Before describing in detail the medical work done by Nova Scotians during the War, it will be useful to give a brief outline of the activities of the Medical Service in war.
Medical attention is required all the way from the recruiting and training camps at home, and those in England and France and along the lines of communication, up to the front areas and fighting Units in the firing line, No Man’s Land and the hand-to-hand encounter in the enemy trenches. But perhaps the function of the Medical Service which calls for the greatest vigilance and most thorough care is the prevention and control of epidemic and contagious diseases.
The most strenuous efforts of the Medical Services are exerted to rescue the man who is wounded in action, and to give him such prompt attention as will prevent him, as far as possible, from bleeding to death or dying from shock or exposure and to hasten him to a place where the best surgical skill can be exercised to save his life and limbs.
The primary aid is under the direction of the Regimental Medical Officer who is assisted by sixteen stretcher-bearers and two orderlies whom it is his duty to keep in a constant state of efficiency by careful training, as unskilled men, during active operations, are constantly being added from the ranks to make up wastage. One Nova Scotia Regiment lost thirty-three per cent. of its stretcher-bearers in two hours in the Vimy Ridge engagement.
This little coterie goes into the trenches with the Unit. The Regimental Medical Officer selects a Regimental Aid Post (R.A.P.) well to the front and as far as possible out of the direct line of enemy fire, so that the wounded may be safely cared for and promptly evacuated. The stretcher-bearers are detailed four to each Company, and these go with their Companies into action and accompany them wherever they go. They are the most exposed men in an engagement; for while the combatants may advance in rushes and seek shelter as they go, the stretcher-bearer is constantly exposed, going back and forth to the relief of the wounded. As a result of the efficiency these men attain, their dressings, applied on the battle-field during action, often can go untouched until they reach the hospital.
At the Regimental Aid Post further treatment is given by the Regimental Medical Officer, food and hot tea or coffee are given and the wounded are rolled in blankets and made as comfortable as possible before being sent out. All cases are tagged, usually a white tag showing the man’s name, number, Regiment, the nature of his injury, and any special treatment or remedies that may have been given. In dangerous cases a red tag is used, which secures the right of way in rapid evacuation and immediate attention.
As soon as casualties are ready for evacuation from the R.A.P. they are handed over to the Bearer Section of a Field Ambulance to be carried to their Advanced Dressing Station. As it is practically never possible to establish the Main Dressing Station sufficiently far forward to convey stretcher cases to it in one relay, and at the same time have it accessible to motor ambulances, light railways and other means of rapid evacuation, Advanced Dressing Stations are set up as near the front as can be evacuated to the Main Dressing Station by horsed ambulances with reasonable safety by day as well as by night. The evacuation of the wounded up to this point must usually be done at night on account of enemy observation; though the walking wounded are often able to take advantage of lulls in the hostile fire and make their way out during the day. Usually arrows are put up along the route pointing the direction for “walking wounded.”
The Main Dressing Station of the Field Ambulance is provided with facilities for attending to cases requiring immediate operation as the only means of saving life. It must be remembered that this Unit is on the field of actual operations and within reach of the direct fire of the enemy. The sick and wounded are here sorted, classified and evacuated as soon as possible to the Casualty Clearing Station (C.C.S.). The few mild cases that can be returned to the line or sent to near-by rest camps after twenty-four or forty-eight hours are held at the Field Ambulance, it being necessary to conserve, as much as possible, the man-power for the line.
The Casualty Clearing Station affords the next relief. This is the first Unit completely equipped for urgent, formal major operations, and some have X-ray apparatus and electrically-heated operating tables. Although cases are not carried to a finality of treatment, and are only kept until fit to move after relief is given, practically all wounds are dressed at the C.C.S. After emergent operations wounds are often packed with dressings and hurried on to a general hospital in the Lines of Communication. It must be remembered that these Units are within range of enemy guns and liable to get short notice from the enemy, by concentrated high explosive shell-fire, to vacate, or they may have to advance with the advance of their own troops. Constant action is therefore necessary to maintain rooms for the steady stream of wounded which they must always be prepared to handle. It is only the most urgent operations that are performed, such as wounds of the abdomen, chest and brain, or such wounds as are liable to become hopeless through infection or complications before reaching the base. The C.C.S. is usually located at a rail head and has access to ambulance trains for evacuation. These trains are wonderfully equipped with an emergency operating room, kitchen, dining room for up-patients and Staff sleeping berths, dispensary, medical officers, nurses and orderlies.
Now comes the first real hospital treatment. All along the coast of France and at suitable places were hospital centres such as Calais, St. Omer, Le Treport, Le Havre, Rouen, Etaples and Boulogne, with General and Stationary and Special Hospitals. These centres were under an A.D.M.S., who was informed usually twice daily by the different hospitals what empty beds were available. From this information convoys (hospital trains) were dispatched from the C.C.S. to the different hospitals. These were notified by telegraph of the approximate time of arrival so that ample provision could be made to transfer by motor ambulance the patients from the train, on arrival, to the hospital.