Battle Casualties and Medical Statistics;: U.S. Army Experience in the Korean War

Table of contents :
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Front Cover
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Title Page (Page i)
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Section 1 (Page v)
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Table of Contents (Page vii)
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Section 2 (Page 1)
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Section 3 (Page 19)
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Section 4 (Page 35)
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Section 5 (Page 55)
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Section 6 (Page 70)
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BATTLE

CASUALTIES

AND

MEDICAL

STATISTICS

U.S. Army Experience in the Korean War

THE SURGEON GENERAL Department

of the Army

Washington, D.C.

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Foreword

Medical planners must have statistics and factors from previous conflicts to future requirements. Medical statistics for World War II have been recorded for future guidance, but the statistics for the Korean conflict have not forecast

heretofore been placed in a readily available reference book. Therefore, this volume has been prepared to provide the medical planner with essential information re lated to the statistics, such as the type of operation, lethality of weapons, and location of wounds.

Medical planning factors and statistics based on actual experience are an abso lute necessity in the preparation and justification of Army Medical Department resources to support contingency plans. Furthermore, data of this nature are one of the key elements utilized in automated

force planning

systems since they pro

units, hospital for estimating Army Medical Department evacuation requirements, and replacements for a theater of operation.

vide the foundation construction,

Of major significance is the inclusion in this volume of revised methodology may be utilized to compute Army Medical Department hospitalization units and related resource requirements. This methodology will provide a common basis for estimating medical workload which may be applied by all planners. Included in the methodology for the first time is an approach for estimating mobile beds required in the field army area. Therefore, with the information contained which

in this document,

has a method which may be employed to estimate workload in the Field Army, Communications Zone, and continental a planner

hospitalization United States, either as an integrated system or as independent areas. It behooves us to learn from past experience and apply lessons learned in pre paring and planning for military operations or contingencies of the future. There fore, I commend this volume to Army Medical Department planners and believe the information

will be an invaluable tool.

Hal B. Jennings, Jr., M.D., Lieutenant General, The Surgeon General.

in

Preface

The great body of combat statistical data available from the United States Army experience in Korea represents the complete spectrum of unit combat opera tions in the field. From the division and Army troops to small unit actions from fortified lines, Korea provides the planner with a concentrated background of factual information. Some of the data presented here are revisions of material previously published by the author in The Surgeon General's monthly report, Health of The Army, and the material on tactical action was previously presented These data have been assembled with the planner in mind, based on a knowledge of material considered essential by Systems Analysts engaged in combat development, war-gaming, weapons evaluation, medicologistical problems, as a monograph.

and in medical research concerning battle casualties.

Part of the discussion

involves historical background necessary to present is required. However, this is by no means a history of the United States Army in Korea. This volume is a compilation of medical statistical whatever qualification

data in detail of division versus nondivision

comparisons, designed for applications research and systems analysis. Although written for the medical whose duties require the estimation of casualties or planning for their

in operations planner,

evacuation and hospitalization, it should also be of interest to the military surgeon by providing information on the nature of traumatisms, their causative agents, and surgical operations required. During most of the time this material

was being assembled, Mr. Eugene L. Hamilton (since retired) was Director of The U.S. Army Medical Statistics Agency, and was largely responsible for the progress of this endeavor. The material pre sented here is somewhat of an extension and reflection of earlier work undertaken in assisting Gilbert W. Beebe, Ph. D., and Michael E. DeBakey, M.D., in prepar ing similar material for their book Battle Casualties (Charles C Thomas, Publisher, 1952). The stimulus provided by Dr. Beebe, 20 years ago, is largely responsible for the production of this volume. COL William J. Foulk and MAJ Ruben F. Fechner, Force Development Division, Plans, Supply and Operations, encouraged the development and provided the necessary impetus for making this material available to planners throughout the U.S. Army. CPT William W. White reviewed the sections on Estimating Bed Requirements through appendix A and made many valuable suggestions. Mrs. Neva C. Stiles performed the many computations for rates and did much to insure the accuracy of these data. Mrs. Lois Aldridge,

War Records Center, National Archives, located the innumerable documents for every day each unit was in Korea during the period of the war. Miss Lillian B. Smith interpreted the many tabulations of World War II and Korean War data; she and Mrs. Miriam T. Whitehead located and furnished much of the basic statistical data. Mrs. Mary J. Dolphin designed the format of all tabular material. Mrs. Doretha Elmore typed the tables and Miss Deborah T. Collier and Mrs. Lorraine P. Stroman typed the manuscript. Mr. Edward L. Lane, Graphic Arts Section, Publications Branch, prepared the statistical charts. In The Historical Unit, U.S. Army Medical Department, Mrs. Martha R. Stephens, Editor of the Editorial Branch, performed the final publications editing, and Mrs. Hazel G. Hine, Chief of the Administrative Branch, supervised the final typing of the manuscript.

Frank A. Reister

BATTLE CASUALTIES AND MEDICAL STATISTICS U.S. Army Experience in the Korean War

DISTRIBUTION LIST Active Army :

OSD (1) OSA (1) USofA (1) ASA (FM) (1) ASA (I&L) (1) ASA (R&D) (1) DASA (1)

DCSPER

(2)

ACSI (1) DCSOPS (2) DCSLOG (2) ACSFOR (2) CORC (1)

CAR (1) CINFO (1) CNGB (1)

CLL (1) CRD (1) CMH (1) TAG (1) TIG (1)

TJAG (1) TPMG (1) CofCh

USAMEDSVS

(1)

TSG (30) CofSptS (1) CofEngrs (1) ACSC-E (1) Med Bds (1)

USCONARC

ARADCOM

(2)

(1) OS Maj Comd (2) except

USAREUR SHAPE (2) MDW (1) Armies (3) Corps (1)

Div (2) Med Gp (2) Med Bn (1) USATC (1) USMA (3)

MFSS (5)

(4)

(1) Med Dep (OS) (1) GH (5) Army Hosp (4) USAH (25-100 Beds) (1) USAH (100-500 Beds) (2) USAH (500-750 Beds) (4) Med Cen (1) except WRAMC (5) BAMC (5) WRAIR (5) AFIP (5)

USAPERSCEN

(1)

Med Lab (1) Arsenals (1) Disp (1)

MAAG (1) JBUSMC (1) Historical Unit,

USAMEDD

(2,000)

NG: State AG (1) USAR: USAH (1).

For explanation of abbreviations

used, see AR 310-50. Request copies remaining on hand after initial distribution be returned to The Historical USAMEDD, Building 501, Fort Detrick, Frederick, Md. 21701.

Unit,

Contents

Page 111

FOREWORD

v

PREFACE Chapter

ONE

Casualty and Morbidity Experience Units and Strength Battle Casual t ics and Admissions Outpatient Care and Carded for Record Only Average Duration of Stay Noneffectiveness Type of Disposition and Place of Final Treatment Deaths Separations for Battle Disabilities

TWO

THREE

FOUR

Effects of Type of Operation and Tactical Action Source and Limitations Offensive Operations Pursuit and Mopping-up Operations Maintaining Static Defensive Lines Limited Operations From Main Battle Positions Defensive (Enemy Offensive) Operations Withdrawal Operations Summary by Type of Operation and Tactical Action Lethality of Weapons and Location of Wounds Death From Wounding Causative Agent and Nature of Traumatism Causative Agent and Tactical Operation Anatomical Location of Wound Anatomical Location of Wounds and Tactical Operation Nonbattle Injuries and Tactical Operation in Korea Hospital Support in Korea Hospital System in Korea, 1952 Source of Data Outpatient and Quarters Care

Hospitalization

Limitations of Data Field Army Area Hospitals Communications Zone Hospitals Prisoner-of-War Hospitals Category of Personnel Cause of Admission Type of Disposition Hospital Death Ratios Average Patient Census and Average Duration of Hospitalization

FIVE

Evacuation of Patients From Overseas Evacuee Report Card Evacuation Policy and Days Before Evacuation Type of Specialized Treatment Required Category of Admission Surgical Operations Performed Overseas

1 1 3

9 12 13 13 15 17 19 1" 20 24 24 27 30 31 32 35 35 36 38 43 46 51 55 55 55 56 56 57 57 64 64 65 65 67 68 69

70 70 70 71 74 75

vii

Chapter

Page

Causative Agents Type of Traumatism and Anatomical Location of Wound Time From Wounding to First Medical Care Time From Wounding to First Hospitalization

SIX

Surgical, Medical, and Logistic Considerations Surgery and the Wounded Surgery and Nonbattle Admissions Medical Surveys of Repatriated Prisoners of War Estimating Bed Requirements Overseas Estimating Patient Accumulations and Dispositions Subdividing the Remaining Curve Nonfixed Versus Fixed Beds Overseas Skipping Echelons of Hospitalization in Evacuation Estimating Beds for Overseas Evacuees

78 79 79 80 83 83 85 87 91 92 94 94 99 101

Appendix

A B

Methods of Computation

Tabular Data

103

Type of Unit, Diagnostic Classification Groups, and Tactical Operation ; and Disability Separations by Detail of Primary Cause of Separation Evacuee, Remaining, and Disposition Factors (four tables) for Patients Admitted to Hospital on One Day of Operations in Overseas Theaters

C

(12 tables) for U.S. Army, Korea, by Month,

107 161

Illustrations Figure 1 2 3 4 5 6

U.S. Army divisions and regiments as percent of U.S. Army strength and regiments as percent of U.S. Army division strength, Korea, July 1950-July 1953 Percent distribution, nonbattle injury admissions, by nature of traumatism and * type of unit, U.S. Army, Korea, July 1950-December 1953 Disease admissions, by diagnostic class and type of unit, U.S. Army, Korea, July 1950-December 1953 Cumulative percentage distributions of average U.S. Army divisional hit rates (KIA, WIA-CRO, and WIA admissions), by type of tactical operation, Korean War. . . Final demarcation line between north and south Korea, 27 July 1953 Causative agents of wounded or injured in action admissions, by type of operation, all U.S. infantry divisions and regimental combat teams, Korea, July 1950-July Causative agents of wounded or injured admissions, by selected periods of time, all U.S. Army infantry divisions and regimental combat teams, Korea, July 1950-

8

Anatomical location of wounded or injured in action as a percent of all admissions for each respective type of operation, all U.S. Army infantry divisions and regi mental combat teams, Korea, July 1950-July 1953 Anatomical location of wounded or injured in action admissions, by selected periods of time, all U.S. Army infantry divisions and regimental combat teams, Korea, July 1950-July 1953 Average number of days elapsed before evacuation from Japan-Korea, U.S. Army personnel, 2 September 1950-31 December 1953 Number of U.S. Army evacuees received in United States from Japan-Korea, monthly by cause of evacuation, 2 September 1950-31 December 1953 Percentages of battle evacuees received in United States compared with percentage of battle admissions in Korea, 2 September 1950-31 December 1953 Accumulation and accumulation-decumulation of wounded hospital admissions, U.S. Army, Korea, 1950-53, converted to one patient per day Subdivisions of the remaining curve, by echelon of hospitalization Percentage of wounded hospital admissions evacuated, by length of evacuation policy, U.S. Army, Korea, 1950-53

9

10 11 12 13 14 15

viii

8 10 22 25

41

1953 7

July

2

1953

42

49

50 72 76 77 93 95 96

Tables Table 1 2 3 4 5

6 7 8 9 10

11 12 13

14

Page

Distribution of U.S. Army division and non-division monthly mean strength, Korea, July 1950-July 1953 of division and separate regimental combat team monthly mean Distribution strength, U.S. Army, Korea, July 1950-July 1963 Percent distribution of U.S. Army and U.S. Army divisions, by type of combat unit, Korea, July 1950-July 1953 Annual rates for killed in action and admissions to medical treatment facilities, U.S. Army, Korea, July 1950-July 1953 Distribution of average mean strength and killed in action; battle and nonbattle admissions to medical treatment facilities, by type of combat unit: number, per cent, and rate, U.S. Army, Korea, July 1950-July 1953 Nonbattle admissions and CRO cases for division and non-division, by period and type of case, U.S. Army, Korea Admissions due to battle injuries and wounds by type of unit and diagnosis, U.S. Army, Korea, July 1950-July 1953 Number and percent distribution of outpatient cases carded for record only, by type of unit, U.S. Army, Korea, July 1950-December 1953 Outpatient treatments at U.S. Army medical treatment facilities, Korea, by cate gory of personnel and type of treatment, 1 June 1951-31 December 1953 Average duration of stay in U.S. Army hospital and quarters, worldwide: World War II and Korean War; and combat units by area of disposition and type of case, Korea, July 1950-July 1953 Average duration of stay in U.S. Army hospital and quarters, worldwide, for nonbattle causes separated for disability, by year, 1950-53 Noneffective rates, U.S. Army division and separate regimental combat teams, Korea, July 1950-December 1953 Disposition of U.S. Army patients originating in Korea, by type of case and place of final treatment, U.S. Army divisions and regimental combat teams, Korea, July 1950-July 1953 Killed in action and died of wounds, by type of traumatism, U.S. Army, Korea,

.......

25

July 1950-July 1953 Number of U.S. Army personnel killed in action and died of wounds, by age group, U.S. Army, Korea, July 1950-July 1953 Deaths and death rates for disease, by principal cause, U.S. Army, Korea, 1950-53 . . Deaths and death rates for nonbattle injury, by nature of traumatism, U.S. Army, Korea, 1950-53 Number of disability separations for battle causes, by type of separation and year, U.S. Army, 1950-53 Distribution of U.S. Army personnel separated for disability due to battle injuries and wounds, by primary diagnostic cause of separation, by type of separation, and by causative agent, 1950-53 Frequency distribution of division-periods, killed-in-action rates, by type of operation Frequency distribution of division-periods, wounded-in-action rates, by type of operation Killed and wounded in action during major offensive operations, U.S. Army divi sions, Korean War Killed and wounded in action during major offensive operations, by tactical action, U.S. Army regiments, Korean War Killed and wounded in action during pursuit and mopping-up operations, by tactical action, U.S. Army regiments, Korean War Killed and wounded in action during pursuit and mopping-up operations, U.S.

