AT THE SIGN OF THE RED CROSS
Regimental Aid Posts—What Night Fighting is Like—The Young Doctor—Making the Grave Bigger—Field Dressing Stations—Where Caution is Required—Where Pluck is Shown—When Does the Doctor Sleep?—Nothing but Tragedy—Those Grand Tommies—Winning a V.C. Clasp—A Dreadful Scene—A Kitchener's Train—Devoted Nurses—The Healthiest War—Preventive Measures—Hospital Ships.
So complete is the organisation of the Red Cross at the front that it is possible to indicate its work in four terms—Regimental Aid Posts, Field Dressing Stations, Clearing Hospitals, Base Hospitals. Add to these the Home Hospitals, to which the men are finally transferred, and you have the work of the Army Medical Organisation at a glance.
During this war the cryptic letters R.A.M.C. and M.S.C. have interpreted themselves into actual glorious service which the British public will ever delight to honour, and it will be borne in mind that most of the Christian ministers who have enlisted during this war, have enlisted into this branch of the service. They bear no arms, but theirs is the highest of all service, that of ministering to the wounded and dying. Such work as this requires heroism of the highest order.
Let us glance at each branch of the work, that the service of the Red Cross may live before us.
1. Regimental Aid Posts.—Just a little behind the firing line, as near to it as possible, often exposed to shell and rifle fire, is the Regimental Aid Post. It may be in a cottage, possibly in a cow-shed, perhaps only under the partial shelter of a hill, with a doctor and a few men of the R.A.M.C. in charge. To it are brought as quickly as possible the men wounded in the firing line. During recent months, however, it has been impossible to bring the wounded even this short distance during the day. It has only been at night that the men in the trenches could remove their wounded hither, or the stretcher-bearers could go out to seek for them. The fire has been so terrible that no one could venture into the open. The men have had to lie where they fell, often in agony, waiting until they could be carried to the aid post to receive first aid from the doctor waiting for them. But the doctor does not always wait; he goes where he is needed most, right into the trenches, risking his life at every step, and there ministers to those who cannot wait to be brought to him.
The Rev. E.L. Watson (Baptist chaplain) vividly describes one such outpost as I have indicated.
"In the vicinity of the trenches star bombs were constantly being thrown up, causing whole lines of trenches to be under the weird flare. German search-lights swept the whole of the surrounding country, bringing to light every movement of the troops not under cover.
"For one brief moment the shaft of light rested on me as I stood watching the scene of battle. The experience is equal to an unexpected cold douche. Night fighting under modern science is, I should imagine, hell let loose, and the surprise to me is that so many should survive the inferno.
"From 8 P.M. to 8 A.M. the rush was terrific. In one of the field hospitals no less than seventy odd wounded were treated, about twenty of these requiring chloroform.
"Be it remembered that each case is hastily but carefully dressed by the regimental doctor at the Regimental Aid Post before coming in to the field hospital for more thorough treatment, then one realises the enormous amount of work that often falls to the men occupying these positions of grave risk and tough work.
"These gentlemen are night and day at the call of the man in the trenches, and gladly make any and every sacrifice to render needed medical and surgical assistance. Each trip they make to the line of fire means that they carry their lives in their hands; for there is more danger getting into the trenches than actually exists in the trenches, because most of the fire passes over our trenches and sweeps the approaches night and day.
"Some few days ago, I had occasion to spend some time with a young regimental doctor in his lonely outpost. We were drawn together by common interests and promised ourselves a smoke night together. The first case that met my gaze in the field hospital was my friend the young regimental doctor, fatally wounded whilst going in the rush of work to render help to the wounded.
"Perfectly conscious, he said as he took my hand, 'You see, Padre, they have claimed me at last. I always felt it would come.'
"Calmly he dictated a brief message to his young wife and child, then bravely waited for the end. He knew exactly the nature of his wound and was quite prepared for the surrender of his soul to God. He accepted his end as nobly as he had striven to do his God-inspired work. The real tragedy of this is in the house yonder in England made desolate by this cruel war."
