With the american soldier goes american medicine. Backing him up, by his side, with him in his advance. In wartime and in peace, the medical department carries on, fighting disease, healing and rehabilitating the sick and wounded and constantly working and constantly working to search out disease vectors to prevent, detect, and control epidemics. Pursue this mission successfully, the medical department was backed up by a network of laboratories, stretching from north to south, east to west. Clinical, Public Health, and Research Laboratories were required everywhere. Diseases new to the army doctor were being encountered. New diagnosed procedures and treatment and control have to be developed and evaluated. Operation and combat under extreme heat and cold produce problems that were a challenge to the medical department and its laboratories. Medicalhis vast laboratory organization, which followed the army to every distant outpost on our fighting front where the many divisions and services of the Surgeon Generals office. Although the Laboratory Division was concerned with every aspect of medical laboratory operation, Outstanding Service was contributed by other Preventative Medicine Services as well as the training at hospital divisions, the personnel and supply services. The Army Medical Department research and graduate school and army interest institute of pathology. These organizations represented a coordinated effort that directed the operation of the armys Medical Laboratories. The first big job was to train field and Hospital Laboratory units as well as technical personnel. For overseas assignments alone, to 17 General Hospitals, 196 patient hospitals, 91 Evacuation Hospitals, and 99 field hospitals had to be organized and trained. This unit training was conducted at camp barclay, texas, camp alabama, forturi, lewis, washington, and it camp in illinois. In addition to the overseas needs, hospital and laboratory for facilities in the interior had to be expended. General hospitals increased from a total of four to 65. 56 Regional Hospitals were established. 26 for the Army Service Forces and 30 for the army. 300 station hospitals were required. 158 for the Army Air Force forces. Addition, 10 Service Command laboratories are the medical department was faced with the enormous job of staffing, training, and equipping various installations for wartime responsibility. Enlisted personnel received training at the medical department and technician schools. Located at fitzsimmons General Hospital and nine other General Hospitals in addition to the army medical center. These men and women became highly specialized medical Laboratory Technicians whose loyal and able wartime record merits the highest praise. Civilian medical schools throughout the country contributed to the training of medical Department Laboratory offices. Officers are not doctors, but they are scientists in their own right. They are a group of scientists who directed bacteriology, chemistry, serology and entomology sections of the laboratories. They made significant contributions to the high level of Research Work of the army laboratories. There were four principal types of Medical Laboratories the Service Command and general, regional, and station hospital laboratories. Public health responsibilities were delegated to 10 service laboratories. Each Service Command had one of these public type laboratories except the large ninth Service Command that had 2, 1 at fort lewis, washington and one at monterey, california. In new york, the Second Service the Laboratory Diagnostic facilities not provided by other medical department laboratories. They investigated outbreaks of disease, expect inspected facilities and personnel. The staff included trained bacteriologists, entomologists, and other specialists. Bacteriology, section water samples are examined for portability. Potability. In the serology section of the second Service Command laboratory, it was not uncommon to make as many as 2000 tests for syphilis a day. One of the main functions of the Service Command laboratory was to make these and other tests. These send known specimens to hospital laboratories in the Service Command. When the reports came back, the Service Command laboratory had determined the quality or the work performed. Food for army consumption had to meet high Public Health standards, so the veterinary section was assigned duties like the examination of milk, dairy, and meets. Some of the most exciting was performed in the chemistry section. In instances where illness or death may have occurred under questionable circumstances, blood and other body fluids were examined for alcohol content in the presence of poisonous metals like mercury, lead, cadmium and arsenic. You can see then that the Service Command labs where the out army counterparts of state, city and Health Department laboratories with responsibilities that were even broader than those of the civilian equivalent. Cases of sisters so misys, hookworm, and other parasitic eases as well as ortho orthopedic, necessitated the use of new diagnostic procedures. New drugs had summoned the use of since the beginning of the war and new methods were required to determine their effectiveness against pathogenic bacteria. New methods had to be developed to determine drug levels and to ascertain octomom concentration required for combating specific infections. Inadditional problem arose the field of tissue diagnosis. The situation was particularly acute because the shortage of pathologists made it impossible the adequate staffing of even the General Hospitals. 