Official history of the canadian forces in the great war




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for considering the origin, development, and constitution

of a field ambulance. Out of that will arise certain general

observations upon its operation and way of life. From

the time that men began going to war they have had some

concern for their wounded, if not from motives of humanity

at least from prudence, so that being restored to health

they could fight again. The field ambulance is the essen

tial battle formation for this ancient task.


War is as old as the race, and wounds go with war;

but there has always been a medicine of some kind to

meet the need. At the siege of Troy, Podalirius and

Machaon were detailed for medical duty and given exemp

tion from all other, and Hippocrates alludes several times

to medical service in the army. His son Thessalus was

on the strength of the expeditionary force which Alcibiades

commanded in Sicily. He was without pay and allowances,

but on ,his return he was awarded a crown of gold. In

the Crissaean war the medical officer had a technical galley

with complete equipment, and the Spartans had a good

service. In the Persian armies the medical oflfrcers were

obliged to attend the enemy wounded as well as their


own.


In the Roman army the development of the medical

service is easily followed. Pliny affirms that the Romans


64


CHAP, vi THE FIELD AMBULANCE 65


were without physicians for four centuries, and in his

opinion they were little the worse for the lack. The

soldiers bandaged their comrades wounds. At times, if

we can believe Dionysius, they bandaged themselves, even

if unwounded, a self-applied bandage being a neater device

in malingering than a self-inflicted wound.


After the battle of Sutrium (311 B.C.), Livy says,

more Romans perished for want of attention to their

wounds than had fallen on the field. Polybius, writing

in the second century, although he described a Roman

camp in detail, says nothing of any provision for the

wounded. The only physicians appear to have been those

whom the commanders or officers took into the field with

them for their private service. Later, however, and

possibly owing to the example of the Greeks, the Romans

along with standing armies established a regular medical

service. The first writer who alludes to them is Onosandros

(1st Century A.D.), but he speaks as if the custom were

not recent. A libertus named Claudius Hymnus, physician

to the twenty-first Legion, was honoured with a funeral

monument in the reign of Claudius. In the time of the

Empire, Medici Ordinarii made regular visits to the sick

even in time of peace, and in case of serious illness the

patient was taken to the Valetudinarium. The physicians

accompanied the troops on marches and in the field; on

the column of Trajan they cannot be distinguished from

ordinary soldiers. The Emperor Aurelian, when military

tribune, forbade medical officers to take fees from the

soldiers; the abuse then must have existed in the 3rd

century. As early as the time of Cicero there were special

tents for the sick. Each camp had a hospital situated on

the left of the Porta Praetoria under the direction of an

inferior officer called Optio Valetudinarii. The medical di

rector was an official called Medicus Castrensis, who was

responsible to the Praefectus Castrorum.


66 MEDICAL SERVICES CHAP.


The solicitude of commanders for the wounded is often

praised during the period of the Empire. Trajan took off

his own garment to make bandages for the wounded. Alex

ander Severus provided carriages to follow the army for the

benefit of the sick. When Valentinian was wounded there

was no physician to attend to him, as all had been sent

forward with the troops, but we do not read of any measures

taken to supply the needs of enemy wounded. The first

mention of an ambulance is in the reign of the Emperor

Maurice (582-602). A corps called o-Kpifiaves or S^Tronrarot

was set apart for this purpose. Leo the Philosopher

(886-911) augmented the number of the corps, and added

water carts to the equipment. In the navy the medical

officers were known as Duplicarii because they were

awarded double pay. According to Galen an ophthalmic

surgeon was attached to the fleet which invaded Britain.

The military status of the medical officers was even in those

days unsatisfactory; and there is yet extant an acquittance

roll in which their names are set apart between the officers

and the other ranks. 1


The almost continuous wars during the reigns of Wil

liam and Mary, and Queen Anne, led to the appearance of

field hospitals. Such hospitals existed in the army of Henry

of Navarre and during the war for the conquest of Granada,

but William III was the first to realize their importance to

a British army in the field. They were called marching, and

later, flying hospitals, to distinguish them from the general

or " fixed " hospitals at the base or on the lines. They were

first employed during the campaign in Ireland. They came

up after action, took over the wounded on the field, and

transferred serious cases to the " fixed " hospitals at the

base. They had before them precisely the same functions

as now fall to the bearer and tent division of a field am-;

bulance and the casualty clearing station. They had a


vi THE FIELD AMBULANCE 67


special medical personnel. They had nurses, transport,

drivers, and men-servants who carried arms. These hospi

tals disappeared from the army after Marlborough s

campaigns, and did not reappear until the 19th century. 2


The field ambulance, as it is organized to-day, is a crea

tion of the South African war. In that war each brigade

had as part of its establishment one bearer company and

one field hospital, and each division had in addition a field

hospital of 100 beds. These units were independent of one

another. There was no continuity of control. At one mo

ment the officer commanding the bearer company, and at

another the officer commanding the field hospital, might

be the senior medical officer of the brigade. In 1901 a War

Office committee recommended that the functions of the

bearer company and those of the field hospital should be

combined, and four years later this recommendation was

put into effect. The new unit was the modern field ambu

lance. In the Canadian service one was detailed to each

brigade of infantry as divisional troops; at a later date

an additional unit as corps troops was formed for corps

purposes.


