Source: Administrative History Section. Administrative Division. Bureau of Medicine and Surgery. The United States Navy Medical Department at War, 1941-1945. vol.1, parts 1-2 (Washington: The Bureau, 1946): 1-31. [The manuscript, identified as United States Naval Administrative History of World War II #68-A, is located in Navy Department Library's Rare Book Room. A microfiche edition of this history is available through interlibrary loan or purchase from the library.].

Navy Medical Department Preparedness, 1941

Men of the Navy Medical Department at Pearl Harbor were just as surprised as other Americans when the Japanese attacked on the morning of 7 December 1941, and, like other men of the Navy and Marine Corps at Pearl Harbor, they were momentarily stunned by the blow. From their first realization of an enemy attack, however, the doctors, dentists, nurses, and corpsmen were unexcelled in personal bravery, in determination, in resourcefulness, and in their capacity to put into practice previously formulated plans.

Between 1939 and 1941 Pearl Harbor had been fortunate in receiving unusual attention from the Surgeon General and the officers who assisted him at the Bureau of Medicine and Surgery in making plans for the Medical Department. When the facilities of the Pearl Harbor hospital had become overcrowded in 1940, every effort had been made to add to the bed capacity, equipment, supplies, and personnel of the Hawaiian area. Although the U.S. Naval Hospital at Pearl Harbor had a normal bed capacity of approximately 250 beds and was one of the best equipped and staffed of the eighteen hospitals then in commission, a new hospital that would be removed further from military installations and be less subject to destruction in case of air attack had been planned and was actually under construction at the time of the Japanese attack.

Because of the great concentration of naval personnel and the activities of the Fleet in the Hawaiian area, the Surgeon General requested and secured permission to send out to Pearl Harbor the Navy's second Mobile Base Hospital, a type of transportable facility which was the most significant institutional organization developed by the Navy Medical Department during the pre-war emergency. To add further to the hospital facilities in the Hawaiian area, the hospital ship USS Solace arrived at Pearl harbor shortly after the Mobile Hospital and was in port when the Japanese struck.

The casualties at Pearl Harbor were cared for at a variety of facilities: at the battle dressing stations and sick bays of the war ships; aboard the hospital ship Solace; at first-aid stations; at the dispensaries of the two naval air stations; the Marine Corps Air Station at Ewa; the Defense Battalions of the Fleet Marine Force; the Navy Yard, and the Section Base at Bishop's Point; at a "field hospital" which was set up in the Officers' Club of the Navy Yard; and at the Mobile Base Hospital and the U.S. Naval Hospital at Pearl Harbor.

Medical Service Aboard Ships

During the Japanese attack, boats took the wounded from ships and from the water surrounding the ships. Oil on the water near sunken or sinking ships made swimming difficult for the men overboard. In the vicinity of the USS Arizona, where the oil was burning, a boat of the Solace was scorched, while the crew, at great danger, rescued men from the water.

Most of the wounded and burned men from the ships and those rescued from the water were evacuated to the hospital ship Solace; to the dock where the USS Argonne, flagship of the Base Force, was moored; or to landing C near the U.S. Naval Hospital.

The Solace, which was unharmed by the attacking force, received its first patients at about 0825. By this time, preparations had already been begun to receive a large number of casualties. Bed patients were moved into upper beds so that the lower beds could be used for casualties. Supplies were broken out and preparations of sterile morphine solution, tannic acid solution, and saline solution were made. Special serums, plasma, and other supplies were issued to dressing stations and wards. One hundred and forty-one convalescent patients were discharged to duty in order to make room for additional casualties in case of repeated air attacks. After casualties began to come aboard the ship at a rapid rate, twenty-three patients were taken care of in the 50-bed emergency ward compartment.

A total of 132 patients were admitted aboard the Solace on 7 December. About 80 men were given first-aid treatment only. Twenty-eight patients, 26 of whom were not identified, died. The final census on 7 December showed 177 beds occupied and 253 unoccupied.

After the first air attack the main battle dressing station of the Argonne was moved to the secondary battle dressing station, where the injured men from the ship were treated. later, the medical department of the Argonne, aided by medical personnel from other ships, received a large number of wounded and burned men at the dock where the ship was moored.

