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$25 per man for the upkeep of our hospitals. That is the war basis that we have worked it on.

Mr. SHERLEY. What do you mean by upkeep, initial equipment and upkeep?

Col. FISHER. No, sir; just the upkeep. The initial equipment we estimated, as shown on the first page of the memorandum which is submitted, would be the equipment of field units like regimental hospitals, regimental camp infirmaries, field hospitals, ambulance companies, evacuation hospitals, etc., and we estimated that original equipment to cost in the neighborhood of $29,815,000.

Mr. SHERLEY. For how many people?

Col. FISHER. For a second million men.
Mr. SHERLEY. For 1,000,000 men?

Col. FISHER. Yes, sir.

Mr. SHERLEY. $29,000,000 to equip 1,000,000 men not at war.
Col. FISHER. Just for the field equipment.

Mr. SHERLEY. What is the maintenance cost of that for one year? Col. FISHER. We have estimated at the rate of $25 per man in addition to that.

Mr. SHERLEY. For men not at war?

Col. FISHER. No, sir; for men at war.

Mr. SHERLEY. That would make $25,000,000 additional for 1,000,000


Col. FISHER. Yes, sir.

Mr. SHERLEY. And that would make a total of $54,000,000. What I am trying to get at, Colonel, is the way you have estimated this. It is plain that you can not have 2,000,000 men on a war basis and that at least one-half of that number will, during the entire period for which you are figuring, never be on a war basis; that is, never be engaged in actual war abroad.

Col. FISHER. But we do feel very strongly, sir, that we ought to go ahead and get the supplies so they will be ready when they do go to war. Now, our estimate of the additional amount needed for the initial equipment is $29,000,000 and that is for equipping the troops for the field. They need that in any case. Then for gas masks, trench sprayers, oxygen apparatus, etc., $23,000,000 more. Then we have to buy a lot of belts to equip hospital corps men which were formerly bought by the Ordnance Department. We have to buy them now, and they will cost $1,755,000. The upkeep during the year we estimate to cost $28.025.000. Then there are some additional small items. In addition to all this, there is bound to be a certain amount of war wastage. If one of our ships going abroad filled with medical supplies, costing millions of dollars, is sunk by a submarine, which is very likely to occur not to one but to perhaps several, we must count on replacing that material; and in addition, there will be a great amount of wastage at the front. Some of our hospital equipment may be captured and some of it may have to be burned or destroyed, so we feel that we must allow an additional 20 per cent for war wastage, losses at sea, etc.

Mr. SHERLEY. If I understand you, Colonel, the real matter that the Medical Department is concerned about is being in position to order supplies which take considerable time for delivery in such quantities as to make certain that you will have sufficient supplies for 2,000,000 men, whether those 2,000,000 men should actually be in

France a year from now or not, because, assuming that they should not be there, some of them, by July next, they would be continually being sent across and you would not be in a position to gather additional supplies unless you made provision now by contract for them. Col. FISHER. Yes, sir.

Mr. SHERLEY. Now, I understand from what has been said informally that your hospital beds, or rather your beds for men, have been based on a percentage of 3 per cent for soldiers here in the United States and 25 per cent for soldiers actually at the front and engaged in hostilities.

Gen. GORGAS. That is our estimate for hospital provision.

Mr. SHERLEY. That is true, is it not?

Col. FISHER. We have really counted on somewhat more in this country. Ordinarily we have provided for about 8 per cent in this country, and, as I understood it, we felt we would need 20 or 25 per cent abroad and 10 per cent in this country, because some of the sick will have to come back here.

Mr. SHERLEY. Then you are estimating on the basis of 10 per cent in America and 25 per cent abroad?

Gen. GORGAS. When I spoke I was thinking of the estimates we made for these camps. Of course, we will have to bring some classes of men back here; for instance, men who are going to be discharged.

Mr. SHERLEY. And your 10 per cent is on the basis of taking care of wounded soldiers who may be returned to this country, and your 3 per cent is your normal percentage for taking care of men within camps and under ordinary conditions here in America?

