THE MEDICAL SERVICE,

BASE HOSPITAL CAMP BEAUREGARD La.

The Medical Service was organized by Major James B. Guthrie of New Orleans, who reported here as Chief of the Service about September 10th, 1927. (Ed. Note: This is in error for 1917.)

He carried the burden alone through the first trying months. With a personnel of Army Surgeons practically untrained in Military Hospital work, a nursing force and ward attendants, willing and alert, but overworked day and night, an epidemic of measles, pneumonia, mumps and later meningitis, his responsibilities were not enviable. Many a midnight round did the "Big Chief" make in those trying times, for the days were too short for the task.

In December 1917 Major (then Captain) Allan S. Kirkwood arrived as Assistant Chief of the Service and shouldered a great part of the work and responsibilities. His quiet, kind and gentle sympathetic manner soon earned him the love and respect of officers, enlisted men and patients, and no one will ever question the statement that he was by far the most popular Surgeon assigned to the nurses Infirmary.

There was a great task to be done during these first few months in the handling of infectious diseases, so as to eliminate the danger of cross infections; measles, pneumonia. mumps and sore throats of various kinds had to be separated in different wards; tuberculosis, ever increasing had to be cared for and rheumatism ever present had to be worked up as to causation. Meningitis rather alarming in the number of cases and the severity of the disease was assigned to a personnel of officers, nurses and enlisted men quarantined from the rest of the Hospital force, the "Meningitis Squad" camped on "Meningitis Hill".

Many of us still remember most vividly the general quarantine placed on the whole camp and Hospital for three long months, isolating us from the rest of the world. The disease presented many problems as to control, eradication and treatment. Knowing that it was spread by healthy persons carrying the germs in the throat, it was necessary to detect all these infected and dangerous "carriers", isolate and rid them of their source of danger. Whenever a case occurred the throats of the whole detachment were cultured and examined. This entailed a tremendous amount of work, taxing our Laboratory facilities, but it was necessary and proved effective. A satisfactory method of serum treatment was soon worked out by the officers in charge, the rationale and efficacy of which is beyond question. Under this treatment the mortality rate was reduced from 50 per-cent in the first series of cases, to 18 per-cent in the last series. The great problem of infectious diseases in Camp was handled effectively by the Medical Service, no known method in modern medicine and sanitation being neglected.

Spring found conditions materially improved, infectious diseases had practically disappeared, meningitis was conquered, but now problems presented themselves at the time Major Donald J, Frick succeeded Major Guthrie as Chief of the Service. Malaria appeared on the scene, and hookworm, the bane of the Southern rural districts, became evident in camp. All cases of malaria were isolated in a screened ward, under mosquito bars. The blood of all patients suffering from malaria was examined in the special ward laboratory, no case was diagnosed malaria until the organism causing the disease was found in the blood, and to prevent the spread of the disease, all cases were kept screened until cured. An energetic crusade against the mosquito, the guilty agent in the spread of the disease was instituted and prosecuted during the whole summer under the direction of the Sanitary officer. A systematic examination of the Thirty Ninth Division for hookworm, and treatment of all soldiers was carried on under the supervision of the new Chief. This again entailed an enormous amount of work in the laboratory. This latter department was well organized under the direction of Major Joseph McFarland and was equal to all emergencies.

As training in camp became more and more intensive, it was necessary to hold convalescent patients in the hospital longer than usual, until able to do full duty, eight hours of hard work or drill with full equipment. The hospital wards designed for sick men soon became crowded with convalescent patients who needed no further medical care, but sunshine fresh air and well regulated outdoor exercise with a proper amount of rest. The morale of these convalescents was by no means improved by daily contact with illness and pain. Furthermore, under the intensive training, more and more men of weaker physique were disabled with irritable hearts and various nervous symptoms. These did not require hospital care but physical rehabilitation. To meet this demand the Convalescent Camp, eight well appointed and comfortable two story buildings were opened in the early spring, Major George D. Gray was placed at the head of the department with Captain Adrian A. Landry in charge of the medical section. The work was soon mapped out and systematized to insure the best results. All convalescents were classified to their various diseases and physical condition; lung cases, empyemas; chronic bronchial troubles, arrested tuberculosis etc., were placed in one section, and given suitable graduated exercises, a careful watch by frequent examinations being kept on their lung condition; heart cases, in another section, under the direct supervision of heart specialists were exercised twice daily, and carefully observed as to the effects of exercise upon the heart's action; cases of chronic rheumatism, broken bones, stiff joints etc., were in another section, under appropriate massage, setting up exercises drills etc., with view as to the course of their special conditions; chronic infectious diseases in a fourth section were worked out with a view of bettering their physical condition. In the work of rehabilitating these soldiers, it was soon discovered that some were not amenable to work, and were physically incapacitated for any work in the army. These were placed in a fifth section, and were eventually discharged from the army, for physical disability.