In the open and under fire, about 150 cots were set up on the dock to take care of the injured men evacuated from ships or rescued from the water. Subsequently, under the direction of the Base Force Surgeon, the cots and medical material were moved to the Officers' Club in the Navy Yard, which was less exposed to enemy fire. By 1030, a "field hospital", supplied and equipped by the Argonne, was set up. The dock continued to be used as a clearing station for the wounded. The most severely injured were sent to the Naval Hospital; less severe cases were sent to the Mobile Base Hospital or to the field hospital in the Officers' Club.

Aboard the USS Nevada 116 men were injured severely enough to require hospitalization; 33 were know to be dead, and 18 were missing. After the first lull in the attack, about 65 casualties received emergency treatment at the forward, amidship, and after dressing stations until these stations were perforce evacuated to the sick bay. In the ship's sick bay between twenty and thirty cases were treated. Throughout the ship, patrol party corpsmen were busy administering first-aid. Two of these corpsmen were recommended for citations by the senior medical officer for their bravery and performance beyond the call of duty. Men of the crew, too, who had previously received first-aid instruction, gave valuable assistance to the medical department in rendering emergency treatment to the injured and burned men. The dead were collected astern. Attempts were made to identify each body before it was tagged and transferred to the Pearl Harbor Hospital. Immediately after the attack there was neither time nor facilities for keeping paper records on either the living or the dead transferred to the hospital.

After the battle was over, the sick bay of the Nevada had to be moved to the mess room of the chief petty officers. When this area flooded the next day, the medical department was again shifted. A first-aid station was established under the overhang of #4 turret on the main deck aft. On the beach, about fifty yards off the starboard quarter, two tents were set up and supplied and equipped. Health records from the Nevada were sent to the Receiving Barracks "for separation and forwarding."

The USS Pennsylvania had four dressing stations. During 1941, partly as a consequence of lessons learned from British experiences in handling casualties in air raids, a station had been established in a part of the ship that was accessible to the crews of the anti-aircraft and broadside guns. This new station, located in the warrant officers' mess room, was "reasonably well protected," had ample space for working, and was near the fixed bunks, toilet facilities, and a supply of fresh water. Ironically, the only bomb that hit the Pennsylvania "detonated in the casemate of the #9 broadside gun on the deck above and just outboard of this space." Among twenty-seven men killed were the junior medical officer and one corpsman stationed in the battle dressing station. Thus the advantages of the location of the station were nullified, and the loss of the doctor and corpsman seriously delayed the care of the wounded.

Neither the action reports nor the annual sanitary reports for 1941 gave much information on the care of casualties aboard ships. The few sanitary reports from ships which mentioned the Pearl Harbor attack, except for the Nevada, Pennsylvania, Argonne, and Solace, gave no descriptions of the arrangements made to take care of the casualties.

The sanitary report from the USS Helena, which had about 100 casualties, devoted a paragraph to the types of wounds and burns and explained how the lack of clothing on the men was responsible for such a large number of flash burns. The report estimated that about sixty of the casualties were permanently lost to the ship because of either death or disability. Of these casualties, 26 died before they could be evacuated and 13 died subsequently in the hospital. The supply of tannic acid jelly, dressings, and syrettes was adequate for the casualties sustained by the Helena. The four Stokes litters allotted to the Helena were insufficient, and the Army stretchers were useless below decks. There were not enough hospital corpsmen aboard, and, according to the report, if the casualties had occurred at sea, the medical department would have been sadly handicapped."

Sanitary reports from the Enterprise, Curtiss, and Honolulu gave casualty figures for their ships. Aboard the USS Enterprise ten officers and men were lost in action; the bodies of only three officers and two men were recovered or identified. Aboard the USS Curtiss, fifteen were killed and sixty-four were injured. The USS Honolulu had no personnel casualties.

Three sanitary reports mentioned changes made in the location of battle dressing stations during or after the attack. During the attack, the after battle station of the USS Vestal was moved from the chiefs' quarters to the lower optical shop aft, which was conveniently located and where the lights were not out. The Curtiss arranged to use the wardroom as the main battle dressing station instead of the sick bay; experience during the attack indicated that the sick bay should be evacuated during battle and closed in order to preserve the water-tight integrity of the ship. The USS Gamble, after the action of 7 December, planned to have a battle dressing station in the galley area instead of the wardroom, which was isolated too much by damage control measures.

