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University of Toronto Library
from funds donated by
Hannah Institute
for the History of Medicine

GUY'S HOSPITAL

REPORTS

(War memorial number)

EDITED BY ^.

F. J. STEWAKD, ^v

AND

HERBERT FRENCH, C.B.E., M.D.

VOL. LXX.

BEING

VOL. LV. OF THE THIRD SERIES.

LONDON:

J. & A. CHURCHILL, GREAT MARLBOROUGH STREET.

MDCCCCXXII.

COMMITTEE OF REFERENCE

J. W. H. Eyre, Esq., M.D., M.S.
P. P. Laidlaw, Esq., M.A., B.C.

Prof. T. Martin Lowry, D.Sc.

M. S. Pembrey, Esq., M.A., M.D.,
B.Ch.

PRINTED BY ASH AND CO., LIMITED SOUTH WARK, S.E.

Guy*s Hospital War Memorial.

PREFACE TO VOLUME LXX.

rpHE fiL'st volume of the Guy's Hospital Reports
-■- was published in 1836. With the issue of this
— the seventieth — volume, annual publication ceases. A
new series is already being published quarterly under the
Editorship of Dr. A. F. Hurst, assisted by a representative
Editorial Committee.

The present volume is devoted to a special purpose.
It is a part of the Guv's War Memorial, and it places on
record the part played by Guy's men and women in the
Great War of 1914—1918.

It opens with an account of the War Memorial Fund ;
of the Memorial Arch, and of its unveiling by H.R.H. The
Duke of York in July, 1921. The rest of the volume is
sub-divided into three Parts.

Part I. is devoted to notices, with portraits, where
available, of each of the hundred and thirty Guy's men
and five Guy's women who lost their lives in the service
of their country.

Part II. is a record of war services and honours, and
Part III. contains papers dealing with some of the ways
in which the War affected Guy's, and records some of the
special experiences of, and work done by, Guy's men and
women during the War.

Parts I. and II. have been compiled by Professor
M. S. Pembrey, the Hon. Secretary of tiie Guy's Hospital
War Memorial Fund, assisted by Mi*. J. H. t!i. Winston
and by Miss Margaret Hogg, C.B.E., the Matron of
Guy's Hospital, who have spared themselves no trouble
in order to make the records as complete as possible

The Editors.
Januarij, 1922.

CONTENTS.

■uy's Hospital War Memorial Fund
Guy's Hospital War Memorial ...
The Unveiling of the War Memorial, July loth, 1921

PAGE

1
6
8

Part I.

Obituary

Part II.

Decorations and Honours ... ... ... ... ... 107

Foreign Decorations ... ... ... ... ... 128

Honours for Guy's Hosgital Nurses ... ... ... 130

War Services ... ... ... ... ... ... 135

War Services of the Administrative Stafi ... ... 200

Guy's Nurses and the European War, 1914 to 1919 ... 202

Part III.

1. Guy's Hospital during the War. By E. P. Poul-
ton, M.D., F.R.C.P

EI. Chemical Research and Munition Work at Guy's
Hospital Medical School. By T. Martin Lowry,
C.B.E., Hon. M.A. (Cantab.), D.Sc. (Lond.),
F.R.S., F.C.G.I.

HE. Offioers' Section, Guy's Hospital. By J. Fawcett.

IV. Queen Mary's Royal Naval Hospital, Southend-on-
Sea. By Sir William Hale-White, K.B.E. ...

11
21

viii. Contents.

V. Some Observations on the Sick and Wounded
from the Gallipoli Campaign. By Charters J.
Symonds, K.B.E., C.B. 27

VI. War Work of the B.R.C.S. Nursing Service. By

Dame Sarah Swift, G.B.E., R.R.C 4.*J

VII. Ophthalmic Practice in ,the Mediterranean and
Egyptian Expeditionary Forces, 1915 — 1918.
By H. L. Eason, C.B., C.M.G., M.D., M.S. ... (Ki

VIII. The Development of Casualty Clearing Stations.

By Owen Richards, C.M.G., D.S.0 115

IX. The War Neuroses and the Neuroses of Civil Life.

By Arthur F. Hurst 125

X. Some Experiences of the Work of General Hos-
pitals in "France. By Philip Turner, M.S.,
■ F.R.C.S 158

XI. Mesopotamia, 1916—1919. By R. Davies-Colley,

C.M.G., M.Ch. 18;]

XII. Dental Surgery and the War. By Montagu F.

Hopson. ... ... ... ... ... ... 197

XIII. The Committee of Reference. By Sir William

Hale-White, K.B.E 213

XIV. The Late Symptoms of Gas Poisoning. By G.

H. Hunt, M.D., F.R.C.P 221

XV. Experiences of a Civilian among the Naval Medi-
cal Service in War. By Sir Alfred D. Fripp,
E.C.V.O., C.B., MS., F.R.C.S 229

XVI. Mobile Laboratories. By Major A. C. H. Gray,

O.B.E., R.A.M.C 257

Contents. ix.

\\i\. Some Impressions of a Divisional Sanitary Officer
in France. By C. D. Edwards, M.C., M.D.
Camb., D.P.H 273

X\ ill. Reminiscences of a Prisoner-of-War in Turkey.

By C. E. M. Jones, Captain 'K. A. M.C.(T.) ... 291

XiX. A Prisoners -of -War Library. By Major Luxmoore

Newcombe and Lieut. John H. E. Winston. ... 3Uo

XX. The War and Guy's Nursing' Service. By Miss

F. A. Sheldon 317

XXI. Tlie 2nd London General Hospital. By F. J.

Steward, M.S., F.E.C.S ... 323

XXII. Work in the Bacteriological Department, 1914 —

1919. By John W. H. Eyre 327

LIST OF ILLUSTRATIONS.

PLATES.

Tilt! Memorial Arch as seen from the Park

The Memorial Arch as seen from the College ...

The Arrival of the Duke of York

The Unveiling- Ceremony ...

The Duke of York speaking at Unveiling Ceremony

TO 1<"ACE
TAGE

Preface >

1 I

8 \

10- '

10 j
12

Part III.
Dr. Arthur F. Hurst —

Illustrating his Paper on the War Neuroses and the

Neuroses of Civil Life ... 133, 136, 137, 139, 141, 142

POETRAITS.

Part I.

PAGE

Allen, N., Capt

Atkinson, N. M. H., Lieut.

Ball, M. E., Lieut

Bond, A. B

Bouic, A., Lieut.

Brogden, I. R. R., Lieut. ...

Cole, A

Davies, G., Capt

Dennett, T. F. P. T., Lieut

Dingley, W., 2nd Lieut

Dix, C. B., Lieut

Edmond, J. A., Capt.

Gardinner, I. J., Lieut

Gardner, A. L., Capt.

List of Illustrations.

PAGE

Cioen, C. L., 2nd Lieut 39

Harris, W. A

Harrison, 8. S. B., Major...

Hajnes, C. G., Capt

Hennessey, P. W. H., Corp.

Hogben, H. F. T., Lieut

Hollands, W. G

Hopkins, H. L., Lieut.

Hno-h-.Tones, K. H., Capt....

James, J. S. H., Lieut.

Kennedy. R. S., Major

King, P., 2nd Lieut.

Knio-ht, R. v., Flight Sub-Lieut...

Kyna^ton, A. E. F., Surg. R.N....

iyi)

Laoey, W. S., Lieut.

Lansdale, W. M., Capt

Leckie, M., Capt. ...

Lowe, F. A., Lieut

Ma.sh, 0. N., Lieut

Maxwell, J. E., Sub -Lieut.

Miller, G. S., Capt....

Monk, G. B., 2nd Lieut

Moorc, L. W., Capt

Neely, H. B., 2nd Lieut

Gates, J. L

Parry-Jones, 0. G., Capt

Peattield, S .J., 2nd Lieut

Pern, M., Lieut. ...

Pryn, W. R., Lieut

Reckitt, C. E., Surg. R.N.

Robertson, J. C, 2nd Lieut.

Sandoe, M. W. A., Lieut.

Saw, N. H. W., Capt. i

Seabrooke, A. S., Capt

Sj^ong. R. W., Lieut

Xll.

TJM of Illustrations.

i'\<.i;

Staoey, .1. B., 2nd Lieut

85|

Stainer, C. H., Lieut

86^

Stanwell, W. A., Lieut

87?

Start, S., Lance Corp

Tilbury, A., Capt

Traill, A. A., Capt

91^

Traill, K. R., Lieut

Waghorn, L. P., 2nd Lieut.

Weimberg', A.

Weller, C, Capt

Whitworth, H. P., Capt

Gladstone, Miss Elsie M

Hopkins, Miss Evelyn

100

Morrell, Miss Marv L.

101

WOODCUTS AND DIAGRAMS.

Part III.

Mr. H. L. Eason —

Illustrating his Paper on Ophthalmic Practice in the |

Mediterranean and Egyptian Expeditionary Forces, ',

1915—1916 87, 100, 102, 103!

Major LuxMOORE Newcombe and Lieut. John H. E. Winston — j
Illustrating their Paper on a Prisoners-of-War Ijibrary 308 j

Gulfs llospildl Win' MeinorUd.

GUY'S HOSPITAL WAR MEMORIAL
FUND.

The widespread desire amongst all connected with Guy's
Hospital that a permanent Memorial should be established in
memory of those from Guy's who lost thieir lives in the war was
recognised at the School Meeting of November, 1917, when an
Appeal Committee was appointed. The first meetings of this
Committee, under the chairmanship of Mr. Cosmo Bonsor, the
President of the Hospital, were concerned with the scope of
the appeal and the constitution of the War Memorial Com-
mittee. The proposals which received most consideration were
the following : —

(a) A Memorial recording the names of Guy's Medical
and Dental men wdio have fallen in the War to be placed
within the precincts of the Hospital.

(b) A Fund to enable the sons of Guy's men, who
have fallen, or suffered by the War, to receive free or
assisted education at Guy's Hospital Medical or Dental
Schools.

(c) A Fund to enable the daughters or widows of
Guy's men, who have fallen, or suffered by the War, to
receive free or assisted education as Nurses or Pupils in
the Special Departments (such as the Massage and Light
Departments) of the Hospital which are open to Women.

(d) An Endowment Fund for Entrance Scholarships to
be open, in the first place, to the sons of old Guy's men.

Guj/s Hospital War Memorial Fund.

TliG Wai- Memorial Coinmii

('(' was c

constituted as follows:

A. — Governors' Rkpresentatives.
President of the Hospital (H. Cosmo 0. Bonsor, Esq.)
Treasurer of the Hospital (The Rt. Hon. Viscount Goschen).
Chairman of the House Committee (F. P. Whitbread, Esq.).

Sir W. Cameron Gull, Bart,
Colonel F. A. Lucas.
R. E. Johnston, Esq.
A. C. Cole, Esq.

J. RoBARTS, Esq.
H. a. Trotteh, Esq.
Major Oswald Magniac.

B. — Representatives of the Hospital and School Staff.

Sir W. Hale-White, K.B.E.

Mr. GOLDING-BlRD.

Sir Charters Symoncs, C.B., K.B.E.
Sir Arbuthnot Lane, Bart., C.B.

Mr. HiGGENS.

Mr. Maggs.

The Senior Physician

(Dr. Shaw).
The Senior Surgeon

(Sir Alfred Fripp).

Mr. HopsoN.
Mr. Rowlands.
Dr. Cameron.
Mr. Bromley.
Dr. Eyre.
Dr. Laidlaw.
Mr. Ryffel.
The Hon. Dean

(Sir Cooper Perry),
The Sub-Dean (Dr. Pembrey).

C. — Representative Guy's

Mr. E. D. Bascombe.
Mr, W. A. Bulleid.
Mr. L. S. Debenham.
Dr. Wheelioit Hind.
Dr. E. R. Mansell.
Dr. R. C. Mullins.
Sir Shirley Murphy.
Dr. C. D. MusPRATT.
Dr. C. J. Pinching.
Mr. A. E. D. Prideaux.

Men (Past and Present).

Dr. R. J. Ryle.
Sir George Savage.
Mr. J. E. Spiller.
Dr. H. J. Spon.
Mr. Chas. Spurrell.
Mr. W. E. Wood.
*The President op ehe

Residents.
*The Editor of " Guy's

Hospital Gazette.
Ex-officio.

The Joint Treasurers appointed were ^Ir. Cosmo Bonsor,
Mr. Maggs, Dr. Shaw, and Sir Alfred Fripp; and Dr. Pembrey
was made Honorary Secretary.

Guy's Hospital War Memorial Fund. 3

An appeal asking for subscriptions, suggestions, and expres-
)ns of opinions on the four proposals was issued in November,
l'Jl8. The question of the issue of a Special War Memorial
Number of "Guy's Hospital Gazette" was referred to the
i^ditor of the " Gaze.tte," assisted by a Sub -Committee, com-
posed of Dr. Shaw, Sir Alfred Fripp, Mr. Hopson, and the
ifonorary Secretary. The result was the publication of . the
^^'ar Memorial Double Number of the "Gazette" on December
th, 1918.

At the meeting of the Committee on June 12th, 1919, it
\\as announced that about 390 subscriptions had been received,
]jut only 183 subscribers had returned the voting papers re-
lating to the proposals (a), (b), (c), and (d) given above. It
was thought well, in view of some objections to these proposals,
issue a furtlier appeal in which the following additional

Ingestions were made : —

1. A portion of the fund to be devoted to the new
" Clijiical " Ward shortly to be built, which should be
called the "War Memorial Clinical Ward," and have in-
subscribed upon its walls the names of the Guy's men
who have lost their lives owing to the war.

2. The adornment of the Dining Hall of the College,
including memorial panels bearing the names of the Guy's
men who have lost their lives in the war.

3. A portion of the fund to be allocated to form the
imeleus for endowment of a Dental Research Scholarship.

Vt the same meeting it was decided that the Fund should be
sed on September 30th, 1919, and a general meeting of sub-
ibers called in October, 1919, to decide upon the form or
ms which the Memorial should take.

rhe Committee held its final meeting on October 28th, 1919»
wlien, after considering a statement of accounts and the results
of the analysis of the preferences for the proposals set forth

4 Guy's Hospital War Memorial Fund.

in the first and second appeals, it decided to place before the
General Meeting of the subscribers the following recommenda- .]
tions : —

(i.) To allocate the sum of £5,300 as follows : —

(«) £2,000 for the erection of a permanent memorial
in the " Park."

(6) £1,000 for the assistance, if necessary, of the
dependents of Guy's men, fallen in the war.

{d) £300 for the memorial adornment of the College
Dining Hall.

(ii.) To appoint an Executive Committee to carry out
the scheme.

The General Meeting of Subscribers held on the same day
approved these recommendations and appointed the Executive
Committee, constituted as follows : — Mr. Cosmo Bonsor, Sir
William Hale-White, Mr. Maggs, Dr. Fawcett, Sir Alfred |
Fripp, Mr. Spurrell, The Dean, the President of the Residents, i
the Editor of " Guy's Hospital Gazette," and Dr. Pembrey > i
(Honorary Secretary). Later on Mr. Eason and Mr. Walford !
were co-opted. H

The Executive Committee held several meetings to consider , |
the typo of the Memorial and finally selected the plans of the :
Memorial Arch designed by Mr. Walford. There was much \ \
difficulty in making a list of the names to be inscribed upon i
the Arch, for there was no exact guide for the selection of the J
names ; every case was considered as far as possible on its ;
merits, and room was left for the inscription of new names, if;j
it should be necessary.

At the request of the Committee and the School, the
Governors of the Hospital accepted in trust the sum of|

Guy's Hospital War Memorial Fund. 5

.ijOOO, and allocated to the Guys War Memorial Trust Fund

.3,519 Is. 3d. 5 per cent. War Stock 1929/47. In this way
provision has been made for the assistance, if necessary, of
1 lie dependents of Guy's men, fallen in the war, and the en-

iijwment of Scholarships, preferably for the sons of old Guy's

len.

The School accepted the suggestions of the Executive Com-
litteo that of the two War Memorial Scholarships tenable at
viuy's, one should be for Medical and one for Dental students,
and further agreed 'that a War Memorial Scholarship for Senior
Medical Students should be included, the School to bear the
charge^ as a contribution to the War Memorial Fund.

The Memorial Decoration of the Dining Hall of the College
has been postponed pending possible extensions of the Club.

The subscriptions to the Fund have been acknowledged from
time to time in the " Gazette," and this will be done in future,
for it was arranged at the time of the first appeal that subscrip-
tions could be spread over a period of five years. It is pro-
posed to publish the audits of the accounts in the same way.

Guy*s Hospital War Memorial.

GUY'S HOSPITAL WAR MEMORIAL.

The Arch and Columnar Screen are the design of Mr. William
J. Walford, F.R.I.B.A., the Hospital Architect, and have been
carried out in solid stone from the Island, of Portland. The
old columns taken down from the Museum Building, -which
used to stand in the Park, have by consent of the Governors
been incorporated in the design. The Memorial is 66 feet in
width and the central Arch measures 21 feet 3 inches from the
ground to the top of ih.^ cornice. Upon the central Arch are
inscribed the names of the men who lost their lives, with the
motto across the Arch ''THEIR NAME LIVETH FOR EVER-
MORE." Across the outside of the Arch is the inscription,
"ERECTED BY THE FRIENDS OF THE GUY'S MEN
WHO GAVE THEIR LIVES IN THE GREAT WAR, 1914—
1919," and the Hospital Crest has been carved upon the Arch.

It was thought that the Archway might form the actual
entrance gateway from Great Maze Pond, but lack of funds
has prevented the requisite new wrought iron gates and
enclosure.

The work has been executed by the Hospital Works
Department.

The following are the names inscribed upon the Central
Arch.

Guy's Hospital \Yar Memorial.

Ackroydt Harold
Allen, N.
Atkinson, N. M. H.

Ball, M. E.
Beale-Browne, T« R.
Bearblock, W. J.
Berfy, Percy Haycroft
Blacklaws, A. S.
Bond, Alexander B,
Bouic, Andre
Box, T. H«
Brogden, I. R. R.
Browne, W. Denis

Card, L. O.
Chaning-Pearcc, W. T.
Clifford, A. C.
Cocks, J. Stanley
Cole, A*
Collins, R. T.

Davies, Gcraint
Dennett, T. F. P. T.
Dinan, G- A.
Dingley, William
Dix, Cyril Bernard

Eccles, Horace Dorset
Edmond, John A.
Evans, John Eric Rhys

Faulks, Edgar
Fitzmatirice, A. L.
Fraser, Eldred Leslie

Gardinner, Ivan J.
Gardner, Alfred Linton
Gatley, Charles A. R.
German, H* B.
Gibson, H. G.
Glaisby, Kenneth
Godsill, Stanley
Gough, B. B.
Green, C. L.

Hamilton. E. T. E.
Harris, W. A.
Harrison, Stanley S* B.
Hartnell. E. B.

IN MEMORIAM.

Haynes, Charles G.
Hayward, Milward C.
Henderson* T. E.
Hennessey, P. W. H.
Hogben, H. F. T.
Hollands, Wilfrid G.
Hopkins, Herbert L.
Horton, J» H*
Howard, Charles R.
Hugh-Jones, K. H,

James, John S. H.
Jones, Evan Lawrence

Kelsey, A. E.
Kennedy, Ronald S.
King, Percy
Knaggs, F. H.
Knight, R. V.
Kynaston, Albert E. F.

Lacey* "William Stocks
Lansdale, William M.
Leckie, M.
Liebson, Stephen A.
Llarena, E. F.
Logan, F. T. B.
Lowe, Frank Augustus

Marshall, Bernard G,
Marshall, Herbert M.
Martin, A.
Mash, Oswald N.
Maxwell, John Earle
Miller, G. S.
Monk, G. B.
Moore, L. W.
Morrish, D. B.

Neely, H. B.
Nicholls, W. H.

Gates, J. L.

Palmer, A. H.
Palmer, H. J.
Palmer, John Stanley
Parry-Jones, O. G.
Peacock, R.
Pearce, D. G.
Peatfield, S. J.

Pern, Montague
Pryn, W. R.

Reckitt, Charles E.
Rees, M. J.
Richards, Ernest H. R
Robertson, E. G.
Robertson, John C.
Robinson, William B.
Ross, John Hampden

Sandoe, M. W. A.
Saw, NoeX H. W.
Scott-Pillow, H. M.
Seabrooke, A. S.
Shepherd-Turneham,

N. P.
Shorland, George
Small, F. D.
Smith, D. W.
Snell, Herbert
Snell, Norris.
Snow, C. F.
Sowerby, Victor H.
Spong, R. W.
Stacey, J. B.
Stainer, C. H.
Stanwell, William A.
Start, S.

Stephen, L. H. Y.
Stcyn, S. S. L.

Tilbury, A.
Tolhurst, St. J. A. M.
Townsend, T. A.
Traill, A. A.
Traill, Kenneth R.

Waghorn, Leonard P.
Watson, C. F. W.
Watt, N. L.
Wearing, D. G.
Webster, Edward M.
Weinberg, Albert
Weller, Charles
Whitworth, H. P.
Williamson, Gerald C.
Wyand, E. H.

The Unveiling of the War Memorial.

The Unveiling of the War Memorial
July 15th 1921.

The Prince of Wales, President of the Hospital, had arranged
to unveil the Memorial on July 15th, but owmg to his indis-
position the ceremony was performed by the Duke of York.
His Eoval Highness was received in the Court Room by the
Treasurer, Viscount Goschen, supported by the Governors of
the Hospital and the Staff of the Hospital and Medical School,
and, after certain presentations had been made, was conducted
to a platform near the Memorial Arch and the stand reserved
for the relatives of the Guy's men who had lost their lives
during the War. Mr. H. CoSmo Bonsor, the Chairman of the
Memorial Committee, opened the proceedings with the following-
speech :

"As Chairman of Guy's Hospital War Memorial Committee I
have been instructed to open our proceedings.

We regret the cause that prevents His Royal Higlmess our
President being with \m to-day, and we express the hope that
rest and care will soon restore his health and energy. We
welcome your Royal Highnes.s as a Governor of our Corporation,
and are very grateful to you for coming at so short a notice to
unveil the Memorial which has been erected by the friends of
those belonging to Guy's Hospital and Medical School who lost
theii" lives in the Great War.

Our Hospital and our Medical School are open to the whole
world; we have no religious test. A large number of our students
come from His Majesty's subjects in India and the Dominions;
we had to be careful in our endeavours to please, not to give
toffence, and we could have no religious dedication.

Unveiling of the War Memorial.

The Artiivat. of thr Dukf. of York.

[Photo by General Press
Organisation. |

The UnveUing of the War Memorial. 9

Our Committee consulted our sul^scribers avS to how their
nations of upwards of £.5.000 should be spent.

They decided that, three -fifths of the amount should be
-ted in trustees, to provide assistance, if necessary, to the
pendents of Guy's men who had fallen in the War. and to
vm a permanent War Memorial Scholarship for the relations
those who had lost their lives or been disabled in the War,
who should have preferential claims in the examination to
tain it.

That the balance should be applied in electing a Memorial
in the Hospital Grounds.

Our Committee have handed to Trustees £2,000 for the pur-
poses of the Scholarship, and the first vStudent has been elected.

When it came to the choice of a fitting Memorial we had
many meetings. We consulted an eminent architect and in-
spected many desigiis: we Avere in a difficulty, and it was our
Hospital Architect, Mr. Walford. who suggested that an arch
should be erected through which all our St^iidents both now
and hereafter would pass.

Mr. Walford's proposal met with unanimous approval.

We are here to-day to express our grat^-tude to all those who
came forward to join His Majest}- s forces at the great crisis
in the history of our Country: we appreciate their unselfishness
and devotion in breaking off their medical studies, interrupting
and probably damaging their future prospects for our safety
and for their King and Country's Cause.

We tender to them our heartfelt thanks.

We are here also to honour and i-emember those who gave
their lives for us.

Yoiu- Royal Highness, it is impossible for us who stayed at
home, to put our feelings into words.

10 The VnveJUng of ^i/r War Mcmiirkil.

We have eiecied tliis aichway with their names attached in
order that theii' memory -Iwill jihviiyv be with us reminding us
of their devotion and sacrifice and inspiring us to follow their
example of putting their Country's good before personal
ambitions."

Dr. Fawcett then spoke as follows: —

■' In consequence of holding tlie position of Senior Physictian
I am accorded the privilege of adding a few words to those
offered to you, Sir, by Mr. Cosmo Bonsor.

Not only is there this Memorial Arch, under which Students
and Staff will pass in their frequent '^comings and goings"
from Hospital to Colleg*e, but also from our funds we have
been enabled to allocato three other sums of money in accord-
dance with the wishes of the majority of the subscribers, viz: —

(1) £1,000 for the assistance, if necessary, of the dependents
of Gu3^'s men who fell in the Avar.

(2 J £2,000 for the endowment of Scholarships, with pre-
ference to the sons of Guy"s men.

(3) £300 for a 'memorial" adornment of the College Din-
ing Hall.

You, Sir, will, I am sure, approve of our distribution of the
funds, and in unveiling this memorial to-day, you add yet one,
more favour to those already conferred by your Koyal House,
His Royal Highness The Prince of Wales, our President, and
your beloved Father and Grandfather, upon this great foun-
dation, of w^hich its sons are so proud.

All over this Empire of ours, Guy's men, their parents and
sons, will thank you for the kindly thought and gracious act by
which you to-day record in publio yibur sympathy with us at
Guy's in the loss of the men whose names are engTaved on these
columns, and who, giving up their lives "for King and
Country," have exemplified in full the meaning of our motto

Unveiling of the War Memorial.

The Unveiling Ceremony,

IPhoto by General Press
Organisation.]

1 Photo by Mr. lin/ffle.]

The Duke of York speaking at
Unveiling Ceremony.

The Unveiling of the War Memorial. 11

f "Dare quam accipere." May we, who' pass under this

arch in future, never forget what we owe to them, land play

iir small part in life the better for the way they played theirs.

On behalf of the Staff and the Students niJaiyl I lask you, Sir,
) express to His Royal Highness the Prince of Wales our great

gret at the cause which prevents him being present to-day,
and our sincere wish that he ma(7 speedily be restored to that
measure of health, vigour, and the power to enjoy life which
we invariably associate with him, and by means of Avhich he
lias already done such incalculable good in maintaining and
j>romoting the spirit of peace and goodwill among men, with-
out which our land cannot prosper."

Sir Alfred Fripp made the following speech: —

' Your Eoyal Highness, My Lord, Ladies and Gentlemen, —

It is characteristio of the kindness and oonsideration to Avhich

11 of us whO' serve under the Governors have become accus-

ined, that their spokesman should wish on this memorable

casi'on to be associated with representatives of the Schools

hich are so intimately connected with the work of the Hospital.

The Senior Physician and the Senior Surgeon have therefore

J lie honour toi offer to you, Sii^, the thanks of iall our colleagues

jV)r your kindness in coming to-day.

Professor Pembrey is really the man upon whom fell the
i>nmt of the work of carrying through this Memorial. As Act-
ing-Dean during the War he took up the Secretaryship of the
Memorial Committee, and has discharged the difficult and deli-
ite duties with great tact and ability. We are verj^ grateful
' him and congratulate him upon the success attained.

Well, Sir, this solemn occasion is also a very proud one, and
indeed represents one of the milestones in the successful de-

•lopment of the foundation of Thomas Guy. As we have
111 ready been reminded it is exactly 25 years since that other
"(currence— epoch making in the history of Guy's — when His

V2 The Unveiling of the War Memorial.

iatu Majesty, King Edward, ciiiiio to the rescue of our Hospital,
and becoming our first Royal President, initiated a policy of
rcccHisliiicI i ;)!i and re -endowment wliidi lnr been completed
under the Presidencies of bis Son, King George, and bis Grand-
son, the Prince of Wales.

Under these three successive Royal Pi ; .-i :l;'iils the Governors
of the Hospital, represented with rare tact, judgment, and enter-
prise by Mr. Cosmo Bonsor, who at the same time — 25 years
ago — took up the Treasurership, and by Viscount Goschen, who
followed him, and served whole-heartedly by that great master
and pioneer in hospital administration. Sir Cooper Perry, have
succeeded in maintaining the Hospital and Schools, in the fore-
front of medical, surgical, and dental education and practice.

This quarter of a century has l)een an eventful period, not
only in the history of the world, but also in the amazing [j
rapidity of development of our profession and the sciences upon
which it is founded. Great and rapid as have been the changes
that have marked this dramatic era, they are nowhere greater
than in the field of our bwn profession, and we are thankful
that our Governors have proved themselves to be of the kind
that they know the importance of changing with the times. It
is to their prevision and understanding that we owe the healthi-
ness and the happiness to-day of all the large family whose
destinies are in their hands, and alsio the fact that when the war
broke out Guy's was found ready to act its proper part.

We who have lived through are proud of the part played
by the sons and daughters of Guy's. You, Sir, are about to
unveil the list of those who made the great sacrifice in the ^^
War, and while we all to-day mourn with their relatives, we
believe that the honour and love they felt for their Alma Mater,
were no less than the honoiu" and love the}^ felt for their
Country.

These names — upwards of a hundred — ^i^epiesent the flower
of the generations of students which matured during the event-
ful quartei- of a century to which I have alluded. The in-

Unveiling of the War Metnorial.

The Duke of York speaking at
Unveiling Ceremony.

[Photo by General Presg
Orfianisatioii.]

The Unveiling of the War Memorial. 13

timacy and confidence, and the mutual oonsideration and for-
bearance which have marked the relationship of the various
estates of our family, have resulted in that high degree of
happiness and esprit de corps, which is at once our most
treasured possession and our strongest bond. Perhaps the
world-wide kinship of Guy's is knit all the closer by the loss
of those whom to-day we are assembled in our old home to
honour — for families are wont to knit closer by grievous loss.

We are proud of our memories of them as well as of the
other splendid achievement of Guy's men since our foundation
two centuries ago. We are happy both in the work and in the
sports of our healthy, vigorous, and successfiul present, and
happy in the confidence that our future will be no less success-
ful under Governors no less enlightened, and happy also in the
knowledge that whenever occasion demands we shall he helped
and encouraged by one of the members of your Royial House,
who have so often honoured us as you, Sir, have to-day, when
you so kindly came among us, and took up yoiur membership
of the Guy's family, and filled the plaoe left vacant by the
much -regretted indisposition of our President, the Prince of
Wales."

The Duke of York then left the dais, stood in front of the
Archway, and by drawing the ropes of two large Union Jacks
unveiled the Arch inscribed with the names of the fallen.
The Duke of York said: "My brother, the Prince of Wales,
wishes me to say how very deeply li£ regrets that his temporary
indisposition has prevented him from being here this afternoon
to perform this important ceremony. In ihis' unavoidable absence
it has been my great privilege to unveil this Memorial to com-
memorate the gallant men of Guy's Hospital, who gave their
lives during the Great War, and I would like to take this
opportunity of expressing my sincere sympathy with the rela-
tives and friends of those whose names figure in your long
Roll of Honour."

Pabt I.

Obitiuirtj. 17

OBITUARY.

ACKROYD, HAROLD, Capt., V.C., M.C., M.D. Son of
Mr. Edward Ackroyd, of Southport. Educated at Shrewsbury,
Cambridge, and Guy's Hospital. He took Cambridge B.A. in
1899, and subsequently proceeded to his M.A., B.Ch., M.D.,
and other medical degrees. For some years he was engaged in
research work at Cambridge, while holding a British Medical
Association Scholarship. In February, 1915, he joined the
R.A.M.C. as a Temp. Lieut., and was subsequently promoted
(Captain. He went to France in August, 1915, and gained the
M.C. for conspicuous gallantry as a Battalion Doctor. He
was slightly wounded July 31st, 1917, but, remaining on duty,
was killed in action August 11th, 1917. After his death he
was awarded the V.C., which, together with his M.C, was
presented to his widow^ and small son at Buckingham Palace.

Captain Harold Ackroyd, V.C, M.C, M.D., late R.A.M.C. (at-
tached R. Berks Regt.), was the son [of Mr. Edward Ackroyd, for many
years chairman of the Southport and Cheshire Lines Extension Rail-
way Company. He received his education at Mr. Clough's School,
Mintholme College, Park Crescent, Southport, and then proceeded to
Shrewsbury, and Gonville and Caius College, Cambridge, where lie
took his B.A. in 1899, and subsequently proceeded to his M.A.,
B.C., M.D., and other medical degrees. He was never in private
practice. For some time he was at Guy's Hospital, London, and
later was the House-Surgeon at Queen's Hospital, Birmingham. Then
for a period he was at the 'David Lewis Northern Hospital. Liverpool.
After this he secured a British ^Medical Association Scholarship, and
for some years was engaged in reiseaxch work at Cambridge. In
February, 1915, he was commissioned as a Temporary Lieutenant in the
R.A.M.C., being afterlwards promoted Capt^iin. He went to France
in Ai^ust; 1915, and was invalided home in August, 19K), and went
out again about November. In the meantime he received the notifi-
cation that he had been awarded the Milit;u'y Cross for conspicuous
bravery as a battalion doctor. Captain Ackroyd w.ts iriruricd in 1908.
and up to that time ho resided in Southport. -iin < uIkmi ho ha,s
resided at Royston, in Hertfordshire. -

After his death Capt. Ackroyd was awarded the V.C, and at a
recent investiture at Buckingham. Palace his widow and small son

Obituary.

received both it .'iiid the Military Cross. The London " Gazette "'
describes the actions for which he was granted the V.C. as follows: —

" Utterly regardless of danger he worked continuously for many
hours up and down \imd in front of the line tending the wounded and
saving the lives of officers and men. In so doing he had to move
across the open under heavy machine gun, rifle, and shell fire. He
cai-ried a wounded officer to a place of safety under very heavy fire.
On another occasion he went some way in front of our advanced J in'
and brought in a wounded man under continuous sniping and macfin
guji tire. His hei'oism was the means of saving many lives, and ]no-
vided a magnificent example of courage, cheerfulness, and determina-
tion to the fighting men in whose midst he was carrying out his
splendid work. This gallant officer has since been killed in action."

[Reprinted from The Guy's Hospital Gazette. October 20th, 1917.]

ALLEN NORMAN, Capt., Royal Warwickshire Reg-iment.
Entered Guy's as a Dental Student in May, 1913, and had only
completed his 1st Professional Exam, when he joined up in
September, 19 U. Killed in action, April 14th, 1918.

Ohitiuiry. 19

Xorman Allen entered Guy's as a Deptal Student in May, 1913. He
passed liis first examinations shortly after the outbreak of war. In
Sepcember, 1914, he etalisted in the Artists' Rifles and proceeded to
FrMJice a few months later. In May, 1915, he obtained a Commission
in the 2nd batt. Royal Warwick Regt., land was wounded in tUe Battle
of Loos on September 28th. He was in England until the following
September when he was again ordered to France, being at this time
attached to the 14th batt.

H(3 was promoted Captain in July, 1917. The 14th batt. was
ordered to Italy in November, 1917, and ireimained there until Maich,
1918, when it was again sent to France to assist in stemming thj©
German offensive of that period.

Capt. Allen fell while "gallantly rallying his men in an attack upon
a German outpost " on April 14th, 1918.

[Reprinted from The Guy's Bosyital Gazette, July 26th, 1919.]

ATKINSON, N. M. H., Lieut., younger sou of Dr. T. R.
Atkinson, an old Guy's man, was for a time a student at
Guy's Hospital. On the outbreak of war he enlisted. He sub-
sequently obtained a commission, and was attached to the Royal
Flying Corps. He was accidentally killed at the Aerodrome,
near Cirencester, December 27th, 1916.

Second Lt. Noel Mitford Hanson Atkinson, younger son of Dr.
T. R. Atkinson. He was educated at Cliigweil School, and obtained his
colours for cricket and football; he won many swimming prizes, and
was a colour-sergeant in the School O.T.C.

20 Obituary,

lie passed the London Matriculation, and eintered Guy's. After a
year at the Hospital he decidepi on a business career and obtained
a clerkship in the Hong Kong and Shanghai Bank.

On the outbreak of war he enlisted in the U.^P.S. Battalion Royal
Fusiliers, where he was soon after joined by his elder . brother who
came over from British Columbia to enlist.

In November, 1915, they were sent out to France, and spent the
winter in the trenches. He becarale a sergeant. Early in 1916 they
were sent home for commissions, wdre at Balliol College, Oxford, and
finally poste^d to the East Lanes. Regt. The elder, Guy, was sent
to France again in October, 1916, was wounded at the battle of th^^
Ancre, and died of gas gangrene on October 30th. The younger, Noel,
had become attached to the R.F.C., and whilst training, having passed
his examinations flor a pilot, was accidentally killed at the aerodrome
near Cirencester on December 27th, 1916.