As now constituted a field ambulance consists of two

divisions, a bearer division comparable with the old bearer

company, and a tent division to perform the duties of the

former field hospital. These divisions are further divided

into three sections, each section being composed of one-third

of the bearers and one-third of the tent division. An am

bulance will then consist of three small units which are

capable of performing the duties of bearers and of hospital,

having accommodation for 50 patients each or 150 in all.

The arrangements for mounted troops are slightly different,

there being two sections instead of three. 3 The peculiar

quality of a field ambulance is the ease with which it can be

resolved into its component parts for any specific duty and

assembled again when the task is done.


68 MEDICAL SERVICES CHAP.


In the British army the field ambulance as a rule

served an infantry brigade and all the other arms and ser

vices in that group or area ; in the American army the corre

sponding unit known as a "section" served a division; in

the French army there was also a divisional group of bearers,

known as brancardier divisionnaire ; but they had in addi

tion 16 regimental bearers as the British had. Once a

patient arrived at the poste de secours he passed out of the

medical service and became a problem for the transport.


The personnel of a field ambulance is formed by 9

medical officers and 238 other ranks. Of the officers one is

a lieutenant-colonel; two are majors, and six captains.

There is in addition a quartermaster; a dental officer and a

chaplain are usually attached. The transport consists of

15 riding horses, and 39 draught horses. The horse and

motor drivers to the number of 36 are technically attached

from the army service corps, but for all practical purposes

they are part of the formation. 4


This transport is all first line, an integral part of the

war organization, and ready at all times to go into action.

The number of horse-drawn vehicles in the end became

fixed at sixteen, with three ambulance wagons added. Of

these, three were water carts, four limbered wagons, seven

general service wagons for technical stores and baggage,

one Maltese cart and one travelling kitchen. Four spare

horses were allowed. Seven motor ambulance cars were

also included in the establishment.


On the march a field ambulance required a road space

of 465 yards, of which 175 were for A section including

transport ; for B and C sections 135 yards each were allowed

with interspace of 20 yards between all. This may be com

pared with a mile and a half for the fighting portion of a

brigade of infantry, and seven and seven-eighths miles for

the fighting portion of a division. When an ambulance


vi THE FIELD AMBULANCE 69


moved by rail it required two railway trains although at

times one sufficed. In billeting, the staffs and medical units

always had the first choice of buildings, an arrangement

that was generously observed.


A field ambulance being a completely mobile unit

which moves with the front line and operates immediately

behind it on advance or in retreat, the design and quality

of the vehicles is a matter of urgent importance. At the

beginning of the war, horsed ambulances alone were used.

In the retreat to the Marne their utter inadequacy was

proved, and they were superseded by motor ambulances

as the main reliance in clearing a field. But to the end

horsed ambulances had quite definite uses. They had

access to areas impossible for motor transport where roads

did not exist, readily evading shell-holes and making de

tours into fields, or they could traverse roads in the making

with ease to the horses and comfort to the wounded. When

their wheels became submerged in the mud a friendly gun-

team would usually be found to extricate them. If they

upset, they could be righted without that ruin which fol

lowed a similar accident to a motor vehicle. On the right

front the Somme battle-field was entirely cleared by horsed

ambulances over roads which were quite inaccessible to

other forms of transport.


Motor ambulances were considered as a possibility

in the year 1908. Before that time the theory was that

supply wagons could on their return journey assist in

evacuating the wounded, but this theory always failed

when put to the test. The need of the troops for supplies

and the need of the wounded for succour could not be

reconciled. In the retreat from Mons it was already proven

that mechanical transport was indispensable, and the first

motor ambulances went to France with the 8th Division

during the first week of November, 1914. On October 21,


70 MEDICAL SERVICES CHAP.


it had been decided that all field ambulances should be

equipped with three horsed and seven motor-ambulances.

This equipment was supplied to all the Canadian units

when they took the field.


The water cart has a long history even in modern

times. In the form of a barrel on wheels it was obsolete

as long ago as 1891; it was top heavy; the barrel was

insanitary; the water flowed about and made the draught

heavy. Some vehicles of this type were supplied early

in 1915, but they never went further than England. They

were very good when empty; but when even partially

filled the weight fell upon the hind wheels; they would

dart into the ditch, and the pole would snap at the largest

knot in the wood.


The type finally employed was known as Mark II

with a filtering apparatus added, and was introduced in

1906. It contained two filters, one right and one left, so

arranged that no unfiltered water could be drawn from

the taps. Lockers were fitted with equipment for steriliz

ing the water with chloride of lime and gauging the amount

of material required. It weighed 1,421 pounds, and the

tank contained 110 gallons.


The wagon-ambulance was designated Mark VI and

was introduced in the year 1903, superseding Mark V of

the year 1889, which in turn was an improvement on

Mark IV, an experimental vehicle of four years earlier, in

that the "lock-under" principle was adopted. In the

earlier patterns the wagons were " equirotal," having

wheels of the same diameter both fore and hind. They

held only two stretchers; there was no room for any

attendant or for kits. Mark V Was an improvement for

transport purposes, but the short lock limited its useful

ness in narrow and crowded areas. In the Canadian

service there were a few wagons of these earlier patterns,


vi THE FIELD AMBULANCE 71^


useless as ambulances, but having a certain permanent

utility for transporting those commodities which in Canada

are usually loaded upon an "express" wagon. One, at

least, of these vehicles remained in service to the end, and

a useful career which began in South Africa was completed

beyond the Rhine.
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