Several sanitary reports commented upon the value of clothing in preventing or reducing the extent of flash burns. The USS Raleigh reported that partial protection against burns caused by burning powder and bomb blast could be gained "through the use of proper clothing." The USS Detroit, the USS Minneapolis, and the Enterprise, reported that the wearing of long trousers and shirts with long sleeves was required because the attack had demonstrated that such additional clothing provided protection against flash burns.

Medical Service at Shore Stations

Ashore, immediately after the attack, first-aid stations were set up quickly in the Receiving Barracks, Recreation Center, Yard dispensary, Officers' Club, Submarine Base dispensary, Naval Air Station dispensary, and Marine Barracks. The Section Base dispensary at Bishop's Point helped the Army to care for men from Hickam Field.

The sanitary report from the Naval Air Station, Pearl Harbor, estimated that about 200 injured and burned men from the station and ships were given first aid at the station dispensary before they were sent back to duty or to a hospital. About 130 patients were transferred to the Pearl Harbor Naval Hospital and the Aeia Plantation Hospital. Evacuation of patients started at about 1045. An effort was made to move critical cases first, and by 1430 all of the most seriously injured were transferred. Seven men who died before they could be evacuated and a dead Japanese aviator were sent to the morgue at the Naval Hospital.

The number of casualties at the Kaneohe Naval Air Station, as ascertained the day after the attack, was seventeen dead and sixty-seven wounded. As quickly as the injured men could be brought to the station dispensary, they were given emergency treatment. The dispensary was "inadequate to care for the 75 or 80 wounded who required hospitalization," and a large number of the seriously wounded had to be sent elsewhere. Since evacuation to the Pearl Harbor Naval Hospital was "out of the question," about forty men were sent to the Kaneohe Territorial Hospital for the Insane. Subsequently these men were transferred either to the Pearl Harbor Hospital or back to the station.

At the Marine Corps Station at Ewa, the hospital tents that housed the sick bay and dispensary were "set on fire by incendiary ammunition," and "a large quantity of equipment and medical supplies" were "damaged by enemy gunfire." Under the direction of the medical officer of Marine Aircraft Group Twenty-one, the fire was extinguished and a burning canvas which covered the medical stores was removed. Despite the fire, casualties were taken from the field between attacks and given prompt treatment by the medical officer and his assistants, who continued to work with their damaged equipment while exposed to enemy machine-gun fire. The most seriously wounded men were evacuated to the Ewa Plantation Hospital. Compared with the other stations subjected to attack, the number of casualties suffered at the Marine Corps Air Station was small. Thirteen men were wounded, three were killed during the attack, and a fatally wounded man died five days later.

The medical departments of the First and Third Defense Battalions jointly set up three dressing stations; one was in the dispensary and one was in each of the recreation rooms used by the two battalions. After 1100, a collecting and casualty dressing station which was established in the barracks was receiving slightly injured men from the Fleet units. On the morning after the attack, the first floor of the building where Company A was quartered was made available to the medical department for the care of casualties who required hospitalization. The annual sanitary reports from the First and Third Defense Battalions for 1941 reported that 136 patients were treated between the day of the attack and 10 December, when most of the patients were transferred to the Pearl Harbor Hospital.

Very little information on the Pearl Harbor attack is available in the sanitary reports from other dispensaries in the Pearl Harbor area. The reports for 1941 from the Fourth Defense Battalion, the Section Base at Bishop's Point, and the Naval Ammunition Depot made no mention of the Pearl Harbor casualties. The report from the navy yard had no information on the methods employed for the care and treatment of the casualties, but described briefly the feeding and housing of a large number of survivors and the issuance of unusual quantities of first-aid supplies on 7 December.

Mobile Base Hospital Number Two

Erection of Mobile Base Hospital Number Two was not yet completed when the Pearl Harbor attack occurred. The materials and equipment of the hospital had been landed less than three weeks before, and only the crew quarters had been put up. Hospital corpsmen had been transferred from the pearl Harbor Hospital only about one week before the attack.

As a result of experiences with Mobile Base Hospital Number One, the packing and marking of equipment and the arrangements for unloading of Mobile Two were improved in such a way as to speed up the process of assembling materials and supplies. When the emergency of 7 December occurred, it was possible to break out the supplies and to care for the casualties who were received and placed in the crew quarters, the only buildings then available for patients. Arrangements were made by the Mobile Hospital to care for 125 patients, and 110 casualties were actually received for treatment. Four medical officers from the Mobile Hospital were sent to help at other stations - two went to the Pearl Harbor Naval Hospital, one to the air station, and one to an "emergency station."

