Chapter XV: Sanitary Tactics

_Personnel and materiel with combatant troops._ The sanitary personnel and equipment normally assigned to various units is given in F. S. R. A regiment acting alone might, in addition to its regular personnel and equipment, be accompanied by 3 ambulances and an infirmary of 12 beds detached from the sanitary units; a brigade acting alone may be accompanied by one ambulance company. This is not to be assumed unless so stated in the problem. An ambulance company may be assigned to a brigade acting as advance guard to a larger force.

_Duty._ The duty of the sanitary organization is to transfer or evacuate all wounded from the battlefield to the sanitary stations in rear with the least possible delay and the minimum of treatment. Each successive station is emptied as soon as possible in order to be prepared to receive fresh cases. The wounded are given at each station only such attention as necessary before they can be transferred.

The wounded are collected as rapidly as possible and receive at each station the necessary attention. They should never be left on the field of battle nor allowed to fall into the hands of the enemy if this can be avoided, as it has a demoralizing effect on the troops. In an advance little difficulty will be encountered, but in retreat after a defeat, especially if the losses have been severe, it may be necessary in avoiding delay and the loss of sanitary personnel and materiel, to abandon some of the more seriously wounded either on the field of battle or at some of the stations in rear. They fall into the hands of the enemy, but are protected by the Geneva Convention. The wounded in such cases become prisoners of war and are available for exchange. The necessary sanitary personnel and medical supplies should be left behind unless the wounded can be placed in care of competent civilians, as may often be done in friendly country.

_Capacity._ An ambulance company has 12 ambulances each of which will accommodate 9 patients sitting or 4 recumbent and 1 sitting.

A field hospital can set up 216 beds.

_Sanitary stations in combat._ The stations and duties of the sanitary troops during combat, are as set forth below. (See Figs. XIII and XIV.)

_Bn. collecting stations._ These stations are established by the assigned personnel as close as practicable to the firing line. The wounded are collected by litter. Each battalion and squadron has 7 litters (on combat wagons); each machine gun company 1 litter; regimental sanitary personnel 8 litters; total with a regiment, 30.

_Regimental aid stations._ These are established by the regimental sanitary troops in a convenient central location as close to the firing line as the necessity for shelter from the enemy’s fire permits. The wounded from the bn. collecting stations are assembled and first aid rendered. Slightly wounded men are directed to the rear. The regimental bands may be placed at the disposal of regimental surgeons to assist in collecting the wounded, etc.

_Dressing stations._ Dressing stations are established by Ambulance Companies, each company can establish one station. In order to avoid unnecessary loading and unloading of wounded and immobilization of the ambulance companies, dressing stations should not be established prematurely, nor too far to the rear. If the course of the action permits, the ambulance companies advance and take over the wounded directly from the regimental aid stations. If however, the action is protracted, or likely to take an unfavorable turn, the evacuation of wounded from the regimental aid stations must often commence prior to the close of the engagement, in which case dressing stations must be established in rear. The location of a dressing station should fulfill the following conditions:

(a) It should be out of range, or otherwise secure from hostile
artillery fire.

(b) It should be close to and conveniently located with reference
to the battle district it serves, the roads leading thereto, and
the general line of communication to the rear.

(c) It should be near but not on a good road.

(d) It should not be near a (friendly) arty. position.

(e) Fuel (fire-wood), water and shelter are necessary.

It is desirable that the stations be near a building or group of buildings. These afford shelter in inclement weather and provide a refuge for the wounded pending their transfer to the Field Hospital in case the Ambulance Co. has to move forward.

The location of dressing station (or stations) is designated at the proper time by the Supreme Commander after consultation with the Chief Surgeon. Serious operations are not ordinarily attempted at dressing stations.

_Slightly wounded station._ The object of a slightly wounded station is to relieve the dressing station of the care of slightly wounded men who are able to walk and require little attention. A slightly wounded station is not ordinarily established for a command less than a division. It is usually established by a field hospital, if one is present, near the station of the latter, or by an ambulance company and later taken over by a field hospital. It should be in rear of dressing stations, on the natural line of retreat, near the important roads and conspicuously marked so that it may be readily found. Here the slightly wounded receive attention and are returned to duty at the front, or sent to the rear. Slightly wounded going to the rear should be collected in small bodies under the command of (slightly wounded) officers and non-commissioned officers.

_Field hospitals._ The field hospitals receive the wounded from the dressing stations. They should in any case be so located as to facilitate the rapid transfer of the wounded to the rear, without unnecessary man-handling of patients. If practicable the hospitals are located in towns and near to rail head. During a forward movement when it is desirable to release the ambulance companies as soon as possible in order that they may go forward with the combatant troops, the field hospitals may move forward and take over the wounded directly from the dressing stations of the ambulance companies. The evacuation of dressing stations is not the first duty of the ambulance companies when they are needed with the advancing troops.

_Police of the battlefield._ After an action the police of the field is completed as promptly as possible, under direction of the Chief Surgeon, by details from the combatant troops. The police of the battlefield includes:

(a) Collection and removal of the wounded (friendly or hostile.)

(b) Collection and disposal of all corpses and carcasses, (burial
and cremation.)

(c) Identification and record of all dead and wounded with
diagnoses.

REGIMENTAL SANITARY TROOPS IN BATTLE.]

_Transportation of wounded._ All wounded who are able to walk are required to do so. The seriously wounded are transported to the rear in stretchers, ambulances, and by any other means available. Empty wagons of combat and other trains may be utilized for this purpose.

When the tactical situation permits, the ambulance companies will transport the wounded to the field hospitals. When, however, the combatant troops are moving forward the ambulance companies should follow them as soon as possible. In such cases the field hospitals may be pushed up to the front, and use made of all hired or impressed transportation available.

Civilian help, both in the transportation and care of the wounded, should be utilized to the fullest possible extent, to relieve the congestion in the sanitary stations. The evacuation system of the Medical Dept, is illustrated by diagrams herewith. (Fig. XIV.)

Transportation by rail should be utilized to the greatest possible extent.