- sions in the standing army is 3,758. (Budget, 1913.) The subordinate medical personnel is divided into two main classes : (a) That belonging directly to the medical department and (b) that belonging to combatant units, but doing duty with the medical department. The subordinate personnel belonging directly to the medical de- l>artment comprises (a) feldshers, (h) nad zirateli. 533 47 FELDSHERS. Feldshers are a peculiar element in the medical service. They are, in effect, partially trained medical men who have not received a de- gree in medicine, and correspond practically to the " Practicante " in Spanish countries. They are divided into two classes: (a) Those who have received their medical training before entering the army and (b) those who have been trained in the army. The first are permitted to practice medicine in civil life after com- pleting their army service, but the second are not so permitted. Feldshers of both classes serve as assistants to medical officers in military hospitals and with combatant units. NADZIRATELI. The nadzirateli are men specially trained in nursing and other hospital duties, and serve in both the large general hospitals and regimental hospitals. Those serving in the general hospitals usually rank as noncommissioned officers. In addition to these two classes belonging directly to the medical department, noncommissioned officers and men belonging to the line are detached from combatant units for duty as hospital atendants and litter bearers. Hospital attendants from combatant units are detailed for duty under the medical department in regimental hos- pitals. Litter bearers are not detached from their units, but are classed as combatants. The number of men trained in the duties of litter bearers is sufficient to not only supply the numbers of bearers required by the regiment in war, but also to furnish the cadres for divisional bearer companies. In addition to the enlisted personnel, officials corresponding to our civil-service men are employed for quartermaster duties, clerical duties, etc. Each regiment is provided with a regimental hospital (lazaret) for use of the regimental sick. It is operated by the regimental medical personnel if no permanent hospital is available. If, how- ever, a permanent military hospital is available, the regimental lazaret is not established, but is kept in storage and the regimental sick are treated in the "regimental receiving rooms" (infirmaries), the seriously sick being sent to the permanent hospitals. When regiments are mobilized for field service their lazarets al- ways accompany them and become part of the medical mobile units in the field army. Distributed among the military districts are large permanent hos- pitals, varying in capacity from 150 to 800 beds. At the outbreak 533 48 of the present war there were 27 of these hospitals in Russia, with a total bed capacity of 15,221 beds. The general administration of permanent hospitals is imder the direction of a line officer, and he commands all the personnel of the hospital. The strictly technical service is under the direction of a chief surgeon, with rank of colonel or lieutenant colonel, with a staff consisting of two or more senior medical officers with rank of lieutenant colonel and a number of junior medical officers with rank of captain and lieutenant. The enlisted personnel consists of feldshirs and nadzirateli from the regular medical service. WAR ORGANIZATION. The medical service of field armies is under the direction of either the Adjutant General of the field army or of a " Director of Medical Services," who is a lieutenant general of the line. Assisting him in the general administration of his office is an office director, also a line officer, whose duties are similar to those of a chief of staff. The administration of this office is divided into (a) the field military hos- pital department, (h) the field military medical department, (c) the field veterinary department, and (d) the department of volun- tary aid. At the head of the field military hospital department is the Field Inspector of Hospitals, a combatant officer with rank of lieutenant general. He is in command of all the medical units in the army except for their technical service. This latter is under the direction of the Field Medical Inspector with rank of lieutenant general in the medical corps. The department of voluntary aid has at its head a Commissioner of the Red Cross Society. At each army corps headquarters there is also a line officer in charge of the general police, upon whom rests the responsibility of evacuating the wounded from the field units. For this purpose he arranges the necessary transportation and for additional men to be detached from combatant units when necessary to assist in collecting the wounded. MEDICAL SERVICE WITH COMBATANT UNITS. Each regiment is accompanied by its lazaret, and this forms the basis of the regimental service. Its personnel consists of 5 medical officers (1 lieutenant colonel in command), 21 feldshers, 1 nadziratel of the medical corps, and 128 litter bearers from the line. The transportation consists of 1 wagon, 4 carts, and 4 ambulances. MOBILE MEDICAL UNITS. The mobile medical units assigned to each division are one divi- sional lazaret and two field hospitals. 