My departure for the seat of war was rather hurried, hence my surgical equipment was not of an extensive nature. It may be of interest, however, to shortly recount what it consisted in, since it proved an ample one, and yet was carried in a small satchel. The plan of selection adopted consisted in carefully going through the equipment of the British Field Hospital, and then adding such other instruments as seemed to me likely to be useful. With few exceptions, therefore, designed to meet emergencies, my set of instruments formed a supplement to the actual necessities carried by the Service hospitals, and was as follows:—4 trephines, Horsley's elevator, brain knife and seeker. 2 pairs of Hoffman's and 1 pair of Lane's fulcrum gouge forceps, 3 bone gouges, 1 pair straight 1 curved necrosis forceps, 1 pair bone forceps. 1 Wood's 1 Horsley's skull saws, 18 Gigli's saws with an extra handle, and two Podrez' directors for the same. 1 set Lane's bone drills, broaches, screw-drivers, and counter-sink with eight ounces of screws: silver patella wire, and 1 pair Peter's bone forceps. 2 aneurism needles, 1 bullet probe, 1 pair Egyptian Army pattern bullet forceps. 4 Lane's and 3 pairs Makins's bowel clamps, Nos. 3 4 and 5 Laplace's bowel forceps, 6 Murphy's buttons, 1 pair Morris's retractors, 6 dozen intestine needles, 2 Macphail's needle-holders, Nos. 4 5 6 Thomas's slot-eyed needles, 1 mouth gag, 1 Durham's double raspatory, 3 strong plated raspatories, 1 pair tongue forceps, 1 tracheal dilator, 1 pair hernia needles, 1 hernia and 1 ordinary steel director, 1 transfusion set with metal funnel, and a stock of Messrs. Burroughes and Wellcome's compound saline infusion soloids. 1 antitoxin syringe. 6 scalpels, 2 blunt-pointed curved bistouries, 6 forcipressure forceps, 1 pair Jordan Lloyd's retractors, 1 pair ordinary retractors, 2 pairs of forceps, 3 pairs of Scissors, 1 skin-grafting razor and roll of perforated tin foil, 1 metal pocket case, and 1 hypodermic syringe with tabloids. A stock of silkworm gut, horsehair and silk ligatures, the latter prepared and sterilised for me by Miss Taylor, the Theatre Sister at St. Thomas's Hospital. Some pairs of McBurney's india-rubber, and cotton-thread operating gloves.

The instruments were packed in sets in small linen holdalls suggested and made by Messrs. Down Bros., who also devised my satchel. In the light of the experience gained I should have preferred a tin case to the satchel, as it never needed to be carried on horseback.

For dressings I trusted entirely to the Royal Army Medical Corps, and at my request Colonel Gubbins, R.A.M.C., sent out to the Cape a quantity of sterilised sponges and pads made by Messrs. Robinson & Co. Ltd. of Chesterfield, which fully met all requirements in this direction.

This equipment was superfluous at the Base hospitals, but when in the field with the troops proved very useful. In the early part of the campaign I was able to do all my travelling by train, but later I travelled by road only. I received the greatest kindness and help in this particular. General Sir William Nicholson, Chief Director of Transport, provided me with a buggy, a pair of horses, and a driver, and Prince Francis of Teck, the Chief Remount Officer, selected a pony suitable to my equestrian powers. The buggy proved a very great success; the box seat carried my instruments and dressings, the front a 4-gallon tin water-bottle for emergency operations, and the rear shelf my personal belongings. The water-bottle was lent to me by the Portland Hospital. (Fig. 3.)

The cart was able to cross any drifts or dongas, and when an engagement was in progress was able to accompany the Ambulance wagons, so that I had all my necessaries on the spot, even at the first dressing station. In point of fact when with the Highland Brigade, on some occasions, we did all necessary operations on the spot during the progress of fighting; a most useful performance, since fighting on several days did not cease till dark, and the evenings were much too cold to allow of operations being done with safety to the patients. The great advantage of the buggy was its lightness and smallness. On one occasion it accompanied me between 500 and 600 miles without a single accident, beyond the fact that one night I was relieved of both my horses by some troopers whose own were worn out.