So does the Regimental Aid Post doctor give his life for his country.
The Rev. Owen Spencer Watkins (Wesleyan) gives us another picture of a Regimental Aid Post.
"Near the trenches in a deserted farm by the roadside is the Regimental Aid Post which last I visited. Two regimental doctors have made it their headquarters—Captain Brown and Lieutenant Eccles—and thither are gathered the sick and wounded belonging to the Manchester Regiment and the East Surreys. I had been sent for to bury the dead. As usual on such occasions, I went out with the bearers and ambulance waggons after dark, and when I arrived I found three men waiting burial. Two as they stood side by side had been killed by the same bullet, the other had been shot whilst issuing rations to his comrades in the trenches.
"'You've timed your visit well, Padre,' said Captain Brown. 'There's been a bit of an attack on. Enemy evidently got the wind up badly, and have been loosing off wildly in the air. Bullets have been falling around the house like hail; half an hour ago you couldn't have got to us. One comfort is that if the bullets were falling here, they must have been going high over the heads of our fellows.'
"'Yes, we're ready for you as soon as ever the waggons are loaded, but Eccles has a man of the East Surreys; perhaps the grave had better be made bigger, and then you can make one job of it.'
"A few minutes later we were passing through the farm-yard at the back of the house, mud over our boot tops, into a field, in the corner of which a little cemetery had sprung up. 'Twenty officers and men, most of them Manchesters,' Brown said in an undertone. 'Winnifrith buried three here last night, and two the night before. No, you need not be afraid to use a light to-night. The weather is too thick for it to be seen by the enemy, and in any case they're busy, for our fellows are attacking. Listen.' Again the angry voice of the machine-gun, the noise of rifle fire, so heavy that it sounded like the bubbling of water boiling in some gigantic cauldron."
2. We pass now to the Field Dressing Stations. It appears to be only when the fighting is severe that these are needed in addition to the Regimental Aid Posts. Sometimes the wounded are taken direct to the clearing hospital from the Regimental Aid Posts; but when the wounded crowd in upon the latter, they can only receive rough first aid treatment there, and are passed back as quickly as possible to the Dressing Station.
This is carefully explained in a letter by Staff-Sergeant Barlow, R.A.M.C., to the Vicar of Prestwich. "Perhaps it would be well to explain where our work as a field ambulance comes in. We are not in the sense of the word a hospital. In the first place a regiment is in the trenches, and in close proximity to the trenches, the regimental bearers carry their wounded to some place of cover or comparative safety, such as a barn or farm-house, or in the case of a town being shelled, cellars are used. These are called Regimental Aid Posts.
"As a Field Ambulance we follow from one to two miles in the rear of the firing line and form dressing stations, using schools or barns for the purpose. Our ambulance waggons and stretcher-bearers go out under cover of darkness to collect from the Aid Posts the wounded soldiers, the waggons halting perhaps half a mile away, while the bearers cross fields and roads to the Aid Posts where the wounded soldiers are.
"This is very dangerous and requires much caution; lights are prohibited, as even the flare of a cigarette becomes a good mark for the enemy's snipers, of whom they appear to have many.
"Each regiment forms its own Aid Post. One ambulance unit attends a brigade. After the wounded are brought to the dressing station, the wounds are redressed, and the soldiers are as soon as possible despatched to the clearing hospitals at the base."
Staff-Sergeant Barlow proceeds to describe his first impressions of this awful work:
"What were my first impressions? you may ask. They were such as I can never forget. We were halted near a farm-house, the tenants of which had cleared out, leaving fowls and pigs unattended. The pigs could not have been fed for several days, as they were shrieking for food; we called it crying. The pigs were fed with food from the lofts. Dinner was served to the men (army biscuits and jam), in the midst of which an order came for an ambulance waggon for a wounded man.
"We were all astir, and it was the first casualty we had had to deal with. The waggon went out, and later several stretcher squads and other waggons. The remainder had to fall back about half a mile to a small village to prepare a school and church for the receipt of the wounded.
