The Organization of the Medical Service of the German Army and its Employment in the Campaign Against Poland
An article by Lieut. Colonel H. Hartleben, Medical Corps, German Army. Military Review, September 1940
provided by Raúl M (Tigre)

The medical service, as well as other branches of the Army, finds itself faced with new missions, new tasks and new problems as a result of the changes brought about in modern warfare by motorization and mechanization. The Campaign in Poland ofered the first opportunity to test the organization of the medical services of the German Army in this new warfare.

The two main problems that must be solved by a military medical service are:
( 1) The problem of providing the best medical supply system that is possible under warfare conditions,and (2) The problem of transportation, especially in a war of movement. A simplification of these problems will result if the organization of the medical service is so elastic as to meet the various requirements of war under all conditions and if it is founded on the simplest and most uniform basic elements possible in order to measure up to the
requirements of the various types of combat elements.

The medical service of the German Army, as in any army, emanates from the combat units. Every soldier carries one large and one small first aid packet and is trained in the application of these dressings. The medical personnel of the combat units includes litter bearers with special training in first aid and the transportation of the wounded. In addition, a medical noncommisioned officer or private with thoroughand careful training in medical service is assigned to each unit. All of the medical personnel, including the litter bearers, carry on their belt a medical kit for first aid. The litters consist of two equal-sized collapsible halves; they are so constructed that the bearers can easily carry and assemble them with few manipulations. Conditions permitting, the litters may be transported on two-wheeled carriers.

The infantry battalion is accompanied by two medical officers-the battalion medical officer and his assistant. Their equipment contains quantities of medicine and dressings sufficient to meet the demands of major operations. Included are tetanus antitoxin and a “pack filter apparatus” for the purification of water derived from any source. This equipment, packed in chests, is carried on a special medical equipment car. Small units may carry enough of this equipment to meet their own demands.

In combat, the equipment of the battalion medical officer, together with his personal equipment which he carries with him in a leather case, serves for the establishment of the battalion aid station. This aid station is located as near to the actual front as possible. As a rule, the wounded receive their first aid by a medical officer at this station, unless such aid has been rendered in battle. Aid by a surgeon-specialist usually cannot be given at the battalion aid station, and no provisions are made for it.

The medical service within the infantry battalion is, thus, conducted independently by its own medical officers and their assistants-the medical NCO’S and privates. The medical service of the other arms is carried out in a similar manner, though with less personnel and equipment. Provisions are made for support by medical companies which go into action when casualties are heavy and serve mainly for the purpose of collecting the wounded in the zone of action.

From the battalion medical detachment, the medical service passes to the medical elements of the division. They comprise normally:
Two medical companies;
One motorized field hospital (accommodations for 200 patients) ;
Two motor ambulance trains (15 motor ambulances each).

These elements are under the command of the division medical officer. Depending upon the type of division, the medical companies are either horse-drawn, motorized, or one company may be motorized and the other horse-drawn. In the case of very highly mobile units, the field hospital is omitted and replaced by a third motor ambulance train, in order to meet the constant transportation requirements.

Both on the march and in combat, the medical companies constitute the main factor of the division medical service. Each company consists of three platoons, each of which has a separate function. The first platoon is made up entirely of litter bearers who collect the wounded in the field and evacuate them from the battalion aid stations. The second platoon organizes the division aid station; it includes at least one surgeon-specialist. The third platoon may be used in support of the other two platoons or for independent missions. Near the division aid station elements of the medical company may be used to establish the collecting station for slightly wounded.

The employment of two medical comptmies in the division makes for great mobility of the medical service. It permits the medical service to keep up with the advance of the combat units and, iu cases where the two companies ape employed separately or in relief, to carry out the surgical work and to evacuate the casualties in a normal manner. It permits the establishment of two medical centers behind the combat troops where the operations cover a wide front. Besides, both comfxmies nmy be employed jointly under favorable conditions. Thus the medical service of the division is elastic enough to conform to any number of changes in the situation.

The equipment of a mwhcal company includes canvas for the erection of the division aid station (where buildings are not available) and modern surgical equipment. Like the battalion medical equipment, the equipment of the medical company is suitably packed in individual chests. Four horse-drawn or motor ambulances are assigned to the company.

The division aid station is the first place at which surgical aid is rendered. Here the wounded are examined as their fitness for removal, their condition is improved and emergency operations are performed. The duties of the division aid station are limited to these functions because of the necessity of maintaining the mobility of the medical companies and of their remaining as near to the combat units as possible—three or four miles behind the front line.

Surgical activity within the division is centered further back in the surgical hospital, where the routine should be similar to that of a regular hospital in the zone of the interior. Its equipment is somewhat larger and heavier than that of the division aid station. The surgical hospital is motorized and can follow the division quickly upon being relieved by other medical units. If necessary, a second surgical hospital may be moved up to support the division surgical hospital, until relief arrives.

The division evacuates its sick and wounded mainly by means of its motor ambulance trains, part of which may be used for the evacuation of patients from the aid stitions to the rear or to the division surgical hospital. The motor ambulance trains serve also for the transportation of wounded to collecting stations or hospitals in the communications zone. The motor ambulance of the German Army accommodates four lying, or two lying and four sitting, or eight sitting patients. A number of motor ambulances are equipped for cross-country travel.