U.S. Naval Hospital, Pearl Harbor

The Naval Hospital at Pearl Harbor was only slightly damaged during the attack. Although located near major military installations, the hospital was not hit by any bombs. The roof of the laboratory building was moderately damaged; about one-half of the animal house was destroyed, and a vacant quarters building was set on fire by a crashing Japanese plane. The vacant quarters building was virtually destroyed by the fire, but the blaze was brought under control by fire fighters and did not spread to other buildings. A pharmacist's mate, who was killed by machine gun fire in the navy yard while returning to the hospital from liberty, was the only casualty suffered by the hospital staff.

The first wave of Japanese planes came over the Naval Hospital. At about 0745 about twenty planes, which presumably came either up the channel or low over Hickam Field, passed immediately over and to the channel side of the hospital buildings. The planes travelled at a high speed and at an elevation of less than 150 feet. None of the planes fired upon the hospital or made any attempt to bomb it. The planes moved so rapidly that the men who saw them, and who were at first uncertain of their identity, were unable to give warning to the intended victims of the attack.

Members of the hospital staff were notified immediately to report to the hospital. As it was Sunday morning, many of the medical officers were at home. The commanding officer, the executive officer, and the other men who lived on the reservation were the first to arrive. Medical officers who were not on the reservation were longer in reporting, but by 0915 the entire staff of the hospital was on duty. Medical officers and corpsmen from ships which had suffered damage during the attack reported intermittently throughout the morning. The two surgeons from the Mobile Hospital were assigned to one of the surgical teams of the hospital. A doctor of the Medical Corps who was convalescing after a major operation voluntarily returned to duty and worked until he became exhausted at the end of the third day. A large number of civilian women who had nursing or first-aid training volunteered to assist the twenty-nine Navy nurses. A total of 114 registered nurses were supplied through the local Red Cross and as many as 26 of these were on duty at one time. About eight or ten nurses who were wives of enlisted men were of "valuable assistance."

Soon after the first attack, special measures were taken to protect the hospital, and arrangements for receiving a large number of casualties were made. At about 0800, stations for air attack were manned. Ambulances and fire-fighting equipment were dispersed so as to avoid total destruction in case of a hit. All battle dressing stations in the wards and the operating suite were set up by 0815. Medical officers, as they arrived, were sent to various dressing stations. Four operating teams were assigned to the main operating suite. A station for minor injuries was established in a vacant building formerly used as nurses' quarters. Patients in the brig and the locked ward were released. To make more room for casualties, ambulatory patients were transferred to two old frame buildings and five hospital tents in the rear of the hospital. Convalescent patients who "requested that they be returned to duty" were permitted to return as best they could to their commands.

The three hospital ambulances, ambulances from other stations, military and civilian trucks, personal cars, and delivery wagons were used to transport casualties to the hospital. Motor transportation was managed by the navy yard garage, where a pool of all vehicles was formed. The device of the pool enabled cars to be sent out in an orderly way to places that needed and could effectively utilize ambulance service.
Civilian as well as military personnel assisted in the transportation of casualties. Under fire and "with no thought of possible injury to themselves or their automobiles," civilians "spontaneously cooperated in bringing casualties to the hospital promptly."

The first casualties arrived at the hospital within ten minutes after the first attack, and by 0900 they were coming into the hospital in a steady stream. Under the supervision of the commanding and executive officers, casualties were distributed to the main operating suite or to any one of the twelve wards where empty beds were available. A receiving ward would have caused a "hopeless bottleneck," and was not used. Although an effort was made to send acute surgical cases to the surgical wards and fracture cases to the orthopedic wards every ward received a variety of cases. The great majority of patients with burns were sent to the medical wards. A regrouping of cases according to type of injury was not attempted during the day of the attack.

Accurate records for the patients admitted to the hospital could not be kept. The rate was much too rapid at first for the men to be properly tagged and for information such as the name, next of kin, and religion to be recorded. Not until the afternoon was it possible to begin recording admission data. Even then the necessary information could not always be obtained. None of the patients wore metal identification tags; and the service, health, and pay records of men were frequently missing. Furthermore, many patients who were unconscious when admitted to the hospital died before they could be identified.

