Ambulance Corps went through a number of changes in the following decades, setting an example for other states and the regulars to follow. By the eve of World War I it had grown to the size of a battalion with 4 specialized companies, 2 of which manned ambulances while 2 provided the enlisted strength for field hospitals.

Action by the War Department came in 1887. Congress, approving an Army request, created the Hospital Corps within the Medical Department. Three grades were provided for enlisted medical specialists: hospital stewards, acting hospital stewards, and privates. Serving as wardmasters, nurses, cooks, and assistants, these men would perform all "hospital services in garrison and in the field" and staff the wartime ambulance service.

The Hospital Corps marked a new departure in two ways. First, prospective enlisted members had to volunteer for the duty and to show real aptitude. Second, a professional career pattern was laid out for recruits. Men who volunteered from line units were given training in first aid and in the duties of a litter bearer for at least four hours a month. After working as litter bearers for at least one year, candidates could take an examination for selection as Hospital Corps privates. After a year of service with the Hospital Corps, privates would be eligible for appointment as acting hospital stewards. Following one year of service on a probationary basis and passage of another examination, they could be appointed permanent hospital stewards. In its first year some 600 privates transferred to the new corps, with 24 passing their examinations and receiving promotions to NCO status as acting hospital stewards. Such planned career development made the establishment of the Hospital Corps important for the Army as a whole, for it launched the continuing development of various new specialties that allowed the Army to emerge as a modern, professional force.

Until the Spanish-American War, however, the Hospital Corps maintained a strength of only about 750, slightly more than one-quarter of whom held NCO rank. Additional responsibilities without commensurate pay raises, however, prompted many potential NCOs to opt for remaining with their line regiments. Others, trained by the Army, left at the end of their initial enlistments

for better jobs in civilian life. When the Army assembled a divisional field hospital at Pine Ridge, South Dakota, in 1890, units in surrounding states and territories had to be stripped of stewards and corpsmen, leaving them almost without medical support for several weeks. Once at the divisional hospital, these corpsmen also revealed unacceptable variations in training. Both problems were addressed quickly. In 1891 two companies of instruction were founded (a third was added in 1893) to standardize training. With staffs of 3 medical officers, 7 NCOs, and 40 privates each, the companies produced competent "sanitary soldiers" by offering a curriculum of infantry drill, first aid, elementary nursing and pharmacology, field hospital setup, field cookery, care of animals, and ambulance driving. Beginning in 1892, recruiting rules were altered to allow direct enlistment into the corps, a policy aimed at attracting civilian druggists, teachers, and cooks, and base pay for a Hospital Corps private was raised from $13 to $18 per month.

The Spanish-American War provided a rigorous test for the Hospital Corps. Though the quality of corpsmen trained in the companies of instruction was excellent, the quantity was insufficient. The Army had no choice but to go back to its old system of detailing men from the line and trying to train them quickly. By the end of the war, 6,588 corpsmen, of whom 608 were NCOs, had served in the combined Regular and volunteer force. In the years that followed, additional reforms again sought to standardize performance and grade structure. In 1903 the medics expanded to a five-rank grade progression, from private to private first class, corporal, sergeant, and sergeant first class.

Beginning in 1904, annual maneuvers funded by the federal government brought National Guardsmen and regulars together for joint training. The Hospital Corps used these occasions to test its ability to perform its wartime mission. Each year the companies of instruction had to cease normal operations, however, to transform themselves temporarily for field service. Finally, in the spring of 1911, the corps reorganized on a permanent, specialized basis into four field hospital companies and four ambulance companies. On maneuvers, these companies supported units in the field; in garrison, they trained in all medical functions.

As hospital steward and assistant hospital steward, the NCO appeared in a new role in the late nineteenth century: the technical specialist. This development certainly was not restricted to the Medical Department.

Already in the 1870s and 1880s technical specialists were well established in the artillery and coast artillery as fire-direction NCOS and electricians, and in the Signal Corps as communications experts and weather observers.

But the Hospital Corps, reflecting advances in medicine as a whole, was particularly affected by the trend toward specialization. In its early stages, medical specialization meant teaching line soldiers the rudiments of field medicine and emergency first aid. Later, Hospital Corps NCOs and privates acquired the skills to perform an increasing number of complex medical procedures without close supervision.