It was not all work and no play in the Convalescent Camp. Realizing the value of instructing, out-door games and amusement in the making up of the soldier, lectures twice a week upon various topics were given by medical officer, Chaplain or YMCA secretaries, out-door games of all sorts, and singing were encouraged and various forms of amusement instituted. The day, from reveille to 4 o'clock was a busy one, with an admixture of work and play so distributed as to better both the physical and mental condition of convalescents. The work is still continued for the physical rehabilitation of overseas patients, physical condition does not yet warrant their final discharge from the service.

The Chief of the medical Service, ever on the alert to increase the efficiency of the Medical officers, instituted a course of lectures, three times a week. These lectures by the different officers in turn upon various subjects and problems proved interesting and instructive. Clinical leatures and demonstrations at the bedside were held daily. The Army surgeon, whilst at his daily work of getting the soldiers fit to fight was in a manner at school himself, profiting by the experience of the men skilled in various branches of Medicine and Specialties. Enlisted men of the Medical Department were not neglected either during these summer days. A daily course of instruction under the direction of the Ward Surgeon and the Chief nurse was instituted

Under the direction of the Chief of the Medical Service, a training school for nurses was established, forty-five student nurses,, bright young women eager to serve their country enrolling. All these activities added burden to the already various duties of the Chief,, so much so that another assistant was necessary. Captain James L. Lewis who had rendered meritorious service in the infectious diseases section, was added to this staff as assistant in charge of that special section.

As the summer days passed by everything moved serenely on the medical side. For the officers the only incident to disturb the calmness of every day duties was the usual weekly oversea orders to the more fortunate ones, chosen to buckle on their armor and got ready for the fray "over there". Sickness was reduced to a minimum and the mortality rate to nil,, when suddenly, as a bolt from the clear Autumn sky, influenza struck the Camp, September 24th, some 260 cases being admitted that afternoon. It literally swept the Camp like wild-fire, approximately 3000 cases being admitted the first week.

The Medical Service was equal to the emergency. With the help of the, Surgical section, the personnel of the various hospitals mobilizing here at the time, and the Camp officials, the situation was soon mastered. Every available building on the hospital grounds and all screened corridors were used for the quartering of the sick. Field hospitals, erected over night, made the hospital reservation appear a veritable tent camp, every foot of space being covered by canvas.

It would be unfair to commend any particular individual for duty well and nobly done, for all worked assiduously for one common purposes The Commanding Officer, Lt. Col. John T. Burrus personally supervising the administrative part of the work, was at his post night and day, ever ready to counsel and help. The Surgical section suspended all surgical work except in absolute emergencies, devoting all their skill and energy to the fight against the insidious foe. The Chief of the Medical Service and his assistants personally supervised the immediate care and treatment of the critically ill. The officers of the several mobilizing hospitals were ever ready to cope with any emergency,, Nurses and enlisted men workod regardless of hours or personal safety, until the work was done and well done. These truly were times that tried men's souls, and tested the spirit of the American soldiers. The situation cleared about October 20th,, the Medical Service soon resuming its normal activity. The beginning of this year found every thing running smoothly. On February 1^st Major Frick retiring to private life, upon his own request, was succeeded by Captain Adrian A,, Landry. With the demobilisation of the Camp, the demands upon the service have been gradually lightened.

A review of the work done by the Medical Service shows that twenty thousand medical cases were treated; influenza 4814 cases, Pneumonia 2275, hookworm 1927, mumps 1026, measles 808, malaria 763,, meningitis 162, typhoid fever 2, all other diseases 8223 cases. The mortality was 689 deaths, 2.44 per-cent, pneumonia with 468 deaths being by far the greatest factor in the mortality rate, deaths due to all other diseases being only 131. It is significant that only two cases of Typhoid fever occurred during this period, and that neither of these cases were contracted in Camp, the first one having the disease when inducted into the service and the other developing it within nine days . This proves that the typhoid vaccine administered to the recruit immediately upon arrival in camp absolutely protects him from typhoid fever. When we recall the appalling incidence of typhoid fever and the mortality in camps during the Spanish-American war twenty years ago, we are impressed with the results achieved by science in stamping out one of the most fatal scourge of Camp life. Let us hope that ere long the combined efforts of the master medical minds who fought pneumonia in army camps and hospitals will bring forth a protective vaccine, as effective agaist this disease as the typhoid vaccine.

ADRIAN A LANDRY

Captain, M.C. USA.

Chief of the Medical Service.