With regard to the general health of the troops as subjects of surgical wounds, I suppose a better class of patient could scarcely be found. The men were young, sound, well set and nourished, and hard and fit from exercise in the open air. Beyond this, in spite of the scarcity of vegetables, a certain amount of fruit, rations of jam, and lime juice made any sign of scurvy a rare occurrence—I never saw a case during the whole of my wanderings. The meat was good, especially in the early part of the campaign, when it was for the most part brought from Australia and New Zealand, and we enjoyed the two collateral advantages of getting plenty of the ice which had been used for the preservation of the meat, in the camps, and the still greater one of having no butchers' offal to need destruction or prove a source of danger. When bread was to be got it was fairly good, and the biscuit was at all times excellent. Except on the advance from Modder River to Bloemfontein, as far as I could judge, no large bodies of the men ever really suffered from shortness of food, and then only for a few days. Drink was a more serious problem: in the early days beer was to be got at the canteens, but with the increase of numbers and difficulties of transport this ceased to be the case, and water was the sole fluid available. This was often muddy, and the soldiers would take very little care what they drank unless under constant supervision; hence a great quantity of very undesirable water was drunk. None the less I think the water was more often the cause of sand diarrhœa than of enteric fever. A large quantity of fluid was by no means a necessity if the men would only have exercised some self-control. During the first week I spent at Orange River, I drank lime juice and water all day, but after that time, by a very slight amount of determination, I thoroughly broke myself of the habit, and drank at meal-times only. Most of the men however emptied their water-bottles during the first hour of the march, and the rest of the day endured agony, seizing the first opportunity of drinking any filthy water they met with. When, for instance, we camped near a vlei, and the General took the greatest care that the mules and horses should be watered at one spot only, in order to preserve the cleanliness of the rest of the pool, the men would often go and fill their water-bottles amongst the animals' feet rather than take the trouble to walk the few necessary yards round. In such particulars they needed constant supervision.

The climate on the western side was a great element no doubt both in the general healthiness of the men and in the general good results seen in the healing of wounds. The days were often hot; thus even in November at Orange River the thermometer registered 115°F. in the single bell tents, but on the other hand the nights were cool and refreshing. The air was very pure and exceedingly dry, while the constant sunshine not only kept up the spirits, but also proved the most efficient disinfector of any ground fouled to less than a serious extent. Dust was our principal bugbear; and when a camp had been settled for a few days, flies; both of these evils increasing rapidly as the stay on any one spot was prolonged. My personal experience of rain was small, but I was twice in camp, once at Orange River and once at Bloemfontein, when very heavy rain fell, and this was sufficient to make the camps terribly uncomfortable for a few days.

Under these conditions, as might be expected, until the outbreak of enteric fever the health of the men was remarkably good, minor ailments alone prevailing. One of the most troublesome of these was diarrhœa, which gained the appellation of 'the Modders,' already a classical name as far as South Africa is concerned. This most frequently, I think, depended on errors of diet, combined with the swallowing of a large amount of sand with the food as dust, and in the water drunk. Cases of severe dysentery, however, were also not very uncommon. Rheumatic pains were a common ailment, which, considering the dryness of the atmosphere, would hardly have been expected. Continued fever of a somewhat special type was not uncommon, and was sometimes spoken of under the name of the district, sometimes as veldt fever—of this I will say nothing, as others better fitted to point out its peculiarities will no doubt deal with it. Enteric fever, our chief scourge, I will pass over for the same reason. I might, however, remark from the point of view of one not very experienced in this disease, that in a large number of the fatal cases I happened to see, the actual cause of death seemed to me to be septicæmia from absorption from the mouth. The mouths were unusually bad, even allowing for the often insufficient cleansing that was able to be carried out, and I was inclined to attribute these in some degree to the dryness of the atmosphere, which very quickly and effectively dried up the mucous membrane of the mouth in patients not breathing through the nose, and encouraged the formation of large cracks. Pneumonia was rare, and this was rendered the more striking from the comparatively large number of men who contracted the disease on board ship on the voyage out from England.

As will be gathered from the above, medical disease seldom called for the aid of the surgeon. Abdominal section was occasionally considered in cases of perforation in enteric fever, and was, I believe, a few times performed, but as far as I know without success. It was also proposed to treat some of the severe dysentery cases by colotomy, but I never saw the method tried. As far as I was concerned I never met with a case of either disease I thought suitable for the treatment. I saw one case in which an abscess of the liver had followed an attack of enteric, which had been successfully treated by incision, and a few cases of tropical abscess which probably came into the country were also subjected to operation. Some cases of appendicitis, as would be expected, also needed surgical treatment. In a few instances empyema followed influenza, and a few cases of mastoid suppuration had to be dealt with.