Training methods also became more specialized, and the responsibilities of medical NCOs as trainers expanded. Before and during the Civil War the Army left the training of hospital attendants to regimental surgeons, but the need to train subordinates took surgeons away from their primary duties, while many of the soldiers detailed to medical service brought little or no interest to their informal apprenticeship. To eliminate these problems, the Army created the two companies of instruction in the 1890s to train personnel recruited directly for a medical military career. NCOs were a part of that process from the very beginning, using their practical field experience to supplement the technical knowledge of the doctors.

By the eve of World War I, skilled and specialized medical units had become an integral part of the Army. During the war each regiment or separate battalion had a sanitary detachment, reinforced by a division-level sanitary train capable of providing one field hospital and one ambulance company to support each line regiment. Additional units existed at corps and army levels. Growth in the overall size of the Hospital Corps was

stimulated by additional pay increases and by the expansion of the grade system from five ranks to seven.

Technological change compelled further development of Army medicine as the lethality of the battlefield escalated dramatically. Fortunately, medical science kept pace. New inventions and improved knowledge allowed treatment to save lives that hitherto would have been lost. Late nineteenth century medical advances made possible the successful treatment of a greater range of illnesses and injuries. New drugs and antiseptics reduced pain and infection. Line commanders welcomed such developments, which held out the possibility of increased unit efficiency, higher morale, and less death and suffering. If large numbers of the wounded could be returned to duty, line units could regain experienced men and maintain manpower levels needed for continuous campaigning.

More was demanded of the medical enlisted ranks, especially the NCOs. They had to recover casualties rapidly, stabilize them, and move them safely to aid stations for treatment. During World War II, the Army's Medical Corps introduced the most sophisticated network of facilities and hospitals yet seen. Later, in Korea and Vietnam, extensive use of helicopters as aerial ambulances dramatically improved evacuation procedures and survival rates. The seriously wounded could be taken from a battlefield to a hospital in as little as twenty minutes. But no matter how sophisticated treatment or evacuation procedures may become, the Army medical NCO will always trace his or her origin to the ambulance men, litter bearers, and attendants of the Massachusetts Volunteer Militia.

The two American Expeditionary Forces (AEF) NCOs faced a familiar scene as the Meuse-Argonne offensive entered November 1918-deep mud, miserable weather, a hopelessly unrealistic schedule, and enemy harassing fire. Neither had enjoyed the luxury of a full night's sleep lately, and their tempers were short. Such problems had faced leaders throughout the history of warfare. But now NCOS had to deal with something new-traffic jams, like the one that the military police sergeant found himself trying to untangle.

"Before your truck can go," he told the sergeant from the Chemical Corps, "that ammunition convoy for V Corps has got to get through the intersection. And they aren't going anywhere until someone finishes changing that flat tire." Each day hundreds of vehicles tried to use the same road at the same time, with everyone claiming the highest priority. To hear convoy commanders tell it, General Pershing had personally ordered every driver to get to

the front as fast as possible no matter what was in the way. Once again, the military policeman thought, it was the NCO on the scene who had to get things moving again. To be successful, he'd have to take full advantage of the authority that the "MP" on his arm and the pistol on his hip provided. At least the drivers had stopped yelling-they could see it wouldn't do any good and the tire was just about changed.

NCOS had straightened out difficult situations in earlier campaigns, and they were equal to the task again. For days and nights on end, they had moved ten divisions of troops and thousands of tons of weapons, ammunition, and equipment into position for this, the largest American offensive of the war. Now that the attack was under way, it was even more important to keep the convoys on schedule to sustain momentum and to achieve the victory that would let the men return home again.

Soldiers performing specialized duties like military policemen and truck drivers are so familiar—and so essential-in today's Army that their presence is taken for granted. Every duty position requires specific skills and training beyond that gained in civilian life. This fact of life is so fundamental that people tend to forget that it has not always been the case. From the Revolution through the Civil War the Army was overwhelmingly infantry oriented, focusing on the ability to execute a handful of common tasks. Throughout its early history the military operated under very limited budgets and could set aside only about five percent of its manpower

to perform specialized functions. Not even the late nineteenth century's explosion of new inventions produced a dramatic change. As late as the SpanishAmerican War, the combat arms still accounted for ten out of every eleven soldiers. The principle of effectiveness gained by division of labor had long been understood in industry, but it was slower in gaining recognition in the armed forces.

One important reason for the earlier limited reliance on technical specialists grew from the Army's restricted peacetime mission. During the late eighteenth and nineteenth centuries, it had served primarily as a