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21st General Hospital Records
Subgroup 1 – Commanding Officer Files

Commanding Officer Col. Lee D. Cady giving official commendations, Naples, Italy, 1944
Commanding Officer Col. Lee D. Cady giving official commendations, Naples, Italy, 1944
21st General Hospital Records
Subgroup 1
Volume: 31 linear feet
Bulk dates: Mainly 1942-1945, with later additions to certain series
Collection code: RG004
Organization of the Collection
Container List
PDF Version

Historical Note

The 21st General Hospital was the successor to Base Hospital 21, among the first American military hospitals to serve in France in World War I. Its officer corps had been drawn in large part from the medical staff of Washington University Medical School and Barnes Hospital (See RG006, Base Hospital 21). After returning to the United States in 1919, Base Hospital 21 was designated a Reserve Officer Corps unit of the General Hospital category. When war broke out again in Europe, the executive officer of the reserve unit was Lee D. Cady, M.D., a 1922 graduate of Washington University School of Medicine and member of the clinical faculty in medicine.

Following the Japanese attack on Pearl Harbor on December 7, 1941, mobilization orders were sent to reserve units throughout the country. Cady, now lieutenant colonel, and an advance party of other medical officers from St. Louis, traveled to Ft. Benning, Georgia. On January 12, 1942, the unit was activated as General Hospital 21. The ranks were increased by officers and enlisted men already in training at Ft. Benning. On February 1 they were joined by fifty-five nurses from Barnes Hospital and the Washington University School of Nursing led by Lt. Lucille S. Spalding. Col. Robert E. Thomas, a Regular Army medical officer, was named as unit commander on February 15. Before General Hospital 21 departed from Ft. Benning, Col. Thomas was replaced as commander by Col. Charles F. Davis.

On October 20, 1942 the unit embarked from New York aboard the SS Mariposa, bound for England. Following a zigzag course through the rough U-boat-infested waters of the North Atlantic, the vessel managed to reach its destination, Liverpool, in safety. From Liverpool, the 21st was sent by train and truck to a billet in a suburb of Birmingham, Pheasey Farms Estate. While in England, plans were announced that the hospital would be a part of “Operation Torch,” an Allied offensive to establish control of North Africa. In Liverpool again, the 21st boarded the SS Monarch of Bermuda, which sailed in a convoy south along the Atlantic coast of Europe. From Gibraltar, the convoy crossed the Mediterranean to Algeria and landed at the Port of Mers-el-Kebir, near Oran, on December 6, 1942. Algeria had newly come under Free French control and thus its strategic resources were at Allied disposal.

The 21st bivouacked at Oran. From there, late in December, the unit was transported into the interior of Algeria. The hospital was assigned to establish operations at a hot water spa. The place, called Bou Hanifia, was located at an oasis in the rocky desert plateau sixty miles south of Oran. The largest building in Bou Hanifia, the Grand Hotel, was chosen to house the main medical and surgical functions. Several smaller hotels in town were also taken over for hospital uses. A solitary first patient was admitted December 24. Hospital functions began in earnest on January 2, 1943, when 472 beds were ready. For a time, there was a critical supply shortage. Makeshift instruments were used in the first days of surgical operations. Medicines and bandages were administered very sparingly. The problem was gradually alleviated as more and more Allied convoys reached the Mediterranean Base Section.

Col. Davis was unexpectedly transferred to another unit in late January. Left to assume temporary command was Lt. Col. Cady. Weeks went by without a replacement for Davis named. Ultimately, with the help of friends higher up, Cady was promoted to colonel and given permanent command of the hospital. Cady revealed a considerable talent for public relations. His many efforts to boost morale and to cement good relations with U.S. and Allied commanders paid off in terms of hospital efficiency. Bed capacity steadily increased. When all appropriate spaces in the hotels were full, temporary buildings were erected to house additional wards. A rehabilitation section was established for special treatment of the wounded. Battles in Tunisia in the spring of 1943 led to capture of thousands of German and Italian troops. Up to 200 of the enemy wounded were treated by the 21st at one time. Handling of prisoners of war necessarily increased the complexity of military operations at Bou Hanifia. At its largest while in Algeria, the 21st had over 4,000 beds. The staff was pressed to handle casualties from the American and British forces that invaded Sicily in July. The number of patients gradually began to decrease once the Allies conquered all of Sicily and launched attacks on the Italian mainland. In November, the order came to “cease construction” at Bou Hanifia and restore facilities of the spa to their prewar functions. In a year of service in the North African campaign, the hospital treated 20,989 patients.