533 49 THE DIVISIONAL LAZARET, The unit is directly under the command of the Division Surgeon. Under him is one medical officer in charge of the dressing-station section and a line officer in charge of the bearer section and wheeled transportation. The function of the divisional lazaret is to form a main dressing station as a link between the regimental stations and the field hospitals. The personnel of the dressing-station section comprises 4 medical officers, 1 officer of administration, 7 noncommissioned officers and 20 privates (medical corps) , and 2 clerks. The personnel of the bearer section comprises 1 officer of administration, 1 clerk, IT non- commissioned officers and 200 privates from line troops, and 2 non- commissioned officers and 37 drivers from transport troops; total, 6 officers, 3 clerks, 26 noncommissioned officers, and 257 privates. The transportation consists of 8 ambulances, 16 wagons, and 3 carts. FIELD HOSPITALS. Field hospitals are provided in the proportion of eight to each division. Four of these are mobile hospitals and the other four are held in reserve on the line of communications. Of the four mobile hospitals two only are assigned to the divisional sanitary train and the other two are field-army units. Each field hospital has a ca- pacity of 200 beHs. The total number of beds in the eight field hospitals allowed for each division is sufficient to provide for 7.4 per cent of the total strength of the division. This is in addition to the beds in the regimental and divisional lazarets. The personnel of a mobile field hospital comprises 4 medical officers, 1 pharmacist, 1 officer of administration, 1 chaplain, 16 noncommis- sioned officers, and 59 privates (medical corps), and 2 noncommis- sioned officers and 26 drivers, transport troops. In addition to the enlisted personnel, there are 4 clerks and 4 Sisters of Mercy. Total, 7 officers, 18 noncommissioned officers, and 85 privates, and 8 civilians. The transportation consists of 20 wagons, 4 carts, and 1 ambulance. LINES OF COMMUNICATION — TRANSPORT COLUMNS. For evacuating wounded from the front to the railhead, sick and wounded transport columns are organized as definite units in the proportion of 1 to each corps. The movements of these units is controlled by the Director of Medical Services for the field army and each hospital is commanded by an officer of the line. The personnel consists of 2 medical officers, 1 quartermaster, 7 noncommissioned 533 60 officers and 17 privates (medical corps), 3 noncommissioned officers and 68 drivers transport troops, 2 clerks, and 2 Sisters of Mercy. Total, 3 officers, 10 noncommissioned officers, 85 privates, and 4 civil- ians. The transportation consists of 27 ambulances, 7 wagons, 1 cart, and 1 rolling kitchen. HOSPITAL TRAINS. Hospital trains are made up from third-class passenger coaches and have a capacity of 250 patients. They are commanded by line officers and have a medical personnel of 2 officers and 45 attendants. SANITARY DETACHMENTS. Special sanitary detachments are organized in the proportion of 1 to each division and 1 to each corps. They are divided into (a) bacteriological columns and (b) disinfecting columns. They are under the command of the Director of Medical Services and are util- ized where needed for special sanitary work. The personnel of a bacteriological column is 3 medical officers, 3 noncommissioned offi- cers and 6 privates (medical corps), and 5 drivers (transport troops). For transportation it has 5 wagons. The personnel of a disinfection column is 1 medical officer, 3 non- commissioned officers, 6 privates (medical corps), and 4 drivers (transport troops). Transportation, 4 wagons. EVACUATION HOSPITALS. There are no distinct evacuation hospitals or clearing stations at the head of the line of communications in the Russian service, but in each area where field armies are operating an "evacuation com- mission " is appointed, whose duty it is to arrange a classifying sta- tion, where wounded can be collected and their disposition deter- mined, and to arrange rest stations, stationary hospitals, etc., on the line. This commission is a cumbersome body and is composed of a president (general officer), 1 assistant (line officer), 1 medical officer, and a delegate of the Red Cross Society. HOME TERRITORY. The general provisions for final disposition of sick and wounded in home teritory are on similar lines to those of other nations, ex- cept that this disposition is under the direction of commissions simi- lar in character to the commissions for evacuating the wounded on lines of communication. The commissions in home territory arrange hospital accommodations and distribute sick and wounded accord- ingly. 