[Reprinted from The Ghiy's Hospital Gazette, February 22nd, 1919.]

BALL, M. E., Lt., R.A.M.C. Qualified M.R.C.S., L.R.C.P.
in 1908, continuing a year later to M.B., B.S. (London). Acted
in capacity of Editor of the Gazette. Commissioned in R.A.M.C.
September, 1915. Served in Gallipoli and Mesopotamia. Later
on the Tigris Front; lie was severely wounded on April 9th,
1916, and died next day at the 16th C.C.S., Orah, Mesopotamia.
He leaves a widow and two children.

Lieutenant Malcolm Edward Ball, R.A.M.C, was the fourth son of
Edward BaU, J.P., and Mrs. Ball, of Lewisham Hill, London, S.E.

Ohitiuiry. 21

^•:ducated at the Koan School and New College Margate, he entered
fruy's Hospital as a student, and qualified M.B.C.S., L.R.C.P. in
1908, continuing a year later to M.B., B.S. London.

Only last year in response to the urgent appeals of the British
Medical Association he offered his sesrvices to the Royal Army Medical
11'orps and was given a commission ijn September. At Suvla Bay he
contracted dysentery and was invalided to Malta. On recovery he
Nvas attached to the Worcester Regiment and proceeded to the Tigris
fiont, where, on April 9th, 1916, he was severely wounded and died
next day.

[Reprinted from The Guy's Hospital Oazette, June 3rd, 191(5. ]

BEALE-BROWNE, T. R., West African Medical Staff. Lost

at sea, 1918. i

After leaving Dean Close School, Cheltenham, Thomas Richard Beale-
lirowne entered Guy's in 1895 and qualiflejd in 1901. He was always
vBen on sports of all kindsi, and while at Guy's took several prizes.

He afterwards distinguished himself in rifle-shooting both at home
and in Nigeria. After a few yetans spent in lunacy work at Taunton
and the County Asylum of Northamptcai, he entered the West African
Medical Service, and on his first tour, 1907 — 08, accompanied the
Anglo-German Boundary Commission and afterwards did good work
as medical officer in various districts of West Africa. He was
always greatly interested in microscopical work, and while stationed
at Yaba, near Lagos, made some interesting investigations with his
friend Dr. Counal, Director of the ReseN^xch Institute. His chief
work there, however, was in connection with leprosy when, after
months of special treatment, he had the satisfaction of noting improve-
ment iu several cases, and in one case an apparent cure which at least
lasted for two years, but unfortunately he lost sight of this patiept
after that time.

Since January, 1917, he was stationed at [Victoria in the Camei'oons,
and after a prolonged and strenuous tour was on his way home for
leave, but wi^in a few hours of landing his boat, the s.s. " Burutu,"
owing to storm and the war condition of no lights under which they
were sailing, came in collision with the s.s. "City of Calcutta," and
he with many other passengers was drowned.

He was tihe eldest son of Colonel )and Mrs. Beale-Browne, Doodes-
wcU House, Gloucestershii-el, and in 1910 married Helen Heron Hay,
daughter of the late Donald MacDonald, Edinburgh, and is survived
'by her. His untimely death entails a s^^eiry great loss to the W.A.M.S.
and to his many relatives and friends. .

[Reprinted from The Gui/s Hospital Gazette, December 14th, 1918.]

BEARBLOCK, WALTER JAMES, Surgeon-Commander,
R.X. Entered Guy's in October, 1883, and obtained the Con-
joint Diploma in 1887. For a short time he was Assistant
Hoiise-Surgeon at the Royal Albert Hospital, Devonport.

During the war he served on H.M.S. Invincible and was
awarded the medal for the Falkland Islands Battle.

22 Ohitiuiry.

BEKRY, PERCY HAYOEOFT, Lieut. He entered 191U,

qualified L.R.C.P., M.R.C.S., 1913, M.B. (Cantab.), 19K3.

Held appointment as A.H.S., 1914. S3rved with the R.A.M.C.

and Western Frontier Fierce, Egypt. Drowned in attempting

to save another man.

Dear Sir,^ — I have received numerous letters of inquiry from his
friends as to how P. H. Berry met his death. The following are a few
pajticulars about the latter part of his career which I feel very many
of his contemporaries are anxious to know: —

Percy Berry left general practice to join the K.A.M.C. on May Ist^
1915, and shortly afterwards left Aldershot for Alexandria with a draft.
He was appointed to the hospital ship "Assaye," and was engaged in
transporting the wounded from Gallipoli through the summer and autumn.
Subsequently he was attached as M.O. to the Berkshire Yeomanry, and
with them joined the Western Frontier Force of Egypt in the campaigxa
against the Senussi. In this he was completely happy, and declared
that he had at last found the ideal form of warfare.

The official account of his death states: "On 10th March, at Berrani,
seeing man drowning, plunged off rock into heavy surf with all clothes
on to rescue. Immediately big wave broke over him, and he disappeared.
Body found five hours later with large wounds, head, apparently ante-
mortem. Buried 11th March, at Berrani, with military honours."

All who knew him well will remember how typical the end was of the
man.

Berry was too well known to require any attempt at description in a
hospital paper. — Yours faithfully,

1, Mildred Avenue, V. GLENDINING.

Watford, Herts.

24th March, 1916.

[Reprinted from The Gxtifs Hospital Gazette, April 8th, 1916.]

BLACKLAWS, ALEC. STUART, son of Mr. David Blaek-
laws, City Councillor of Kimberley, South Africa, entered Gruy's
Hospital in May, 1914, as a third year Dental Student.

During his studentship at Hospital he showed himself an
enthusiast in all branches of sport and was very conspicuous
as a member of the Hospital football eleven.

He qualified for the L.D.S. in May, 1916. He immediately
joined the Officers' Training Corps, and was appointed 2nd
Lieutenant to the Royal Field Artillery on 12th March, 1917.
For gallantry and distinguished service in the field he was
awarded the Military Cross.

He was killed in action in France on the 7th January, 1918.

Ohittiary.

BOND, ALEXANDER BECKETT, Capt., R.A.M.C. Edii-
;ited at Bradfield College and Guy's. He entered Guy's as a
Medical Student in 1910, gaining the Guy's Arts Scholarship'.
He was concussed while playing football in 1913, and was
obliged *n consequence to give up Medicine. In 1915 he sailed
for Australia, where he took' up k post as Schoolmaster. To
the surprise and admiration of his friends, he returned to
England in January, 1917, with an Australian Contingent.
IFe succumbed November 5th, 1917, while a prisoner of war
in Germany, to wounds received in France during April of
that year.

IIo combined with his knowledge of the classics a true appreciation
r good music and painting. He was the possessoi- of a very pleiasant
i)ice, and although his shyness prevented him from performing at
nspital concerts, he overcame this whem his more intimate friends
i-itod him at his home.

Another name has been laddefd to Guy's Roll of Honour, and we feel
-lire that all those who knew him will join us in expressing our deepest
-ympathy with his family in their great loss.

[Reprinted from The Guy's Hospital Gazette, September 21st, 1918.]

Obituary.

BOUIC, ANDRE, Lieut. Entered Guy's as a Medical Stu-
dent in 1914. Having passed the 2nd Conjoint in the early part
of 1916, he joined the forces. He was killed in a flying accident
while holding the rank of Lieut, in the Royal Flying Corps.

All those who have known him must feel deeply grieved at the
death of Lieut. Andre Bouic in the Eoyal Flying Corps. He passed
his Second Conjoint at the beginning of last year, and though he was
perfectly justified in staying on at the hc^pital, he felt it his absolute
duty to join the forces. He did so, leaving behind great affections,
above all his fiancee, to whom he Piad only a few days previously be-
come engaged. His sense of duty and uprightness was so great that
once he had made up his mind jhe nejver hesitated. No one who knew
him could fail to appreciate his most charming and attractive per-
sonality. His brilliant intellect, combined with his devotion to his
friends made him a great favourite whefrever he happened to be.

He died gloriously, serving his country and in a manner becoming
his generous nature. We tan only wish he could see how his memory
is dear to all he left.

[Eeprinfced from TheGuif^ Ho^vpital Gaze^tte, April 21st, 1917.]

BOX, T. H. Formerly Junior Clerk in the Counting House.
Served in the Northumberland Fusiliers as a Lance -Corp oral
and was kilbd in action, May 4th, 1917.

Ohituary. 25

BROGDEN, I. E. R., Lieut., R.A.M.C. Was educated at
Marlborough, Cambridg-e, and Guy's. He entered the Wards in
1914, and after qualifying held appointments as Out-Patient
Officer and H.S. to Mr. Dunn. On completing the latter ap-
pointment he joined the R.A.M.C, and shortly afterwards,
while proceeding abroad to Egypt, was drowned on the Arcadian
on April 15th, 1917.

It was witli great regret that all his friends heard that Lieut.
I. K. R. Brogden was reported by the War Office as " missing, believed
drowned," on April 15th. He had been in the R.A.M.C. for some
?i.K weeks only and was on his iway to Egypt.

Lieut. Brogden was 24 years of age and was educated at Marl-
borough, Clare College, Cambridge, and Guy's. He tentered the wards
here in January, 1914, land, after doing the usual ward appointmejnts,
was appointed Out-Patient Officer and later House-Surgeon to Mr.
Dunn. On completing the latter appointment he lentered the R.A.M.C.
and as Pbie was passed fit for garrison service abroad was being sent
to Egypt when he met his death. No deltails have up to the present
been heard, bu|b it is thought that he was probably lost On ihei Arcadian.

[Reprinted from The Guy's Hospital Gazette, May 19th, 1917.]

BROWNE, W. DENIS, Lieut., Royal Naval Division. Edu-
cated at Rugby and Clare College, Cambridge, he came to Guy's
in January, 1913, and succeeded Clive Carey as organist to the
hospital and conductor of the musical society. He took part in
tlie Antwerp Expedition. Killed in action at the Dardanelles on
June 7th, 1915.

26 Obituary.

Me was educated at Rugby school and Clare College, Cambridge,
where he heJid' a cla.ssical and two musical scholarships, and was already
marked as a musician of exceptional promise.

His compositions includjed a short baJLeifc and a few admirable songs,
and some Latin clmrch music which has been performed at Westminster
Cathedral.

He joined the Royal Naval Division in Septdmber, 1914, with his
friend Rupert Brooke, and took part in the Antwerp Expedition. He
was slightly wounded at the Dardanelles on May 8th, 1915, and had
only just rejoined his battalion when he Was killed.

His singular charm of character had gained Jiim many friends, and
he will be long rcmembe(red by all who met him at Guy's.

[Reprinted fi'om The Guy's Hospital Gazette, July 17th, 191.5.]

CARD, LEWIS OSWALD. Entered Guy's in 1897, but
left before taking any professional examiujation to join the
Regular Army. He served through the Boer War between
1899 — 1903, with the Border Horse and the Imperial Light
Horse, and obtained two medals with seven clasps. In 1906 he
served with the Transvaal Mounted Rifles in the Zululand Re-
bellion, where he obtained the medal and clasps. Between
1906 and 1914 he was a member of the H.Q. Squad of the
Northern Mounted Rifles — was a first class shot and was a
member of the Loyd-Londry team of the H.Q. Squadron.
'During the war he was promoted to the rank of Corporal and
would have taken his commission, but died from Avounds whilst
serving with the R.A.S.C.

CHANING-PEARCE, WILFRID THOMAS, Temp. Capt..
M.C. and Bar, R.A.M.C. Was educated at Rugby, Cambridge,
and Guy's. He qualified early in 1911. Soon after commence-
ment of hostilities he joined the R.A.M.C, and was serving in
France until the time of his death. He received the Military
Cross in 1917. He met his death on October 1st, 1917, being
shot by a German at close range while nobly carrying out liis
duty.

It is with very deep regrejt that we have to announce in the
casualty list the name of Temp. Capt. Wilfrid Chaning-Pearce, M.C.
R.A.M.C; the third son of Dr. and the late Mrs. Chaning-Pearce. of
Montague House, Ramsgate. He was educated at " Lindenthorp,"

Obititary. 27

Broadstaii's, and Rugby, and later entered Emmanuel College, Cam-
bridge, where he took his Scieoice Tripos land commenced his medical
studies. Continuing at Guy's in 1908 he held numerous appointments
and was held in very great esteem Iby all with whom he was associated
in any way during that time, until his departure on qualifying early
in 1911.

Soon after the commencemept of hostilities he joined the R.A.M.C,
and had been serving in France practically since that time.

No mention of how the Military Cross was gained has been received
by the family, except in the bare official announcement that it had
been bestowed early in September, 1917.

[Reprinted from The Guy's Hospital Gazette, November 3rd, 1917.]

CLIFFORD, A. C, 2nd Lieut., 3rd Dragoon Guards. Edu-
cated at Marlborough and Emmanuel College j Cambridge. Quali-
fied M.B., B.C. (Cantab.); M.R.C.S., L.R.C.P. Was President
of the Residents. Killed in action at Ypres, June 1st, 1915.

COCKS,, J. STANLEY, Capt., R.A.M.C. Died from typhus,
at Beyrut, 1919.

To many Guy's men the news of the deiath of J. S. Cocks at Beyrut
following typhus will be a source of profound regret. Those who knew
him intimately will mourn one of those rare and lovable characters
whom it is a privilege and a pleasure ito know. Those who knew him
more casually will miss the merry, quaintly humorous, yet withal seorious,
figure of their hospital days.

He was decidedly a shy and sensitive man. On first acquaintance
he often passed as a quiet, retiring fellow of no very remarkable parts.
What a tremendous misconception ! He had force and determination
the casual observer would never dream he possessed. If Jack Cocks
made up his mind to do a thing nothing would deter him, provided he
thought it the right -and proper thing to do. He wouldn't argue about
it or explain, but simply did it.

[Reprinted from The Gwj's Hospital Gazette, March 8th, 1919. J

28 Obituary.

COLE A., Pte. Employed in the Works Department. Joined
the 8th Eoyal Berks. Regt., and died on service, May 22nd,
1918.

COLLINS, R. T., Lieut.-Col. D.S.O., R.A.M.C. Qualified
at Guy's in 1902. Entered R.A.M.C. in 1903, became a Capt.
in 1907, ^Major in 1915, and Temp. Lieut.-Col in 1916. Received
D.S.O. in 1918, and also gained the Croix de Guerre. Killed
in action on September 18th, 1918.

Lieut.-Col. Keginald Thomas Collins, D.S.O., E.A.M.C., was kiUed
in action on September I8th, aged 38. H© was born on December
22nd, 1879, the only son of Dr. JWolfenden Collins, late of Sydelnham,
and was educated at Guy's Hospital, taking the diplomas of M.K.C.S.
and L.R.C.P.Lond. in 1902. He entered the R.A.MC. as lieutenant
•on August 31st, 1903, became captain on .'T'ebruaj-y 28th, 1907, major
•on February 28th, 1915, and . temporary lieut.-col. on September 11th,
1916. He received the D.S.O. on January '1st, 1918, and also had
gained the Croix de Guerre.

[Reprinted from The Guy's Hospital Gazette, November ,'30th, 1918.

Obitu^rp. 29

[

DA VIES, GERAINT, Capt., 9th Northumberland Fusiliers.
Elder son of Dr. Morgan Davies, M.D., F. E.G. S., Goring Street,
St. Mary Axe, was mortally wounded, gallantly leading his men
in a counter attack near Neuve Eglise at dawn, Sunday morn-
ing, the 14th April, 1918.

Piissing the Matriculation in January, 1914, li6 ientered Guy's Hospital
for the M.B. course the foUowing October, and' passed in " First
Medical " in July, 1915. Relinquishing the profession for which
he had so many aptitudes he joined (the .Artists' Rifles O.T.C., Novembei',
1915. On the 15th of July, 1916, he was gazetted Second Lieutenaat
to the 4th (Res.) Battalion Northumberland Fusiliers, and on October
14th, 1916, he passed over to France, where he was attached to the
9th Northumberland Fusiliers, in which battalion he remained until
the end. The story thence onwardjs is the story of being continually
engaged holding various points along the fighting front — at Les Boeufs.
Le Transloy, Sailly-Saillisel, St. Leger, Monchy-le-Preux, Gavrclli.
Hargicourt, Poel Capelle, Wancourt, Hcvin, Armenti6rs, and Bailleul.
From Second Lieutenant he was gazetted full Captain on December
27th, 1917 — ample testimony of his capacity and sagacity as an officer.

Obituary.

DENNETT, T. F. P. T., Lieut., Queen's Royal West Swrey
Regt. (attached R.E.C.). He was educated at Whitgift School
and Guy's. At the outbreak of war he joined the Surrey Yeo-
manry, and went out to Egypt and the Dardanelles in the 29th
Division. In March, 1916, he left for France, where he served
for some time. In December, 1916, he obtained a commission in
the Royal West Surrey Regt. He was again sent to France, ati-
tached to the Royal Flying Corps. On August 4th, 1917, he
died of wounds received during a flight over the German lines.

Lieut. T. F. P. T. Dennett was educated at the Whitgift School.
Croydon, and Guy's Hospital. On the outbreak lof war he joined the
Surrey Yeomanry and went out to Egypt ^d . the Dardanelles with
the 29th Division. In March, 1916, he left for France, where he
served for some time. In August, 1916, he returned to England to
obtain a commission, and on December 19th, 1916, was gazetted to
the Eoyal West Surrey RegimCint. He was lagain sent to France, and
was soon attached to the Flying' Corps. On August 4:th, 1917, he died
of wounds received during a flight over the German lines. His
squadron commander thouglht vexj highly of him, and he was ex-
tremely popular among all with whom he came in contact. In his
work he was absolutely fearless. Thougfh not |at Guy's for very long,
he was much liked by his contemporaries, to whom his death will
be a source of great sorrow.

[Reprinted from The Ghiy's Hos^yitM Gazette, September 8th, 1917. J

Obituary. ai

DIN AN, G. A., 2nd Lieut., Royal Dublin Fusiliers. Edu-
cated at University College, Cork, and Guy's. He was well-
knoAvn in cricket circles. Commissioned in January, 1916, to
Royal Dublin Fusiliers. Killed, September 9th, 1916.

Second Lieutenant Greorge Albert Dinan, Royal Dublin Fusiliers,
killed on September 9th, was the fourth ison of Mr. John Dinan, of
Knockeven, Rushbrooke, Queeoistown, Ireland. Born in April, 1891.
he was educated at the Beaiedictine College, Ramsgate, and was sub-
sequently a student of University CoHqge, Cork, and of. Guy's Hos-
pital. London. He was well known in cricket circles. He received his
commissioiR in January of this year and was gazetted to the Royal
Dublin Fusiliers.

[Reprinted from The Guy's Hospital Gnzette, October 7th, 1916.]

DINGLEY, WILLIAM, 2nd Lieut. Born at Barnet, Sep-
tember, 18C5, youngest son of Mr. W. Dingley, Tufnell Park.
Joined the U.P.S. in September, 1914, went with the Brigade
to France, November, 1915, was gazetted to the 7th Suffolks,
July, 1916. After fighting on the Somme, .Avas killed near
Arras gallantly leading his platoon, April 29th, 1917.

Obituart/.

DIX, CYRIL BERNARD, Lieut. Entered Hospital 2nd Octo-
ber, 1914. Voluntarily enlisted in the Artists' Rifles, Novem-
ber 22nd, 1915, and gained commissioned rank as 2nd Lieut.
8th East Surreys, in May, 1917. Killed in action while leading-
his platoon to attack at Zillebeke (Belgium), August 10th, 1917.
Age 20.

ECCLES, HORACE DORSET, Capt., R.A.M.C. Entered
Guy's in 1888 and qualified in 1893. After qualifying, he prac-
tised in South Africa for about three years, subsequently migrat-
ing to New Zealand where he established himself in a practice
in North Island. He served in the Boer War with the 8th New
Zealand Contingent as Surgeon -Captain. At the outbreak of
the present war he offered his services to the Home Government
in either a combatant or medical capacity, and was granted a
Captaincy in the R.A.M.C. He was attached as Medical Officer
to the 13th Royal Irish Rifles, with whom he remained until his
death, late in 1917. He was mentioned in despatches a few
weeks before his death.

Eccles was dS, a most kind and lovable nature and will long be re-
membered with affection by his many flriends in the Old Country and in
the Colony. He was an all-round sportsman, a good shot, and a keen
fly fisherman. While in the Medical School he won the three-mile
race on one occasion. Like most sportsmen he was very fond of
animals.

[Reprinted from The Gtnfs Bosfiial Gazette, December 1st, 1917.]

Obituary. . 33

EDMOND, JOHN ADAMSON, Capt., R.A.M.C. Entered
Guy's, 1905. Qualified, 1910. Later held appointments as
A.H.S. to Mr. Turner, then Out-Patient Officer and later H.S.
to Sir Alfred Fripp. Appointed anaesthetist to the Hospital in
1913. Joined R.A.M.C. in May, 1916. Killed in France in
December, 1917, while attending to wounded under heavy shell
fire at an advanced Dressing Station.

To the already long Koll of Honour pf Guy's men one has reluctantly
to add another well-known and familiar name, that of John Adamson
Edmond. Born on May 20th, 1887, he "Was the younger son of J. A.
Edmond. Esq., late of the Civil Service.

Ho was educated at a preparatory school and the City of London
School, and entered Guy's in October, 1905, passing his Second M.B.
in January, 1908. In 191B he obtained his M.B., B.S., and was ap-
4)ointed Anaesthetist to the Hospital in January, 191G, liaving previously
been Resident Meiiical Officer in Bright.

In 1915 he entered into partnership with Robert and the late
Arthur Tilbury, R.A.M.C. He had only a short period of private
practice, but he was fast making liimsalf a favourite on account of
his personality and his "powers as a general practitioner.

In May, 1916, he was given a commission in the R.A.M.C, and
served first on an ambulance train in France. He was then transferred
to a Field Ambulance with which he remained until the time of his
death.

We offer our heartfelt sympathy to his wife (Sister Tilbury, late
Sister Cornelius) and his small daughter on the great loss they have
sustained.

[Reprinted from The Gmfs Hospital Gazette, January 12th, 1918.]

I'ART I. O

84 Obituary.

EVANS, JOHN ERIC RHYS. Entered Guy's 1908. Quali-
fied L.D.S. 1912. Killed ia action, Dardanelles.

FAULKS, EDGAR, Lieut., R.A.M.C. Entered in 1897,
qualified L.R.C.P., M.R.C.S., 1902. Held House Appointments
as A.H.S. and H.S. in 1903. Died of wounds in France,
September 27tli, 1915, while attached to the 95th Brigade,
R.F.A.

FITZMAURICE, A. L., Colonial Medical Service. Died on

service, 1915.

"We regret to announce the death of A. L. Fitzmaurice, which took
place in Somaliland.

Born on April ISth, 1SS5, he was educated at Belvedere School, Ilay-
ward's Heath, and matriculated into London University in June, 1903.
He entered Guy's in October of the same year and passed the Final
Conjoint in 1909. He held various house appointments, being A.H.S.
to Mr. Fagge from January to June, 1910, and H.P. to Dr. Shaw from
July to December. As a resident he gained much appreciation as an
anaesthetist, and his popularity with his colleagues was such that he
became Vice-President of the Residents.

In February, 1911, he went to the Bagthorpe Infirmary, Nottingham,,
where he remained for about eighteen months. He next held an ap-
pointment at the South Eastern Hospital, New Cross, from August, 1912,.
till early in 1914. He took the M.B., B.S. degree in May, 1913. After
a course at the London Tropical School of Medicine he joined the-
Colonial Medical Service, and left England for Berbera, British Somali-
land, on April 30th last. The date and circumstances of his death are
not yet known; the last letter received was written from Burao, whero-
he had been attending to Indian troops wounded in the recent fighting
in the interior of the Somaliland Protectorate. He was then in the
best of health and spirits.

[Reprinted from The Guy's Hospital Gazette, January 30Lh, 1915.]

FRASER, ELDRED LESLIE, 2nd Lieut., Tank Corps. En-
tered 1909, qualifiad L.D.S., 1912. Killed in action, 20th
November. 1917.

Obituary.

GARDIXNER, IVAN JEPHSON, Lxut. (21 years). Younger
twin son of Dr. Gardinner, King's Lynn. Served in Egypt,
1916, with l/oth Norfolks. Trained for R.F.C. in Egypt, acted
as Observer in Palestine, 1917, and was Lecturer in No. 3,
S.M.A., Cairo, 1917 — 18. Invalided home. Lost at sea through
the torpedoing of the Leasowe Castle, May 28th, 1918.

GARDNER, ALFRED LINTON, Capt.,
1901, qualified L.R.C.P., M.R.C.S., 1912.
1918.

R.A.M.C. Entered
Killed in action,

,}() Ohitiuiry.

Born at llfracombe in 1882, t!ie saii of the late John T. Gardner. .1
practitioner of that town, he foll;>wed his father and two uncles n- ;i
student at Guy'is Hospital, entering in the year 1901. He was dresM 1
for Sir Arbuthnot Lane and Mr. Dimn, and, after qualifying, becaino
Assistant Medical Officer ut th3 Sick Asylum, Bromley-by-Bow, where
ho stayed for about one year, and tlwm, having married, settled in tlie
family practice at llfracombe.

He was a musician of no mean merit; a brilliant pianist and a com-
poser of quite good music. In addition to composing the music for
the Guy's theatricals for thrac years in suceassion, lie brought out a
quintet for strings and a fugue, Iwhich w^ere performed in a west-end
concert hall, and he was assistant lorg'a.nist at Christ Church, Chelsea.
In spite of his great talent ias a musician, however, he was always;
ready to indulge his audience in lany miusio to their taste, and, ais the
present writer knows from experience wasi a most inspiriting accom-
panist.

In January, 1917, he joined the R.A.M.C., and immediately was
sent to France, and While on temporary duty with the 4th North
Staffs. Rogt., was killed on the 10th of April while reposing in a
cellar which served as the regimental aid post of his battalion.

He leaves a 'widow to mourn his loss, and one little son.

[Reprinted from Th& Guy's Hmjntal Gazette, May 18th, 1918.]

GATLEY, CHARLES ALEXANDER ROBERTSON, Capt.,
R.A.M.C. Entered 1907, qualified L.R.C.P., M.R.C.S. 1912.
Held House appointments as A.H.S., 1912, H.S. 1913. O.P.O.
1913. M.O., Hall Walker's Hospital for Officers, 1914—15.
55tli F.A. and 7th Buffs., B.E.F., 1916—17. Died from the
after-effects of wounds.

GERMAN, H. B., Major, M.C., R.A.M.C. Entered 1898,
qualified L.R.C.P., M.R.C.S., 1904. While a student, gained
his Soccer blue on several occasions, and was the finest squash
racket player in his time at Guy's. Joined Naval Medical Ser-
vice May, 1904. Killed in action September 17th, 1918.

Yet another Guy's man has made the supreme sacrifice. The letter
which follows bears witness to the high esteem in which Major
German was held, both by his colleagues at the Front and by his old
friends at Guy's, who will join with us in expressing our deep sympathy
with his widow and family in their sorrow.

Mrs. German has received the following letter and we are indebted
to her for kindness in allowing us to publish it: —

It is with the deepest sympathy that I write to tell you of the
death in action of your husband, Major German, M.C. Major German
and myself established an advanced Dreissing Station on the night
of 17th September, and during the following day were suddenly

Obituary. 37

heavily .shelled. Several men were hit including the Senior Roman
Catholic Chaplain of the Division, and it was while going to the
assistance of the latter that your husband met his death. I knew
Major G-erman for over two years, and he and myself were close friends.
He was held in the deejpest esteem and respect by all ranks and was
fearless and untiring in his efforts for the woundeld.

In deepest sympathy with you in your great loss, believe me to
remain. Yours faithfully,

F. H. L. HOLLAND,

Major, R.A.M.C..
[Reprinted from The Guy's Hospital Gazette, November 30th, 1918.]

GIBSON, HOWARD GRAEME, Major, R.A.M.C, Men-
tioned for War Services. Entered Guy's in January, 1902,
and qualified M.R.C.S., L.R.C.P. in January, 1907. He joined'
the R.A.M.C. soon after taking his diploma, and served with
that Corps throughout the war. Died, December 2nd, 1919.

•
GLAISBY, KENNETH, Lieut., R.F.xi. Younger son of Mr.
Walter Glaisby of York. Educated at Aysgarth and Uppingham,
where he was a member of the Shooting Eight. He received a
commission in August, 1915, at the age of 19, after one term at
Guy's Hospital. He went to the Front in February, 1917, and
Mas killed in action on November 1st of the same year.

Lieut. Kenneth Glaisby, K.F.A. (killed in action on November 1st),
was twenty-one years of age and younger son of Mr. Walter Glaisby»
of 4, St. Leonards, York. Educated at Aysgarth and Uppingham, he
was in the running and shooting eight at Uppingham, and shot for the
School at Bisley in 1913. He received his commission in August, 1915,
at the age of nineteen, after one term at Guy's Hospital as a raedicaj
student, where he passed his first professional examination. He went
to the front in February of this year and was gazetted lieutenant in
July. His Commanding Officers have written to his parents as follows: —
" ;^Iay we say that, although he had only been a short time in the
battery, his loss has come as a great blow to us, both for personal
reasons, as he had a charming disposition, and also for military reasons,
as he was a most capable officer, and willing to do more than his ow\n
share of work. We were much struck by his soldier -like qualities,
keenness and sound commonsense. We feel that we liavc lost a good
officer, and we can ill-afTord to lose such."

[Reprinted from The Guy's Hospital G^izette, November 17th, 1917.]

GODSILL, STANLEY, Lieut., London Irish Regt. Entered
Guy's in April, 1914. After 18 months at Hospital, he joined

38 Obituary.

tho London Univorsity O.T.C, and was granted a commission
in the London Irish Regiment. After seeing active service in
France, Egypt and Salonika, he Avas sent to Palestine in 1917.
Took part in capture of Jerusalem. Killed in action on De-
cember 2ard, 19^7, aged 21.

We regret to announce the death of Stanley Godsill, wlio was killed
In action in Palestine on the 23rd December, 1917.

Stanley Godsill was educated at B<?rkhamsted School, where he was
a good athlete and a keen Imember of the School O.T.C.

On leaving School in April, 1914, he entered Guy's Hospital as a
Medical and Dental Student. Aftt^r completing eighteen months at
the Hospital, he joined the London University O.T.C. and was im-
mediately granted a commissiGn in the London Irish Eegiment. After
seeing active service in France, Salonika, and Egypt, he was finally
gent to Palestine in 1917. Here he saw severe fighting, taking part
in the engagements that led to the capture of Jerusalem, and was
with the troops who subsequently entered.

He was killed in action on 23rd December at the age of 21. Ifi
the words of his General, " He was a very fine young officer of the
very best type, who died leading his men with unflinching" gallaintry
and devotion." '

[Keprinted from The Gui/'s Hospit(;l Gazette, March 23rd, 1918.]

GOUGLI, B. B., Lieut., R.A.M.C. Entered Guy's as a stu-
dent in 1892. Qualified 1897. Was in general practice in So-
merset until June, 1915, when he obtained a commission in the
R.A.M.C. After being at the Front little more than a week,
he was killed while attending wounded in a dug-out, February,
19H). He was at the time Medical Officer to the 8th Battalion
South Staffordshire Regiment.

Lieut. Bernard Bradly Gou^h was born at Stockwell on September
14th, 1873, and was educated at Reigate Grammar School and at St.
Andrew's, Caterham. He entered Guy's Hospital as a student in 1892,
and was admitted M.R.C.S. and L.R.C.P. in 1897. He held hospital
appointments at Burton-on-Trent, Wolverhampton, and Great Grimsby.
After practising for a short time at Capsl and Oakamoor, StafFordshire,
ho acquired a general practice at Compton Martin, Somerset, in 1902,
where he resided until 1915.

Col. Julian sends the following lotter to the relatives of: Lieut.
Gough : —

" I deeply regret to inform you that on the evening of the loth
inst., whilst Lieut. B. B. Gough, R.A.M.C., was attending wounded
in a dug-out near the trenches, a Ger:man shell fell into the dug-out^
and burst, instantaneously killing him and nine wounded, one of whom
was an officer. He died doin^ his duty tx> his utmost in the sefrvicn
of his King and country, and we, his comrades, lament his loss, and

Obituary. 39

offer you our sincerest sympathy in your sad bereavement. He was
at the time with the 8fch Batt. South Staffordshire Eegiment as their
medical officer, to which battalion he had g^one a few days before
from the 51st Field Ambulance, in relief lof a medical officer wlio ha(?
had to be sent to hospital ill. When found he had still a drejssingi
and pair of scissors in his hands. His letters and effects' hare been
taken over by the battalion, from whom you will doubtless hear in a
few days. I enclose a lettejr and "j^ost card which have been delivered
at my office."

[Reprinted from The Guy's Hospital Gazette, March 11th, 191G.]

GREEN, C. L., Second-Lieut., Essex Regfc., attached E.F.C.,
the elder son of Dr. and Mrs. Green, Woodside, S.E., was born
on December 5th, 1894. He was educated at Durlston Court,
Swanage, and afterwards at St. Bees School (S.H. 1908—11).
After passing the London Matriculation he entered Guy's as a
Medical Student, and later went to Edinburgh University.
When the war broke out he joined the Edinburgli O.T.C.
Having passed his examinations, he then joined the Ist Sports-
man Battalion as a private. Shortly after he was made a
corporal. In December, 1914, he was given a Conunission in
the 11th Essex. In October, 1915, he went to Franco and was
in the trenches till August, 1916. He was wounded in the
hand by a bomb, but quickly recovered. He returned to

40 Obituary.

England and was transferred to tlie R.F.C. Whilst flying on
January 7th he had a crash near Southend, Bromley, for
want of petrol, and he was taken up unconscious. He re-
covered, however, and rejoined at Hounslow on March 16th
and soon got his wings. On June 6th, 1917, lie left for France,
and was killed in action on June 9th.

HAMILTON, E. T. E., Temp. Major, E.A.M.C. Served in

German South West African Campaign, 1914 — 15. Mentioned

for Avar services. Died on service.

We regret to announce the deatli of Dr. Hamilton which took place
on March 8th at his residence in Johannesburg, South Africa. The
son of a Naval Surgeon, he was (born at Eathgar, near Dublin, in 1807.
Entering Guy's in 1886 he became a distinguished student, taking
honours in Physiology at the B.Sc. Examination in 1889. He took
the Conjoint Qualification in 1891. At London University he took the
M.B., B.S. (Honours in Medicine and Forensic Medicine) in 1892; M.D.
in 1893 and M.S. in 1895; and F.E.C.S. in 1893.

After serving an appointment as House-Surgeon to Sir H. G. Howse,
he became Demonstrator of Anatomy .at Guy's, a post he held for four
or five years.

In 1898 Dr. Hamilton went out to South Africa and started
practice on the Rand. During the Boer War he was medical officer on
one of the hospital ships and in various hospitals ashore. After serving
with the rank of Mla^jior in the field during the recent rebellion, Dr.
Hamilton became principal Medical Officer at Swakopmund, the chief
post of German South West Africa, now in British occupation, where
he developed an intestinal complaint, and, being much run down from
pressure of work, he was ordered to Johannesburg to recuperate.
There he became subject to attacks of mental depression, and it is
supposed that in one of these fits he terminated his life, as he was
found with a fatal bullet wound in his head.

Much sympathy is felt for his widow, an old Guy's nurse. His
funeral took place with military honours.

[Eeprinted from The Guifs Hospital Gazette, April 24:th, 1915.]

Obiiuari/.

HARRIS, W. A. Was the son of Mr. W. Harris, Grounds-
man of the Guy's Hospital Athletic Ground. Was employed in
the Dental School. Joined the 6th London Regt. soon after
war broke out and was killed in action at Loos, Sept., 1918.

HARRISON, STANLEY S. B., Major, M.C., R.A.M.C. He
qualified at Guy's in November, 1914. Joined R.A.M.C. soon

42 Obituary.

ai'tor and Avas sent to France. Mi'. 1917. Gassed by a high
explosive shell and died from k, suiting bronelio-pneumonia on
October 10th, 1918.

