I'm a frontline soldier in the US army during the second world war. I develop a severe toothache that worsens over time, what level of treatment would be available to me?

by AlexologyEU
the_howling_cow

I’m assuming here that the toothache would result in the discovery of some sort of more serious infection and an eventual tooth extraction or extractions, requiring a surgery under general anesthetic and a few days’ rest, so as to examine all the low levels of medical treatment the U.S. Army offered during WWII.

If the toothache became utterly unbearable so as to prevent the soldier from participating in combat effectively, he would be evacuated (or voluntarily evacuate himself) to his battalion’s aid station. The medical detachment of the infantry regiment consisted of a headquarters section of four officers and thirty men (which maintained the regimental aid station) and three battalion sections each of two officers and thirty-two enlisted men (which maintained the three battalion aid stations). The total strength was thirty-four officers and 136 enlisted men. The detachment was issued no weapons, but had four 1/4 ton jeeps with trailers, three 3/4 ton trucks, and one 2 1/2-ton truck. The purpose of the battalion aid stations was to receive casualties from the front line companies that had either been evacuated by the surgical technicians (platoon aid men) or the supporting litter bearers, or had evacuated themselves, provide minor medical care, and evacuate more serious cases to higher echelons. Neither the battalion aid stations or the regimental aid station (which served the other elements of the regiment) were equipped to provide any sort of surgical treatment, and it was advised against beginning any preliminary procedures for the initiation of more complex treatment, as it could cause backups which could potentially lead to life-threatening complications for other casualties.

Patients would not normally be evacuated from a battalion aid station to the regimental aid station, but the dental officers and equipment of the regimental medical detachment were located in the headquarters, so it is conceivable that this could be one of the rare cases. A dental examination chair and related equipment, and a chest of dental tools (such as forceps and stitches) was provided for the performance of minor procedures not requiring general anesthetic (although ether was listed among the contents of the chest). The dental officers could be missing entirely, as “it was found that the dental officers in the infantry regiments were underutilized and in many cases, they were removed from the regiments and used to form roving dental teams that provided dental care for a geographic area, rather than for specific units,” meaning that a men would have to be evacuated to an equal or higher echelon to be examined by a dentist.

The medical battalion of the infantry division served a similar purpose; one collecting company was attached to each regiment, and received patients from the battalion aid stations. The clearing company, which also acted as the collecting company for non-regimental divisional units, triaged patients, performed minor treatment if necessary (similar in extent to the regimental medical detachments), and either returned men to their units or evacuated them to higher echelons. Because of the volume of casualties that passed through them, neither the medical detachments of the infantry regiments, the medical detachments of other divisional units that had such, or the divisional medical battalion were equipped to hold men more than a day or two before either returning them to their units or evacuating them.

Field hospitals, 400 bed mobile units (capable of moving themselves in one lift with their organic transportation), could either operate on their own or be broken into three 100-bed platoons, which was the norm. In combat, these hospitals’ platoons were normally attached to divisions, to relieve the clearing companies of the divisional medical battalions of non-transportable patients. Operating in this manner, only the most urgent cases where any transportation beyond a short litter carry or ambulance ride could be life-threatening, such as men with "massive chest and abdominal injuries, severe compound fractures, and traumatic amputations" were evacuated here.

Evacuation hospitals, which received patients from field hospitals for further treatment or holding and moved them on to higher echelons (general or convalescent hospitals, usually located several hundred miles to the rear), or received, treated, and held patients briefly (i.e., the mildly injured, so as to not clog up divisional clearing stations) before returning them to their units, were either 400-bed semi-mobile (in this case, 25 percent mobile with one lift of all organic transportation) or 750-bed units. They were capable of operating in the same manner as field hospitals (as was done in Italy, when field and evacuation hospitals were “leapfrogged” up the peninsula), but usually received patients who required anesthetic surgery of a less urgent and/or more complex nature than that which was offered at the former facility. The field and evacuation hospitals themselves lacked enough organic surgical personnel to allow them to function at the extent which they would be called upon to do, so surgical augmentation teams from auxiliary surgical groups would be attached to provide more staffed operating tables. The EA-EF teams had three officers, three men, and a nurse, while the EG team had one officer and three men:

  • Team EA: general surgery
  • Team EB: orthopedic surgery
  • Team EC: shock treatment
  • Team ED: maxillofacial surgery
  • Team EE: neurosurgery
  • Team EF: thoracic surgery
  • Team EG: gas treatment

Because of the nature of battle injuries, thoracic and shock treatment teams were mostly found in field hospitals, while evacuation hospitals had more maxillofacial, neurosurgical, and orthopedic teams. Because of theater-determined evacuation policies, the field armies attempted to keep as many patients within their boundaries as physically possible, operating a full array of their own medical facilities to prevent the loss of patients to the Communications Zone.

Sources:

Cosmas, Graham A., and Albert E. Cowdrey. United States Army in World War II, The Technical Services, The Medical Department: Medical Service in the European Theater of Operations. Washington, D.C.: United States Army Center of Military History, 1992.

Hall, Donald E.From the Roer to the Elbe With the 1st Medical Group: Medical Support of the Deliberate River Crossing. Fort Leavenworth: Combat Studies Institute Press.