Navy Medicine September-October 1942
Jennifer Mitchum
The struggle for control of Guadalcanal would play a central role in the war in the Pacific. U.S. forces had landed there virtually unopposed in August as part of a plan to halt Japanese expansion in the Pacific. Shortly thereafter, Japanese sent reinforcements to Guadalcanal in an attempt to isolate U.S. ground forces and cut them off from reinforcement and supplies. Night landings by the "Tokyo Express" increased and U.S. forceswere engaged in heavy battles both ashore and at sea.
At Bloody Ridge on 13-14 Sept, marines, supported by heavy artillery fire, halted waves of enemy troops who were attempting to break through to Henderson Field. Then, in the Battle of Cape Esperance the night of 11-12 Oct, U.S. forces were successful in throwing back a force of enemy cruisers and destroyers as only one destroyer of the enemy's five-ship force escaped damage. Three enemy destroyers and one cruiser were sunk. U.S. damages were comparatively light with two cruisers and one destroyer damaged and one destroyer sunk. Despite heavy losses, the Japanese returned and shelled Henderson Field and by 16 Oct, a convoy of six transports had reached Guadalcanal.
On 26 Oct, the Battle of Santa Cruz began as a carrier task force under RADM Thomas C. Kinkaid and RADM George D. Murray closed a numerically superior Japanese force. Although American forces were
successful in checking enemy movement toward Guadalcanal, it was costly as the Enterprise (CV-6), South Dakota (BB-57), San Juan (CL-54), and Smith (DD-378) were all hit and the Hornet (CV-8) and Porter
(DD-356) lost. Comparatively, no enemy ships were sunk and only one Japanese cruiser was damaged.(1)
Navy medical personnel had their work cut out for them as casualties mounted from these battles and patrolling as well asfrom frequent enemy shelling and aerial attacks. Corpsmen, accompanying combat troops and patrols, provided emergency treatment and dressing. In addition to corpsmen, at least one medical officer accompanied patrols comprised of more than two companies.
As transportation came ashore, jeeps instead of ambulances were sent to pick up wounded in battle zones because of their size, low-center of gravity, and ability to travel in difficult terrain. The standard jeep with slight alterations could carry three or four stretcher cases and one sitting case. However, jeeps were not always available and oftentimes personnel had to carry wounded long distances on stretchers.
On 18 Sept, reinforcements for the 1st Division, 7th Marines, arrived bringing with them the first full food rations since the initial landings and a "completely equipped medical company."(2) Despite naval gunfire their first night ashore, the medical company was able to set up a tent hospital west of the Lunga River and be in operation within 48 hours.(3)
Disease: Still Enemy Number One
Although U.S. forces ashore and at sea came under fierce enemy attack, tropical diseases, heat, filth, and flies caused more casualties than actual battles as more were hospitalized due to disease than to wounds. Sunburn and heat exhaustion resulted as the defense line expanded into the hot, shadeless ridges 1 to 3 miles from the shore lines. Medical personnel issued salt tablets to replace salt lost through body perspiration and waterin 5-gallon cans was carried to the front lines to combat heat exhaustion.