It is with deep rogret we have to record the death of Major Stanley
Sextus Barrymore Harrison, who died on tho Weistein Front on the
10th of October, 1918, from the effects of gas poisoning. He was
educated at Guy's, and took the Conjoint Diplomas in October and No-
vember, 1914. He was soon after in training, and went out to France,
where he spent his whole service, ffc; and his party were gassed by a
H.E. and mustard gas shell of large calibre, which landed in the
doorway of his dug-out. He recovered at ,the time, but died a few
days later from broncho-pneumonia. He won the Military Grose for
conspicuous gallantry and devotion to duty (se3ond supplement to the
London Gazette, Friday, 11th May, 1917, p. 4591). His many |riends
at Guy's will wish to convey to his relatives their sincetrc sympatJiy
with them in their great loss.

[Eeprinted from The Guifs TIoiipHal Gazette, November 30th, 1918.]

HARTNELL, EDWARD BUSH, Temp. Capt., R.A.M.C.,
London Mounted Brigade. Entered Guy's in March, 1892,
after having been to Bristol and Dublin. He passed the Final
Conjoint in 1893, and prior to the war was in practice at
Bridgwater, Somerset. Died on service in Egypt on April
24th, 1916.

HAYNES, CHARLES GRAHAM, Capt., 4th King's Royal
Rifles, attached R.A.F. M.C. 1916, Bar 1917. Was educated

Obituary. 43

at Mill Hill School, and after passing* the London Mati-ic,
■entered Guy's in May, 1912, at the ag-e of 17. He passed the
1st M.B. in 1913, and the Organic Chemistry of the 2nd
•exam, in July, 1914. He joined up in October, 1914. ' Reported
Missing, 1918.

Sir, — I have never seen any mention of C. G. Haynes in your
^' Honours " or " Casualty " columns.

The many pre-war people now back at the hospital will hear with
fjreat regret that Graham Haynes was reported " missing " on October
:23rd, 191S, on a reconaisance flight, and that nothing up till now has
been heard of him.

He joined the Artists' Kifles at the outbreak of war and landed in
Prance with them in October, 1914. He was commissioned in France
in April, 1915, to the ith Battalion King's Eoyal Rifle Corps, and was
•wounded in May at the second battle of Ypres. He returned to the
front to the 17th Battalion K.R.R.C. in September, 1916, and won the
M.C. at the Schwaben Redoubt

In the fighting in Shrewsbury Forest, Ypres Sector, he won a bar to
the M.O

In November, 1917, he was seconded to the R.F.C., and was at home
training as observer and then as pilot until August, 191S, when he
again went to France. He became a Flight Commander and regained
his acting captaincy, and saw heavy air fighting in September and
October.

I hope you will be able to find space for this belated account, or
part of it, in your next number. I fear after all these months his
chance is small. It is only to be hoped that he may turn up all right,
and we shall have the luck to see him again playing " rugger " for the
hospital. — Yours sincerely,

R. J. HODGKINSON.

[Reprinted from The Gwfs Hospital Gazette, Maxch 22nd, 1919.]

HAYWARD, MILWARD CECIL, Capt., R.A.M.C., T.F.
He was educated at Epsom, Cambridge, and Guy's. Graduated
M.B., B.C. in 1903. At the time of the Boer War he was ap-
])ointed Civil Doctor to the Guards at Windsor. Volunteered at
tlie beginning of the present war. Severely wounded at Ypres,
and died from wounds, May 23rd, 1916.

Captain M. C. Hayward, who died from acute septic pneumonia at
Brighton on August 23rd, was the second eon of the late Henry Hay-
ward, of Queen Anne Street, London, by Jiis second marriage. He was
educated at Epsom, Cambridge, and Guy's Hospital. He graduated
B.A. in 1893, M.A. in 1898, and M.B. and B.C. in 1903. He also
took the English double qualification in 1898. He filled the post of
Clinical Clerk at the Samaritan Hospital for "Women, House Surgeon

44 Ohiliiiini.

and iJuii-r i'li\ -ici.-iii ;il raddiugloij 'ir-ii < 'IhMi (;ii".s Hospital, and
Kesident .Mr,lir';il oiliccr at the ' Nort li-\\'( -i l.onrlou Jlospital, after-
wards se(tiii'_! ii|i ill inactice in Ab!n.2:di)H m I'Jdl'. At tha time of the
Boer Will he \\.i- ,i|>pi)inbed Civil Doctor to the Guards at Windsor.
and hi', vohinic rcil :it, the beginning of the present war with a good
deal of official experience. He joined the 3rd Home Counties Field
Ambulance on December 3rd, 1914:, and after recovering from severe
concussion was sen! to Fran^^c. Here shortly afterwards he was
dangerousl}^ wounded, u <h;'ll hitting him in the back, and causing
concussion of th:; spine, while a bullet pierced his lung. After being
on sick leave till .March Isb of this year he was iseint to a .military"
hospital, but while; on duty there he succumbed to pneumonia.

[Reprinted from Tlw Giufs Ho^spital Gazette, October 7th, 1916.]

HENDERSON, T. E., Lieut., South Staffs. Eegt. Was edu-
cated at University Colleg-3 School, passing the London Matric.
with First Class Honours in June, 1893. Entered Guy's as a
Dental Student in May, 1910, and qualified in May, 1913.
At Guy's he took the First Year's Dental Prize in 1911 and the
Second Year's Prize in 1912. He was Assistant Demonstrator in
Dental Metallurgy from June to July, 1911, and Assistant
Dental House Surgeon from January to March, 1912. He was
in practice until September, 1914, when at the age of 38 years
he joined the Public Schools Battalion, and in July, 1915, re-
ceived a commission. A year later he went to France and was
killed while defending an advanced post at the corner of Del-
ville Wood on August 31st, 1916.

Second Lieuteuant Henderson, killed in France, was educated at
University College School, from which school he matriculated with
First Class Honours in June, 1893. He did not enter Guy's as a dental
student until May, 1910, but from that time until qualification in May,
1913, he endeared himself to all with whom he came in contact. He
took the First Year's Dental Prize in 1911, and the Second Year's
Prize in 1912. He was Assistant Demonstrator of Dental Metallurgy
from May-July, 1911, and Assistant Dental House-Surgeon from January-
March, 1912. After qualifying in 1913 he acted as" an assistant until
September, 1914, when, at the age of 38 years, he joined the Public
Schools Battalion, and in July, 1915, received a commission. A year
later he went to France, and in defending an advanced post at the
corner of Delville Wood was reported "missing' on August 31st 1916.
The War Office now reports that evidence has been received that he
was killed in that action.

[Keprinted from The Gui/s Hospital Gazette, November 17th, 1917.]

Obituary.

HENNESSEY, P. W. H., Corp. Employed in the Works
Department. Joined the Queen's Eegt., was mentioned in des-
patches. Killed in action, July 31st, 1917.

HOGBEN, H. F. T., Lieut., 2nd Norfolk Eegt. Came to
Guy\s in October, 1909, witli the London Univel•^<ity Open Scho-
larsliip from Bedford Grammar School, ^^1lil© with tlio Artists*

46 . Obituari/.

Rillt's he acliievod many successes as a marksman at Bisley.
Represented tlie Hospital as a " heavy-weight " and in other
sports. Killed in action in Mesopotamia, November 23rd, 1915.

Harry Hogbeu received his early education at Bedford Grammar
School, and entered Gny's in October, 1909, winning the London Uni-
versity Open Scholarship. He passed his first M.B. examination in July,
1910, and entered the wards in October, 1912. Amongst his appoint-
ments he was ^Icdical Ward Clerk to Sir Cooper Perry, and Dresser /o
Mr. Steward.

At the outbreak of war he was working for his final examination,
but as he already held a commission in the 10th Middlesex, he had to
forego his studies and answer to the Mobilisation Order.

After training in England for two months, his regiment was ordered
out to India in October, 1911, in which country he remained till August
of this year. He was then selected to take a draft from the lOth Mid-
dlesex to the Persian Gulf, where he became attached to the 2nd
Norfolk Regiment. He fell in an action in which his regiment was
engaged between the days of November 22nd and 24th.

During his life at Guy's, Harry Hogben was a member of the Artists*
Rifles, was a keen Territorial, whilst his skill as a marksman was
envied bj^ all his pals. At Bisley he achieved many successes, and was
in the King's Hundred in the years 1913 and 1914. Amongst other
sports he represented the Hospital as a " heavy-weight," and was
always a regular man to turn out for a game of " Rugger."

And so the Alma Mater has to mourn the loss of another of her sons
one who, on the point of qualifying, gave up all — and right willingly too
— for his King and Country.

[Reprinted from The Guy's Hospital Gazette, January 1st, 1916.]

HOLLANDS, WILFRID GEORGE, 2nd Lieut., aged 23,
killed at Serre, nftar Bapaume, October 12th, 1916, was the eldor

Obituary. 47

son of 'Mr. and Mrs. Alfred Cliristy Hollands, of 73, Wyatt
Park Road, Streatham Hill, S.\Y. He left Guy's to join Public
Schools Battn., 16tli Middlesex Regt., September, 1914, received
his commission in 7th Royal Fusiliers, May, 1915, went to the
front April, 1916, and was attached to the 4th Royal Fusiliers
as the battalion Bombing Officer. He was buried at Colincamps,
near Albert, France.

HOPKINS, HERBERT LESLIE, Lieut., R.A.M.C. En-
tered Guj^'s October, 1905, taking the Open Scholarship in Arts,
Junior Proficiency Prize in 1908. Secretary of Guy's Physiolo-
gical Society. Qualified M.R.C.S., L.R.C.P., and M.B., B.S.
(Lond.) in 1911. Killed in action October, 1914.

H. L. Hopkins, who was just 28 years old at the time of 'his death,
entered Guy's iii September, 1905, with an Open Scholarship in Arts.
He obtained the ^I.B,, B.S. Lond., in October, 1911, having also
passed the Conjoint and the Primary F.R.C.S. In addition to the cur-
riculum, he had tilled thc5 positions of Assistant Demonstrator in Ana-
tomy and Physiology, Pathological Assistant to the Surgical Registrar,
and had filled diesserships in all the special departments.

48 Obituary.

Ou quulitying, he deUu-iiiinod not to go for the house appointments
that would have fallen his way, but became House-Physician at Derby
Infirmary. He filled this position for twelve months, during which
time he came into contact with several old Guy's men. He then de-
termined that Public Health was his sphere of action, and spent six
months at the City of London Chest Hospital.

In August, 1913, he became Assistant M.O.H. and Assistant Inspector
of Children to West Suffolk, and Clinical Tuberculosis Officer to the
West Suffolk Insurance Committee. He was prevented .from sitting
for his D.P.H. Oxoh. in May, 1914, but successfully obtained the M.D.
Lond. (in State Medicine) in July, 1914.

A few days later, on the outbreak of war, he pbtained a temporary
commission in the K.A.M.p., and was at once appointed Sanitaxy
Officer to Devonport Barracks. A few days later he was despatched
to the front as Sanitary Officer to No. 11 Base Hospital, in which
position his friends did not fesl any great anxiety about him. Since his
death the writer's family have received a letttier in which lie states that
he has beon attached to the 1st Devon regiment. Further details are
at present impossible to gather.

[Reprinted from The Guy's Hoa^ntal Gazette, October 10th, 1914.]

HORTON, J. H., Lieut. -CuL, D.S.O., I.M.S. Was the son
of Major J. Horton, of Woolwich, and was educated at Guy's
Hospital, where he gainod the Arthur Durham Prize in 1891,
and took the Diplomas of M.R.C.S. and M.R.C.P. TLond.) in
1895. He was H.P. at Guy's and at the Royal Bethlem Hos-
pital. In 1902 he became a Liout. in the I.M.S. , Captain in
1905, Major in 1913, and Brevet Lieut. -Col. on December 21st,
1916. He served in East Africa in 1902. Was mentioned in
Despatches in 1904, and gained the Medal with two clasps and
the D.S.O. on the N.W. Frontier of India. In operations in the
Mohmand Country in 1908, the Medal ^^ith clasp; and as Sur-
geon to the British Red Cross Society in the Balkan War of
1912, the Medal Avith clasps. He also had the 4th Class of
the Order of St. George and St. Vladimir of Russia. On March
17th, 1908, he was Medical Officer of the 14th Bengal Cavalry.
At the beginning of the present war he was appointed to the
command of the 126th Indian Field Ambulance. Reported as
having died on Active Service in the Casualty List published on
August 2nd, 1917.

Lieut. -Col. James Henry Horton, D.S.O., I.M.S., was reported as
having died on active service, in the casualty list published on August
2nd. He was born on December 27t'i, 1871." After filling the post Jof

ObitiMffj. 49

iouse -physician at Guy's and at the RoyaJ Bethlem Hospital successively,
he went to India as a. special- plagaie inedical officer. He was on© of the
four plague officers who accepted commissions in the I3I.S. as lieutenant
from January 29th, 1902, and while at Xetley gained the Marshall
"Webb medal and prize. He became captain on January 29th. 1905,
major on July 29th, 1913, and was specially promoted brevet Lieut. -
colonel on December 21st, 1916. He served in East Africa in 1902,
in the operations in Somalilnnd, was present in the action at Jidballi ;
on the North- West Frontier of India,; in the operations in the ^lohmand
country in 1908, medal and clasp; and as surgeon to the British Red>
Cross Society in the Balkan War of 1912, medal and clasp.

[Reprinted from The Guy's Hospital Gazette, August 25th, 1917.1

HOWARD, CHARLES REGINALD, Capt., R.A.M.C. Edu-
cated at Guy's and Cambridge, -where he graduated B.A. with
Hons. M.B., B.C. (Cantab.) 1902, qualified L.R.C.P., M.R.C.S.
in 1902, (and M.D. in 1907. Acted. as A.H.S. and H.S. at Guy's
and later Avent to East Africa as Bacteriologist to the Govern-
ment of Zanzibar. Joined R.A.M.C. in 191G. Promoted Cap-
tain in 1917. Killed in action in East Africa on September
26th, 1918.

Capt. Charles Kegiuald Howard, E.A.M.C, attached King's African
Rifles, was killed in action in East Africa on Sept. 6th. He was the
youngest son of Robert Luke Howard of Tynemouth, formetrlj'- of St.
Albans, and was educated at Guy's Hospital, and at Cambridge,
where he gTaduated B.A. with honours, M.B. and B.C. in 1904, and
M.D. in 1907, also taking the diplomas M.R.C.S. and L.R.O.P.Lond.
in 1902. After acting as assistant house-surgeon and house-surgeon at
Ouy's, he went to East Africa as bacteriologist to the Government of
Zanzibar. On his return to England he (settled in practice at Garston,
Frome, Somersetshire, where he wajs honorary surgeon to the Victoria
Hospital, Frome, medical officer of health to the Frome Rural District
Council, and assistant school medical officer to the Somerseitshire
Education Committee. He took a temporary commission as lieutenant
in the R.A.^E.C. on March 1st, 1916, and was promoted to captain
on the completion of a years service.

[Reprinted from The Guy's Hosjntal Gazette, November 30th, 1918.]

PART 1.

Obituarfj.

HUGH- JONES, KENNETH HERBERT, Capt., 5th, attached
12th, Rifle Brigade,. Entered 1915, Arts Scholar. Killed in
action September 20th, 1917.

Kenneth Herbert Hugh-Jones was the fourth son of Mr. mid Mrs.
Llewelyn Hugh-Jones, of Chevet Hey, Wrexham, Denbighshire, anc.!
was born on the 4th December, 1896. H© received his early education
at Colet House School, Rhyl, and from there gained in 1910 a classical
foundation scholarship at Bradfield College. During the whole of
his time there (except his first term) ilie was a member of the O.T.C.
and latterly a platoon sergeant. He w^as also chapel prefect.

On leaving Bradfield in 1915 he gained an Open Scholarship in Arts
at Guy's Hospital, and went into residence in October, but on Decem-
ber 11th he enlisted in the Artists' Rifles, and passing through
the Cadet School, received a commission in fthe Special Reserve in the
Rifle Brigade. Second Lieut. Hugh-Jones went to France on the 25tb
October, 1916, and was attached to the 12th Battalion of the Rifle
Brigade. He was gazetted Captain as from 2ith August, 1917, and
was killed on 20th September, 1917, close to Langemarck, Flanders,
while leading his men to the attack.

His Colonel wrote: "It is a very grqat blow to the battalion, as he
was one of the best officers we have ever had. He had long since
proved his value, and was in command of his company in an attack
20th September. He was extremely popular with liis men and with
all the officers. I am sure he died as he would have wished, at the
head of his compan}^"

[Reprinted from The Guy's Hospital Gazette, February 23rd, 1918.]

Obituary. 51

JAMES, JOHN STEPHEN HARVEY, Lieut., King's Royal

Rifles. Entered Guy's as a Medical Student 1912. Joined the

Forces 1914 (Artists' Rifles). Killed in action, Rue de Bois

Richebourg I'Avone, May 16tli, 1915.

J. S. Harve}- James — the only child of Mr. and Mis. Quintus S. H-
.lames, of Coneyboro', Shanklin (late of Mill Hill) — was educated at Colet
Court and St. Paul's School. He entered Guy's Hospital Medical School
in 1913, after matriculation. He had passed his first ]\LB. when wai-
broke out. Some months before, he had joined the Artists' Eifles, and
was mobilised with many other Guy's men in that regiment immediately.
He left for France with the 1st Batt. Artists' Kifles !in October, 1914.
There he passed in his turn through the Artists' Rifles Officers' School
at Bailleul, and in March, 1915, was gazetted to the 1st Batt. of tne
King's Royal Rifle Corps (2nd Division). He joined them direct from
the School, and was with his battalion until liis death on the night,
May 15th — IGth, 1915. He was killed at Rue de Bois Richebourg
I'Avone, in a Rutcessful night attack. Ho fell with many of his riflemen
in the final assault on the parapet of the German trenches.

By his stout heart and modest cheerfulness under all conditions he
had earned universal popularity.

His many friends in the Artists' and at Guy's will always remember
"Jimmy." thf cvor cheerful, with the never failing sense of humour.

JONES, EVAN LAWRENCE, Capt., R.A.M.C., attached
Highland Light Lifantry. Entered 1907, qualified L.S.A. 1913.
Killed in action, 1918.

KELSEV, A. E., Temp. Capt., R.A.M.C. Drowned in H.M.
Hospital Ship Glenart Castle, torpedoed February 26th, 1918,

Obituary.

KENNEDY, RONALD SINCLAIR, Major, M.C., M.D.,
R.A.M.C. Born July 14tli, 1887, the only son of Dr. and Mrs.
Kennedy, of Wallahra, and Sydney, N.S.W. Educated at Ton-
bridge School, Christ's College, Cambridge, and Guy's. At Cam-
bridge he got his blue for Rugby Football, and was one of the
best forwards at Guy's in his time. He took the Diplomas of
M.R.C.S., L.R.C.P. (Lond.) in April, and M.B., B.C. (Can-
tab.) in June, 1912, having taken Cambridgo B.A. Honours in
1909. He left Guy's early in 1913 to join the Egyptian [Medical
Service. He gained the M.D. (Cantab.) in 1917. He was
" lent " for service at the Front by the Egyptian Government,
and was originally attached to the Artillery, but subsequently
exchanged into the Infantry, where he saw much hard fighting
and gained the M.C. during the Somme offensive. He was
killed in action on April 17th, 1918. After his death he was
awarded a Bar to his M.C.

Ohitiiarij. 53

KING, PERCY, 2nd Lifeut., 7th East Surrey Regt.. Educated
at Portsmouth Grammar School, Kings College, London, and
Guy's. Entered Guy's as a Dental Student in October, 1911.
L.D.S. March, 1915. Joined London University O.T.C., and
received a Commission in the East Surrey Regiment, May, 1915.
Sent to Egypt on detached service November, 1915, where he
was slightly wounded whilst carrying despatches. Sent home
November, 1916, to join the R.A.F. Served in France as
Balloon Officer from January to June, 1917, when after a nasty
spill, ho joined his regiment near Arras, where he M^as wounded
in the trenches August 4th, 1917, and died next day.

KNAGGS, F. H., Temp. Capt., R.A.M.C. M.O. Hudders-
field War Hospital. Died June 24th, 1917.

Mr. F. IT. Kna^gs, who died oix June 24th from pneumonia after
a brief illness afc the ago of 56 yefars, was the third son of the late
Dr. Samuel Knaggs, who practised for many years in Huddersfield.
He was educated at the Hudde(rsfiold CoUegle and at Rossall, taking
his medical course at Guy's Hospital, whore he held appointments
in the Eye and Ear Departments, being later Clinical Assistant at the
(Moorfields) Royal London Ophthalmic Hospital.

Obituary.

After ii term of two y(>nrs as Iloueo Surgeon at the Gloucester Gcneinl
Intirniiiry and Eye Jnstitution h!e commenced gettieral practice in
1881) witli his father and steadily gained in reputation as m spelcialist
in eye and oar atfections. For sejveral years he assisted his brother,
Mr. R. Lawford Knaggs, in the Ophthalmic and Aural Department
of the Leeds Public Disi:)ensary, and in 1905 became Honorary Sur-
geon to the recently created Ophthalmic and Aural Department at
the Huddersfield Royal Infirmary, to which his father w^as for many
years Senior Honorary Surgeon. His death thus breaks a connection
with that institution which had existed sines its first establi^hmeait.
From the date of its opening in October, 1915, Mr. Knaggs had been
a Civilian Medical Officer at ths Huddersfiald War Hospital, and in
January' last received a commission as Temporary Captain in the
Royal Army Medical Corps. He leaves a widow and one daughter
and a wide circle of friends to mourn their loss. ^Ir. Knaggs was
formerly honorary secretary of the Huddersfield Medical Society, where
he read a number of practical papers bn ophthalmic subjects, some of
which were published in our columns.

[Reprinted from The Guy's Hospital Gazette, July I4th, 1917.]

■KNIGHT, E. v., Flight Sub-Lieut. Educated at Bedford
Grammar School, where he was captain of the school Rugby
XV. and while still at school played for the East Midlands.

Obituaiy.

While in his teens he ^vas reserve three-quarter for England.
He entered Guy's as a Dental Student in May, 1914. On the
outbreak of war he joined up and was granted a conmiission in
the London Rifle Brigade, serving in France for over a year.
He subsequently joined the R.N.A.S. He was killed in a flying
accident on March 12th, 1917.

The late Lieut. E. V. Knight, E.X.A.S., who was killed in England
on March 12th tlirough his machine coming 'down in a spinning nose
dive, was formerly captain of Bedford School. While there he played
threequarter in the County Championship for the East Midlands, and
later on in the same competition for (his home county of Somerset.

He joined Gu3''s as a Dental student in May, 1914, but joined the
University of London O.T.C. at the outbreak of war, and from there
obtained a commission in the London Eifle Brigade serving in France
for over a year. Afterwards he transferred tO' the Cyclist Corps,
and finally joined the Navy.

He leaves a widow tand daughter, and lis the second captain of Bed-
ford School Eugby of recent years to lose his life this year in a flying
accident in England.

His genial and generous disposition was such that he not only never
did a mean action, but could not bear to entertain an unkind thought
of anyone. He seemed to know practically everybody in the sporting
world and will be greatly missed.

[Ecprinted from The Oin/s Hospital Gazette, April ^Ist, 1917.]

KYNASTON, ALBERT EVELYN FAIRFAX, Surg., R.N.,
H.M.S. Devonshire. Entered 1898, qualified L.R.C.P.,

M.R.C.S., 1904. Died of enteric.

Obituary.

In the first week of the tvvar he joined the Koyal Nav;d Reserve, and
was sent to II. M.S. Devonshire. His end was like his life, he was
taken ill, pooh-podhed it, and went on till the fourth week of an attack
of enteric; pneumonia compelled him to go into hospital and he died,
aged 33, on the 13tli October, ^t Dimstaith, on Cromarty Firth, wher<e
he was buried on Wednesday, October llth, at the Dunstaith Naval
Cemetery.

[Reprinted from The Guy's Jlo.spital Gazette, October 24th, 1914.]

LACEY, WILLIAM STOCKS, Lieut., R.A.M.C, 140th Field
Ambulance. Entered Guy's 1906, qualified L.D.S. 1908, and
L.R.C.P., M.R.C.S. 1912. Died of wounds.

LANSDALE, WILLIAM MORRIS, Capt., R.A.M.C. (S.R.).
Entered Guy's in 1909, having won the Entrance Scholarship

Obituary. 57

in Arts. He qualified in 1915 Avitli the M.B., B.S.(Lond.). His

career at Guy's ^vas a brilliant one; he won both the Junior

Proficiency Prize and the Wooldridge Memorial Prize in phy-

siolog'v; in 1914 he was prize essayist of the Physical Society^

and in the same year won the Eeaney Prize for pathology. He

joined up immediately upon qualifying, and was attached to

the 5th Royal Berkshire Reg-t. He remained with his Battalion »

for whom he did magnificent Avork, until he was killed by a

shell on August 26th, 1918, while tending the wounded.

Entering Guy's, in 1909, he won the Entrance Scholarship in Arts, and
very easil}^ passing his examinations, qualified M.B., B.S.London in the
minimum time possible. At the end of hLs studieis pin anatomy and phy-
siology he won both the Junior Proficiency Prize and the Wooldridge
Memorial Prize in Physiology. In 1911 he was prize essayist of the
Physical Society, with a very brilliant contribution on the para -syphilitic
lesions, and in the same year won the Beaney Prize for Pathology.
Had Lansdale proceeded to house-appointments, there is no doubt that
he would have secured a very brilliant academic career at Guy'fe. As
a man, Lansdale was quiet and reserved, but under that reserve there-
lay a warm, affectionate disposition, and the restless enthusiasm of
genius. Lansdale was the son of a distinguished old Guy's man, with
whom all Guy's men will condole in his bereavement..

[Reprinted from The Guy's Hospital Gazette, October 5th, 1918.]

LECKIE, M., Capt., D.S.O., R.A.M.C. Entered Guy's in
1899 and the R.A.M.C. in 1908. He had a distinguished career
in Egypt, and on the outbreak of war went to the Front with

58 Ohituary.

tlie Expoditionaiy Force, hoiiig attached to the Northiiiiiborlaiid
Fusiliers. D.S.O. at Mons. Killed August 28th, 1914.

Captain Malcolm Leckie, formerly of Guy's Hospital, went to the
front with the Expeditionary Army, being attached to the Northum-
berland Fusiliers. Before that period his short career in the service
had been almost entirely parsed in Efe^ypt, where he left a high reputa-
tion for personal amiability, professional capacity, and devotion to
duty. This latter quality he displayed in its highest form at the
Battle of Mons.

Malcolm Leckie entered Guy's in 1899, passed the Second Conjoint
in January, 1903, and the Final in April, 1907; he thein read for the
R.A.M.C., which he entered in January, 1908. At Guy's he dressed to
Mr. Golding-Bird, and was Clinical to Dr. Hale White and Dr.
Pitt in the last three months of 1907.

During some three j^ears in the Dissecting Room I got to know
him well, and chiefly remember his kecuness for everything he under-
took; he was one of the first to take up hockey ^at Guy's and' to
establish it as a regular Hospital game.

He was typical of that fortunately common stamp of Conjoint
man who makes public opinion among his fellows, and is respected and
liked for himself and his manlinetss; I should say that Leckie spent
himself for his friends, and recently talking over with one of his
chums our recollections of him, we agresd that he was happiest when
taking immense pains to do some small kindncsis to others often for
those who had but slight claim on his friendship. To those who knew
him well he \\1as always the same kind, generous, unselfish person,,
with rather a thoughtful manner and slow to express his own views;
one can well imagine that his place in his Mess '^''ill remain unfilled,
and many a sick or wounded soldier will know he has lost a (friend.

C. H. F.

[Reprinted from The Guy's Boxiiltdl Gaxette, January 2nd, 1915.]

LIEBSON, STEPHEN ABRAHAM, Capt., R.A.M.C. Went
to German South West Africa at the outbreak of war, as M.O.
of the Rand Lig-ht Infantry. After this campaign was .over, he
became M.O. in the 3rd South African Infantry and, after a
period of training in England, proceeded first to Egypt and
then to France.

He was in the Delville Wood fight and received the Military
Cross for attending^ wounded for five days in an open trench,
although twice wounded himself — over 1,400 casualties passed
through his hands.

He was finally transferred to a Scotch Regt. and was killed
in action at Hendicourt on March 22nd, 1918.

Obituary. 59

LLARENA, E. F., 2nd Lieut., 2nd Suffolk Reg-t. From
Duhvich College he came to Guy's in October, 1910, and at
once made his reputation as an enthusiastic "Rugger" placer.
A member of the Water Polo Team in 1911, he captained the
1914 team which wrested the cup from the London Hospital.
In August, 1914, he joined the Artists' Rifles, and while in
France obtained a commission in the Suffolk Regt. Killed in
action while attacking a wood near Ypres on June 20th, 1915..

" Larry," as he was known to all (his old friends up iait the Hospital,

received his early education at Dulwich College, where he was an

cnthusiatic " Rugger "' player and a Sergdant in the Officers' Training
Corps.

He entered the Medical and Dental Schools in October, 1910, and
passed his First Professional and First Conjoint Examinations in 1912.

When the War began he was working for his Second Conjoint Ex-
amination, and he joined the ^\j'tists' Rifles in August, 1914. He
obtained his commission while in Francs and became Second Lieutenant
in the 2nd Battalion of the Suffolk Regiment.

Ahyays to the fore in any sport, he g'ained his " Rugger Blue " in
the 1912 — 1913 season, and played for the 1st X^. regularly afterwards.

As a wat^r-polo player he also excelled and was a member of the
water-polo team in 1911 and onwards, and in 1914 captained the team
which wrested the . cup again from the London Hospital. He also
figured as a meriaber of the Inter-Hospital Swimming Four,

By the death of E. F. Llarena tthe hospital has lost one of her best
athletes who answered the call to arm^ during the first week of 'war
and now must be added to the Roll of Honour of Cruy's men, who
have met that glorious end on the battlefield.

[Reprinted from The Guy' a Hospital Gazette, July 17th, 1915.]

LOGAN, F. T. B., Hon. Surg. Foye House Red Cross Hos-
pital. Died.

Obituary.

LOWE, FRANK AUGUSTUS, Lieut., R.N.V.R., CoUiug-
wood Battalion. Entered Guy's 1906 as Dental Student, quali-
fied L.D.S. 1910. Killed in Gallipoli, 1915.

MARSHALL, BERNARD GOLDSMITH, 2nd Lieut., 3rd
Northants Regt. Entered Guy's 1913, as a Medical Student.
Killed in action at Loos.

MARSHALL, HERBERT MYERS, Dent. Commandant, Royal
Naval Medical Service, H.M.H.S. China. Came to Guy's as la
Dental Student in October, 1915, and qualified L.D.S. Eng-. in
November, 1917. He joined the Royal Navy soon after and
was killed the following year.

MARTIN, ALBERT, Major, N.Z.M.C. Entered Guy's in
October, 1878 and had a brilliant career whilst at this -Hospital.
As a student he took 1st Prize at the 1st, 2nd, and 4th Year
Student exams — the Michael Harris Prize in 1881, and the
Beaney Prize in 1883. He obtained Honours in Anatomy lat
the 2nd M.B., B.S., and was awarded the Gold Medal in
Medicine for the M.D. London in 1885. He eventually prac-
tised in Wellino-ton, New Zealand. Died of wounds.

Ohitu€iry.

MASH, OSWALD N., Lieut., M.C., R.F.A. Entered Guj's
as a Dental Student in 1910, but was obliged to leave in 1912
on account of ill-health. Eeturnevd in 1914 and joined the Legion
of Frontiersmen at the outbreak of war. Transferred to Queen's
Own Oxfordshire Hussars. Finally granted a connnission in the
R.F.A. He went to Franco early in 1915, took part in the
Battle of the Sonuiio. He gained the M.C. duiinu- the wintei*
of 1917. Killed in action June 1st, 1918.

It is with great regrot that we announce the death of Lieut.
Oswald Nelson Mash, M.C, R.F.A., who was killed in action on the
morning of June 1st, 1918. He was ith3 youngest son of the late Mr.
J. S. Mash, of Ipswich, and of Mrs. ]\Iash, Reed Hall, llolbrook.

He entered Guy's Hospital as a Dental Student in 1910, where he
remained two years, during which period he gained the Royal Life
Saving Society's Bronze Modal. In 1912 he was obliged to leave
Guy's on account of ill-health. After about a year spent in South

Obituary.

Africa he returned fit ;ind well Jiaid lecomineucod dental work. He
wiis about to take the finril L.0.8. fat the titne when war broke out.
At the first call for men he joined tiie Le<.don of Frontiersmen, and was
for sonic time at the Remount J3cpot lat Southampton. From there he
was transferred to the Queeni's Own Oxfordshire Hussars. Having
passed the necessary tests, he entered the Machine Gun Corps, and
from there he was grantod a oommission ^n the E.F.A.

Just three j^ears ago he wqnt out ,to France, and was at Ypres and
at the Ba,ttle of the Somme. Afte(r (being' out ten months he wa>s
invalided home with shell shock. As soon as he was fit enough ho
applied to be sent to the line lagain, and aftelr a ftim© rejoined his old
Division, the Siith. At thi? time he Igainod the M.C., but having shell
shock and being badly gassed was sent (home shortly afterwards as per-
manently unfit for the firing line. After three weeks' leave he again
applied to be sent out to Franoei a WQok before Christmas, 1917. He
remained for the reist of the winter on the Staff at Havre. As the
fresh German offensive drew near he applied to rejoin his comrades
in the line, and this request bqing granted, he was once again back
with his old Division. On June 1st he was killed.

[Reprinted from The Guy's Hospital Gazette. July 27th, 1918.]

MAXWELL, JOHN EARLE, Sub-Lieut., E.N.A.S. Elder
son oi Mr. John A. Maxwell. Was educated at Haileybury and
left in 1911. After studying- Law for two years, he came to
Guy's in 1913. In January, 1916, he obtained a commission in
the R.N.V.R., and was attached to the E.N.A.S. In Novem-
ber, 1916, he proceeded to the Eastern Mediterranean as an
Observer in the R.N.A.S. Reported missing on March 30th,
1917, having failed to return from a long" distance reconnaissance
over enemy territory (Bulgaria).

Obituary.

Lieut. Maxwell was' the elder son of ;Mr. John A. Maxwell, solicitor^
of 52, Bishopsgate, and was born on June 24th, 1892. He was edu-
cated at Haileybury, and left in 1911. After studying law for two
years he came to Guy's as a first year studeait in /January, 1913. Ip
Januarj-. 1916, he was given a commission in the E.N.V.E. and was
attached to the E.N.A.S.

After serving at various air stations in England, he was ordered to
the Eastern Mediterranean in November, 1916. On March 30th of the
present year he went np for a long-distance reconnaissance over enemy
territory, but failed to return. He was accordingly reported missing
as from this date, though the authorities held out considerable hopes
of his safety owing to the failure of the enemy to report such ap.
unusual occurrence as the bringing do\vln of a British aeroplane. But
unhappily, after ten weeks of uncertaintj^, definite reports were re-
ceived . to the effect that the machine had been shot down on March
30th, and that both Lieut. Maxwell and ithc pilot had been killed.

News of Lieut. Maxwell's death was received with very genera]
regret at Guy's, as he was a contemporary^ of the majority of men now
in the wards. He was for some time secretary of the Physiological
Society and took a ver^^ active part 'in the discussions at the meetings-
He was one of the youngest Fellows of the Ro3'al Astronomical Society,
having been elected at the age of 22. Some time beifore his death he
was made Armament and Intelligence Officer of his squadron. He had
just those qualities which make for success in an airman — absolute fear-
lessness and great keenness on his work. We offer our most sincere isym-
pathy to his parents in their bereavement.

[Reprinted from The Gvi/'.s- Hosj>ifal Gazette. July 14th, 1917.]

MILLER, G. S., Capt., R.A.M.C. Entered Guy's in Octo-
ber, 1907; Avon the Junior Proficiency Prize and the Sands-Cox
Scholarship in Physiology. After he liad passed the Final Fel-
lowship he took a conunission in the R.A.M.C. in April, 1915.

<J4 Obituary.

For a short time attached to the Cambridge Hospital, Aldershot.

Lat(H' he went to France and wliih; serving \vith No. 1 Field

Andjulance he met his death at High Wood on Septemljer 8th,

1916.

George Scfton Miller eintcred Guy's in October, 1907, from the
Colfe Grammar School, having passed the Senior Cambridge Local in
December, 1906. In 1910 he passed the 2nd M.B.Lond. and the 1st
F.|R.C.S., and in the same year gained the Junior Proficiency Prize
and the Sands-Cox Scholarship in Physiology. Entering the wards,
he dressed to Mr. Steward and Mr. Dunn, was Clinical to Dr. Hale
White and Dr. Pitt, Assistant IIou-;g- Surgeon to Mr. Rowlands, and,
finally, liousc-Surgeon to Sir Arbuthnot Lane from August, 1913, to
January., 1914. After this he acted as Resident Medical Officer at
Lambeth Infirmary for 15 months and attended Guy's weekly as
Chief Clinical Assistant in the Throat Department, and during thi.?
time worked for and passed the Final F.R.C.S. (December, 1914); as
he was then only in his 24th year he could not ge/*: this Diploimaj
which was granted him as recently as May, 1916.

