Each ambulance company establishes a dress ing station (or field ambulance) in a protected location, usually some distance in the rear o' the aid station (in trench warfare about 400 yards from the front trench) and an advanced surgical post adjacent, where urgent operations under bomb-proof are performed. The number and location of dressing stations are determined by the division surgeon, acting under instruc tions of the division commander, and the di rector of ambulance companies supervises their opening. At these dressing stations light nour ishment is provided, dressings are examined and adjusted, splints applied, antitetanus serum injected, morphia tablet given if the man it suffering acutely, and an iodine cross marked on the forehead to show that this attention has been given. Patients requiring transportation are made as comfortable as possible until it is practicable to transport them by horse litter to the advanced surgical aid post, or by am bulance— possibly by motorcycle with two story side car—to the field hospitals. The site for a dressing station should have the advan tages of protection from rifle fire and from di rect artillery fire, accessibility for wheeled transportation (motor transport if possible) and a supply of water. There are five depart ments: dispensary, kitchen, receiving and for warding, slightly wounded, seriously wounded. As soon as a dressing station is opened, bearers proceed under the direction of a medical officer to the front as far as the enemy fire permits. Ordinarily they will be divided into as many sections as there are aid .stations, and each sec tion under a noncommissioned officer will pro ceed toward an aid station. These men direct wounded able to walk to the station for slightly wounded, and they transport other wounded from the aid station to the dressing station As soon as the line of evacuation of the wounded is determined, ambulances are brought to the dressing station; they must arrive as early as possible, even at the risk of losses Quickly loaded, they carry wounded from the dressing station. to the nearest field hospital The system may also include transportation by narrow-gauge railroad from the advanced surgical post to the field hospital, man-power push-carts being used.
If the wounded man arrives at the field hospital in good condition, he is not unloaded but is sent on to the evacuation hospital. The field hospitals generally have only a limited equipment, no beds or cots, but straw over which blankets are spread, and aim to provide shelter, nourishment and emergency treatment. The mobile hospitals coming into use are fully equipped. Field hospitals are placed one to three miles in the rear of dressing stations, and care for the sick and wounded of the division until the sanitary service of the line of com munication takes charge of them. The stopping of hemorrhages, cleansing of wounds and such emergency operations as will permit the moval of the wounded to the rear are per formed here. The field hospitals are in charge of a medical officer with the rank of major. designated as director of field hospitals. The field hospital personnel includes a major manding) ; five captains and lieutenants (one of whom is an adjutant and quartermaster and four are ward surgeons) ; three sergeants first class (one acting first sergeant in general super vision of the hospital and in charge of medical property and records; one in charge of trans portation and quartermaster property and rec ords; one in charge of mess supplies and cook ing); six sergeants (one in charge of dis pensary, one in charge of operating equipment, one in charge of patients' clothing and effects, three in charge of wards) ; three acting cooks; 5$ privates first-class and privates (45 attend ants, one dispensary assistant, one artificer, four orderlies, three supernumeraries), and of the Quartermaster Corps, one sergeant (wagon master) and seven privates (drivers).
The regimental camp infirmaries and the four ambulance companies are all in charge of one major, designated as director of ambulance companies. He makes frequent inspections, supervises the removal of wounded and directs the opening of dressing stations and advanced surgical posts. He is assisted by a sergeant and a private first-class or private, hospital corps, both mounted.
The evacuation hospital (casualty clearing station) has been styled the keystone of the military hospital system. It is the first sanitary unit in which provision is made to retain patients for any length of time, and it is in the evacuation hospital that the great mass of rapid war surgery is done. Evacuation hos pitals are often located in pairs and occasionally with special hospitals for shock and head cases in connection. They are from 5 to 10 miles from the front, but as near up as possible and on good roads, often on railroads. But all their equipment is light and mobile, so that it can be quickly removed if the exigencies of the conflict require. They have facilities for X-raying, the location of the foreign body be indicated by an indelible cross on the patient's skin. Teams of expert young surgeons perform the operations in these units, and these surgeons get 90 per cent primary healings in war surgery. It is a rule that no war wound that is to pass out of the control of the operat ing surgeon before it is healed is to be closed primarily. If operation is deferred, wounds are thoroughly cleansed and .packed with gauze soaked in Carrel solution, the entire area is wrapped in compresses, solidly bandaged, strapped or splinted, and the patient is ready to be shipped 100 miles. In some cases an evacuation hospital is pushed forward and takes charge of the patients in the location of the field hospital. In other cases vehicles from the advance section of the line of communica tion are sent forward to the field hospital to receive the patients, and in many cases the trucks going to the rear for supplies will trans port the patients back to the refilling point, where they will be turned over to the vehicles sent forward from the advance section. The evacuation hospital is equipped with cots, blankets and comforts, but ordinarily it will be cleared of patients as early as practicable in order that it may be ready to receive others from the front.
Between the evacuation hospitals and the base group there are rest stations and Red Cross units comprising an intermediate group, the medical officer in charge being known as surgeon, intermediate group.
Patients usually are brought back by trains or boats to the base hospitals, where all possible comfort and facilities for their care are pro vided. The sick and wounded who will be able to return soon for duty will be retained in these hospitals rather than turned over to the service of the interior. These base hospitals are operated with methodical regime and have all facilities for substantial surgical work and to expedite convalescence. By far the greater proportion of the operations here are "civil surgery" as distinguished from "war surgery." The bed capacity in the rear of the zone of the advance is aimed to be adequate to care for 10 per cent of the total forces when troops take the field, with facilities for rapid expan sion. One base or general hospital is estab lished for each 500 beds to be provided. The base hospitals are centres of great medical ac tivity. i Often there are contagious disease hos pitals n connection. Here are located medical supply depots, materials being accumulated here and sent forward as required. Here also are field laboratories and casual camps for sanitary troops. There are also Red Cross units. Sam tary inspectors having the rank of lieutenant colonel, and who are assistants to the division surgeon, supervise the medical operations, with the surgeon, base group, in immediate charge.