Catarrhal fever, dengue, and malaria were the major medical problems. Malaria was by far the worst offender. It appeared 2 weeks after the initial landings in August. By the end of August, 22 First Marine Division patients had been hospitalized for malaria as compared to 900 on the sick list for other diseases.(4) In September, 239 had been admitted for malaria and 1,724 for other diseases. By October, the number of patients hospitalized for malaria was almost three-fourths the number of patients that had been admitted for other diseases with 1,941 on the sick list with malaria and 2,630 with other diseases.(5)
LCDR James J. Sapero, MC, commanding officer, malaria control unit, South Pacific, credited the high
incidence of malaria to troops landing in the area with "the highest malarial infected mosquito rate in the world"(6) and to mistakes made early on after landing. "This landing under combat was followed by a
repetition of many of the same mistakes which were made in the first landings on malarious islands under
non-combatant conditions. The situation from a malaria standpoint threatened to become a critical factor in the success of the operation. The military situation at Guadalcanal was saved by the use of Atabrine," he said.(7)
Medical personnel began using Atabrine as a suppressive treatment on 10 Sept. Medical personnel were advised to issue each member of the force four tablets per week. Patients who had toxic reactions to Atabrine were given quinine. There were problems with malaria control. Initially, medical personnel untrained in preventive medicine work, oiled mosquito breeding areas within camps. Later, the malaria
control unit, consisting of one medical officer, an entomologist, an engineer, laboratory technicians, and
enlisted personnel assumed this task but were unable to oil all necessary areas. In addition, medical personnel had a hard time getting troops to ingest the drug and often medical personnel stood at mess lines to issue the tablets and looked into the mouths of the recipients to ensure that they swallowed them.
Because of a lack of hospital beds, many suffering from malaria received treatment in their
organizational areas. However, most cases were hospitalized during the acute phase and returned to the
hospital for follow-up treatment. The majority of those admitted to the hospital for malaria returned to duty. Those not fit to return to duty after 10 days or 2 weeks were evacuated by air and sea.
Air Evacuation
Air evacuation of sick and wounded was begun on a large scale during the Guadalcanal campaign. The advance echelon of Marine Air Group (MAG) 25, consisting of 14 R4-D2 aircraft, arrived in the South Pacific on 1 Sept.(8) Planes could accommodate 18 stretchers but usually carried 10 because of space
occupied by auxiliary gas tanks needed on long trips over water.(9) On 3 Sept, they flew into the combat zone and regularevacuation of casualties by air began. Prior to this, only a few isolated cases had been evacuated via combat planes.
Patients were usually loaded under a blanket of darkness and enemy shelling and bombing. During the first 6 weeks, patients were loaded and flown to their destinations without the supervision of medical
personnel. In addition, there were no facilities for handling the patients at unloading terminals. A general order was quickly issued by the wing commander requiring that a) receiving medical units establish facilities and assign medical personnel to receive the patients at the airports, b) medical officers and hospital corpsmen accompany patients aboard flights whenever possible, and c) receiving medical facilities provide transportation to the receiving hospitals.(10)
By 18 Sept, 147 patients had been evacuated from Guadalcanal by air and this number was rising steadily.(11) However, at this point, evacuation by sea remained the most widely used evacuation method with 701 patients departing by that route.(12)
Initially, task force commanders in assault areas and the Commander, Forward Area oversaw air
evacuation of combat casualties. In October, Army transports and MAG 25 began making joint operations carrying patients to Sydney, Australia; Auckland, New Zealand; and Espiritu Santo, New Hebrides.
Aviation Medicine
Prior to the national emergency, the Division of Aviation Medicine at BUMED consisted of one
medical officer and one clerk. Approximately 49 flight surgeons, whose primary responsibility was to
determine the physical qualifications for flying of personnel, were on duty with aviation commands ashore and afloat. At that time, flight surgeons received training at the Army School at Randolph Field, TX, because there were no Navy training facilities at which to train them. In addition, there were no funds or facilities for
aviation medicine research nor were flight surgeons engaged in research.
Aviation medicine in the Navy rapidly developed, however, after the national emergency. Beginning in 1938-39, the number of flight surgeons progressively increased. In addition, some flight surgeons were assigned flight duty and the Bureau of Aeronautics (BuAer) granted permission for four flight surgeons to receive flight training each year and to be designated as naval aviators. On 29 Nov 1939, a Navy flight
surgeon school wasestablished at the Naval Air Station, Pensacola, FL.(13) In July 1942, authority was obtained for an insignia for flight surgeons and the "wings" were added to the official uniform regulations. Also that year, a Division of Medical Research was established at BUMED to "direct all aspects of a broad medical research program."(14) The Aviation Medical Research section of BuAer was incorporated into the new research division. A flight surgeon was then assigned to the BuAer as a technical liaison officer so that information could be more easily exchanged between BuAer and the aviation medical organization at BUMED. The Division of Aviation Medicine continued to expand its staff at BUMED throughout the war. On 29 Oct 1942, the Surgeon General directed that an Aviation Psychology Branch be established at BUMED as part of the Aviation Medicine Division. This directive transferred to BUMED the functions previously
performed in the Medical Research Section of BuAer, that of developing and administering psychological tests used in selecting or classifying Naval Aviation personnel and employing psychologists to administer the tests.