On joining the R.A.M.C. he was for a short time attached to the Cam-
bridge Hospital, Aldershot, and then, after acting temporarily as a regi-
mental M.O., was detailed to No. 1 Field Ambulance and remained
with it till his death, which occurred at High Wood; he was buried
near Mametz.

He was brilliantly successful in his work, a splendid officer and a
charming friend.

[Reprinted from TIlo Guy's Hospital Gazette, October 7th, 1910.]

MONK,, G. B., 2nd Lieut., Rojal Warwickshire Eegt. En-
tered Guy's in October, 1913, as Medical and 2nd Year Dental

Ohituary.

.65

Student. Joined the Artists' Rifles early in 1914, and went to
Fiance in October of tliat year. Specially chosen with the first
batch of 80 Artists to lead the remnants of the 7th Division.
Killed December, 1914, while leading an attack.

MOORE, L. W., Capt., Gloucester Regt. Studied at Guy's
for 3 J years, and on the outbreak of war he enlisted as ^ private
in the Gloucestershire Regt. Was quickly promoted to a second
lieutenancy. Went to the Front in March, 1915, and served with
his regiment until the time of his death, August 29th, 1918.

Lieut. Moore, \vho was acting Captain of his company, was only 23
years of age last November. He was educated at Tewkesbury Gram-
mar School and King's School, Worcester. Upon the completion of
his school career he took up his Istudies for the medical profession, and
was for 3?r years at Guy's Hospital before the outbreak of war, when
he at once sought liis country's service. For four years he was a
member of the local company of Territorials, and whilst in London
he joined the medical unit of the London University O.T.C. The
CoiuiiKniding Officer of the latter recommsnded him for immediate
connnissioned rank, but he enlisted as a private in his county's
regiment, and wa.s quickly promoted to a second lieutenancy. lie
wont to the Front in March, 1915, and had served with his regiment
until the time of his dcMth. As a youth he was assistant scoutmaster
of the 1st Tewkc>bury Troop of the' B.P. Scouts.

[Reprinted from The Gin/s Hospital Gazette, September 23rd, 191G.]

PART I,

GIJ Obituary.

MORRISH, D. B., 2nd Lieut., King's Own Yorkshire Light
Lii'antry. Qualified L.D.S. (Eng.) from Guy's Hospital jin 1913.
Was in practice at Cambridge. While acting as Trench Mortar
Officer to his Battalion, he ^vas killed in France, August 18th,
1916.

Wo regret to record that another young member of the Dental
Association, 2nd Lieutenant Donald Bernard Morii^h, King's Own York-
shire Light Infantry (Trench Mortar Officer), has fallen in action.
He was killed in France on August 18th, 1916. Lieutenant D. 13.
Morrish was the younger son of Mr. and Mrs. John Morrish, of 40,
Carson Koad, Dulwich, and was 25 years of age. He qualified as
L.D.S. Eng. from Guy's Hospital in 1913, and had been in practice
at Cambridge. He joined the British Dental Association in 1913.
At hospital Morrish was a quiet, efficient worker; popular among his
fellow students and all with whom he came in contact.

[Reprinted from The Guy's Hospital Gazette, September 9th, 1916.]

NEELY, H. B., 2nd Lieut., 3rd Suffolk Kegt. Was a Dental
Student at Guy's in October, 1908, and qualified in November.
1912. Won his full Hospital and United Hospital colours for
football. He commenced private practice at Southampton, but
on the outbreak of war at once rejoined his old regiment " The
Artists." Later received a commission in 3rd Suff'olks. Killed
in action at Ypres 25th April, 1915.

Ohiiuary. 67

From his earliest days lat Guy's, when ho came a5 a pupil in Dental
Mechanics in October, 1908, to the time ho qualified in November, 1912,
he ^va3 a tower of strength to the Dental side, mentally and physically.
In addition to his ordinary hospital appointment-s, he was Assistant
Demonstrator of Dental Metallurgy from January to March, 1911, and
Assistant Dental House Surgeon from July to September, 1912.

At sports he was in his element, and won his full Hospital and United
Hospital colours for football.

After taking " his degree he passed into private practice, filling two
or three posts as lasi^i-stant, for a short time, and then, setting up at
Southampton. Here he was very successful until war broke out, when
he immediately closed his practice, like the sportsman he was, and
rejoined his old volunteer regiment, "The iirtists." Later he received
his commission as Second Lieutenant in the 3rd Battalion of the
Suffolk Kegimenfc, and was sent on active service to France.

In the heavy fighting which took place around Yprcs about the end
of April, he was one of the many officers who fell in action — brave men
who gave their lives cheerfully and willingly for their country. We
men of Guys can realise what a lo5S he must have been to !his men,
for he was always a man who thought for others before himself.

[Reprinted from Tho Guy's Hospital Gazette, May 8th, 1915.]

NICHOLLS, W. H., Capt., R.A.M.C. Educated at Bradfield
College and Guy's Hospital. On the outbreak of war he passed
the Conjoint Examination and immediately entered the R.A.M.C.
In January, 1916, he quickly learned to fly and Avas granted a
pilot's certificate. Served in India, where he was killed by an
accidental gunshot wound February 22nd, 1916.

Captain W. H. Nicholls, who was killed by an accidental gunshot
wound at Jhansi, Central Provinces, India, on February 22nd, 1916.
at the age of 24 years, was the only son of Mr. H. H. J. Kicholls
M.Ii.C.S., oc Worthing, who was for many years in practice at East-
bourne. He was educated at Bradfield College and Guy's Hospital.
Though near his qualifying degree at the London University, on the
oulbreak of war he passed the conjoint examination and immediately
entered the R.A.M.C, in which he was gazetted Captain in 1915.
He was a boxer and all-round athlete, find sharenl in the men's games,
and was very popular with them. Whilst in medical charge of tho
Norwich Flying Corps he utilised his knowledge of mechanics and
natural interest in machinery to learn to fly himself, and he was granted!
a pilot's certificate in January, 191G, an unusual distinction in the
R.A.M.C. Soon after this he was ordered iabroad and met his death
not long after reaching India. In private life ho was a keen sportsman
and a timall yacht owner, and there will be sorrow in many a Worthingj^
fisherman's home for the loss of a liberal friend.

[Reprinted from TJw Guy's Hospital Gazette, March 25th, 1916.]

(58 Obituary.

GATES, JOSHUA LAURENCE. Was educated at Gra-
hamstown, South Africa and after passing- the Cape Matric,
entered Guy's as a Dental Student in May, 1911. He obtained
the Pupils' Scholarship in Dental Mechanics in 1913, and joined
the Public Schools Battalion of the Eoyal Naval Division early
in 1915. He was killed in Franco in 1918.

PALMEE, A. H., Major, R. A.M. C. Eldest son of Dr.
Palmer, of Barton-under-Neeclwood, Burton-on-Trent, and was
educated at the Birmingham Medical School and at Guy's Hos-
pital. After qualifying in 1895, he practised at Barton-under-
Needwood, where he held the posts ofi Medical Officer and Public
Vaccinator of Barton District and Surgeon to the Barton Cottage
Hospital. He joined the Staffordshire Yeomanry in 1904. Died
at Cairo on May 2nd, 1917, of wounds received on April 17th,
1917.

Surgeon-Major Ambrose Henry Palmer, E.A.M.C. (T.F.), died at".
Cairo on May 2nd of wounds reseived on April 17th, aged 47. He
was the eldest son of Dr. Palmer, fof Barton-und^r-Needvvood, Burton-
on-Trent, and was educated at the Birmingham Mefdical School and
at Guy's Hospital. After taking ths diplomas of M.R.C.S., L.R.C.P.
Lond., and L.S.A. in 1895 he went into practice at Barton-undcr-
Needwood, where he was Medical Officer and Public Vaccinator of

Obituary.

Barton District, Surgeon to tha Bart'>n Cottage Hospital, and Surgeon
to the Post Office. He joined the Staffordshire Yeomanry on Decembcn-
24th, 1904, became Surgeon-Captain on June 24th, 1908, and was pr-j-
moted to Surgeon-Major last year.

[Reprinted from Tho Guys Hospital Gazette, May 19th 1017.]

PALMER, HENRY JOHN, Lieut., Duke of Coinwairs Light
Infantry. Was educated at the Plymouth Technical Institute,
and after passing- the London Matric. in 1912, entered Guy's
in May of the following year. Hei passed the 1st M.B. Lond.
in July, 1915, but went on active sorviee in December of the
same year. Killed in action near St. Quentin, March 29th,
1918.

PALMER, JOHN STANLEY, Lieut., Durham Light Infantry.
Entered Guy's 1910 as a Dental Student, qualified L.D.S. 1913.
Died of wounds October 18th, 1916.

PARRY-JONES, O. G., Capt., R.A.M.C. Educated at Sher-
borne, Magdalen College, O.xford, and Guy's. Prominent mem-

70 Obituary.

bor of Rugby XV. In the early part of the war he served as
a 2n(l Lieut. Avith tlie Lancashire Fasiliers. Later he qualified
and Mas at once gazetted to the R.A.M.C. In France -was
Medical Officer to the 8th Suffolks. Died of wounds Septem-
ber, 1916.

We regret to record that Capt. Owen Parry- Jones, Il.A.M.C, elder
son of Dr. and 'Mrs. Parry-Jones, Full Street, Derby, has died in
France, from wounds rcceiv^ed in the recent fighting.

Owen Guy Parry-Jones was born at Pinxton, Derbyshire, in June^
1887. He was educated first at a Preparatory School at Bournemouth,
and then at Sherborne School, where he reached the Sixth Form
and was School Prefect, but was, perhaps, more distinguished for his
musical gifts and athletics. He was a prominent member of the
Rugby XV., won the Stealplechase, and was a Sergeant in the O.T.C.
He went up to :Oxford with a iChoral Scholarship at Magdalen College,
became captain of the College XV., and 'played many times for the
University. After taking his ;B.A. degree he entered Guy's Hospital.
He was Very specially a Guy's m:an, his father was here from 1878
to 1885, and his toother wa<s for* a ^hort time Sister Cornelius. Known
to all liis friends 'as P. J., he was beloved by everyone who met him.
In the Rugby XV. he excelled as a forward, physically strong and.
powerful, he was one of the mainstay(s of a teiim that for some years
remained undefeated in the Final Cup Ties. He also played for Kent,
and was a member of two teams that went to France and Austria
respectively. Possessed of a very fine baritone voice, his services for
" Ward Concerts " at Christmas time was always most eagerly sought
after.

In 1913 he accepted a Commission in (the Special Reserve of Officers
and was called up when war broke but, when he was just on the eve
of qualifying las a medical man, and was sent to the Lancashire Fusi-
liers as Second Lieutenant. He served with them at their depot and
at Hull for five months, and then in view of the ishortage of doctors
he was given a month's leave to try and qualify. This he did.
and became M.R.C.S. and L.R.C.P. in January, 1915, and was at
once gazetted Lieutenant in the R.A.M.C and joined a training camp
at Eastbourne. Promoted Captain in May, 1915, he went out to
France in July, 1915, with the 56th Field ximbulance in the 18th
Division. For the last few weeks he had been attached to the 8th
SuflPolks, and whilst with them he met his death. On September
28th he was standing outside the Advanced Aid Post when he received
severe wounds from fragments bf a shdU. ' He died the following day,
and we 'are told that he remaineti bright and cheerful to the end.
Thus P. J., in laying down his life feo voluntarily for his Country,
reflects Honour and Glory on the name he bore, which will ever be
remembered by his Hospital — Guy's.

[Reprinted from Ths Guy's Bosjyital Gazette^ November 4th, 1916.1

PEACOCK, RUDOLPH. Entered Gay's as a dental student
in 1897, and obtained the L.D.S. diploma in 1899. Killed in
aetion, October 8th, 1916.

Obituary.

PEARCE, D. G., Ca.pt., 1st East Kent Regt. Came to Guy's
from Dulwich College. Was to have taken his final in Novem-
ber, 1914, but on August 4th he enlisted as a private in the
H.A.C. and served witli tlie 1st Battalion of that regiment till
he was invalided home Avith frostbite. Later he gained a com-
mission in the East Kent Regt. Killed in action, September
3rd, 1916.

Captain Dudley George Pearce, of The Buffs, aged 25, was the
son of the late George Pe^irce, of Bournemouth. He was educated at.
Dulwich College, where in 1910 he took Jiis colours for football. He'
became a inedical student at Guy's Hospital, fcind was to have taken his
final examination in November, 1914. On the day of the outbreak
of war, however, he enlisted as a private in the H.A.C, and left for
France with the 1st Battalion of that regiment in Sdptember, 1914.
He was invalided home at the end of the same year Avith frostbite,
having taken part in isome of the iheaviast fighting of the war up to
that period. On his recovery he received a commission as second
lieutenant in the East Keiit Reigiment, and left again for the Front
with his battalion. After much fighting and personal distinction, he
was on February 23rd of this year promoted on the field from second
lieutenant to captain, and gazetted as such 'as from November, 1915.

[Reprinted from The Guifs Bov^yital Gazette, October 7th, 1916.]

PEATFIELD, S. J., 2nd Lieut., 9th Royal Berkshire Regt.
(attached Machine Gun Corps), was the youngest son of Mr. H.

72 Obituary.

Peatfield, Dental Surgeon, oi Biig-liton. He joined the London
University O.T.C. in October, 1914, and obtained his commission
in June, 1915. He was sent to France in March, 191G, and was
severely wounded at Ypres on July 1st of the same year and
died tho following dav. Ho was 22 vear.s of as"e.

PERN, MONTAGUE, Lieut. Entered Guy's as a Medical
Student in 1907, qualified L.R.C.P., M.R.C.S. 1912. Killed
in action, March 9th, 1915.

Ohiiiiary. 73

PEVX, W. R., Lieut., R.A.M.C. Entered Guy's in January,
1909, and took his Final Conjoint Examination in January,
1914. He took an active interest in the O.T.C., and for one
season organised the "Guy's Nomads" Rugger XV. At the
outbreak of Avar he joined as a Civil Surgeon and worked at
a base hospital in Rouen. Later he was attached to the 2nd
Lincolns and finally met his death while serving with the 9th
Field Ambulance in Belgium, 1915.

W. ]\. Pryn, son of Deputy Surgeon-General Pryn, came up to
Guy's from Kelly's in January, 1909. As 'a hard and conscientious
worker, examinations held no terrors for him and he had little difficulty
in qualifying in the shortest possible time. He dressed to Mr. Duniv
and Mr. Turner, and was Modisal Ward Clerk to Dr. Hale White and
Sir Cooper Perry, and Clinical Clerk to 'Dr. Shaw. He took his Final
Conjoint Examination in January, 1914.

During his five 3^ears up at Guy's lis took an active interest in the
Officers' Training Corps, of which he was a. member for three years, and
for one season he organised the " Guy's Nomads " Rugger XV.

On leaving, he took up the post of Housc-Surgepn at the Guildford
County Hospital. At the outbreak of war he joined the army as a
Civil Surgeon, and worked for three montlis at a Base Hospital in
Rouen. From there he became attached to the 2nd Lincolnshire Re-
giment and finally met his death while serving with the 9th Field
Ambulance.

[Reprinted from The Guy's Hospital Gazette, July 31st, 1915.]

Obituary.

RECKITT, CHARLES EDWARD, Surg-., R.N. Was the
son of Lieut. -Col. J. D. T. Reckitt, R.A.M.C, and was edu-
cated at Bedford Grammar School and Berkhamstead School,
entering Guy's Hospital in October, 1905, qualifying in 1913.
He was A. U.S. at Guy's and subsequently Ophthalmic House
Surgeon at the Hull Royal Infirmary. He joined the Navy in
April, 1915, and Avas Senior Medical Officer in H.M.S. Shannon.
Li December, 1916, he developed cellulitis of the forehead and
died in Haslar Hospital following an operation.

Surgeon Charles E. Eeckitt, who died on. January 20th as a result
of illness contracted on active service, was 30 years of age. He
qualified in 3913, and was Assistant House- Surgeon at Guy's, and
subsequently he held the post of Ophthalmic House-Surgeon at the
Hull Eoyal Infirmary.

In April, 1915, he joined the navy and was senior surgeon on
H.M.S. Shannon. In December, 1916, he developed cellulitis of the
forehead. After several operations, osteomyelitis of the frontal bonf^
was followed by a subdural abs3es3, of which he died in Haslar
Hospital.

[Reprinted from The Gutfs HospiUd Gazette, February 21th, 1917.]

Obituary. 75

EEES, M. J., Caipt.,R.A.M.C. Qualified M.R.C.S., L.R.C.P.

(Lond.) in 1902 and M.D. in State Medicine in 1906. Died on
October 30th, 1916, of wounds received while attending to the
wounded.

Captain Morgan James Rees, R.A.M.C., died on October 30th, aged
■Al, of wcunds received on October 22nd while attending to the wounded
under fire. He was the younger son |of the late John Rees, of Stepney^
and was educated at 4}he City of London School, at the Univea'sitjr
College of Wales, Aberystwyth, and at Guy's Hospital. He took the
diplomas of M.R.C.S. and L.R.C.P.Lond. in 1902, and D.P.H. of the
London Colleges in 1904, the degrees of Bl.B.Lond. in 1902, and M.D.
in State Medicine in 1906. After filling the posts of Assistant Medical
Officer of the lirook Hospital of the ^Metropolitan xVsylums Broad, and
Assistant ]\ledical Officer of Health to the County Borough of Reading,
ho became JNIedical Officer of Health and Superintendent of the Isola-
tion Hospital for Aberdaxe Urban Distri3t in 1906, and in 1911 was
appointed one of the Medical Inspe!3tors of the Local Government
Board. He was a Fellow bf the Society (of Meidical Officers of Health,
and of the Royal Society of Medicine, and a Me/mber of the Royal
Sanitary Institute.

He took a temporary commission in tha R.A.^M.C. a little over a
year ago.

[Reprinted from The Guy's Hospital Gazette. December 2nd, 3916.]

EICHARDS, ERNEST HARRY RICHARD, 2nd Lieut.,
21st Manchesters. Entered Guy's 1914 as a Dental Student.
Joined Artists' Rifles, November, 1915. Killed in action at
Croisilles, April 2nd, 1917.

ROBERTSON, E. G., Capt., (attached R.A.M.C). En-
tered Guy's Dental School in 1905. Played for the Hospital
as full back in 1906 — 07. Obtained a Dental Commission at
outbreak of war and served two years in France. In August,
1917, he was transferred to the Queen's Hospital at Frognal,
Sidcup, and died October 28th, 1918, from influenza, aged 33.

We regret to announce the death, at » the Queen's Hospital, Frognal.
on the 28th October, of Ernest Guy Robertson, L.D.S., Captain, att.
R.A.M.C.

Son of the late Dr. F. F. L. Robertson, of Aberdeen nud Bart.'^,
E. G. Robertson entered this hosp^al from \Portsmouth Grammar School
in 1905 to graduate in dentistry. He repre*9ented the Hospital as a
full-back in the football XI. which won the Intcr-Hospital Cup in
1906 and 1907, and in the latter year was elected to tlie Clubs' Union.

In 1909 the deceased gentleman stai-ted to practise at Southampton,
where he became Honorary Dental Surgeon to the Southampton and

7(i Ohiiuiry.

SoiUh Uiiiits liifiniiary and to the Fro3 Eye IIo>pil;il. Soutlinmpt i
and Doiital Surgeon to Mr, C. B. Fry's traiiiiiij,' ship Msrruri/ in tin-
Ilanibh^ ]Uver. On the outbreak of war he apjdied for and obtained
one of the first dental comniissioas, and in Decombor, 1914, he left
for Salisbury Plain. In the following' summer he was drafted k-
Franco, and for two j^ears served at a casualty claaring station. lb-
was then recalled to England and appointed to the newly-organised
department for jaw work at the Cambridge Hospital, Aldcirshot. In
August. 1917, he was transferred to the I'liefw Queen's Hospital at Frog-
nal, Sideup.

[ Reprint ed from The Guy's Hospital Gazptte, November '3011k lOlS.j

ROBERTSON, JOHN C, 2nd Lieut., Caiueion Highlanders.
Entered Giiy.s in 1912 as a Medical and Dental Student. Hav-
ing passed his 1st Professional Examination in September, 1914,
he joined tlie Cameron Highlanders as a private. He was about
to take a commission in Februar}', 1915, but taking advan-
tage of an opportunity of getting to the front uith the Camerons,
destroyed his papers. He Avent through Neuve Chapelle un-
scathed, but at Festubert, on the morning of May 17th, 19 lo,
fell Mounded, and from .that day nothing has been heard of
him .

John C. Robertson was born in Selkirk (Scotland). He came to
London with his family when he was labout 5 years of age. His first

Obituary. 77

-chool was a ladies' one, and after lattending that for about six months
ho went to Balham High School fay- a few years. From there he went
to Dunhcved College, Launce^ton, was there for four and a half to
live years, finishing there, and in 1912 he went straiglit to Guys
llcspital as dental and medical student (joint course).

He had just finished his two years in the Dental ^lechanical De-
jjartment and had passed his First Professional Examination in Sep-
tember, 1914. The day after he knew the result, he, along with
.thors, joined as private the 4th Camdron Highlanders about the end
'if September, 1914, at Bedford, where he was trained.

Ho remained at Bedford until February, 1915, 'and although he had
his papers ready for a commission, he, lalong with several of his
friends, when they got the order to go to the Front, destroyed his'
I'ommission papers, preferring to go out as ian ordinary private. They
landed in France, and within seven days were in the trenches. He
\vcnt through the battle of Xeuve Chapelle unscathed, but at the
battle of Festubert, on the morning of the 17th May, 1915, he fell
wounded, and from that day to thLs nothing has beon heard of him.

»He has disappeared absolutely and entirely, and thus a young and
promising life, of hijh character, was ended.

[Reprinted from The Guy's Hospital Gazette, January 11th, 1919.]

ROBINSON, WILLIAM BERESFORD. Entered 1907, quali-
fied L.R.C.P., M.R.C.S., 1912, M.B., B.S. (Lond.) 1913. Held
House Appointments as A.H.S. 1913, H.P. 1914, O.P.O. 1913.

William Bercsford Robinson, M.B., B.S.Lond. M.R.C.S., L.R.C.P.;
died May 12th, 191S; born at Christchurch, New Zealand, in 1888, he
matriculated in New Zealand, and came to England by way of India
in 1907. In October of that year he entered at Guy's and passed thei
Primary Fellowship in 1910, giving promise of a brilliant career.

In 1911 he was laid up for three months with an attack of acute
rheumatoid arthritis, from which his recovery was slow, but lie, never-
theless, qualified with his contemporaries in 1912, and pas-sed the M.B.,
B.S., in May, 1913. Ho held the appointments of Clinical Assis-
tant, A. U.S., O.P.O. , and H.P. to Sir Cooper Perry. He was a member
of the hospital shooting eight, and during his last three ninths at
hospital was President of the Residents. Subsequent to this he went
into private practice in Sutton until the beginning of 1910, when,
feeling that he would sooner be doing something more directly con-
nected with the war, he joined the staff of the 2nd London General
Hospital at Chelsea, where he worked until he contracted septicaemia
in January, 1918.

There is no doul)t that by his death a career of brilliant promise
has been cut short. Respected and liked, his unselfishness and willing-
ness to help contributed largely to the comfort and well-being of those
around him, and he persisted in continuing his work until forced to
give up on account of his ill-health. He leaves a widow and one child.

H. C. B.

[Reprinicd from The Giu/s Hospital Gazette, Jmn' It. 19 IS.]

Obituari/.

ROSS, JOHN HAMPDEN, Private, 4tli Devon Regt., T.F.
Entered Guy's 1909, (lualifiecl L.D.S. 1911. Died of wounds in
Mesopotamia, Juno 5tli, 191(5.

SANDOE, M. W. A., Lieut., Dovonsliiie Reg-t. Eldest son
of Dr. and Mr.s. Sandoe, of Broad Cljst, Devonshire. He was
educated at Allliallows, Honiton, Guv's Hospital, and Durham
University. Killed in action on May 7th, 1917, aged 21.

Lieut. M. W. A. Sandoe was the eldest son of Dr. and Mrs. Sandoe,

of Broad Clyst, Devonshire. He was 21 years of age and was killed in

action on May 7th of this year. He was educated at Allhallow's,

Honiton, Guy's Hospital, and Durham University. His Colonel writes

of him to his parents : — " Your son was a most excellent officer in

every way; the men thought a great deal of him. I had a very high

o^iinion of him, and he is a great loss to me."

[Reprinted from Th? Gtiy's Hospital Gazette, June 2nd, 1917.]

Ohitivary. 79

SAW, NOEL HUMPHREY WYKEHAM, Capt., M.C.,
R.A.M.C., attached 4th Worcester Regt. Entered Guy's 1909
as la Medical Student, qualified L.R.C.P., M.R.C.S., 1915.
Killed in action, October 9th, 1917.

Capt. Noel Humphrey Wykeham Saw, M.C., R.A.M.C, att. Worcestea?
Regiment, who was killed in action on the 9th OctobcJr, 1917, aged 25,
was the younger son of Mr. and Mrs. Saw, junior, of 11, Vanbrugh
Park Road, Blackheath.

Ho was educated at Strathedon House School a.nd Cheltenham Col-
lege (Xewick House), and belonged to the College O.T.C. On leaving
Cheltenham he became a student at Guy's Hospital, and joined the
Artists' 'Rifles, o£ which he remaino'4 a meinbor for four years, resign-
ing early in 1911 to dev^ote him-:elf entirely to his last year of
medical study. He played football for Guy's and Blackheath, and
was a good runner in the mile and half-mile.

On the outbreak of war he applied to rqjoin the Artists, but was
advised to complete his medical course in October if possible. He
became full}' qualified as physician and surgeon in February, 1915, and
at once joined the R.A.M.C. (Special Re);crve), and in July was sent in
charge of troops to Mudros. Becoming attached to the Wore ejitexsh ire
Regiment (29th Division) he went to the Gallipoli Peninsula and re-
mained there until the end, taking part in both evacuations at Suvla
Bay and Cape Helles. After some montlis in Egypt and at Suez the
Battalion came to France, and Capt. Saw! was present at the Battle
of the Somme, where, in rcl3ognition of hi^ gallantry during the first
five days of July, he was awarded the Military Cross. He saw much
service in France and Flanders, and met Avitli hi> death on the battle-
field whilst tending the wounded on tho 9th of October, 1917.

[Reprinted from The Guy's Hospital Gazette, March 8th, 1919.1

Obituary.

SCOTT-PILLOW, H. M., i>nd Lieut., R.F.C. Entered Guy's
as a Dental Student in May, 1914. Shortly after the outbreak
of the Avar ho joined tlie Public Schools Corps, and was granted
a commission later in the Middlesex Regiment, from which he
was transferred to the E.F.C. He went to France in July,
1917, and Avas killed on August 8th of the same year.

Mr. II. M. Scott-Pillow entered Guy's as a Dental Student in Mny,
1914. Shortly after the outbreak of war he joined the Public SchooJ^j
Corps, and was later given a commission in the Middlesex Regiment
from which he transferred to the Koyal Flying Corps. He went to
France in July of this year, and was killed in action on August Sth.
The officer commanding the 7th Squadron Royal Flying Corps, to which
he was attached, writes of him to his mother, " your son had shown
himself a very promising and capable pilot, who always did his work
well, and he endeared himself to all with whom he came in contact."

[Reprinted from ^'A(9 Gui/h Hospital Gazette, jS'ovcmbcr 17th, 1017.]

SEABPtOOKE, A. S., Capt., R.A.M.C. Educated at Ton-
bridge and Christ's College, Cambridge, he came to Guy's in
1908, where he had an unusually successful career. In March,
1915, he joined the R.A.M.C, and was attached to the Rawal
Pindi Hospital, Boulogne. This was presently transferred to
Mesopotamia, where, as the result of overwork and unsanitary
conditions, he met his death on July 1st, 1916.

Captain A. S. Seabrooke, who died on July 1st, 1916, in Mesopotamia,
at the age of 31, was the se3ond son of Mr. (and Mrs. Jonathan Sela-

Obituart/. 81

l.rooke. of Grays, Essex. He was born on October 26th, 1881, at Marsh
House, Grays, and, when nine years -old, went to Maze Hill School,
St. Leonard's. In 1898 he went to Tonbridge School, where he became
head of his house.

Alec Seabrooke was a keen sportnian. His father taught him to use
gun when he was only ten years old, and he became a very igood
-:iOt. There could be no more congenial companion for a walk with
a gun. He was an untiring sportsman after partridges in Septeinber*
and, owing to his walking powers, was generally found as outside gun,
right or left. He was no cricketer, nor did he achieve success as an
oarsman, but Guy's men can tell you of his prowess at football. He
played golf, and on one occasion woln a cup at the Gray's Golf Club.
He was a powerful swimmer, and was quite at home on horseback.

In 1903, Alec Seabrooke proceeded to Christ's College, Cambridge,
where he entcjred heartily into the life and spirit of the University,
and was a member of the Mounted Infantry Corps.

Entering Guy's Hospital in 1908, Alec Seabrooke had an unusually
successful career, not merely from academic brilliance, but because he
was recognised as a man of exceptional character, who gained the
confidence of every one with whom he canue in contact. He was
President of the Guy's Resid^ts, and held House Appointments for
two years, including House-Surgeon and Easidejnt Obstetric Physician.
In ]\rarch, 1915, he gave up the fpast of Eesideint Obstetric and joined
the Royal Army Medical Corps. After a short period of training lat
Aldershot he proceedeld to France, where he was attached to the Eawal
Pindi Hosiiital.

[Reprinted from The Gui/s Hospital Gazette, July 29th, 191G.]

SHEPHERD-TURNEHAM, NORMAN PERCY, Capt., York-
shire Reg-t. Entered Guy's as a Dental Student in October,
1897, and qualified L.D.S. in May, 1901. He eventually .'•ettled
in practice at Maidenhead. Killed in action, Sept. 28th, 1916.

SHORLAND, GEORGE, Temp. Surg., R.N. Entered Guy's
in October, 1894, and passed the Final Conjoint in 1901. Prior
to the war he was in practio3 at Mill Hill, and in addition
held the appointments of M.O., Railway Clearing House,
Euston, and Hon. Surg, to the Railway Benevolent Institute.
Killed in action on H.M.S. Invincible in Battle of Jutland.

SMALL, FRANCIS DUDLEY, Capt., R.A.M.C, attached
15th Cheshire Regiment. ^Vas educated at King's College,
Canterbury, and entered Guy's as a Dental Stuident in October,

PART I. F

82 Obituary.

11)11. He passed Part I. ot* tho P'inal L.D.S. in November,
1914, and joined the army very 60on after. Wounded and miss-
ing, 1918.

SMITH, DOUGLAS WILBERFORCE, Capt., R.A.M.C., at-
tached 6th Manchester Regt. Entered Guy's in September, 1898,
passed the Final Conjoint in 1901, and tho Final M.B., B.S. in
the same year. He was A.H.S. to Sir Charters Symonds in
1901, and passed his Final F.R.C.S. in 1911. Killed in action,
Fricourt, July, 1916.

SNELL, HERBERT, 2nd Lieut., Lancashire Fusiliers. En-
tered Guy's April, 1903, Scholar in Dental Mechanics. Took
Final L.D.S. May, 1905. Killed in action April 9th, 1917.

SNELL, NORRIS, Capt., 8th Battalion East Yorks Regiment.
Entered Guy's a^ a Dental Student in 1893 and qualified L.D.S.
in 1896. Killed in action July 14th, 1916.

SNOW, C. F., 2nd Lieut., R.F.A. Entered Guy's Hospital

Dental School, May, 1908, and qualified L.D.S. in May, 1910.

Went to South Africa the following year. Went through the

German West African Campaign with the S.A.M.C. Coming

home in October, ho was given a commission in the artillery.

Killed in action, June 30th, 1916.

Second Lieutenant Charles F. Snow, the elder son of Mr. W. H.
Snow, Compton House, Peterborough, has been killed in action. Twenty-
eight years of age, he was eiucated at the Cathedral School, Peter-
borough, and the Barton School, Wisbech. He entered Guy's Hospital
Dental School, May, 1908, and qualified L.D.S. in May, 1910. He
went to South Africa five years ago, and at the outbreak of war was
attached, as senior lieutenant, to the Kimberley Eegiment. Afterwards
he was transferred as captain to the South African Medical Corps,
going through the German West Africa campaign.

[Reprinted from Th^ Guy's Hospital Gazette, July 15th, 1916.]

SOWERBY, VICTOR HOLGATE, Lieut., Lincolnshire Regt.
Was educated at Old Clee Grammar School where he won a

Obituary. 83

liolarship. Was head of the school and Captain of the Cricket
and Football Teams. He became a Student at Guy's Hospital
in October, 1915, but enlisted in the London Regt. in the fol-
lowing month. He proceeded to France early in 1916 and was
appointed 2nd Lieut, in the Lincolnshire Regt. in June, 1917.
He received a wound in the chest and died on his way to the
Dressing Station on August 1st, 1917.

Second Lieut. V. H. Sowerby was educated at Old Clee Grammar
School, where he won a scholarship, was head of the school, and cap-
tain of the cricket and football teams. He became a student at
Guy's Hospital in October, 1915, but enlisted in the London Eegiment
the following month, and volunteered to proceed to France early in
1916, although then only 18 years old. He was selelcted with a few
others to act as domestic indoor guard ^o the King, when his Majesty
spent a week in France. This was an interesting experience, and
resulted in the gifit of a Koyal \']pipe as a souvenir. ^He remained in
Franco and Flanders witlhout any leave until appointed Second Lieu-
tenant in the Lincolnshire Eegimeint, June, 1917, when he was granted
a few days' leave.

[Reprinted from The Guy's Hospital Gazette, September 8th, 1917.]

SPONG, R. W., Lieut., R.A.F. Entered Guy's Dental School
in 1911. Died at Shorncliffe October 30th, 1918. Gained Hos-
pital Blue 1911—12 for Association Football. Joined Middle-

84 Ohituary.

sex Yeoiuuiiry at outbreak of war, and was attached later to the
Machine Gun Corps Cavah'y in Ireland. Later on went to
Franco, but returned to the Ho^^pital in 1917 to complete his
Dental course. Obtained a Dental Connnission in Royal Air
Force, Avith Avhich he was serving at the time of his death.

By the death on October 31st of Lieut. R. W. Spong, E.A.F.^
another Guy's man has made the great sacrifice while serving in His
Majesty's Forces.

Entering Guy's in 1911, on the Dental side, it was not long before
R. W. Spong proved himself a keen , sportsman as well as a keen
student, and gained a well-deserved popularity amongst all — both
medical and dental. Playing for the Hospital at Association Football
he proved himself a fast and sound forward, and his weight served
him well. He gained his Blue in the Session 1911 — 12, playingj
several times for the Unitqd Hospitals, after .which he forsook Associa-
tion for the Rugby Code, and when war broke out was fast becoming
an adept at the game. He was .pilso a good long-distance swimmer and
100 yards sprinter.

When war broke out he had passed the .first half of his Final Dental,
but immediately joined the Middlek^ex Yeomanry, soon earning corporal's
stripes and a commission. He then took a machine gun course at
Grantham, and was attached to M.G. Corps Cavalry in Ireland, and
was with them through the Irish trouble in Dublin. He then went
to France, where he served for some time before coming home in 1917
to take the second half of his 'Dental Final. He then returned to a
Home Station, but owing to illness he nvas' demobilised in October,
1917. For a while he carried on his dental work, but feeling he was
fit enough he obtained a Dental Commission in the Royal Air Force,
with which Force he was serving up -to the time of ihis death. In ?all
his actions — in work and sport — ^lie was a typical Guy's man, and will
be generally missed by all who knew him.

[Reprinted from TJie Guy's Hospital Gazette, December 14th, 1918.]

Obituary.