19 pathologic centers were established, most of them in larger and strategically located General Hospitals. Thesemaintained between pathologic centers and the Army Institute of pathology. By this means, consultation and assistance on vital problems as cancer diagnosis was provided each hospital installation in the zone of interior. The third type of laboratory in the zone of interior within the Regional Hospital which was concerned principally with cases originally eating originating in the gi. Here aredures observed representative of the work done in most Regional Hospital laboratories. To provide qualified technicians to staff these laboratories as well as those at patient hospitals, onthejob training was often given. The fourth type of lab was the patient hospital lab. The rains of procedures performed very greatly and was determined by the size and location of the hospital. In most of the larger hospital laboratories, a small scale bacteriology, serology, chemistry and Pathology Service was provided in addition to the routine print clinical pathology. So the army Medical Laboratories trained and developed in the zone of interior went to war to face the stress of battle conditions overseas. Although constantly improvisations were required to conditions, the organization is presented as a guide, medical Department Units in a the mediterranean theater presents a good example of planned, Efficient Laboratory organization in a theater of operation. In the combat zone, the evacuation Hospital Laboratory provides facilities for emergency and routine clinical pathology. In italy, the eighth Evacuation Hospital was equipped with with qualitative urine analysis, examination of feces, hematology, including blood typing, hemoglobin determination, and other diagnoses. The laboratory was also able to examinationsfield and similar tests on spinal fluid. In the mediterranean and some of the other theaters, field hospitals were utilized in the combat zone as elements in the chain of evacuation. The 15th assigned to the mediterranean theater is representative of such a hospital and its laboratory. Regardless of their assignment, field hospitals generally held patients for a short period only, therefore the reins of Lab Procedures were limited. The mobile laboratory in the field, the medical laboratory, supported the field and Evacuation Hospitals as well as providing facilities for combat and other nonmedical service organizations. This laboratory could be assigned either to an army or a communications zone. The medical laboratory is composed of the headquarters and five professional sections that make up a base stationary laboratory. A field primarily as Public Health type laboratory, it performs epidemiological studies, investigations, and surveys. Its concerned also with routine serology, bacteriology and pathology as well as water analyses, examination of meat, food, and dairy product carried out for all such services. Courier jeep systems to work out. After making his rounds of the hospitals, the courier brings specimens to the second laboratory. In the chemistry section of the laboratory, beverages are being analyzed. In the bacteriology section, tubes of media are being prepared for water analysis. The Second Medical Laboratory illustrates the versatility of such an installation. Epidemiological and Laboratory Studies in the distribution of salmonella and typhoid were undertaken. Army and civilian food handlers were surveyed for intestinal pathogens. When examinations had been completed, reports are distributed by the courier. The medical laboratory maintains mobile units. This laboratory truck was the headquarters for the studies of epidemics and infectious hepatitis. These mobile units could be used for supplement to brearley the services of a hospital temporarily the services of a Hospital Laboratory. The medical laboratory also serves the station hospitals, located in the communication zone. The medical Corps Officer is devoted fulltime to the laboratory and is assigned as chief of service. Because more definitive treatments are given here, facilities are more complete than those found in the evacuation and field hospitals and bacteriological, chemical, and other treatments can be performed. The path obligee pathology section provides its own specimens and provides a complete pathological service. However, the most complete clinical Laboratory Facilities in the theater are found in the General Hospitals. Patients are referred here from the evacuation, field, station, and other hospitals for more specialized treatment. The greater variety of clinical material necessitated a larger and more complete laboratory. Here in the pathology section, and emergency diagnosis is to be made on a frozen tissue section. The pathologist examines the slide and can render an immediate diagnosis. Slide tests are used for the identification of the dysentery producing salmonellas. Typhoid fever and other infections, diphtheria tests and other cultures, amoeba cultures, and tests for bacterial resistance to drugs can be made here. In the General Hospital the , chemistry section is prepared to perform cholesterol and other determination, in addition to other requested determinations. Here, the copper sulfate technique for the blood specific remedy is used to assist with the management of shock. Where a large concentration is required for hospitals, an economy of assistance is affected by the organization of a Hospital Center. Special responsibilities are delegated to each hospital. For instance, one General Hospital performs all the bacteriology and serology required by all the General Hospitals in the center. In england, the 12th Hospital Center was composed of the 55th and other General Hospitals. The laboratory of the 55th was superbly equipped. Here, a tissue section is being prepared for microscopic examination. Over here, anaerobic