Military physician

“ No Person ought to be appointed a Physician to the Army, or Military Hospitals, without previously undergoing the same Examination at the College of Physicians, as those do who enter Fellows and Licentiates of the College, that none but proper Persons may be employed. ”

“ The ward officers acted as orderly officer in rotation—that is, they took casualties and night work for twenty-four hours in rotation—and had the supervision of the wards on their nights on duty. In civil hospitals members of the staff may not meet for weeks at a time; but in a military hospital surgeons and physicians attended daily, and at the morning meeting the orderly officer’s report for the previous night was read, and it was possible to talk over the various cases. A great deal of good team work was done, the surgeons, physician and pathologist concentrating on the worst cases. ”

“ They are attended to in a particular quarter or ward without expence to themselves or to their corps. Particular care is taken not to mix their linen or clothes with others, and they are always washed apart. No soldier, whose disorder has been pronounced incurable was or is received into any of the public hospitals. The physician or surgeon only gives the incurables a certificate of their state and condition. ”

“ The comparative richness of the results of Army medical research was attributed, in part, to the fact that "the civilian profession, while frequently establishing the principles used as a basis for disease control, lack the opportunity to prove their worth which are offered the military by reason of the latter's contract with bodies of troops under discipline." ”

“ Such knowledge of medicine and surgery as is possessed by the medical profession generally will not alone suffice to make an efficient military surgeon. He must have, in addition, knowledge of the administration and sanitation of large field hospitals and camps, in order to safeguard the health and lives of men intrusted in great numbers to his care. ”

“ No portion of the military service has been more misrepresented than the medical department. An opinion seems to prevail quite extensively that the army surgeon is generally a young graduate, vain of his official position, who cares little for the health of the soldier, and glories in the opportunities afforded by a battle for reckless operations. ”

“ In the hurry and confusion of a war, and amidst the pressure of hundreds of new cases in a day, what can the surgeons of the hospital be expected to do for science, or even for the improvement of medical and surgical practice?—The answer is seen in the new arrangements in England, where a statistical branch has been established in the Army Medical Department. Of course, no one but the practising surgeon or physician can furnish the pathological facts in each individual case; but this is what every active and earnest practitioner does always and everywhere, when he sees reason for it. ”

“ H-m, I know these ship's doctors, Mr. Merrick, and I wouldn't care to have you and your nieces trust your lives to one, in case you become ill. Believe me, a good physician is as necessary to you as a good surgeon. Do you know that disease will kill as many of those soldiers as bullets? ”

“ In response to this call, some who were whole and needed not a physician, as well as those who were sick, reported at the surgeon’s tent for prescriptions. Much used to be said by the soldiers in regard to the competency or incompetency of army surgeons. It was well understood in war time that, even though an examination of fitness was required of surgeons to secure an appointment in the army,—at least in some States,—many charlatans, by some means, received commissions. ”

“ Such a center, the Committee reported, was an "urgent and immediate" need, due to the "comprehensive and global nature of modern military medicine" if the Medical Department was "to fulfill its mission of protection and care of troops, to keep pace with worldwide developments of significance to military medicine and to maintain a productive relationship with the medical profession at large * * *. The Army Institute of Pathology and medical museum are presently housed in an antiquated building which seriously limits the important functions of this institution. ”

“ An even broader concept of the place of the Institute of Pathology in the general scheme of military medicine after passage of the National Security Act of 1947 resulted from the appointment and deliberations of the Committee on Medical and Hospital Services of the Armed Forces. ”

“ One can be sure that the record of the past will serve as an inspiration to those individuals responsible in the future for the destiny of the Armed Forces Institute of Pathology and its important role in advancing military medicine. ”

“ Many of the rejections by the Medical Department have caused grief to high-spirited young men not conscious of physical weakness or defect, and perhaps having no weakness or defect which embarrassed their usefulness in civilian occupation; but both the strength of the Army and justice to the men involved require [343] that the test of fitness for military service should be the sole guide, and the judgments of the most expert physicians have been relied upon to give us an army composed of men of the highest possible physical efficiency. ”

“ The achievements in the field of discovery of the chemist, the physicist and the biologist have given the military surgeon an advantage in diagnosis and treatment which was denied to his predecessors, and we are able to measure the effects of these advantages when we come to appraise the results which have been attained. ”

“ He also says, "It must be remembered, for the sake of our honor as a profession, that the army medical service, though an absolutely essential part of His Majesty's forces, has not only never been granted a proper place in the administration of military affairs, but even now [early in 1917] has no representative on the Army Council."
The medical profession cannot be held primarily responsible to the British nation for errors in the vital question of the rum ration and the medical and surgical care of soldiers. ”

“ In much the same way as the activities of the American Registry extended beyond the strictly military aspects of the Institute into fields of civilian medicine, so the Medical Illustration Service had responsibilities which were broader than the limits of the Institute. ”

“ This department of an army, next to the commissariat, is the most important of all the non-combatant sections. The surgical treatment of the wounded in actual fighting, and still more the combat with disease engendered by crowding, unhealthy stations, and the reckless habits of the soldiery, necessitate a large medical staff; for, on an average of the whole army, it is found that the rate of sickness is at least quadruple that for the civil population. In the British army every battalion, when at home or in the temperate zone, has a surgeon and an assistant-surgeon ”

