THE MEDICAL DEPARTMENT: MEDICAL SERVICE IN THE WAR AGAINST JAPAN. By Mary Ellen Condon-Rall and Albert E. Cowdrey. (CMH Pub 10-24, forthcoming.)

This volume treats the medical history of the war against Japan, a story that was as varied as the theater itself, which covered approximately a third of the surface of the earth. The South and Southwest Pacific Areas and the China-Burma-India Theater were ravaged by tropical diseases; cold injury was aproblem in the Aleutian fighting; and combat surgery was everywhere important. The need to fight a war on islands required the Army to make many changes in a force structure designed for land combat, and the Medical Department followed suit in order to provide medical support on the beaches, during the move inland, and in deep jungle fighting beyond the reach of vehicles.

Command arrangements differed as widely as the physical environment. Theater surgeons were obliged to work in both Army- and Navy-run theaters and within joint and combined command structures. The complications that resulted, especially in the Southwest Pacific Area, were significant not only because coherent medical policy was long delayed, but because of the special difficulties of the Pacific war. Command support was needed to assign medical materiel the high priorities that it needed in order to cross thousands of miles of open ocean and arrive at the proper location, at the right time, and in adequate quantity. Even more important, command support was absolutely essential to enforce the rules of preventive medicine so vital to troop health

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while fighting in primitive and highly malarial lands.

In the South and Southwest Pacific the authors record the complex medical learning process that took place. Although troops in both theaters had been in combat from the first days of the war, their lack of time for preparation was reflected in the early epidemics that weakened both the defenders of Bataan and the conquerors of Guadalcanal and Papua. Hard-won mastery of preventive medicine and amphibious medical organization contributed crucially to the later triumphs of American arms. In all the Pacific theaters, amphibious medical support was a complex art that was learned and perfected to a great extent under enemy fire. In the Central Pacific Area the treatment and evacuation of wounded rather than fighting disease became the centerpiece of medical activity. Finally, medical personnel in the China-Burma-India Theater devoted their efforts not only to support of the small American forces, but to aiding the miserably ill-equipped Chinese armies and teaching the rudiments of medicine to young Chinese officers.

Although care of American and Allied forces grew ever more sophisticated, medical support for guerrillas and prisoners of war continued to be primitive in many respects. Care of civilians injured in the fighting gradually improved, however, leading to the successful efforts of the postwar military government in Japan to suppress disease among former enemies, preserve life, and provide for the victims of the atomic bombs.

Key topics:
1. The organization of a theater medical service in joint and combined commands (Chs. II, III, VII, XI, XIII).
2. Medical interaction with Allied civil health authorities in wartime (Chs. II, VII, X, XII).
3. The organization of medical support for operations in primitive regions (Chs. IV, VI, IX).
4. Medical support of amphibious operations (Chs. IV, V, VI, X).
5. Medical support of guerrilla bands (Ch. XI).
6. The provision of medical care for conquered populations (Ch. XIII).
7. Medical consequences of a nuclear attack (Ch. XIII).