26

Killed and wounded in action during operations maintaining static defensive

27

Killed and wounded in action during operations maintaining static defensive lines, by tactical action, U.S. Army regiments, Korean War Killed and wounded in action during limited operations from main battle positions, U.S. Army divisions, Korean War Killed and wounded in action during limited operations from main battle positions

15 16 17 18 19

20 21 22 23 24

Army divisions, Korean War

29

by tactical action, U.S. Army regiments, Korean War

4 5 6

6 7 9 9 11

12 12 13

14 16 16 17 17 17

18 20 21 23 23 24 26

lines,

U.S. Army divisions, Korean War

28

3

26 27 28 29

Table 30 31 32

Page

Killed and wounded in action during defensive (enemy offensive) operations, U.S. Army divisions, Korean War Killed and wounded in action during defensive (enemy offensive) operations, by tactical action, U.S. Army regiments, Korean War Killed and wounded in action during withdrawal operations, U.S. Army divisions, Korean War

33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48

50 51 52 53 54 55 56 57 58 59

31 31

Killed and wounded in action during withdrawal operations, by tactical action, U.S. Army regiments, Korean War Killed and wounded in action, by type of ground operations, U.S. Army divisions, Korean War Killed and wounded in action during ground operations, by tactical actions, U.S. Army regiments, Korean War Admission rates, by type, U.S. Army division and separate regimental combat teams, U.S. Army, Korea, 1950-53 Disease and nonbattle injury, by type of ground operations, U.S. Army divisions, Korean War and wounded-in-action admissions, by type of case, U.S. Army, Killed-in-action and Korean War World War Killed-in-action and wounded-in-action admissions and CRO cases, by type of unit and type of case, U.S. Army, Korea, July 1950-July 1953 Percent distribution of battle casualties, by causative agents, U.S. Army, World War and Korean War Fatality percentage of deaths among total hit (killed and wounded in action), by causative agent and nature of traumatism, U.S. Army, Korea, 1950-53 Case fatality percentage of deaths among wounded in action, by causative agent and nature of traumatism, U.S. Army, Korea, 1950-53 Killed in action, by causative agent and type of ground operation, U.S. Army divi sions, Korean War Wounded in action, by causative agent and type of ground operation, U.S. Army divisions, Korean War

II

II

Percent distribution for anatomical location of wounds, by category of casualty, and Korean War U.S. Army, World War Fatality percentage of deaths among total hit (killed and wounded in action), by anatomical location of wounds and causative agents, U.S. Army, Korea, 1950-53 . . Case fatality percentage of deaths among wounded in action, by anatomical location of wounds and causative agents, U.S. Army, Korea, 1950-53 Fatality percentage of deaths among total hit (killed and wounded in action), by anatomical location of wounds and nature of traumatism, U.S. Army, Korea,

II

1950-53 49

30

Case fatality percentage of deaths among wounded in action, by anatomical location of wounds and nature of traumatism, U.S. Army, Korea, 1950-53 Killed in action, by anatomical location of fatal wound and type of ground operation, U.S. Army divisions, Korean War Wounded in action, by anatomical location of wound and type of ground operations, U.S. Army divisions, Korean War Nonbattle injury, by causative agent and type of ground operation, U.S. Army divisions, Korean War Nonbattle injury admissions, by anatomical location of injury and type of ground operation, U.S. Army divisions, Korean War Patient flow and other hospitalization data, U.S. Army hospitals, Korea, 1952, all personnel, nonbattle causes Patient flow and other hospitalization data, U.S. Army hospitals, Korea, 1952, U.S. Army personnel, nonbattle causes Patient flow and other hospitalization data, U.S. Army hospitals, Korea, 1952, all personnel, battle causes Patient flow and other hospitalization data, U.S. Army hospitals, Korea, 1952, U.S. Army personnel, battle causes Admissions to hospital for all causes, by category of personnel and by type of hospi tal within major operational echelon, U.S. Army hospitals, Korea, 1952 Admissions to hospital, by cause of admission and by type of hospital within major operational echelon, U.S. Army hospitals, Korea, 1952

32 33 33 33 34 35 36 36 37 37 39 40 43 44 44

45 45 47 48 52 53 58 00 62 63 65 66

Table 60 61 62

63 64 65 66 67 68 69 70 71 72 73 74 75 76

Page

Dispositions from hospitals, by type of hospital within major operational echelon, for selected types of dispositions, U.S. Army hospitals, Korea, 1952 Percentage distribution of dispositions from hospital, by type of disposition, for selected groupings of U.S. Army hospitals, Korea, 1952 Average bed occupancy and average duration of hospitalization, by cause of admis sion and by type of hospital within major operational echelon, U.S. Army hospi tals, Korea, 1952 All evacuees received in continental United States, by area of origin and category of personnel, 2 September 1950-31 December 1953 Percentage distribution, by mode of transportation and type of personnel, all evacuees received in United States, 2 September 1950-31 December 1953 All evacuees received in United States, by specialized treatment required and cate gory of personnel, 2 September 1950-31 December 1953 U.S. Army evacuees received in United States, by specialized treatment required and type of admission, 2 September 1950-31 December 1953 Percent distribution of U.S. Army evacuees, by specialized treatment required and type of admission, 2 September 1950-31 December 1953 U.S. Army evacuees, by prior operation overseas, category of admission, and over seas areas, 2 September 1950-31 December 1953 U.S. Army wounded evacuees received in United States, by causative agent, 2 September 1950-31 December 1953 Number and percent of U.S. Army wounded evacuees, by type of traumatism, 2 September 1950-31 December 1953 Percent distribution of U.S. Army wounded evacuees, by anatomical location of wound, 2 September 1950-31 December 1953 U.S. Army wounded evacuees, from time of wounding to first medical care, 2 Sep tember 1950-31 December 1953 Percent of U.S. Army evacuees wounded, reaching surgical and evacuation hospitals within a specified number of days after wounding, July 1950- August 1953 Cumulative percentage reaching surgical or evacuation hospitals after day wounded, Army wounded in action evacuees by month wounded, July 1950-August 1953. . Admissions for wounded in action and surgical operations, anatomical location and type of surgery, U.S. Army, Korea, July 1950-July 1953 Admissions for wounded in action with surgical operations, annual rates, and percent distribution,

July 77 78 79

by type of surgery and type of unit, U.S. Army, Korea,

July

81 82 83 84 85 86 87 88

67

69 70 70 73 73 74 75 78 79 79 80 80 81 84

1950-

1953

Comparison of admissions excluded to total nonbattle admissions processed, by type of admission with surgical operation, U.S. Army, Korea, July 1950-December 1953 Number and percent of nonbattle admissions processed, by type of admission with surgical operation, U.S. Army, Korea, July 1950-December 1953 Admissions for disease with surgical operations, annual rates, and percent distribu tion, by type of surgery and type of unit, U.S. Army, Korea, July 1950-December 1953

80

66

Admissions for nonbattle injury with surgical operations, annual rates, and percent distribution, by type of surgery and type of unit, U.S. Army, Korea, July 1950December 1953 U.S. military repatriated prisoners of war, Korea, by age group Average weight lost by body build at capture and by weeks in captivity, U.S. mili tary repatriated prisoners of war, Korea Number and percent of wounded in action by anatomical location of wound, U.S. military repatriated prisoners of war, Korea Number and percent with surgical operations, U.S. military repatriated prisoners of war, Korea Number and percent of results of psychiatric examinations, medical survey of U.S. military repatriated prisoners of war, Korea Number and percent of results of eye, lip, and mouth examinations, medical survey of U.S. military repatriated prisoners of war, Korea Number and percent of results of chest X-ray examinations, U.S. military repatri ated prisoners of war, Korea Number and percent of results of skin examinations, medical survey of U.S. military repatriated prisoners of war, Korea

84 85 86

86

87 88 88 89 89 90 90 90 91

xi

Table 89 90 91 92 93

Page

Number and percent of stool examinations, U.S. military repatriated prisoners of war, Korea Field army accumulation-decumulation factors, by type of case, and specified evacua tion policies Theater accumulation-decumulation factors, by type of case, and specified evacua tion policies Accumulation-decumulation factors for wounded patients by echelon, for a 5-day Army and 30-day theater evacuation policy CONUS accumulation-decumulation factors, by type of case, and specified evacua tion policies

91 97 98 99 100

Appendix Tables Table

B-l B-2

B-3

B-4

B-5 B-6 B-7 B-8 B-9 B-10

B-ll B-12

C-l C-2

C-3

C-4

Numbers and annual rates for killed in action, wounded in action, and nonbattle causes, admissions and CRO cases, by year and month, U.S. Army, Korea, July 1950-July 1953 Numbers and annual rates for killed in action, wounded in action, and nonbattle causes, admissions and CRO cases, by year and month, all U.S. Army divisions and regimental combat teams, Korea, July 1950-July 1953 Numbers and rates for killed in action, wounded in action, and nonbattle causes, admissions and CRO cases, by year and month, U.S. Army non-divisional unite, Korea, July 1950-July 1953 Summary of battle and nonbattle admissions: all divisions and separate regi mental combat teams, by type of casualty, diagnostic classification, year and month, Korea, July 1950-July 1953 U.S. Army divisions and separate regimental combat teams, by tactical operation, U.S. Army, Korea, July 1950-July 1953 U.S. Army division headquarters, headquarters and service companies, by tactical July 1950-July 1953 - operation, U.S. Army, Korea, U.S. Army regiments and regimental combat teams, by tactical operation, U.S. Army, Korea, July 1950-July 1953 U.S. Army division artillery, by tactical operation, U.S. Army, Korea,

July

110

112

114 118 124 130

July

1950136

1953

U.S. Army division engineer battalions, by tactical operation, U.S. Army, Korea, July 1950-July 1953 U.S. Army division medical battalions, by tactical operation, U.S. Army, Korea, July 1950-July 1953 U.S. Army division tank battalions, by tactical operation, U.S. Army, Korea, July 1950-July 1953 U.S. Army personnel separated for disability due to battle injuries and wounds, by primary diagnostic cause of separation, by rank, by type of separation, and by causative agent, 1950-53 Remaining and disposition factors for wounded patients admitted to hospital overseas on any one day of operations, wounded admissions in Korea, 1950-53,

142 148 154

160

converted to one admission per day Remaining and disposition factors for disease and nonbattle injury patients ad mitted to hospital overseas on any one day of operations, disease and nonbattle injury admissions in all overseas areas, 1950-53, converted to one admission per day Evacuee factors for wounded patients admitted to hospital on any one day of operations, wounded admissions in Korea, 1950-53, converted to one admission per day Evacuee factors for disease and nonbattle injury patients admitted to hospital on any one day of operations, disease and nonbattle injury admissions in all

162

1950-53, converted to one admission per day

168

overseas

xii

108

areas,

164

166

CHAPTER

ONE

Casualty and Morbidity Experience

UNITS AND STRENGTH

from

July

30

At 0400 on Sunday, 25 June 1950, the Russiantrained North Korean Army swept south across the 38th Parallel in four major drives. The U.S. Govern ment, which maintained a small military mission in South Korea at the time, reported the aggression to the

U.N. (United Nations)

On 27 June mended

all

1950,

member

Security Council.

the Security nations

act

Council recom to assist South

Korea to repel the armed attack and restore peace. The same day, President Harry S Truman ordered U.S. military forces to assist in this effort, and on 1 July 1950, the first U.S. Army combat units landed in Korea.

During the 3 years of fighting and periods of peace negotiations, nearly half a million American soldiers served in Korea, including medical evacuees, those rotated to the United States, units moved out of Korea to Japan and other areas, and individuals discharged from the Army. This resulted in a turn over of strength in the Eighth U.S. Army of almost three times the average monthly strength of ap proximately

208,000 men for the 37-month period —

July 1950-July Table strength

as for U.S. Army division and non-division

units.

Eight U.S. Army divisions and two separate regi mental combat teams served at one time or another

in the Korean War in addition to the 1st U.S. Marine Division, the ground force contingents of other United Nations, and the Armed Forces of the Republic of South Korea. Twenty-two nations joined forces under the U.N. flag in providing ground, air, naval, or medical support to resist the

U.S. Army division units were as follows: the 24th Infantry Division, the first to enter Korea on 2 July 1950, fought until 4 February 1952 when it was ordered back to Japan; the 1st Cavalry Division returned to Japan on 30 December 1951 after serving in Korea from 18 July 1950; the 25th Infantry Division served from 9 July 1950; the 2d Infantry Division aggression.

the 5th Regimental

Combat

3

part of the Eighth throughout

X

Corps became a U.S. Army and remained so

return of these units to Pusan,

the period of the war.

The total U.S. Army strength in Korea represents strength as averages of end-of-month reported by The Adjutant General (1). The division and separate regimental combat team mean strengths included in table 1 and the breakdown by organic midmonth

1953.

presents the U.S. Army monthly mean for the total U.S. Army in Korea as well 1

Communist

1950;

August 1950; the 187th Airborne Regimental Combat Team first entered Korea on 17 September 1950, left the war zone on 27 June — 1951, and returned to Korea on two occasions 12 May-17 October 1952 and, again, on 22 June 1953; the 7th Infantry Division from 18 September 1950; the 3d Infantry Division from 10 November 1950 (although the 65th Regimental Combat Team, in a part of the 3d Infantry Division, arrived Division, Infantry 5 September 1950); the 45th December 1951; and the 40th Infantry Division, 11 January 1952. Eighth U.S. Army headquarters completed its movement to Korea on 25 August 1950. The X U.S. Corps, previously activated to direct the amphibious landing at Inchon on 15 September 1950, acted as an independent force directly under Upon the withdrawal the Supreme Commander. 1950 and the in December from North Korea

Team from

The

major

units (table 2) are the average monthly strengths served as reported to the Army Surgeon General on summary health reports (2) received from separate units operating medical treatment division

The non-division

facilities. derived

by subtracting

average

the division

strength strength

was from

the total. the buildup of the U.S. Army Forces, units, which had peaked at almost 90 per 1950, averaged cent of the strength in August about one-half of the U.S. Army strength in Korea, while regimental units averaged almost one-third

After

division

Table 3 and figure 1 reflect these relative distributions by type of unit. Regimental of the strength.

troops, which consistently averaged 58 to 60 per cent of division strength, ranged from a high of 51

l-

20

30

40

0

60

0

80

0

100

PERCENT

0

I

J Army

1950

— U.S. divisi.s

STRENGTH

*nd

L

Figure

0

JASONDJFMAMJ

OF

r-Oim.ts

1951 as p-r4dnt

of U.S.

Army

AS

1.

July

str.Oth

JASONDJFMAMJJASOND

REGIMENTS

and 1I03.

_L

PERCENT

rd*im.ts

OF

1952

ARMY

as p-r4.t

U.S.

of U.S.

Army

STRENGTH,

division

str-nOth,

Kor-*,

1953

a,a-a--

JFMAMJ

KOREA

July

1I00-

J

Table 1.—-Distribution of U.S. Army division and non-division monthly mean strength, Korea, July 1950-July 1953 Mean strength Month U.8. Army

Division

Non-division

AND ADMISSIONS

CASUALTIES

The responsibility of the Medical Department of the U.S. Army for battle casualties, as well as for nonbattle (disease and nonbattle injury) patients, lies in proper diagnosis and treatment

and also in

providing for the timely evacuation and hospitaliza

1950

July

Total

tion of these patients. medical Consequently, interest in battle casualty statistics relates directly to information needed (such as diagnosis, anatomical

29,610 59,139 93,321 131,488 158,498 161,294

25,817 52,335 69,256 86,938 91,817 94,309

3,793 6,804 24,065 44,550 66,681 66,985

633,350

420,472

212,878

158,430 164,577 193,349 205,162 215,392 222,947 231,185 225,517 240,185 253,761 262,045 243,757

98,381 100,870 101,896 111,749 117,037 116,592 111,241 115,914 125,087 124,370 119,915 120,745

60,049 63,707 91,453 93,413 98,355 106,355 119,944 109,603 115,098 129,391

ele organizational ment, diagnosis, causative agent, surgical operation, and anatomical location of wound, provide the chief source of the data presented. The official battle

142.130 123,012

ously, because casualty information is derived from

1,363,797

1,252,510

1951

2,616,307 195t 223,730 226,407 227,902 230,548 233,620 235,446 237,738

102,078 107,790 110,967 114,074 114,654 116,619 120,290 115,562

222.047

121,652 118,617 116,935 116,474 118,966 118,827 117,448 116,562 115,481 115,335 114,038 110,403

2,772,319

1,400,738

1,371,581

232.124 235,963 235.361 231,433

120.482 120.026 117.395 111,644

195S

March April

July Total Grand total

220,045 221,680 225,810 228,912 243,938 256,969 271,169

106,837 104,371 103,794 106,661 115,100 121,118 133,297

113,208 117,309 122,016 122,251 128,838 135,851 137,872

1,668,523

791,178

877,345

7,690,499

3,976,185

3,714,314

207,851

107,464

100,387

percent of total U.S. Army strength in Korea in August 1950 to a low of 26 percent in November

for the organic fairly stable distribution over

proportions a

the complete period of the war.

and nature of trauma) to provide medical who become battle casualties.

location,

care for personnel Inasmuch

information can be obtained only

as this

from medical records, they are the basic source of

Tabulations

data.

