Chapter VIII: The Care of the Wounded

Among the many sad sights witnessed in modern warfare, I question whether there is any more pathetic than a train of wounded men passing down from the Front. Every description of injury is noticeable, for shot and shell are not discriminating. From cases of the severest abdominal and head wounds, the patient being in a more or less collapsed condition, one turns to the laughing lad, with only a clean shot through his forearm, and who still has the exciting influence of the 'scrap' thickly upon him. But slight or dangerous, each requires attention, for owing to the grave danger of septic trouble, the smallest scratch may prove fatal. In their handling of the enormous number of casualties, the work of the R.A.M.C. will stand out in luminous letters when the history of the war is written. From sanitation, to a major operation, this Department is equal to the occasion, and one is lost in admiration at the splendid devotion to duty exhibited by this strictly scientific branch of the service.

Wounded men always possess a sad and enthralling interest to the public mind. It is not morbid curiosity alone which draws men and women to gaze upon the unhappy sufferers, rather I think it is a feeling akin to awe, for it is recognized that these men have been in the thick of it, and the imagination of the onlookers sees the courage they have displayed, and peering through the veil beholds the terrible sights they have seen. These, and similar thoughts cast a glamour over the most ordinary wounded man, and clothe him with a heroism which in all probability he of all men is most unconscious of possessing.

The variety of circumstances under which men get wounded is unbounded. Multitudes of those bowled over have never seen a German. It may be far back in the rear that a 'Jack Johnson' or 'Black Maria' (for we have many names for the German high explosive) has knocked a man out. It is all over in a moment; in the quiet of the night, or amid the bustle of the day the deadly shriek of an approaching shell falls upon the man's ear, and before he can seek for cover--even supposing there is any to hand--the roar of the explosion will probably be the last thing that he will remember before he awakes to his agony. Or nearer to the line, the whistle of an approaching shrapnel speaks of coming danger, and then a prone figure on the ground tells of one more who has been 'pipped,' to use a colloquialism of the Front. When we consider the extreme range of a seventeen-inch gun as being not far short of thirty miles, the difficulty of being out of range is at once apparent. Nearer at hand, within a few yards, an accurately thrown bomb is a fruitful source of injury to our fighting men, whilst in these days of accurate rifle fire 'snipers' mark the slightest movement at a thousand yards. In the fierce rush of the taking of a trench, men are as thick on the ground as the leaves of Vallombrosa. At such times, notwithstanding the specific orders to the contrary, men are constantly helping each other. For brotherly love will assert itself even amid the rush of battle. Here is an order from the 'Standing Orders' of the Seventh Division:--

'Wounded men.--All ranks are forbidden to divert their attention from the enemy in order to attend wounded officers or men.'

But notwithstanding this command, again and again heroic deeds are performed by combatants in their endeavour to get their wounded comrades out of imminent danger.

It was a noble deed of the Rev. Nevile Talbot, who, learning that his brother in the Rifle Brigade was hit, rushed into the zone of fire, only to find his beloved relative dead; straightway he immediately diverted his attention to the need of a wounded 'Tommy' near by. The Rev. and Honourable B.M. Peel was badly hit in the head and left leg, in charging with the Welsh Fusiliers; true, he had no right to be there from a military point of view, but I believe the O.C. had given him permission, and certainly his heroic action inspired the men, and has left a splendid memory in the minds of those who were with him. In such ways the front line of casualties occur. How are they dealt with? I will describe as briefly as possible the procedure which governs the handling of the wounded from the fighting line to the Convalescent Home in England.

(1) Nearly every Battalion has its Regimental Surgeon and
Bearers; the latter are men who are specially trained to
render First Aid, and to carry the wounded out of the zone
of immediate fire.

(2) At this point the stricken one is taken in hand by the
Bearer Section of the Field Ambulance, under the command of
an R.A.M.C. officer, who, where necessary, quickly renders
First Aid by applying a tourniquet where there is arterial
bleeding, or bandaging up an ordinary wound. These men,
whether attached to the Field Ambulance or a regiment, are
worthy of the highest praise. No courage is of a higher
order than that which enables men, devoid of the excitement
of fighting, to pass within the deadly hail of lead.

(3) The wounded man is then conveyed to the Field Dressing
Station of the Field Ambulance. This may be located in a
deserted building: a barn, a farmhouse, or some such place.
It may be even placed behind a haystack, or in a wood, but
certainly in the most sheltered position that can be found.
Here the man's wound receives more careful attention, but
with a rush of such cases it is impossible to bestow all the
care that is desired. Very hurriedly the man's clothing is
cut open, the wound cleansed with iodine, or some such
disinfectant, bandaged up again, and the sufferer is ready
for evacuation to a Casualty Clearing Station.

