Frontispiece of Album de la guerre.

U.S. Army Base Hospital #4 Embarks for Europe

By Susan Speaker ~

The United States declared war on Germany on April 6, 1917. Just one month later, the first unit of the American Expeditionary Force embarked for England on the HMS Orduna. This was not a combat unit (the first of those would not arrive until late June) but rather the staff of U.S. Base Hospital #4: twenty-seven medical officers and sixty-four nurses from the Lakeside Hospital in Cleveland, Ohio, plus four clerical workers, and 155 enlisted men. Within a few weeks, they would relieve the staff of a British base hospital in Rouen, France. During the Great War, the Allied forces operated hundreds of these general hospitals located behind the lines in France and back in Britain and the United States.

16 men in uniform pose in three rows outdoors in front of a temporary building.
U. S. Army Base Hospital Number 4, Rouen, France: Personnel, ca. 1917
National Library of Medicine #101396166

The base hospital groups—organized at the top American medical schools and teaching hospitals—were able to mobilize quickly because planning for such units had been going on since 1915. Even though the U.S. was reluctant to go to war, many Americans had volunteered as nurses, ambulance drivers, and surgeons in the first few years of the conflict. They included those who established and staffed the Ambulance Americaine, a 570-bed supplemental hospital outside of Paris. In 1915, the “Ambulance” began hosting surgical teams from America’s leading medical schools, in three-month rotations. The groups were in charge of a 150-bed ward, which provided essential experience in wartime hospital work. The first rotation began in January 1915 with a team from Western Reserve Medical School in Cleveland, headed by Dr. George Crile. Rotations from Harvard, the University of Pennsylvania, Northwestern University, and Washington University followed. Crile and other team leaders were soon convinced that (despite America’s official neutrality at the time) well-organized hospital units should be planned. Such planning could reduce adjustment time for the new medical officers and nurses working in a foreign country under wartime conditions, which also, of course, would benefit the hospital patients.

In August 1915, U. S. Surgeon General William Gorgas asked Crile to design a hypothetical 500-bed base hospital unit, including types and numbers of personnel, and all the equipment and supplies it would need. Drawing from his experience at the Ambulance Americaine, Crile proposed to use 78-person teams organized by large university teaching hospitals, and coordinated with the Reserve Medical Officer Corps and the American Red Cross. The Surgeon General was so impressed that he asked Crile and Harvey Cushing (who headed the Harvard group) to organize model units at Lakeside Hospital and Harvard. Meanwhile, he worked to convince the Congress and the Army to support more military medical preparedness efforts. To demonstrate the base hospital idea, in October 1916, Crile’s unit conducted a hospital mobilization exercise at the American College of Surgeons annual meeting in Philadelphia.

On April 28, 1917 Crile got a telegram from Gorgas ordering the mobilization of the Lakeside Hospital unit, and a week later, the Base Hospital #4 staff was on its way.

Their ten-day voyage is documented in the Marion A. Blankenhorn papers in NLM’s holdings, including a diary and several letters written by Dr. Marion Blankenhorn. Blankenhorn described drilling the men on the ship decks, inoculating them against typhoid fever, and having to put on civilian clothing when the ship entered the war zone, to mislead any German submarines. An album assembled by the Base Hospital #4 group after the war includes photos of the journey as well.

NLM’s World War 1 digital collection also include histories of some of the individual base hospitals as well as hospital newsletters. Check Circulating Now in a few weeks to read more about the adventures of Base Hospital No. 4!

Over the next two years, Circulating Now will periodically publish posts featuring NLM collections that illuminate the medical history of The Great War.

Susan Speaker, PhD, is Historian for the Digital Manuscripts Program of the History of Medicine Division at the National Library of Medicine.

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