May

1951. The relative division units show

BATTLE

records,

casualty

of

individual

these

medical

by day of occurrence,

counts,

are compiled by The and are based on casualty re through command channels. Obvi however,

Adjutant General ports forwarded

source record systems, patient data on categories of battle casualty and the gen erally corresponding categories compiled from com mand channel casualty reports may differ slightly different certain

with respect to totals. Records received by The Surgeon General show the following counts: 18,769 killed in action, 77,788 wounded in action and admitted

to medical

treat

slightly wounded in action and carded for record only — making a total of 92,363 wounded. The official totals included in The Adjutant General's report (S) show 19,585 killed in action (including 251 killed after capture) and 79,526 wounded in action. Although these ment

facilities,

and

14,575

differences are not significant in analysis for opera tions research, planning, or similar purposes, never theless for completeness, The Surgeon General's

killed-in-action count was increased from 19,353

by

matching

serial

numbers

18,769

from

to

The

General's individual records of death with The Adjutant General's records. With respect Surgeon

to the differences counts,

the

between

command

the wounded-in-action

channel

casualty reports were, generally, submitted only for those wounded in action who were "unit losses" (evacuated rear ward and admitted to a medical treatment facility and

for which

next-of-kin notifications

were re at the very beginning of the Korean War, there was slight ambiguity concerning

quired).

However,

reporting requirements, and some of the wounded who were treated at division clearing stations and 3

Table 2.—Distribution of division and separateregimental combatteam monthly mean strength,by type of unit, U.S. Army, Korea, July 1950-July 1953 Mean strength Division organic units Month

Division

Headquarters, headquarters and service companies

Regiments

Division artillery

Battalions Engineer

Medical

Tank

I950

July

25,817 52,335 69,256 86,938 91,817 94,309

3,609 6,093 7,924 9,183 10,391 10,877

14,661 30,094 39,345 51,948 54,202 55,108

4,751 9,802 13,421 16,148 16,808 17,248

1,944 3,062 3,826 4,448 4,586 4,798

420,472

48,077

245,358

78,178

22,664

8,684

17.511

98,381 100,870 101,896 111,749 117,037 116,592 111,241 115,914 125,087 124,370 119,915 120,745

10,700 11,227 11,377 11,903 12,787

57,995 59,989 60,652 67,878 70,430 67,454 64,553

4,979 5,134 5,268 5,723 6,043 6,198 5,958

68.689 72,135 70.250 69,308 71,065

24.528 23,133 23,598

5.933 6,682 6,612 6,137 5,927

1,886 1,836 1,860 1,912 1,937 1,971 2,056 2,117 2,309 2,315 2,101 2,176

4.276 4.206 4.033 4,292

13.882 14,894 15,586 14,454 14,062

18,545 18,478 18,706 20,041 21,172 22,059 20,382 20,826 24,298

4.668 4,559 4,288 4,467 4,769 5,079 4,782 3,917

1,363,797

159,227

800,398

255,766

70,594

24,476

53,336

14,722 12,967 13,084 13,684 13,608 13,737 13,600 13,891 13,510 13,613 13,874 11,895

71,280 72,099 70,141 69,498 72,773 72,509 70,573 68,393

5,749 5,590 5,686 6,053 6,105 5,656 5,628 6,384 6,339 5,769 5,322 5,240

2,081 2,010 2,122 2,144 2,123 1,995 1,984 1,925 1,922 2,008

4,339

67.956 68,274 66,612 66,880

23,481 21,715 21,660 20,885 20,626 20,788 21,406 21,746 21,595 21,658 22,434 20,870

1.969 1,775

4.013 3,827 3,743

1,400,738

162,185

836,988

258,864

69,521

24,058

49,122

106,837 104,371 103,794 106,661 115,100 121,118 133,297

11,400 11,319 11,491 12,156 12,208 12,262 13,783

64,914 63,296 62,462 62,913

5.144 4,605 4,556 5,219

1,794 1,798 1,869 1,999

69.794 74,676 82,106

19,947 19,560 19,409 20,182 21,634 22,441 24,681

5.270 5,200 5,996

2.074 2,262 2,139

3,638 3,793 4,007 4,192 4,120 4,277 4,592

791,178

84.619

480,161

147,854

35,990

13,935

28.619

3,976,185

454,108

2,362,905

740,662

198,769

71,153

148,588

12,273

63,862

20,018

5,372

1,923

4.016

622 1,191 1,403 1,644 1,849 1,975

230 2,093 3,337 3,567 3,981 4,303

19*1

April

July

14.351 14,004

195t 121,652 118,617 116,935 116,474 118,966

March May

118.827 117,448 116,562 115,481 115,335 114,038 110,403

July

4.236 4,242 4.210 3,731 4,142 4,257 4.223 4,159

195S

April May

July Total

107,464

1

Table 3.— Percent distribution of U.S. Army and U.S. Army divisions by type of combatunit, Korea, July 1950-July 1953 July 1950

through July 1953

Type of combat unit

not lost to their units were inadvertently included in the command channel reports. On the other hand, medical

records were submitted

not only

for the

"unit losses" but also for all of the slightly wounded, but could be treated in the vicinity, usually at an aid or clearing

even those who were not admitted

station, and returned to their units before the close of the morning report day. The latter, not officially excused from duty for as much as 1 day for medical

CRO

January-

December 1952

January-

July

1953

100.0 51.7

100.0 66.4

100.0 52.1

100.0 50.5

100.0 47.4

(30.7) 48.3 100.0 11.4 59.5 18.6 5.0 1.8 3.7

(38.7) 33.6 100.0 11.4 58.3 18.6 5.4 2.1 4.2

(30.6) 47.9 100.0 11.7 58.7 18.7 5.2 1.8 3.9

(30.2) 49.5 100.0 11.6 59.7 18.5 5.0 1.7 3.5

(28.8) 52.6 100.0 10.7 60.7 18.7 4.5 1.8 3.6

admissions,

and 859

killed in action,

DNBI

January-

December 1951

152 wounded

admissions per 1,000, respectively, occurred. the decline, on a yearly basis, of

Table

4 shows

approximately 90 percent from the high rates ex in 1950 for both killed in action and

perienced wounded

compared for

admissions

DNBI

units

for total U.S. Army, Korea,

to the overall

shows

drop of about 46 percent

The decline for division drops for disease and non-

admissions. sharper

(carded

battle injuries, while non-division units experienced a much smaller decline in nonbattle patients.

The reporting of DNBI (disease and nonbattle of the injury) cases is solely the responsibility Medical Department, U.S. Army, and information pertaining to these cases relates directly to the

Since this report is concerned chiefly with the presentation of combat medical statistics, both text

care, were, as previously for record only) cases.

complete medical

episode treatment.

of

noted, the

July-

December 1950

their

respective

periods of as used

The term "admission"

in both text and source tables refers to instances of medical

treatment given on an excused-from-duty basis. These patients may have been treated in a hospital or infirmary bed or "in quarters" (in a dispensary bed, at an aid station or clearing com pany, or in the person's usual quarters). Admissions

to all medical treatment

in Korea num

facilities

bered 443,163 for all causes during the complete period of the war, July 1950- July 1953. In addition to

the

77,788

wounded

365,375 nonbattle

admissions,

there

were

(82.4 percent of the

admissions

total), of which 290,210 resulted from disease and 75,165 from nonbattle injury.

In

terms

of

annual

rates

per

1,000

average

strength, for the complete period of the war, the overall counts represent 30 per 1,000 for killed in action, 121 per 1,000 for wounded in action admis sions, and 570 per 1,000 for disease and nonbattle injury admissions. All of these rates are lower than the corresponding

May

1945

theater

period

during

annual rates for the June 1944of operations

World War

II,

in the European where rates of 44

and source tables that show admissions reflect data related mostly to division combat units. Data are and for total U.S. Army, given for non-division

Korea, to achieve perspective. For example, while units comprised slightly more than onehalf the average total U.S. Army strength in Korea division

(table 5), they suffered almost 95 percent of the killed and wounded in contrast to slightly less than one-half of the

DNBI

admissions.

The differences

are more pronounced at the regimental level, where units comprising only 31 percent of the average U.S. Army strength in Korea accounted for more than

five-sixths

of the killed

pared to about one-third

and wounded

of the

DNBI

com

admissions.

The respective unit annual rates also are highest at the regimental level, being 85 per 1,000 for killed in action, 337 per 1,000 for wounded admissions, and 641 per 1,000 for DNBI admissions. While these data cover all of the U.S. Army divisions and regiments that fought in the Korean War, the figures for headquarters

and service companies and

for artillery, engineer, medical, and tank battalions reflect

only the assigned organic division or at tached units of the respective type. Separate com bat units such as corps or army troops are included

with non-division

units

which

represent

combat

Table 4.— Annual rates for killed in action and admissions to medical treatmentfacilities, U.S. Army, Korea, July 1950-July 19S3 [Rates expressed as number of cases per 1,000 average strength per year]

Selected indexes

U.S. Army: Killed in action

July 1950

through July 1953

July-

December 1950

January-

December 1951

January-

JanuaryJuly

December 1952

Percent decline July-December 50 January-July 53

1953

30 691 121 570 453 117

136 1.232 426 806 607 199

36 810 163 647 507 140

11 576 52 524 424 100

12 492 56 436 357 79

-91 -60 -87 -46 -41

56 751 220 531 405 126

198 1,454 587 867 633 234

67 958 299 559 498 161

21 519 96 423 330 93

25 432 108 324 255 69

-87 -70 -82 -63 -60 -71

2 628 16 612 504 108

14 797 110 687 558 129

3 647 14 633 516 117

1 635 7 628 520 108

1 547 9 538 450 88

-93

-60

Division and regimental combat team: Admissions, all causes

Non-division:

-31

-92 -22 -19 -32

Table 5.—Distribution of averagemean strengthand killed in action; battleand nonbattU admissions to medical treatmentfacilities, by type of combatunit: number, percent,and rate, U.S. Army, Korea, July 1950-July 195S [Rates expressed as number of cases per year per 1,000 average (respective unit) strength] Average mean strength

Killed in action

Type of combat unit Number

U.S. Army

Regiments Artillery battalions

Tank battalions

Percent

207,851 100,387 107,464 12,273 63,862 20,018 5,372 1,923 4,016

Number

Percent

19,353 699 18,654 328 16,764 928 394 28 212

100.0 48.3 51.7 5.9 30.8 9.6 2.6 0.9 1.9

100.0 3.6 96.4 1.7 86.7 4.8 2.0 0.1 1.1

Rate

30.2 2.3 56.3 8.7 85.1 15.0 23.8 4.7 17.1

Admissions

Disease and nonbattle injury

Wounded in action

Number

U.S. Army

77,788 4,827 72,961 902 66,329 3,268 1,299 70 1,093

Percent

100.0 6.2 93.8 1.2 85.2 4.2 1.7 0.1 1.4

Rate

121.4 15.6 220.2 23.8 336.9 53.0 78.4 11.8 88.3

Number

365,375 189,390 175,985 13,170 126,175 20,645 7,790 2,760 5,415

Percent

100.0 51.8 48.2 3.6 34.5 5.7 2.1 0.8 1.5

Rate

570.1 611.9 531.1 348.0 640.8 334.5 470.3 470.5 437.3

Table 6.— Nonbattle admissions and CRO casesfor division and non-division, by period and type of case, U.S. Army, Korea [Cases stated as number per year per 1,000 average strength] Division

Period and type of case

Non-division

CRO cases

Admissions

Number

Rate

Number

CRO casea

Admissions

Rate

Number

Rate

Number

Rate

July 19S0-July 19S3 175,985 134,100 Nonbattle injury Augu.it l9S3-Dicember 19SS All nonbattle causae Disease Nonbattle injury

July 1950-December19S3 All nonbattle causes

41.885

531 405 126

22,015 21,040 975

66 63 3

189.390 156,110 33,280

612 504 108

73,295 72,210 1,085

237 233 4

18,335 16,060 2,275

320 280 40

5,980 5,660 320

105 99 6

25,780 22,125 3,655

459 394 65

12.925 12,740 185

230 227 8

194,320

500 386 114

27,995 26,700 1,295

72 69 3

>215,170 178,235 36,935

588 487 101

150.160 44,160

• 86,220

236 232 4

84.950 1,270

' An additional 135 admissions (130 disease and five nonbattle injury) occurred before July in calendar year 1950. * An additional 10 disease CRO casesoccurred before July in calendar year 1950.

zone troops as well. troops comprised about 48 per cent of the average U.S. Army strength in Korea and provided slightly more than one-half of the

prevalent type, representing 57 percent of wounds of all types and 35 percent of the total number of admissions to medical treatment facilities for Fractures wounds. accounted for 23 percent of the

facilities for The extremely low

total wounded, with compound fractures amounting to 19 percent. The distribution of the balance of

per 1,000 for killed in action and

wounds (table 7) shows each of the other types of traumatisms was less than 3 percent of the total wounded. For division and separate regimental

support

and communications

These non-division

admissions

to

medical

disease and nonbattle annual rates of

2

treatment

injuries.

per 1,000 for wounded admissions reflect the relatively low level of risk and exposure to 16

combat

All

for

most

of

these

non-division

of the detailed cross-tabulations

troops. of data in

combat teams, the relative distribution was almost identical

to

U.S. Army, Korea. The non-

total

units show slightly less proportionately

in the source tables presented for overall counts of disease and nonbattle injury cover admis

division

sions through December 1953 and, therefore, reflect

wounds, such as burns, contusions, and concussions.

cluded

a slightly larger number

of admissions

than does

fractures Figure

2

slightly more for

and

graphically

other

for

types

of

depicts similar distributions for

the shorter period through July 1953. The overall annual admission rates, however, are somewhat

nonbattle

smaller. From the data presented in table 6, it may be seen that this reduced annual rate is due, largely,

were the leading cause of admissions for division units, followed by sprains, strains, and dis locations (17 percent), cold injury (16 percent), and

to the lower rates experienced during the August1953 peacetime period. In addition, the changeover from combat permitted more nonbattle patients to be treated within the division medical

December

service

as

contributed

CRO

and, undoubtedly, outpatients to the overall reduction of the division

1953.

injury

Fractures,

admissions amounting

total,

wounds of all types (15 percent). Contusions con tributed 12 percent of all nonbattle injury admis sions for divisions. percent

Although fractures caused 19 injury admissions in the

of all nonbattle

non-division

units,

they ranked second to sprains, for which accounted

rate. Non-division troops, on the other hand, did not experience a comparable shift between

strains,

inpatients and outpatients. The most frequent traumatism

represented injuries for

non-division

tusions

(13

percent).

leading

cause

admission

diagnosed as the

cause of battle admissions was wounds of all types (62 percent). Penetrating wounds were the most