STAGEY, JOHN BREWEE, 2nd Lieut., 8th East Surrey
Regt. Third son of M ;. H. Stacey, Firle, near .Lewis, Sussex,
was killed in action between November 18th and 20th, 1916, dur-
ing- an attack on Grandcourt, France. He was only 20 years of
age and was educated at Eastbourne College. He entered Guy's
Hos])ital as student in September, 1913, joined the London
O.T.C. in 1914, was given a commission in the East Surrey
lOtli Reserve, December, 1915. Trained at Chelmsford and
Fermoy, Ireland. Went to France, July 13th, 1916, was re-
j)orted slightly wounded and missing after an attack near
Grandcourt on November 18tli, and his body Avas found by a
wounded officer of the Duke of Cornwall's Light Infantry, on
November 20th.

Obituary.

STAINER, C. H., Lieut., Loyal North Lanes. Regt. Edu-
cated at Guy's Hospital, qualifying as L.D.S. (Eng.) in 1913,
and was in practice in South Africa on the outbreak of war.
He joined the Loyal North Lancashire Regt. as a combatant,
and was killed in action on November 15th, 1916, while at-
tacking a German trench.

We regret to hear that Lieutenant C. H. Stainer, of the Loyal
North Lancashire Regiment, was killed in action on November 15th
1916, while attacking a German trench. He qualified as L.D.S. Eng.
in 1913, and was in practice in 'South Africa on the outbreak of war.
He was very popular while a student lat Guy's, and his death has
occasioned sincere regret among his brother officers and friends.

[Reprinted from The Guy's Hospital Gazette. January 27th. 1917.]

Ohihiary. "67

STANWELL, WILLIAM ALEXANDER, Lieut., 3rd Lan-
cashire Fusiliers. Entered Guy's 1913 as a Medical Student.
Killed in action July 9tli, 1915.

The late Second-Lieutenant W, A. Stanwell was the only son of Dr.
and Mrs. Stanwell, of Rochdale. He received his early education at
Blundell's School, and entered Guy's in October, 1913, having pajssed
the London Matriculation Examination in the previous July. At the
outbreak of war he was working for his First M.B. (London) Exa-
mination.

Lieutenant Stanwell was attached to the 2nd Lancashire Fusiliers.
He was only 21 years of age. At the time the war broke out he \vasi
studying for his father's profession of medicine at Guy's Hospital,
London. He had then already had some military training, had been
for five years in his school cadet corps in Devonshire, and had after-
wards become a private in the Artists' Rifles in London. With the
Artists' Rifles he went to the front in France in October, 1911; he was
later awarded a commission and transferred to the 2nd Battalion the
Lancashire Fusiliers.

He was killed in action on July 9th, and so the Hospital has lost
another of her younger sons who gave up everything to go out and
fight for his country. We otter our sincere sympathies to all his rela-
tives and friends.

[Reprinted from The Guy's Hospitrd Gazette, July 31st, 1915.]

Obitiuiry.

START, S., Lance -Corporal. Emx^loyed in Works Dept.
Joined the Machine Gun Corps and was awarded the Military
Medal for gallantry in France. Died of wounds, 1917.

STEPHEN, LIONEL HENRY YORKE, Capt., R.A.M.C.
Entered Guy's in April, 1893, and passed the Final Conjoint
in 1897. During- the South African War he served as Civil
Surgeon to the Field Fiorces, and after as R.M.O. to the Royal
Isle of Wight Hospital. Died on service, 1918.

STEYN, S. S. L., Lieut., lloth Brigade R.F.A. Educated
at the Diocesan College, Rondebosch, Cape Town. Went to Ox-
ford with Rhodes Scholarship in 1910. Gained his Blue at Ox-
ford for Rugby Football and International Cap for Scotland.
Entered Guy's 1913. Joined King Edward's Horse at outbreak
of war as a private. Granted a commission in R.F.A., Novem-
ber, 1914. Killed in action, December 12th, 1917.

Obituary. 89

TILBURY, A., Capt., R.A.M.C. Was educated at Aiidover
Grammar School and Guy's Hospital. Qualified in 1913. He
then Avas Clinical Assistant in the Genito -Urinary Department.
At the outbreak of war he received a commission in the
R.A.M.C. In December, 1915, he was promoted to Captain,
and was sent to Egypt with the M.E.F. He returned to Eng-
land in March, 1917. While on the transport Trans tjliYmia the
ship was torpedoed on May 4th, 1917, and Capt. Tilbury was
rei)orted among those drowned.

Captain A. Tilbury, son of John Tilbury, Sheardown House, Oakley,
Hants, aged 29, was educated at Andover Grammar School and, as a
private i)upil, by Rev. J. Atkins, M.A. He entered Guy's in October,
190G. He played Association Football for the Hospital for one season,
but while doing the appointment of Extern his health broke down
and he developed a small tuberculous focus in his right apex, and
had to leave the Hospital for a year, during which time under Dr.
Fawcett's kindly supervision and care he recovered and took the
Conjoint Diploma in January, 1913. He then did Clinical Assistant in
the Throat Department and in the Genito-Urinary Department, at the
same time joining his brother, Mr. R. Tilbury, in partnership at Queen's
Road, Pcckham. When war broke out he was called up as a reservist
in the London University O.T.C., and was at once given a commission
an the R.A.M.C. He was sent to Canterbury Barracks under Col. W.
W. Pope, where he remained for one year. In Septeml)er, 1915, on
obtaining his Captaincy he was sent to P^gypt with ihc Mediterranean

90 OMtuar?/.

Expeditionary Force, and was stationed at Boulac for over a year and
then moved to Kantara. In March of this year he came home on
.special duty. In May he proceeded overland to a French port with
troops and sailed on May 3rd on the transport Transylvania. She
was torpedoed and sunk on Maj' 4th in the Mediterranean, Captain
Tilburv has been reported " missing, believed drowned " by the War
Office/

[Reprinted from The Guy's Hmpital Qazette, June 2nd, 1917.]

TOLHURST, St. JOHN ALEXANDER MOLESWORTH,
Capt., N.Z.M.C, T.F. Came to Guy's from Wellington Col-
lege, New Zealand ,in October, 1901. Qualified Conjoint in
January, 1907, and passed his Final M.B., B.S. Lond. in
1909. Whilst at Guy's he held the appointments of Clinical,
A.H.S., O.P.O. and H.P. Just prior to the war he Avas in
practice at Wellington, New Zealand. Killed in action May
I2th, 1918.

TOWNSEND, THOMAS AINSWORTH, Capt., M.C.,
R.A.M.C, T.F., 24th London Regiment. Was educated at New
College, Oxford, and entered Guy's in October, 1909. He passed
the Final Conjoint in 1914 and held the appointment of Oph-
thalmic House Surgeon till Janu^^ry, 1915. He afterwards left
for service in Serbia, and subsequently went to France. He
was awarded the M.C. in 1916. Bar to M.C., 1918. Order
of St. Sava (Serbia). Wounded, 1917. Killed in action at
RocqungTiy, March 24th, 1918.

Obituary.

TRAILL, A. A., Capt., R.A.M.C. Was educated at Charter-
house and New College, Oxford, where he became President of
the University Lawn Tennis Club and won the Challenge Cup.
After passing the 1st M.B. he came to Guy's. On qualifying
he held the appointment of A.H.S. to Mr. Rowlands and on
the termination of his appointment joined the R.A.M.C. In
the spring of 1917 he was sent to France. While at Oxford he
had a severe attack of haemorrhage from a duodenal ulcer, and
a recurrence of this trouble when with his regiment at the front
was the cause of his death at the age of 27.

Captain Anthony Traill was the second son of Mr. and Mrs. E. B.
Traill, of Felmarsh, Essex. He was born near Dublin on July 1st,
1890, and was educated at Charterhouse and New College, Oxford. At
the latter place he became President of the Oxford University Lawn
Tennis Club, and won the Challenge Cup. While at Oxford he began
his medical studies, and after passing the first M.B. examination, came
up to Guy's Hospital. After qualification he held the appointment of
Assistant House-Surgeon to Mr. Rowlands, and quickly made his namo
as a most promising operator. On the termination of his appointment
he joined the R.A.M.C, and was for .some months employed in training
recruits at R.A.M.C. depots at Aldershot and Blackpool. In the spring
of 1917 he was sent out to France. While at Oxford he had a severe
attack of hasmorrhagc caused by a duodenal ulcer, and a recurrence of
this trouble when with his regiment at the front was the cause of his
death at tho age of 27.

His life was one of great promise, and all who knew iiim looked for
him to excel in his profession. Both at Oxford and at tho Hospital

92 Obituary.

Captain Tiuill was extremely popular. He was intensely interested in
his i)n)i'es.sional work and an extremely quick and able operator. Though
he (lid not serve for very long in France, he did a great deal of
valuahlc work in training depots in this country at a time when the
training of recruits was a more urgent necessity than the provision of
medical othcers for service at the front.

I Heprinled from Th" Gui/'.^ Hospital G/izette, September 22nd 1917.]

TRAILL, KENNETH ROBERT, Lieut., Royal Berks Regt.
Son of Dr. C. G. Traill, was born January 9tli, 1894. He was
educated at Sunningxlale School and Bradfiekl College. He
matriculated at London University and entered Guy's Hospital
in 191 L He passed 2nd London and 1st Conjoint Examinations
in 1914. Joined the Inns of Court O.T.C. in August, 1914, and
received a commission in the 6th Battalion Royal Berkshire Re-
giment, went to France in June, 1915. He was wounded in
February and rejoined in March, 1916. Killed on July 1st,
1916, at the Battle of the Somme.

Obituary.

WAG HORN, LEONARD PENGELLY, 2nd Lieut., Royal

Berks Regt. Entered Guy's 1909. Joined the Forces August,

1914. Killed in action November, 1914.

We hear with groat sorrow that Second Lieutenant L. P. Waghorn
was killed in action on Xovember the Gth. Lionel Pengelly Waghorn.
aged 24, was educated at Marlborough. He matriculated into Loudon
University in June, 1909, and entered Guj^'s in the following October.
He passed the 1st M.B. in July, 1911, and the Second Conjoint Exa-
mination in October, 1913.

Second Lieutenant L. P. Waghorn belonged to the Inns of Coirrt
Officers' Training Squadron, and on the outbreak of the war, at his
fourth year of medical training at Guy's Hospital, he volunteered for
service at the front. He was gazetted to the Royal West Kent Ecrjfi-
mcnt, and from there attached to the Royal Berkshire Regiment. Ho
had only joined this regim.Qn.t a (few daj^s when he Avas killed in action
on Xovember Gth. Ho was the second son of Engineer-Captain W.
Waghorn, R.N., formerly Professor of Phj-sics at the Royal Xaval
College, Greenwich. — The Tivies, November 17th.

[Reprinted from The Guy's Hosyital Gazette, November 21st, 1914.]

Dr. J. W. Waghorn writes: —

Let me, in the first} place, thank you for yQwx letter and your kind
and sympathetic appreciation of Leonard's friendship with ,vour.sclf
and his other hospital friends. As regards any facts of his life : he
was in his 24th year; he was cducat^l at Morton and Vickcrs' private
school at Englefield Green. (Morton was the well-known 'Varsity
bowler and was much attached to Leonard). From there he went to
Marlborough. His entry and work at Guy's you know better than I
do probably.

He was in the Inns of Court Officers' Training Squadron, and had
been promoted to Lance-Corporal. At the outbreak of war he volun-
teered for service at the front, but was nnxi'MK. if po-:^ible, to get into

94 Obituary.

the R.A.M.C., and consequently did not avail himself of the oppor-
tunities he had of l^eing appointed to some Yeomanry Corps, and per-
haps on tliat account was appointed, to his surprise, to an infantry
regiment, the 3rd Battalion (Reserve) of the Royal West Kent Rejgi-
mont (Quean's Own). Although he was unacquainted with infantry
drill and duties, he soon made himself an efficient officer at Chatham,
and earned the esteem of his Commanding Officer.

He was attached to the Royal Berk^hires at the commencement of
October, left for France on October the 3rd, was employed on some
work neai" the fighting line in which he had frequent occasion to use
his medical training, but where and what the work was he never told
us.

On the 3rd of November he joined the Berkshire^ in the fighting line,
and was killed outside his " dugout " instantaneoiusly by a splinter of a
shell on November 6th.

[Reprinted from The Gwfs Hosjjital Gazette, December 19th, 1914.]

WATSON, CECIL FEANCIS W., West African M.S. Entered
Guy's in January, 1892, passed the Final Conjoint in 1899.
He obtained the Diploma of Tropical Medicine in 1906, and
the Diploma of Public Health, Ireland, in 1909. He afterwards
left to take over the part lof Senior M.O. (of the West African
Medical Staff in Northern Nigeria. Lost at Sea.

WATT, NORMAN LINDLEY, 2nd Lieut., King Edward's
Horse and R.F.C. Was educated at Natal and Pembroke
College, Oxford, and after passing the 1st M.B. Oxon. in 1913,
entered Guy's in October, 1914. He was in the midst of his
first clinical appointment when ho joined up, in November of
the same year. Died of wounds, July 27th, 1917.

WEARING, DOUGLAS GEORGE, L.D.S. Entered Guy's
as a Dental Student in April, 1933, qualified L.D.S. Eng. in
May, 1905; and was Assistant Demonstrator of Metallurgy the
same year. He settled in practice at Sidcup and wks Consulting
Dental Surgeon to the Sidcup Cottage Hospital. Died of pneu^
monia in Ireland whilst serving with troops as Dental Surgeon.

WEBSTER, EDWARD MACKAY, 2nd Lieut., Royal Berks
Regt. Entered Guy's in 1911 as a Medical Student. Killed
in action August 1st, 1917.

Obituary.

WEENBERCt, ALBEKT. Entered 1913. Dental. Joined
S. A.M.C., 1916 ; went to France, 1917. Killed in action, 1918.

Born in Brussels on- February lith, 1<S92, the deceased came out to
South Africa with his parents in November of the same year. Subse-
quently he laid the foundations of a bright career in the city, and took
his intermediate examination at the Christian Brothers' College. Later
he pursued his studies at the Rhodes College, Grahamstown, where he
was successful in gaining his B.A. degree. Having decided to practice
dentistry, he first studied at Bloemfontein. In 1913 he proceeded to
London to pursue his dental course at Guy's Hospital, and he showed
signs of making his mark in the profession he had selected. In August,
1910, when he was within nine months of qualifying in dentistry, he
.■sacrificed this in order to" participate in th3 war: this, despite the fact
that had he but waited the further short period in order to qualify,
he could have secured his commission. At the outset he joined the South
African Medical Corps, but in the early part of 1917 he was drafted
to the South. African Field Ambulance in France. He participated in
all the hard fighting with the South African Brigade, and on account
of his knowledge of dentistry his services were frequently requisitioned
at the base when opportunity offered. He cheerfully braved all the
hardships of campaigning, and his letters to his parents were written
in optimistic strain. He has nobly oflered his young life, as so many
others have done, on the altar of sacrifice for the cause of righteousness
and freedom.

Private Albert Weinberg had a promising career. Amongst his many
accomplishments he was a brilliant violinist, and whilst in Kimbcrley
he was a member of the Kimberley Musical Association, and frequently
gave his services as a solo violinist at various charitable efforts.

[Reprinted from Th-^ Diamond Fields Advertisir, Kimberley, Wednes-
day, October 30th, 1918.]

90 Obituary.

WELLER, CHARLES, Capt., R.A.M.C., 3rd Cavalry Divi-
sion. Entered Guy's 1903, qualified L.D.S. .1905 and L.R.C.P.,
M.R.C.S. 1910. Killed in action, 1917.

Capt. Charles Weller, R.A.M.C, 2/3rd London Field Ambulanct..
Married. Only child of Mr. Charles Weller, Clarendon House, Eedhill,
Surrey. Killed in the trenches at Ypres, August 16th, 1917.

Volunteered for servicei at the outbreak of war. Joined the R.A.M.C.
as a lieutenant, November 4th, 1911, and sent to France to No. 1
Clearing Hospital. Promoted Captain after one year's service, and
was M.O. with the 3rd Cavalry Field ximbulancs for another year. He
took four months' leave to attend to [his own practice and returned to
France, March 24th, 1917, and was M.O. 'at No. 11 General Hospital
until May when it w^as given over to the Americans. He then joined
the 2/3rd London Field Ambulance, and at (the time of his death had
been lent as M.O. to the 1st London Regiment.

Cop3^ of letter sent me from Franc©: —

" On August 16th the division w^ere in (action and the 1st Londons,
to which the late Captain was attached, w^ere in the trenches, word
came down to the Regimental Aid Post that the Batt. Headquarters
had been shelled and that officers were buried.

Capt. Weller decided to igo forward and took with him two squads
of stretcher bearers. When he reached the communication trench the
enemy began their counter-attack and the late Captain decided it was
unsafe to prcfDead, at least for a time. Several wounded men were
lying near and he visited most of them, and thein took jshelter in the
trench.

Ohittiary. 97

After he had been tlielrc a few fiiioments, he lurned and said ' I am
hit.' He was bleeding from the uppeir 'part of his forearm, and whilst
I was trying to Btay the flow of blood his head fell over mj lirni. I
removed his steel helmet and found his brains protruding from his
forehead, and he expiiet-d in a few [moments. He met his death nobly
carrying oiit his duty in this diabolical War."

This was written by a corporal who was with him by orders of
Colonel Ducat. Colonel Ducat 'adds he was greatly liked and respected
by all, and both myself and the rest of my officers feel his loss deeply,
hnviiie lo=;t n ir-'iU'int officer and a friend.

WHITWORTH, HENRY PAEKS, Capt., M.C., R.A.M.C.,
att. Scottish Borderers. Son of Dr. Win. Whit worth, St.
Agnes, Scorrier, Cornwall. Entered Guy's October, 1908, hav-
ing* x)assed the London Matriculation in the preceding July.
He passed the M.B., B.S. Lond. in July, 1911, and the Final
Conjoint in March, 1914. Held all the Ward appointments
and in addition Clinical and O.P.O. in 1914. He was severely
wounded in the summer of 1916, and subsequently was on
Home Service for some time, but returned to France in 1918.
Died of wounds, October 29fch, 1918.

WILLIAMSON, GERALD COUTTS, 2nd Lieut., Esse.x Regt.
Was educated at Bishop's Stortford College, and came to Guy's

PAKT I. G

98 Ohittiary.

as a Third Year Dental Student in May, 191.3. He passed the
Preliminary Science Exam, prior to entering the Hospital, and
the First Professional in November, 1913. He went on active
service soon after war broke out, l)ut Mias killed in Flanders on
October 9th, 1917.

WYAND, EDWARD HERBERT. Son of S. I. Wyand,
Esq., of Lexham Gardens, W. Entered Guy's as a Dental
Student in October, 1899, and qualified L.D.S. in November,
1901. During the South African War he was Civil Dental
Surgeon to the South African Field Forces, and later. Avas
Dental Surgeon to the Troops at Aldershot.

Obitmry. 99

DEAN, Miss CONSTANCE W. Entered Guy's Hospital iu
July, 1912, and left on completion of three years' training- to
take her C.M.B. Certificate, after which she held the post of
Staff Nurse at the Cottage Hospital, Beckenliani for a short
time. She then took an appointment under the British Red
Cross Society, and died of pneumonia following- influenza at
Woburn Abbey Hospital on Decamber -Ith, 1918.

GLADSTONE, Miss ELSIE M. Entered Guy's Hospital
as a Probationer in June 1912, and on completion of her
training- in July, 1915, joined the Civil Hosj)ital Reserve, and
served on a hospital ship before going to France. She ct>u-
tracted influenza which was followed by pneumonia while work-
ing- at the 48th Casualty Clearing Station in France, and died
on January 24th, 1919. She wa.s awarded the Royal Red
Cross 2nd Class, but did nofc live to i-ecoive it. She was buriod
in France with military honours.

100

Obituary.

HOPKINS, Miss EVELYN. Entered Guy's Hospital as a
Probationer in December, 1912, and on completion of her train-
ing joined the Private Staff of the Guy's Trained Nurses' Insti-
tution, leaving- in April, 1917, to take up work in a Military
Hospital. She was appointed a Sister lat the Endsleigh Palace
Hospital and during her service there, contracted influenza and
died of pneumonia on November 5th, 1918.

Ohiluury

101

MORRELL, Miss Mary L. Entered Guy's Hospital a,s a Pro-
bationer in September, 1913, and on completion of her training-
in October, 1916, joined the staff of the Guy's Trained Nurses'
Institution. Early in 1917, she joined the Q.A.I.M.N.S.R.,
and in December, 1918, she was invalided home from Salonika.
She returnad to her home in Ireland but did not recover, tmd
died on Augfust 18th, 1919, after a long illness. Her funeral
was conducted with military honours, and attended by a largo
contingent of local ex-soldiers.

102 ObUuary.

VVOODUEAD, Mrs. Agno.s (uco Walkor). Entoiod Guyb
Hospital as a Probationer in Au<^ust, 189G, but was obliged to
loavo on account of ill health in November, 1897, without com-
pleting' her training. She regained her health later and was
able to take appointments as Stall: Nurse and Sister in Provin-
cial Hospitals. On the outbreak of war slie took a[)pointmonts
under the British Red Cross Society, and in December, 11)17,
was appointed Night Superintendent at King Edward Vll.
Hospital, Windsor, and died there on May Gth, 1919, from the
after effects of an operation.

Paet II

Honours. i07

Decorations and Honours.

Victoria Cross (V.C.)

ACKKOYD. Capt. H., M.C., M.D., late K.A.M.C. (attached Royal Berks.
Regiment).
For most conspicuous bravery. During recent operations Capt.
Ackroyd displayed the greatest gallantxy and devotion to duty.
Utterly regardless of danger, he worked continuously for many
hours up and down and in fi'ont of the line, tending- thie
wounded and saving the lives of officers and men. In so doing
he had to move across the open under heavy machine-gun, rifle
and shell fire.

Distinguished Service Order
Companions 'with Bar (D.S.O.) /

Dear, Lt.-Col. H. J., D.S.O., London Regt., 1918.

For conspicuous gallantry and devotion to duty. During an action
he commanded his battalion in the most gallant and determined
manner, rushed the crossing of a stream, and captured many
prisoners. It was largely due to his personality and gallantry
that this operation proved a success.

OSBURN, Major A. C, D.S.O., R.jA.M.C, 1918,

For conspicuous gallantry and devotion to duty. On seeing the enemy
approaching close to his dressing ^ptation, he carried out the evacu-
ation of the wounded under heavy shell fire in the coolest and
most gallant manner. Having cleared away all the cases by
ambulance train and cars, he re-established his dressing station
further in the rear. As officer commanding bearer divisions he
constantly inspected his line of bearer posts and forward dressing
station under heavy fire. The successful evacuation of the
wounded from the divisional front was due to his careful organi-
sation and fearless supervision under the most trying conditions.
He was an example of gallantry, courage and resource worthy
of the highest praise.

Pye-Smith. Lt.-Ck>l. C. D., D.S.O., M.C., R.A.M.C.

For conspicuous gallantry and devotion to duty when in commanfl
of the three field ambulances of the division during txjn days'
operations. Though the weather conditions were abnormally bad.
and a large number of the wounded of another division had not
been evacuated; owing to his •prcf^ence, conduct and influeoice, all
the wounded were got away promptly and without assistance from
the infantry.

Companions (D.S.O.)

FUgshawe, Brevet Lt.-Col. H.V., R.A.M..C,, 19 in.
Barron, Brevet Lt.-Col. R. M., I. M.S., 1918.
Barrow, Lt.-Col. H. P. W., R.A.M.C, 1918.

108 Honours.

Bird, Lieut. -Col. Johu Wilfred, R.A.M.C. (T.F.), 6th London Field
Ambuhmce.
For conspicuous devotion to duty, during operations at Maxoc and
Loo«, between Septcinibcr 25th and HOth, 1915, in dealing
with casualties. On one occasion he worked for 23 hours with-
out any cessation in dressing* and tending the wounded. He act
a fine example, which liad far-reaching results.

Beown, Lt.-Col. R. T., R.A.M.C.

Brown, Major T. F., R.A.M.C.

Browne, Lt.-Col. G. B., R.F.A., 1917.

Butler, Lt.-Col. A. G., R.A.M.C, 1917.

Collins, Lt.-Col. R. T., R.A.M.C, 1918.

Cooper, Staff Surg. H., R.N.

COPLANS, Lt.-Col. M;, A.D.M.S., R.A.M.C.

Crawford, Lt.-Col. V. J., R.A.M.C.

Davies, Lt.-Col. W. T. F.

Dear, Lt.-Col H. J., R.A.M.C attached London Regt.

DowsETT, Lt.-Col. E. B., R.A.M.C, 1918.

Dymott, Major G. Lang, 281st Battery, R.F.A.

Evans, Brevet Col. C R., R.A.M.C.

Evans, Lt.-Col. J., R.A.M.C, 1918.

Falwasser. Lt.-Col. A. T., R.A.M.C, 1918.

Farrington. Capt. W. B., Notts and Derby Regt., attached R.F.C.,
1918.

Gbiffin, Capt. E. H.

For conspicuous gallantry and devotion to duty. He established
his dressing station well forward during an attack, and went up
to the front line through a storm of artillery and machine-gun
fire utterly regardless of personal safety. He moved about in the
open for 36 hours without food or rest attending to the wounded,
often leading parties of bearers through heavy barrages unt 1 every
wounded man had been carried back. He remained behind aftei'
the battalion was relieved, sfll searching for wounded under heavy
fire, though several times badly shaken by the explosion of the
shells. He stet a most inspiring example of courage and devotion
to duty.

HORTON, Brevet Lt.-Col. J. H., I.M.S.

Lauder, Major J. F. L., R.A.M.C.

Layton, Lt.-Col. T. B., R.A.M.C, T.F., 1918.

Leckie, Capt. Malcolm, R.A.M.C, 1914.

For gallant conduct and exceptional devotion to duty in attend-
ing wounded at Frameries, where he wa^ himself wounded.

Lewis, Lt.-Col. R. P., R.A.M.C, S.R., 1918.
Littlejohns, Major A. S., R.A.M.C, 1917.
Minns, Capt. A. N., R.A.M.C
MoFFATT. Lt.-Col. H. A., S.A.M.C, 1917.
Murray, Lt.-Col. C M., S.A.M.C, 1918.
OsBORN, Major A. C, R.A.M.C.

Hxmoivrs. 109

Pallant, Capt. H. A., M.C.

For conspicuous gallantry and devotion to duty. Hearing that a
number of men belonging to* another battalion were on the enemy
bank of a river and unable to cross it owing to the bridge being
destroyed, and to their being apparently unable to swim, he
hurri^ to the scene, swam the river fully clothed, and induced
the men to enter the water and cross with the aid of a ropti.
The most exhausted one he personally conveyed across. During the
time the enemy were continually shelling both the river and the
banks. He set a splendid example of energy and devotion to
duty.

Pallant, Brevet Lt.-Col. S. L.. R.A.M.C., 1917. '

PiLCHER, Lt.-Col. E. M., R.A.M.C.

Pollock, Lt.-Col. C. E., A.M.S., Headquarters Staff.

Powell, Lt.-Col. J. E., R.A.M.C, 1917.

PURDOK, Lt.-Col. W. B., R.A.M.C.

Pye-Smith, Lt.-Col. C. D., M.C, R.A.M.C

For conspicuous gallantry and devotion to duty. When in charge
of an advanced dressing station his serg-eant-major and the whole
of his staff were killed. He reorganised the work with the assis-
tance of a lance-corporal, and in consequence of his energy
and presence lof mind the work was not delayed. He led his
fjearers continually into tlie front line, rescuing wounded under
heavy shell fire, and working with great heroism for 60 hours,
setting a splendid example to all.

Reynolds, Lt.-Col. L. L. C, Oxford and Bucks L.T., 1910.

Richards. Capt. J. F. G., R.A.M.C, 1918.

Richards, Capt. Owen, R.A.M.C

Richardson, Col. H., R.A.M.C, 1918.

Stewart. Capt. J. L., M.C

For conspicuous gallantry and devotion to duty. Although hip
aid-poet was in the open, a few yards behind the front line.
he remained there caring for the wounded, and through his
efforts they were all dressed and evacuated. He was the only
medical officer of the brigade left.

Stout, Major T. D. M., N.Z.M.C, 1917.

Stuart, Lt.-Col. H. D., R.A.M.C, 9th Linc^. R^t., 1917.

Walkrr, Brevet Major A., R.A.M.C, 1918.

HJe established forward dressing stations and continued to work
in them until forced to move by the immediate proximity of the
enemy. He was repeatedly working in the open under heavy
fire, no protection being available. lie undoubtedly saved many
lives which would have been lost but for his initiative.

WAtsoN. Major D, R, ^l.A.M.C, 48th Field Ambulance, 1918.

Willan, Lt.-Col. G. T., R.A.M.C (T.F.), 1917.

Wright, Lt.-Col. T. J., R.A.M..C,, 1917.

Young, Major J., R.A.M.C, East Lanes. F.A., 1918.

110 Honours.

Distinguished Service Cross (D.S.C.)

llELSHAM. Surg.-Lioiit. ChrLstopher T., R.N., II.M.S. Broke.

The King has been j^aciously pleased to give an order for the
award of the Distin^ai ished Service Cross to Surg.-Prob.
Christopher T. Helsham, E.N.V.R., H.M.S. Broke, who worke<i
with great energy and ability in attending the wounded in thf
i-ecent action with Grerman destroyers in the Channel.

OSMAN, Prob. Sub. -Lieut. A. A., R.N., 1918.

2nd Bar to Military Cross (M.C.)

Hancock, Temp. Capt. (Act. jVIajor) Allen Coulter, M.C, R.A.M.C.
(attached II.L.I.), 1917.
He established his A.D.S. in the village, although it was under
veiy heavy shell fire. He attended and evacuated a very large
number of wounded, working all night, finally going out him-
self along the front to see if there wore any left.

Bar to Military Cross (M.C.)

BiDDLE, Major E., M.C, R.A.M.C, 1918.

Chaning-Pearce, Capt. Wilfred Thomas, M.C, R.A.M.C, 1917.

Davies, Major J. Edgar, R.A.M.C, attached South Wales Borderers.

German, Capt. H. B., M.C, R.A.M.C.

While in charge of fetretcher bearers he supervised the <'vacuation
of the wounded from the front line to the advanced dressing
station, often under heavy shell fire. He also continuously dressed
wounded in a dressing station unprotected from shell fire.

Griffin, Capt. E. H., M.C, R.A.M.C.

Hancock, Temp. Capt. (Act. Major) Allen Coulter. M.C, R.A.M.C
(attached H.L.I.), 1917.
For conspicuous good work in (advanced dressing stations, notably
when he successfully conducted evacuation of wounded under
heavy shell fire and adverse circmnstances. Again, when the CO.
was wounded, Capt. Hancock took command and by his initiative,
personal courage, and devotion to duty was responsible for the
able carrying out of "wounded thro!u|gfh a barrage of shell ficre for
six days. He was then severely gassed, but persisted in attempt-
ing duty until physically incapable.

Haynes, Capt. C G., M.C, 4th King's Royal Rifles, 1917.

In the fighting in Shrewsbury Forest, Ypres Sector, 1917, he
successfully led attacks on three strong points, and later, aided
by one man, he captured a dug-out iind took two officers and
four other ranks prisoners.

Jones, Capt. J. P., M.C, R.A.M.C

Kennedy, Majoi- R. S., M.C, R.A.M.C.

For conspicuous gallantry and devotion to duty. When in charge
of advanced bearers he collected and led forward reinforcing
bearer squads in a Imoist gallant mannea* through a hejnvy barrage
and through lines of retiring infantry, until he gained touch
with the regimental aid-post. He cleared many wounded who
would otherwise have been left to the enemy. A splendid example
of persevering gallantry and fearlessness.

Honours. Ill

Lauder, Major J. F. L., M.C., R.A.M.C., 1918.

Messenger, Capt. H. L., M.C., R.A.M.C, 1918.

Shearwood, Major- A. L., M.C., R.A.M.C. (S.R.), 1918.

Stephenson, Major John, M.C., R.A.M.C, 1917.

Stewart, Capt. James Lennox, M.C., R.A.M.C. aUacht'd to the Gordon
Highlanders.
For conspicuous gallantry and devotion to duty. He behaved
with the utmost gallantry in removing the wounded under shell
fire. He continued to work in the open, exposed to severe shell
and machine-gun fire until every wounded man had be-'n brought
in.

TowNSEND, Capt. T. A., M.C., R.A.M.C.

For conspicuous gallantry and devotion to duty. .Vlthuugh twice
wounded, he refused to have his wounds attended to, and con-
tinued to dress the wounded under a continuous and heaVy con-
centration of high explosives and gas shells. Not only did he
attend the wounded and gassed of his own unit, but rendered
aid under conditions of great difficulty to wounded of neighboui-
ing battalions whose medical officers had become casualties. His
complete disregard of personal danger and splendid devotion weie
a magnificent example to all.

Wood, Capt. C. A., M.C., I.M.S., attached 1/1 Gurkhas, 1917.

Military Cross (M.C.)

AcKiiovD, Capt. Harold, R.A.M.C.

For conspicuous gallantry and devotion to duty during operations,
i te tended the wounded under heavy fire, and finally when he had
seen that all our wounded men from behind the lines had been
got in, he went out beyond the front line, and brought in both
our own and enemy wounded, although continually sniped at.

Andrews. Lieut. -Col. J. A.

Annesley, Capt. F. D., R.A.M.C, 1918.

When a report was brouglit to lu^adquarters of a brigade that
the cook-house of the battery had been struck, and that there
were many killed and wounded men inside, he immediately left
his aid-post and went forward to see what assistance he could
give. Whilst going up a shell struck the remaining portion of
the cof)k-house, partially bmying occupants. lie personally as-
sisted in extricating the*men, drcs<el thiwr wounds on the spot,
under heavy shell fire, and got th(!m sal'cly to tht* dressing
station. His promptness rmd courage were undoirbtedly the meanp
of saving many lives.

Ballard, Major R. P., R.A.M.C, 1918.

Baxter. Capt. C W. W., I.M.S., 1917.

For conspicuous gallantry and devotion to duty. Wiuii uud<r
hejivy shell and riilc fire lie dispLiyod gnat gallantly and devotion
to duty in attending to and ev.Kuiatiiui th<' wouiidfl. flis ser-
vices proved of inestimable value.

Bexstead. Capt. H. J.. R.A.:S[.r., 191S.

112 Honours.

Bevib, 2iid Lt. Sidney William, R.F.A.

For conspicuoas gallantry and devotion to duty. When tdephonie
and visual communication was impossible and his orderUes were
absent on duty, he thrice carried messages from the front line
under intensely heavy shell fire. •

BiDDLE, Major E., R.A.M.C, 1917.

For conspicuous galhmtry and devotion. He showed great gal-
lantry in supervising the r<imov;il of the wounded from a heavily
shelled area. By his untiring energy and disregard of poTsonMl
danger he saved many lives.

BoswELL, Oapt. P. R., 1918.

Browne, Major E. Gardner, E.G. A. (T.F.).

Chaning-Pearce, Capt. Wilfred Thos., R.A.M.C.

For conspicuous gallantry and devotion to duty in attending tiu;
woimded men belonging to nine different battalions under
heavy and continuous shell fire. His aid post was the only one
in the vicinity in such a forward position, and he worked con-
tinuously and without rest until all the wounded had been at-
tend^id to, displaying splendid devotion to duty.

Clark, Capt. A. J., A. M.S., 1917.

Connolly, Capt. B. G., 1918.

Conybeare, Capt. J. J., R.A.M.C, late INlajor 4t.h Oxford and Bucks
Light Infantry, 1915.

Cook. Capt. John, R.A.M.C, 1917.

For conspicuous gallantry and devotion to duty. He went out
under heavy shell fire, attended to the wounded, carrying them
to cover, and setting a fine example of fearlessness and devotion.

Crawford, H. G.

Crosse, Capt. S. Spencer, R.A.M.C, 18th Bait. King's Royal Riiies, 1918.
Thanks to his untiring efforts in tending wounded under heavy
fire no wounded were left in the enemy hands.

Darke, Capt. S. J., R.A.M.C. (attached West Surrey Regt.).

For conspicuous and gallant conduct in the field. Aithou'jfh
badly wounded he worked for five-and-half hours under heavy
shell fire, tending the 'wounded without letting anyone know he
was wounded himself. His gallantry throughout the operation
was very fiine.

Davies, Major J. Edgar, R.A.M.C, attached South Wales BordewM-s.

Davis, Capt. H. H., R.A.M.C. (attached York, and Lanes. Regt),
1918.

Dean, Capt. C, R.A.M.C, 1918.

Denver, Act.-Col. C H., R.A.M.C.