638 51 VII. JAPAN. PEACE ESTABLISHMENT. The military survice is divided into — (a) the active army (Gue- neki) ; (h) first reserve (Yobi) ; (c) second reserve (Kobi) ; (d) re- placement troops (reserve of recruitment) (Hoju) ; (e) the na- tional army, first and second parts (Kakurnin). Service is obligatory on all males between the ages of 17 and 40. The period of service is regulated as follows : Gueneki. — Three years, save for the infantry, where men pass the third year under the status of furlough, and in the train troops, where the service is but six months. Tohi. — Comprising men coming from Gueneki; 4 years and 4 months. Kobi. — Men from Kobi ; 10 years. Hoiu, — Comprising men in excess of the needs of Gueneki; 12 years and 4 months. Kakurnin., -first fart. — Two years and 8 months for men coming from Kobi and 7 years and 8 months for men coming from Hoju. Kakurnin., second fart. — All men between 17 and 40 not comprised in the preceding categories. The active army is divided into 19 divisions and 19 reserve divi- sions. It is contemplated to gradually increase this army to 25 divisions, with a similar number of reserve divisions. Each of these divisions occupies a military district and is com- plete in itself, not only as regards combatant troops, but as regards auxiliary troops, including the medical department. The total peace strength of the active army is 235,500. ORGANIZATION OF THE MEDICAL DEPARTMENT. The medical department, both in peace and war, is organized largely along the lines of the German medical service. COMMISSIONED OFFICERS. The commissioned officers in the medical service consist of medical officers and apothecaries. The titles, ranks, and numbers of medical officers are: Title. Rank. Number. Director general (gun-i-cho) Surgeon general (gun-i-kan) Senior surgeon, first class (itto-gun-i-sei; — Senior surgeon, second class (nito-gun-i-seij . Senior surgeon, third class (santo-gun-i-sei). Surgeon, first class (itto-gun-i) Surgeon, second class (nito-gun-i) Surgeon, third class (santo-gun-i) Lieutenant general. . , Major general Colonel. Lieutenant colonel. . . Major Captain First lieutenant Second lieutenant Total. 538 12.5 473 279 281 1,231 52 BESERVE MEDICAL OFFICERS. In addition to the medical officers on permanent duty with the active army, there are always a large number of reserve medical officers available for service. These reserve medical officers are formed out of several elements. (a) Medical officers retired from active service but who are able to perform certain services. (h) Medical officers who were "one-year volunteers." These are men who, while medical students, were drafted to the colors, and whose service was limited to one year on condition that they enter the reserve as medical officers upon receiving their qualification. (c) Eeserve medical officers maintained by the Red Cross Society. PHARMACISTS. Pharmacists hold commissioned rank and comprise those serving with the active army and those serving in the reserve in the same way as medical officers. With the active army there are chief phar- macists (yaku-zai sei) to the number of 10 and pharmacist officers (yaku-zai kwan) to the number of 112; total in active service, 122. ENLISTED PERSONNEL. The enlisted personnel for medical service is selected from men who have passed the first year of their service in line organizations. These men, in the proportion of two per company, are detailed for medical service with their organization and receive training in their duties from medical officers serving with the organization. After a period of such training they are transferred to the garrison hospital at the headquarters of the division in which they are serving, and are there given a course in hospital training. When their hospital train- ing is completed, they may be returned to their organizations as non- commissioned officers of the medical service or they may continue on duty as ward masters, clerks, etc., in hospitals. Eventually they pass to the reserve as reserves of the army medical service, and wpon mobilization they are utilized to form the various medical field units. The duties of nurses and hospital attendants in military hospitals are not performed by enlisted men. Such duties are performed by men who were not of sufficient physique to be enlisted. They are civil employees and are used largely in time of war in hospitals on lines of communication and in home territory. 633 53 ADMINISTRATION AND DISTRIBUTION OF PERSONNEL, The general administration of the medical department is vested in a Director General, with the rank of lieutenant general, who is the head of the medical bureau of the war department. In matters of general administration, decentralization is the key- note of the Japanese Army, and each division is almost autonomous. It is maintained complete in all its branches in time of peace so that it can be moved in its entirety in time of war and its place im- mediately taken by a reserve division. The medical department is no exception to this general rule. At the headquarters of each division district there is a Chief Medi- cal Officer, with rank of colonel, who is in direct charge of the medical personnel, hospitals, supply depots, etc., within his division. There is also at each division district headquarters a garrison hos- pital to which all of the seriously sick of the division are sent. This hospital is under a Hospital Director, with rank of colonel or lieu- tenant colonel, and a considerable staff of medical officers. Attached to each division hospital is one pharmacist and one officer of the " in- tendance" in charge of supplies other than medical. In time of war these garrison hospitals become the