cultures are inspected for bacterial growth. Blackout curtains permitted lab work 24 hours a day. Complete as the service was in italy and other theaters, there was needed a higher echelon laboratory to perform other examinations and investigations of important medical, veterinarian, and sedentary problems. This need was fulfilled but the medical general laboratory, which provided facilities comparable to the research and graduate school and the institute pathology. One medical general laboratory was assigned to each of the four major theaters. For example, the 15th was assigned to the mediterranean theater. Though the mission of the laboratory was primarily epidemiological, clinical and Research Problems were also investigated. The theater blood bank, part of the laboratory, supplies most of the blood used in the theater. These tests are being loaded for truck shipment to a forward area. Lets let the Commanding Officer of the 15th describe the work. The work of our unit and those it serves is integrated in the mediterranean theater of operations. That work consists of diagnostic procedures, the support and supervision of other laboratory units, epidemiological studies, and research. Our main test and research has been malaria and ativan therapy, gangrene, shock, and jaundice. As a diagnostic center, field and laboratory researchers and investigations emanate from the medical general laboratory by virtue of their specially selected staff in the range of equipment and supplies allotted to them. In the 15th general laboratory, research on a disease produce data on which a new concept is now based. Officers and enlisted technicians from other Medical Laboratories were referred to the medical general for short periods of training in special fields. This pathologist is performing an autopsy for medical officers from the Clinical Services and Laboratory Officers for training. In the biochemistry section, important studies on infectious drugstis and the use of in malaria were made. Other sections including pathology also assisted in these studies. The bacteriology section contributed significant studies to the field of intestinal pathogens. Othersw species of were discovered by this laboratory. As a diagnostic center, it covered tissue and clinical pathology. Because of the Research Work conducted, it constituted an important part of the laboratory. Attached to the 15th medical general laboratory was one of the museum and medical arts detachments. These units did all the photographic and illustrative work involved in making up epidemiological charts and recording unusual surgical operations, injuries, and diseases peculiar to the countries in which troops were stationed. By means of courier service, nearby hospitals and periodic inspections of laboratory units, the 15th medical general lab was able to maintain contact with all installations in theater. The laboratory also maintain close communication with the Surgeon Generals office, the Army Medical Department of research and graduate school, and Army Institute of pathology. This was the general plan of the Laboratory Service designed for a theater of operations. However, particular epidemiological problems such as encephalitis, required more detailed investigations. Therefore, missions were sent out by the epidemiological board, such as italy in 1945, to investigate diphtheria. To combat typhus, a commission established laboratories in cairo and dispatched personnel to europe. Naples,he epidemic in teams from the commission assisted in the control of the epidemic. Malaria was a problem as troops moved across north africa, into italy and neighboring islands, so Malaria Survey and control units were dispatched to operate with the armies. Activities of this unit in corsica were typical of the work. Every preventative measure was ddt, beingding dispersed by airplanes. In the pacific malaria was a problem, complicated by the huge and widely separated areas that had to be kept under observation by the control unit. The Solomon Islands campaign proved a severe test for these units. They searched for mosquito vectors and determine their habitat. The men took medicine, used repellent, and hung nets. There were many breeding places on the road to japan. To control them, every method of spraying dusting, boiling, and , draining was used. Typhus proved a serious disease hazard in the pacific and indiaburma theater. Since much less was known, extensive studies had to be made of the disease in the animal hosts and insect vectors carrying it. Rodents and other mammals were investigated as the animal reservoir for this disease. Tics, mice, and other surface insects were studied as possible vectors. Studies of birds and surface parasites were undertaken. These extensive studies added not only to our knowledge of scrub typhus, but also the habits of possible vectors of other diseases. The study of the insect vectors of scrub typhus involve serious hazards, since the disease is a dangerous one and occasionally carries a high mortality. Field investigators had to observe strict precautions to avoid exposure. Mite which carried the disease. In general, laboratories in the pacific had more problems, but because of the nature of the campaign, were able to devote more time to investigate such diseases as schistosomiasis, scrub typhus, fungus infection, hookworm, and dysentery. The pacific counterpart of field and hospital laboratories did not differ greatly from installations active in europe, except they were modified to diagnose these newly encountered diseases. The 18th medical general laboratory in hawaii, by virtue of a trained staff in specialized equipment, contributed significantly to our knowledge of the epidemiology and diagnosis of