A total of 546 battle casualties and 313 dead were brought to the hospital on 7 December. Approximately 452 casualties were admitted to the hospital in less than three hours. Of the total admissions, 93 came from battle stations aboard ships, temporary first-aid stations ashore, and several plantation hospitals in the vicinity of Pearl Harbor. A record was not kept of more than 200 men who received first-aid for slight injuries and were returned to duty immediately without being admitted to the hospital. The census of patients in the naval hospital at midnight, 7 December, was 960.

Identification of the dead and preparation of bodies for burial began at about 1100 of the day of attack. This "most unpleasant" work was done by a detail under the supervision of a hospital pathologist of the Medical Corps, who was assisted by an officer of the Dental Corps, and an officer of the Hospital Corps. Identification was slow, difficult, and sometimes impossible. None of the men wore metal identification tags, and the clothing of some of the men was marked with several different names. Some of the bodies were so badly charred or mutilated that they could not be identified from physical features; fingerprints could not be taken from some of the men because their fingers were missing or badly mangled; and only portions of some bodies were brought in.

A systematic procedure for keeping record on the dead was followed. On the Navy form for reporting deaths all available data, including fingerprints and names if possible, were recorded. Each body, whether identified or not, was tagged with a serial number. This serial number was also placed on the Navy form for reporting deaths, the grave marker, the casket, and on the canvas wrapping, if used.
All bodies, except those of identified officers, were placed in plain wooden caskets. "Bodies of officers were placed in standard Navy caskets in order that they might later be disinterred and shipped home if desired." Burials began on 8 December in Oahu Cemetery, Honolulu. Two officers of the Chaplain Corps and two civilian priests from Honolulu rendered proper religious rites at the hospital and at the funeral ceremonies held each afternoon in the Oahu and Halawa Cemeteries. The brief military ceremony held at the burial grounds included a salute fired by a Marine guard and the blowing of taps by a Marine bugler.

Supplies at the Naval Hospital were, in general, sufficient to take care of the unprecedented demands created by the Pearl Harbor disaster. Shortages of dried plasma and tannic acid developed because of the great number of burn cases. Additional wet plasma was obtained from the blood bank established at the Queen's Hospital, Honolulu; and other supplies were requested by dispatch and flown from the West Coast by plane.

Medical Supplies

Three kinds of medical supplies were exceptionally useful in caring for the Pearl Harbor casualties. Morphine sulphate was given to relieve pain both at the time of first-aid treatment and after evacuation to the hospital or hospital ship. Syrettes of morphine were particularly easy to administer by the men who rendered first-aid. Plasma was a potent weapon against shock, the most dangerous threat to the lives of most of the men who were hospitalized. The sulfa drugs, which were given orally and locally, were undoubtedly a major factor in preventing infection of many wounds and burns.

Types of Injuries and Their Treatment

The casualties at Pearl Harbor suffered from many types of burns and wounds. Most of the burns were extensive and superficial. There were numerous variations in the types of wounds. There were flesh wounds; gunshot wounds of the head, neck, body and extremities; small, medium, and massive wounds caused by shell and shrapnel; extensive wounds produced by fragments of bombs and metal; penetrating abdominal wounds; traumatic amputations; wounds which contained foreign bodies; and simple, comminuted and compound fractures. A number of men also suffered from asphyxia. Some of the men suffered from a combination of wounds and burns. Mouth and jaw wounds were surprisingly rare. The number of men who developed neuropsychiatric disturbances as a result of the bombing was small. Only nineteen neuropsychiatric cases, of which seven were treated just a few days, were admitted to the Pearl Harbor Naval Hospital. Almost all the patients suffered from shock in varying degrees.

About sixty percent of the casualties were burn cases. Over seventy percent of the cases admitted to the Solace were burn cases, and about forty-seven percent of those admitted to the Naval Hospital were burn cases. According to one source of information, 254 burn cases were admitted to the Naval Hospital; another source stated that "approximately 350 patients were admitted with body burns."

Some of the burns were caused by burning fuel oil and many were "flash burns" caused by "temporary but intense heat from exploding bombs." Although superficial, the flash burns were quite extensive; some of the men had as much as eighty percent of the body surface burned. Patients who were admitted to the hospital while still living suffered from first and second degree burns. Most of the deeply burned died before they could be hospitalized. Of the men whose faces were burned, the eyes of only four were "damaged". Many of the cases were "complicated by multiple shrapnel wounds.