December through to 18 percent of the

and

dislocations,

almost 25 percent of the total. Wounds of all types 16

percent

of

the

units,

total followed

nonbattle by

con

Cold injury, which was a of nonbattle injury admissions for 7

PERCENT 0

10

20

10

26

Simple and other

Fractures DIVISION NON - DIVISION Wounds DIVISION NON- DIVISION

Other

Abrasions and blisters DIVISION NON- DIVISION Amputation, traumatic t%%%3 10 %

DIVISION NON- DIVISION

{ffi]

Burns

"-»"•«»

0.8%

i^fflg

6.8 % 8 0 %

Concussion DIVISION NON - DIVISION Contusion

118 %

DIVISION

13.5 %

NON- DIVISION Cold

injury

15.8%

DIVISION NON- DIVISION reaction

Prophylactic

DIVISION NON- DIVISION Sprains,

^0.9% $y%X$ 1-9%

strains, and dislocations

division non- division

124.6%

All others DIVISION NON- DIVISION

Figure

yyyyyyyyyyyyyyyyy\

2. — Percent distribution,

8 9 %

nonbattle injury admissions, by nature of traumatism July 1950-December 1953.

troops (16 percent), amounted to slightly than 3 percent for non-division units. This

division less

latter phenomenon

results from

the degree of ex

posure to the elements required of combat troops. The most important cause of disease admissions among

U.S.

respiratory

Army infections,

troops in Korea was acute which accounted for one-

fifth of all disease admissions for all Army units. This condition was responsible for 15 percent of the disease admissions percent 8

among division

of the disease admissions

troops and 26 in non-division

and type of unit, U.S. Army,

units. The second most frequent for divisions tions,

closely

disease.

digestive

Korea,

cause of admission

was symptoms and ill-defined condi followed by infective and parasitic

This latter diagnosis and diseases of the system, with annual admission rates of

53 and 47 per 1,000,

respectively, were the second and third leading causes of disease admissions for non-division units. Psychiatric conditions repre sented division

over

9

troops,

average strength

percent

of disease admissions

producing

for

a rate of 36 per 1,000

per year. This compares

with

5

Table 7.— Admissions due to battleinjuries and wounds by type of unit and diagnosis, U.S. Army, Korea, July 1950- July 1953 Admissions

Diagnosis

Number

Total

Wounds, total

Dislocation of joint

percent for non-division

Division and regimental combat team

Total

units and a rate of 25 per

per year. The frequency of admissions for the various other diagnostic classes is shown in figure 3. 1 ,000

Percent

Number

Non-division

Pereent

Percent

Number

77,788

100.0

72,961

100.0

4,827

100.0

17,910 1,020 14,495 2,395 48,217 3,937 27,551 8,902 7,827 11,661 649 1,120 270 766 1,781 2,055 13 75 1,880 1,883 1,169

23.0 1.3 18.6 3.1 62.0 5.1 35.4 11.4 10.1 15.0 0.9 1.4 0.3 1.0 2.3 2.7 0.0 0.1 2.4 2.4 1.5

17,031 953 13,894 2,184 45,319 3,658 26,106 8,470 7,085 10,611 581 1,072 250 683 1.628 1,890 12

23.4 1.3 19.1 3.0 62.1 5.0 35.8 11.6 9.7 14.5 0.8 1.5 0.3 0.9 2.2 2.6 0.0

1,810 1,727 958

2.5 2.4 1.3

879 67 601 211 2,898 279 1,445 432 742 1,050 68 48 20 83 153 165 1 75 70 156 211

18.2 1.4 12.4 4.4 60.0 5.8 29.9 8.9 15.4 21.8 1.4 1.0 0.4 1.7 3.2 3.4 0.0 1.6 1.5 3.3 4.3

—

—

conditions (table 8). units, almost all (98 percent) were cases. It should be noted that these

balance was due to nonbattle

For non-division nonbattle

patients do not represent the total number of out patient visits or treatments at U.S. Army medical

OUTPATIENT CARE AND CARDED FOR

treatment

RECORD ONLY

for which a record was specifically

facilities

in Korea,

but only those

cases

required by ap

Army regulation (4). The CRO cases generally include all of the wounded who are treated as outpatients and all nonbattle cases which are propriate

During the period July 1950-December 1953, U.S. Army medical treatment facilities in Korea treated 128,790 patients who did not require ad mission, but who, for one reason or another, were carded for record only. About one-third of the

CRO

cases

from divisions

were wounded

and the

received

"dead

on arrival."

In addition,

certain

patients with conditions which might possibly result in a claim against the U.S. Govern ment, those for whom a record is required for ad nonbattle

Table 8.— Number and percentdistribution of outpatient casescardedfor record only, by type of unit, U.S. Army, Korea, July 1950-Decembcr195S Division

Total

Non-divlsion

Type of case Number

128,790 14,575 114.215 111,650 2,565

Percent

100.0 11.3 88.7 86.7 2.0

Number

40,477 12,482 27,995 26.700 1,295

Percent

100.0 30.8 69.2 66.0 3.2

Number

88,313 2,093 86,220 84,950 1,270

Percent

100.0 2.4 97.6 96.2 1.4

CLASS IX

Numbers per 1,000 average strength per year

RATE

0

20

10

40

30

70

60

90

80

100

110

120

130

Aeu'

^^^^^^

DIVISION NON-DIVISION Tt

50

XI

57 126

Symptoms and ill-defined conditions

DIVISION NON-DIVISION

X

Infective

and parasitic

DIVISION NON-DIVISION

NON-DIVISION Skin and Cellular

v 11

Eye and Adnexa

DIVISION NON-DIVISION

* Iv

Urinary

division NON-DIVISION

XVIII

and male genital

mmma

~T"TT

Bones and organs of movement

Ear,

XX

nose, and throat

zn

ai lergic,

JL

system

vmm

NON- DIVISION

endocrine

Yfa

4 4

observation

(no disease found ) etc.

3. — Disease admissions, by diagnostic class and type of unit, U.S. Army, Korea,

or

disease cases

treated as outpatients

other

reasons,

and

all

venereal

are carded for

record only. Wounds of all types accounted for 85 percent of all wounded CRO cases, with abrasion and blisters

10

respiratory disease

NON-DIVISION

9

ministrative

(6 percent),

5

t88S3l 6

ALL OTHER

and metabolic

Includes admissions for medical and surgical

Figure

Other DIVISION

11

Egg

DIVISION

DIVISION NON-DIVISION

aj

Neoplastic

NON-DIVISION

NON-DIVISION Circulatory

20

10

Dental

division

division NON-DIVISION

0

NON-DIVISION

18

DIVISION

* '

RATE

DIVISION

16

OIVISION NON-DIVISION

VIII

CLASS

.7

contusions

(3 percent),

burns and con

cussions

(2

percent

July 1950-December

each),

sprains

1953.

and

strains

(1 percent) (1 percent), and other and unqualified accounting for the balance of 15 percent. The nonbattle injury CRO cases were distributed as

wounds of all types (35 percent), fractures (11 per cent), drowning victims (10 percent), sprains and

Table 9.—Outpatient treatmentsat U.S. Army medical treatmentfacilities, Korea, by categoryof personnel and type of treatment, 1 June 1951-St December1953

categories

Ear, nose, and throat

Pediatrics X-ray and radium therapy

strains (7 percent), contusions (7 percent), multiple injuries (6 percent), burns (5 percent), abrasion and blisters (3 percent), poisoning (2 percent), avulsion and other and unqualified

(13 percent).

Infective and parasitic disease (largely venereal disease) accounted for almost 90 percent of the CRO cases for disease conditions. Urinary and male genital disease, with 6 percent of the total, was a distant second, followed by skin disease percent) and bones and organs of movement (about 1 percent). None of the other diagnostic classifications was responsible for more than 0.5 percent of the total disease CRO cases in Korea. (2

The requirement for submission of Outpatient Report (DD Form 444) was instituted by Army regulation (5) beginning with the month of June 1951. Before that time, outpatients were recorded locally by medical treatment facilities through use of an outpatient register. The regulations (4) in effect at that time required submission of a register card on each individual entered on the register at every medical treatment facility. The available data for U.S. Army, Korea, are taken from the Outpatient Report and, consequently, cover the period 1 June 1951-31 December 1953. About 10.1 million outpatient visits to Army medical facilities in Korea during this period re the performance of about 10.9 million quired outpatient treatments. In addition, Army medical treatment facilities in Korea performed more than 40,000 complete

physical

examinations

flight physical examinations),

5.5

(including

million immuniza

tions, and 32,000 specified periodic examinations or tests. It should be noted that these data exclude all dental outpatient

Of the

10.9

4.343,535 3,118,578 245,793 99,732 366,826 135,741 328,109 23,043 653 73 572

—

treatments

given

Navy and Marine Corps

4,314,952 3,104,207 243 ,505 98,864 364,923 130,585 324,752 22,563 642 73 572

21,429 2,986

6,218 3,871 241 91 787 716 452 24

—

— — — —

21,302 2,964

35 1

All other

Air Foroe

22,365 10,500 2,047

6.584,627 4,887,611 375,971 46,688 643,155

777 1,116 4,440 2,905

322.425 290.976 15,438 15 158

456 11

— — —

—

440 752 998

92 21

by Army medical treatment facilities in Korea during this period, approximately 4.3 million (40 percent) were received by active-duty military personnel, almost all of whom were Army personnel. The remaining 6.6 million (60 percent) were re ceived by "all other" personnel, chiefly enemy of war. In terms of an index per 1,000 average strength, the annual outpatient treatment rate was 6,954 per 1,000 for U.S. Army personnel in Korea during the June 1951-December 1953 prisoners

This rate, however, is considerably lower individual year total Army worldwide

period. than

the

annual

outpatient

treatment

rates

of

8,200

for

for 1953. The distribution by type of treatment

1952 and 8,600

among various categories of personnel, as shown in table 9,

that active-duty military personnel re ceived less than one-half of the various other types of treatments, with the exception of general surgery ; ear, nose and throat ; neuropsychiatry ; psychological indicates

and X-ray and tests; gynecology; physiotherapy; radium therapy. For example, 60 percent or more of general medicine, dermatology, surgical dressing room, ophthalmology, obstetric, and pediatric treat ments were received by other than military; princi pally, enemy prisoners of war. In comparing the various outpatient

treatments

by type of treatment, general medicine, with almost of the workload, constituted the three-quarters most frequently required treatment. Surgical dress ing room with 9 percent of all treatments was second, followed

by dermatology

nose, and throat

(6 percent),

cent),

and general

the remaining

care.

million outpatient

Army

Total

10,928,162 8,006,189 621,764 146,420 1,009,981 458,166 619,085 38,481 668 231 572 440 22,181 3,984

Dermatology General surgery

(1 percent),

Active-duty military personnel

All

Type of treatment

types

(6 percent),

ophthalmology

ear,

(4 per

surgery (1 percent). None of of treatment represented as

much as 0.5 percent of the total. 11

Table 10.— Average duration of stay in U.S. Army hospital and quarters, worldwide: World War II and Korean War; and combatunits by area of disposition and type of ease,Korea, July 1950-July 1953 Type of case Area of disposition

Total Army, World War II Total Army, Korean War Divisions and regimental combat teams: All areas Far East Command AH overseas areas Continental U.S

AVERAGE

DURATION

OF STAY

from division returned hospital

Data on average duration of patient stay in are important from the standpoint of planning for inpatient medical care. The number of beds that must be provided, as well as the amount of professional and ancillary personnel needed, are hospital

cases

and quarters) involve no loss of time

from duty. The data on and separate regi mental combat teams cover all of their cases originat

average

duration

for

ing in Korea during

division

1950-53, regardless of where

the final disposition eventually occurred. ample, table 10 shows that the overall

For

ex

average per division wounded was 96 days com pared to 93 days for total U.S. Army, Korea, and duration

129 days for

World War

II. An

average of 34 days

Far East Command (Japan-Korea), 37 days in all overseas areas (in cluding the Far East Command); for wounded cases evacuated to the United States, an average per case

was spent

in

the

of 258 days was lost for each wounded pitalized in the United States. Disease

case

fact,

for

divisions,

the

15 11 12 141

40 22 23 200

to duty anywhere averaged 65 days in or quarters, whereas the died-of-wounds only

10 days.

Korea averaged

19

All

other

wounded

for disability separations reasons, had the largest days).

Returns to

originating

days, nonbattle

duty in

in divisions deaths

17

days,

For disease of stay was 14 days cases, the average duration per case for returned to duty, 23 days for deaths, all other

dispositions

233

days.

200 days for all other disease dispositions. Comparable for division nonaverage durations battle injury cases were 36 days for returns to duty, 9 days for deaths, and 299 days for all other

dispositions.

The longest average durations, obviously, occur among those cases separated from the Army, usually among the disability separations. Most of the reasons for this have to do with the nature and severity of these cases from a medical viewpoint and the type and amount of treatment provided. Some of the reasons also result from the admin processing required as well. The data included in table 11 show the average duration for all nonbattle cases worldwide separated for disistrative

Table 11.— Average duration of stay in U.S. Army hospital and quarters, worldwide, for nonbattlecausesseparatedfor disability, by year, 1950-53

Year

All nonbattle causes

Disease

Nonbattle injury

as

data for divisions in duration-of-stay Korea are distributed by type of final disposition, large differences are noted. Wounded admissions 12

21 14 14 170

(371

nonbattle

injury average duration was almost three times long as that for disease cases. When

96 34 37 258

hos

injury combined cases averaged 20 days in both World War II and the Korean War. However, by type of case, nonbattle injury had the longer

In

30 28

and non-

battle

duration.

19 18

cases

and

to medical

20 20

duration

of stay relate to all cases treatment facilities (hospital and exclude all CRO cases, which

These data on duration

injury

129 93

among nonbattle and

nonbattle

units in Korea who were eventually

averaged

average

All

All disease

nonbattle causes

dispositions, including and for administrative

directly related to the numbers and types of patients inpatient care and to the length of stay that is likely to result. requiring

admitted

All

Wounded in action

1950 1952

251 116 166 169

242

no

154 158

392 279 326 297

ability in the U.S. Army each year from through

1950

1953.

Table 12.— Noneffective rates, U.S. Army division and separate regimental combatteams, Korea, July 1950-December1953 [Daily average number of patients in hospital and quarters per 1,000 average strength] Admitted in Korea and time lost.

NONEFFECTIVENESS indexes used to One of the most significant measure the health of the Army is the noneffective rate. This index is usually represented as the average

daily number of patients in hospital and quarters basis per 1,000 average strength during the period considered. This measure of time lost from duty not only indicates the non availability of personnel for the performance of on an excused-from-duty

their assigned duty, but also is important from the standpoint of providing medical care for them by The amount of the Army Medical Department. noneffectiveness depends primarily on two factors: (1) the rate of admission to hospital and quarters on an excused-from-duty basis, and (2) the average length of stay in hospital and quarters once the patient

is admitted.

The noneffective rate of 35.8

for the Far East Command

means that,

average day during the period

July

on the

1950-December

36 individuals out of each 1,000 1953, roughly division troop strength in Korea were not avail able for duty because they had been admitted to hospital or quarters for medical reasons. This may

also be expressed as 3.6 percent of division strength in Korea being noneffective for medical reasons on the average day during this period. The other rates reflect the cumulative effect of among division troops in Korea, as additional time is lost in other areas. For example, the noneffective rate of 36 per 1,000 per day is

shown

in table

12

noneffectiveness

increased almost three times when all of the days of noneffectiveness are considered, although these days

of noneffectiveness

are not usually

charged

back to the command of origin when computing noneffective rates.