Submarine Medicine
Prior to World War II, about eight medical officers in the Navy were qualified in submarine medicine. They had been trained primarily in deep-sea diving and were familiar with the construction and operation of a
submarine, the problems of submarine escape and salvage, the use of the rescue "bed" and the escape "lung" and the operation of the training tank. With war dawning, facilities of both the Deep Sea Diving School,
Washington, DC, and the Submarine Base, New London, CT, were activated so that more officers could be trained immediately. Hospital Corps personnel were given a course of indoctrination in submarine operation at the Submarine School, New London, CT, prior to being assigned to submarine duty. Physicians were not
assigned to submarine duty.
The most common ailments plaguing submarine crews were injuries, upper respiratory tract infections--"colds," sore throat, catarrhal fever, tonsillitis--and diseases associated with the digestive system--
gastroenteritis and chronic constipation. Occasionally, acute appendicitis flared up. Urogenital and skin
diseases were also present but infrequent.
Of these ailments, appendicitis posed a unique problem for submarine personnel. Hospital corpsmen assigned to submarines were instructed not to perform surgery but in some cases the circumstances seemed to warrant it. One classic story is that of PhM1c Wheeler B. Lipes who, while assigned to the USS Seadragon (SS-194), became the first pharmacist's mate to perform a major operation aboard a submerged submarine on war patrol.
On 8 Sept, PhM1c Lipes found a young shipmate in the crew's compartment of the submarine. The patient complained of abdominal pain, particularly in the right lower quadrant. After 3 days observation, Lipes diagnosed his condition as acute appendicitis and recommended to the commanding officer that surgery was indicated. Lipes used rudimentary equipment to perform the operation such as the ward room mess table, 5 tablespoons with handles bent back as retractors, commercially sterilized "handy pads" enclosed in tissue paper envelopes for gauze sponges, and a large tea strainer covered with gauze for a mask in which ether could be dripped. The surgery was a success and the patient fully recovered. The successful surgery
performed under the trying circumstances was not universally acclaimed however. There was strong
opposition at BUMED to corpsmen performing such surgeries especially after two other submarine corpsmen performed appendectomies. The practice was then officially forbidden.
Other Developments in the Pacific
Like Navy medical personnel in combat areas, those elsewhere in the Pacific also demonstrated excellence and dedication to saving lives and to providing the best possible care. USS Solace (AH-5), serving as a station hospital ship at Efate, New Hebrides in September, shuttled back and forth between combat zones and
mobile and base hospitals. On 3 Oct, Solace sailed for Auckland, New Zealand, to pick up casualties. On 22 Oct, she then sailed for the west coast of the U.S. via Pearl Harbor.
Casualties from Guadalcanal were admitted to Base Hospital No. 2, Efate, New Hebrides, usually
within 36 hours after they were injured. Such speedy delivering was due mainly to most of the patients being brought by air to an airfield 6 miles from the hospital. A quonset hut for the reception of patients was placed near the landing strip of the airfield and a medical officer supervised the transfer of patients from airplane to
ambulance. Base Hospital No. 2 reported difficulties in obtaining and maintaining medical supplies. Thus, hospital staffers faced difficulties in chemoprophylaxis and therapy because of shortages of quinine and Atabrine. Mobile Hospital No. 3 in American Samoa did not receive many battle casualties. Instead, filariasis was the major medical concern. CUB 1 was now in full operation in Espiritu Santo, New Hebrides. By the time USS Wasp (CV-7) was sunk on 15 Sep, CUB 1 had already grown to an orderly row of Quonset huts, and floored, screened tents that would accommodate approximately 600 patients. In addition, it had X-ray machines, a pathological laboratory, and a medical store, and three operating theaters.(15) All of these were needed to care for Wasp survivors and those of other vessels as well as those being flown in from shore
combat zones.