“ Unless ample provision is now made by Congress to put the Medical Corps where it should be put disaster in the next war is inevitable, and the responsibility will not lie with those then in charge of the War Department, but with those who now decline to make the necessary provision. A well organized medical corps, thoroughly trained before the advent of war in all the important administrative duties of a military sanitary corps, is essential to the efficiency of any large army, and especially of a large volunteer army. ”

“ Inestimable facts of treatment are learned by watching, at the same time and in the same place, a ward full of patients ill of the same disease. People of all countries know this by the special learning which their physicians obtain in large civil hospitals: and the same thing happens in military hospitals, with the additional advantage that the information and improved art tend to the special safety of the future soldiery, in whatever climate they may be called on to serve.
There has long been some general notion of the duty of army-surgeons to record what they saw in foreign campaigns ”

“ The fourth member of the military staff is the Surgeon, who with his four assistants, medical officers of the Army, watch over the health of the command. Under his charge is the hospital for cadets, and that for enlisted men.
The Surgeon has authority to excuse an officer or cadet from any duty whatsoever on account of illness. In the eyes of the cadets he stands as the guardian of the Gates of Paradise. When the body is fatigued, or one’s head is choked up and eyes running from a bad cold, illnesses that in reality do not incapacitate one for duty, to have a nice sympathetic Dr. ”

“ One saw only black and white and yellow faces peering anxiously forth, and one understood that these soldiers had no words to express their sufferings, they only wait "for help."
A young doctor, just commencing his life of self-sacrifice, his eyes heavy with fever, his shoulders drooping with fatigue, seeks the military doctor in charge at the station and hands him a list giving him some information, brief and military, on the wounded hundreds behind him. Some are so injured they must have instant help. ”

“ In addition to the services of the Institute to the Armed Forces, the Committee approved the arrangement with the Veterans' Administration as "an essential part of a vast plan of collective research whereby former military personnel may be followed through the various medical vicissitudes of their lives to old age and death," to the end that medical services for the military might be improved. The Committee likewise approved the cooperative arrangements between the Institute and the U.S. Public Health Service, the Atomic Energy Commission, and the medical, dental, and veterinary professions. ”

“ Many other factors, such as the physical and mental condition of the men, the facilities for affording first aid, and the transport arrangements, also play a part in determining the nature and condition of the wounds that have to be dealt with by military surgeons. ”

“ Nay, many even of the well-educated surgeons sent out were for some time of little use, for superior professional skill is of little value in comparison of experience in military arrangement; where one soldier dies from the want of a delicate operation, hundreds perish from the absence of military arrangement. ”

“ What brings these men through these trials and dangers is not only their American intestinal fortitude, all of them are armed with knowledge. Somewhere, aboard ship, in naval training stations, or in "boot" camps, doctors wearing the Navy's blue and the gold oak leaves and silver acorns which are the insignia of the Navy Medical Corps have taught these men how to protect themselves, if possible, from infection and disease. ”

“ For the first time also in any campaign the labours of the surgeon and the physician have had the aid of the bacteriologist, the pathologist, the physiologist and indeed of every form of scientific assistance in the solution of their respective problems. The clinician entered upon the great war armed with all the resources which the advances of fifty years had made available. If the surgical problems of modern war can be said not to differ sensibly from the campaigns of the past, the form in which they have been presented is certainly as different as are the methods of their solution. ”

“ Yet, taking them all in all, the military ‘cut up’ better than any other professionals. The doctors might be agreeable; they know a vast deal of life, and in a way too that other people never see it; but meet them en masse, they are little better than body-snatchers. ”

“ Institute set up an extensive service, making study sets available to all Army laboratories, to keep medical officers throughout the Army informed about the pathology of the diseases prevalent during the war. ”

“ Preventable Diseases.—Men should be given a certain amount of theoretical knowledge of preventable diseases. These matters will be taken care of to a large extent by the Medical Corps; but men should be taught just what precautions are necessary to avoid recourse to the hospital. ”

“ The medical service provides treatment and preventive medicine for military personnel and, in certain circumstances, for dependents and for persons employed by the military. Its services are also available to the public at large during individual emergencies, if they are the most immediately available, and on a larger scale during epidemics or natural disasters. Military personnel may also avail themselves of emergency facilities in nonmilitary hospitals or clinics. ”

“ HOUGH military surgeons are technically non-combatants, yet practically they are as much exposed to peril as other officers, and frequently have to perform work demanding the greatest care and calmness under the most disturbing dangers. ”

“ From the days when the first duty of the so-called army surgeon was to minister to his commanding general, and when the private soldier received but the scantiest if any attention, we have arrived at that time when the good health of the entire army is the aim and pride of the medical corps, and when public opinion demands for every enlisted man a degree of watchful care greater than many parents bestow upon their own families. ”

“ The relations between the military and medical authorities must be so settled and made clear as that no professional jealousy among the doctors shall keep the commanding officers in the dark as to the needs—of their men, and that no self-will or ignorance in commanding officers shall neutralize the counsels of the medical men. ”

“ The importance of immediate appearance before the Medical Boards which will sit at every centre of mobilization is apparent. Until men have undergone medical examination they cannot know whether or not their services will be required. ”