The admission rate through December 1953 for disease cases from divisions in Korea (386 admissions per 1,000) was more than three times that from nonbattle injury (114 per 1,000), while total days lost was only one-third more than the days lost from nonbattle injury. The difference results in an average duration of stay for disease cases (15 days)

of about one-third that for nonbattle injury cases (40 days). The noneffective rate, however, is higher for disease (19 per 1,000 per day) compared to 15 per 1,000 per day for nonbattle injury, when all days lost are considered. For the Far East Com-

Overseas areas

All

Type of case

All overseas

35.8 14.9 20.9 13.6 7.3

38.2 16.6 21.6 13.9 7.7

90.0 57.5 33.4 18.8 14.6

Wounded in action . . All nonbattle causes. Nonbattle injury.

Far East Command

.

the noneffective

mand,

that for nonbattle

rate for

Continental United States

52.7 40.9 11.8 4.9 6.9

disease is twice

injury. Obviously,

some of the

diagnoses, such as tuberculosis, with a low admission rate, contribute heavily to specific

disease

the noneffective

rate because of the lengthy

pitalization required for the average

case.

hos

The non

effective rate of 21 per 1,000 per day for all nonbattle causes in the Far East Command compares

favorably with the U.S. Army

worldwide

non

effective rate of 22 per 1,000 per day for the 1950-53 period. The wounded, on the other hand, with an admission rate of 220 per 1,000, about two-fifths of the combined nonbattle admission rate for divisions (500

per 1,000),

effectiveness

contributed

experienced

heavily

during

the

to the nonwar.

The

average duration for division wounded of 96 days was four and one-half times the 21 days for the average nonbattle case, while the total days lost for wounded was almost twice that for nonbattle

The noneffective rate for wounded of 15 per 1,000 per day in the Far East Command was higher than either the disease or the nonbattle injury non

cases.

effective rates; when total days lost is considered, the wounded noneffective rate is higher than that for disease

and nonbattle

injury admissions com

bined.

TYPE OF DISPOSITION FINAL TREATMENT

AND PLACE OF

Dispositions by place of final treatment provide information related to the echelon-wise structure of

Army medical support and to the different types of final disposition medical

that occur at the various levels of

care. This information

can be important to those concerned with developing patient flow by

Table 13.— Disposition of U.S. Army patients originating in Korea, by type of caseand place of final treatment, U.S. Army divisions and regimental combatteams, Korea, July 1950-July 1953 Wounded in action Place of final treatment

All disposi tions

Death

Duty

All nonbattle causes

Disability separa tion

All

Other separa tions

disposi tions

Duty

Death

Disability separa tion

Other separa tions

Number

All medical treatment facilities . . . Aid,

clearing,

and

72,961

1,574

64.159

6,239

989

175,985

485

173,525

1,625

350

7,024

412

6,612

—

—

72,835

90

72,745

—

—

41,544 1,312 6,371 1,687 32,174

1,036 609 151 82 194

40,498 703 6,220 1,605 31,970

— — —

— — —

5

91,220

5

90,835 8,100 32,940 6,515 43,280

30

5

335 80 125 15 115

20

8.180 33,065 6,530 43,445

4,449 692 19,252 12,211 5,428 173

63 2 61 35 13 1

4,386 432 12,231 7,262 3,673 128

—

— 10 974 647 319 3

4,350 385 7.195 4,320 2,535 105

5

248 5.986 4,267 1,423 41

55 20 25 5

4,340 290 5,315

1,440

12

1,168

255

5

235

collecting

Army hospitals, Far East Corn-

Field Other Non-Army medical treatment facilities, Far East Com mand Other overseas hospitals Continental United States Class 11 hospitals Class I, specialized Other Army hospitals medical treat Non-Army facilities, ment conti nental U.S

S

—

— — —

20

30

3.140 1,950 40

5 60 1,540 1,015 495 20

35 285 145 65 40

5

185

10

35

—

— —

—

Percent

All medical treatment facilities. . . Aid, clearing, and collecting stations Army hospitals, Far East Corn-

100.0

Field Other Non-Army medical treatment facilities, Far East CornOther overseas hospitals Continental United States Class I, specialized

various

of

medical

configurations

100.0

100.0

100.0

100.0

100.0

100.0

100.0

—

41.4

18.6

41.9

—

51.8 4.6 18.8 3.7 24.7

69.1 16.5 25.8 3.1 23.7

52.4 4.7 19.0 3.8 24.9

1.2

8.6 — —

1.2

8.6

1.0 —

0.3 3.7 94.8 62.5 30.5 1.2

10.0 81.4 41.4 18.6 11.4

0.6

10.0

9.6

26.2

10.3

—

57.0 1.8 8.7 2.3 44.2

65.8 38.7 9.6 5.2 12.3

63.1 1.1 9.7 2.5 49.8

0.1

0.5

0.1

0.5

6.1 0.9 26.4 16.8 7.4 0.2

4.0 0.1 3.9 2.2 0.8 0.1

6.8 0.7 19.1 11.4 5.7 0.2

—

—

4.0 95.9 68.4 22.8 0.6

1.0 98.5 65.4 32.3 0.3

2.5 0.2 4.1 2.5 1.4 0.1

11.3 4.1 5.2 1.0

2.5 0.2 3.0 1.8 1.1 0.0

2.0

0.8

1.8

4.1

0.5

0.1

1.0

0.1

Non-Army medical treatment facilities, continental U.S

echelon

100.0

support

and

with providing by type

of medical support

of hospital.

Final dispositions among admissions from division in Korea during the combat period, July 1950-July 1953, are shown in table 13. For division

units

wounded patients, 73 percent had a final disposition in the Far East Command. Ten percent of all wounded dispositions occurred at medical facilities

— — —

— — —

— — —

100.0

—

—

in the Far East Command (Air Navy facilities). The remainder con sisted of 1 percent with dispositions at "other overseas hospitals" (usually in Hawaii or Puerto Rico) and 26 percent in continental United States. When the distribution by type of disposition is considered, marked differences result. For example, medical Force

facilities

and

of the died of wounds occurred

forward of hospital (such as aid, clearing or collect ing stations, and dispensaries), 57 percent occurred

in the the largest number occurring at surgical hospitals. The second highest number died of wounds at medical facilities forward of

at Army

hospital

14

hospitals,

and

6

percent

at non-Army

96 percent

Far East Command,

in Korea.

Of all division

wounded

with

disposition to duty, 80 percent were returned to duty in the Far East Command. The largest pro portion (50 percent) was returned to duty from hospitals in the Korean Communications Zone and in Japan (other Army hospitals, Far East

Army

and 10 percent returned to duty at the aid, clearing, or collecting stations in Korea. Almost Command),

all separations were processed in continental States,

although

few

a

separations

United

occurred

at

Tokyo Army Hospital in Japan (other Army hos pitals, Far East Command) and a few at military hospitals in Hawaii and Puerto Rico (other overseas The distributions by hospital in the hospitals). United States were about the same for both types of separations: approximately two-thirds processed at class II hospitals and most of the remainder separated at class

In

I

specialized treatment hospitals.

types of disposition for division wounded, 2.2 percent died of wounds, 87.9 terms of the relative

separations were processed at Tokyo Army hospital (other Army hospitals, Far East Command) and at

"other overseas hospitals" (Hawaii and Puerto Rico). The distribution by type of final disposition for division

nonbattle

0.3 percent

died,

separated for all causes.

DEATHS The Adjutant (3)

to duty,

and 9.2

percent separated for disability and administrative reasons.

General's

shows a total

battle

of 27,704 battle

U.S. Army personnel in Korea. In 19,585 killed in action (of which

declared

returned

shows that

returned

total U.S. Army, Korea, was 0.2 percent died, 99.1 returned to duty, and 0.7 percent were

total U.S. Army in Korea of 2.5 percent died of percent

percent

percent

after capture),

88.3

cases

to duty, 0.9 were separated for disability, and 0.2 were other separations. The comparable distribution for

percent returned to duty, 8.5 percent were separated for disability, and 1.4 percent were administrative separations. This compares with the distribution for wounds,

admission

98.6

wounds

casualty

report deaths among addition to the

251

were killed

there were reported 2,034 died of (including 104 died while captured), 3,791 dead from

died of nonbattle

missing

causes

in action, and

2,294

while captured or missing.

In terms of an annual rate per 1,000 average strength, all 27,704 deaths due to combat represent a loss of

The distribution of final dispositions for division nonbattle admissions is markedly different from battle dispositions. Almost 96 percent of all DNBI cases had final dispositions in the Far East Com mand, with 41 percent occurring at medical facili ties forward of hospital. Only 4 percent of all nonbattle final dispositions occurred in continental United States. Nonbattle deaths were distributed

43.2 per 1,000 for Korea compared to 51.9 per 1,000 for all battle deaths in the European Theater of Operations from June 1944 through May 1945.

as

19

World War

or

collecting

percent at either dispensary stations,

or aid, clearing, 16 percent at surgical hos

pitals, 26 percent at evacuation hospitals, 3 percent at field hospitals, 24 percent at other Army hos pitals (station and general), and 1 percent at non-Army medical facilities, totaling 89 percent in the Far East Command. The balance (11 per The cent) expired in United States hospitals. division nonbattle admissions with a final dis position to duty in the Far East Command amounted to 97 percent of the total. The largest proportion (42 percent) were returned to duty without being admitted to hospital. The balance (55 percent) duty dispositions were largely nonbattle from evacuation

pitals Army

(25

(19

percent),

percent),

station

and surgical,

and general hos field, and non-

facilities were percent). Separations (11 and class I specialized processed mainly at class treatment hospitals in the United States. A few

II

When the number of deaths (killed in action plus died of wounds) among the total number hit (killed in action plus wounded in action, including died of wounds) are considered, 21.8 percent resulted in death in Korea.

II,

In all theaters of operation during 28.0 percent died of all those hit,

and in the European theater, 25.1 percent died. If percentage ratios of all battle deaths to the total

surviving wounded

plus battle deaths are com puted, 26.3 percent died in Korea compared to 25.4 percent in the European theater and 29.3 percent in all of World War

II.

Another index of the measure of combat mor tality is the ratio of the number killed in action to the number wounded in action including the died of wounds. This ratio was 3.1 (including Air Corps) and 3.9 (excluding Air Corps) wounded to one killed in action for all theaters of operation

during

World War II compared to 4.1 wounded to one killed in Korea. Of all the numbers of battle deaths, only The Surgeon General's counts of the died can be related to wounded admissions treatment

facilities.

Among

of wounds to medical

the 77,788 wounded 15

Table 14.— Killed in action and died of wounds, by type of traumatism, U.S. Army, Korea, July 1950-July 1953 [Rates stated as number of deaths per 1,000 average strength per year] Killed in action

Died of wounds

Type of traumatism Number

19,353 10,437 8,916 344 96 84 20 144 7,445

Total deaths

Wounds

67 2,580 4,798 460 46 116 35 123 347

to medical treatment

admitted

1,957 died of wounds,

rate of 2.5 percent. than the 4.5 percent

War

II.

Since the killed

facilities

in Korea,

representing This rate is markedly a case

fatality lower

for all of World

recorded

in action are not routinely ex

personnel, less than one-half (46 percent) had the type of traumatism recorded as cause of death. The died of wounds, on the amined

medical

by

are all seen

still alive and

while

other

hand,

record

the Emergency Medical Tag WD Form 8-26 (4)) is initiated at the time of

AGO

first medical care. not recorded, 9

a

(usually

percent

The traumatism,

or was recorded

as

of the died-of-wounds

however,

was

"unknown" for cases. Table 14

Table 15.— Number of U.S. Army personnel killed in action and died of wounds, by age group, U.S. Army, Korea, July 1950-July 1953 Cause of death Age group

20-24 25-29 30-34 35-39 40-14 45-49

Total

Hi

Total deaths

Killed in action

Died of wounds

4,702 11,984 2,506 1,019 353 105 17 4 620

4,297 10,825 2,264 911 316 103 14 3 620

405 1,159 242 108 37 2 3 1 —

21,310

19,353

1,957

Rate

Percent

30.20 16.29 13.91 0.54 0.15 0.13 0.03 0.23 11.62 0.10 4.03 7.49 0.72 0.07 0.18 0.05 0.19 0.54

100.0 53.9 100.0 3.8 1.1 0.9 0.2 1.6 83.5 0.8 28.9 53.8 5.2 0.5 1.3 0.4 1.4 3.9

shows that more than action

with

Number

1,957 178 1,779 357 132 168 27 30 1,057 75 707 275 69 23 16 4 18 235

3.05 0.28 2.77 0.56 0.21 0.26 0.04 0.05 1.65 0.12 1.10 0.43 0.11 0.03 0.02 0.01 0.03 0.36

Percent

100.0

9.1 100.0 20.1

7.4 9.5 1.5 1.7 59.4 4.2 39.7 15.5 3.9 1.3 0.9 0.2 1.0 13.2

of the killed in

four-fifths

a recorded

Rate

traumatism

resulted

from

wounds of all types, while traumatic amputations were the cause of death in 5 percent of the known cases. Fractures were involved in about 4 percent of the recorded

killed-in-action

cases.

More than

percent of the died of wounds could be ac counted for by wounds of all types: largely, pene and puncture type wounds. trating, perforating, Fractures were responsible for 20 percent, and 59

traumatic

amputation wounds cases.

in 4 percent, of the died-of-

The majority of those either killed in action or in Korea occurred in the 20-24 year age group (table 15). Ninety percent of all of these deaths were men under 30 years of age, while those 19 and under incurred 22 percent of the died of wounds

deaths.

Nonbattle deaths resulting

from vehicular acci and suicides are most likely to be "dead on arrival"; therefore, the total dents, drowning,

homicides,

count of nonbattle deaths must also be distinguished from the smaller number of deaths which occur after admissions to medical treatment, such as those 13 for division units in Korea. For example, there were 10,220 nonbattle deaths in the U.S. Army, during the 4-year period 1950-53, of which 2,410 were due to disease and 7,810 to injury. The number of CRO deaths nonbattle

presented in table

amounted

to 6,760; 575 were due to disease, and the majority (6,185) to nonbattle injury. The total

number

of nonbattle

(including CRO) for admissions in Korea was

Table 17.—Deaths and death rates for nonbattleinjury, by

deaths

Army nonbattle 2,452, with 509 resulting from disease conditions and 1,943 from nonbattle injury. In terms of annual U.S.

nature of traumatism, U.S. Army, Korea, 1950-53

[Rates stated as number of deaths per year per 1,000 average strength] Nature of traumatism

Number

rates per 1,000 average strength, 3.25 per 1,000 died of nonbattle causes among U.S. Army

Rate

Percent

death

personnel in Korea during 1950-53, compared to 4.57 per 1,000 for the European theater from June

May 1945. Approximately two-fifths of the disease deaths in U.S. Army, Korea (table 16), resulted from in fective and parasitic disease. Acute poliomyelitis, 1944 through

Other head injuries Internal injuries of chest, abdomen,

1,943 276 59 355

2.58 0.37 0.08 0.47

100.0 14.2 3.0 18.3

403 83 347 84 336

0.53 0.11 0.46 0.11 0.45

20.7 4.3 17.9 4.3 17.3

infectious fever,

encephalitis, and epidemic hemorrhagic the latter first encountered in Korea, were

largely responsible. Another 40 percent of the disease deaths resulted from four broad groups of causes: neoplastic diseases, diseases of the circula

tory system,

diseases of the digestive system, and diseases of the urinary system. Acute respiratory disease, largely pneumonias, contributed over 6 percent of the deaths from diseases.

