Official history of the canadian forces in the great war
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| should be resting on stretchers, covered with blankets, protected by serum, comforted with morphine, nourished vin SOMME - VIM Y - PASSCH END ABLE 99 with food and drink, their wounds dressed; or that they should be lying unattended on the cold field that snowy night. He was recommended to seek further back for the cause of delay. Certainly, two roads, la Targette and Brunehaut were declared impassable on quite insufficient evidence. In any case, a casual telephone message from the front at 10 p.m., that these roads were available, quickly brought 80 cars to the rescue. But this was an affair of the Corps and of the Army, not of the Divisions. The medical director of the Canadian Corps might have insisted more firmly that he have ample motor convoy under his own control to clear direct from the advanced dressing station at Aux Rietz; or, alternatively, he should have been allowed to move his main dressing station forward from les Quatre Vents to Mont St. Eloy. This judgement, it must be borne in mind, is merely one of those deliverances easy after the event. Mont St. Eloy, Bois de Bray, Ecoivres, as possible sites, were much crowded with other troops and were under continuous enemy observation. In the event of failure, or even of partial success which left the enemy guns in position, all these areas would have been untenable. Once the battle was joined and the issue probable a main dress ing station should have been opened forward at Mont St. Eloy. In spite of these difficulties all the advanced dressing stations were cleared by 2 a.m. on the morning following the battle; and in those 22 hours 5,976 cases were either safe in the casualty clearing stations or warmly housed at les Quatre Vents. During the three days 9th-llth April, 1917, the casualties, wounded but exclusive of killed, were 7,350; the enemy casualties cared for were 706. The stretcher cases were 4,265 and the walking cases 3,791. The 100 MEDICAL SERVICES CHAP. usual ratio of stretcher cases to walking cases is as one to three; in this battle the heavily wounded were the more numerous. After Vimy and before Passchendaele the only major operation which required a change in medical arrangements centred about Hill 70 on August 15, and 16, 1917. The battle of Arleux was fought on April 28 and 29, and the third battle of the Scarpe including the capture of Fresnoy on May 3 and 4; but these require no especial mention as the medical services operated by the customary method. At Hill 70 three divisions were engaged, the 1st, 2nd, and 4th; and the medical arrangements were purely divisional. The total number of wounded was 84 officers and 2,581 other ranks; and of prisoners of war 8 officers and 243 other ranks were relieved. For the three divisions the main dressing stations were at Noeux-les-Mines, Fosse 10, and " Toronto Junction " respectively. Evacuation was by trench tramways, except on the 1st Divisional front where the rails were early destroyed by shell fire. On other fronts they were a complete success ; trains carrying 42 wounded were dispatched continuously. This action was one of the few in which unreserved praise can be awarded to the weather; the warmth and dryness and the ample transport made the task of evacuation easy; the suffering of the wounded was kept within control. The assault began at 4.25 a.m.; by four in the afternoon the aid-posts were empty and the advanced stations reported clear; by six o clock the evacuation was 66 officers and 2,055 other ranks. The area was not entirely devoid of inha bitants, and arrangements were made for civilian casualties in cellars and tents where 1,345 cases could be entertained. Until October there was comparative ease for the medical service. vni SOMME - VIM Y - PASSCHENDAELE 101 PASSCHENDAELE The Canadian Corps took over the battle line in front of Passchendaele at 10 a.m. October 18, 1917, and delivered the first attack on October 26. By this time a change in the command of seven of the field ambulances had taken place. The new commanding officers were Lieut.-Colonels G. J. Boyee, No. 1; J. J. Eraser, No. 2; A. S. Donaldson, No. 3; C. F. McGuffin, No. 4; D. P. Kappele, No. 5; E. R. Selby, No. 8; C. W. Vipond, No. 9; T. M. Leask, No. 10; and Major H. H. Moshier, No. 11. The operation order for the medical service in the battle of Passchendaele opens with an ominous note, from the medical director of the Corps, which reads : " It is ex pected that under the prevailing conditions, the evacuation of the wounded will be a matter of extreme difficulty. Owing to the almost complete absence of shelter of any kind, it will be impossible to keep cases under cover; and in consequence the wounded will suffer hardship if the weather is bad. The evacuation from the forward area can only be conducted during the day. At night stretcher parties lose themselves, as there are no land marks. Added to this, the deep soft mud, the number of shell holes, and the absence of roads, render the work of carrying stretchers extremely arduous. During the present fighting, it required six men to a stretcher, six hours, to carry from the regi mental aid posts to the nearest point where wheeled trans port was available. These men were then completely worn out. It is therefore estimated that 400 stretcher bearers per brigade will have to be detailed in addition to the ordinary medical personnel." This order is dated 21st October 1917, and the gloomy prediction was amply fulfilled. The casualties were: killed 3,130; wounded 12,076; missing 947. In this battle 102 MEDICAL SERVICES CHAP. all four Canadian divisions were engaged; the 1st and 2nd each made one tour in the line; the 3rd and 4th were en gaged twice. The last tour of the 3rd, however, was only for a few days, and was merely holding a position previous to handing over to a new corps. The divisions were in the line for each tour, eight to thirteen days, and then went out of the line to the rest area. The medical arrangements were partly corps and partly divisional. The divisional medical arrangements concerned the advanced dressing stations, clearing the front, and evacuating sick to the corps dressing stations. There were two divisions in the line, at one time. For the first tour the 3rd, and 4th were in the line, with the 4th on the right and the 3rd on the left. These divisions had their own advanced dressing stations, which were moved according to the need. The main dressing stations were operated under