Of surgical diseases the one most special to the campaign, although not of great importance, was the veldt sore. This was a small localised suppuration most common on the hands and neck, but sometimes invading the whole trunk, more particularly the lower extremities however, when the covered parts of the body were attacked. The sores were no doubt the result of local infections; they reminded me most of the sores seen on the hands of plasterers, and I think there is no doubt the dust was responsible for them. I think piles were somewhat more prevalent than they should have been among the men, but this was probably dependent on the strain involved in defæcation in the squatting position, since the soldiers were for the most part regularly attentive to the calls of nature.

I saw a good many cases of lightning stroke, and some were fatal. Sunstroke was not common, and, considering the heat, it was very remarkable how little the men suffered from this condition. This was no doubt in part attributable to the absence of the possibility of getting alcoholic drinks, but it is not common for any one in South Africa to suffer in this way, probably as a result of the continuous nature of the sunshine.

In spite of the labours of hospital surgeons at home, it was rather instructive to see the number of men who suffered with hernia, varicocele, and varicose veins to a sufficient degree to necessitate going to the base. The experience quite sufficed to explain the trouble which is taken to prevent men with these complaints entering the service.

General Consideration of the Number of Men Killed and Wounded

I will now pass to the question of the proportionate frequency with which the men were killed or wounded during the present campaign. I propose to take only one series of battles, with which I was personally acquainted throughout, to illustrate this point. This seems the more satisfactory course to follow, since the number of casualties is still undergoing continuous gradual increase, and besides this the warfare has assumed a peculiar and irregular form, statistics from which scarcely possess general application.

The battles included, those of the first Kimberley Relief Force, were fought under fair average conditions as to the nature of the ground. In the first two the defending enemy occupied heights, in the two following the ground advanced over by our men was comparatively even; thus at Modder River there was only a gradual slope upwards, and at Magersfontein the advanced trenches of the Boers were only slightly above the level of the ground over which the advance was made. At the same time, at the latter battle a great number of the Boers engaged were on the sides of the hill well above the advanced trenches. In no case were the Boers in such a position as to have to fire upwards, to them a considerable advantage. It must also be noted that throughout the Boers were able to rest their rifles; hence the fire should have been at any rate of an average degree of accuracy. In the advances of our own men, anthills and stones were practically the only cover to be obtained, and little or no help was given by variations in the general surface. All these points seem to favour a large proportional number of hits on the part of the riflemen. I very much regret that I am unable to say what was the proportional number of shell wounds among the men hit, but I can say with some confidence that among the wounded it was not as great as ten per cent. I should be inclined to place it as low as five per cent. Again, I cannot fix the proportionate occurrence of wounds from bullets of large calibre such as the Martini-Henry, but this was certainly not large. I think if ten per cent. is deducted to represent the number of hits from either of these forms of projectile, that we may fairly assume the remaining 90 per cent. of the wounds to have been produced by bullets of small calibre. The numbers of the opposing forces were probably fairly even.

Taking all these circumstances together, and bearing in mind that our army was always in the position of having to make frontal attacks on men well protected in strong positions, I think it must be allowed that a fair idea should be possible of the effectiveness of the modern weapons. Only one circumstance, one inseparable from any fighting with the Boers, seems to affect the numbers in an important manner. This consists in the fact that the Boer rarely fights to the bitter end, hence the greater proportion of his hits are obtained at long distances.

TABLE I

Table I. gives the number of men engaged, and also that of the killed and wounded at each of four battles. Table III. shows for comparison the relative number of killed and wounded in some former campaigns while older forms of weapon were in use.

With regard to the numbers in Tables I. and II. it should be at once said that they are only to be regarded as approximate, since they do not exactly tally with those officially reported in the 'Times' at a later date. Sources of error may, however, have crept into both, and as there is little difference in the gross numbers, I have preferred to retain the series compiled by Major Burtchaell, R.A.M.C., as Table II. contains interesting information as to the proportionate number of men who died during the first 48 hours, after being wounded.

TABLE II

Showing Proportion of Mortality amongst Men Hit, (a) on the Field, (b) during the First Forty-eight Hours

The high death rate among the officers will at once arrest attention, but this has been noticed in other campaigns, particularly in the Franco-German war. It is mainly attributable to the circumstance that the officers, as leading, are always in the front and most exposed position. I much doubt whether at the end of the campaign the entire abandonment of distinctive badges will be found to have had any very important result in decreasing the relative number of casualties as between officers and men. At close quarters distinctive uniform is no doubt a danger, but at the common ranges of 1,000 yards and upwards the enemy's fire is rather directed to cover a zone than to pick out individuals.