With hospital equipment packed into more than three thousand crates, the unit gathered again at Oran. The destination this time was Naples, Italy. The nurses sailed December 4, 1943 on the hospital ship Shamrock. The remainder of the unit boarded the British transport vessel HMS Cameronia two days later. Col. Cady found himself to be the ranking American officer on board and thus in charge of all U.S. personal during the voyage. In Naples, the Allies converted a fair-grounds, the “Prima mostra delle terre italiane d’oltremare,” into a medical center and assigned its operation to several units, including the 21st. Near the fairgrounds was another tourist attraction, Terme di Agnano, like Bou Hanifia a hot water spa. There the officers of the 21st were billeted.

After the relative comforts of Bou Hanifia, Naples afflicted substantial hardships again on the unit. Fierce fighting continued only a short distance away. Cold rains drenched the region throughout December and January. A good portion of the fairgrounds buildings were badly bomb damaged. Tents were used to shelter many of the sick and wounded while repairs were being made. During these difficult days, members of the unit were themselves hospitalized with upper respiratory infections and fatigue. But, despite all these problems, the hospital was able to regain operating efficiency within days of arrival at the fairgrounds. In January 1944 Allied forces invaded the central Italian coastline at Anzio. In the weeks that followed, attacks were launched on German positions in the mountains, notably at Cassino. Trainloads and shiploads of casualties from these engagements, as many as three hundred at a time, were brought to the hospital, straining staff and bed capacity to the utmost. In addition, the unit was called upon to help stem a typhus epidemic in Naples. The most critical period of service to the Italian campaign came in June, with battles leading to the fall of Rome. Bed capacity of the 21st at that time reached three thousand.

The success of the D Day invasion of Normandy (June 6, 1944) permitted Allied offensives in southern France in August. By September, territory as far north as Lorraine had been liberated from German control. Orders were sent for the 21st to follow and establish operations anew on French soil. On September 25, the unit pulled out of the Naples facility. Just short of 15,000 new patient records had been added to hospital statistics. The 21st was recognized as one of the finest medical units in the European theater, and not only by Americans. For assistance to the Free French forces, Gen Alphonse Join awarded the 21st a French unit citation.

The new location for the 21st was a psychiatric hospital near Mirecourt, south of Nancy. Once again, the unit found itself uncomfortably close to a battle zone. On October 21, 1944, less than a month after the 21st had left Naples, it was accepting patients anew. The psychiatric hospital buildings had been in the final stages of construction when the war began. They were not damaged during the German occupation. Now, with finishing touches by American engineers, the facility was admirably suited to the needs of the 21st It boasted spacious wards and central heat. By November, over three thousand patients were being treated daily.

The 21st endured perhaps its hardest test in late December 1944, during the “Battle of the Bulge.” The surprise German counteroffensive breached Allied lines in Belgium and Luxembourg and, for then critical days, threatened a new invasion of France. Plans to evacuate the hospital were hastily drawn up. On December 26, the buildings at Ravenel were strafed by enemy planes and one bomb hit the grounds, causing slight damage. On that very day the German drive was stopped. The hospital, of course, accepted a great many of the wounded from the battle. The pressure continued as the struggle crossed the border into Germany itself. In January 1945 the 21st expanded to 4,040 beds. On January 7 the hospital treated its 50,000th patient. The facilities at Ravenel were used to their fullest extent. Sick and wounded were cared for even in the attics of buildings. Ambulatory patients were pressed into service on the wards and in the hospital headquarters.

The early months of 1945 gradually brought an end to this crisis. The long-awaited end of the war in Europe, V-E Day, came May 8. But victory brought a new variety of challenges to the hospital command. The number of patients dwindled, but many severely wounded remained for treatment. Meanwhile, the medical and nursing officers were needed for other assignments and were rapidly transferred out of the unit, creating staffing shortages. Col. Cady and his remaining cadre struggled to maintain hospital services despite daily changes in the duty roster.