these diseases. The epidemiological branch worked in cooperation with the theater surgeons office. A central studies of disease hazards were made immediately after enemy forces were neutralized and an island secured, but before command was established, including an investigation of water supplies, insect vectors, and diseases current among enemy forces and native populations. Such studies, known as medical and sanitary surveys, were made of multiple islands. They served practical, immediate, and future purposes. The 18th medical general lab was capable of extensive operations, as those required for investigation of the hawaiian influenza epidemic of 1945. The procedure for the Lab Diagnosis is demonstrated here. A special study of pollenosis, or hayfever, was required, because new hazards were encountered. Pollen extracts were prepared by defecation, then made into solutions used for diagnosis and treatment. The evaluation of ddt and other agents in the control of arthropod borne diseases required the development of new methods of trapping and rearing mosquitoes and other insect vectors. Here, flies are raised for this purpose. These and other insects in various stages of development were subjected to new agents. On our way back, lets stop off in puerto rico, headquarters comprising the antilles department. Those overseas areas organized as departments rather than theaters of operation, and were served by these labs, comparable in size and scope to the Service Command labs in the zone of interior. These laboratories provided the facilities of not only a Service Command lab, but those of a histopathologic center as well. Study tests were maintained for the training of pathologist, and officers and enlisted were given onthejob training. Early in the war, malaria and dengue fever were problems in the caribbean. The entomologist played an Important Role in containing these diseases. The laboratory performed at a tremendous volume of a surveys. Nt in washington, the office of the surgeon general, the Army Medical Department research and graduate school, and the institute of pathology cam came data, specimens, and reports from all over the world. From india, a slide of a suspected tumor. From hawaii comes a report to the estriol of an outbreak suspected of being influenza. From puerto rico, cultures from an outbreak of dysentery are sent in. From persia, a tissue assessment believed positive for leishmaniasis. Of virulentcultures diphtheria. From panama, studies on salmonella. Immediate action is required on these specimens and reports. Diagnosis, information on methods of control, and other requested data are radioed to these overseas installations. To the Army Institute of pathology was given the job of establishing an armylike plan army wide plan of diagnostic service in pathology. The institute consists of four main subdivisions. The department of pathology, the American Registry of pathology, the army medical Illustration Service, and the army medical museum. Initial review of pathological specimens is conducted by the department of pathology. When cases are received, they are sent to the preparation room, each is assigned to a staff member who assumes responsibility for the case. If necessary, specimens referred to the Histology Laboratory where microscopic slides are made. Next, they are examined by pathologist and consultants. Since Army Regulations autopsy cases before did to the institute, as well as tumors in diseases of current interest, the volume of work was staggering. Over 1000 autopsy cases and 1000 surgical specimens a month or reviewed by the institute. Problem cases are those of particular interest are studied under the microscope, which makes it possible to review a specimen at the same time. Various features of the slide are pointed out and discussed by one or more of the doctors. At a typical consultation conference, a group confers on a microscopic slide which might have been sent from the european or Pacific Theater of operations 48 hours before. The comments of doctors are recorded and later transcribed into the case record. The professional record section takes care of the coding and analysis of this material. After all the material has been coded and filed, select cases are referred to the department pathology. Also in this office is a collection of study tests that conclude consist of clinical and pathological data demonstrating examples of problem diseases. Such are on loan to civilian medical schools as well as Army Installations everywhere in the world. They represent unusual valuable teaching material, selected from one of the largest collections of specimens assembled. The third big subdivision of the institute, falls the job of pictorial activities. Not only does the Illustration Service mount, index, and file the medical photographs, but acts as a Central Agency for the collection, separation, duplication, cataloging, and exhibition of materials pertaining to wounds, injuries, and diseases of medical military importance. It also trains the medical and museum arts detachments doing the same work in overseas installations. Illustration teams are constantly at work, making clinical pictures and drawings, recording the progress of new diseases, and documenting new or unusual surgical techniques. These units are skilled and the in both still in Motion Picture photography, blackandwhite, color, and infrared film, and fully equipped to handle it photomicrographs and assignments, as well as other work. In addition, the Illustration Service is responsible for research and experimentation in photography and the development of new clinical and photographic techniques. Lisa specimens and graphic materials have been collected during the past 75 years