Col. FISHER. Yes, sir. We are perfectly astounded, to be frank, with the way we need to increase our estimates. They are increasing the number of men every time they tell us anything about it. The prices are going up perfectly astoundingly, and we find additional things required that we never dreamed of before, and the estimate we make one month the next month seems insignificant.

Gen. GORGAS. As to those figures, the English actually have 1,000,000 beds and the French 650,000 beds, so the estimates are based upon fairly good knowledge.

Mr. SHERLEY. When you say the English have 1,000,000 beds, you mean 1,000,000 beds, including those that are in England and in France?

Gen. GORGAS. Everywhere; yes, sir.

Col. FISHER. As a matter of fact, I do not believe the sum which we have put down here will cover our needs from the way things begin to look now. The figures are perfectly appalling, and they mount up from day to day with the additional demands. This is a very conservative estimate. The prices have gone up since the estimate was made, and I begin to doubt now, even with this appalling figure, whether we can do the things that will be required of the medical department for even the Army we will have. The last thing I was told before I left the office was that, from an estimate which was being made, it would cost $8,000,000 just for automobile tires, and we have only put down $6,000,000 for the entire purchase of automobiles and spare parts and accessories. I am appalled by the way estimates go, the increasing prices, and the growing need for things.

The CHAIRMAN. Colonel, have you a statement which shows the purposes for which the money has been allotted?

Col. FISHER. Yes, sir; we have that statement right here. (The statement referred to follows:)

Memorandum re supplemental estimates under "Medical and Hospital Department, 1918," submitted June 26, 1917.


Initial medical equipments for second million men not

covered by previous estimates, viz:

Motor ambulances, spare parts and accessories___ $6,840, 000

Motorcycles for medical service__

Cooking utensils and tableware_.

Fabrics and textiles____

Foods, beverages, and condiments_

Hardware and metal articles.

Medical and surgical instruments and appliances

Medicines, antiseptics, and disinfectants__

Rubber goods_


Surgical dressings and sutures_

384, 000

4, 500, 000

440, 000

350, 000

880, 000

3, 400, 000

Tin containers_.

Wooden articles

Miscellaneous supplies.

290, 000 126, 000 9,750,000 160,000 995, 000


Gas masks, trench sprayers, and oxygen apparatus for 2,000,000
men, at $10 each, $20,000,000, plus $2,000,000 for a 10 per cent
reserve, plus $2,000,000 for refilling and repairs, less $1,000,000
allowed on previous estimates.
Medical Department belts, 30,000 officers, at $3.50 each, $105,000,
plus 300,000 enlisted men at $5.50 each, $1,650,000‒‒‒‒
Current medical upkeep during the year, at $25 per year per man,
1,000,000 men for an entire year, $25,000,000, plus 500,000 men for
nine months, $9,375,000, plus 500,000 men for six months,
$6,250,000, less $12,000,000 allowed on previous estimates__.
Veterinary supplies, allowed on previous estimates___.

Mosquito destruction, Canal Zone posts, allowed on previous esti


Machinery for four steam laundries_


$29, 815, 000

23, 000, 000

1,755, 000

28, 625, 000 000, 000

000, 000 160, 000

83, 355, 000

16, 671, 000

100, 026, 000


Additional 20 per cent for wastage, losses at sea, etc.

Grand total


Surgeon General's Office, June 26, 1917.

The CHAIRMAN. In estimating for gas masks, for instance, for 2,000,000 men, you estimate for masks for every man in the Army? Col. FISHER. Yes, sir; and in addition we must have a reserve. The Secretary of War told us to estimate two for every man and a 10 per cent addition for a reserve.

The CHAIRMAN. My understanding is that with 2,000,000 men in the field about half of them will be behind the lines.

Col. FISHER. They have to be practiced in using gas masks, and while they do not wear them all the time, a great many of them will have to be utilized. We are getting demands for gas masks in this country now in order that they may be taught how to use them. Men have to be trained to put gas masks in place in six seconds, and they

go into lethal chambers with gas masks on. There seems to be a great deal of drill required in order that they may do this thing properly in the time allowed.

The CHAIRMAN. Have you adopted a standard type of motor ambulance?

Col. FISHER. Yes, sir.

The CHAIRMAN. What do they cost?