On September 20, the U.S. Army bestowed its meritorious Service Unit Plaque on the 21st. The citation read, in part: “The professional skill and tireless devotion to duty demonstrated by the personnel of the 21st General hospital were in keeping with the highest traditions of the Armed Forces of the United States.” The award, it is true, came too late to be distributed personally to most hospital personnel. The portions of the staff remaining at Ravenel had, by this date, been relieved of medical duties and were packing for the return voyage.

Final statistics compiled by the unit were impressive. They indicate that the 21st admitted 65,503 patients in its nearly three years of overseas service. The total surgical operations numbered 33,440. Dental treatments amounted to 69,375. The hospital laboratories had run 246,805 tests. Blood transfusions given were 11,258. The Convalescent and Rehabilitation Section treated 21,175 patients. In three years, over 2,200 persons had served as members of the 21st.

After a short period at a staging area near Marseilles, Col. Cady and his staff boarded the victory ship Westminster, which sailed October 28. The ship landed at Boston November 7. The members of the 21st were taken to Camp Myles Standish, given an official welcome, and reoriented for their imminent return to civilian life.

The 21st ceased to exist as an active military unit at this point (it has since been revived as a U.S. Army Reserve General Hospital). Yet the careers of those who had served with the hospital during the war continued profoundly to be influenced by the experience. Cady became a director of Veterans Administration hospitals in Dallas and Houston. Many of the other medical and nursing officers returned to St. Louis, a substantial number to resume practice at the Washington University Medical Center.

(Condensed from “The Spa, the Fairgrounds, and the Psychiatric Hospital; the 21st General Hospital in World War II,” by Paul G. Anderson, Outlook, Spring 1982, 2-9.)

Provenance

Most of the 21st General Hospital Commanding Officer’s files, together constituting Subgroup 1, were the gift of Lee D. Cady, M.D., former unit commander, to the Washington University School of Medicine Library. Cady’s donations were made in 1969, 1971, 1975, and 1981. Subseries 3 of Series 1 was the gift of Lucille Spalding, R.N., to the Archives in 1972. Series 2 was the gift of Roy L. Prewett to the Archives in 1971. Subseries 5 of Series 3 was the gift of David F. Hollander to the Archives in 1971. See also Subgroup 2, records of the 21st General Hospital Surgical Service in World War II, which is described separately.

Access and Use

The collection is open and accessible for research. Certain categories of documentation, however, may carry restrictions on access. For detailed information, contact the Archives and Rare Book Section (arb@wusm.wustl.edu). The Library holds copyright to the writings of Lee D. Cady.

Scope and Content

Properly speaking, this is not a group of institutional records, but a collection of manuscripts and war memorabilia brought together and preserved by veterans of a military unit. Several of the series were generated as official records of the 21st General Hospital when it was stationed overseas, 1942-1945. But included also are many files and writings compiled or composed by the principal donor, Lee D. Cady, M.D. as late as 1975. The collection is designated a record group because it documents the history of an organization, rather than the career of any particular individual and because this organization at its inception was sponsored by Washington University School of Medicine.

The record group, as processed and described in this inventory by the Archives staff, is comprised of sixteen series. The series include narrative histories and reports, unit newspapers, records of the unit before activation, training materials, transit orders and rosters, files pertaining to each of the overseas duty stations, personnel files, general subject files, maps and plans, and select publications concerning the war and locales where the unit served.

Microfilm Edition

Subgroup 1, the Commanding Officer’s files, is available for use on microfilm. The microfilm edition consists of twenty-one reels of 35mm negative image film. Title pages only of the publications in Series 15 were microfilmed, and the published maps of Series 14 and certain other portions of the record group were omitted entirely. Reel numbers are indicated at appropriate sections of this finding aid.

Related Materials

The Visual Collections of the Archives contain numerous photographs and artifacts relating to the 21st General Hospital that were donated by Cady and other unit veterans. Interested researchers are advised to consult the finding aids to the Visual Collections for details.

Medicine in Times of Need is an online exhibit based on the 21st General Hospital Visual Collections and the Base Hospital 21 Visual Collections. This Becker Library exhibit is at: http://beckerexhibits.wustl.edu/gh21/index.htm.

