Splints, of which an immense number were necessary even for the very short period in which we were actually engaged in the conduct of the war, formed a real Red Cross specialty. Our army hospitals were entirely dependent upon the American Red Cross for these necessities—the total orders for which in July and August of 1918, totaled some 15,000 to 20,000 weekly. For that entire year the output was 94,583 splints, the factories often working from eighteen to twenty hours a day to keep pace with the requisitions upon them. Our Red Cross also supplied all the nitrous oxide used in American hospitals of every type in France. The use of this ultra-modern anæsthetic, to the increasing exclusion of ether and of chloroform, forms one of the fascinating chapters of the medical conduct of the war. Although it had been employed as an anæsthetic in the United States for a number of years before the beginning of the war, its first use in Europe was when Colonel George W. Crile—the distinguished surgeon from Cleveland, Ohio—introduced it into operations in the then American Ambulance Hospital at Neuilly—afterward the American Red Cross Military Hospital Number One. That was in 1915. Nitrous oxide as an anæsthetic immediately attracted the attention of a number of eminent British surgeons.
"It is good," said Colonel Crile, tersely.
And so it is—good. It is so good that Colonel Alexander Lambert, at that time chief surgeon of our American Red Cross, immediately made it the standard anæsthetic of its medical service. For, like so many other American surgeons, he quickly concurred in the opinion that nitrous acid, used in combination with oxygen, three parts to one, is the least dangerous as well as the best adapted for use when operating upon cases of chest surgery, abdomen wounds, or of shock. Under this anæsthetic the percentage of recovery is seventy-two per cent, as compared with fifty per cent for either chloroform or ether. Moreover, it has none of the disagreeable after effects which come almost invariably with the use of chloroform or ether. To quote Colonel Lambert:
"The use of nitrous-oxide anæsthetic to the exclusion of ether or chloroform in case of at least the seriously wounded seems to me not only advisable but beyond the advisability of discussion."
Its official use, therefore, was predicated. It was first supplied to the casualty-clearing stations; American and British coöperating for the sake of an exchange of ideas as to its best use. Our Red Cross supplied an apparatus of special design that had gradually been evolved from those already devised. This allowed the separate administration of the nitrous oxide, of oxygen, or of ether—which at times was used in small quantities—or of the three in various combinations. And all our American nurses were trained as anæsthetists in its use.
The making of the nitrous-oxide gas itself was one of many similar tasks assigned to the Manufacturing Department of our Red Cross, of which Major Arthur W. Kelly was department chief. He ordered a huge gas-making plant from America which, after some considerable delay, finally was set up at Montreau, fifty miles distant from Paris. In the meantime the Red Cross had discovered a man in the French Army who had had some experience in the making of nitrous oxide. He was released from active army service and at once started to work making an emergency supply, the limited quantities carried to France by Colonel Crile having become completely exhausted. This small plant had a daily capacity of about 4,000 gallons. But when the bigger machinery from America had finally been set up—in the midsummer of 1918—this output was increased to 75,000 gallons a day. This could easily have been doubled, had it not been for a single limiting factor—the extreme difficulty of securing 3,280 gallon cans in which the gas was transported. Finally the Red Cross secured some hydrogen tanks that had been captured from the Germans in their first July defeats. It was then and not until then that the nitrous-oxide plant began running at anything like its real capacity. And with the definite result that from September, 1917, to October 23, 1918, our Red Cross was able to supply our army with 699,420 gallons of this precious anæsthetic, its own hospitals with 405,620 gallons, and some miscellaneous institutions with an additional 251,110 gallons, while it saw Great Britain formally acknowledge nitrous oxide as an anæsthetic par excellence and even conservative France making the first steps toward its adoption.
A few of the medical and surgical requisitions of a typical American Army Division—the Second—upon our Red Cross are before me as I write. They are indicative of the overwhelming demands that were made upon it, not only from every corner of the front, but from every corner of France that was occupied by our fighting men—and what corner was not?
It was at the request of the chief surgeon of this Division that one of its field hospitals—originally supplied direct from the army's own sources of supply—was amplified by the American Red Cross, by the use of Bessoneau tents and other equipment so as to become practically a mobile unit, capable of handling far heavier cases. The supplying of the equipment shown by these requisitions began while the division was still in the vicinity of Montdidier and continued until after it had moved to Meaux and was in active preparation for its great rôle at Château-Thierry. In addition to the Bessoneau tents, the following were the requisitions which were delivered to this single formation while it was under heavy pressure: