EVACUATING CASUALTIES, 12 JULY 1943. Jeep, converted into an ambulance, could carry three litters and one sitting patient. While Hester's men had been attaining limited tactical successes, unusual medical problems had appeared within his division. Enemy resistance was not great at first. Some go men of the 43d Division were killed, up to 17 July; 636 were wounded. Other men had been injured by vehicle collisions, falling trees, accidental explosions, and the like. Disease had put over 1,000 men out of action. (XIV Corps G-3 Jul, 17 Jul 43.) Diarrhea and dysentery, ailments helped along by improper field sanitation, were prevalent in early July. They put men on the sick list for several days. Skin fungus infected about one quarter of the men. And there was always malaria. Although malaria control measures seem to have been carried out so conscientiously that few new cases broke out in the Occupation Force, all the troops had been in the Solomons for some time and there were always recurrent cases. An especially large number of casualties was caused not by wounds or infectious disease but by mental disturbance. Between fifty and a hundred men were leaving the line every day with troubles which were diagnosed as "war neuroses." Col. Franklin T. Hallam, surgeon of the XIV Corps, arrived in New Georgia on 14 July when mental troubles were at their height. In Hallam's opinion, "war neurosis" was a "misnomer in most instances," because men suffering simply from physical exhaustion "were erroneously directed or gravitated through medical channels along with the true psychoneurotics and those suffering with a temporary mental disturbance currently termed 'WAR NEUROSIS.' " (Ltr, Col Hallam to The Surgeon, USAFISPA, 31 Oct 43, sub: Med Service, New Georgia Campaign, P- 31.) These unfortunate men "who had not changed clothes or had two continuous hours of sleep all had the same expression. Their hair was matted and muddy, and beards were 1/2 inch in length, eyes were sunk in, dark, and had a strained expression. Gait was plodding and methodical, no spring or bounce. When they stopped walking they fell in their tracks, until it was time to proceed again ." (This description comes from a personal account, "Medic on Munda," by Capt. Joseph Risman (Medical Corps), 169th Infantry, and is quoted in SOPACBACOM, History of the New Georgia Campaign, Vol. I, Ch III, p. 26, OCMH.) Colonel Hallam's description is even more graphic: At least 50% of these individuals requiring medical attention or entering medical installations were the picture of utter exhaustion, face expressionless, knees sagging, body bent forward, arms slightly flexed and hanging loosely, hands with palms slightly cupped, marked coarse tremor of fingers...feet dragging, and an over-all appearance of apathy and physical exhaustion. About 20% of the total group were highly excited, crying, wringing their hands, mumbling incoherently, an expression of utter fright or fear, trembling all over, startled at the least sound or unusual commotion, having the appearance of trying to escape impending disaster. Another 15% showed manifestations of the various types of true psychoneurotic complexes. The remaining 15% included the anxiety states, and those with various bizarre somatic disturbances. These were the individuals whose symptoms were of insidious onset, starting with insomnia, vague digestive symptoms, bad dreams, frequency of urination, irritability, diminished ability to concentrate, and a generally reduced efficiency in the performance of assigned duties. (Ltr, Hallam to The Surgeon, USAFISPA, 31 Oct 43, sub: Med Service, New Georgia Campaign, PP. 36-37.) Of about 2,500 men in the New Georgia Occupation Force whose troubles were diagnosed as "war neuroses" between 30 June and 30 September, the 43d Division contributed 62 percent during the period 30 June-31 July. About 1,500 cases came from the three infantry regiments of the 43d Division: 700 from the 169th Infantry, 450 from the 172d Infantry, and 350 from the l03d Infantry. (Ibid., P. 32. of the 2,500 cases occurring from 30 June to 30 September, the 43d Division had about 1,950 or 79 percent; the 37th Division, 200, or 8 percent; the 25th Division, 150 or 6 percent; Navy and Marine Corps units, 200 or 8 percent. In July, the New Georgia Occupation Force had 1,750 cases or 70 percent, in August, 650 or 26 percent, and in September, 100 or 4 percent.) Attempting to explain this mental trouble, Hallam divided the causes into two groups he termed "basic causative factors" and "precipitating causative factors." Basic causes involved leadership, orientation, discipline, and physical fitness. Units with poor leaders were more apt to have trouble than those in which the standard of leadership was high. Mental and Leadership Breakdown In some units there was a direct correlation between the incidence of mental troubles among the leaders and among the led. When soldiers were not adequately oriented--not told what was going on, what their objectives were, and what they were expected to do--they were more apt to become excited by loose talk and wild rumors. The significance of lack of proper discipline and physical fitness in any military organization, but especially in one engaged in battle, is perfectly obvious. Interestingly enough, however, Hallam noted that men "with borderline physical defects, consisting principally of eye, teeth, joint, weight, and feet defects, did not break, but did some of the best fighting. (Ibid., P. 35.) Remarkably few men wounded in action became neurosis cases, perhaps because their knowledge that they would be evacuated eased their mental strain. The basic causes, of course, were present in some units when they came to New Georgia. It was Hallam's opinion that men affected by any of the basic causes were triggered into mental disturbance by the precipitating factors, which were combat fatigue, enemy action, noise, and mass hysteria. Combat fatigue, the almost unutterable physical and mental weariness that comes from long stress and strain in battle, probably accounted for half the diagnoses of war neuroses. The most effective enemy action was the kind which so seriously disturbed the 169th Infantry--the real, and occasionally the wholly imaginary, nocturnal harassing tactics of the Japanese. Although aerial bombardment was also effective, the noises to which Hallam referred were not the sounds of guns firing and shells bursting, but the natural sounds of a jungle night, the breezes, branches, birds, and land crabs. These caused great anxiety among men to whom they were unfamiliar. On occasion mass hysteria took over; mental breaks spread like infection among troops. Most of the mental cases, and especially those caused by fatigue, Hallam believed, could have been cured by a few days in a rest camp in the combat area. Sedatives, sleep, clean clothes, baths, shaves, good food, relief from duties, and recreation would soon have enabled the men to return to their units. But up to mid-July there were no rest camps, nor even any real hospital facilities, in New Georgia. The 43d Division, about 30-35 percent understrength in medical officers and enlisted men, had only a 125-bed clearing station to care for casualties. (The 17th Field Hospital came up from Guadalcanal and opened on New Georgia on 28 July.) Men requiring more than twenty-four hours of medical treatment were being evacuated, usually by water, to Guadalcanal, with the result that casualties frequently did not reach hospitals until three days after they had been taken out of the line. These medical problems, coupled with the slow progress of ground operations up to mid-July, caused serious concern to all the responsible higher commanders. More The Offensive Stalls Japanese Plans Operations of Northern Landing Group Operations of Southern Landing Group Casualties Command and Re-inforcements Back to Table of Contents -- Operation Cartwheel Back to World War Two: US Army List of Issues Back to MagWeb Magazine List © Copyright 2002 by Coalition Web, Inc. This article appears in MagWeb (Magazine Web) on the Internet World Wide Web. Other military history articles and gaming articles are available at http://www.magweb.com