The division medical service as outlined above may be reinforced temporarily, if necessary, by additional medical elements. Besides, surgical hospitals of the army unit may be employed in all zones if circumstances call for such reinforcements, as, for instance, in the case of epidemics.

A corps medical officer is designated to supervise the execution of the directives from the army medical service, to supervise the progress of the division medical service and to take such corrective action as he may find necessary. He is authorized to shift the medical elements within the division for the pourpose of balancing their strength. He also has at his disposal special medical elements which he may employ whenever the divisions call for help. He may also call upon the army chief medical officer for additional medical units if required.

The purpose of the organization of the medical service above the division is to regulate and execute the evacuation of patients to the rear, and to sort the sick and wounded according to medical requirements. All of this belongs to the functions of the army chief medical officer. Depending upon the hize of the army, he has at his disposal a varying number of medical units, especially motorized surgical hospitals designed for local support of the division medical services. For evacuation purposes, he has under his command a number of motor ambulance trains organized like those of the divisions. These medical units are combined into an army medical detachment.

Each army has two evacuation battalions. They are organized into three companies of three platoons each. Each platoon is equipped to set up a separate collecting station. The collecting stations serve merely as transfer stations where the patients receive simple medical attention and are afforded rest and food for brief periods. These stations are placed at points where the situation indicates a concentration of wounded and also at points where the sick and wounded must be distributed among the various hospitals in the communications zone or loaded on hospital trains.

The hospitals in the communications zone are divided into hospitals for the slightly wounded and hospitals for the seriously wounded; each numbers up to 500 beds. They are equipped as much like regular hospitals as possible and contain special wards under the direction of surgeon-specialists. Where local hospitals are available, they are, of course, put into service. Other large buildings may also he used to house the hospitals. The mobile hospital equipment includes as standard equipment capable X-ray apparatus and dark room equipment, all suitably packed in chests.

In order to keep the medical services with combat units properly supplied at all times a medical supply depot is allocated to each army. This army depot may establish branch depots where and when it deems such stations necessary.

The officers of the medical service are picked for their professional ability as well as for their qualities as leaders. Assigned to the chief medical officers of the armies as consultants are carefully selected and recognized specialists in their profession—generally university professors. The latter assist the medical officers of the various medical establishments either with advice or, when necessary, actual help.

In addition, the army chief medical officer has at his disposal special groups of auxiliary surgeons. These surgeons, carrying their own sets of surgical instruments, go into action where their assistance is most urgent, be it at the division surgical hospital or the division aid stations. It was demonstrated in the Polish campaign that it is not advisable to send these surgeons any further forward than the division aid station.

The German Army entered the war against Poland with a medical service organized along the lines described above, and found that no material changes were necessary in that organization—that it could solve all the prohlems with which it was confronted.

Chief among the problems encountered was that of transportation, for not only did the military operations proceed at an extraordinary pace but. the road conditions in Poland were decidedly poor. Nevertheless the elasticity and the simplicity of the organization enabled the medical service to keep itself and its supplies moving forward with the cormbat units while casualties were being evacuated with a maximum of efficiency and speed.

The motorized medical units bore the brunt of the burden, the horse-drawn medical companies being unable to keep up with the swiftness of the military operations. The motor ambulance trains performed tremendous feats. Thanks to the motorization of the division surgical hospitals, they were able to follow the combat units at a relatively fast pace. In many instances, the hospital units established themselves quickly in local hospitals, schools or other public buildings, even though the primitive conditions in certain parts of Poland made it necessary frequently to resort to auxiliary measures.

The great distances that the medical units were required to cover could have been fatal to wounded whose condition called for special treatment in clinics located in the zone of the interior. The large number of demolished railroad bridges were quickly repaired, however, thus permitting the use of the specially equipped hospital trains for the evacuation of patients by rail to the zone of the interior. In very serious cases, such as gunshot wounds of the eye or skull and fractures of the femur, patients were evacuated by aircraft-either in ambulance planes or in the regular transport planes. Evacuation by air over great distances proved highly satisfactory, particularly since no major variances in altitude were involved.

In view of the prevalence of centers of communicable diseases in Poland, a certain number of losses due to various kinds of diseases was anticipated. However, every German soldier being inoculated against typhoid fever, the number of typhoid cases was extremely small. Dysentery cases occurred, for the troops had to march through many regions where that disease was common. Well trained in hygiene, the troops succeeded in keeping the disease down and prevented the spread of a regular dysentery epidemic. There was not a single case of smallpox among the soldiers. The inoculation of all wounded against tetanus proved a complete success. Lockjaw has lost its terror as a war disease.

The casualties were relatively small. Official figures have been released, placing the killed at 10,000 and the wounded at 30,000. Thus the ratio of killed and wounded is 1:3, a somewhat higher ratio than that of the war of 1914. The higher ratio can probably be attributed to the numerous engagements fought at close range and to the increase in effectiveness of modern weapons.