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Mary C. Gillett's fourth and final volume The Army Medical Department, 1917 1941, provides a long-needed in-depth analysis of the department's struggle to maintain the health and fighting ability of the nation's soldiers during both World War I a conflict of unexpected proportions and violence and the years that preceded World War II. In 1917, unprepared as a result of the widespread conviction that to prepare for war is to encourage its outbreak, the Medical Department faced confusion exacerbated by a shortage of both equipment and trained personnel. While bringing to bear knowledge of disease and disease prevention gained in the years after the Spanish-American War, it redesigned and developed its approach to evacuation; struggled to limit the damage to health and effectiveness caused by poison gas, an unfamiliar and deadly weapon; worked to devise ways to limit the suffering and deaths from gas gangrene; began its research into the unique problems of aviators; and desperately tried but failed to control the 1918 influenza pandemic, leaving behind a mystery concerning this disease that is yet to be completely solved.