From the War Department Annual Reports, 1919, Vol. 1, Part 3, Report of the Surgeon General, Government Printing Office, Washington, DC, 1920, starting on p. 3471-75:

The hospital center of Vittel dated from November, 1917, when a medical officer was detailed to arrange for the lease of such buildings in the watering places of Vittel and Contrexeville as were available and suitable for hospital purposes.

Troops were being rushed from the United States as fast as ships could transport them, and it was necessary to provide hospitalization for them as they arrived. It was the intention of the higher authorities that the Americans occupy the sector from Toul and Nancy to the Alsace border, and it was in this region the American divisions were sent for their combat training with the seasoned French troops. This explains the establishment of our first hospitals in the east of France, seemingly. Far from the culminating struggles of the Great War, the two towns of Vittel and Contrexeville are in the Department of the Vosges, in the foothills of the mountains of the same name, about 60 kilometers south from Nancy, 55 kilometers southeast from Toul, 60 kilometers east from Chaumont—the location of general headquarters of the American Expeditionary Forces—and about 90 kilometers west from the Alsace border. The hospital center of Vittel-Contrexeville was at that time the nearest to the front, and at all times the farthest east of any of the base hospitals of the American Expeditionary Forces.

Vittel has an excellent water supply derived from springs in the hills above the town, which, though at times taxed to the utmost, was beyond suspicion as to purity. Contrexeville was not so fortunately situated with respect to its water supply. Practically all water supplies in Contrexeville were determined to be nonpotable. These supplies were not labeled “nonpotable,” as is customary, but signs were posted forbidding patients and personnel drinking any but treated water. Inadvertently a “nonpotable” sign was placed upon one of the well-known springs. Complications, assuming almost international importance [were] the result, with a call upon the commanding officer by the mayor and other dignitaries.

Prior to the arrival of the Americans and for a short time after the establishment of our hospitals the French occupied some of the hotel buildings for hospital purposes. Building and plumbing were in extremely poor condition. By the time of the arrival of the first unit, November 17, 1917, sufficient buildings had been provided for a normal capacity of 5,500 beds, with villas for quarters for officers and nurses, and the large gambling house, the Casino, for barracks for the men.

All buildings were of the usual French constructions, concrete and stone, more or less fire-resisting in some cases; in others, especially in Contrexeville, veritable fire traps. Practically every hotel building had its own kitchen range installed and in fair working condition.

All buildings were piped for water and had a sewage system wholly inadequate for the number of patients in each during crisis expansion. Cesspools were situated under the kitchen floor, and whenever the capacity of the cesspool was exceeded, the inevitable result was a flooding of the floor of the kitchen. By continually pumping out the cesspool this was reduced to a minimum.

In each building, rooms were reserved for the use of the proprietor for the storage of his furniture and personal property, and in the basement of each was a room said to contain wine. Someone, either French or American, would enter these rooms, with the result that a “procés-verbal” and a complaint and claim for damages would be served upon the commanding officer. Many of these claims were groundless and were the result of the mercenary aims of the owners. Every claim necessitated the appointment of a board for its investigation, and subsequent settlement by the rent requisition and claims service.

On account of the difficulty of obtaining furniture and kitchen utensils, authority was obtained for the purchase of those articles. A considerable amount of these articles [was] thus obtained upon the promise to the proprietors to resell to them after the war. Heavy solid copper kitchen utensils from 5 to 30 kilograms were purchased at the uniform price of 10 francs per kilogram. Upon the abandonment of the center, it was found that on account of the increase in price of copper, the original purchase price was obtained. Other articles were sold at a depreciation of 20 per cent for the use for the year or more. Base Hospitals 23, 36, 32, and 31, assigned to the towns of Vittel and Contrexeville, were originally equipped by the American Red Cross; that of 36 being intended for a capacity of 1.000 beds, while the other 3 were intended for 500 beds.

November 17, 1917, the first of these units arrived in Vittel. Base Hospital 36 was organized in Detroit, Mich.
December 18, 1917, the second unit arrived in Vittel. Base Hospital 23 was organized in Buffalo, N. Y.
December 26, 1917, Base Hospital 32 arrived in Contrexeville.
January 1, 1918, Base Hospital 31 arrived in Contrexeville.

March 13, 1918, each unit, with the exception of Base Hospital 36, received as reinforcement one of the lettered hospital units. Unit “B,” organized at Yonkers, N. Y., joined Base Hospital 23. Unit “R,” organized at Fairfield, Iowa, joined Base Hospital 32. Unit “G,” organized at Syracuse, N. Y., joined Base Hospital 31.

At this period there was very little action at the front. This was a trying time. Not sufficient patients were received to keep officers and nurses professionally occupied; many were homesick, mails were not arriving with regularity, and the war was not progressing very satisfactorily to the allied cause.

The increase in total capacity from 2,500 beds, which was the number originally intended for all four units when organized, to the 5,500 new schedule necessitated requisitioning additional equipment.