For conspicuous gallantry and devotion to duty when in com-
mand of divisional bearers. It was due to his fearless and
capable handling of his party that the evacuation of the woundcKl
was carried out with rapidity and success.

Douglas, Lt.-Col. Claude Gordon.

Dresing, Capt. H. G., R.A.M.C, 1917.

For conspicuous gallantry and devotion to duty. After being
shelled out of his dressing station he took up another position
and continued throughout the day, and performed operations
under heavy shell fire, which was causing continual casual tiu^
around him.

Honours. 113

Duckworth, Capt. J.B.H., 7th Worcesters.

Dunning, Hon. Capt. J. B., R.A.M.C.

For conspicuous and gallant conduct in the field. He went into
the open under heavy Bhell fixe and tended the wounded until he
was severely wounded himself.

Socles, Capt. G. D., R.A.M.C.

While evacuating wounded from the fixing line, although obliged
to retire on four separate occasions, he, with great skill and
resourcefulness, cleared all his wounded safely. His complete
disr^ard to danger was entirely responsible for a completely
successful evacuation under circumstances of considerable difficulty.

Edwards. Capt. C. D., R.A.M.C.

Elliot, Capt. H. H., R.A.M.C.

During several days' operations he was out under heavy fire,
finding wounded men, attending to them, and helping them back
to the aid-post; and though wounded, continued at duty. When
his aid-post received several direct hits, he succeeded in evacu-
ating all the wound e<l to a safer position. Ho set .n fine exanip3e
to his stretcher bearers.

Elltston, Capt. G. S.. R.A.M.C, 1918.

Evans, Capt. Ed., R.A.M.C.

Evans, Capt. H. W., R.A.M.C. (Special Reserve), 1917.

For conspicuous gallantry and devotion to duty. He showed the
utmost bravery and zeal when commanding a stretcher bearer
division. He directed the bearers and tended the wounded in the
open. By his exertion he secured the efficient clearing of the
wounded over a very big dist^nnce.

Evans, Capt. J. A., R.F.A., 1917.

Evans. Capt. L. W., R.A.M.C. (attached 9th Ea.st Laucs. Regt.), 1918.

Far KINGTON, 2nd Lt. R. G., R.F.A. (Special Reserve).

For conspicuous gallantry and devotion to duty when his battery
was subjected tQ( a very heavy hostile fire in an exposed position.
He rallied his men and set them a fine example of his coolness
and determination, personally unloading ammimition under heavy
shell fire, and reorganising the teams as they suflFered loss.
During two da3rs' heavy fighting he set a splendid example of
gallantry and disregard of danger.

Fklton, Major R., R.A.M.C, 1916.

For conspicuous gallantry and devotion to duty during operations.
He tended the wounded during an intense bombardment, svnd a
few days later, when a shell blew* in the orderly room killing
three men and burying the remainder, he rescued (he? latter under
most dangerous conditions. But for his pluck iuid devotion to
duty many more lives would have been lost.

Fry, Capt. W. Kolsey.

FoLLBE, Capt. F. H., R.A.M.C.

Furlong, D. W.

Qalbraith, Capt. D. H. A.. R.A.M.C, 1917.

George, Capt. W., R.A.M.C. 1917.

114 Honours.

German, Capt. 11. B., K.A.M.C.

For conspicuous gallantry and devotion to duty. When his
dressing station was heavily shelled he organised th.(i removal of
38 stretcher cases. He also rescued several wounded of anothei-
division under heavy shell fire. He established dressing stations
without delay at various stages in an advance of four or five
miles, and so enabled the wounded to be rapidly evacuated.

GODDrNG, Capt. H. C, K.A.M.G.

Goldstein, Capt. H. M., R.A.M.C.

For conspicuous gallantry and devotion to duty in establishing a
forward aid-post in our advanced lines over a mile in front of
Ills regimental aid-post. By his courageous decision to reiuuiu
there, in spite of heavy shelling, and his great gallantry and de-
votion in attending to the wounded, all the casualtie^s were
evacuated before the battalion was relieved.

GkekxVE, Capt. J. A. C, E.A.M.C, 1917.

When an advanced dressing station was shelled with «-inch shells,
he at once went to the spot and began to dig out men that were
buried. Though the shelling continued, he did not desist until
satisfied that the men were dead. He then assisted in clearing
the entrance to the dressing station and attended to the wounded
within. He showed a total disregiard to personal snfoty in his
efforts to save life.

Griffin, Capt. E. H., E.A.M.C.

For conspicuous gallantry and devotion to duty in action. With-
out food or sleep he worked incessantly, tending the woimdod
of his own and other units under heavy fire. He showed an
absolute disregard of danger. On other occasions he has done
similar gallant work.

Hampton, Lieut. F. A., R.A.M.C.

Hancock, Temp. Captain (Act. Major), Allen Coulter, E.A.M.C. (at-
tached H.L.I.), 1916.
For conspicuous gallantry and devotion to duty. He led a rescue
piixty in the open under heavy fire, and rescued 28 wounded
men. He displayed great courage and determination throughout
tlie operation.

Hardy. Capt. G. F., E.A.M.C, 1917.

Harris, Major L. Price, E.A.M.C, 1918.

Harrison, Major S. S. B., 1917.

Havxes, Capt. C G., 4th King's Eoyal Eifles, 1916.

At the Schwaben Eedoubt, " He led bombing attacks with great
courage and determination, and finally after bombing for one
and a half hoiuxs, was able to capture two officers and fifty ineii.

Henderson, Lt. H. J., E.A.M.C, attached Essex Regt., 1917.

For conspicuous gallantry and devotion to duty. He established
his aid-post within 300 yards of the enemy's position, and dressed
and evacuated cases in the open. It was due to his splendid
example, cheerfulness and courage that a great number of lives
were saved. '

Henhy, Lt. C J., E.F.A., S.R.

For conspicuous gallantry and devotion to duty when Liaison
Officer with an infantry battalion. When communications with
the artillery were cut he and his two telephonists made every

Honours. 115

effort to re-establish communication until it became impossible.
He was of the greatest assistance in helping to get men from
battalion headquarters, and a tunnelling! company out of a txmnel.
and by his coolness and cheerfulness under extremely heavy fia«
he set a splendid example to all ranks.

Hodgson, Capt. Stewart, K.A.M.C.

For conspicuous gallantry and devotion to duty during recent
operations. For a whole day, often under direct rifle and
machine-gun fire, he attended the wounded and directed their
evacuation. Althoug^h wounded he continued his duties with
exceptional coolness and skill until the advancing enemy com-
pelled withdrawal.

Hudson. 2nd Lt. E. P., R.F.A. (Special Reserve).

When the battery was heavily shelled lq a forward position, he
set a splendid example of coolness and courage ^to his men. Later
in the day he took command of the battery in a most diflBcult
situation and conducted a withdrawal under heavy fire. It was
largely owing to his determined efforts that the operation was
successfully carried out.

Jackson, Major R. W. P., R.A.M.C.. 1918.

Johnson, Major William, R.A.M.C, 1916.

Jones, Capt. J. Gaymer, R.A.M.C, 1918.

Jones, Capt. J. P., R.A.M.C.

Jones. Capt. J. T., R.A.M.C, 1917.

Jones. Major R.O.H., R.A.M.C.

For conspicuous gallantry and devotion to duty. For many
hours he had to occupy a most exposed position under heavy
fire, where he dressed and attended the wounded at gre;ir per-
sonal risk.

Kelsey, Lt. W., R.A.M.C.

Kennedy, Major R. S., R.A.M.C, 1917.

For conspicuous gallantry and devotion to duty in dressing and
attending to wounded men 'under extremely heavy shell fire. At
great risk of his life he made several journeys to (he front line
and personally brought in wounded men who othciwisc must hive
ber;n killed by the intense hostile barrage.

Lauder. Major J. F. L., 1916.

Ltebson. Capt. A. Stephen, S.A.M.C.

For conspicuous gallantry and devotion to duty when tending
the wounded during operations. Though himself wounded and
with nothing bu(t a small! trench to work in, he carried on during
several days under heavy shell and sniping fire with the gro;ite6t
courage, t

Lindsay, Lt. G. P., 2nd Border Regt., 1917.

Litchfield, Capt. P. C, 1918.

Lloyd. Capt. V. E., R.A.M.C, 1918.

While in charge of stretcher bi'ai-eis he worke<i for hours under
shell fire evacuating wounded, and in an advanced dressing stjition
exposed to shell fire heJ dressed and evacuated a kiTge number of
wounded .

Lucas. Major R. H., A. M.S., 1918.

11^ Honours.

Mankibld, Major G. H. H., R.A.M.C.

For conspicuous gallantry and devotion to duty in action. He
worked day and night tending the wounded in our advanced
positions under iieavy fire, and carried many of them down the
trench after all his bearers had been wounded.

Marsh. 2nd Lt. H. E., R.F.A. (T.), 1917.

For bravery in the field during the Messines-Ypres offensive.

Marshall, Capt. B. S., A.M.S., 1918.

MA8H. Lt. 0. N.. R.F.A., 1917.

During a il)fOinb;u:dment of his babteiy position a dump of howitzer
charges was set on fire by a shell. The dangei- of the situation
was greatly added to by, some, gas shells which had been scattered
amongst the burning charges, but this officer, with the greafxist
coolness and courage, rushed to the fire and extinguished it, by
his prompt and gallant action preventing an explosion which
would undoubtedly have had serious and far-reaching results.

Messenger, Capt. H. L., R.A.M.C.

For conspicuous gallantry and devotion to duty while an excep-
tionally heavy shoot was being carried out by a battery. He
crossed 400 yards in the open under heavy baiTage to attend to a
wounded man. On his way he was knocked down by an ex-
ploding sheU, but in Ispite of this he proceeded with his duties.
He showed great grit and determination.

Milton, Capt. Leonard, R.A.M.C, 1918.

Minns, Capt. A. N.

MULLALLY, Major G. T., R.A.M.C. (S.R.), 1917.

Nelson, Capt. K. M., R.A.M.C, 1917.

For conspicuous gallantry and devotion to duty in attending to
the wounded with the utmost fearlessness under heavy shell and
machine-gun fire. He constantly went out to our most ad\anced
positions in aid of the wounded, and his careful search <if the
battlefield resulted in most of the serious cases being found and
brought back to the Idi-essing station. His unselfish devotion was
directly the cautse of bo [many lives being saved.

Newland, Capt. W. D., R.A.M.C, 1918.

Pali.ant, Capt. H. A., R.A.M.C.

For conspicuous gallantry and devotion to duty when attending
to the wounded imder heavy fire. Later he voluntarily acted a«
stretcher bearer, and helped to Carry off nearly forty wounded
under heavy shell and machine-gun fire.

Paetridge, Capt. W. L., R.A.M.C.

Passey, Capt. R. D., 1918.

Petley, Act. Major C E., R.A.M.C, 1918.

Phillips, Lt.-Col. E., R.A.M.C, 1918.

PoPHAM, Rev. A. E. ^ ^

PXJBDOM, Lt.-Col. W. B.

PUEKiss, Capt. K. N., R.A.M.C, 1919.

Pye-Smith, Lt.-Col. C D., R.A.M.C.

For conspicuous gallantry and devotion to duty. He tended
and dressed the wounded under intense fire throughout the
operations with great courage and determination. He haa on
many previous occasions done very fine work.

Honours. J 17

Beinhold, Lt.-Col. C. H., I.M.S.

Reynolds, Capt. W. J^. E., ll.A.M.C, 1917.

For conspicuous gallantry and devotion to duty in working con-
tinuously for twenty-four houi-s amongst the wounded. In ad-
dition to his work at the regimental aid-post he went to tlie
front frequently by day and night attending the wounded under
heavy fire.

Roche, Capt. E. H., K.G.A., 1916.

Saw, Capt. N. H. W., R.A.M.C, M.O. i/c 4th Batt. Worcester Reet.,
1916.

Searle, Major Chas. F., R.A.M.C, 1/4 Northampton R^t., 1917.

Sharp, Lieut. N. A. D., R.A.M.C, attached Nigerian Regt.

Shaw, Lieut. G. D., R.F.A., 1917.

Shearwood, Major A. L., R.A.M.C (S.R.), 34th Field Ambulance.

Smart, Major H. D., R.A.M.C, attached Lanes. Regt.

Smith, Capt. H. Joste, R.A.M.C (T.F.), East Anglian F.A., 1917
For conspicuous gallantry and devotion to duty. He followed
his battalion in the attack, and attended to the wounded nil day
and night under very heavy fire of every description. It wa8
due to his courage and spl(;ndid devotion that so many of the
wounded were brought in.

Smith, Capt. Philip, R.A.M.C.

Starlixg, Capt. E. C VV., R.A.M.C. (Special Reserve).

For conspicuous gallantry and devotion to duty. He remained
day and night at his post under continuous shell fire, and was
untiring in his work on behalf of the wounded, to whom his
unremitting care and umuflied calmness was the greatest com-
fort and assistance. He set a splendid example of courage and
self-sacrifice.

Stkphenson, Major John, R.A.M.C

For conspicuous gallantry and devotion to duty when in charge
of stretcher bearers. He remained in charge ot his se'.'Lor 13
days, refusing to be relieved, although his bearers had to be rein-
forced and the aid-post had constantly to change position owing
to heavy shell fire. His personal example and gallant Jeadej.ship
were largely responsible for the way in which bearers stuck to
their dutj;.

Stewart, Capt. J. L., attached lx) the Gordon Highlanders.

TowNSEND, Capt. T. A., R.A.M.C

For conspicuous gallantry and devotion to duty. He displayiid
great courage and determination in rescuing several men who had
bean buried under heavy fire. On three previous occasions he
has done very fine work.

ViDOT, Capt. 8., R.A.M.C

He carried on his work continually imder heavy shell fire
throughout the operations, and stayed In^hiud afttir the battalion
was relieved to attend to the wounded. He had previously
entered a dugout which was full of fuine> imd rescued a wounded
officer.

Walker. Act. Major ^o.•^h\h, R.A.M.C, 1918.

In carrying out his work at an aid-|>ost station which was c^-
tinually being shelUvl, his organisation and arrangements for

118 Honours.

the work \v(!rc admirable; 120 woandod passed through his hands,
all congestion was avoid<'-d, and the dispatch with which they
were collecbed and evacuated probably saved many lives.

TYatkin, Capt. P. J., K.A.M..C,, tittiu-Aied to the Bedfordshire Itegt.
For two days he drassed tfie wounded undcu- licavy shell fire,
and when the captured trenches had been cleaiei he commenced
to search the shell Iholets in " No Man's Land " in spite of heavy
sniping fire, until ordered, to desist.

Wood, Capt. C. A., I.M.S., attached 1/4 Gurkhas, 1917.

Air Force Cross (A.F.C.)

Wright, Capt. J. A. Snarey, 1918.

Military Medal (M.M.)

Hawkins, Lieut. C. F., 1917.
Lloyd, Pte. 0. 0., Artists' Eifles.
Start, Lance-Corporal S., M.G.C.

Order of the Bath.
Companion (C.B.)
Browne, Major-General E. G.
BuRGHARD, Colonel F. F. (Civil).
Connolly, Col. B. B.
Davy, Col. Sir H., 1917.
E.\S0N, Lieut.-Col. H. L., 1919.
Lane, Col. Sir W. A., Bt., 1917.
Luce, Major-General Sir E. H., 1916.
PiLCHER, Lieut.-Col. E. M., 1918.

Pryn, Surgeon Eeax Admiral Sir W. W., 1917 (Civil).
Eawnsley, Lieut.-Col. G. T., 1918.
Symonds, Col. Sir Charters J., 1916.
Tubby, Col. A. H., 1917.

Order of St. Michael and St. George.
Knight Commander (K.C.M.G.)

Atkins, Col. Six John, 1919.

Luce, Major-G«neral Sir E. H., 1919.

Companion (C-M.G.)

Atkins, Col. Sir John, 1916.

Barrow, Lieut.-Col. li. P. W., 1917.

Brown, Lieut.-Col. E. T., 1918.

Browne, Major-General E. G.

Davies-Colley, Col. E., 1918.

Benyer, Capt. S. E. i

-Douglas, Lieut.-Col. C. G., 1919.

Honours. 119

Bason. Lieut.-Col. H. L., 1917.
GWYN, Lieut.-Gol. W. P., ]919.
Humphrey, Brevet Colonel L., 191(5.
Luce, Major-General Sir R. H., 19 IS.
Marshall, Lieut.-Col. W. L. W.. !9i;.
Ogilvie, Col. W. H.
Rawnsley, Lieut.-Col. G. T., 1916.
Starling. Lieut.-Col. E. H.
Statham, Col. J. C. B., 1919.
Sutton, C^l. Alfred.
Tubby, Col. A. H., 1916.
Wenyon. Lieut.-Col. C. M., 1918.

Royal Victorian Order.
Commander (C.V.O.)

Bankart. Fie ;t-Surgeon A. R.

Member (M.V.O.)
Bardswell. Major Noel.
Bett, Deputy Surg-Genenil W.

Order of the British Empire.
Knight Commander (K B.E.)

Davy, Colonel Sir II., 1919.

GOADBY, Sir Kenneth W., 1918.

Murphy, Lieut.-Col. Sir Shirley, 1919.

Pryn, Surgeon Rear Admiral Sir W. W., 1919 (Military).

Symonds, Col. Sir Charters J., 1919. /

White, Brevet Colonel Sir W. Hale, 1919.

Companion (C.B.E.)

Bagshawe. Brevet Lieut.-Col. II. V., 1919.

Beyts, Col. W. G., 1919.

Brereton, Brevet Lieut.-Col. F. S., 1919.

Craig, Lieut.-Col. Sir Maurice, 1919 (Milit;ixy).

French, Lieut.-Col. Herbert, 1919 (Mil tar v).

Gold IE, Capt. E. G.

(ioODALL, Lieut.-Col. Edwin, 1919.

Mollison, W. M., 1920.

Okmond, Brevet Major A. W., 1919 (Alilitury).

Pilcher, Lieut.-Col. E. M., 1919.

Pollock, Lieut.-Col. C. E., 1919.

Sheen, Col. A. W., 1918.

Statham, Col. J. C. B., 1919.

Stephens, Lockhart, 1919.

1 20 Honours.

Officer (O.B.E,)

Barker, Major F. A.. 1919.

Barrow, Lieut. -Ck)l. H. P. W., 1919.

Briggs, Major J. J. E., 1919.

Broster, Major L. E., 1919.

Browne, Surgeon Capt. Robley H. J., 1919 (Militaj-y).

Brownfield, H. M.

Campbell, Capt. J. M. II., 1919 (Militaijj.

COPLANS, Lieut.-Col. M., 1919.

CORIN, Major H. J., 1919 (Militaxy).

Delmege, Capt. J. A., 1919.

DOBSON, Major M. E., 1919.

Fisher, Major H. W., 1919.

FrEiMANTLE, Li6at.-Col. F. E., 1919.

Furlong, D. W., 1919.

Genqe- Andrews, Capt. G. E., 1919,

Glover, Capt. J. A., 1919.

Good ALL, Lt.-Col. E. W., 1919.

Gray, Lieut.-Col. A. C. H., 1919.

Greenwood, E. C, 1919.

Hanafy, J. Z., 1919.

Harvey, J. H., 1919.

Herbert, Lieut.-Col. A. S.

Hodgson, J. W., 1918.

Hughes, Capt. E. C, 1919.

Key, B. W. M. Aston, 1919.

Mann, Surgeon Lieut. H. C, 1919.

Marriott, Fleet Surgeon H. B.

Marshall, Major GeoflPrey.

Moore, Major J. Yorke, 1919.

MUMFORD, Capt. W. G., 1919.

NuNN, Surgeon Commander G., R.N., 1919.

O'Meara, Lieut.-Col. E. J., 1919.

Payne, J. Lewin, 1919.

Percival, Surgeon Lieut. H. F., 1919.

Pitt, Major G. Newton, 1919.

Eankine, Surgeon E. A., 1919.

Eayner, Major A. E., 1919.

Eowlands, Capt. E. P., 1919.

Scott, Capt. D. C, 1919.

Scott, Surg. E. D.

Slesinger, Surgeon Lieut. E. G., 1919^

Honours. 121

Smith, Capt. G. Warwick, 1919.

Stott, Major H., 1919.

SwAX, Major E. II. J., 1918 (Military).

Taylor, Major Sir E. Stuart, 1919.

THO:\rAS, Surgeon Conunander, A. R., 1919.

TiCEiiuRST, X. F.. 1919.

Wexyox, Lieut. -Col. C. M., 1919.

Wills, Surgeon Commander W. K., 1919. i

Wood, Capt F. T. H., 1919.

Member (M iB.£.)

AUDLAXD, W. E.

Harris, Capt. W. J., 1919.

LlXDSAY, W. J.
LOAVE, Capt. E. C.

The Order of the Hospital of St. John of Jerusalem
in England.

Esquire.

IIaxxafy, J. Z.

Nixxis, Surgeon R. P., E.N.

Mentioned in Dispatches.

Alcock, Capt. Frank.

Aldis, Capt. C, 1917.

Allex, Capt. T. S.

AxDERSOX, Major E. G.

AxDREWS. Major J. A. (3 times).

AxNis, Major E. G.

Atkins, Col. Sir John (3 times), 19 IG.

Attwood. Capt. R. D., 1917.

Baqshawe, Brevet Lieut.-Col. H. V. (twice).

Ballard, Major R. P. (3 times), 1917.

Barnes, Capt. J. E.

Barron, Breve't Lt.-Col. R. M. (twice), 1917 and 1918.

Baruow, Lieut.-Col. II. P. W. (twice).

Bird, Lieut.-Col. J. W., 1917.

Bowle, Major S. C.

Bradbury, J. C. O.

Bro<!ter, Mtijor L. R., 1918.

Brown, Lieut.-Col. R. T. (3 times).

Brown, Lt.-Col. T. F.

PART II. B

122 Honours.

Browne, Major-Gen. E. G.

Browne, Lieut.-Col. G. B. (3 times).

BuRGHARD, Colonel F. F.

BuRNEY, Major W. H. S. »

Butler, Lieut.-Col. A. U., 1917.

Campbell, Capt. J. M. H. (twice).

Campion, Capt. K. B. (twice), 391G.

Cardin, Capt. H.

Carter, Capt. 11. H., 1918.

Carter-Braine, Capt. J. F. (twice), 1918.

Chapman, Staff S erg. -Major E. .W. P.

Clark, Capt. A. J., 1917.

Clarke, Major 11. M., 1917.

Clewer, Capt. D., 1918.

Cock, Lieut. Stanley, 1918.

Cogan, Col. L. D. B., 1918.

Collins, Lt.-Col. K. T., 1917.

Coplans, Lieut.-Col. M. (4 times).

CORIN, Major H. J., 1918.

Costabadie, Lt. H. P.

Covell, Major G. C.

Cross, Capt. F. G., 1919.

Davies-Colley, Col. E. (twice), 1917 and 1918.

Davis, Capt. H. H.

Delmege, Capt. J. A., 1918.

DiGBY, Capt. W. E. S.

Douglas, Lieut.-Col. Claude G. (twice), 1918.

Dowsett, Lieut.-Col. E. B. (5 times).

Dunbar, Lieut. C. G.

Eason, Lieut.-Col. H. L., 191C.

Eastes, Capt. G. L.

EcCLES, Capt. G. D., 1918.

Eccles, Capt. H. D., 1917.

Edmund, Capt. J. Adamson, 1918.

Evans, Brevet Col. C. R.,' 1917. •

Evans, Capt. H. W., 1918.

Evans, Lieut.-Col. J., R.A.M.C, (twice), 1917 and 1918.

Evans, Major J., 1917.

Evans, Capt. L. W., 1917.

Falwasser, Lieut.-Col. A. T., 1917.

Eraser, Capt. A., 1917.

Eraser, Capt. F. C.

Honours. 123

Fre:\iaxtle, Lieat.-Col. F. E., 1918.

Feexch, Lieut. -Col. Herbert, 191S.

Fulton, Lieat.-Col. H.. 1917.

Galloway, Sui-g. -Lieut. W. D.

Garland, Capt. J. 0., 1917.

Geoege, Capt. A. L., 1917.

German, Capt. H. B., 1917.

GiBB, Major C. de W., 1919.

Glover, Capt. E. N., 1918.

GoLDiE, Capt. E. G., 1918.

Gray, Lieut. -Col. A. C. H.

Geeene, Capt. C. W.

Griffin, Capt. E. H. (twice).

Griffin, Capt. T. H., 1917..

GwYNN, Lieut.-Col. W. P., 1918.

Hall, Col. A. W.

Hamilton, Surgeon George.

Hanafy, J. Z., 1919.

Hancock, Major A. C, 1916.;

Hanson, Gunner J. F.

Hardy, Capt. G. F., 1917.

Hennesey, Corp. P. W. H.

Hewetson, Lieut.-Col. H. (twice), 1917 and 1918.

Hildred-Carllll, Surg. -Lieut.

Hinde, Major E. B.

Hodgson, Capt. C. E., 1920.

HORTON, Brevet Lieut.-Col., J. H.

Howard, Capt. C. P., 1917 and 1918 (twice).

Hull, Col. A. J. (twice).

Humphrey, Brevet Col. L. (twice).

Hunt, Brevet Major G. H., 1915.
John, Capt. D. W. (twice), 1917.
Jones, Capt. J. T., 1917.
Kendall, Major X. E., 1918.
Kennedy, Major K. S., 1918.
Lauder, Major J. F. L., 1917.
Layton, Lieut.-Col. T. B. (twice), 1918.
Leckie, Capt. Malcolm, 1914.
Leigh, Major H. V., 1917.
Lewis, Lieut.-Col. R. P. (twice).
Lidderdale, Capt. J. F., 1917.
Litchfield, Capt. E. M.

124 Honours.

LiTCiii'iKLD, Capt. p. C, 1919.

Little JOHNS, Major A. S., 19 J 7.

LocKYER, Capt. G. E., 1919.

Lucas, Major R. IL, 1918.

Luce, Major-Gen. Sir R. H., 1917.

Maesiiall, Capt. E. S. (twice).

Marshall. ]Major Geoffrey.

Maesilu/l, Capt. R. P., 1919.

Marshall, Lieut. -Col. W. L. W. (twice).

jMattiieavs, Lt.-Col. .J., 1917.

Messenger, Capt. H. L.

Miller, 3Iajor A. A.

MiLLETT, Surgeon II., 1915.

Mills, Major P. S., 1917.

MiNETT, Major E. P. (twice).

Minns, Capt. A. X. (twice).

Montgomery, Capt. R.

Moore, Major J. Yorke.

Moore, Capt. P. W., 1918.

Morrell, Capt. F. II., 1918.

Mullally, Major G. T., 1916.

MuMFORD, Capt. W. G. (twice).

Murray, Lieut. -Col. C. M. (twice, 1917 and 1918).

Nelson, Capt. K. M., 1917.

Nicholson. Lieut.-Col. C. R., R.A.M.C, 1918.

Ogilvje, Col. W. II., 1918.

Osburn, Lieut.-Col. A. C. (twice).

OzANNE, Brevet Major R. C.

Pallant, Capt. H. A., 1917.

Pallant, Brevet Lieut.-Col. S. L. (twice).

Parry- Jones, Capt. 0. G.

Phillips, Lieut.-Col. E. (twice).

PiLCiiER, Lieut.-Col. E. M., 1918.

Plumptre, Capt. C. M., 1918.

Pollock, Lieut.-Col. C. E. (three times), 1917.

PoPHAM, Rev. A. E.

Powell, Lieut.-Col. J. E., 1917.

Prall, Lieut.-Col. S. E., 1917.

Price, Major P. S., 1918.

Pritchard. Major G. B.

PYE-SiriTii. Lieat.-Col. C. D. (twice), 1917 and 1918.

Rahman. IJrevct Major M. A. (twice).

Honours. 125

Rawxslev, Lieut.-Col. G. T. (three times), 1916—1918.

Kayner, Major A. E., 1917.

Reixhold, Lieut.-Col. C. H. (twice).

Richards, Capt. J. F. G.y 1917.

Richards, Capt. Owen.

Richardson, Col. H. (twice).

Rivers, Surgeon Lieut. -Commander A. T.

Roberts, Capt. C. S. Lane.

Robertson, Lieut.-Col. J., 1917.

Robertson, Capt. J. F.

Rogers, Major F. E. W., 1918.

RowELL, Lieut.-Col. H. Ellis.

Saunders, Capt. S. McK., 1917.

Searle, Capt. Chas. F. (twice).

Seymour-Price. Major P. (twice), 1918 and 1919.

Shaw, Lieut. G. D., 1917.

Siiearwood, Major A. L., 1918.

Sheen, Col. A. W., 1918.

SiiELTON, Capt. H. L. C, 1917.

Slesinger, Surgeon Lieut. E. G.

Smart, Major H. D. (twice).

Smith, Capt. E. G., 1917.

S-AEiTH, Capt. G. Warwick (twice), 1917 and 1918.

Smith, Capt. Philip (twice).

SooTHJLL, Major Victor F., 1917.

Spicer, Capt. A. H., 1917.

Sprague, Surgeon Lieut. -Commander C. G., 1917.

Stansfield, Capt. T., 1917.

Starling, Lieut.-Col. E. H., 1917.

Stephenson, Major Jolin, 1917 (twice).

Stewart, Lieut.-Col. II. (twice), 1917.

Stewart, Capt. J. L. (twice), 1918.

Stott, Major H.,

Stout, Major T. D. M.

Stuart, Lieut.-Col. H. D. (twice).

Swan, Major R. H. J., 1916.

Symonds. Col. Sir Charters J.,

Taylor, Capt. Sir E. Stuarti (twice).

Thomas, Major A., 1918.

TiMPSON, Capt. G. G., 1917.

Tubby, Col. A. H. (twice).

TrnvER. Mnjor IT. ]\r. S.

]!>() Hmiours.

Turner, Major Philip, 1917.

Walker, Brevet Major A., 1918.

Walker, Major H., 1917.

Walkek, Major Josiali, 1917 (twice).

Wallis, Major M. J, T., 1917.

Watson. C. E. S.

Webber, Oapt. A. M., 1917.

Wedd, Capt. Beomard H.

Wenyon, Lieut.-Col. C. M. (twice), 1918.

Wilcocks, Lieut.-Col. A. J.. 1917.

Willax,' Lieut.-Col. G. T., 1916.

Willlams, Lieut.-Col. A. D. J. B. (twice), 1917 and I9IS.

'Wilson, Hon. Capt. W., 1918.

Wood, Capt. F. T. H., 1918.

Wright, Major C. S. E. (twice), 1917.

Wright, Lieut. -GoL T. J. (twice).

Young, Major J., 1918.

Mentioned for War Service.

Caetee, Lieut.-Col. A. H., 1917.

Connolly, Col. B. B.

Crook, Surgeon-Lieut. A. H., 1919.

Denver, Capt. S. E., 1917.

Endean, Surgeon-Lieut. P. C, 1919.

Forty, Capt. A. A., 1917.

Fothergill, Major E. Kowland.

Gibson, Major H. G., 1917.

Goodall, Lieut.-Col. E. W., 1917.

Goodhaet, Capt. G. W., 1917.

Greenwood, E. C, 1918 and' 1919.

Hamilton, Major E. T. E., 1914 and 1915.

Hind, Lieut.-Col. W., 1917.

Knapp, Lieut.-Col. G. H., 1914 and 1916.

Leipoldt, Capt. C. F. L., 1914 aaid 1915.

Magrath, Lieut.-Col. C. W. S.

Marshall, Lieut.-Col. W. L. W. (twice).

Maynard, Lieut.-Col. E. F.

MoiTATT, Lieut.-Col. H. A.

MuLLiNS, Capt. K. C, 1914 and 191.5.

Murphy, Lieut.-Col. Sir Shirley.

Neavman, Surgeon-Lieut. F. C, K.N., 1919.

KoEMAN, Surgeon-Lieut. T., E.X., 1919.

Honours. 127

Petley, Act. Major, C. E., 1917.
Phillips, Major W. A. (twice).
PiLCHEE, Lieut. -Col. E. M.
KOBEETSON', Lieut.-Col. J., 1917,
Rook, Major H. C, 1917.
RouTH, Lieut.-Col. C. F., 1917.
Salvage, Lieut.-Col. J. V.
Samut, Lieut.-Col. E. P.
Shaep, K. a. Dyce.
SiCHEL, Major G. T. S., 1917.
Stephen, Capt. L. H. Y.
Stone, Capt. E. W., 1917.
Tayloe, Major J. G., 1917.
TiCEHUEST, i5". E., 1919.
Wenyon, Lieut.-Col. C. M., 1917.
Wilson, Lieut.-CoL A. E., 1917.
WiNTEE, Lieut.-CoL T. B.
Weight, Lieut.-Col. G. A., 1917.

Territorial Decoration <T.D.)

Beeey, Major II. Poole, E.A.M.C. (T.).

Black, Major George, E.A.M.C. (T.).

Dowsett, Lieut.-Col. E. B.

Geiffiths, Lieut.-Col. Charles T.

Hind, Lieut.-CoL W., 1917.

Paget, Lieut.-Col. Peter, 1917.

ElGBY, Major J. A.

Eowell, Lieut.-Col. H. Ellis, 191G.

Thomas, Major A.

Wallace, Major J.

1 28 Honours.

FOREIGN DECORATIONS.

BELGIAN.
Croix de Guerre.

Annesley, Capt. F. D., 1918.
CoPLANS, Lieut.-Col. M., 1918.
MuNDEN, Lieat. M. M.

Ordre de TOfficier.

Barrow, Lieut.-Col. H. P. W., 1917.

Chevalier de I'Ordre de Leopold.

CoPLANS, Lieut.-Col. M., 1917.

Chevalier de I'Ordre de la Couronne.

CORIN, Major H. J., 1919.
Pedley, Surgeon C. F., 1916.

EGYPTIAN.

Order of the Nile (Third Class).

Anderson, Major E. G.
Ogilvie, CoL W. H.

FRENCH.

Officier Legion d'Honneur.

Browne, Major-General E. G.

Croix de Guerre avec Palme.

Ballard, Major K. P., 1918.
Slesinger, Surgeon-Lieut. E. G., 1915.

Croix de Guerre.

Collins, Lieut.-Col. K. T., 1918.
Cooper, Staff-Surgeon II., 1918.
Jackson, Major K. W. P., 1917.
Phillips, Lieut.-Col. E., 1919.
Ward, Major F., 1918.

I
Medaille Militaire.

Symonds, Capt. C. P. (asi a combatant at Mons).

Honours. 129

Medaille des Epidemics.

Taylor, Major Sir E. Stuart.

ITALIAN.

Order of Crown of Italy.

Hewetson, Lieut.-Col. H., 1918.

Croix de Guerre.

COPLANS, Lieut.-Col. M.

Silver Medal with Palm — Italian Red Cross.

Erskine-Collins, Capt. J. E., R.A.M.C.

PORTUGUESE.
Military Order of Avis-Commander.

Beereton, Brevet Licut.-Col. F. S.

RUSSIAN.
Order of St. Anne.

Hewetson, Lieut.-Col. H. (2iid Class with Swords).
Spicek, Capt. A. H. (3rd Class).

Order of St. Stanislas.

Turner, Surgeon Probationer W. A. (3rd Class), 1917.

SERBIAN.

Order of St. Sabe.

Drew, 2nd Lieut. V.

Greenwood, Capt. A. A.

Nicholson, Lieut.-Col. C. R. (5th. Class).

Townsend, Capt. T. A., 1917.

Walker, Major H.

Croix de Guerre.

Greenwood, Capt. A. A., 1919.

Silver Medal— Serbian Red Cross.

Drew, 2nd Lieut. V.

130

Honours.

HONOURS FOR GUY'S NURSES.

The Most Excellent Order of the British Empire.

Grand Cross

Covvmander

Officer

Member

Dame Sarah A. Swift, E.R.C.
Miss Maegaret Hogg.

Miss M. C. CORBISHLEY, E.R.C.
Miss M. A. NuTT, R.R.C.
Mrs. H. B. Turner.
Mrs. Katharine Cook.
Miss N. Barker.
Miss E. Lorraine.

Lady of Grace of St. John of Jerusalem.

Dame Sarah A. Swift, G.B.E., R.R.C.

Bar to the Royal Red Cross.

Miss G. M. Allen, R.R.C.

Miss Mary C. Fisher, R.R.C.

Royal Red Cross 1st Class.

Miss G.

M. Allen.

Miss V.

X. Kiddle.

Miss E.

F. Beloe.

Miss G.

Lulham.

Miss E.

C. Cheethaim.

Miss M.

J. L. Lyons.

Miss M.

