The medical field has changed drastically since the beginning of the American Revolution. Caring for casualties on the battlefield was a major problem in the recovery and care as this was the responsibility of the Quartermaster Sergeant and select Soldiers from the field, mainly Noncommissioned Officers (NCOs). Injured Soldiers could not call for the skilled medic as they did not exist yet. Regimental Surgeons performed initial treatment, but there was still a problem as the numbers of casualties had risen.
The quality of care performed by the Quartermaster Sergeant and his team was poor, and Commanders did not send their best men to assist with health roles needed by the Surgeon. The detailed men lacked motivation, often spent time on the battlefield and caring those in the temporary medical facilities. Ambulances were not up to par, causing problems for the detail to effectively move the injured to the Surgeon without worsening their conditions. President George Washington saw that medical care was critical to assist on the battlefield, as two-thirds of the Soldiers died from disease rather than wounds during the Civil War.
On 17 July 1776, Congress authorized the employment for the Hospital Steward (Medical NCO). Their roles were to serve as litter bears, foodservice, pharmacists, orderlies and nurses. Hospital stewards only received one dollar a day and two rations for their services. They were then given additional responsibilities to purchase whatever items needed to care for patients. By 1780, stewards’ roles began to fulfill administrative and logistical functions as the requirements for hospitals grew. At the end of the war in 1784, the Army downsized, and it was without a Medical Department for four years.
Although they had no official rank, Hospital Stewards again were Soldiers detailed from line units to provide health care for Soldiers within the Army. Detailed Soldiers were required to be able to read, write, and have some background in mathematics and chemistry. In 1813, as the Army was reorganizing, Congress had yet to extend the use of the Steward. The Secretary of War, without the approval of Congress, authorized the enlistment of stewards for a short period to meet the medical needs of the Army.
Not being able to provide sufficient care was still of importance to the Secretary of War, he decided that to meet the mission requirements, selected NCOs from line units would also serve in these roles. They handled personnel management, patient care, food service, and overall administration of the hospital; skills in which they learned performing on the job training. Those leaders were still forced to return to their line units and complete drill three times a week, payroll muster, and often were left behind with patients when the Surgeon was away with other units.
The NCOs were required to spend part of their time retrieving casualties from the battlefield and caring for the wounded who admitted to the temporary medical facilities. Performing these missions were also challenging as they did not have adequate Ambulances to transport patients without causing further injury. A significant improvement came in 1856 when Congress authorized the appointment of as many Hospital Stewards the Secretary of War deemed necessary. They were recruited onto the hospital rolls as NCOs, permanently attaching them to the Medical Department.
Dr. John Letterman, medical director of the Army of the Potomac, created the first ever Ambulance Corps. NCOs were in charge of two to three ambulances within their regiment and was assigned a driver, two litter bearers, and two stretchers. Once assigned to the Ambulance Corps, Enlisted Soldiers remained and regularly trained under the instruction of their regimental surgeon. The execution of the Ambulance Corps proved to be an efficient tactic on the battlefield, causing state National Guard units to adopt the concept.
The Ambulance Corps disbanded in 1864 and all critical specialties (nurses, ambulance men, pharmacist, etc. ), were eliminated. The only enlisted to remain in the hospitals were the steward. After several attempts over the years made by the Surgeon General, Congress authorized the establishment of the Hospital Corps in 1887, via General Order 29. The establishment of the new Corps allowed for the Hospital stewards to wear full sized chevrons that were similar NCOs worn throughout the Army. Their chevrons distinguished the stewards from the rest of the NCOs, which included a red cross in the center.
Acting Hospital stewards wore the same chevrons except for the stripe on the top, and privates of the hospital corps wore the “White armband with a Red Cross. ” 1 March 1887 is considered the “Anniversary of the Hospital Corps. General Order 29 defined the stewards pay, successful completion of board requirements given by medical officers, promotion ability, and it gave the Army power to enlist as many privates that the service may require. The order allowed for hospital stewards to be detailed whenever their skills were needed with an increase of pay to $25 per month hile serving in those roles.
The Army provided three grades for enlisted medical personnel: hospital stewards, acting hospital stewards, and privates. Within its first year, hospitals began allowing eligible privates to test to become “Acting” stewards. After passing, successfully serving one-year probation as an “Acting” steward and passing another examination, they were appointed as “Permanent” stewards, NCO status. Instead of maintaining their soldiering skills, “Companies of Instruction” were formed to enhance medical skills and provided courses such as first aid, anatomy, and physiology.
Stewards also rotated through the hospitals as Ward Master, nurses, cook, and performed administrative functions to sharpen their medical skills. The companies of instruction also sent their NCOs to teach line Soldiers field medicine and basic first aid. In 1903, the Hospital Corps was disestablished, and the term steward and private of Hospital Corps changed to Sergeant and Private. The title Master Hospital Sergeant was used until 1920. The Army Medical Department began formal training at Fort Oglethorpe, Georgia during World War I.
The knowledge and skill set of enlisted personnel were rapidly improving. They were now training volunteer recruits in areas such as veterinary, dental, radiology, laboratory and psychiatry. The Army’s first dentist was an NCO, who worked under the direction of his regimental surgeon. Training within Army medicine transformed to be more specialized in nature and experienced NCOs had to take the place of the Surgeon in training the enlisted members. By 1890, the Army had created its second company of instruction to train personnel who enlisted solely for a military medical career.
For over 20 years, the growth of Army medical units and staff rapidly grew. Medical science kept a steady pace with change and growth; new medicines evolved causing more demands on the NCO ranks. The medical NCO was equipped and sophisticated enough to evacuate casualties from a battlefield to a hospital within 20 minutes. They began usage of helicopters and other ambulances in which helped moving the sick and wounded to medical facilities, significantly enhancing evacuation procedures.
These additions helped the medical NCO along with the Surgeons to return numerous Soldiers to duty, increased the morale of units, it contributed to lower the overall number of deaths. The Army introduced its first formal instruction for NCOs within the Active, National Guard, and Reserve forces. The Medical Field Service School (MFSS) opened at Carlisle Barracks, Carlisle, Pennsylvania. The MFSS developed medical equipment and doctrine suitable for the battlefield. NCOs used their field experience to apply classroom instruction and field exercises to train in combat casualty care and disease prevention.
They tested new equipment and handled training the enlisted technicians on its proper use. Thousands of NCOs attended this school during its 26-years of operations. As the Army opening Medical Replacement Training Centers in Camp Lee, Virginia and Camp Grant Illinois, there was still a critical shortage of medical NCOs on the front lines in combat. Medical NCOs were forced to train line Soldiers in basic first aid prior to returning to their regular duties where they improved their medical proficiency skills. The term “DOC” was now the new term to identify medical NCOs.
Being there were still massive shortages of Medical NCOs in every element of the Army, females began enlisting into the Women’s Auxiliary Corps (WAC). They trained as pharmacy, laboratory, and X-ray technicians. This reduced critical shortages overseas and allowed the Army to send men into battle while maintaining the medical facilities in the United States. Upon closing the MFSS at Carlisle Barracks, Pennsylvania, it then relocated to Fort Sam Houston Texas, where it remains to this present day. The Medical Training Center trained enlisted personnel