The especially high mortality among the officers at the battle of Graspan was attributable to the casualties among the naval officers, and the men of the brigade suffered most severely also.

It will be noted that the most expensive battles were those of Belmont and Magersfontein.

If the numbers of the men actually taking part in the fighting in these battles as given in Table I. are massed, we get an approximate total of 12,420.[3]

Of this number, 1,959 or 15.06 per cent. were reported as killed, wounded, or missing. Thus: killed, 315 or 2.53 per cent.; wounded, 1,512 or 12.17 per cent.; missing, 132 or 1.06 per cent. Reference to Table III. shows that these percentages almost exactly correspond with those obtaining in the entire Crimean campaign, and are greater than those observed in the German army during the entire Franco-German campaign.

The mortality statistics given in Table II. are of great interest, since to those dying on the field are added all men dying within the first 48 hours in the Field hospitals. From the surgical point of view these men all received mortal injury, and are therefore properly included among the fatalities. Their inclusion, moreover, makes an appreciable difference in the percentage proportion of mortal injuries to wounds. Thus, if the numbers are massed (omitting the 'missing'), we find that in the four battles 1,827 men were hit, of whom 315, or 17.24 per cent., were killed. Among the wounded carried off the field, however, 49 received mortal injuries, and if these are added to the 315, we find that the proportion of mortal injuries reaches 19.92 per cent.

TABLE III[4]

The proportion of men killed to those wounded was as follows: killed 315, wounded 1,512, or 1 to 4.8. If we add to the men killed on the field of battle the 49 dying in the next 48 hours, the proportion of fatalities is increased to 1 to 4.15. The higher of these proportions is certainly the surgically correct one.

With regard to the general accuracy of the numbers given above, a comparison of those published for the campaign up to September 15, 1900, is of value, as the two series substantially tally. Thus, up to that date, 17,072 men were hit, and of these 2,998 were killed. The proportion killed to wounded was therefore 1 to 4.69.

If it be borne in mind that of the wounded men included in Table I., 1.5 per cent. died later in the Base hospitals, the percentages are almost identical.

Table III. is inserted with a view to instituting a comparison between the number of casualties in the present and earlier campaigns.

For the purposes of this table it is necessary to take the approximate number of men at Lord Methuen's disposal, irrespective of their active participation in the fighting.

The result of this addition to the total is to show that the percentage of men killed and wounded was slightly lower than in the Crimean war, and nearly corresponded with that observed in the Franco-German campaign.

As it has been shown that our numbers correspond in general with those of the whole war up to September 15, 1900, there can be little doubt that the same ratios will be maintained to the close of the campaign.

On the face of the numbers, therefore, there is little ground for assuming that the change in the nature of the weapons has materially influenced the deadliness of warfare at all. This is capable of explanation on the ground that in the Crimea the battles were fought at much closer quarters, and hence the weapons of the time were as effective, or more so, than the present ones. That this increased distance between the combatants will always counterbalance the increased deadliness of the weapons in the future is more than probable, since the range of effectiveness has been increased both in rifle and in artillery fire. In the present campaign the effect of the latter was very noticeable, since the Boers were, as a rule, quickly displaced by shell fire, unless they were in especially favourable positions, and this although no great number of men was hit by the projectiles. Under these circumstances, except on some occasions, neither side derived all the advantage from the increased shooting powers of their rifles which might have been expected. To a lesser degree this will probably always be the case in the future.

In connection with these remarks, however, I would point to column 4 of Table III., as showing how difficult it is to draw definite deductions from any particular set of numbers alone. This column shows that in the Russo-Turkish War of 1877 all the percentages were practically doubled or more, and in the case of the number of men killed on the field of battle, the number was nearly five times as great as either in the Crimea or the present campaign. The explanation here depends on the race of men and their tenacity in resistance alone. In the case of either nation death in battle is little feared, and slight inclination to avoid it exists. When the theory of war held by the Boer—i.e. going out to shoot an enemy without incurring risk of being yourself shot—is borne in mind, the special circumstances attending the present campaign are sufficiently obvious to need little further remark. A future campaign in which the combatants are as equally well armed, but each side stands to the last, will probably give very different results.

It is unfortunate that no details can be given as to the influence of range in altering the relative numbers of killed to wounded. It may be stated, however, that in no instance did the percentage of killed to wounded reach 25 per cent. At the battle of Magersfontein it amounted to 19.26 per cent., at Colenso to 17.97 per cent., and at both these engagements there is little doubt that a considerable number of the men were hit within a distance of 1,000 yards. When the distances were very short the injuries were frequently multiple; and this character was a more common source of danger than increase of severity in the individual wounds received at a short range.