More than

four-fifths

of the

nonbattle

injury

deaths can be accounted for by the seven types of traumatism listed in table 17. Skull fractures and other

head injuries

of all nonbattle

were responsible for one-third injury deaths. The balance were

largely from internal injuries of chest, abdomen, and pelvis (21 percent) and to lacerated and open wounds (18 percent). Burns and poisoning, each

with about an equal number of deaths, caused 4 percent of the deaths, separately. Included in the 1,943 nonbattle injury deaths were 131 suicides and 101 homicides among U.S. Army personnel in Korea during the 1950-53 time period. Table 16.— Deaths and death rates for disease by principal cause, U.S. Army, Korea, 1950-53

[Rates stated as number of deaths per year per 1,000 average strength] Principal cause

Number

Rate

Percent

509

0.67

100.0

208 60

0.28 0.08

40.9 11.8

18

0.02

3.5

33

0.04

6.5

89

0.12

17.5

25

0.03

4.9

18 58

0.02 0.08

3.5 11.4

SEPARATIONS

There were 7,057 individuals separated during the period 1950-53 for disabilities caused by battle wounds. The highest number of these separations occurred in 1952; at the end of 1953, there still remained

I)

VI) Acute

IX)

respiratory

infections

Diseases of the circulatory

in hospitals

for treatment

1,032

of battle

individuals admitted

disabilities.

tions, by type and year of separation, in table 18.

These separa are included

II

Except for 105 World War cases, these dis abilities relate to U.S. Army patients with wounds incurred in the Korean War. Impairments and diseases of the bones and organs of movement were mainly responsible for perma nent retirement, and disabilities involving impair ments of the nervous system, chiefly peripheral neuropathy, were responsible for most of those on the temporary duty retired list. One might expect this latter situation since these disabilities often require longer periods of observation for evaluating their ultimate effects. These differences might be noted from table 19, which shows selected diagnostic categories by type of separation.

Distribution

Infective and parasitic diseases (Class Neoplastic disease (Class II) Diseases of the nervous system (Class

DISABILITIES

FOR BATTLE

by

broad

category

of

causative

Table 18.— Number of disability separations for battlecauses, by type of sejMralion and year, U.S. Army, 1950-53

Year

(Class

Total separations

Permanent separations

Temporary separations

Separations with severance pay

114 1,430 3,046 2,467

110 1,323 2,587 2,036

1 14 89 246

3 93 370 185

7,057

6,056

350

651

system

(Class XI) Diseases of the digestive system and hernia (Class XIII) Diseases of the urinary system and male genital system (Class XIV) .

1950 1951 1952 1953 Total

17

Table 19.— Distribution of U.S. Army personnelseparatedfor disability due to battleinjuries and wounds, by primary diagnostic cause of separation, by type of separation, and by causativeagent, 1950-58

Primary diagnostic cause of separation

Total number of sepa rations

Type of separation (percent)

Total

Retir ement Perma nent

Causative agent (percent)

Sepa ration with severance pay

Tempo rary

Total

Explosive projectiles

Grenades, mines, etc.

Small arms

Other '

7,057

100.0

85.8

5.0

9.2

100.0

41.3

16.0

30.4

12.3

4,215 519

100.0 100.0

87.4 83.5

3.0 1.7

9.6 14.8

100.0 100.0

39.2 38.2

17.6 12.7

31.6 34.8

11.6 14.3

535 1,477

100.0 100.0

77.2 98.0

4.9 0.4

17.9 1.6

100.0 100.0

30.5 41.5

10.3 29.1

47.4 20.9

11.8

308 474 300

100.0 100.0 100.0

77.0 97.9 84.6

9.4 2.1 7.7

13.6 7.7

100.0 100.0 100.0

34.4 45.5 52.4

13.0 7.4 12.3

35.4 45.4 23.0

17.2 1.7 12.3

602

100.0

72.2

4.0

23.8

100.0

33.7a

12.8

32.2

21.3

1,668

100.0

80.3

11.3

8.4

100.0

42.3

10.3

35.2

12.2

738

100.0

96.4

1.2

2.4

100.0

51.5

22.9

14.2

11.4

102 334

100.0 100.0

79.4 71.8

4.9 6.3

15.7 21.9

100.0 100.0

43.1 37.7

8.8 12.0

37.3 26.0

10.8 24.3

Impairments and diseases of bones and organs of

Contracture or shortening of

8.5

Malunion or nonunion of Paralysis of extremities Other impairments and diseases of bones and organs of movement Impairments and diseases of nervous system Impairments and diseases of

—

Impairments and diseases of digestive system, inOther impairments and diseases.

1 Flame throwers, bayonets, chemicals, fire, and explosions.

agents shows that explosive projectiles caused more battle casualty separations than any other group of causative agents, while small arms were second in importance.

When causative agents are related

to the diagnostic causes of separation, explosive projectiles, for example, caused 41.5 percent of the' grenades and mines, 29.1 percent; amputations; small arms, 20.9

18

percent;

and all other causative

agents, 8.5 percent. extremities,

In

cases

of paralysis

of

the

45.5 percent were caused by explosive 7.4 percent by grenades and mines,

projectiles, 45.4 percent by small arms, and 1.7 percent by all causative agents. Table B-12, included in appendix B, presents the primary diagnostic causes of separation in detail by rank, type of separation, other

and causative agent.

CHAPTER

TWO

Effects of Type of Operation

SOURCE AND LIMITATIONS

In plex

The operations

war, battle casualties result from many com factors which seldom, if ever, combine to situations

identical

produce

for

each

type of cam

paign, each type of tactical operation, and, indeed, even for each type of tactical action. Some of these factors, which vary in significance, are the weapons and their relative firepower; the size and

employed

experience of opposing forces; the excellence of plan and tactics of battle; the type of terrain and of position;

advantage

and the tactical,

strategic

and logistical support provided. Disease cases, on the other hand, are more a product of exposure related

climate,

to geography,

while nonbattle

injury

and season of year, result

cases

and Tactical Action

from

external

classified

here

account

for

93

percent of the total number hit (killed and wounded, including CRO cases) among U.S. Army troops in the Korean War. Of the final medical counts, there fore, 18,654 of the 19,353 killed in action, 72,926 of the 77,788 wounded-in-action admissions, and 12,468 of the 14,575 slightly wounded CRO cases are in cluded in the divisional operations. Detailed data for nonbattle

as

well as battle

casualties

are in

B (source tables B-5 through B-ll), separately, for divisions, regiments, head quarters and service companies, division artillery, and for engineer, medical, and tank battalions, for every tactical division operation of the Korean War. The chief sources used in determining the types cluded in appendix

of tactical actions and types of operations were the

causes other than the hostile act of an enemy. The

unit periodic operation reports, various staff jour

incidence of battle casualties, however, by particular operations and tactical actions, and of nonbattle

nals,

by type of operation, can often provide a basis for the projection of the combined effects of certain of these variables, which are important from both the tactical and logistical standpoints. In addition, certain operations of the same type, by

each day and covered a unit's combat

admissions

one coincidence or another, produce battle casualty rates that are similar,

and certain

types of opera

and

These

other

command

and

reports

were

operations

staff

reports

(7). prepared

usually

operations was

for the previous 24-hour period. No attempt

made to go below regiments for the tactical action, a few selected were necessarily

and, consequently,

arbitrary, especially when more than one tactical action was given for the three infantry battalions of a regiment. In general, the selection involved

tions consistently

nothing

casualty

particular day was most likely to have produced most, if not all, of the

average higher or lower battle rates than do other types. For example,

certain types of ground operations in World War were

observed

to

produce

higher

than

II

average

In

preparing that material, re search into division tactics did not go beyond the casualty

rates (6).

classification of ground operation for the entire division, and only counts of the wounded in action who lost time from duty were made available. The preparation of these data has included research into the tactical action of the separate regiments

in relation

tion of the division these operations

to the type of ground opera

as a whole.

Casualty counts for

have been expanded

to represent

the total number hit: the killed in action plus all of the wounded in action, even those who were slightly wounded and who lost no days from duty and were

CRO

cases.

tactical

more than action

a

determination

to which

as

on any

casualties in any single given regiment on the same day. Since reporting procedure at Army and division level followed the pattern of recording only the

principal tactical

activity in which

a particular

regiment was engaged in any 24-hour period, it was was from these reports that final determination made. The chronology of the various tactical opera tions, and the dates when U.S. Army divisions, their

organic regiments, and attached separate combat teams were committed or re

regimental

lieved, was documented more accurately no special problems. The classification of tactical

and posed

operations

was de

veloped to classify all of the killed and woundedin-action casualties sustained by each of the eight 19

Table 20.— Frequency distribution of division-periods, killed-in-aetion rates,1by type of operation Type of operation men per day

Offensive operations

Pursuit operations

0.0-0.19 0. 2-0. 39 0.4-0.59 0.6-0.79

14 17 6 1

1.0-1.19

1 2 2

1.4-1.59

Maintain defensive lines

10 1

Limited operations from MBP t

43 1

Defensive operations

8 8 9 5 4 3 6

Withdrawal operations

1 7 5 4 a 2

Redeploy and regroup

Corps or Army reserve

S 1

2

8

2

8

i

1.8-1.99 1

i

2.2-2.39 2.4-2.59 2.8-2.99

i i i

3.6-3.79 3.8-3.99

i i 11

43

Total

0.11 0.14 0.05

0.39 0.36 0.36

44

44

29

6

0.06 0.05 0.05

0.62 0.63 0.46

1.10 1.18 1.08

0.12 0.10 0.07

0.04 0.05 0.04

0.00> 0.01

0.00'

1Killed in action stated as number per 1,000 average strength per day. 1 Main Battle Position such as defensive lines. >Leas than 0.005 per 1,000 men per day.

mental

combat

and the

teams which

two separate regi served at one time

or another in the Korean War. The types of opera tions and tactical actions reflect the character of to

the

a

is,

U.S. Army divisional

experience in Korea, which certain extent, influenced by the quality of

various

The

after-action

of

reports. types operations developed are offensive opera tions, pursuit and mopping-up, maintaining static defensive lines, limited operations from main battle divisional

positions,

defensive

(enemy offensive) operations, operations, redeploying and regrouping, and corps or army reserve. The types of regimental

are slightly ambiguous. For example, "airdrop attack" includes not only the parachute drop but also ground action of whatever classifica tion that might occur on the same day. The action "establish, hold, or consolidate defensive positions" necessarily

includes the operation of outposts, security guarding, and static defense on main battle positions, as well as the classical "holding" action on offense and

The only other less-well-defined action "patrolling," and that includes ambush, reconnais

defense.

is

U.S. Army divisions

security, contact, and raiding parties.

sance,

withdrawal

tactical actions are attack, heavy resistance; attack, light resistance; airdrop attack; assault river cross ing;

defense,

enemy

attack

or

counterattack;

OFFENSIVE The major

OPERATIONS U.N. offensive operations

withdrawal and rearguard action; patrolling; estab

occurred within the first

lish, hold, or consolidate

War. These operations

mop or

redeployment; and reserve. The divisional operation covers an overall stated period of time and the regimental action represents activity within the overall tactical day-to-day period. While most of these tactical actions pose no special problem of definition, some divisional

20

Korea

are distinguished from the attacks by relatively small forces

limited

objective

(limited

operations from main battle positions) in of the 11 offensives studied represents United Nations Forces effort against the

that major

each

a

gains;

movement

in

months of the Korean

enemy involving more than one division over wide front. In two instances, the experience of a single U.S. Army division shown. The first one (Inchon a

consolidating

defensive positions;

is

ping-up

or

16

Table 21.— Frequency distribution of division-periods, wounded-in-adion rates,1by type of operation Wounded in action per 1,000 men per day

Type of operation Offensive operations

Pursuit operations

Maintain defensive

Limited operations from MBP '

Defensive operations

Redeploy and regroup

Withdrawal operations

Corps or Army reserve

0.0-0.49 0.5-0.99 1.0-1.49 1.6-1.99 2.0-2.49 2.5-2.99 3.0-3.49 3.5-3.99 4.0-4.49 4.5-1.99 5.0-5.49 5.5-5.99 6.0-6.49 6.5-6.99 7.0-7.49 7.5-23.49 23.5-23.99 43

Total Mean, unweighted . Mean, weighted . . . Standard deviation

1.93 1.80 1.57

11 0.44 0.54 0.33

44 0.25 0.27 0.11

8 2.64 2.66 1.87

3.49 3.17 4.08

0.49 0.42 0.27

0.07 0.07 0.02

0.02 0.02 0.01

1Wounded in aotion and admitted to a medical treatment facility, stated as admissions per 1,000 average strength per day. 1 Main Battle Positions such as defensive lines.

landing)

involved the 1st U.S. Marine Division and

the 7th U.S. Army Division; the second (Operations Nomad-Polar) involved a force of two Republic of

The average divisional rates for major offensive operations as shown in table 22 are 0.36 KIA, 0.21

WIA-CRO,

and 1.80 WIA-admissions for a total of

Korea divisions along with the 24th U.S. Army Division: in both, data are given for the respective U.S. Army division alone. Although these data cover only U.S. Army experience, every action included both Republic of Korea and other United Nations Forces as well. In these 11 offensive operations, six U.S. Army

These are weighted mean rates obtained by weighting each individual divisional rate by the

divisions and two separate regimental combat teams

weighted mean rates, as they are in all of the suc

contributed

ceeding tables. When statistical comparisons are made on the total hit between different types of

43 division-periods

averaging 14.7 days and totaling 25,737 men hit. For all divisions, tables 20 and 21 give the distribution of divisional KIA (killed in action) and WIA (wounded in action) admission rates, respectively, expressed as cases per 1,000 average divisional strength per day over the entire period of participation of each. These rates ranged from 0.02 to 1.45 for killed in action and from 0.17 to 7.40 for wounded in action. Frequency WIA-CRO rates are distributions for divisional they represent neither unit replacements would be required nor admissions to medical treatment facilities from not

losses

shown

because

for which

which hospitalization

and evacuation

requirements

originate. Figure 4, however, presents the counter part of these distributions for the total hit, which includes the

WIA-CRO

cases.