and assembled for teaching and study. The museum is constantly expanding, with more exhibits added as data are compiled. A collection of pathological specimens unique in history of medicine is stored for study purposes. Many specimens date back to the civil war, and much of the materials were collected in a spanishamerican war in world war i. Many valuable studies have been made on the material collected during world war ii, but years will be required to complete these investigations. To study the effects of the atomic bomb, army pathologists were assigned to teams to study hiroshima and nagasaki. Specimens were collected and detailed studies were made in a section devoted only to this work. Also backing up the army laboratories in their work was the Army Medical Department of research and graduate school. For thousands of officers who had the opportunity to attend, this tropical disease course, they know the value of this training. In addition, a Continuous Program of onthejob training was in progress. For students and staff, a wellstocked library was provided. The various divisions of the school all contributed to the training, research, diagnostic laboratory work, and production of biologicals which constituted the wartime mission of the army medical school. In the division of biologic products, typhoid vaccine is being produced. Are fed withflasks the typhoid culture. After incubation, when the growth has been obtained, it is harvested. The liquid that contains typhoid is processed to kill the organisms, then the vaccine is bottled, labeled, and inspected. Important advances in the study of the virus and diseases were made at the school during the war. In this dry ice box, restored specimens shipped for study from every part of the world, from italy for the study of a fever, typhus, andirst the philippines for rabies. To cultivate these, eggs have become a useful medium is used to isolate viruses, maintain strains, and produce vaccines. Special precautions are taken in the laboratorys handling of viruses. To avoid laboratory infection of the technician, the work is conducted in cubicles. Many of the viruses and diseases can be diagnosed by test tube procedures. In this portion of the laboratory, tests for typhus are being made. Fixation tests are used to differentiate different types of infections. During the war, many new vaccines were developed. The virus and Diseases Laboratory had the job of testing these vaccines for potency. Here, mice are being inoculated for an encephalitis vaccine. It is part of the Army Development and graduate school that functions as the army center for training and research, and Laboratory Diagnosis. Here, chemical procedures to determine the quality of Meat Products are in progress. Students are being instructed in the inspection of food and the Laboratory Tests associated with this examination. The invasion of okinawa and the subsequent occupation of japan gave the medical department the problem of combating japanese encephalitis. The Veterinary Division and the virus section of the school were given the job of producing a chick embryo vaccine against japanese be encephalitis. In producing the vaccine, first, fertile eggs are selected, then punctured to prevent inoculation. Rubber gloves, face shields, and gowns protect technicians from contact with the virus. The eggs are inoculated, and the two openings are sealed. Next, the eggs are placed in an propagation permit of the virus. Following incubation of the embryos are harvested. Then the embryos are drowned in a mill and ground into a solution. With this preparation the vaccine is made. In this brief tour, the divisions all intimately ofcerned with the activities army labs have not been shown, but their cooperation and assistance have been invaluable. The Laboratory Division in the Surgeon Generals office was in the preventative medicine service. This emphasizes the Public Health responsibilities of the division and its relationship to the other divisions in the preventative measures and medicine service. At the height of the war, this service was composed of 10 divisions and charged with prevention, control, and Laboratory Diagnosis of disease. All the material accumulating from these Research Laboratory investigations was reviewed by washington and after study, appeared in the form of scientific papers in military and civilian medical publications. This material formed the basis for directives on the diagnosis, prevention, treatment, and control of the armys problem diseases. The work of the army laboratories continues, as in wartime, the diagnostic facilities of the laboratory are providing Clinical Services. The army surgeon, now under peacetime conditions, looks to the laboratory for problems related to the blood bank, transfusions, antibodies, and wound infections. The epidemiologists await laboratory reports. Observations are made on the status of the armys health. In wartime, the laboratories assisted in the attainment of remarkably low morbidity and mortality rates. Researchers helped in the development of new procedures for disease prevention. Our wartime knowledge has been put to practical peacetime use. The american soldiers look up to these men behind their microscopes, these quiet men behind the scenes, these men who work in army laboratories, whose neverending battle with disease goes on in wartime and in peace. Announcer this is American History tv on cspan 3, where each weekend we feature 48 hours of programs featuring our nations past. From the very beginning, the human race has had to contend with problems of survival, disease, and death. Through the ages, entire populations were decimated and became extinct. Leaving behind only scant remnants of their cultures