"My first thoughts were: What is it like; shall I be able to stand the sight of it? In the evening our waggons began to return, bringing many wounded. The medical officers rolled their sleeves up and set to work. My duty fell to assisting by taking off the dressings from the wounds, the first one being that of a soldier with part of his elbow blown away. It looked awful, but I got over it very well. Why? Because we had not time to think of it. There were others to attend to, most patiently waiting—and I think it is in such circumstances as these that one can see the true pluck and courage of the British soldier,—with here and there one pleading for attention.
"Everyone worked hard; the hours passed as minutes, and when all were attended and we looked in solemn silence around, I turned to a comrade and asked the time. He answered it was after 4 A.M. I thought it was midnight. We had dealt with 134 wounded, among whom were several Germans. Under a shed in the school-yard lay five men who had died after being brought in; they were reverently buried in the local cemetery. Since this we have had worse and much of a similar nature, but they have become a conglomeration of events. It is the first night with the wounded that lives, and through it all a voice within me continually saying: 'And this is war.'"
3. Away behind the firing line, in some quiet spot unreached by shell or rifle fire, is the Clearing Hospital. To this spot come the ambulance waggons bearing their ghastly freight of broken bodies gathered from Regimental Aid Posts and Dressing Stations.
The doctors are busily at work. Night is their busiest time. We wonder when the doctor at the front sleeps. We wonder with how little sleep it is possible to support life. These men seem tireless. Hour after hour through the night they toil on, probing here, amputating there.
This is where we see in all its horror the meaning of that new word "frightfulness." I cannot describe the scenes that may be witnessed. I have before me, as I write, copies of Guy's Hospital Gazette from the beginning of the war, kindly supplied me by the Editor. It is necessary that descriptions of the horrors should be written for professional eyes, but I will not harrow the feelings of my readers. I turn away from their perusal echoing the words of Staff-Sergeant Barlow—"And this is war."
A RESCUE PARTY.
Systematic search is made for the wounded, who often crawl away in the hope of reaching their own lines.
Drawn by Sydney Adamson.[ToList]
I will rather let the Rev. E.L. Watson (Baptist chaplain) describe to us, as he saw it, the work at such a Clearing Hospital.
"In the same ward were many wounded upon the floor stretchers, lying still in their soaked and muddy clothes just as they had fallen, with bloody bandages showing up in dreadful contrast against their poor soiled bodies. Some delirious, others lying in profound silence, but noble fortitude. In a ward like this one sees nothing but tragedy.
"In the receiving room the R.A.M.C. officers were working at highest pressure to save life and limb, by steady hand and cheery manner imparting confidence and hope to every patient in turn.
"I could not help expressing admiration for the way in which each piece of work was carried out, but the officer commanding simply said, 'You know, Padre, we cannot sacrifice enough for the man who is standing up to this hail of hell for us.'
"I was surprised to see such a large percentage of officers among the wounded. No wonder our men are proud of their leaders; where risks must be taken, the officer claims this as his privilege and thus shows the way in every undertaking. One brave major leading his men into the German trenches, when hit, simply shouted "Go on!" as he fell wounded in the head. He is being buried to-day, as every brave soldier desires, in his uniform and blanket."
It will be perhaps as well to look at a similar scene through a doctor's eyes, and I therefore quote a letter from a medical officer at a receiving base in France published in the Scotsman.
"We get the wounded here at practically first-hand. They are brought in with all possible speed, dealt with at once, and sent out to other hospitals as soon as we can send them, to make room for the others who may (and who invariably do) come. They're wonderful chaps, those Tommies. Great stuff; too good to lose! They are brought to us at all hours. Exhausted, covered with mud, hastily but well bandaged on common-sense principles; and aye the quiet, plucky grin, or the patient, enduring set of the jaw.
"'What price this little lot, doctor? '—and the querist indicates where the bullet entered his thigh. 'And me futball leg, too!' growled another one, brought in dripping one night. 'And who will do the schorin' fur the ould tame now? All the same, sir, I schored ag'in' the man that did this, or wan av his side.' Man, they're wonderful! They tell us, under the nervous stress in which we usually find them, some things that have made me wish to lay my eye to the sights of a rifle, despite my bay windows. They tell them in such a matter-of-course fashion, too, that they simply sink in.