The extent of the burns suffered by the men was determined by the amount of clothes they happened to have on at the time of the attack. Of the men who were burned, those with the least amount of clothing suffered the most extensive burns. Indeed, the correlation between the amount of uncovered body surface and the amount of body surface affected was strikingly high. Often times the burns simply followed the line of clothing. All the doctors who reported on the Pearl Harbor burn cases remarked upon the protection that clothing offered against the so-called flash burns. Even skivvy shirts, shorts and other thin apparel served as protection against flash burns. Men who were wearing undershirts had no burns on the chest or abdomen; men who were wearing undershirts and shorts only, had burns on the face, arms, and legs; men who were completely dressed usually had only their faces and hands burned.

Most of the burned patients who had been overboard in water, when they came to the hospital or hospital ship, were covered from head to foot with fuel oil. There was no time to attempt preliminary cleansing of these patients and comparatively scant cleansing of wounds and burns could be done at first. Consequently the body surface was treated a though no oil were there, and local treatment for burns was applied over the oil. The efficacy of treatment was apparently unaffected by this unusual procedure. According to Fleet Medical New Letter 10-41, the removal of fuel oil from casualties, described as a "tedious" and "painful" process, was accomplished by "washing with large quantities of water and soap." Two medical officers from the Solace reported that they "found that the most effective method was the use of tincture of green soap with water."

The treatment of burns was left to the discretion of the ward officers and varied a great deal. All patients were subjected to some type of tanning process as rapidly as possible. Tannic acid jelly and solution, picric acid, gentian violet, and the triple dye, with or without silver nitrate, were the main substances applied to the burns. Sulfanilamide powder was mixed with these substances in some instances. Morphine was administered to men with severe and painful burns.

Because of the large number of burn cases, means of applying the substances to a great number of men in a short time had to be improvised. At the Naval Hospital, ordinary flit guns were used to spray tannic acid solution upon the burned surfaces. Aboard the Solace, dressing which were soaked in tannic acid solution were placed on the burned areas. Dressings were also dipped in a mixture of mineral oil and the sulfa drugs and applied to the burns. These liquid applications were "more easily applicable and more practical" than the tannic acid jelly which was pressed from the tube containers and smeared on the burn.

During the day of the attack, the observation of sterile precautions was generally not attempted. Applications were made to all parts of the body that were burned; the face, hands, and feet were treated like any other part of the body. The eyes were protected while the face was being sprayed. Patients who came on board the Solace with tannic acid dressings already applied were not treated except to keep them wet during the next twenty-four hours.

On the second and third day after the attack, men with severe burns were placed under heat cradles. Numerous improvised bed cradles were used. These heat treatments were continued night and day for about a week.

Early debridement of the burned areas was not attempted. On the third day after the attack, when eschars were removed, different forms of local treatment, including tannic acid solution, gentian violet spray, sulfanilamide in mineral oil, wet dressings, and open exposure under a heat cradle, were used with no apparent difference in the results. On the fourth day and thereafter the treatment continued substantially unchanged. Patients were cleaned in the morning, debridement was carried out, applications were made, and plasma and other intravenous fluids were administered.

After the second and third days, sulfathiazole and sulfanilamide were administered to patients with burns that became infected. Patients with elevated temperatures, when caused by local infection, were given one gram of sulfanilamide every four hours until their temperatures became normal. After the fourth and fifth day, sulfanilamide in powder form or suspended in petrolatum was applied locally to infected parts of the burned surfaces.

Shock treatment for the burn cases started as rapidly as possible. Heat, plasma, normal saline and saline solution with five percent glucose were given. For the first forty-eight to seventy-two hours, when only small amounts of plasma were available, normal or saline with glucose solutions were given. By the third day, wet plasma was available to supplant the saline solution and dried plasma. Doctors and nurses, assisted by hospital corpsmen, administered the plasma. Drs. I.S. Ravdin and P.H. Long reported that medical officers at the Naval Hospital were "exceedingly skillful in getting into veins which could not be seen or felt."

Administration of plasma and other intravenous therapy for burn cases was extremely difficult because of the edema which many patients with burns suffered. The location of constricting or collapsing veins was especially difficult at night during the first week or ten days, when, because of blackout precautions, only the dim blue light from flashlights was available.