Col. FISHER. In the neighborhood of $2,000, including the spare parts we have to provide them with.

The CHAIRMAN. What type of car do you use?

Col. FISHER. We are using a three-quarter-ton truck chassis with a special body which was devised by a board of medical officers.

The CHAIRMAN. Does that give a satisfactory vehicle?

Col. FISHER. Yes, sir; it has been very satisfactory. We use pneumatic tires.

The CHAIRMAN. I saw out here one day an ambulance which was presented by the employees of the Senate. It looked like it was a Ford.

Col. FISHER. We are using some Fords also.

The CHAIRMAN. Do they cost as much as that?

Col. FISHER. No, sir. We have tried the Fords. The border trouble gave us quite an experience in the matter of ambulances, and we hoped we were going to be able to use Fords. We sent a number of them down there, and they went all to pieces and were absolutely unserviceable, so we felt we had to adopt a stronger type. We are using, however, a good many Ford machines.

The CHAIRMAN. But you had to have a heavier type and a stronger type machine to stand up?

Col. FISHER. Yes, sir. The machine which we now have was demonstrated to be quite satisfactory down in Mexico and on the border. The CHAIRMAN. Colonel, how do you purchase your supplies-by competitive bidding?

Col. FISHER. The Secretary has directed us, as an emergency exists now, that advertisements will not be made. We find out prices by consulting various dealers and make awards practically, to all intents and purposes, as by advertising, although not by formal advertisement.

The CHAIRMAN. When you inquire for prices, do you indicate the quantity of material you want?

Col. FISHER. Yes, sir.

The CHAIRMAN. And get a proposal on that basis?

Col. FISHER. Yes, sir.

The CHAIRMAN. Have you operated through the advisory commission of the Council of National Defense?

Col. FISHER. They have been a great deal of help to us.

The CHAIRMAN. What is the method in purchasing? Do they recommend the persons and the prices to be paid? Just how do you operate?

Col. FISHER. The principal value they have been to us is that they call on groups of manufacturers to come on here to Washington. For instance, take the surgical-instrument makers. It was apparent that we could not get the surgical instruments in this country, 80 per

cent of them having been made in Germany formerly. They called the surgical-instrument makers to Washington and had them form a committee, from which an executive committee was established, which made arrangements. We gave them the total number of instruments, etc., we wanted, and by allotting to various manufacturers the quantity that each one could make, they have been able to supply our needs. Working through committees called and formed by the Council of National Defense, we have been getting along very


The CHAIRMAN. How do your prices compare with what you previously paid?

Col. FISHER. The prices of everything have gone up enormously. The CHAIRMAN. How was the price of these articles agreed upon? Col. FISHER. In some cases they have been on a cost plus percentage basis. Our surgical dressings, for instance, were made with a guarantee that they should not be above a 10 per cent profit. The CHAIRMAN. Is there a basic price fixed?

Col. FISHER. There was a basic price fixed and then an agreement was made that if it was more than cost plus 10 per cent, the Government should get the benefit of a reduction.

The CHAIRMAN. What arrangement is made to check up the cost? Col. FISHER. The Munitions Board agreed they would have accountants work upon that matter with a view to checking that, and they have checked with the surgical dressings people particularly their overhead charges and have agreed that they would make arrangements to check those costs.


(See p. 387.)

The CHAIRMAN. How many female nurses is it estimated will be employed?

Gen. GORGAS. You mean the number we will need for this whole army?


Gen. GORGAS. About 14,000.

The CHAIRMAN. How much are they paid?

Gen. GORGAS. $50 a month in the United States and $60 abroad. The CHAIRMAN. How many are there now in the service, do you know?

Gen. GORGAS. I do not recollect. I could easily give you those figures. I should say 1,500 or 2,000. There are 50 in each of the base


The CHAIRMAN. They are asking for $8,742,000 for pay of female nurses during the current year. Will all that money be required this year?

Gen. GORGAS. I think so. I think that we will have the 2,000,000 men to care for before the year is out.

The CHAIRMAN. You will not have 2,000,000 men a full year?

Gen. GORGAS. No, sir; not a full year. You can reduce it to that


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