"'When did you get this?' I asked a man wounded in both thighs.
"'Yesterday morning, at eight, sir; chargin'. Dropped between their trenches an' ours. Half a dozen of others there too, all wounded, lay there all day. Those snipers poured lead into anything that showed signs of life. Chap next to me was badly hit, and inclined to move. I warned him twice to lie flat an' not squirm, as the Germans were watchin' for every move, an' would plug him, wounded or not. He stuck it steady for four hours. Then he tried to roll over, an' showed a shoulder. Got it. Soon's the snipers couldn't see me after dark, I started to drag myself back, an' met some of the boys out to look for us. It was more than seven to one against us that day.' And so it goes on.
"It's a great experience this. As a surgeon, I know its value. But I wish it was over. It's awful. The stream of wounded seems unceasing, and sometimes I ask myself, when I've time to realise it at all, how long I will be able to meet this strain. We must do our work, however, and I'm proud to do it for those grand men the Tommies."
It is, of course, difficult to single out for mention the names of doctors who are doing this heroic work at Regimental Aid Posts and Dressing Stations. Where all are heroic particular mention would be invidious. There is, however, one outstanding name—Lieutenant Arthur Martin Leake, R.A.M.C. I mention him because he has been the recipient of a unique distinction. He served through the South African War and there won the V.C. for conspicuous bravery. Having won the V.C. it could not be given to him again, and so a clasp has been added to the Cross.
The brief official record is as follows:
"Lieutenant Arthur Martin Leake, Royal Army Medical Corps, who was awarded the Victoria Cross on May 13, 1902, is granted a clasp for conspicuous bravery in the present campaign.
"For most conspicuous bravery and devotion to duty throughout the campaign, especially during the period October 29 to November 8, 1914, near Zonnebeke, in rescuing while exposed to constant fire a large number of the wounded who were lying close to the enemy's trenches."
So far as I know this honour is unique. Probably Lieutenant Leake would say that he is no braver than scores of other doctors who are nobly doing their work at the front, but he has had his opportunity and he has used it, and by so doing has brought honour upon the whole medical profession. Great is the man who fearlessly "takes occasion by the hand" in the cause of humanity.
When all that can be done for the men at the clearing hospitals is accomplished, they are despatched to the rear. Those who, in the opinion of the medical staff, can bear the journey to this country are despatched thither direct via hospital train and hospital ship. The majority, however, are taken to the base hospitals, where they lie until they are well enough to be sent home, or death eases them of their pain.
In the early days of the war this transit to the base was difficult in the extreme, and the wounded arrived there in a shocking condition. It is as well, perhaps, that we should know what really happened, so I copy a paragraph from Guy's Hospital Gazette of November 7, 1914. It is from a letter signed "G.H.F.G."
"The train has just arrived and even now some few wounded are being removed from the waggons, the gravest of all being given treatment in an improvised hospital by the sidings, others less serious, though bad enough in all conscience, are carried on stretchers to the central goods shed, where the commandant, aided by a large staff of excitable, bearded assistants, directs to what hospital they are to be sent.
"For some minutes we watch the unloading of these waggons. Preceded by orderlies the officer passes from door to door, entering some, and questioning briefly the men lying full length or sitting in what comfort they can upon the straw-covered boards. As the panel slides back a fetid odour of pus reaches the nostrils; startled by the unexpected brightness a couple of horses tethered at one end of the truck stamp and whinney. Carrying an acetylene flare, which makes weird effects of chiaroscuro on the bare walls and floor, an orderly comes in and collects the histories of the men. One man, wounded in the head, persists in taking him for a German, the others laugh and point to their foreheads. A little further on, in second and third-class carriages, men with arms in slings, and less serious body wounds, crowd in the corridors and clamour for food and drink."
What wonder after this that we are told that most of the wounds received in those early days were septic on their arrival at the base hospital?