Many of the injured men had compound fractures. These patients were given tetanus toxoid or prophylactic antitoxin until the supply was exhausted. Procaine anesthesia was given to most of the men who were in shock. Plasma, when it because available, was given to the men who were in severe shock. The skin surrounding the injured part was cleaned with soap and water. A partial debridement was done for almost all the wounds. After debridement and reduction, crystalline sulfanilamide was placed in the wound and the surface was covered with sterile vaseline gauze. Over this dressing a case of plaster of paris was applied as soon as possible. The part was then X- rayed and the position of the fragments outlined with indelible pencil on the cast. This method of marking the cast proved to be a useful way of providing desirable information to medical officers who treated the men after their evacuation. For from four to ten days after the initial treatment, patients with the compound fractures were given sulfanilamide or sulfathiazole by mouth.
This method of treating the compound fractures proved quite satisfactory. Drs. Long and Ravdin, who saw these patients during their investigation, reported that they had done amazingly well. "The patients (December 17th) looked well, there were no excessive febrile reactions, and their morale was excellent." The same to doctors stated in an article in the Naval Medical Bulletin:

Seven weeks after injury the wounds were healing rapidly. In many instances there was clinical evidence of union. There were no instances of serious infection except in three patients with knee joint injury. The fragments had remained in good position. There was no evidence of osteomyelitis of the long bones. These achievements would not have been anticipated prior to the advent of sulfanamide therapy.

Because of lack of time and insufficient medical personnel, surgical operations could not always be performed upon men within six hours after they were wounded. Excision of wounds could not be attempted in some cases until the third or fourth day.While the supply lasted, these patients were given tetanus toxoid or antitoxin. While awaiting definitive treatment, wounds were treated by infiltration of novacaine, excision of the worst torn skin and muscle, application of sulfanilamide powder, and dressing with vaseline or plain sterile gauze. Absence of infection in most of these wounds indicated that with the aid of sulfa drugs, the time between injury and definitive treatment could be extended safely, when necessary, beyond the six-hour "golden period" of therapy.

The Success of Navy Medicine at Pearl Harbor

Abundant testimonials of the success of the Navy medical Department on 7 December 1941, can be found in the files of the Bureau of Medicine and Surgery. Two civilian doctors, I.S. Ravdin and Perrin H. Long, who were sent to Pearl Harbor and the West Coast to investigate the medical and surgical treatment of the casualties, commended the professional service rendered to the wounded and burned men. The fleet medical officer, who felt "extremely proud of the manner in which the Medical Departments involved handle this sad situation," reported in a letter of 11 December that all casualties were "properly, expeditiously, and thoroughly treated and housed without the least confusion and with a splendid spirit." The medical officer in command of the Naval Hospital at Pearl Harbor, in a report to the commandant of the Fourteenth Naval District, dated 19 December, commended member of the hospital staff for the "exemplary manner" in which they performed their duties and stated that the "hospital organization operated smoothly and efficiently." The medical officer in command of Mobile Hospital Number Two, in a report to the Chief of the Bureau of Medicine and Surgery, dated 13 December, praised the "remarkable job of breaking out needed supplies and equipment from storage piles," and expressed his belief that the achievements of the mobile Base Hospital at Pearl Harbor provided additional proof of the utility of this new type of hospital. The commanding officer of the Naval Air Station at Keneohe Bay, in a report to the commandant of the Fourteenth Naval District, dated 8 December 1941, affirmed that the "wounded and dead were collected as rapidly as possible and the station dispensary functioned in an excellent fashion." The sanitary report from the First Defense Battalion, stated that "all hands turned to and performed their duties in an able and efficient manner." The Marine Corps officer in charge of the Third Defense Battalion declared: "I most heartily commend the Medical and Hospital Corps of this battalion on their performance of duty during the defense of the Navy Yard, Pearl Harbor, T.H., against the Japanese air attack on 7 December 1941. The promptness and coolness under fire with which the aid stations were established and the preparations for and the treatment and evacuation of wounded in the midst of a terrific bombing and strafing attack indicated a very high state of morale, training, and ability." Only a small proportion of the ships at Pearl Harbor mentioned the attack in their sanitary reports for 1941, but in the reports from the Solace, Argonne, Curtiss, Honolulu, and Nevada statements were recorded similar to those from the shore establishments.