Elsewhere
While the war was being waged in the Pacific, Navy medicine continued its program of expansion in CONUS and abroad, commissioning USNH Coco Solo, C.Z., and USNH Key West, FL, on 1 Sept and 19 Oct
respectively. Construction had begun on USNH Coco Solo, C.Z., a 200-bed hospital, in December 1941 when an Executive order put aside 39 1/2 acres in the Canal Zone for a naval hospital. The site was located along the Trans-Isthmian Highway, adjacent to France Field (Army Air Corps). In addition, Mobile Hospital No. 5 arrived in Noumea in September.
On 27 Oct, the Navy Medical Research Institute, under CAPT William L. Mann, MC, commanding officer; CAPT R.H. Draeger, MC, as Executive Officer and Professor A.C. Ivy as director of Research, was
commissioned as part of the National Naval Medical Center, Bethesda, MD. The research center would
function in close cooperation with other components under the direct command of the medical officer in
command of the center, who was RADM C.W.O Bunker, MC. One of its functions was to "visualize and
attempt to solve in advance, problems before emergencies arise."(16) Upon commissioning, the scientific staff consisted of 13. The institute was later divided into four departments for research: environmental medicine, naval preventive medicine, equipment research, and dental research.
Worth Mentioning a Second Time
Navy medical personnel involved in the Guadalcanal campaign kept with tradition as they exhibited
exceptional service and expertise. In this campaign, as in others, there are many notable stories. One is that of PhM2c Daniel Albert Joy, USNR, whose bravery and extraordinary heroism and courage earned him a
citation and the Navy Cross posthumously. In addition, a ship would later bear his name.(17) At the height of battle with the enemy on Guadalcanal on 5 Oct, PhM2c Joy, while assigned with combat troops, unhesitatingly braved enemy fire and made his way to the front lines to remove wounded and carry them to safety.
He continued this hazardous task until he was killed by Japanese gunfire. Joy had enlisted in the Naval Reserve on 8 Feb 1937.
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References
1. Karig W, Purdon E. Battle Report: Pacific War, Middle Phase, p 150.
2. U.S. Navy Medical Department Administrative History 1941 - 1945, Vol. I: Narrative History, chap 2, p 22.
3. Ibid.
4. The History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 73.
5. Ibid.
6. U.S. Navy Medical Department Administrative History 1941-1945, Vol. I: Narrative History, chap 2, p 26.
7. Ibid.
8. The History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 203.
9. Flaherty TT, Yavorsky WD, McWilliams JG, "Evacuation of Wounded by Air from the Battle of Guadalcanal," U.S. Naval Medical Bulletin; 1943 41(4), p 917.
10. The History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 204.
11. U.S. Navy Medical Department Administrative History 1941 - 1945, Vol. I: Narrative History, chap 2,
p 20. 12. Ibid.
13. The name was later changed to "School of Aviation Medicine and Research."
14. The History of the Medical Department of the United States Navy in World War II, Vol. I: A Narrative and Pictorial Volume, p 210.
15. Oman CM, Doctors Aweigh, p 170.
16. U.S. Navy Medical Administrative History, 1941 - 1945, Vol.II: Organizational History, chap. 10, p 596.
17. Daniel A. Joy (DE-585) was launched 15 Jan 1944 by Bethlehem-Hingham Shipyards, Hingham, MA. It was sponsored by Mrs D.A. Joy and commissioned 28 April 1944. PhM2c Joy was the first hospital corpsmen to receive this honor since World War I.