Two members of the 21st General Hospital, Col. Lee D. Cady and Lt. Col. Harry Agress, participated in the Washington University School of Medicine Oral History Project. Audio recordings and transcripts are available online for both Harry Agress and Lee D. Cady.

Organization of the Collection (Series List)

Container List

Series 1: Diaries, Narrative Histories, and Reports, 1942-1981

This series contains chronological records of the 21st General Hospital. Much of the series is Cady’s postwar narrative history, Diary of the 21st General Hospital (Subseries 5), and two revisions, The fighting twenty-first (Subseries 6-7).

The unit histories, the nursing reports, and the log of inactivation of medical officers and nurses are the wartime records in Series 1. Unit histories, according to Cady’s memorandum regarding reports, 2 June 1944 (6:1), “go below the surface of bare events.” Content includes organization; training and development; and problems of assembly, embarkation, movement, and debarkation; and operations (amount of work). Where applicable they cover the character of country and terrain, the attitude of military and civil officials and of the population of the region and the resources of the country. Of particular interest were methods employed to restore operation of damaged buildings, sewage, water, and electricity; and methods adopted for control of discipline, police and fire protection and health. Supporting documents attached are photographs, directives, orders, statistics, and charts.

All documents are in English. Boxes 1-9, Volumes 1-3, Microfilm reels 1-4.

Subseries 1. 21st General Hospital Officers and Nurses Diary: Inactivation, 1944-1945

Box 1 [oversize]

Reel 1

Subseries 2. Annual and Monthly Histories of the Hospital, 1942-1945

Box 2

Box 3

Reel 2

Box 4

Box 5

Subseries 3. Reports of Nursing Activities, 1943-1945

Box 6

Subseries 4. Drafts of a Complete Narrative History By Lee D. Cady, 1955

Box 7

Reel 3

Subseries 5. Diary of the 21st General Hospital, 10 November 1955, Mimeograph

Box 8

Box 9

(Not Microfilmed)

Subseries 6. The Fighting Twenty-First, 1942-1945. Revised Manuscript, 1955-1975, Vols. I and II

Vol. 1

Reel 4

Subseries 7. The Fighting Twenty-First, Revised Manuscript, 1971 (-1981), Vols. I and II

Vol. 2

Vol. 3

Back to Series List

Series 2: First Sergeant’s Daily Reports, 1943-1945

The First Sergeant’s Daily Reports are a record of disciplinary action, duty assignment and illness. Each day, the sergeant compiled a statistical report with his log of enlisted men under the following categories: detached service, passes, absence without leave, arrest in quarters, in confinement, special duty, awaiting court martial, company punishment, awaiting disciplinary action, duty assignment changes, sick in hospital, and attached personnel in hospital. Wards and diagnoses were given for those in hospital. The first sergeants were Herman B. Golden, 18 Jan 1943-22 June 1943; Sidney S. Shindler, 22 June 1943-12 Aug 1845; and James L. Gibbons (Acting), 14 Aug-31Aug 1945. All documents are in English. Box 10, Volume 4, Microfilm reels 4-5.

Vol. 4

Box 10

Reel 4 (continued)

Reel 5

Back to Series List

Series 3: Unit Newspapers, 1942-1945

War news was the focus of The 21st Headline News, June 1943 to August 1945. The paper (Subseries 5) began when patients and personnel asked T/Sgt. Morris Weissman and Cpl. David Hollander how the war was going. These men had access to the unit’s only radio. To save time, Weissman and Hollander posted their digest of war news from the BBC radio broadcasts from London at the hospital pharmacy. Later they mimeographed the digest. News of the unit such as nightly movies and court martials sometimes appeared in the daily. Weissman and Hollander produced the paper on their own time until June 1944 when it became part of Weissman’s duties (“History of the 21st Headline News,” 11:1).

Another long-running unit newspaper was the Daily Bulletin, 1944-1945(Subseries 4). It contained official unit announcements rather than war news. The first unit newspaper was the 21st News Bulletin, 1942 (Subseries 1). Succeeding it was The Twenty-first Stir, 1942-1943 (Subseries 2). Edmund Delavy, a noted illustrator, drew humorous cartoons for both papers. All newspapers are in English. Boxes 10-11, Microfilm reels 5-6.