How different it all is at the present time! Now well-appointed hospital trains move backwards and forwards from the clearing hospitals to the base. For the first time we enter the nurse's sphere. Everything changes when the nurse appears upon the scene. She loves order. Cleanliness is her life. She is trained in all the little arts of nursing which bring comfort and peace. She can do what no man can do. The doctor is splendid at his own special work, the stretcher-bearer, the ambulance man, and the hospital orderly at his. But it remains for women to do what man can never do, and with her light touch, and tender sympathy, to soothe and comfort and bless.
When pain and anguish wring the brow
A ministering angel thou.
The hospital trains are called "Kitchener's trains"—another tribute to the great man who, from his room at the War Office, seems to overlook everything and forget nothing.
Miss Beardshaw, writing to her old hospital—Guy's—gives a description of one of these hospital trains well worth reproduction here.
"Ours is known as the 'Khaki Train '—a Kitchener's Train; it is half Great Eastern and half L.N.W. There are 220 beds, stretcher ones, two layers. In between each carriage is a little department, a place for plates, mugs, dressings, &c. The officers' and sisters' part is at one end with their kitchen. Dispensary in the middle. Patients' kitchen and orderlies' quarters at the other end. There are three medical officers, one army sister in charge of wards A and B and the general run of all our work. I have C, D, and E wards, and Miss Wilson has F, G, H; a 'London' nurse has the three others. The army sister is an old Guy's, so I think we shall be very happy together. There are forty-five orderlies. The paint of the train white, bed frames dark red, curtains green, and blankets dark brown, so the general effect is very pretty. It is kept most beautifully clean, and the orderlies are very proud of their train—the best on the line, they say. We go up and down to the clearing station, so I am greatly looking forward to seeing Sisters Kiddle and Ames. I do hope they will not be moved before we get there. We often take convalescent patients about, often to Havre. Have been between Havre and Rouen twice these last few days."
What a picture this gives us of organisation at its best! "Beautifully clean!" Surely this is just what is needed, and we cannot wonder that over sixty per cent. of the wounded are able ere long to return to the firing line.
4. And then after the journey in the hospital train de luxe, there is the Base Hospital, with everything in perfect order, and all that can be done for the wounded men. I have written about the work in the base hospitals in the chapter on "Work at the Fighting Base." It is not necessary, therefore, that I should linger here. I will, however, add a tribute which the Rev. R. Hall (Wesleyan) pays to the nursing sisters. Says Mr. Hall:
"I must say a word about the nursing sisters. No braver and truer women ever lived, kind and gentle and brave in the face of disease and death. By day and night they watch and care for our comrades; many a lad's dying hours are made more comfortable by the gentle touch and loving word of these devoted women.
"I heard one day that in another hospital seven miles away one of our own men was dying. I went over and found that he was isolated; he was dying of an infectious disease. He was in great agony. A sister stood beside him, and was trying to comfort him and ease his pain, at the same time the tears flowed freely down her cheeks.
"I have been profoundly impressed by the work of this branch of the Service. We forget sometimes that it is easier to face the shell and the bullet in the excitement of battle than it is to watch hour by hour and tend to those who are suffering from some deadly infectious disease, or from some ghastly wound received in battle."
Mr. Hall's tribute is surely well earned. In this war woman has been as brave as man or braver. She has given of her best and dearest, she has worked and prayed and endured. And away out there among our wounded and dying, far from the excitement of battle, by day and by night she has given herself—all she is and all she has—to the service of her country. And in doing so she has earned the undying gratitude of those to whom she has ministered, and of the land she loves so well.
I turn now to consider another branch of Red Cross work at the front—the treatment and prevention of disease.
This has been the "healthiest" war ever undertaken by the British Army. The great problem of all armies is how to keep out infectious disease, and never before has the problem been solved. If still not completely solved, it is certainly in the fair way to solution.