A short consideration of the circumstances especially influencing the ultimate mortality amongst the wounded subsequent to the reception of the injury is here necessary, although I shall be obliged to make my remarks as short as possible. The subject is best treated of under the two headings of Transport and Hospital Accommodation.

Transport.—The importance of transport is felt from the moment of the injury till the time of arrival of the patient in the mother country. To the surgeon it is of the same vital importance as the carrying of food for the troops is to the combatant general.

(a) Removal of the wounded from the field of battle. My experience was opposed to hurried action in this matter, although it is necessary to gather up the wounded before nightfall if possible. As a rule wounded men should not be removed from the field of battle under fire, at any rate when the troops are in open order at a range of 1,000 yards or more. I saw several instances in which mortal wounds were incurred by previously wounded men or their bearers during the process of removal, while it was astonishing how many scattered wounded men could lie out under a heavy fire and escape by the doctrine of chances. The erect position and small group necessary to bear off a wounded man at once draws a concentrated fire, if fighting is still proceeding.

As to the best and quickest method of removing the patients to the first dressing station, there were few occasions when this was not more satisfactorily done by bearers with stretchers than by wagons. The movement was more easy to the wounded men, and, as a rule, time was saved. Over rough ground the wagons travel slowly, and patients with only provisional splints were shaken undesirably. A stretcher party in my experience easily outstripped the wagon unless a road or very smooth veldt existed. A larger number of men is of course required, but I take it that on the occasion of a great war men are both more easily obtained and fed than are transport animals. From what I have been able to learn, both the Indian dhoolie-bearers and the hastily recruited Colonial bearer companies were most successful in the removal of the large number of wounded men from the field of Colenso. I had several opportunities of comparing the two methods on a smaller scale during the fighting in Orange River Colony, and felt very strongly in favour of the stretcher parties.

For removal of patients from one part of a hospital to another, or sometimes in loading trains, &c., great economy of men, and increased comfort to the patients, may be attained by the use of some form of ambulance trolly.

I append an illustration of what seemed to me the simplest and best I came across among several in use in South Africa. The description beneath is by Major McCormack, R.A.M.C., its inventor (fig. 5).

When wagons were necessary or preferable, the Indian Tongas (fig. 6), presented by Mr. Dhanjibhoy, were most useful; they carried two men lying down, the same number as the big service wagon, and were drawn by two ponies only. Although somewhat highly springed, the vehicle is so well arranged and padded, that the occupants are seldom hurt by striking against the sides with rough jolting, unless quite helpless. I occasionally made long journeys in this vehicle with much comfort.

It consists of an under-carriage built up of two light wheels with steel spokes and rims with rubber tyres and ball bearings; on the axle are two light elliptic springs, to which is attached a transverse seat for the stretcher-carrier proper. This is securely bolted on to the seat, and consists of two pieces of hard wood, suitably worked, and forming an angle frame. On the bottom side the stretcher poles rest, and the sides of the L formed by the carrier proper prevent most effectually any jerking or turning of the stretcher when once it has been laid in the carrier. The carrier is about thirty inches long, but can be increased to any length desired. It has been found that this length is admirably suited for all purposes. To prevent the stretcher from any lateral or upward movement, two buttons with tightening screws are attached to the top of the carrier on each side. When the stretcher is laid on the carrier the screws are tightened and the stretcher is held rigid.

Two iron supports are provided, one at each end and on opposite sides of the carrier. These are lowered when it is desired either to place the stretcher on the carriage or remove it therefrom, which can be effected in a second. The carriage meanwhile remains perfectly still. When the carriage is in motion the iron supports are turned up, and lie along the respective sides of the carrier, where each rests in a small clip. The great object of this stretcher carriage has been to obtain mobility, strength, and lightness combined with efficiency and a ready and easy means of transport for sick and wounded, no matter where a patient has to be transported from. The loaded stretcher and wheeled carriage can be readily handled by one man on good roads, and by two men in rough country. The springs prevent any jar being felt by the patient on the stretcher.

(b) For the longer journeys to the Field or Stationary hospitals, the service wagon and other transport vehicles came into use, particularly the South African ox-wagon.

