On the Fringe of the Great Fight

by George Gallie Nasmith

Should a case of diphtheria, for example, be found in a soldier, all his immediate friends and companions with whom he had been in contact, would be swabbed to see whether they were infected. Those found to be infected would be removed from the army at once.

In a case of suspected typhoid fever the examination of serum, blood and excreta would be necessary to determine whether the case were really typhoid or not. If found to be typhoid the laboratory would be called upon to try to discover the source of the infection. The same general methods hold good in other epidemic diseases where the laboratory is capable of making the diagnosis, to see whether any danger lurks in "contacts" or "carriers" and to find the source of the infection where possible.

Very frequently material from wounds is sent in by the hospital surgeons to see whether wounds are infected. The soil of Flanders has been liberally manured for hundreds of years, and in every cubic yard of this manured soil are millions of the germs which cause gas gangrene and tetanus (lock-jaw) when introduced beneath the skin. If a wound is infected with gas gangrene or other dangerous organisms, the knowledge that they are present may materially modify the treatment used by the surgeon, and the laboratory is of value to him sometimes in determining that point.

The usual routine work of a hospital clinical laboratory was also carried on by us for the casualty clearing stations in the area, and all kinds of work from the making of a vaccine for the treatment of bronchitis in a British General to the inoculation of a civilian child with anti-meningitis serum came within our scope.

The hygiene work of the laboratory is also of a varied character: It consists of the examination of water supplies, milk and foods; the detection of poisons in water, and, occasionally, in human beings; the evolving of methods to purify effluents discharged into streams; work on poison gases and methods used to combat these, and many other things.

In each division there are some sixty water carts, each of which holds about 110 gallons. We attempted to get samples from all of these in turn, to see whether the water had been disinfected. As all the sources of water supply in Flanders, with few exceptions, contain large numbers of bacteria, and as a properly chlorinated water contains very few bacteria, it is easy to tell from a couple of simple tests whether or not the water in the carts has been chlorinated.

As we sometimes had eight divisions in our area at one time, this water control meant a good deal of work. The water carts were usually to be found at the headquarters of the unit to which they belonged, and we quickly discovered that the way to get the largest number of water samples in the shortest time was to travel by the map up and down the twisting narrow roads which intersected each other as though following the trails of the original inhabitants.

It must be remembered that four or five miles behind the front line every farm house and barn is in use most of the time for billeting soldiers, and that these farm houses are infinitely more numerous than they are in America. Little villages and towns are very frequent and many of them bear the same name as other towns and villages a few miles apart. Thus there are at least two Bailleuls, two Givenchys, two Neuve Eglises and so on. In our quest of these water carts we had to search the countryside diligently and we averaged a great many miles a day; we soon got to know every road and almost every farm house in our area.

When a cart was found it was necessary to get the man in charge of it—the water detail—in order to obtain information as to the source of supply, the amount of chlorine used, whether there had been complaints of taste and so forth. While the information was being obtained, officers of the unit would often come out to see what the trouble was and would ask questions; possibly some non-coms and men would also gather about, and the first thing we knew would be giving, to a very interested audience, a little lecture on the dangers of drinking untreated water; their interest would be greatly increased if a bottle filled with the water, to which a couple of drops of solution had been added, turned bright blue, thus showing the presence of the free chlorine. By such means a good deal of practical educational work was done, and the danger of men drinking raw water thereby reduced.

Reports of all samples were sent to the A.D.M.S. of the division concerned, who forwarded them to the medical officers of the units, with more or less caustic remarks should the samples be bad. The M.O. in turn would get after the man in charge of the water cart, who usually had some more or less plausible excuse.