In the campaigns of the forty years previous to this war the proportion of sick to wounded was twenty-five to one, and of deaths through disease to death by shot, shell, or bayonet, five to one. In the South African War the proportion of sick to wounded was over four to one. We all remember the terrible share that enteric had in the wastage of that campaign. How the soldiers dreaded it. "Better," they used to say, "three wounds then one enteric."
Now enteric has almost entirely disappeared. Speaking in February 1915 the Under Secretary of State for War said that so far during the campaign there had been only six hundred and twenty-five cases in the British Expeditionary Force and of these only forty-nine had died—a percentage of deaths less than half as great as that among the victims of typhoid in the forces still in this country.
Of typhus and cholera there had not been a single case. Strange to say, one hundred and seventy-five of the men had had measles, and among these there had been two deaths. One hundred and ninety-six men had had scarlet-fever and there had been four deaths. How far the healthiness of the climate affects these figures it is difficult to say, but it must be remembered that it has been a terribly wet winter.
How far inoculation against typhoid has prevented the disease is also an interesting question. The doctors have a note of victory in all their statements on this subject, and the figures seem to justify their satisfaction.
Certainly preventive measures have counted for much. Early in the war the medical officers of the various ambulances acted, so far as time permitted, as sanitary officers, and in later days a well-organised Sanitary Section has accomplished great things. The cleansing of camps, the appointments of sanitary offices, the provision of baths, and, generally, every possible attention to hygiene, have kept our men exceptionally free from sickness, and no praise can be too high for the men who have accomplished so much for the British soldier.
ON THE MARNE.
The pet dog of a French regiment finds wounded soldiers and brings the stretcher-bearers to them. This dog has learnt to dig himself a hole when firing is going on.
Drawn by E. Matania.[ToList]
On the other hand, of frost-bite there have been over nine thousand cases. It is questionable, however, if the vast majority of these cases are really cases of frost-bite. Medical opinion inclines to the view that most of these are a new disease known as trench foot, caused by standing in the trenches with putties too tight and boots too small.
Guy's Hospital Gazette publishes some remarkable figures. "On one occasion a rifle brigade after marching fifteen miles went at once into the trenches, and within forty-eight hours, over four hundred were incapacitated through the foot trouble described in this report. One hundred and eighty men of the Cameron Highlanders were in the trenches without being relieved for eight days and only three suffered from slight frost-bite. None of them wore anything upon their legs and feet, except boots, which may explain the sparsity of cases."
If this be so, then frost-bite of this description is also largely preventable, and the recommendation of the doctors as to large, easy fitting, and water-tight boots, less tightly bound putties, &c., will prevent most of this trouble in future.
On the whole, the country can congratulate itself very heartily on the noble and successful work of the various Red Cross departments. The doctors who have sacrificed their lives will not be forgotten, and will be regarded as heroic as any officers who have led a charge from the trenches. The nurses have earned a debt of gratitude we can never repay. Nursing efficiency has gone far since "Our Lady of the Lamp" moved with such tender dignity up and down the wards in the hospital at Scutari. We would pay our tribute of admiration to the work of our nurses in this war, and say, "Many daughters have done virtuously, but thou—thou modern lady of the lamp—excellest them all."
I must not close this chapter without a word about the well-appointed hospital ships which ply backwards and forwards between the French and British coasts, each with its doctors, nurses, and chaplains on board, bearing a freight of suffering humanity, such as our coasts have never seen before. Everything in order, everything in the way of comfort and ease provided. It was a dastardly act to aim a German torpedo against the Asturias. Fortunately the attempt failed, but what profit would it have been if this life-giving ship had been sunk? Enough surely has been done to take life. The object of such ships as these—ships which cannot be mistaken for any others—is to woo back to life, until their suffering humanity can be tenderly placed in the care of loving hands and hearts at home. Here we are waiting for them, and here we have a right to expect them, that, nursed back to health in the hospitals of our land, they may, by and by, greet wife, and mother, and child, and sweetheart in their own homes once more.
But oh the cruel work of war! The legacy of broken bodies and broken hearts! We look on, and look up to the City of God even now coming down from God out of heaven. Sursum corda! The hour of redemption draweth nigh.