The Human Machinery of War

The Human Machinery of War: Disability on the Front Lines and the Factory Floor, 1941-1945
Confronting Disease
Photograph: African American Soldier Receiving Medical Treatment in the Field in New Guinea


"U.S. soldiers take cover under fire somewhere in Germany," n. d.  Of fighting in Europe in the winter of 1944, General Patton wrote, “The most serious menace confronting us today is not the German Army, which we have practically destroyed, but the weather which, if we do not exert ourselves, may well destroy us through the incidence of trenchfoot,” a condition of the feet caused by dampness and cold that could cause infection and in the worst cases need amputation (Cowdrey 266-67)

Office of War Information, 1943, "U.S. Negro troops in New Guinea. Medical care is well provided for all American and allied forces in New Guinea. Here a field medical dispensary is set up and operated by a Negro medical detachment. Soldiers go daily for 'sick calls' and any possible illness is checked or given immediate care." Photograph: African American Soldier Receiving Medical Treatment in the Field in New Guinea". Soldiers in the Pacific faced various mosquito-borne diseases like malaria and dengue fever; diarrhea, fevers, and nausea were common; and the heat and moisture caused fungal infections. In New Guinea in 1942, Lieutenant General Robert L. Eichelberger discovered, “Every member—I repeat, every member—of that company was running a fever.” In 1943, disease in New Guinea “peaked at 6,600 per 1,000 per year—on average, every man could expect to go to the hospital six times a year.” Soldiers in the Mediterranean also battled mosquito- and fly-borne diseases. In the summer of 1943, American soldiers in Sicily faced startling rates of disease, as they battled malaria and sandfly fever (Cowdrey 63-65, 76 -77, 132-33).
Excerpt from Frank A. Reister, ed., Medical Department, United States Army, Medical Statistics in World War II (Washington, D. C.: Government Printing Office, 1976), 12-13, 38-39.

The noneffective rate is one of the most important indexes for measurement and evaluation of manpower loss from medical causes. The daily noneffective rate for the U.S. Army, worldwide, during World War II was 42.2 per 1,000 average strength. This means that 42 Army personnel among every 1,000 (4.2 percent of strength) were excused from duty for medical reasons on the average day during the period 1942-45. On a proportional basis, 68 percent of manpower loss was due to disease, 14 percent to nonbattle injury, and 18 percent to wounds. In terms of daily noneffective rates per 1,000 average strength, these rates were 28.8 for disease, 5.8 for nonbattle injury, and 7.6 for wounds. These rates, with the exception of nonbattle injury, are lower than the corresponding noneffective rates for World War I when, of each 1,000 troops, 41.6 were noneffective each day from disease, 4.5 from nonbattle injury, and 11.6 from wounds during the extended period 1 April 1917-31 December 1919.

The data summarized in text table V show the relative importance of the different types of admissions (excluding CRO* cases which lose no time from duty) as causes of noneffectiveness. The wounded, which represented less than 4 percent of all admissions (excluding CRO cases), averaged 118 days lost per case. The estimated nonbattle admissions (excluding CRO cases) averaged only 20 days per case. Certain disease diagnoses, such as tuberculosis which requires extended periods of treatment, are apparently responsible for the relatively high noneffective rate. This is in contrast to the low average number of days lost, which reflect the inclusion of large numbers of short duration admissions. Disease admissions, representing 85 percent of all admissions, on an excused-from-duty basis, lost an average of 19 days. Nonbattle injury, with 11 percent of admissions, averaged 30 days per case. . . .

Table V.-- Admissions, days lost, and noneffective rates, U.S. Army, 1942-45
Type of admission Number of admissions (1)
Noneffective days
rate (2)
TotalPer admission
All causes-------------------------
Nonbattle injury---

(1) Excludes cases carded for record only. Nonbattle admissions are estimates based on ration of CRO counts for 1944-45.
(2) Rates stated as number of U.S. Army personnel excused from duty for medical reasons each day per 1,000 average strength.
. . .

[*Carded for the Record Only. These cases called for outpatient treatment, and patients were returned to duty the same day.]
Of the 403,689 admissions for malaria, 40 percent (178,830) originated in the Pacific and an additional 20 percent (75,337) in the Mediterranean theater. Although only about 10 percent of the malaria cases were incurred in China-Burma-India, the highest annual admission rate of 89 per 1,000 for this disease was experienced there. Similarly, the Africa-Middle East theater reported only 10,225 admissions for malaria, yet produced an admission rate of 77 per 1,000. The Pacific theaters, although responsible for most cases of malaria, reflect admission rates of 62 and 56 per 1,000 for the Southwest Pacific theater and Pacific Ocean Areas, respectively. The noneffective rates, however, were highest in the Pacific and Orient: 4.18 per 1,000 per day in the Pacific Ocean Areas, 3.26 per 1,000 in the Southwest Pacific, and 3.35 per 1,000 in China-Burma-India. The annual malaria admission rate for the Mediterranean theater was 49 per 1,000 for the 4-year period (1942-45), and the corresponding rate was 42 per 1,000 for Latin America. Europe, with only 27,188 malaria admissions (7 percent of the total), experienced an annual admission rate of 6.5 per 1,000 average strength. . . .

Photograph: U.S. Soldiers Take Cover in a Snowy TrenchPhotograph: African American Soldier Receiving Medical Treatment in the Field in New Guinea