A. Chittock.

Miss C.

A. Tait McKay.

Miss M.

C. Corbishlky.

Mrs. M.

Morrison (nee Willes)

Miss G.

COEDER.

Miss E.

M. Newton./

Miss M.

Cruickshank.

Miss A.

B. XUNN.

Miss B.

H. Daniels.

Miss M.

O'Neill.

Miss P.

EXSHAW.

:Miss M.

L. Potter.

Miss K.

E. Finnemoee.

Miss H.

SUART,

Miss L.

V. Haughtox.

Dame S

. A. Swift, G.B.E.

Miss M.

E. HOBHOUSE.

Miss C.

E. Todd.

Miss A*

E. Hulbert.

Miss A.

Willes.

Mrs. W

. Jones.

Miss L.

Wood.

Miss M.

E. Jones.

Hon ours.

131

Royal Red Cross 2nd Class.

Miss L.

M. Axso>f.

Miss W

M. Jones.

Miss E.

F. Beloe.

Miss A.

M. Lithgow.

Miss S.

Bevan.

Miss A.

E. I. Lowe.

Miss E.

K. Blayney.

Miss C.

E. LusTic.

Miss M.

Blenkarn.

Miss M.

J. L. Lyons.

Miss Edith E. Bott.

Miss K.

Mackenzie.

Miss C.

BOTTOMLEY.

Miss F.

Malkin.

Miss C.

Beitton.

Miss L.

G. Mannell.

Miss E.

Broome.

Miss M.

M. Mansfield.

:\[iss F.

E. Brown.

Mrs. D.

Marshall (nee Wilson)

Miss M.

A. Brown.

Miss M.

E. Marsh,

Mrs. A

. M. Chisolm.

Miss B.

Martin.

Mrs. M

A. Clarke.

Miss K.

MacMorland.

Miss M.

E. A. Colston.

Miss K.

M. Moore.

Miss M.

E. Cook.

Mrs. M

Morrison (nee Willes)

Miss N.

Connolly.

Miss M.

A. MUMFORD.

Miss A.

I. Coward.

Miss N.

Nawn.

Miss G.

E. CUSTANCE.

Miss M

O'Neill.

Miss A.

E. Davidson.

Miss C.

Pearce.

Miss E.

J. Densham.

Miss A.

M. Phillips.

Miss L.

Denton.

Miss E.

H. Porter.

Miss M.

L. Dixon.

Miss E.

E. QUILTER.

Mrs. J.

L. Edwards.

Miss H.

K. Rainbow.

Mrs. A.

W. Ekins (nee Blott)

MiRs E.

Raven.

Miss G.

Field.

Miss A.

M. Richardson.

Miss F.

M. A. FiNNis.

Miss K.

I. Richardson.

ATiss A.

FOTHERGILL.

Miss K.

M. ROOKE.

Miss L.

Fox.

Miss S.

A. Selby.

Miss G.

A. Fuller.

Miss L.

G. Sheild.

Miss C.

Gerraed.

Miss F.

A. Spedding.

Miss E.

M. Gladstone.

Miss E.

Stedman.

Miss E.

A. V. Grant.

Miss C.

E. Strange.

Miss E.

M. H. Gooderham.

Miss B.

Sullivan.

Mrs. E.

Goss.

Miss K.

E. G. Taylor.

Miss C.

M. Hancock.

Miss A.

M. Timbrell.

Miss F.

M. Hepburn.

Miss K.

M. Vine.

Miss M.

A. Hilliard.

Miss M.

Vivian.

Miss M.

E. Hobhouse.

Mrs. E.

F. Watkins.

Miss B.

A. Hope.

Mrs. E.

M. Weller.

Miss S.

A. Hyland.

Miss G.

M. White.

Miss K.

F. Irwin.

Miss M.

E. WlNDEMER.

Miss L.

M. Jenkins.

Miss N.

WiNDEMER.

Miss L.

E. Jolley.

Miss D.

Woollett.

Miss E.

S. Johnson.

Miss E.

Wood.

132 Honours.

Military Medal.

Miss F. Broome. A.K.R.C. Miss C. Todd, R.R.C.

Miss M. A. Chittock, R.R.C. iNIrs. E. Watkins, A.R.R.C.

Miss E. S. JoiiN.sox. A.R.R.C.

The Albert Medal.

:\riss G. L. White, A.R.R.C.

Special Service Cross.

:\Ir3. A. M. Chisolm.

Florence Nightingale Medal.

Miss Gladys L. White, A.R.R.C.

FRENCH.
La Medaille d^honneur des epidemics.

Miss Geace Corder, R.R.C. First Class.

Miss M. C. CoEBiSHLEY, R.R.C. Second' Class.

Miss C. du Sautoy. Second Class.

Silver Palms.

Miss C. du Sautoy.

The Croix De Guerre with Golden Star.

3Iiss Florexce Tubes.

The Enseigne with Gold Palms.

Miss Florexce Tubes.

/
Medaille de La Reconnaissance.

Miss Alice M. Fletcher.

BELGIAN.

Medaille de La Reine Elisabeth.

Miss C. E. Druce. Miss F. H. Feeshney.

Miss F. A. MoRGAX. Miss F. A. Spedding.

Greek Military Medal of Merit.

Miss M. I. Hudd. 3Iis3 M. A. Shepherd.

Honours.

133

Serbian Samaritan Cross.

Miss K. C. Crisford.

Italian Special War Medal.

Miss A. E. Farrar.

Russian Military Medal. Order of St. George.

:Mis> A. E. Farrar. Mjss E. M. Fox.

Russian Military MedaK St. Anne's.

Miss A. E. Farrar..

:\riss

Miss E.

Miss

Miss C.

^riss

:mi-5.

:\iiss X.

^riss

Miss

:\r

Miss

Miss G.

.Miss

]\Iiss E.

iSEiss

Miss E.

:\ti3s

Miss

^r.iss

Miss

-Miss

\V.

-Afiss

:\riss

Miss

Mentioned

M. Allex, R.E.C.
C. Baker.

F. Beaedshaav (twice).
M. Bottomley, A.R.R.C.
Cheetham, R.R.C.
R. Coxes (nee T^'ler-Cove).
Connolly, A.R.R.C.
Corder R.R.C. (twice).

, C. CORBISHLEY, R.R.C.

I. Coward, A.R.R.C.

E. CUSTANCE, A.R.R.C.
J. Densham, A.R.R.C.

F. Druce.

ExsHAV, R.R.C. (twice).
M. Fox.

G. Fraser.
H. Fresiiney.

J. Gibson.

M. Hepburn, A.R.R.C,
, B. Harris.
M. Jones, A.R.R.C.

E. JOLLEY, A.R.R.C.

Jordan.
, X. Kiddle, R.R.C.
M. LiTiioow, A.R.R.C.
R. I. Lowe, A.R.R.C.

in Despatches,

Miss E. V. LuLHAM.

Miss C. E. LusTic, A.R.R.C.

Miss M. J. L. Lyons, R.R.C.

Miss E. E. P. MacManus.

Miss M. Maddison.

Miss L. G. Mannell, A.R.R.C.

Miss B. Martin, A.R.R.C.

Miss K. M. Moore, A.R.R.C.

Mrs. M. Morrison, (nee Willes).
R.R.C. (twice).

Miss M. I. Nelson.

Miss A. B. XuNN, R.R.C.

Miss M. L. Potter.

Miss M. X. K. Rae.

Miss E. Raven.

Miss E. Ray.

Miss A. M. RiciiARDSON, A.R.R.C.

Miss C. L. Shann.

Mis? H. M. Sharwood.

Miss A. Sheldon.

Miss F. E. SOUTHCOTT.

Miss ir. SUART, R.R.C. (3 tunes i.
Miss C. E. Todd, R.R.C, M.M.
:^rrs. W.vtkins, A.R.R.C, M.M.
Miss G. L. White, A.R.R.C.
Miss E. Wood, A.R.R.C.
:Miss L. Wood, R.R.C.

134

Honours.

The names of the following- liave been brought to the notice
of the Secretary of State for War, for valuable services rendered
in connection with the War in Home Hospitals : —

Miss L.

F. Anson.

Mrs. E

M. Goss, A.R.R.C.

Miss M.

Appleton.

Miss E.

R. Groom.

Miss F.

M. Baker.

Mrs. Hart-Synnott (nee Drowcr)

Miss M.

E. Ballance.

Miss A.

M. Hooper.

Mis. G.

A. ^EVINGTON (nee Jordan).

Miss C.

E. Hulbert, R.R.C.

Miss E.

K. Blayney, A.R.K.C.

Miss W.

Moleswoeth.

Miss M.

A. Blenkakn.

Miss M.

O'Reilly.

Miss C.

Beitton, A.R.RX!.

Miss E.

Randles.

Miss F

R. Browne.

Miss D.

M. Shepiieed.

Miss C.

E. Canty.

Miss M

L. Simpson.

Mrs. M

A. Clarke, A.R.R.C.

Mrs. R.

C. Stewaet.

Miss G.

Cornell.

Miss E.

M. Studdeet.

Miss A.

E. Dean.

Miss H.

SUAET, R.R.C.

Miss C.

Densham.

Miss G.

V. Wallis.

Mrs. M

. L. Elliott.

Mrs. C.

T. Ward.

Miss M.

J. Ferdinand.

Mrs. E.

M. Wellee, A.R.R.C.

Miss M.

Fooed-Kelcey.

Miss J.

E. Whittam (twice).

Miss E.

M. Fox.

Miss M.

E. WiNDEMER, A.R.R.C.

Miss E.

Goodeeham, A.R.R.C.

Miss E.

M. Yates (twice).

Boll of ^Yar Service.

135

WAR SERVICES

AGKEOYD; H. ...

Adams, D. W. S.
Adams, F. S.

Adams, M. M.
Adams, K. K.
Ahmad, A. M.
Alcock, Frank

Alcock, J. A. :m.
Aldis, C.

Alexandee, S. K.
Allan, A. P.

Allan, D.

Allan, W. J. McBain
Allen, G. W.
Allen, Norman

Allen, R. W.

Allen, T. S.

Allpoet, a.

Alston, W. Evelyn.
Andeeson, R. G. .

ANDERTON, J. E.

Andeew, G. W.
Andeew, E. G.

Temp. Capt.

Pte. ...

Temp. Capt.

Capt. ...

R.A.M.C. Y.C., 1917. M.C, 1916.

Killed in action. B.E.F. France.
S.A. General Hospital.
R.A.M.C. South "Wales Borderers.

Wounded, 1918.
S.A.M.C.

Temp. Dent. Surg. R.N.V.R. H.M.S. Thunderer.
Lieut. ... ... I.M.S. Resigned.

Capt R.A.M.C, T.F. Mentioned in des-
patches. Egyptian E.F.
Temp. Surg. ... R.N. H.M.S. Agadir.

Capt R.A.M.C. (20th F.A.). No. 10

Stationary Hospital. Ment. in
despatches, 1917.
Div. Surg. ... V.A.D. Hospital, Faversham.

M.O I/c Wallacefield Convalescent Home

for Wounded Soldiers.

Lieut R.A.M.C. M.E.F., 1915—16,

Senior Medical OflScer, Furness
Officers' Hospital. Harrosrate,
1917—19.
Sub-Lieut., R.N.

Artists' Rifles.

Royal Warwickshire Regt. KiUed

in action, April 14th, 1918.
Frangaise, Special service at Hop.
Militaire, V.R. No. 76.
R.A.M.C. Surgical Specialist No.
12 General Hospital, B.E.F.,
1914 — 17, Team Surgeon 2nd
Army, 1917. Lahore Indian
General Hospital, 1917- 19.
Royal Herbert Hospital. Wool-
wich, 1919—20. IMcnt. in desp.
R.A.M.C. (Vol.) Military Hos-
pital, Rochester Row, S.AV.
R.A.M.C, T.F.

R.A.M.C. Att. Egyptian Army.
Mentioned in desj)atohes. Order
of the Nile, 3rd Class, by H.H.
the Sultan of Egypt.

M.O New Mills V.A.D. Red Cross

Hospital.

Capt R.A.M.C, T.F.

Capt R.A.M.C, T.F. (Connvnll R.n.A.)

Sui-g.
Pter ...
Capt

Croix Rouge

Temp. Capt.

Major

Major
!Major

];JG

Roll of War Service.

Andhews, J. A. ..
Andeews, R. C.

Annesley, F. D. ..
Annis, E. G.

Anthony, A. L.
Anthony, M.
Apergis, H. D.

Armer, a

Aemsteong, C. W. W.

ASHBY, E

ASHWELL, H. G.

ASHWIN, R. H.
ASPINA1.L, R. Stivala
Atkins, F. R. L. ...
Atkins, Sir John ...

Atkinson, C. H.
Atkinson, J. L.
Atkinson, N. M. H.

ATT WATER, G. L.

Att water, H. L.

AtT WATER, W. F.

Att wood, R. D.
Aubrey, F. L.
Aubrey, H. P.

AUDLAND, W. E

Aylen, G. H.
Ayling, A. C.

Act. Lt.-Col.
Lieut. ...

Capt. ...
Act. Major

Capt. ...
Temp. Lieut
Capt. ...
Temp. Lieut
Temp, Surg-.
Temp. Capt.

mentioned in

Wounded.
-16. Artists'
Scots Guards,

Croix do

R.A.M.C. Thrice
despatches. M.C.

Scots Guards, 1915
Rifles, 1917—19.
B.E.F.

R.A.M.C. M.C, 1918
Guerre (Belgian) 1918.

R.A.M.C, T.F. oth London Field
Ambulance, 1914. 2/5 London
Field Ambulance, 1915. ^0/c 7th
Prov. Field Ambulance, 1915.
0/c 226 Field Ambulance, 191G
17. President, No. 9 -Travelling
Board, 191.S. Ment. in de-p.

R.A.M.C, S.R.

R.A.M.C

R.A.M.C, S.R.

R.A.M.C

R.N. Chatham

R.A.M.C.

Hospital.

Temp. Lieut. -Col., R.A.M.C

Temp. Capt.
Capt. ...
Temp. Lieut
Col. ...

Act. Major
Temp. Lieut
2nd Lieut.

Surrr. Lieut.

S.R.

R.A.M.C.

A.M.S. Three times mentioned in
despatches. C.M.G., 1916.

K.C.M.G., 1919.

R.F.A.

R.A.M.C.

East Lanes. Rcgt., attached R.F.C
Late R. Fus. Cadet at Oxford
await'ng Commission. Acciden-
tally killed at Aerodrome near
Cirencester, December 27th, 1916.

R.N. R.N. Hospital, Haslar, 1916.
H.M.S. Chatham (North Sea),
1916—18. R.N. Barracks, Ports-
mouth, 1918. R.N.. M.T.O.,
East Coast of England, 1918 —
19. R.N., M.T.O. South Coast,
1919.

R.A.M.C

. R.N.V.R. IIM.S. Neoro,l^^G,
11. M.S. Crescent, additional for
Medical Transport Duties in
Scotland, 1916.

R.A.M.C. Ment.
1917.

R.A.M.C
Surgeon.

R.A.M.C.
Artillery.
Johns Military Hospital, Welling-
borough, 1915—19. Assistant
County Director, V.A.D., Nor-
thants T.F. Assoc. M.B.E.
CiA'il Dental Surgeon to Troops, Portsmouth.
2nd Lieut. ... R.G.A.

Temp. Capt. ...
Suro". Sub. -Lieut

Temp. Capt.
Capt. ...
Temp. Capt.

I/c

(Dental),

in despatches.
Army Dental

42nd Group Heavy

M.O.

St.

Roll of War Service.

137

Badcock, J. H.
Bagshaave, H. V.

Bailey, E. R.
Bainbridge, F. a. ...
Baker, A. de Winter
Baker, L. T.

Baker, W. L.

Ball, M. B

Ball, W. C. ...
Ballard, R. P.

Bamber, H. E.

Bankart, a. R.
Barber, Hugh

Barber, H. W.

Bardswell, Nod

Dental Surgeon to Red Cross Hospital for Facial
Injuries.

Brevet Lt.-Col. R.A.M.C. A.D.M.S., Egyptian E.
Force. D.S.O. C.B.E., 1919.
Twice mentioned in despatches.

Surg. ... R.N.

Temp. Capt. ... R.A.M.C.

Resident Anaesthetist, London ,'War Hospital, Epsom.

Capt M.O., 10th Light Horse Regiment,

Australian Forces.
R.A.M.C.

R.A.M.C, attached 9th Worcesters^
13th Division. Served in Galli-
poli and Mesopotamia. Died of
wounds, April 10th, 1916, at the
16th CCS.', Wadi Camp, Orah,
Mesopotamia.
General List, Anti-Gas Dcpt.
R.A.M.C. 46th Field Ambulance,
1915—19. Red Cross, Calais,
1914. Mentioned in despatches
three times. M.C., 1918.

Croix de Guerre, Avec Palme
(French), 1918.
R.A.M.C. (S.R.) Prisoner of Waj
Camp, Bramley, Hants., 1918.
M.O. 86th General Hospital. 82
C.C.S., Onega River Front, 11th
and 13th Yorks, Russia, 1918—
19. Kitcheners Hospital, Brigh-
ton. 1919.

Surgeon Commander, R.N. C.V.O.

Lt.-Col.
Lieut. ..

Major ...
Act. Major

Capt.

]Major

Barge, II. F.
Barker, F. A.

. Pte. ...
Act. Major

Barker, H. T.
Barlow, N. A. H. ..

. 2nd Lieut.
. Surg. Lieut.

Barnes, F

.. Temp. Capt.

PART II,

R.A.M.C. Physician, 81st General
Hospital, France, 1917. Path-
ological Specialist, 39th General
Hospital, France, 1918—19.

R.A.M.C. Rochester Row Hospital,
1915 — 16: India, Mesopotamia,
Arabia and German East Africa,
1917. 25th General Hospital,
France, and 101st Field Ambu-
lance, 33rd Division, 1918.

R.A.M.C. Netley Hospital; Malta
(M.E.F.); Sicily, O.C. Hospital
(Major, R.A.M.C), 1915. M.O.
Hospital Ship BritamiiCj No. 2
General Hospital B.E.F. France,
Major 0. I/c. Officer's Division,

1916. :^i.v.o.

London Scottij-h.

I.M.S. 100th Indian F.leld Am-
bulance. O.B.E., 1919.

Devon Regiment.

R.N. H.M.S. Murray. Harwich
Force, 1914—15. R.N. Hosp.,
Plymouth, 1917. H.M.S. Tube-
raxn, Mediterranean, 1918.

R.A.M.C.

108

Boll of Wdr Service.

Babnes, J. E.
Barnes, J. Millard
Barnett, E. p.
Barrand, H. J.

Barrett, A. ...
Barron, R. M.

Barrox, R. D.
Barrow, H. P. W....

Barrow-Clough, W. J.
Barrs, a. Gr.
Bartlett, C. E.

Bastard, H, R.
Batchelor, F. C. ...
Bates, K. L.
Batsford, J. F.

Baxter, C. W. W. ...
Baylis, H. p.
Beadel, a, J.

Bead NELL, C. M. ...

Beadnell, H. 0. M.

Beale-Browne, T. R.

Bearblock, W. J. ...

Beley, G.
Bell, A.

Bennett. C. C.
Bennett, J.

Bennett, T. I.
Benstead, H. J.
Bensted, L. ...
Bensted, M. W.

Bent, P. C. W.
Bent. S. C. H.
Bent, V. T. C.

Temp. Capt. ... R.A.M.C. Ment. in despatches.

Capt R.A.M.C, Dental.

Dental Surgeon to Red Cross Hospital, Cheltenham.

Lieut.

Temp. Caj>t. ...
Brevet Lt.-Col.

Capt. ..
Lt.-CoL

Surg. Lieut.
Lt.-Col.
Temp. Capt.

Surg. Lieut.
Lt.-Col.
Capt. ...
Lieut. ...

Capt

Lieut. ...
Act. Major ..
Surg. Capt. ..
Major

West African
Fleet Surg. .

Temp.
Hon.

Surg.
Capt.

Capt. .
Dental

Sub -Lieut

Act. Major
Temp. Capt.
Temp. Capt.
Temp. Lieut.

Temp. Lieut.
Temp. Capt.
Capt

1st G.B. Manchester Regt., India,
Singapore and Hong-Kong, 1916
— 19. 9th Leicester Regiment,
Home, 1914—15. 8th Cheshiies,
Egypt and Mesopotamia, 1916.
Wounded, Mesopotamia, 1916.
R.A.M.C.

I.M.S. 113th Indian Field Am-
bulance. Ment. in despatches
twice, 1917—18. D.S.O., 1918.
. N.Z.M.C, France.
. R.A.M.C. Deputy Assistant Di-
rector General A.M.S. Twice
mentioned in despatches. C.M.G.
1917. D.S.O., 1918. O.B.E.,
1919. Ordre de I'Officier (Bel-
gian), 1917.
. R.N.

. R.A.M.C, T.F.
. R.A.M.C. Attached 52nd Heavy

Artillery Group.
. R.N. H.M.S. Otway.
. N.Z.C.C

. R.A.M.C. 1st Base M.T. Depot.
. l/4th R. Batt. Essex Regt., T.
Suvla Bay (Gallipoli). Wounded,
August, 1915.
. I.M.S. M.C, 1917.
. R.N.V.R. Wounded in Gallipoli.
. R.A.M.C.

. R.N. H.M.S. Vernon.
. R.A.M.C.

Medical Staff. Lost at 6ea, 1918.
. R.N. Medal for Falkland Islands
Battle. Killed in action. H.M.S.
Invincible.
. R.A.M.C

Surgeon to Queen Mary's Auxiliary
Hospital, Roehampton.
, R.N.
R.A.M.C, S.R. Y.T.C Musketry

Instructor, Minoliead.
R.A.M.C

R.A.M.C. M.C, 1918.
R.A.M.C.
R.A.M.C No. 30 Stationary Hos-

pitaL B.E.F.
R.A.M.C
R.A.M.C

R.A.M.C M.O., R.A.M.C Train-
ing Centre (Blackpool), 1916.
M.O., 8th Stationary Hospital.
Wimereux. 1917. M.O., 74th
Field Amb.. 1917. M.O., Dover

Boll of War Service.

139

Bentley, E. J.

Benton, N

Beegh, V. E. D. ...

Berncastle, H. F. G. Lieut.

Berey, a. W.
Berey, F. S. D.
Berry, H. Poole

Berry, J. Allan
Beery, J. B.

Berry, P. H.

Bett, W

Bevan, a. H.

Be van-Beg WN, F. V.

Beven, Octavius
Bevers, E. C.

Bevis, D. a.
Be VIS, S. W.
Beyts, W. G.

BiCKERTON, J. M. ,.
BiDDLE, E

BroDLE, F. J.

BmwELL, L

Biggs, J. J. E.
Billing, E.

Birch, G

Bird, J. W.

Bird, T.

Bird WOOD, G. T.

F.A.

Batt.
I/c

Milifcary Hoepital, 1918—19.
Wounded at Zilibeke, June,
1917.

Temp. Lieut. ... K.A.M.C.

Temp. Surg. ... R.N. H.M.S. Tuberose.

Capt R.A.M.C. (Dental). Asst. Dent.

Surg., Aldershot Command.
... 3rd Bedfordshire Regiment. Sig-
nalling Officer. Died October,
1918.

Act. Major ... R.A.M.C. 2/3rd E. Lanes.
Wounded, 1918.

Temp. Capt. ... S.A.M.C. 3rd South African
German East Africa.

Major R.A.M.C. Regt. M.O., 4th

Lines., B.E.F., 1911. M.O
Grantham V.A.D. Hospital, and
O.O., R.A.M.C, Lincolnshire Vo-
lunteers, 1916. Territorial De-
coration.

Capt N.Z.M.C. No. 3 N.Z. Convalescent

Hospital, ' Hornchurch, Essex.
Wounded Messines, June, 1917.

Lt.-Col. ... R.A.M.C, T.F. M.O. Royal Field

Artillery, 1914—16. O.C 330th
. Field Amb. at Margate, 1916 —
18. Electro-Therapeutic Special-
ist, Military Hospital, Fort Pitt,
Chatham and President, Medical
Board, Volunteer Decoration.

Lieut R.A.M.C. Western Frontier Force,

Egypt. Drowned in attempting
to save another man.

Surg. Rear Admiral, Various Depots and Hospitals.
Plymouth Hospital. M.V.O.

2nd Lieut ... E. Kent Regt. (The Buffs), late
R.A.M.C. 23rd F.A.

Capt R.A.M.C. Wounded.

M.O. ... ... 3rd H.A.C.

Major R.A.M.C, T.F., Southern General

Hospital.

2nd Lieut. ... Hants R.E., T.F.

Temp. 2nd Lieut., R.F.A., M.C

Col A.M.S. C.B.E., 1919.

Surg. Lieut. ... H.M.S. Royal Oak, late R.A.M.C.

Act. Major ... R.A.M.C. 91st Field Ambulance.
M.C, 1917. Bar to M.C, 1918.

2nd Lieut. ... 1st Welsh Regiment.

Fleet Surg. ... R.K. H.M.S. Marmora.

Temp. Major... R.A.M.C.

Temp. Capt. ... R.A.M.C. No.
^Mesopotamia

Temp. Capt. ... R.A.M.C.

Lt.-Col. ... R.A.M.C 5th London Field Amb

Egyptian E.F. Ment. in des
I>atches, 1917. D.S.O., 1915.

Anaesthetist, County of London War Hospital.

Lt.-Col. ... I. M.S.

1 General HospitaL
1917—19.

140

BiEKS, A. H.
Bishop, C. A. D.

Black, George

Black, J.
Black, K.

Roll of War Service.

Blacklaws, a. S.
Blackler, H. J.
Blackwood, B.
Blake, E. W.

Blake, G. A.
Blachford, J. V

Bligh, W.

Bloom, G. F. H.

Body, T. H.

Bolakd, E. E.
Bolus, H. B.
Bolus, P. R.

Bond, A. B.

Bookless, J. S.

Booth, E. H.
Boswell, p. R.

BouTC, J. A.

BOWELL, E. W.

Temp. Capt.
Capt

Major, ...

Surg. Sub.
Major ...

'Lieut. ...

Capt

Temp. Lieut.
Capt

.... R.A.M.C. No. 37 C.C.S., B.E.F.
... West African Frontier Force.

Sierra Leone.
... R.A.M.C, T.F. M.O., attached 1/4
Royal Sussex Regiment, 1914 —
15. Egypt, 1915. Khartoinn
Military Hospital, 1916—17 ;iim1
48th. Stationary Hospital, Alex-
andria and Gaza, 1917 — 1918.
Territorial Decoration.

Lieut., R.N.V.R.
... R.A.M.C. Surgeon, Cambridge
Hospital, Aldershot. Specialist
in Advanced Operative Surgery,
Bombay Brigade. S.M.O., H.M.
Troopship Caronia. Surg, Spe-
cialist 82nd CCS. Surg. Vo-
logda and Dvina Forces, North
Russia.

Killed in action.

R.F.A.

R.A.M.C.

R.A.M.C Cambridge Hospital, Al-
dershot, 1915x 18th CCS., Brit.
E.F., 1915—19. Surgical Spe-
cialist, No. 43 and 58th CCS.,

Capt.
Temp.

Capt.

Lt.-Col.

B.E.F. ,
R.A.M.C.
R.A.M.C.

Bristol.
R.A.M.C

1919.

Beaufort War Hospital,

Royal Herbert Hospital,
Woolwich, 1915. No. 9 General
Hospital, Rouen, 1916. Surgical
Specialist and O.C Nos. 29, 5J.
CCS., Italy, 1918—19. Surgi-
cal Specialist, No. 2 CCS.,
Flensburg, Sleswig Holstein, 1920

Lieut ... Dental Surgeon, R.A.F. Dental

Officer I/c Yarmouth and Dis-
trict Air Stations, 1918—19. D.O.
I/c Bircham New^ton, Sedgeford,
etc., Aerodromes, 1919 — 20.
Temp. Capt. ... R.A.M.C. 4th Group Heavy Ar-
tillery.
2nd Lieut. ... L.R.B. Wounded.
Asst. Quartermaster, V.A.D. Kent Hospital, No. 41.
Capt. (Act. Major), R.A.M.C. 25th F.A., 8th Divi-
sion. Wounded.
Capt A.A.M.C Died of v^^ounds in Ger-
many, November, 1917.

Capt R.A.M.C. Ophthalmic Specialist,

Havre.
Physician, Red Cross Hospital, Hove.

Capt R.A.M.C. 149th Brigade, R.F.A.

17th CCS., B.E.F. M.C, 1918.
2nd Lieut. ... R.A.F. Accidentally killed.

Capt R.A.M.C. S.R. Pathologist lat

Basra, Peschawar and Landi
Kotar.

Roll of War Service.

141

Bo WEN, 0. ...
Bo WEN, W. H.

Bowes, E. S.

BOWLE. S. C.
Box, W. F. ...

Boycott, A. E.
Beadbuey, J. C. 0.

Beadxack, G, a.
buadxam, c. h.
Beailey, a. E.
BeaileYj W. H.

Bbaithwaite, J.
Beereton, F. S.

Beett, W. G.
Beewee, C. H.
Beidgee, J. D.

IBEIDGEii, R. D.

Beiggs, J. J. E. u
Beockwell, J. B. C.
Beodeick, C. C. .
Beogdex, I. R. R. .

Beo:mley, L.

Beook, S. S.
Beoome, F. 0.
Beostee, L. R.

Beowx, C. M.

Beowx, G. M.

Beoavx, it. M.

Beoavx, H. S.

Beowx, R. T.

Beowx, T. F.

Beowx. W. Mark
Beowxe, E. G.

Temp. Capt. ...
Hon. Assistant

Temp. SuTg. ...

Major

Act. Major ...

Temp. Capt. ,.,
Snro-

M.O

Lieut.

R.A.M.C.

Surgeon to Research Officers' Hos-
pital, Cambridge.

R.N. H.M.S. CornwaU.

R.A.M.C. Mentioned in desp.

R.A.M.C. 4th Canadian Hospital,
Salonika.

R.A.M.C.

Military Hospital, ShornclifFe, Be-
van Hospital, Sandgate, No. 1
Rest Camp, Folkestone.

0/c Helena Hospital, Shorncliffe.

R.A.M.C, Dental.

Surg. Commander, R.N., Ilaslar.
Major...

Temp. Capt. ..
Brevet Lt.-Col.

Hosp.

Temp. Capt.

Capt

Temp. Capt.
Act. Major
Temp. Capt.
Surg. ...
Temp. Capt.

Temp. Capt.

Temp. Capt.
Surg. ...
Major ...

Temp. Lieut.
Temp. Capt.
Lieut. ...
Temp. Capt.
Lt.-Col.

Lt.-Col.

Regiment.
Drowned

Surg. Sub-Lieut.,
Maj.-Gcn.

Beowxe, E. Gardner Major

Com. Ophth. Surgeon, Gen.

for Indian Troops.
R.A.M.C.
R.A.M.C. C.B.E., 1919. Portuguese

Military Order of Avis-Com-
mander.
R.A.M.C. Officers' Hosp., Tid worth
Bedford Regt. Twice wounded.
R.A.F.M.S. Senior M.O., Tees

Garrison, Middlesborough, 1917.

M.O. I/c No., 2 Fighting School,

Marske-by-Sea, Yorks., 1918.

M.O. I/c R.A.F., South Shields

and Seaton Carew, Durham,

1918—19.
R.A.M.C.

R.A.M.C, T.F. O.B.E., 1919.
R.A.M.C
Warwick
R.A.M.C

1917.
R.A.M.C. 39th CCS

and Civil Surgeon,

Military Hospital.
R.A.M.C.

R.N. R.N. Barracks, Portsmouth.
R.A.M.C. 34th F.A. Mentioned

in despatches, 1918. 0 .B.E.,

1919.
R.A.M.C.
R.A.M.C.

1st Devon Regiment.
R.A.M.C.
R.A.M.C. East African Force.

Mentioned in despatches three

times. C.M.G., 1918. D.S.O.

A.M.C Mem. in despatches.

D.S.O.

R.N.V
A.M.S.

Staff.

C.B.

d'Honneur.
R.G.A., T.F. 1st

Batterv. M.O.

15th April,

, Salonika,
Southwaxk

Temp. Surg. Gen. H.Q.
Mentioned in despatches.
C.M.G. Officier Leg-ion

London Heavy

142

Roll of War Service.

Browne, G. B.
Browne, Robley H. J.

Browne, W. Denis ...

Browne-Caethew, R.
Brownfield, H. M....

Browning, S. II. ...
Bruce, H. W.

Brumwell, G. W. ..
Bryan, C. A. D. ...
Bryant, C. H.

Bryant, E. H.
Brydone, J. M.

Buchanan, A.
Buchanan, A. G. ..
Buck, A. D

Buckeridge, G. L...
BUEE, W. B.
Bulleid, Arthur

BULLPITT, C. M.

Burgess, E. A"
Burgess, W. F. E...

burghard, f. f. ..

Lt.-Col.

Sui-g. Capt.

Lieut. ...

H., Physician ...
Lt.-Col.

Temp. Capt. ...
Temp. Lt.-CoL

Surg. CoL
Temp. Lieut. ..,
Temp. Capt. ...

Capt

M.O

Temp'. Capt, ..,

Capt

Temp, Civil

II. A. F. Three times mentioned in
desp. D.S.O., 1917. Wounded,
1917. Died, 1919.
R.N. H.M.S. Hyacmth, P.M.O.,
Cape Squadron, 1914—16.

II.M.S. Lion, P.M.O. Battle
Cruiser Force, 1916—19, O.B.E.
(Military), 1919.
R.N.V.R. Killed in action. 7th

June, 1915.
Brook War Hospital.
T.F. 1/2
East Liss,

Red Cross
Petcrsfield.

Burner, L. H,
BURNEY, W, H. S.

Burnside, B.

burridge, w.
Burton, A. H. G.
Bush, W. H.
BUSTEED, J. H.

R.A.M.C,

Hospital
R.A.M.C.
R.A.M.C.

Hospital
V.D.

R.A.M.C.
R.A.M.C.

Cross Hospital.
N.Z.M.C. No. 3 F.A., N.Z.
Watney Hospital, and R.F.C.

pital, Eaton Square, S.W,
R,A.M.C.
R.A.M.C, T.F., and Lowland

I/c South wark Military

Surgeon to Hove Red

Div.
Hos-

F.A.

Royal

Staff Surg.

Capt

Pte.

Temp. Col.

Dental Surgeon, R.N.V.R.

Marine Infirmary.
. R.N.

. R.A.M.C, S.R.

. R,A.M.C, S.R. B.E.F., France
(Artists' Rifles), 1914—16.
Salonika and Constantinople,
1918 — 21. Act. Major I/c Base
Laboratory, Constantinople.
. Artists' Rifles.
Temp. Civil Medical Olficer. 3/8th Lancashire Fus.
Temp. Civil Surgeon, Military Hospital, Preston,
Brighton.
A.M.S., T.F. Consulting Surgeon
B.E.F., Chairman Surg. Advisory
Committee of Wax Ofiice. Surg.
Central R.A.F., Hospital, Surgi-
cal Advisor to Medical Advisory
Board, R.A.F., Consulting Sur-
geon, Queen Alexandra's Hos-
pital, Millbank. Mentioned in
desp., 1914—16. CB. (Civil) -
R.A.M.C.
R.A.M.C. Mentioned in despatches!

Wounded, 1918.
R.N. H.M.S. Vindictive, and R.N.

Hospital, Chatham.
R.A.M.C Attached Malta.
R.A.M.C
R.A.M.C
I/c Troops, All Hallows Hospital Ditching-
ham, 1915 — 19. Bungay and
Flixton, 1917—19. -

Temp. Capt.
Act. Major

Temp. Surg.

Lieut. ...

Capt

Temp. Capt.
M.O., "

Boll of War Service.

143

butlee, a. g.
Butler, H. R. C.

Lt.-Col. ... A.A.M.C. Mentioned in despatches.

1917. D.S.O., 1917.
Dent. SuTg. ... V.A.D. Hospital, Tiverton.

Cade, C. R

Caldecott, r.
Cameeon, J.

Camp, A. F.
Campbell, H. J.
Campbell, J. M. H.

Campian, J. H.

Campion, 0. St. L.
Campion, R. B.

Campkin, p. S.

Camps, P. W. L. ...
Canning, H. G. R.

Caede, L. 0....
Cardin, H.

Cabling, W.

Carr, T. E. a.

Carter, A. H.

Carter, A. J.
Carter, H. H.
Cabter-Braine, J. F.

