THE CARE OF THE WOUNDED
The first thing to do with a wounded man is to “first-aid” him. This, of course, is done chiefly to check dangerous bleeding, prevent the aggravation of unset fractures, and, generally, to enable the patient to travel with as little risk and pain as possible to a place where his injuries can be more completely dealt with.
The next thing to do is to get him out of the trench. (If he has been wounded in No Man’s Land, he must first be got back into the trench.) If he can walk out, he does. During some of the chief engagements on the Somme in 1916 many seriously wounded men walked astonishing distances to dressing-stations in order to leave the ambulances and stretchers for others in still worse case.
Removal from the Trench.
If a man wounded in or near the firing trench cannot walk, he may have to be carried on a stretcher for a mile or more along a deep, narrow communication trench with scores of right-angled turns and a few more irregular incidental twists. It may have an uneven and slippery floor, perhaps a foot or two under water at its lower-lying parts.
Four strong men, used to the job, find it extremely hard work to carry a stretcher case along such a trench. They may repeatedly have to raise the stretcher well above their heads, almost at arm’s length, so as to clear the walls of the trench at an awkward turning. To overcome this difficulty a trolley stretcher, suspended from a mono-rail running above the trench almost at the surface level, is used in such trenches as permit of its passage. It saves an immense amount of tedious labour and much lessens the discomfort of wounded men.
The Advanced Dressing-Station.
Arrived at an advanced dressing-station, a patient can be immediately operated upon, if this be necessary to save life. Or his wound may be one of those which, though grave, are likely to do better for some delay before operation. Just whatever is necessary at the moment is done; the recognised precautions against the states technically known as shock and collapse are taken; and then the patient is sent on at once to a casualty clearing station, with its ampler space and larger equipment. Probably he will ultimately pass from the C.C.S. to a general, or stationary, hospital more remote from the Front, and perhaps to a hospital in England.
The Eye Hospital.
If a case presents any special difficulty it will be sent to a specially equipped ward or to a specialist hospital. A typical hospital of the kind is the Army Eye Hospital, near the coast, commanded by a London oculist of distinction. Part of its equipment is a magnet of great power, which begins to draw out of the eye any fragments of metal that are in it as soon as the patient enters the room.
By combining the use of instruments with this extricatory power of the magnet the sight of many men with severe eye-wounds is saved; the hospital possesses a remarkable collection of jagged fragments and sharp splinters of metal thus cut and coaxed out of eyes. Or a man with a rather intractable fracture of the thigh may be sent to one of the special wards photographed here, where the limb, and his whole body, can be slung at any angle that is convenient.
Ingenious Aids.
In the British Hospital of St. John of Jerusalem, near the French coast, there was lying, throughout last winter, an Australian soldier whose life, in the opinion of the surgeons, had only just been saved by the perfection of a special kind of bed which someone had given to the hospital. The man had been deeply and very dangerously wounded in the back, in such a way that his wounds could not have been dressed in an ordinary bed without such changes of position as would themselves have been injurious.
By an ingenious mechanism the special bed could be hoisted, tilted and inclined till it was in any desired plane and at any convenient height, and any portion of the patient’s body could be reached without turning him over.
A Perfect Hospital.
This Hospital of St. John is perhaps the most perfect we have in France. It is housed in good wooden huts, amply spaced out and admirably planned for convenience in working and administration; each wooden ward is light, airy, cheerful in colour and provided with every imaginable aid to cleanliness and good order. One of its special belongings is a cardiograph, or apparatus for recording on a chart, by the help of electricity, all the movements of the heart, so that in cases of irregular action of the heart the evenly serrated line produced on the paper by a normal heart action is varied with spasmodic upward leaps or downward collapses.
Varied Conveyances.
Between the front and the base a wounded man may travel, for some part of the way, in any one of a large variety of conveyances. The ordinary stretcher and the overhead trolley have been mentioned. The wheeled stretcher, balancing like a dog-cart between two large bicycle wheels, or between two smaller ones with pneumatic tyres, is extremely useful for saving jolts and labour. Its chief sphere of action is between the rear ends of communication trenches and the points, perhaps a mile or two farther on, beyond which it is not advisable for motor ambulances to go. But of course it can only be used to advantage where the ground to be traversed is not completely broken up by shell fire, mines or bombs.
Narrow-Gauge Railways.
An excellent way of transporting casualties—where it is available—is by the narrow-gauge Decauville railways which now carry stores and ammunition up from many of our full-gauge railheads to the front line, or near it. A photograph shows two ambulance trolleys accommodating four laden stretchers. A similar trolley is used at some casualty clearing stations to convey patients from the wards to the Red Cross train by which they are to be evacuated. Such contrivances are sometimes invented independently, in slightly different forms, by the staffs of different clearing stations or hospitals. Like the combatants, the medical officers are constantly devising new methods and new apparatus to meet the changing needs of active service.
Motor Ambulances.
The motor ambulance, to carry four stretcher patients, is the regular means of conveyance from a few miles behind the front line to the casualty clearing stations at the railheads. “Sitting wounded” travel either in motor ambulances, with the interior arranged to receive them, or in motor lorries—usually in the former. From the casualty clearing stations the wounded go to the base, as a rule, either by train or by canal.
Water Transport.
For cases requiring special ease of movement and quiet the broad, square-built French canal boats make excellent travelling hospitals. Nearly all the rivers of Northern France are canalised, and these waterways are kept up free of toll by the State, so that water transport is almost as available as transport by rail. A photograph shows what roomy wards the ordinary French canal boat provides. The boats in British use are usually towed in pairs by small tugs. During the battle of 1916 the big red crosses on the boats’ sides were to be seen everywhere on the Somme.
Red Cross Trains.
The equipment of Red Cross trains is more generally known and several improvements have been made in it during the war. With its operating theatre, kitchen, store-room and staff accommodation, a Red Cross train is now a travelling hospital rather than a vehicle plying between one hospital and another.