Photo from the BH32 unit history - from Contrexeville looking toward Vittel

Photo from the unit history of BH 32.

Each unit had its own quartermaster and medical supply officer and controlled its own transportation. It soon became a race as to which unit could get the most equipment. Transportation was running wild, touring cars went as far as Paris and Bordeaux on purely joy-riding trips, and ambulances were out on two or three days' trips with officers. Acting upon the suggestion of the chief surgeon of the advance section, Service of Supply, in which the hospitals were located, and under whose jurisdiction they then were, a major in the Medical Corps, on January 17, 1918, assumed command of the group of hospitals. This was the first suggestion of the centralization of the administration of the group of hospitals. Each unit earnestly avoided any relations with the other organizations, and this extended to personal relations among officers, nurses, and enlisted men. There was a distinct tendency to carry on the normal rivalry of the various cities in which the units were organized. This rivalry at times became jealousy, and it became necessary to station men at the station to prevent one unit taking property arriving for another unit. Each unit avoided performing any duty which might in any manner pertain to any other unit.

April 25, 1918, the commanding officer of the group detailed a captain of the Quartermaster Corps as “acting quartermaster for the hospital center of Vittel.”

The commanding officer assumed control of all transportation of the various hospitals and restricted its use. Up to this time each unit considered the transportation it had as its own property, not to be available for any other unit. Later all transportation was collected into the large garage in Vittel and controlled by the group quarter master.

The result was at once evident in the improvement in service and the saving in gasoline. The opposition to the centralization of the transportation at times was rather amusing. Officers who formerly had a car at their disposal to make official trips would make as many calls as possible upon the center quartermaster for transportation, and if there were two to make the trip they would wait and call for cars at different intervals. An attempt to break down the system was made. To overcome this a bus service was established between the two towns, and those who had business were required to use it instead of calling for a touring car.

From the first the centralization of the administration of the center met with opposition from all of the units. They had started their work independently from any other organization and resented any central control. This to a great extent was increased by the fact that the officer in command of the center was also in command of one of the units. The commanding officer of the center therefore, upon his own request, was relieved from duty with Base Hospital 23 and placed in command of the center alone by paragraph 132, Special Order No. 148, Service of Supply, August 7, 1918.

During the winter and spring of 1918 patients were admitted principally from the surrounding training areas and from Baccarat and Luneville, where our troops were in the trenches, and where actions with the enemy were often taking place. Numerous gassed cases were admitted to the center at this time. It seemed as if every new organization had to have its lesson in gas warfare before being cautious, and several times a sudden call for help on account of the number of gassed cases would come from Evacuation Hospital No. 2, situated at Baccarat.

During this period of adjustment considerable restlessness was manifest, especially among the officers and nurses. Not enough patients were arriving to keep them busy, and the keenest rivalry developed in obtaining patients. This at times reached the stage of soliciting patients from organizations at the front. Convoys would arrive by ambulance with instructions “not to stop at Base Hospital No. —, but to go direct to Base Hospital No. —.” A receiving office was established and all arriving ambulances were required to report there, where all distributions were made by direction of the commanding officer of the center.

Central laboratory and morgue. – Each base hospital was originally equipped with a full laboratory equipment, and each established its own complete laboratory. It was soon seen that it would not be practicable to have a complete laboratory. It was therefore decided by the officer in charge of laboratories to have one central laboratory in each center, well equipped, and smaller laboratories in the individual hospitals for the routine work. This idea met with tremendous opposition on the part of the various hospitals. However, the central laboratory was established, taking such equipment from the individual base hospitals as was necessary to organize and equip one central laboratory in each of the towns, Vittel and Contrexeville. At first the central laboratory was in charge of one of the laboratory men detailed from one of the units. This was unsatisfactory to the other unit in the town. No confidence was placed in the work of an officer from another unit. It was seen that an officer not connected with any unit would be necessary. As a result, an officer was ordered to the center as laboratory officer of the center laboratory, remaining in charge until the close of the center.

For some time the French kept a railroad artillery train parked in the city. Considerable time was required to get this removed. Again, the British attempted to establish a motor lorry park in the city. This was later abandoned. It was not considered in keeping with the provisions of the Geneva convention to attempt to construct a cross for protection so long as those combatant organizations were within the city. After these organizations were ordered away the cross was constructed. All the surrounding towns were repeatedly bombed. German planes were overhead frequently and it was believed that this center sooner or later would be bombed. Fortunately this never occurred.

Convalescent camp. – Early in the history of the center the commanding officer obtained 10 Marquee tents as a nucleus for a convalescent camp. These were later ordered shipped to Bazoilles and the idea of a camp was abandoned. During the month of September definite steps were taken to establish a convalescent camp for 1,200 patients to serve the center. A piece of land 50 acres in extent was leased and construction started. A total of 12 huts was erected by the engineers and 40 type Henry tents obtained. This camp was ready to take in patients when the armistice was signed, and the project was abandoned.