2.37.

proportion

of the total man-days

for the specified

type of operation which it represents. The arith metic means are slightly higher: 0.39, 0.25, and respectively, totaling 2.57 hit per 1,000 men each day. All of the rates given in table 22 are 1.93,

operations as well as between operations of the same type, the differences are highly significant. the mean rates of certain pairs — for However, example, Operations Ripper vs. Rugged; the Inchon landing vs. Operation Detonate; and the January vs. Operation Daunt differ significantly (P>.05). Neither do the means differ for the two highest division rates, which represent the last two major offensives 1951

U.N. counteroffensive

less — do not

of the war and surpass all others for any type of operation studied. This variation might indicate that, while very different rates are being averaged, nevertheless some

certain

instances

uniformity exists. Table

regimental

rates per

1,000

do occur

in which

23 presents weighted

men per day

for the 21

TOTAL HIT PER 1,000 MEN PER DAY 30.0

20.0

20

50 70 30 40 60 PERCENTAGE BELOW RATE PLOTTED

80

90

100

Figure 4.— Cumulative percentage distributions of average U.S. Army divisional hit rates (KIA, WIA-CRO, and WIA-admissions) , by type of tactical operation, Korean War. various regiment tactical actions performed during the parent divisions' offensive operations. Needless to say, these rates for each separate type of action differ

significantly

between

the

several

types of The mean hit

with but one exception. for the airdrop attack of the 187th Airborne Regimental Combat Team at Munson-ni

operations

rate of 11.13

22

in support of Operation Ripper (table 23) does not differ significantly from that (12.33) for the jumps on the Sukchon-Sunchon

area north of Pyongyang

to trap retreating North Koreans during the Eighth U.S. Army's operations of pursuit (table 24). How ever, if the relative distribution of killed and wounded

is considered,

a significantly

higher

pro-

Tablx 22.— Killed and wounded in action during major offensiveoperations, U.S. Army divisions, Korean War Operation

Calendar period 1

Number Division days of divisions

Mean division strength

Rate'

Number Total hit

KIA

WIA CROt

Adm >

WIA

Total hit

KIA

CRO»

WIA

WIA Adm'

16-27 Sept. 1950

4

48

15.217

4.334

790

340

3,204

5.94

1.08

0.47

4.39

18-30 Sept. 1950

1

13

14,127

418

94

I

319

2.28

0.51

0.03

1.74

25 Jan.-20 Feb. 1951

6

125

16,495

3,788

667

218

2,903

1.84

0.32

0.11

1.41

21 Feb.-7 Mar. 1951

4

56

16 , 135

1.065

144

117

804

1.18

0.16

0.13

0.89

7 Mar.-4 Apr. 1951 Operation Rugged — to secure 1-15 Apr. 1951 phase Line KANSAS Operation Dauntless — to secure phase Line UTAH . 10-22 Apr. 1951 Operation Detonate — to re take Line KANSAS after Chinese Communist Forces Spring Offensive. . . 20 May-8 June 1951 Operation Piledriver — to secure Line W YOMING 3-12 June 1951 and Iron Triangle Operation Commando — to secure Line JAMES 3-15 Oct. 1951 TOWN Operation Nomad and Polar — to secure Lines later designated MISSOURI . . . 13-22 Oct. 1951

6

161

16.562

3,786

566

329

2,891

1.41

0.21

0.12

1.08

6

44

17.278

1,057

156

136

765

1.40

0.21

0.18

1.01

3

36

18.479

1,151

95

73

983

1.73

0.14

0.11

1.48

6

88

19,201

3.725

530

376

2,819

2.20

0.31

0.22

1.67

4

35

18.622

2,018

231

379

1,408

3.09

0.35

0.58

2.16

2

16

19,942

2.643

405

230

2,008

8.28

1.27

0.72

6.29

1

10

21,585

1,752

265

76

1,411

8.12

1.23

0.35

6.54

43

632

17,164

25,737

3,943

2,279

19,515

2.37

0.36

0.21

1.80

Breakout of Pusan Perimeter. .

Inchon Landing and LiberaCounteroffenaive against Chinese Communist Forces Operation Killer — to reestab lish U.N. Line east of Operation Ripper — to outflank Seoul and capture

Total

» Inclusive dates within which one or more U.S. Army divisions (including attached separate regimental combat teams) contributed combat days to the indicated operation. * Slightly wounded-in-action casestreated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. * Wounded in action and admitted to a medical treatment facility. * Stated as cases per 1,000 men per day.

Table 23.— Killed and wounded in action during major offensiveoperations, by tactical action, U.S. Army regiments,Korean War

Tactical action

Attack, light resistance

Defense, enemy attack or counter attack

Number of regi ments

Regi ment days

Mean regiment strength

Rate'

Number Total hit

KIA

WIA CRO '

WIA

Adm >

Total hit

KIA

WIA CRO '

WIA

Adm»

18 19 1 15

208 517 1 39

3.290 3,375 4,223 3,071

12.596 6,025 47 1.182

1,800 936 3 179

678 667 0 118

10,118 4,422 44 885

18.41 3.45 11.13 9.87

2.63 0.54 0.71 1.49

0.99 0.38 0.99

14.79 2.53 10.42 7.39

17 19

42 427

3.373 3,301

1,472 1,353

314 229

113 220

1,045 904

10.40 0.96

2.22 0.16

0.80 0.16

7.38 0.64

17 8 19 18

80 14 164 432

3,258 2,587 3,295 3.345

453 121 298 337

59 24 35 62

64 16 50 91

330 81 213 184

1.75 3.34 0.54 0.23

0.23 0.66 0.06 0.04

0.25 0.44 0.09 0.06

1.27 2.24 0.39 0.13

151

1,924

3,319

23,884

3,641

2,017

18.226

3.74

0.57

0.32

—

Establish, hold, or consolidate defensive

Total

2.85

1 Slightly wounded-in-action casestreated on an outpatient basis usually at an aid station, and returned to duty before the close of the morning report day. a Wounded in action and admitted to a medical treatment facility. * Stated as cases per 1,000 men per day.

23

Table 24.— Killed and wounded in action during pursuit and mopping-up operations, by tactical action, U.S. Army regiment*,Korean War

Number of regi ments

Tactical action

Attack, heavy resistance Attack, light resistance Assault river crossing Defense, enemy attack or counter attack Patrolling Establish, hold, or consolidate defen-

Regi ment days

Mean regiment strength

11 14 1 2

33 69 2 6

2,801 2,953

11 3 17

Rate'

Number

KIA

Total hit

WIA

CRO'

WIA Adm'

Total hit

KIA

WIA CRO '

WIA

Adm '

147 42 37 11

17 7 0 1

629 148 47 53

8.57 0.97 12.33 3.80

1.59 0.21 5.43 0.64

0.18 0.03

3.407 2,851

793 197 84 65

22 7 376

3,149 3,303 2,866

693 13 567

159 1 95

23 0 77

511 12 395

10.01 0.56 0.53

2.30 0.04 0.09

0.33

21 9 19 19

127 59 123 1S1

3,284 2,830 3,014 2,950

154 135 119 179

45 14 26 12

9 15 4 35

100 106 89 132

0.37 0.80 0.32 0.41

0.11 0.08 0.07 0.03

0.02 0.09 0.01 0.08

0.24

127

97S

2,965

589

188

1.04

0.20

0.07

0.77

2,999

2,222

—

0.06

—

0.07

6.80 0.73 6.90 3.10 7.38 0.52 0.37

0.63 0.24 0.30

1 Slightly wounded-in-action casestreated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. >Wounded in action and admitted to a medical treatment facility. >Stated as cases per 1,000 men per day.

were portion of those hit at Sukchon-Sunchon killed in action. As was the case with the divisional rates, certain pairs of regimental tactical action rates

divisional offensive operations are be similar; for example, attack light

during

found

to

latter operation resulted in relatively The regiment tactical actions during division pursuit operations (table 24) show that more than one-half of the regimental-periods were spent in patrolling and establishing and holding days,

this

light

casualties.

defensive positions, the former to locate the fleeing enemy and the latter to block his escape. All but

resistance, and mopping-up.

rates for tactical actions in pursuit are lower than the corresponding regimental rates for division offensives: airdrop attack, as two of the regimental

PURSUIT

AND MOPPING-UP OPERATIONS

Operations of pursuit were easily denned and of the from the complete disintegration

resulted

North Korean Army in retreat. While the bulk of their

battered

army

fled north,

fragmented units formed pockets of resistance in

mentioned, and reserve status. previously The latter phenomenon resulted from the absence of any well-defined

front, and units in reserve often found

themselves under attack from the bypassed enemy.

cut off from escape the hills of South Korea. Both of the areas north

and south of the 38th Parallel required large sweep ing actions in the pursuit and mopping-up of these enemy elements. The Iwon landing and pursuit by the 7th U.S. Army Division, although a part of the general pursuit in North Korea, was considered separately

to

evaluate

any

differences

that the

amphibious character of this action may have pro duced. The three operations represent 11 divisionperiods averaging 27.5 days in length. The distribu tions of the

KIA

and

WIA

admissions

20

(tables and 21) show a high concentration below 0.20 and The weighted mean rates for 0.50, respectively. these operations are given in table 25 and differ significantly. The pursuits the main forces produced

in North Korea against

the highest rates. Since on Iwon Beach and the movement

the landings north were virtually unopposed during the first few

2\

MAINTAINING STATIC DEFENSIVE

LINES

The static type of defensive line in Korea de arbitrary phase lines which more the natural features of terrain such river and ridge lines. These lines delineated

veloped from often followed as

major objectives on offense and composed secondary When it became ap

lines of resistance on defense.

parent that the thinly held line north of Seoul was beneath the weight of a major disintegrating

U.N. Forces were North Korea to Line "D," beginning on 5 January 1951. This line ran from the Yellow Sea in the west through Pyongtaek, northwest through Wonju and just north of Samehok on the east coast (fig. 5). During most of this time, Offensive,

Chinese

Communist

ordered

to withdraw from

main Chinese

Communist

Forces pressure was on

Figure

5. — Final demarcation line between north and south Korea, 27

July

1953.

Table 25.— Killed and woundedin action during pursuit and mopping-up operations, U.S. Army divisions, Korean War Operation

Pursuit and mopping-up, south 38th Parallel Pursuit north of 38th Parallel to Yalu Iwon landing and pursuit, north 38th Parallel

Calendar period 1

Number Division days of divisions

Mean division strength

Number Total hit

KIA

Ratet

WIA CROt

Adm 1

Total hit

KIA

WIA WIA CRO ' Adm !

WIA

28 Sept.-30 Nov. 1950

5

113

16.946

832

194

129

509

0.44

0.10

0.07

0.27

5 Oct.-27 Nov. 1950

5

162

15,601

2.533

463

129

1,941

1.00

0.18

0.05

0.77

31 Oct.-27 Nov. 1950

1

28

14,788

229

45

5

179

0.55

0.11

0.01

0.43

11

303

16,028

3.594

702

263

0.73

0.14

0.05

0.54

Total

2,629

1 Inclusive dates within which one or more U.S. Army divisions (including attached separate regimental combat teams) contributed combat days to the indicated operation. 3 Slightly wounded-in-action casestreated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. 1 Wounded in action and admitted to a medical treatment facility. * Stated as cases per 1,000 men per day.

Table 26.— Killed and woundedin action during operations maintaining static defensivelines, U.S. Army divisions, Korean War Operation

Calendar period 1

Number Division days of divisions

Mean division strength

Rate '

Number Total hit

KIA

WIA

CRO'

Adm 1

Total hit

KIA

WIA WIA CRO ' Adm1

WIA

Line "D" (Furthest Chinese Communist Forces penetra5-29 Jan. 1951

6

107

16,548

372

93

13

266

0.21

0.05

0.01

0.15

18 Feb.-6 Mar. 1951

2

32

16,194

147

22

26

99

0.28

0.04

0.05

0.19

4-29 Apr. 1951

6

48

17,847

303

46

74

183

0.35

0.05

0.09

0.21

3

58

19,323

438

33

151

254

0.39

0.03

0.13

0.23

3

55

18,486

223

27

18

178

0.23

0.03

0.02

0.18

3

219

18,859

1,987

280

583

1,124

0.48

0.07

0.14

0.27

3

200

20,657

2,324

344

336

1,644

0.56

0.08

0.08

0.40

1

46

18,504

649

90

123

436

0.76

0.11

0.14

0.51

6

957

17,971

7,287

1,042

1,594

4.651

0.42

0.06

0.09

0.27

6

940

19.208

6.007

761

1,246

4,000

0.33

0.04

0.07

0.22

5

832

19,808

6,990

891

1,385

4,714

0.42

0.05

0.08

0.29

44

3,494

18,926

26.727

3,629

5,549

17,549

0.40

0.05

0.08

0.27

Line BOSTON (South bank of Han River southeast of Line KANSAS (Phase Line across Korea around 38th Parallel) Line GOLDEN (Line halting Chinese Communist Forces Spring Offensive north of

29 Apr.-19 May 1951 Seoul) Line NO NAME (Line halting Chinese Com munist Forces Spring Offensive in IX and X Corps) 29 Apr.-19 May 1951 Line WYOMING-I Corps (Phase Line forward of KANSAS around 38th Parallel on Western Front) . . 10 Junc-2 Oct. 1951 Line WYOMING-1X Corps (Phase Line forward of KANSAS above 38th Parallel on Central Front) . . 13 June-31 Oct. 1951 Line KANSAS/HAYS X Corps (Phase Lines above 38th Parallel in X Corps Sector on Eastern Front) . . . 15 July-4 Oct. 1951 Line JAMESTOWN (Main 7 Oct. 1951-27 July Battle Position, Western 1953 Front). Line MISSOURI (Main 23 Oct. 1951-27 July Battle Position, Central 1953 Front). Line MINNESOTA (Main 16 Oct. 1951-27 July Battle Position, Eastern 1953 Front). Total

1 Inclusive dates within which one or more U.S. Army divisions (including attached separate regimental combat teams) contributed combat days to the indicated operation. 2 Slightly wounded-in-action cases treated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. * Wounded in action and admitted to a medical treatment facility. 4Stated as cases per 1,000 men per day.

26

Table 27.— Kitled and wounded in action during operations maintaining static defensivelines, by tactical action, U.S. Army regiments,Korean War

Number of regi ments

Tactical action

Defense, enemy attack or counterattack

Establish, hold or consolidate defensive positions

Total

Regi ment days

Mean regiment strength

Number Total hit

KIA

404 688 1,576 46 13,778

81 100 314 4 1.822

35 64 258 7 2,880 1,559 75 181

WIA CRO'

8 20 20 5 26

7 53 75 8 4.764

26 26 25

3,156

3,595

421 2,512

3.609 3.567

6,930 391 640

886 66 91

156

10,996

3,593

24.453

3,364

3.265 3,427 3.580 3,457 3.607

Rate>

WIA

288 524 1,004

5,059

KIA

Total hit

Adm t

WIA CRO '

WIA

Adm>

35. 9,076

17.67 3.78 5.87 1.66 0.81

3.54 0.55 1.17 0.14 0.11

1.53 0.35 0.06 0.25 0.17

12.60 2.88 3.74 1.27 0.53

4,485 250 368

0.62 0.25 0.07

0.08 0.04 0.01

0.14 0.05 0.02

0.40 0.16 0.04

16,030

0.63

0.09

0.13

0.41

1Slightly wounded-in-action cases treated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. 1 Wounded in action and admitted to a medical treatment facility. 1Stated as cases per 1,000 men per day.

Republic of Korea elements and the 7th U.S. Army Division from Wonju eastward to Checon. During the next 8 months, from February through Septem ber 1951, other major lines, designated BOSTON, KANSAS, GOLDEN, NO NAME, WYOMING and KANSAS/HAYS, reflected the main defensive positions of U.N. Forces back and forth across the map of Korea. After the last major U.N. offensives

in

October

1951,

which advanced

the

U.N.