(4) Some miles behind the firing line, a convent, schools, or
any suitable house, or group of buildings, has been set
apart as a hospital, and under the present system greater
assistance can now be rendered to the patient. Even
operations may be performed if the case is one of special
urgency. At this point I would call attention to the
remarkable revolution that has taken place in the transport
of the wounded, through the agency of Motor Ambulances, in
lieu of the pair horse Ambulance formerly in use, and which
rumbled along the uneven roads, thereby causing an
intolerable amount of suffering to the badly stricken men
therein. The sufferers are now conveyed swiftly, and with
far greater comfort, to their temporary destinations; and
hundreds of lives are being preserved by means of this
miracle of modern times.

(5) The hospital train at the 'rail head' which serves the
district is the next experience of the wounded man. Those
who have examined these wonderful accessories to modern
warfare will have been struck by the completeness of the
arrangements. Beds of the most comfortable description,
having regard to space, are provided, whilst sitting cases
are arranged for in ordinary carriages. Furnished with a
well-appointed kitchen, nothing is left to be desired as
regards the food, and this, I need hardly say, appeals very
strongly to a man who has been living upon Army rations for
weeks or months past. There is even a small operating
theatre in the best equipped hospital trains.

(6) This brings us to the Base Hospital, where is found the
finest talent, both medical and surgical, that the country
can produce. Some of our greatest civilian medical men, in a
temporary capacity, are now rendering invaluable aid to the
remarkable cases which proceed from the fell work of shot
and shell. These hospitals, some of which are due to the
magnificent enterprise of private individuals, provide for a
very large number of patients. In one centre alone there
are eight hospitals, with fourteen beds in each. Here, too,
are working the most highly trained nursing sisters, and the
wounded man will, to his dying day, remember the patient
skill bestowed upon him by these devoted women. A patient
recently remarked to a friend of mine, who asked him whether
he didn't think the sister was an angel, 'Indeed she is,
sir, a regular fallen angel.' His adjective was a little out
of place, but he meant to describe exactly what we all feel
with regard to these splendid ministers to our need.

(7) The hospital ship next receives the sufferer, and herein
everything that modern ingenuity can devise is applied to
the necessities of the case. Landing at some convenient
British port, an English hospital train receives the wounded
man, who is speedily whirled away to--

(8) The Home Hospital, where, of course, the man remains under
the ablest care, until he is happily classified a
convalescent.

(9) The Convalescent Home is perhaps the happiest stage of the
whole curriculum, and Tommy runs a chance of being spoiled
ere he is ready for the fighting line, or, in case of
permanent disablement, for the care of his own kith and kin.

I must not forget the remarkable qualities of the Orderlies of the R.A.M.C. I have often been struck with the tender care and solicitude which they bestow upon the wounded coming under their attention. In their ranks are found all sorts and conditions of men: clergymen, medical students; indeed, the premier Earl of Scotland, the Earl of Crawford and Balcarres, enlisted as a Private in the R.A.M.C. and is now a Corporal in a Field Ambulance. Such an example cannot fail to place this distinguished branch of the Service on the highest level of utility and importance.

So far, I have more particularly dealt with the care of the wounded. This, however, is only one side of the vast work under the care of the medical side of the Army. With the lamentable effect of the evil of bad water experienced in the South African war, the Authorities have been most drastic in their insistence of a pure water supply to the Army. To-day every unit has its filter cast, and most urgent orders are in circulation forbidding men to drink from any other supply. This alone has prevented a large amount of disease.

One of the ills that our men have to contend with is 'feet.' No one, excepting those who have had to march on French and Belgian roads, can realize the pernicious effect of cobbled stones, with their many inequalities, upon the feet of the men; hence in every well-commanded Battalion frequent feet inspections are held--in many instances daily. This simple preventive, coupled with a copious supply of socks sent out by the people at home, has helped the great majority of 'Tommies' to keep their pedal extremities in going order.

The inspection of kit, from a sanitary point of view, is another important phase of the hygienic question. Where men have to exist for days without a change of clothing, it will be readily understood that the effect is extremely prejudicial to health, and therefore a medical supervision of the clothing of the men is of supreme value to their health. In many places facilities for hot baths are provided for the men coming out of the trenches, and greatly is this boon prized. One of the commonest sights behind the firing line is a detachment of men swinging along, with towels in their hands, on their way to or fro the tub.

In some places whilst the men are in the bath their clothes are carefully disinfected, and then handed back to them thoroughly cleansed and fit for further use. Notwithstanding all these precautions, there is, of course, a certain amount of sickness which is inevitable among so great a number of men, but it is significant in proportion to the numbers employed. After many months with troops I can emphatically say that the bodily care of our men, by the medical authorities, is beyond all praise, and has done much to preserve the redundant health which is characteristic of our Army in the field. 'Cleanliness is next to Godliness,' and I must add that it comes in a good second in the British Expeditionary Force in Flanders and France.

WORK AT THE BASE