principal hos- pital of the division and all other hospitals, convalescent camps, etc., which are established within the division, become its branches and are under the control of the Hospital Director. No hospitals are maintained by individual regiments. Dispensary treatment is given in those units and all sick requiring hospital treat- ment are sent to the garrison hospital. There is, however, a regi- mental medical service consisting of medical officers belonging to the medical corps and an enlisted personnel belonging to the regiment itself. Japan is the only nation which maintains in peace a commissioned medical personnel with regiments and other combatant units larger than that provided for similar units in war. The regulation allow- ance for medical officers in peace is 10 to each regiment, while in war it is only 6 to each regiment. This unusual provision is made so as to have available medical officers trained in military duties for use in time of war with field medical units. WAR ORGANIZATION. In time of war two or more divisions (usually 3) are mobilized to form field armies. At the head of the medical services of all field armies is a Principal Medical Officer of field forces, with the rank of lieutenant general. His station is with the general staff at headquar- ters in Tokyo. 533 54 Each field army has a Principal Medical Officer, with rank of major general, on the staff of the field army commander, and there is a Principal Medical Officer, with rank of colonel, on the staff of the in- spector general of lines of communication for each field army. Each division has a Principal Medical Officer, with rank of colonel. All Principal Medical Officers, including those of divisions, have two medical officers as assistants and several enlisted men of the medical service as clerks. DIVISIONAIi MEDICAL SERVICE, When a division is mobilized and joins a field army, the whole of its peace staff accompanies it into the field, and their place in the depot division is taken by officers of the reserve or from the retired list. The medical personnel accompanying the division is rearranged and augmented by personnel obtained from the reserve in order to form the field medical units authorized for each division in time of war. MEDICAL SERVICE WITH COMBATANT UNITS. Medical officers on duty with regiments have rank of captain or lieutenant. Each battalion of infantry has two medical officers, and similar units, such as a battery of artillery, have one medical officer. Thus a regiment of infantry (three battalions) has six medical officers; a regiment of artillery (three batteries) has three medical officers; a regiment of cavalry (two squadrons) has two medical officers; etc. ENLISTED PERSONNEL. In each regiment of infantry there is one senior noncommissioned officer and junior noncommissioned officers in the proportion of one to each company. In addition to these men who have been trained in the medical service, four men from each company are detailed as litter bearers. The total enlisted personnel for medical service in a regiment is 15 noncommissioned officers as medical assistants and 48 privates as litter bearers. In the smaller units, such as a battery of artillery, company of engineers, etc., there are no litter bearers, but one noncommissioned officer of the medical service is on duty with each medical officer. FIELD MEDICAL UNITS. The medical units with each division are one bearer battalion and six field hospitals. 633 55 BEARER BATTAUEONS. Bearer battalions are under the command of a major of the line, with an intendance officer attached. Each bearer battalion consists of — (a) two litter bearer companies; (&) a dressing station section. Each litter beareT company is commanded by a captain of the line and is composed of 40 litter squads or 160 bearers, with an additional personnel for auxiliary services, such as drivers, cooks, etc. The dressing station section consists of eight medical officers (two captains and six lieutenants), one apothecary, and senior and junior noncommissioned officers of the medical service as assistants to the medical officers. The exact number of such noncommissioned officers can not be ascertained. FIELD HOSPITALS. Field hospitals have a capacity of 200 bed cases each. During the Eusso- Japanese War, however, field hospitals were frequently called on to take care of as many as 600 serious cases. Each j&eld hospital is under command of a major surgeon, with five medical officers as assistants. Its personnel comprises, in addition, one apothecary, one intendance officer, 18 noncommissioned officers, and 90 privates. LINES or COMMUNICATION. The medical establishments usual to lines of communication are maintained by the Japanese Army. The personnel for these estab- lishments is largely derived from that furnished by the Eed Cross Society and that procurable from among the civilian population. It is a fixed rule, however, that all of these establishments shall be un- der the command of a regular medical officer of experience. The organization of several units on the lines of communication is peculiar to Japan. The usual evacuation or clearing hospitals at the head of lines of communication are replaced by " the reserve medical personnel." RESERVE MEDICAL PERSONNEL. These units are organized in the proportion of one to each division, to follow up the field hospitals during an action and establish sta- tionary field hospitals at suitable points to relieve them. They also establish rest stations along the route of evacuation. Each unit is under command of a major, medical corps, with 12 other medical officers, 3 apothecaries and an enlisted personnel approximately three times that of a field hospital. 