Forces

to more favorable terrain, the lines became more static and were supported by a series of strong out posts forward of the main lines. The latter became known as the "Outpost Line of Resistance," and the main line was designated "Main Battle Posi tion." Attacks on single strong points, such as Bloody Ridge, Heartbreak Ridge, Porkchop, and Old Baldy on the outpost lines, and other limited actions

to move or improve

positions

on the main

operations in this class and placed in the class of limited opera tions from main battle positions. The last main defensive

lines,

were omitted

from

battle positions which remained more or less static to the end of the war in July 1953 were Line JAMES TOWN on the western front, Line MISSOURI on the central front, and Line MINNESOTA on the eastern front. Figure 5 shows the final demarcation line as of 27 July 1953. These operations

(table 26) had the lowest rates

of any active operation; only the passive operations of redeploying, regrouping, and reserve were smaller. The distributions in tables 20 and 21 show the bulk of the rates below 0.20 KIA and 0.50 WIA, re spectively. The highest rate, 0.76 hit per 1,000 men per day, occurred for the KANSAS/HAYS line in the X Corps sector because most activity occurred

there. Advances and shorten

by

U.N.

X

Corps

tended to straighten this area

lines, and in addition,

was more remote from the Kaesong neutral zone. There are no large differences between the average rates for the individual lines although

the numbers

are so large that any small differences in the rates are highly significant statistically. The number with similar rates — for example, Line D and No Name; Kansas and Missouri; Golden, Jamestown, and Minnesota

— indicate

that one might find less varia

tion in this type of operation. The static nature of these operations is also reflected in the fact that 1.5 percent of all of the regimental time was spent either in defending (defense and with drawal actions) against enemy attacks on the main less than

line or in counterattacking (attack actions) to re store positions (table 27). Almost three-fourths of the time was used for patrolling and holding the while the balance of time was used

main positions,

and reserve. The redeploying, regrouping, average daily regimental rate of 0.63 hit per 1,000 was also the lowest rate experienced for any type of active operation. for

LIMITED OPERATIONS

FROM

MAIN BATTLE

POSITIONS Beginning in July 1951, with the start of peace talks at Kaesong on the 38th Parallel, no large-scale operations were undertaken by U.N. Forces through out the summer until October 1951. Limited opera tions, with relatively small forces of regimental size or smaller, were undertaken,

however, to keep the 27

Table 28.— Killed and wounded in action during limited operations from main battleposirions, U.S. Army divisions, Korean War

Number of opera tions

Limited operations

WYOMING I Corps. . WYOMING IX Corps. KANSAS X Corps. HAYS X Corps JAMESTOWN

6 6

..

2 4 16

MISSOURI MINNESOTA

4 3

Calendar period'

Division days

6 7

20 21

19,280 20,762

1,134 1,786

166 283

2 4 17

15 32 120

18,889 19,706 18,452

1,839 3,470 7,067

5 3

39 10

17,571 20,851

44

257

18,847

1 July-3 Oct. 1951 26 June-21 Sept. 1951 26 July-5 Sept. 1951 9 Sept.-15 Oct. 1951 16 Oct. 1951-24 July 1953 10 Feb.-4 Nov. 1952 10 Feb.-4 Nov. 1952

Total

Mean division strength

Number

Number of divisions

KIA

Rate4

Adms

WIA

Total hit

KIA

WIA WIA CRO' Adm

192 186

776 1,317

2.94 4.10

0.43 0.65

0.50 0.43

2.01 3.02

316 578 1,242

154 221 826

1,369 2,671 4,999

6.49 5.51 3.19

1.12 0.92 0.56

0.54 0.35 0.37

4.83 4.24 2.26

2,339 307

391 57

386 49

1,562 201

3.41 1.47

0.57 0.27

0.56 0.24

2.28 0.96

17,942

3,033

2,014

12,895

3.71

0.63

0.42

2.66

Total hit

WIA

CR0>

)

1 Inclusive dates within which one or more U.S. Army divisions (including attached separate Regimental Combat Teams) contributed combat days to the indicated operation. * Slightly wounded-in-action cases treated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. 1 Wounded in action and admitted to a medical treatment facility. * Stated as cases per 1,000 men per day.

enemy off balance and to seize dominating

terrain,

thereby improving the defensive positions. On Line

I

WYOMING in the Corps area (Western front) closest to the Kaesong neutral zone, the dominating terrain of the Sobang Mountains was obtained in action during the first 4 days of after,

activity was limited

to

July raids

1951. There

and

to two

designed to sweep the enemy from the Corps front. On Line WYOMING in the IX Corps Sector (Central front) , several small-scale operations

operations

secured new positions

on the line in addition

to

tank-infantry raids into the "Iron Triangle." Line

in the X Corps sector (Eastern furthest from the Kaesong neutral zone was front) and a large portion of U.N. activity was centered there. The battles for Bloody Ridge from Line

KANSAS/HAYS

KANSAS sector of HAYS sector

on the

the line and Heartbreak Ridge of the line are the most notable

for the high division respectively, as given in table 28. When the rates are related to the specific and were largely responsible

hit rates of 6.49 and

5.51,

of the U.S. Army 2d Infantry Division that fought there, very high regimental rates are obtained. The 9th Infantry Regiment on Bloody Ridge had average daily rates of 3.52 KIA, 2.01 WIA-CRO, and 16.49 WIA-admissions, totaling 22.02 men hit per 1,000 troops exposed over a 10-day period. The 23d Infantry Regiment fought for Heartbreak Ridge almost twice as long as the 9th Infantry Regiment on Bloody Ridge, and sustained average daily rates of 3.14 KIA, 0.30 WIA-CRO, and 11.48 WIA-admissions, totaling 14.92 men hit per 1,000. regiments

28

Again, after the last two major U.N. offensives in October 1951, action was reduced from large mili

tary operations to company and platoon patrols and raids. More often, the battles raged over single strong points or outposts forward of the main lines which, themselves, remained more or less static to the end of the war in operations

July 1953. A total of 16 limited B-5 through B-ll, appendix

(see tables

B) involved U.S. Army troops from Line

TOWN,

notably

JAMES

the several battles for outposts

on

Porkchop Hill and Old Baldy, and the defense of outposts Kelly, Carson, Elko, and Vegas, among others. The respective highest average daily regi mental rates for any individual limited operation occurred on Line JAMESTOWN. The highest average daily regimental KIA rate appeared during the fourth battle for Old Baldy, 18-21 September 1952. The enemy first ejected the troops of the U.S. Army 2d Infantry Division from the peak. The 38th Infantry Regiment counterattacked and, after a bitter engagement, reoccupied the position. The average daily regimental KIA rate for this regiment was 6.29; the WIA-CRO rate, 1.44; and the daily WIA-admission rate, 17.44; totaling 25.17 men hit per 1,000 over the 4-day period. The 7-day attack of 24-30 October 1951 on unnamed by the 5th and 7th Cavalry Regiments,

Hill

199

U.S. Army

1st Cavalry Division, produced the highest average daily regimental WIA-CRO rate. This average

rate was 6.58

WIA-CRO

per 1,000 per day over the and was experienced by the 5th Cavalry Regiment. Companion rates for this regi ment were 2.63 KIA and 13.90 WIA-admissions, complete

period

Table 29.— Killed and woundedin action during limited operations from main battle positions by tactical action, U.S. Army regiments, Korean War

Number of regi ments

Tactical action

Attack,

heavy resistance

Defense, enemy attack or counterattack

Regi ment days

Mean regiment strength

Rate'

Number Total hit

KIA

WIA CRO'

WIA

Total hit

Admt

KIA

WIA

CRO>

WIA

Adm>

17 17 20 3 23

92 62 101 3 183

3,602 3,652 3,609 3,496 3,598

7,883 1,474 5,221 10 1,223

1,223 240 1,054 2 149

630 154 550 4 299

6,030 1,080 3,617 4 775

23.79 6.51 14.32 0.95 1.86

3.69 1.06 2.89 0.19 0.23

1.90 0.68 1.51 0.38 0.45

18.20 4.77 9.92 0.38 1.18

21 13 17

190 47 103

3,591 3,516 3,542

958 224 87

196 31 6

150 38 38

612 155 43

1.41 1.36 0.24

0.29 0.19 0.02

0.22 0.23 0.10

0.90 0.94 0.12

131

781

3,590

17.080

2,901

1,863

12,316

6.08

1.03

0.66

4.39

Establish, hold, or consolidate defensive

Total

1 Slightly wounded-in-action cases treated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. * Wounded in action and admitted to a medical treatment facility. 3 Stated as cases per 1,000 men per day. ,

totaling 23.11 hit. The 7th Cavalry Regiment had much lower rates for all categories of casualty for a total of only 7.44 men hit per 1,000 per day. Both the highest average daily regimental WIA-admission rate and the highest average daily regimental total hit rate occurred during the last battle for Porkchop

U.S. Army 25th Infantry Infantry Regiment, Division, over an extremely short (2-day) period in

(6-10 July 1953), before the decision on 11 July 1953 to abandon the outpost since it had lost its

average divisional WIA-CRO rate of 0.42 topped all of the other division WIA-CRO rates by type of operation. The weighted and unweighted means

Hill

tactical value. Elements of the 17th and 32d In fantry Regiments, U.S. Army 7th Infantry Division, defended the position. The 17th Infantry Regiment through 10 July 1953, when it was relieved by the 32d Infantry Regiment, sustained average daily regimental rates of 26.66 WIA-admissions and 36.01 total hit, the highest of any individual limited operation. The average daily KIA rate was 4.93 and the WIA-CRO rate was 4.42 per 1,000 per day for this regiment. The 32d Infantry Regiment had slightly lower average rates in all categories, totaling 25.47 men hit. Limited operations for U.S. Army troops from Line MISSOURI numbered only four and, with one exception strong

points

outposts produced

(ambush operation), involved single of unnamed Hills 598 and 391 and

Charlie and King. The attack on Hill the highest

average regimental

598

rate for

limited operations from this sector of 16.66 total hit for the 32d Infantry Regiment, U.S. Army 7th Infantry Division, over a 14-day period in October 1952. After the heavy battles in the X Corps zone on the Eastern front (later designated as Line MINNESOTA), the activity was relatively quiet except for a couple flareups in the Heartbreak Ridge area. The highest average regimental rate for this sector, 12.49 total hit, was experienced by the 27th

Operations of this type also pro high divisional rates and ranked second among all types of operations in the Korean War. It is interesting to note, however, that the September

1952.

duced relatively

for division

KIA

and WIA-admissions, respectively,

are almost identical from 0.01 to 2.04 for

(tables 20 and 21) and range and from 0.05 to 7.35 for

KIA

WIA-admissions. A fairly even distribution through out the range of values indicates less uniformity among operations of this type. Approximately 70 percent (31) of the division KIA rates and about 61 percent (27) of the division WIA-admission rates exceeded 0.36 KIA and 1.80 WIA-admissions which are the respective weighted mean division rates for offensive operations. Table 28 shows the average mean division rates for limited operations from the various lines with operations from Line KANSAS and from Line HAYS (largely Bloody Ridge) (largely Heartbreak

Ridge) leading; operations from

Line WYOMING in IX Corps zone ranked third. Although specific operations from Line JAMES TOWN produced individual high average regi mental rates, the overall fifth.

Table

division

averages ranked rates

29 gives the average regimental

for tactical actions performed during these limited operations. The regimental rates for attack (against both heavy and light enemy resistance) are the highest experienced for any type of operation, as is the regimental rate for movement and redeployment. This latter situation resulted from the difficulties --»9

Table 30.— Killed and wounded in action during defensive (enemy offensive) operations, U.S. Army divisions, Korean War

Operation

Number Division days of divisions

Calendar period 1

Delaying Invasion, South 4 July-3 Aug. 1950 Korea Defense of Pusan Perimeter. . . 4 Aug.-15 Sept. 1950 CCF Counteroflensive, North 25 Nov.-15 Dec. 1950 CCF Counterattack, Wonju12-21 Feb. 1951 CCF First Spring Offensive, 22-29 Apr. 1951 1851 CCF Second Spring Offensive, 17-22 May 1951 1951 CCF Attack, Western and 6-13 Oct. 1952 Central Front, 1952 Corps CCF Attack ROK Front, 1953 10-18 June 1953 Battle of Kumsong River 14-20 July 1953 Salient

II

Total

Mean division strength

12,043

Rate 4

Number Total hit

KIA

WIA

Total hit

KIA

WIA WIA CRO' Admj

2,438

WIA CRO »

Adm>

8 4

69 168

4.579 11.431

1.991 2.623

150 717

8.091

5.51 4.75

2.40 1.09

0.18

14.345

0.30

2.93 3.36

6

34

16,778

3.684

562

114

3,008

6.46

0.99

0.20

5.27

3

24

17.220

2,109

651

162

1.296

5.11

1.58

0.39

3.14

5

32

18,343

1,914

314

219

1.381

3.25

0.53

0.37

2.35

3

15

19,520

1,221

333

116

772

4.18

1.14

0.40

2.64

1

8

17.395

399

51

119

229

2.88

0.37

0.86

1.65

1

9

22,957

998

174

145

679

4.83

0.84

0.70

3.29

3

17

21,860

900

182

137

581

2.42

0.49

0.37

1.56

29

376

15,484

27.235

1,879

18.475

4.67

1.18

0.32

3.17

6,881

1 Inclusive dates within which one or more U.S. Army divisions (including attached separate Regimental Combat Teams) contributed combat days to the indicated operation. * Slightly wounded-in-action cases treated on an outpatient basis, usually at an aid station, and returned to duty before the close of the morning report day. 1 Wounded in action and admitted to a medical treatment facility. 4 Stated as cases per 1,000 men per day.

often encountered in attempting lieve troops on the outpost

individual

to reinforce or re

line of resistance, es

rate of 3.73 resulting from the major enemy counter attacks of World War (6). In both wars, these

II

coinciden tally,

During the first 11 months of the Korean War, North Korean and Chinese Communist Armies launched six major offensives, beginning with the attack across the 38th Parallel by the Russiantrained North Korean Army on 25 June 1950. The

averaged 13 days in Table 30 presents the distributions of individual operations. The rates do not vary so widely as do the numbers hit. The highest divisional rate, 6.46 hit per 1,000 per day, resulted from the Chinese Communist intervention into the Korean War with their launching of a major offensive in November 1950. The U.S. Army 2d Infantry Division met the full impact of the overwhelming Chinese Force and slowed the attack which might have endangered the Eighth U.S. Army with en velopment. The U.S. Army 2d Infantry Division

seventh attack

sustained rates of 3.04

when

pecially

outposts

were

under

attack by the enemy.

DEFENSIVE

length.

(ENEMY OFFENSIVE)

occurred in October

OPERATIONS

1952

and was

the largest attack of the year. The last two enemy offensives occurred in June and July 1953 before agreement at Panin this class had the highest rates, on the average. The distributions in tables 20 and 21 show about half of the divisionthe signing

munjom.

of the

armistice

The operations

periods centered between 0.2 and 0.79 for KIA and between 1.0 and 2.49 for WIA-admissions. The weighted and unweighted averages differ by more than those for any other type of operation, and both are above the parallel rates for the other types.

The average WIA-admission rate of 3.17 with the corresponding divisional WIA

compares 30

operations,

KIA,

WIA-CRO,

and men hit per 1,000 per day over the period of this operation. Need less to say, this was the highest hit rate for any 23.50

1.28

WIA-admissions, totaling

27.82

U.S. Army division in the Korean War and the WIA-admission rate paralleled the average WIA rate of 23.30 experienced during the beachhead landings on Saipan in World War II, the latter being the second highest divisional WIA rate among all of the World War operations studied (