WASHINGTON (NYTIMES) - Anna Mae Hays, a front-line nurse who was named the United States military's first female general after serving in three wars - braving snake-infested jungles in India during World War II, enduring numbing cold in Korea and seeking to reduce a punishing casualty rate in Vietnam - died on Monday in Washington. She was 94.

The cause was a heart attack, a niece, Doris A. Kressly, said.

Hays, who grew up mostly in Pennsylvania as the daughter of Salvation Army officers, had enlisted in the Army Nurse Corps during World War II. She was shortly deployed to a field hospital in northeastern India, where she treated construction workers and Army engineers building a road to China, sometimes assisting in amputations.

In South Korea, she helped establish the first military hospital in the coastal city of Inchon, the scene of a decisive victory for UN forces in 1950.

During her three decades in the military, which culminated in her appointment to chief of the nurse corps, Hays witnessed extraordinary medical advances, from the introduction of lifesaving antibiotics and painkillers to helicopter airlifts of wounded soldiers.

"If I had it to do over again," she said after her retirement in 1971, "I would do it longer."

As a one-star brigadier-general, she paved a career path for other women by recommending that married officers who become pregnant should not face compulsory discharge, and that appointments to the Army Nurse Corps Reserve not depend on the age of the applicant's children.

She also widened educational opportunities for nurses, deployed more of them overseas and imposed stricter academic standards for admitting them.

Hays helped establish the Army Institute of Nursing at what is now Walter Reed National Military Medical Centre Army Hospital in Maryland. As the emergency-room nursing supervisor there, she cared for President Dwight D. Eisenhower when he underwent surgery in 1956 for ileitis, an inflammation of the small intestine.

When vice-president Richard M. Nixon came to visit, The Morning Call of Allentown, Pennsylvania, reported at the time, Eisenhower asked her advice on whether to see him.

"No," she replied.

She left the room, shook Nixon's hand in the hallway and said, "I'm sorry, but the president doesn't feel he is able to see you."

Her elevation from colonel to general on June 11, 1970, also established what Gen. William C. Westmoreland, the Army chief of staff, called "a new protocol for congratulating lady generals." Westmoreland planted what Time magazine described at the time as "a brassy kiss" on her mouth.

At the ceremony, Eisenhower's wife, Mamie, presented Hays with the stars Eisenhower had received when he was promoted to brigadier-general in 1941.

Moments later, Elizabeth P. Hoisington, the director of the Women's Army Corps, was also promoted to brigadier-general.

Both promotions were made under a relaxed congressional policy on appointments of women in the military. Enacted during the administration of Lyndon B. Johnson, it was implemented under Nixon. Hoisington died in 2007.

Westmoreland pronounced them the first female generals in the West "since Joan of Arc."

Anna Mae Violet McCabe was born on Feb 16, 1923, in Buffalo, New York, to Daniel Joseph McCabe and the former Mattie Humphrey. Her parents' mission for the Salvation Army took them to New York and Pennsylvania; they settled in Allentown, Pennsylvania in 1932.

Anna Mae was torn between nursing - she would practice by tying bandages on broken chair legs - and music. But though she played the piano in church and the French horn in her school band, she decided against applying to the Juilliard School in New York because her parents could not afford it.

Instead, she attended the Allentown Hospital School of Nursing, graduating in 1941. She immediately volunteered for the American Red Cross.

After the Japanese attacked Pearl Harbour in December 1941, with her brother in the Marines and a younger sister living with their widowed mother, she travelled 60 miles to Philadelphia to join the Army Nurse Corps.

She was trained in Louisiana and then assigned to a military base hospital in Assam, India. There, Army engineers were building the Ledo (later Stillwell) Road into Burma, and Merrill's Marauders, a special operations unit, were staging raids on the Japanese.

"It was a strange mix of fear and excitement," Hays told the Allentown television station WFMZ in 2014. "For someone who had never really been away from home, it was like an adventure."

She survived monsoon weather, dengue fever, dysentery, malaria and leeches while living in a bamboo hut, treating Army personnel and construction workers and often helping doctors amputate their gangrenous limbs.

A first-lieutenant when World War II ended, Hays considered becoming an airline stewardess (a job that at the time often required a nursing degree) but decided instead to re-enlist. She held supervisory positions at Tilton General Hospital at Fort Dix, New Jersey, and Valley Forge General Hospital in Phoenixville, Pennsylvania. After war erupted on the Korean Peninsula, she was deployed there with the 4th Field Hospital.

"I think of Korea as even worse than the jungle in World War II because of the lack of supplies, lack of warmth in the operating room," Hays said in an interview for an Army oral history in 1983.

After the war, she was working at Walter Reed when she met William A. Hays, who directed workshops there that provided jobs for disabled people. They married in 1956; he died in 1962.

"I wish you would get married again," Westmoreland's wife, Katherine, later told her. "I want some man to learn what it's like to be married to a general."

Hays, who died in a Washington nursing home, had lived in Arlington, Virginia. She is survived by nieces and nephews.

She earned a bachelor of science degree from Teachers College at Columbia University in 1958 and a master's from the Catholic University of America in Washington in 1968.

She was named chief of the Army Nurse Corps in 1967 and promoted to colonel. During her four-year tenure, she made three trips to Vietnam to monitor medical care there at a time when casualty rates were the highest of the war. She was awarded the Distinguished Service Medal and the Legion of Merit.

Asked how she hoped to be remembered, Hays said in 2013, "First of all, as the first woman general, but as a very honest person, as a kind individual who did her best - and succeeded."