Subseries 1. 21st News Bulletin, 1942

Box 10

Reel 5 (continued)

Subseries 2. Twenty-First Stir, 1942-1943
Subseries 3. Bi-Weekly Snafu, 1943
Subseries 4. 21st General Hospital Daily Bulletin, 1944-1945
Subseries 5. 21st Headline News, 1943-1945

Box 11

Reel 6

Back to Series List

Series 4: Records of the Reserve Unit, 21st General Hospital, 1919-1941

Lee D. Cady kept a correspondence file while serving as adjutant of the reserve unit, executive officer, chief of medical service and director (12:2). Documents include rosters, memoranda, letters of assignment, special orders, personnel letters, circular letters, and function and organizational charts. Major subjects were the assignment and promotion of personnel and the course credits necessary to maintain an officer’s commission. Correspondents were the Surgeon General’s Office and the Office of the Commanding General at Headquarters, Seventh Corps Area. All documents are in English. Box 12, Microfilm reels 6-7.

Box 12

Reel 6 (continued)

Reel 7

Back to Series List

Series 5: Ft. Benning Correspondence and Records, 1940-1970

Officers of General Hospital 21 were ordered to report to Fort Benning, Georgia, on January 10, 1942. The recruitment and training of physicians and nurses that began there is the primary subject of this file. Documents include rosters, memoranda, daily information sheets, telegrams, clippings, function sheets, training and hospital schedules, announcements, requests for commissions, army regulations concerning reserve officers, and drawings of a proposed insignia. All documents are in English. Box 13, Microfilm reel 7.

Box 13

Reel 7 (continued)

Back to Series List

Series 6: Orders and Rosters, 1942-1945

The transport of the General Hospital personnel is the focus of this file documenting movement of the unit from the U.S. to England (October 1942), North Africa (December 1942), Italy (November 1943) and France (October 1944). Lee D. Cady kept this chronological file from activation on January 12, 1942 to final demobilization in November 1945. Documents include memoranda; rosters of nurses, officers, and enlisted men; special orders listing all personnel being mobilized with rank, assignment and next of kin; movement orders, and passenger lists. An unexpected treasure is the list of records (records inventory) transferred to the AG [Adjutant General] inactive branch upon demobilization. All documents are in English. Box 14, Microfilm reels 7-8.

Box 14

Reel 7 (continued)

Reel 8

Back to Series List

Series 7: Hospital Regulations and Standing Orders, 1941-1944

This series contains hospital regulations and standing orders on the standard operating procedure for the 21st General Hospital. Documents include rules, regulations, tables, and memoranda. All documents are in English. Box 15, Microfilm reel 8.

Box 15

Reel 8

Back to Series List

Series 8: Bou Hanifia Files, 1942-1970

The unit established its first hospital at the Algerian resort town of Bou Hanifia, sixty miles south of Oran, from January to December 1943. Documents pertaining to this duty station are in English, French and occasionally Arabic. Microfilm reel 8, with the exception of the “Honorary Arabs” items, which were not filmed. Box 16 and 1 [oversize].

Box 16

Reel 8 (continued)

Box 1 (Oversize materials)

Not microfilmed.

Back to Series List

Series 9: Naples Files, 1846, 1940-1944

The 21st General Hospital moved with the Allied armies from North Africa to Naples, Italy. There the Allies set up a medical center close to the fighting that was staffed by the 21st and other medical units. Records of the 21st at Naples include standing orders, passenger lists, invitations, memoranda, reports, regulations, training schedules, a language guide, special orders, personnel lists, a prospectus, and clippings. Documents are in English and Italian. Box 17, Microfilm reels 8-9.

Box 17

Reel 8 (continued)

Reel 9

Back to Series List

Series 10: Mirecourt Files, 1943-1952

The 21st General Hospital moved with the troops to Mirecourt, France, and resumed operations at Ravenel Hospital there in October, 1944. Documents of the hospital include letters, memoranda, postcards, circulars, reports, sketches, itinerary and hospital orders, notes for commendations, dinner invitations and menus, award plaques, sheet music, and historical reports. Documents are in English, French, and German. Box 18-21, Microfilm reels 9-11.