The service wagon (fig. 7) is a heavy four-wheeled vehicle, drawn by ten mules. The good construction of the wagon was amply proved by the manner in which it stood the hard wear and tear of the present campaign. It is, however, very heavy, and in comparison with its size affords very small accommodation. Two lying-down patients and six sitting is its entire capacity. Some modified patterns were in use, notably those with the Irish and Imperial Yeomanry Field Hospitals, capable of carrying four lying-down cases, the men being arranged in two tiers. Major Hale, R.A.M.C., made a very successful trek from Rhenoster to Kroonstadt with some of these, carrying twice the regulation number of lying-down cases in his wagons. Some modification in the mode of fixation is, however, necessary to increase the security of the stretchers of the upper series.

A really satisfactory wagon, combining both strength and comfort, still remains to be devised.

During the later stages of the campaign, a very large number of patients were transported by the South African ox- or mule- (buck) wagons. Although not of prepossessing appearance, and unprovided with any sort of springs, these vehicles were far from unsatisfactory. The ox-wagon consists of a long simple platform, 19 ft. 2 in. in length, 4 ft. 6 in. in width, from the sides of which a slanting board rises over the wheels for the posterior two-thirds. These bulwarks increase the actual width to 6 ft. 6 in., which corresponds with the gross width occupied by the wheels. One third is covered by a small hood 5 ft. 6 in. in height erected on wooden stave hoops. The latter was often absent in transport wagons. The two hind wheels are large, the fore somewhat smaller. They are attached to very heavy wooden cross-beams bearing the axles, and the two beams are connected by a longitudinal bar, continuous with the düssel boom or pole. This latter bar is in two sections, the connection of which allows considerable play in the long axis and serves to break the jolts occurring when either pair of wheels passes over uneven spots on the ground. When some sacks of oats or hay were spread over the floor the wounded men travelled comparatively comfortably in these wagons, the great distance between the fore and hind wheels tending to minimise the jolting. The principal objection to them was the slow pace of the oxen, and the fact that to obtain the greatest amount of work from these animals a major part of the journey must be performed during the night. The ox-wagon carries, with comfort, four lying-down cases on stretchers, or six without stretchers; or twenty sitting-up cases.

The mule- or buck-wagon, which is of the same class but smaller, can only accommodate two stretchers, four lying-down men without stretchers, or 12-14 sitting-up cases. As a rule, the wagons were loaded with recumbent cases in the centre, while more slightly wounded men sat around, and were able to give help to those lying down when needed. The wagons can be covered with canvas throughout.

The steady even pace of the oxen is a great advantage, and I was often surprised to see how well men bore transport in these wagons, who seemed utterly unfit to be moved had it not been an absolute necessity. A very large number of the wounded from Paardeberg Drift were transported to Modder River in them.

One other advantage of these wagons, the possibility of converting them into an excellent laager, is not to be underrated. Any one who saw the comfortable encampment which a naval contingent on the march made by massing the wagons with intervals covered by macintosh sheets, could at once appreciate their capabilities for a long trek.

Traction engines were, as far as I know, never employed as a means of transporting the sick. The tendency of these heavy machines to stick in the mud and to break down bridges is so well known that it hardly needs mention. Putting these disadvantages on one side, with a supply of fuel ensured, and such roads as are afforded by a civilised country, a great future is probably before this means of transport for the wounded. A large number of patients might be carried at an even pace, and the camps would be saved all the trouble and worry of the transport animals.

Trains.—In many cases in Natal, and in a few instances on the western side, the wounded men were able to be transferred from the first dressing station directly into the trains. Space will not allow me to describe any of those in use, but the accompanying illustration shows the general arrangement of the beds in Nos. 2 and 3 trains (fig. 9). The carriages were converted from ordinary bogie wagons of the Cape Government Railway stock under the supervision of Colonel Supple, R.A.M.C., P.M.O. of the Base at Cape Town. Each train was provided with accommodation for two medical officers, two nursing Sisters, orderlies, a kitchen, and a dispensary, and each carried some 120 patients. The trains were under the charge of Major Russell, R.A.M.C., and Dr. Boswell (and later other civilian medical officers) and of Captain Fleming, R.A.M.C., D.S.O., and Mr. Waters, and carried many thousand patients from all parts of the country to the Base and Station hospitals. They were most admirably worked, and seemed to offer little scope for improvement except in minor details. To them much of the success in the treatment of the wounded who had to traverse the immense distances incident to South Africa must be attributed. I made many pleasant journeys in each of them. Later, two additional trains, Nos. 4 and 5, of a similar nature, were added. Two trains, No. 1, and the Princess Christian train, which I was not fortunate enough to see, performed similar duties for Natal.