corps arrangements, and were disposed as follows: Vlamertinghe Mill for stretcher cases; Ypres Prison for walking wounded; collecting post for sick at Red Farm opposite Vlamer tinghe; Brandhoek for gassed cases. One casualty clear ing station was at Nine Elms, operated by the Australians, and two at Godewaersvelde. The wounded were evacuated from the front by hand, by horsed ambulances, wheeled stretchers, and light tramway, to Frost House, which was the transfer point from the 4th Division on the right. The transfer point of the 3rd Division was Bridge Farm. From these two transfer points wounded were taken back by light railway or ambulance cars to the main dressing station at Vlamertinghe. The walking cases were sent back by lorries or found their way to the prison at Ypres. The battle had been in progress for some weeks before the Canadians arrived, and disaster dogged every corps in volved. The Canadian commander refused to engage until he should have taken measures which, if they would not vm SOMME - VIMY - PASSCHENDAELE 103 ensure success, would at least render disaster improbable. One of these measures was to make certain that his wounded could be evacuated. Nothing so strengthens morale as the certainty of such relief. For a whole week his sappers were engaged in building plank roads, pushing up light tramways, and preparing those movable pathways known as " bath-mats." For the Canadians the battle opened on October 26, in heavy rain. The first walking wounded arrived at Somme Redoubt, where wheeled transport was available, at 6 a.m. The stretcher cases began to arrive an hour later. By 2 p.m. the aid post on the right sector was clear, and by 6 p.m. all aid posts and advanced dressing stations on the whole front of the right sector were free of wounded. On the left sector infantry bearers rendered great assist ance. From Somme Redoubt the further evacuation was made easy by wheeled stretchers over the plank road and by the tramway that worked alongside, and carried patients as far as Culloden Junction. Three broad gauge trains con veyed the walking wounded from Ypres Prison to Gode- waersvelde, and another train from Vlamertinghe cleared those cases which had come down by light railway from Culloden and Bridge Farm. By this means ambulance cars were kept off the roads, and even the motor convoy was much relieved. The whole front was cleared in 12 hours. The Chaplain Services, the Red Cross, and the Young Men s Christian Association combined their efforts, and at arranged places provided hot drinks and food, stoves, fuel, clothing, and cigarettes. The supply of blankets was un failing. The action was resumed on October 30, and the med ical arrangements were nearly identical. The weather was fine but very cold. Later in the day rain fell, but by that 83635-S 104 MEDICAL SERVICES CHAP. YIII time the wounded were cleared. The first cases arrived at 6 a.m. ; the whole front was free of wounded by four in the evening. In the final actions, November 6 and 10, evacuation was easier, as trench mats were in more general use. The walking wounded began to arrive at 7 a.m. ; by 3 p.m. both sectors were clear; by 5 p.m. 800 wounded had passed through Ypres Prison, and 350 through Vlamertinghe, most of them stretcher cases. In this action Captain R. A. Ireland was killed; Captain K. A. McCuish, who took over, was wounded at once, and died next day. CHAPTER IX THE SURGERY OF THE FRONT The number of wounded in the Canadian army pass ing through medical formations was 144,606. The number of troops overseas was 418,052. The ratio of wounded was, therefore, 34-59 per cent, that is, more than one person was wounded out of three who served. Of these wounded, 16,459 died, that is 11-4 per cent. Nearly nine out of ten recovered in some degree from their wounds. The extent to which modern surgery, civil and military, triumphed is contained in that statement. For comparison, exclusive of overseas troops, the Brit ish wounded were 1,583,180. The enlistments were 4,970,902. The percentage of wounded in all areas was therefore 31.84. Amongst those troops employed in France the percentage of wounded was 37.56. The total British battle casualties in France, including killed, died of disease, wounded, missing, and prisoners, were 55 . 99 per cent; that is, of every nine men five became casualties, of whom more than three in nine were wounded. The surgeon had no unfair advantage. From his point of view never was a filthier war waged. From time imme morial Flanders has been the battle-field of Europe, and in the intervals of peace the land was most carefully farmed. The inhabitants gather up all excreta, their own included, 105 83635-8J 106 MEDICAL SERVICES CHAP. like crumbs from a rich man s table; and this by-product is an important element in making up the economic profit and loss account of the individual. The soil is deeply in fected. With the disturbance of the ground by trenches, graves, and shells, the infection was general and virulent. Tetanus came into its own; but not for long. Early in 1915 the menace was grave. The proper serum was used. The danger passed. The supply became deficient and the menace recurred. With ample supplies the infection was brought under complete control again. When the fighting was at its worst, and even one base hos pital was receiving five hundred wounded every day, a week would pass without more than one case of tetanus being discovered. The surgeons of this hospital No. 3 Canadian General observed from their experience that 1,500 units was the proper average preventive dose of serum; that the apparent severity of the wound was not a trustworthy indi cation of the amount to be used; that a trivial abrasion on the heel or the impairment of skin in " trench foot " allowed an infection as grave as might be expected in a heavy wound. The commandant of this hospital also observed that patients might be saved after definite signs of tetanus had disclosed themselves, as in cases of cephalic involvement and primary spasms of muscle. But it was necessary to administer the serum in doses that seemed incredibly large. Several hundred thousand units must be injected into the veins, into the thorax, into the sheath of the spinal cord, and under the skin. By these measures more than half the cases were saved, provided an early diagnosis had been made. This led in turn to the manufacture of a serum in a highly concentrated form, and to every such suggestion the British medical director gave instant accept |
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