Box 18

Reel 9 (continued)

Box 19

Reel 10

Box 20

Box 21

Reel 11

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Series 11: Admission, Disposition, and Evacuation Lists, 1943-1945

The registrar’s mission was to prepare medical records and necessary statistics in conformity with existing regulations and P.B.S. circulars (Unit history, July 1944, p. 87. Box 3, Folder 1). The monthly statistics in the registrar’s report of unit histories came from these logs of the comings and goings of patients, 1943-1945.

Admission lists identify incoming patients and their location within the hospital. Disposition lists trace where the patients went after leaving the hospital: their return to unit, first replacement depot, or transfer to other hospitals. Evacuation lists chronicle the evacuation of patients to other hospitals after being stabilized. Evacuation lists start in November 1944, the first full month of operation in the European Theater of Operations. The registrar complains in the November 1944 unit history that “this installation has been functioning as an evacuation hospital and not in the capacity for which it was intended (p. 137A, (3:10).” Properly or not, the evacuation lists record the massive air evacuations to the United States begun in July 1944 (Unit history, July 1944, p. 88). Documents are in English. Boxes 22-26, Microfilm reels 11-13.

Subseries 1. Admission Lists, 1943-1945

Box 22

Reel 11 (continued)

Box 23

Reel 11-12

Reel 12

Subseries 2. Disposition Lists, 1943-1945

Box 24

Box 25

Reel 13

Subseries 3. Evacuation Rosters, 1944-1945

Box 26

Back to Series List

Series 12: Files on Personnel and Friends of the Unit, 1925-1981

The lives and careers of unit personnel and friends is chronicled in this treasury of clippings, questionnaires, correspondence, photographs, Christmas cards, birth and marriage announcements, employment applications, and obituaries, as retained or compiled by Lee D. Cady. The subseries arrangements are his, especially the first (Subseries 1), which segregates the files of “outstanding individuals.” The correspondence found throughout often postdates active service with the unit and includes letters of recommendation for jobs, personal letters, and nominations for military awards. Cady asked his staff for wartime snapshots, individual portraits, and other memorabilia for his unit history, but relatively few photographs were submitted, and of those, the best have been transferred to the visual collections. Postwar reunions are frequent subjects of the files. At the end of the series is the “little black book,” 21st General Hospital: England, Africa, Italy, France, a unit directory of personnel published in September 1945. Documents are French and English. Boxes 27-39, Microfilm reels 13-19.

Subseries 1. “Outstanding Individuals” of the 21st General Hospital, 1940-1978

Box 27

Reel 13 (continued)

Reel 14

Box 28

Box 29

Reel 15

Box 30

Subseries 2. Medical Officers. 1940-1970

Box 31

(Names filed in Subseries 1 are not included here.)

Reel 16

Box 32

Subseries 3. Nursing Officers, 1941-1977

Box 33

Subseries 4. Enlisted Men, 1925-1961

Box 34

Reel 17

Subseries 5. Enlisted Men, Medical Detachment, 1943-1971
Subseries 6. Physiotherapists, American Red Cross Personnel, 1943-1965
Subseries 7. Supplemental Files, 1940-1977

Box 35

Subseries 8. Friends of the Unit, 1942-1971

Box 36

Reel 18

Box 37

Box 38

Reel 19

Subseries 9. Supplementary Files, 1941-1981

Box 39

Subseries 10. “21st General Hospital,” 1945

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Series 13: General Subject File, 1925-1973

Lee D. Cady’s correspondence with military hospitals and units and miscellaneous correspondence not connected with duty stations or the reserve unit are filed in this series. Entertainers who performed for staff and patients are featured under files headed “United Service Organization” and “Barretts of Wimpole Street.” The Algerian company that served the 21st General Hospital at Bou Hanifia and Mirecourt is also the subject of a file. Types of documents include reunion fliers, correspondence, programs, clippings, photographs, rosters of company award recipients, lists, maps, postcards, pamphlets, magazine articles, award certificates, reports, schedules, histories, and orders. Documents are in French and English. Boxes 39-41, Microfilm reels 19-20.

Box 39

Reel 19 (continued)