Part 41 (1/2)

The care of the wounded in war has been the problem of the ages.

Richard the Lion-Hearted took a hospital s.h.i.+p to the coast of Palestine. The German people of the Middle Ages had their wounded in battle treated by their wives, who followed the army for that purpose.

It remained for Frederick the First of Prussia to establish a military service in connection with a standing army.

With the invention of firearms battlefield surgery faced new problems, notably hemorrhage, and took a step forward to meet these altered conditions. It was a French surgeon who solved the problem of hemorrhage by tying the torn blood vessels above the injury. To England goes the credit for the prevention of sepsis, as far as it may be prevented on a battlefield.

As far as it may be prevented on a battlefield! For that is the question that confronts the machinery of mercy to-day. Transportation to the hospitals has been solved, to a large extent, by motor ambulances, by hospital trains, by converted channel steamers connecting the Continent with England. Hospitals in the western field of war are now plentiful and some are well equipped. The days of bedding wounded men down on straw are largely in the past, but how to prevent the ravages of dirt, the so-called ”dirt diseases” of gaseous gangrene, blood poisoning, teta.n.u.s, is the problem.

I did not see the first exchange of hopelessly wounded prisoners that took place at Flus.h.i.+ng, while I was on the Continent. It must have been a tragic sight. They lined up in two parties at the railroad station, German surgeons and nurses with British prisoners, British surgeons and nurses with German prisoners.

Then they were counted off, I am told. Ten Germans came forward, ten British, in wheeled chairs, on crutches, the sightless ones led. The exchange was made. Then ten more, and so on. What a sight! What a horror! No man there would ever be whole again. There were men without legs, without arms, blind men, men twisted by fearful body wounds. Two hundred and sixteen British officers and men, and as many Germans, were exchanged that day.

”They were, however, in the best of spirits,” said the London Times of the next day!

At Folkestone a crowd was waiting on the quay, and one may be sure that heads were uncovered as the men limped, or were led or wheeled, down the gang-plank. Kindly English women gave them nosegays of snowdrops and violets.

And then they went on--to what? For a few weeks, or months, they will be the objects of much kindly sympathy. In the little towns where they live visitors will be taken to see them. The neighbourhood will exert itself in kindness. But after a time interest will die away, and besides, there will be many to divide sympathy. The blind man, or the man without a leg or an arm, will cease to be the neighbourhood's responsibility and will become its burden.

What then? For that is the problem that is facing each nation at war--to make a whole life out of a fragment, to teach that the spirit may be greater than the body, to turn to usefulness these sad and hopeless by-products of battlefields.

The ravages of war--to the lay mind--consist mainly of wounds. As a matter of fact, they divide themselves into several cla.s.ses, all different, all requiring different care, handling and treatment, and all, in their several ways, dependent for help on the machinery of mercy. In addition to injuries on the battlefield there are illnesses contracted on the field, septic conditions following even slight abrasions or minor wounds, and nervous conditions--sometimes approximating a temporary insanity--due to prolonged strain, to incessant firing close at hand, to depression following continual lack of success, to the sordid and hideous conditions of unburied dead, rotting in full view for weeks and even months.

During the winter frozen feet, sometimes requiring amputation, and even in mild cases entailing great suffering, took thousands of men out of the trenches. The trouble resulted from standing for hours and even days in various depths of cold water, and was sometimes given the name ”waterbite.” Soldiers were instructed to rub their boots inside and out with whale oil, and to grease their feet and legs. Unluckily, only fortunately situated men could be so supplied, and the suffering was terrible. Surgeons who have observed many cases of both frost and water bite say that, curiously enough, the left foot is more frequently and seriously affected than the right. The reason given is that right-handed men automatically use the right foot more than the left, make more movements with it. The order to remove boots twice a day, for a few moments while in the trenches, had a beneficial effect among certain battalions.

The British soldier who wraps tightly a khaki puttee round his leg and thus hampers circulation has been a particular sufferer from frostbite in spite of the precaution he takes to grease his feet and legs before going into the trenches.

The presence of septic conditions has been appalling.

This is a dirty war. Men are taken back to the hospitals in incredible states of filth. Their stiffened clothing must frequently be cut off to reveal, beneath, vermin-covered bodies. When the problem of transportation is a serious one, as after a great battle, men must lie in sheds or railway stations, waiting their turn. Wounds turn green and hideous. Their first-aid dressing, originally surgically clean, becomes infected. Lucky the man who has had a small vial of iodine to pour over the gaping surface of his wound. For the time, at least, he is well off.

The very soil of Flanders seems polluted. British surgeons are sighing for the clean dust of the Boer war of South Africa, although they cursed it at the time. That it is not the army occupation which is causing the grave infections of Flanders and France is shown by the fact that the trouble dates from the beginning of the war. It is not that living in a trench undermines the vitality of the men and lays them open to infection. On the contrary, with the exception of frost bite, there is a curious absence of such troubles as would ordinarily result from exposure, cold and constant wetting.

The open-air life has apparently built up the men. Again and again the extraordinary power of resistance shown has astonished the surgeons.

It is as if, in forcing men to face overwhelming hards.h.i.+ps, a watchful Providence had granted them overwhelming vitality.

Perhaps the infection of the soil, the typhoid-carrying waters that seep through and into the trenches, the teta.n.u.s and gangrene that may infect the simplest wounds, are due to the long intensive cultivation of that fertile country, to the fertilisation by organic matter of its fields. Doubtless the vermin that cover many of the troops form the connecting link between the soil and the infected men. In many places gasoline is being delivered to the troopers to kill these pests, and it is a German army joke that before a charge on a Russian trench it is necessary to send ahead men to scatter insect powder! So serious is the problem in the east indeed that an official order from Berlin now requires all cars returning from Russia to be placarded ”_Aus Russland_! Before using again thoroughly sterilise and unlouse!” And no upholstered cars are allowed to be used.

Generally speaking, a soldier is injured either in his trench or in front of it in the waste land between the confronting armies. In the latter case, if the lines are close together the situation is still further complicated. It may be and often is impossible to reach him at all. He must lie there for hours or even for days of suffering, until merciful death overtakes him. When he can be rescued he is, and many of the bravest deeds of this war have been acts of such salvage. In addition to the work of the ambulance corps and of volunteer soldiers who often venture out into a rain of death to bring in fallen officers and comrades in the western field, some five hundred ambulance dogs are being used by the Allies to locate the wounded.

When a man is injured in the trenches his companions take care of him until night, when it is possible to move him. His first-aid packet is opened, a sterilised bandage produced, and the dressing applied to the wound. Frequently he has a small bottle of iodine and the wound is first painted with that. In cases where iodine is used at once, chances of infection are greatly lessened. But often he must lie in the trench until night, when the ambulances come up. His comrades make him as comfortable as they can. He lies on their overcoats, his head frequently on his own pack.

Fighting goes on about him, above him. Other comrades fall in the trench and are carried and laid near him. In the intervals of fighting, men bring the injured men water. For that is the first cry--a great and insistent need--water. When they cannot get water from the canteens they drink what is in the bottom of the trench.

At last night falls. The evening artillery duel, except when a charge is antic.i.p.ated, is greatly lessened at night, and infantry fire is only that of ”snipers.” But over the trench and over the line of communication behind the trench hang always the enemy's ”starlights.”

The ambulances come up. They cannot come as far as the trenches, but stretchers are brought and the wounded men are lifted out as tenderly as possible.

Many soldiers have tried to tell of the horrors of a night journey in an ambulance or transport; careful driving is out of the question.

Near the front the ambulance can have no lights, and the roads everywhere have been torn up by sh.e.l.ls.