638 56 SICK AND WOUNDED TRANSPORT DETACHMENT. One of these units is organized for each division. Its duty is to evacuate wounded from the field hospitals to the stationary field hospitals or to the railhead. Each unit is commanded by a major from the retired or reserve list of the line. It has three medical officers and a small staff of noncommissioned officers and privates of the medical department. No provision is made for transport materiel or bearer personnel. The former is improvised or requisitioned and the latter organized out of local resources. BASE HOSPITALS. Base hospitals are established as necessary on lines of communi- cation. There is no definite schedule for their personnel and equip- ment, but they are supplied from local resources or from the per- sonnel of the Red Cross Society. Regular medical officers are in command of these hospitals, however. In conducting the medical service on lines of communication, it is the policy of Japan to utilize voluntary aid to the greatest extent. It is a fixed rule that all medical units, however, such as hospitals, hospital trains, hospital ships, etc., shall at all times be imder the command or regular medical officers of experience. HOME TERRITORY. All of the sick and wounded that are sent to the home territory are treated in reserve hospitals. These reserve hospitals are simply the peace garrison hospitals at the headquarters of each division enlarged as the occasion demands. During the Russo-Japanese War many of these garrison hospitals were expanded to accommodate from 10,000 to 15,000 patients. These hospitals are under the command of the Hospital Director (colonel or lieutenant colonel) of the division district. Through subordinate commanders he directs the operations of all subsidiary hospitals, convalescent camps, etc. The necessary personnel for these reserve hospitals is derived from the depot divi- sional medical service, from the reserves, from the Red Cross Society and from available civilian sources. 633 57 SUMMARY. Percentage of medical offlvei's in permanent peace estaMishments. Nation. Per cent. Remarks. 0.52 .43 .42 .36 .34 .36 .30 .29 United States RnglftTid In addition to permanent personnel, there are on duty 96 officers from the reserve corps and 15 contract surgeons, making a total peace percentage of 0.54. In addition to permanent personnel, there are on duty 65 officers from the France retired list and 182 from the reserve list, making a total peace percentage of 0.53. Austria All these countries having compulsory service, augment their permanent peace personnel by medical men domg their service with the colors. Germany Italy Percentage of medical personnel for duty directly with troops as taken from tables of organization. Nation. 1. Japan... 2. France.. 3. Germany 4. Austria.. Commis- sioned. 0.52 .44 .42 Enlisted. 5.10 4.70 5.30 Nation. 5. United States 6. Italy 7. Russia 8. England Commis- sioned. 0.42 .40 .33 .26 Enlisted. 3.80 3.20 7.00 6.50 A study of these figures shows that the percentage of medical per- sonnel maintained by the United States is about the same as that of England, less than that of Japan and greater than that of continental countries where compulsory service exists. It also shows that upon mobilization for war the entire medical personnel of the continental armies was not sufficient to complete the sanitary quota of the field armies ; and that of Japan and the United States would be just sufficient, while England, by reason of the fact that she does not make such ample provision for her field forces as do other armies, had a slight surplus of medical personnel available for duty in administrative positions with volunteer forces and on lines of communications and home territory. Experience has shown that the total number of sanitary personnel required for the various hospitals and other establishments on lines of communication and in the zone of the interior is even greater than that required for service directly with troops ; and it has also shown that the higher administrative positions in these establishments, as well as with field arms composed of raw troops, should be under the direction of trained military surgeons. In countries having compulsory service, and, consequently, a large reserve, it is the custom to detail regular medical officers from the 533 58 standing army for such administrative positions and to supply the de- ficiency so caused from the reserves. In countries not having large reserves instantly available, it is necessary to maintain in time of peace a medical personnel sufficiently large to be capable of proper expansion and the proper absorption of untrained volunteer aid in time of war. o PAT. JAN. 21. 1908 ' 667390 ^fo / LIBRARY UNIVERSITY OF CALIFORNIA UBRARY \.