CABTRIDriE, A. A. M.

Cattell, G. T.

Chadwick. G. R. ...
Chadwicic, ^NforU'v ...

Temp. Surg.
Capt

Temp. Lieut.
CivU M.O.
Capt

Temp. Capt.

Capt.
Capt.

Temp. Capt.
Capt. ...

Surg. Lieut. ... R.N. R.N. Hospital, Plymouth, and
H.M.S. Cottesmore.
. R.N. H.M.S. Sapphire.
. R.A.M.C. Temp. Surg. Haslar

Hospital.
. R.A.M.C, DentaL

Bradford War Hospital.
. R.A.M.C. Twice ment. in desp.
Mesopotamia, 1918. O.B.E.,
1919.
.R.A.M.C. Attached Wiltshire Regt.

Wounded, 1918.
. R.A.M.C.

. R.A.M.C, S.R. O.C. Dental An-
nexe, Alexandria, Egypt. Twice
mentioned in despatches, 1916.
Hon. Dental Surgeon to Lord Knutsford's' Hospital
for Officers.
R.A.M.C. 51st CCS.
]/6 Hampshire Regt. India, 1914
— 17. Mesopotamia, 1917—18.
Egypt, 1918.

CorpI R.A.S.C Died of wounds.

Temp. Capt. ... A.M.S. Mentioned in despatches,

E.E.F. 1918.
Capt. ...J ... R.A.M.C, T.F. 5th Southern

General Hospital.
Act. Major ... R.A.M.C, T.F. 2/1 N. Midland
Field Amb., attached 2/7 Sher-
wood Foresters, B.E.F. M.O.
.3rd South Staffs. Regt., 1914.
M.O. 2/4 Somerset L.I., India,
1915. Prisoner in Germany, 1918.
Hon. Physician, Wolverhampton General Hospital.
Physician I/c Private Convales-
cent Home for Wounded Officers,
Peuu, Wolverhampton. Meiit.
for War Services, 1917.
Commandant... M.O., 0/c Auxiliary Military
Hospital.

Capt R.A.M.C Ment. in despatches,

1918.

Capt R.A.M.C, S.R. 2nd Londcm

General Hospital. 1914. 2nd
London CCS., 1915. 300th (Ni-
gerian) Field Ambulance, East
Africa, 1917 — 19. Connaught

Hospital, Aldershot, 1919. Twice
mentioned in despatches, 1918.
... Sutton Red Cross Hospital.
Lt.-Col. ~. Commandant, Prisoners of War,

Rouen.
Surgeon and Agent, Admiralty.
Lieut R.A.M.C

144

Roll of War Service.

Chamukus, \.{. S. ...
Chanino-Pearce, W. T.

CiiArMAN, C. L. G
Chapman, V. D. H
Chapple, H.

ClIARLES, G. F.

Chaeles, S. W.
Chase, K. G.
Cheesman, a. E.
Chevreau, p. R.
Child, Stanley

Childe, L. F.
Chisholm, R. a.

Chubb, W. L.
Churchill, G. B.
Clark, A. E.

Clark, A. J.

Clark, J. B.
Clark, J. K.

Clark, R. F.
Clark, W. F.
Clarke, A. E.
Clarke, A. V.
Clarke, G.
Clarke, H. M.

Clarke, K. B.
Clatavorthy, J. H

Cleveland, A. J.
Clewee, D. ...

Clifford, A. C.

Clough, a. H.
Clowes, E. F-

Clowes, N. B.

Cock, F. W.
Cock, Stanley

2ncl Lieut.
Capt

Capt

Temp. Capt. ...
Temp. Capt. ...
Temp. Lieut. ...
Surg, Lt.-Com.
Temp. Lieut. ...
Capt

Lt.-CoL
Hon. Lieut.

M.O. to Hants

Major

Capt

R.F.A. 9Gth Army Bde., B.E.F.
R.A.M.C. 9Gth Field Ambulance,

B.E.F. Killed in action, let

October, 1917. M.C. and Bar to

M.C., 1917.
R.A.M.C.
R.A.M.C.
R.A.M.C.

Surgeon
R.A.M.C.
R.A.M.C,
R.A.M.C,

R.N. H.M.S
R.A.M.C
R.A.M.C,

Mounted
I.M.S.
R.A.M.C.

5th CCS., B.E.F.
R.A.F. Hospital.
Dental.
Dental. Ea,st Africa.
Base Hospital, Calais.
Ceres.

T.F.
Brigade

South
F.A.

Wales

No.
Hospital.

British Red

Fleet Surg.
Temp. Capt.
Temp. Capt.
Col. ...
Act. Major .
Temp. Major

Hon. Capt
Temp. Lieut.

Major...
Temp. Capt.

Jnd Lieut.

Cross
V.A.D.
R.A.M.C.
R.A.M.C. Hampshire Medical

Volunteer Corps.
A.M.S., H.Q. Staff. Mentioned

in despatches, 1917. M.C, 1917.
R.A.M.C.
Australian Infantry. Wounded

twice, 1916 and 1917.
R.N. H.M.S. Vivid.
R.A.M.C.
R.A.M.C.
A.M.S. (T.F.).
R.A.M.C.
R.A.M.C Ment. in despatches,

1917. Wounded, 1917.
R.A.M.C Invalided out.
R.A.M.C 4th London General

Military Hospital.
R.A.M.C. Norfolk War Hospital.
R.A.M.C Senior Dental Officer,

Seaford Garrison, and No. 5

Hospital, Army of the Rhine.

Mentioned in despatches, 1918.
3rd Dragoon Guards. Killed in

Temp.
Capt.

Caut.

Capt. .

Anaesthetist,
Lieut. ...

action,
R.A.M.C
R.A.M.C

B.E.F.

1916.

Hospital
.. R.A.M.C,

General
King George
.. R.A.S.C

London

Blackheath

Officer, 1917

Ypres, 1915.

50th
1916.
Officer
1915
T.F.

Field Ambulance,
Somme Offensive.
I/c Reading War
—16. 1917—18.
3rd Southern

Hospital.

Late Pte., R.A.M.C. 1st

CCS. Staff Officer,

Depot M.T. Gias
-18. Mentioned in

despatches.
1918.

Avesues Les Aubert,

Holl of War Service.

145

COCKCROFT, G.

Cocking, A. W.

COCKREM, G. B.

Cocks, J. Stanley

Temp. Lieut. ... R.A.M.C.

Temp. Surg. ... E.X.

Surg. Lt. -Commander, E.X. H.M.S. Blick Prince,
Mediterranean and Xortli Sea,
1514—15, H.M.S. Bctha, Grand
Fleet, 1915—16. H.M.S. Tamur,
China, 1916.

Capl R.A.M.C. Died at Beyiut from

Typhus, 1919.

COE, W. E

Temp. Lieut. ..

. R.A.M.C, Dental.

Coffin, S. W.

Temp. Lieut. ..

. R.A.M.C. India.

COGAN, L. D. B. ...

Act. Col.

. R.A.M.C. A.D.M.S. I/c 88th Field
Ambulance. Ment. in despatches,
1918. Wounded, 1917.

Cohen, L. C.

Lieut

. R.A.M.C, D.

Cole, P. P.

Temp. Capt. ..

. R.A.M.C. 1st Southern Geueral
Hospital.

Cole, P. P.

Hon. Surg.

. King George Hospital. Ophthal-
mic Surgeon, Brook War Hosp.

Cole, T.' P.

Temp. Capt ...

R.A.M.C. Wounded.

Coleman, E.

Capt

. R.A.M.C

Coleman, J. G. H.

Temp. Lieut. ..

. R.A.M.C.

Collar, F

Capt

. East African M.S. Invalided home.

Collier, H. N.

Capt

. R.A.M.C Welsh Field Ambul.
Wounded, 1917.

Collins, H. Abdy ...

Commandant ,.

. 6th Suffolk Volunteer Regiment.

Collins, J. E. E. ...

Temp. Lieut. ..

. R.A.M.C

Collins, M. Abdy ...

Lt.-Col.

R.A.M.C Evvell War Hospital.

Collins, R. T.

Lt.-Col.

R.A.M.C I/c F. A. Mentioned
in desp.. 1917. D.S.O., 1918.
Croix de Guerre. Killed in
action, September, 1918.

COLLIS. A. J

Lt.-Col.

Xorthern Cyclist Battalion.

CONNOLI.V. B. B. ...

Col. (rtd.) ..

R.A.M.C. Mentioned for war ser-
vices. C.B.

Connolly, B. G. ...

Capt

. R.A.M.C. M.C., 1918.

Constant, C. F. ...

Temp. Capt. ..

. R.A.M.C.

Conway-Jones, P. N. C

Cadet ...

. 10th Battalion London Regiment.

CONYUEARi:, J. J.

Capt

. R.A.M.C, S.R. Late Temp. Major
4th Oxford and Bucks L.I.
M.C. 1915.

Cook, A. X.

Surg

R.X.

Cook, Frank

Act. Major ..

. R.A.M.C, S.R. B.E.F. and Meso-
potamia Exp. Force. 1914—19.
Surgical Specialist, 1916—19.

Cook, J

Capt

. R.A.M.C. 268th Brigade, R.F.A.
M.C, 1917.

Cooke, E. J.

Surg. Lieut.; ..

R.N. R.N. Hospital, Haelar, 1916
—17. H.M.S. AlsatioH. 1916—17

Cooke, 0. H.

2nd Lieut.

. King's Own Yorkshire L.l.

COOKES, R. V.

Capt

. 10th Staffordshire Regiment. 1914.
Sherwood Foresters. 1915 — 19.
Served in Gallipoli. Egypt,
France.

COOMBES, C. G.

Lieut

R.A.M.C, S.R.

Cooper, C. M.

Lieut

R.A.M.C. North Midland F.A.

Cooper. H.

Staflf Suit:. ..

. R.N. D.S.O. Croix de Guonc.-

146

Cooper, J. Sephton,

Cooper, T. P.

COPLANS, M.

COPLANS, S. H.

Copley, S.
CORFE, E. W.

COEIN, H. J.

Boll of War Service.

Capt.

Dent. SuTg.
Lt.-Col.

Cadet

Capt.
Hon.

Major

Dent.

COSTABADEE, H. P. ...
COSTOBADIE, V. A. P.

COTTO^^, H.

COUACAUD, p.
COUNSELL, H. E. ...

Cousins, B. P.

COVELL, G. C.

Coventry, C.
Cowley, K. L.

COWPER, C. M.
Cox, a. Neville

Cox, A. R.
Cox, J. R.
CoxoN, A. C. M.

Temp. Lieut. ...
Hon. Capt.

Capt

Surg. Sub. -Lieut
Major ...

Lieut. ...

Major

Temp. Capt.
Lieut. ...
Capt. ...

Capt. ...

2nd Lieut.

Capt

Capt. . . .

Craig, Sir Maurice... Lt.-Col.

. R.A.M.C. 1/1 East Lanes. Field
Ambulance. Egypt and Sinai
Peninsular, 1916—17. B.E.F.,
France, 1917.
. R.N.V.R.

, R.A.iNl.C., T.F. A.D.M.S. Four
limes mentioned in despatches.
D.S.O., 1917. O.B.E., 1919.

Chevalier de I'Ordre de Leopold.
Croix dc Guerre (Belgian) and
Croix de Guerre (Italian).
.. Artists' Rifles, and 2/13 London

Regiment. Wounded.
. S.A.M.C.
Surgeon to V.A.D. Hospital, East

Finchley.
. R.A.F. Dental Surgeon, Dunker-
que, 1914. Dental Surgeon,
Dunkerque and Belgian Coast,
1915—18. Consulting Dental

Surgeon, Belgian Field Hospital,
Furnes, 1914. Hon. Consulting
Dental Surgeon to Naval Units.
1915 — 18, Ment. in despatches,
1918. O.B.E. (Military), 1919.
Chevalier de I'Ordre de la Cou-
ronne, 1919.
. R.A.M.C. Ment. in despatches.
.. R.A.M.C, T.F.
. R.A.M.C.

, R.N.V.R. H.M.S. Unciine.
R.A.M.C, T.F. Base Hospital,

Oxford.
7th Duke of Cornwall's Light In-
fantry. Wounded.
I.M.S. 139tliI.F.A. (East Africa).
Served in Egypt and Salonika.
Mentioned in despatches, East
Africa.
R.A.M.C.
R.A.M.C, DentaL
R.A.M.C. 2nd North Midland

Field Ambulance.
R.A.M.C 7th General Hospital,
103rd Field Ambulance, B.E.F.
49th CCS., B.E.F., 1916—18.
63rd (R.N.) Machine Gun Batt.
R.A.M.C, S.R.
5th Norfolks, T.F. Wounded and

prisoner, Dardanelles, 1915.
R.A.M.C. Assistant to Consulting
Physician (Neurological) for
Home Forces, 1918. Neurologi-
cal Specialist, H.Q. Medical
Board, War Office, 1918. B.E.F.
(Special Neurological Work) Co!n-
sulting Physician, Lord Knuts-
ford's Special Hospital for
Officers. C.B.E. (Military), 1919.

Roll of War Seiviee.

147

Ceaig, R. N
Crapper, H. S.
Crawford, B.
Crawford, H.
Crawford, V. J.
Creasy, R. ...
Creasy, R., Junr.
Cresswell, F. p.
Crew, F. D.
Crocker, C. J.
Crofts, A. D.

Croneex,
Crook, A. H.

Crook, E. A.
Crook, F. W.
Cross, F. G.

Temp. Capt.
Temp. Lieut
Lieut. ...

Capt

Lt.-Col.
Surg. ...
Surg. ...
Ophthalmic
Temp. Lieut
Temp. Lieut
Hon. Lieut.

Fleet Surg.
Surg. Lieut.

Temp. Surg.
2n(i Lieut.
Capt

R.A.M.C.

R.A.M.C.
R.A.M.C.

136th Field
Dental.

M.C.

Ambulance.

Cross, L. H.
Crosse, S. S.

. Temp. Lieut
. Capt

Croucher, H. V.
Crowe, A. A. R. .
Crump, C. H.
Curle, R. ...

. Pfce. ...

. Capt

.. Capt

Currie, J. A.

. 2nd Lieut.

Currie, 0. J.

CURSQN, G. C. W.
Curtis, F. ...
Gushing, R. J. W.

Cutler, F. J.

Cutler, H. A.
OUTTS, G. L.

Lt.-Col.

Surg. Sub-
Surg. ...
Capt

Capt. ...

Temp. Capt
Surg. Sub.

S.R.
D.S.O.

... British Red Cross Unit, Italy.
... R.N. H.M.S. lioyal Oak.
Surgeon, Welsh War Hospital.
. ... R.A.M.C.
. ... R.A.M.C.
... R.A.M.C. M.C. 4th Res. Battalion

Coldstream Guards.
... R.N.

... R.N.V.R. H.M.S. Victory. Men-
tioned for War Services, 1919,
... R.N. H.M.S. Excellent.
• ... 2nd King's Royal Rifles.
... R.A.M.C. Specialist in Gynaeco-
logy and Advanced Operative
Surgery, Mediterranean E. Force,
1915. Egypt, 1915—16. Ba-
luchistan, 1916. India, 1916—
19. Ment, in despatches, 1919.
. ... R.A.M.C.. Dental.
... R.A.M.C. 18th Batt. King's Roy.

Rifles. M.C, 1918.
... Artists- Rifles O.T.C., 1917,

... N.Z.M.C.

... R.A.M.C. No. 2 General Hospital,
Le Havre and British Salonica
Force.

... R.F.A. "Z^' Battery, C.G.A.,
German South West Africa.
1915. c/50 Brigade, R.F.A.,
9th Division, B.E.F., France,
1917—18.

... S.A.M.C. German S.W. Africa,
1915. A.D.M.S. Nos. 1 and
14 Military Districts. South
Africa, 1916. East Africa, 1917
—18.
Lieut., R.N. H.M.S. Lychnis.

... Abbot's Hospital and Reigate Hos.

...R.A.M.C, T. 2nd London General
Hospital. I/c Military Hosp.,
'Chepstow. Senior M.O., Chep-
stow and Beachey Camp.

... R.A.M.C. Surgeon Military Hos-
pital. Pembroke Dock, 1914—17.
B.E.F., France, 1917—18. M.C.
I/c N.F.F. 23 (Mustard Gas
Filling Factory).
. ... R.A.M.C

Lieut., R.N.V.R. 1915. (Late Pte,
H.A.C., Infantry.)

Dakin, W. R.
D'Albon, M.

Temp. Medecin-Major, French Army.
Temp. Lieut. ... R.A.M.C.

148

Daldy, a. M.

Daldy, M.

D 'Alton, Mark

Danby, a. B.

JioJl of War Service.

Daeke, S. J.
Davidson, A.

Davidson, G. G.
Davies, A. H.
Davies, a. W. a.

Davies, D, A.
Davies, F. D. S.

Davies, G.

Davies, H. A. B.
Davies, J. C.

Davies, J. Edgar

Davies, J. W.

Davies, K. J. H.
Davies, L. G.
Davies, W. L. G.

Davies, W. T. F.

Davies-Colley, H.
Davies-Colley, R.

Capt.

Temp Capt,
rte. ...

Surg. Lieut.

Temp. Capt.

Il.A.M.C, T.F. 0. I/c Ophthal-
mic Centre, 2nd Eastern District
also 2nd Eastern Gen. Hospital.
R.A.M.C.

L.V. Rifles, Motor Battalion.
R.X. R.N. Hospital, Plymouth,
1915. H.M. Monitor XVIII.,
1915 — 17. (Dardanelles and Sa-
lonika, Macedonia and Bulgaria.)
R.N. Barracks, Devonport, 1917.
H.M. Hospital Ship Classic,
1918, Grand. Fleet, 1919.
R.A.M.C. (Attached West Surrey
Regt.) M.C. Wounded. Prisonei-
1918.

Temporary
(Attached
Wounded.

Captain
London

in Germany
Surg. Commander, R.N.M.S.

R.A.M.C.

Regiment.)

Civil Surgeon, Military Hospital Queen's Gate.
Temp. Capt. ... R.A.M.C.
Capt R.A.M.C, S.R.. Wounded. May,

1918.
Civil Surgeon, 3rd London General Hospital.
M.O Glamorgan and Monmouth Hos-
pital for French wounded.
Capt ... Northumberland Fusiliers. Killed

in action.
Temp. Capt. ... N.Z.M.C.
Act. Col. (Temp. Major), R.A.M.C. Attached 34th

Division, R.E.
Major R.A.M.C. S. Wales Borderers and

F.A. 1916—19. M.C. and Bar.
Lt.-Col. ... R.A.M.C. 1st Welsh Field Ambu-

Surg. Sub. -Lieut

lance.
R.N.V

Temp. Capt.
Temp. Capt.

Lt.-Col.

Temp. Capt.
Col. ...

Davis, H. H.

Temp. Capt

Davy, Sir H.

... CoL ...

DwK, H.
Da^v, S. W.

Temp Capt
... Capt

R. H.M.S. Saracen.

R.A.M.C. M.O. 33rd Batt. R.F.

R.A.M.C. Attached 3rd King's-
Liverpool Regiment.

S.A.M.C. D.S.O. Wounded, Ger-
man South-West Africa.

R.A.M.C.

A.M.S. Surgeon Specialist, No.
14 Stationary Hospital, and
Rawal Pindi British Gen. Hosp.,
1914 — ^15. Mesopotamia, 1916 —
19. Consulting Surgeon to Me-
sopotamia Ex. Force, 1917 — 19.
Tv^ice mentioned in despatches,
1917 and 1918. C.M.G., 1918,

R.A.M.C. York and Lanes. Regt.
Mentioned in Despatches.
1918.

R.A.M.C, T.F. Consulting
cian Southern Command.
1917. K.B.E., 1919.

R.A.M.C Wounded, 1918.

R.A.M.C. I/c Orthopedic Depart-
ment, Northern Command.

M.C

Phvsi

c!;b.

Boll of War Service.

149

DAWE, C. H.

Dawson, E. A.
Day, F. W.

Day, W. L. M.
Day-Leavis, a. K.

Deacox, E. F.
Deax„ a. C.

Dean, C.

Dean, L. T.
Dear, H. J.

Deeks, Geoffrey

Delmege, J. A.

Dexman, R.
Dennett, P.
Dennett, T. F. P. T.

Denning, A. F. W.
Denny, H. R. H.
Densham, a.
Densham, a. T.
Denyer, C. H.
Denyer, S. E.

Depree, H. T.

De Robillard, J. E. E.

Deverall, E. p.

Dick, F. A

Dickey, W. C. M....
Dickson, A. C.
DiGBY, W. E. S. ..,

DiMOCK, E. C.
DiNAN, G. A.

Ding LEY, W

DiSMORR, C. J. S.
Dix, C. B.

Dixon, J.

DOBSON, M. R.

Surg. Commander, R.X. II.M.S. Sirius.

2mi Lieut.
Temp. Lieut.

Somerset Light Infantry.

19th Royal Fusiliers and R.F.C.,

B.E.F., France, 1915—16.

Squadron, R.F.C., 1916, (t

tiUery Observer . )

Lieut R.A.M.C.

Capt 9th West Yorks. Regiment.

Division, B.E.F.
Temp. Surg. -Lieut., R.X., Chatham Hospital.

2nd
Ar-

11th

Temp. Lieut.

Temp. Capt.

Temp. Capt.
Act. Lt.-Col.

Lieut. ..

Temp. Capt.

Temp. Capt.
Tioc per
Lieut. ...

R.A.M.C. Dental. 35th General
Hospital, B.E.F., and 18th Field
Ambulance.

R.A.M.C
B.E.F.

R.A.M.C.

R.A.M.C.
D.S.O.

35th
M.C.

General
1918.

Hospital,

1918. Bar to

Temp. Lieut,
Fleet Surg.
Temp. Capt.
Temp. Lieut
Act. Col.
Temp. Capt.

D.S.O.,
1918.

9th London Regiment. Attached
M.G.C., 47th Division, B.E.F.,
and 2Cth Division, M.E.F.

R.A.M.C. Ment. in despatches,
1918. O.B.E., 1919.

R.A.M.C.

Surrey Yeomanry, 29th Division.

Queen's Royal West Surrey Regt.
Attached R.A.F. Killed in ac-
tion, August, 1917.

R.A.M.C.

Temp.
Capt. .

R.N.V.R.
R.A.M.C.
R.A.M.C.
R.A.M.C.
R.A.M.C.
Garrison
services,
Surg. -Lieut., R.N.
R.A.M.C.

M.C, 1917.

H.Q. Staff,

Mentioned

Ilumber
for wax

1917. C.M.G.

Lieut. ...

Temp. Lieut.
Hon. Capt.
Temp. Capt.
Capt

Temp. Capt.
2nd Lieut.

2nd Lieut.

Temp. Capt.
Lieut. ...

Temp. Capt.
Major ...

Att. West Yorks
ment. Wounded, 1917.
R.A.M.C, Dental. 1914,
Rifles.
2nd London C

Regi-
Pte.

CS.

Ment. in despatches.

Artists'
R.A.M.C.
R.A.M.C
R.A.M.C.
W.A.M.fS.

Gameroons.
R.A.M.C, Dental.
Royal Dublin Fusiliers. KlUed

in action, September, 1916.
7th Suffolk Regiment and Public

Schools Battalion. Killed in

action, 1917.
R.A.M.C.
Eiist Surrey Regiment. Killed in

action, 1917.
R.A.M.C.
R.A.F. (Medical Service). O.B.E.,

1919.

150

Roll of War Service.

DoDD, H. G.

DODD, W. H.
DOHERTY, J. N.

Doll, H. W.
domville, e. j.

DONN, K. L.

donnell, j. h.
dorwaed, c. d. m.
doubleday, f. n. .
Douglas, C. G.

Capt E.A.M.C., T.F. 1st Northern Gen.

Hospital, 19] 5— 16. 315th Bde.
R.F.A., B.E.F. France, 1916—
It). 5th Duke of Wellington's
Ecgt., 1919. Kitchener Military
Hospital, Brighton, 1919 — 20.

Recruiting Medical Officer for Wimborne District.

Temp. Capt. ... R.A.M.G., Dental.

Hon. Lieut. ... R.A.M.C. 17th General Hospital,
Alexandria.

Temp. Lieut. -Col., R.A.M.C.

Temp. Lieut. ... R.A.M.C, Dental. Army Dental
Surgeon.

Act. Major. ... R.A.M.C, T.F.

Lieut 2nd Royal Sussex Regiment.

Dental Surgeon to King George Military Hospital.

Lt.-Col.

Douse, J. F.

... Temp. Capt.

DOWLING, G. B.

... Pte. ...

DOAVSETT, E. B.

... Lt.-CoL

DOYLE, A. R.

Drake, G. H.
Drake, G. H.
Dredge, W. A.
Dresing, H. G.

Temp. Surg.
Temp. Lieut.
Temp. Lieut.
Temp. Lieut.
Capt

Drew, H. W.
Drew, V.

Drixg, W. E.

Druitt, D. C

Dryland, G. W.

Du Boulay, H. H. ...

Duckworth, J. E. H.
Duff, K. M. K.
Duke, B

Duke, E

Duke, Joshua
Duke, Lyndhurst

Temp. Capt.
2nd Lieut.

M.O.

Temp. Capt. ...
Temp. Lieut, ...
Civil Surgeon,

Capt

Lt.-Col.

Temp. Capt. ..
Lt.-Col.

. A.M.S. Twice mentioned in des-
patches, 1918. M.C C.M.G.,
1919.

.. R.A.M.C.

.. King Edward's Horse.

. R.A.M.C, A.D.M.S. 60th Division.
D.D.M.S. XX. Corps. B.E.F.,
France, Egypt, Palestine,

Macedonia. Five times ment. in
despatches. D.S.O., 1918. Ter-
ritorial Decoration, 1919.

Lieut., R.N. H.M.S. Aiolon.

.. R.A.M.C, Dental, and R.G.A.

.. Canadian A.M.S.

.. R.A.M.C, DentaL

.. R.A.M.C. M.O. i/c 3rd Bridging
Team, B.E.F., 1915—16. M.O.
i/c 1st Battalion The Queens
(R.W.S.) Regt., 1916—17. M.O.
i/c various Regiments, B.E.F,,
1918. M.C, 1917, during at-
tack on Fontaine-le-Croiselles
(Battle of Arras).

.. R.A.M.C

.. Attached G.H.Q.I., Salonika Force
as Officer Interpreter. Silver
Medal Serbian Red Cross, Order
of St. Sava.

... I/c 7th Devons. 1914—15 M.O.
No. 20 Kent V.A.D. Hospital.
1914—18.

.. R.A.M.C.

i/c Military Patients, Royal Hos-

T>i t ft 1 . Wpvm ou th . 191 4 — 1 8 .
7th Wore esters. M.C.

latli Battalion C of London Volun-
teer Regiment.

R.A.M.C.

I.M.S.
R.A.M.C.

Boll of War Service.

151

dumayxe, h. g.
dunbae, c. g.
Duncan, G. E.
duxdeedale, g.

Dunning, J. B.

DUNSTAN, R. ...
DtJEHAM, E. H.
DUTTON, T. ...

Dyke, V. R.
Dymott, G. L.
Dymott, G. V.

Lieut R.A.M.C,

Temp. Lieut. ... R.A.M.C.
Surg. Commander, R.N.

Dental.

Ment. in despatches.

H.M.S. Vivid.

Lieut R.A.F.M.S. Civil M.O., East

African Medical Service. Civil
Surgeon, Queen Alexandra's Hos-
pital, Millbank (during leave),
and Temp. Lieut., R.A.F.
R.A.M.C. 13th Royal Sussex Regt.
B.E.F. M.C. Wounded,
to Troops Paignton.

Hon. Capt

M.O.

Hon. Lieut.
Civil Surgeon,
Temp. Capt. ..

M»jor

Lieut

R.A.M.C. Welsh Hosp., Netley.
Hammersmith Battalion.

R.A.M.C.
, 281st Battery, R.F.A. D.S.O., 1918

R.A.M.C, Dental. Army Dental

Surgeon.

Eagee, R.
Eagleton, a. J.
Eason, H. L.

Capt

Temp. Capt.
Lt.-Col.

Easter, W. A.
Eastes, G. L.

... Lieut, ...
... Capt

Easton, W. a.

... Temp. Capt

Eaton, 0.
Eccles, G. D.

... Temp. Capt
... Temp. Capt.

ECCLES, H. D.

... Capt

Eccles, H. N.

... Capt ....

Eddison, H. W.

... Temp. Surg

Edey,, F. H.

... Capt

Edey, G. R.

Lieut. ...

Edey, T. H.

... Temp Capt.

Edqae, N.

... Hon. Dental

... R.A.M.C. Wessex R.A.

... R.A.M.C.

... R.A.M.C. Consulting Ophthalmic
Surgeon to Forces in the i\Iedi-
terranean, Egypt, Palestine and
Syria, 1915—19. Pres. Standing
Medical Board, Alexandria, 1917
— 18. President Special Medical
Board, R.A.F. , Middle East,
1917 — 18. Mentioned in desp.,
M.E.F., 1916. C.M.G., 1917.
C.B., 1919.

... R.A.M.C. 68th Field Ambulance.

... R.A.M.C. 2nd London Sanitary
Corps. Ment. in despatches.

... R.A.M.C. 68th Field Ambulance,
Salonica.

... R.A.M.C.

... R.A.M.C. TVIent. in despatches.
1918. M.C, 1918. Wounded,
1917.

... R.A.M.C. M.O., 13th Royal Irish
Rifles. Mentioned in despatches,
1917. Killed in action, August,
1917.

... R.A.M.C. Victoria War Hospital,
Bombay, 1916—18. India Troop
War Hospital, Amballa Punjab,
1918—19. Cambridge Hospital,
Aldershot, 1919. X-ray Specialist
Bombay Brigade, 1916—18. X-
ray Specialist Lahore Division,
1918—19. X-ray Specialist Al-
dershot Command, 1919.

-Lieut., R.N. H.M.S. Thesevs.

... A.S.C In Mesopotamia.

... R.A.M.C.

... R.A.M.C.
Surgeon, V.A.D. Hospital, Enfield.

152

Roll of War Service.

Edmond, J. A.

Edney, C. H.

Edridge, Eay
Edwards, C...
Edwards, C. D.
Edwards, C. H.
Edwards, F.
Eglington, D. C.

Ehrlich, H. a.

Elkington, G.
Elkington, G. W.

Elliott, E. L.

Elliott, H. G.
Elliott, H, H.

Elliott, S. G.
Ellis, G.
Ellis, G. G.
Ellis, J. S.
Elliston, G. S.
Elavood, HerbieiTti^

Elwood, W. a.
Endean, F. C.

Enice, J. W.
Ensoe, C. a.
Ensor, J.
Erskine-Collins, J.

Esceitt, F, Iv.

ESKELL, p. R.

Etches, W. R.

Capt. ..

2nd Lieut.

Capt .»..

Temp. Lieut. ...
Temp. Capt. ...
Temp. Capt. ...
M.O. to V.T.C:
2nd Lieut.

Capt. ..

Temp.
Lieut.

Temp.

Capt.

Temp. Lieut.
Temp. Capt.

Temp. Lieut.
Temp. Lieut.
Temp. Capt.
R.JV..O....

Capt

Capt.
Surg.

Temp. Capt.
Temp. Capt.

... R.A.M.C. 11th General Hospital,
B.E.F. Attached Ambulance
Train and 60th F.A., 20th Div.
Killed at Villiers Plouich in
Battle of Cambrai, Nov. 30th,
19 J 7. Mentioned in despatches,
1918.
Suffolk Regt., 1915. Pte., II.A.C,
B.E.F., 1916. Ambulance Unit
attached 3rd Italian Army. In-
valided out, April, 1919.
.«.. R.A.M.C.
R.A.M.C.
R.A.M.C. • M.C.

R.A.M.C. War Hosp., Norbury.
South London Regiment.
Black Watch, 1911. Artists' Rifles,

1915. R.F.C.
R.A.M.C. Attached 2nd Ilamp-

shires.
R.A.M.C.

... 3rd Devonshire Regt. Attached
84th M.G. Coy.
Surg. -Lieut., R.N. Shotley Sick Quarters,
1914—15. R.N. Hospital Ships
Somali and Karapfira^ 1915 — 17,
Mediterranean. R. N. Hospital,
Plymouth, 1917—19.
R.A.M.C, Dental.
R.A.M.C. Sth Welsh Pioneers.

M.C, 1917. Twice wounded.
R.A.M.C, Dental.
R.A.M.C

R.A.M.C, Dental.
Essex County Hospital, Colchester.
R.A.M.C, T.F. M.C, 1918.
R.A.M.C, Dental. Dental Surgeon,
L'llopital de I'Alliance, Yvetot,
1915. Dent. Surgeon 36ien Corps
Armee Francais, 1916. Dental
Surgeon 12th Batt. Royal Innis-
killinjT Fusiliers, 1917. O.C,
No. . "2 IMobile Dental Unit,
B.E.F., 1918.
R.A.M.C.
R.N. H.M.S. Vivid. Mentioned

for War Services, 1919.
R.A.M.C.

R.A.M.C. Poena, India.

Golders' Green Auxiliary Hospital.

R.A.M.C. Att, Howitzer Batteries

Italy, 1917. B.E.F. . Italy,

1917—19. Silver Medal Italian

Red Cross with Palms.

R.A.M.C M.O. i/c 62nd Laboui

Group, 4th Army.
R.A.M.C.
R.A.M.C

Lieut.

Temp. Lieut,

Capt

Temp. Surg.
Capt

Temp. Lieut. .

Boll of War Service.

153

Evans, C. K.

Evans, Ed. ...
EvAXS, Evan

Evans, E. A.
Evans, E. G.
Evans, Herbert L.

EvAXS, H. W.

Evans, J.

Evans, J. A.

Evans, J. E. R.

Evans, L. W.

Evans, R

Evans, T. Garfield...

Evans, T. G.

E very-Clayton, L. E.

EWEN, H. W.

EwiNG, A. W. ...

Brevet Colonel, R.A.M.C. D.S.O. :\reiitiunfcd in
despatches, 1917.

Temp. Capt. ... R.A.M.C. M.C.

Temp. Capt. ... R.A.M.C. M.O. 1st Batt. Car-
marthenshire Volunteers.

Temp. Capt. ... R.A.M.C. Glamorgan Vol. Corps.

Temp. Capt. ... R.A.M.C.

M-0 Battle House Auxiliary Hospital,

and The Guards' Auxiliary Hos-
pital, Reading.

Capt R.A.M.C, S.R. 48th Field Am.,

Limerick, 1914. France, 1915 —
17. Egyptian Exp. Force, 1918
—19. O.C. Medical Division,
1919. Mentioned in despatches,
1918. M.C, 1917.

Lt.-Col. ... R.A.M.C I/c Welsh Field Am-

bulance. Twice Ment. in des-
patches, 1917, and 1918. D.S.O.,
1918.

Major R.A.M.C Mentioned in despatches.

1917.

Capt R.F.A. M.C, 1917.

... Killed in action at the Dardanelles.

Temp. Capt. ... R.A.M.C. Attached 9th E. Lanes.
Mentioned in despatches, .1917.
M.C, 1918. Mesopotamia.

I/c, Red Cross Hospital Croxley Green.

Temp. Capt. ... R.A.M.C. 34th Welsh General
Hospital.

Capt CA.M.C

v., Temp. Captain, R.A.M.C. B.E.F.

X-ray and Electrical Therapeutist at Isle of Wight
War Hospitals.

Temp. Capt. ... R.A.M.C

Fagge, C H.
Fagge, R. H.

Fai-wasser, a. T.

Farrant, E.
Parrington, R. G.
Faruingtov, W. B.

Fasken, N. E.
Faulks, Edgar

Fawcett, F. W.
Fawcett, J.
Fwvcfs D. A.

Temp. Lt.-Col. R.A.M.C. (Major A.M.S,) Hamp-
stead Military Hospital.

Capt R.A.M.C.T.F. oth Northern Hos-
pital, 1914—17. 59th General
Hospital, B.E.F., 1917.

Temp. Lt.-Col. R.A.M.C., T.F. Commanding 2/1
Home Counties Field Ambulance.
Mentioned in despatches, 1917.
D.S.O. , 1918.

Temp. Lieut. ... R.A.M.C, Dental.

2nd Lieut. ... R.F.A., S.R. M.C, 1918.

Capt Notts and Derby Regiment. At-
tached R.F.C D.8.O., 1918.

Lieut R.M.A.

Lieut R.A.M.C. Killed in action in

France, 27th September, 1915.

Temp. Capt. ... R.A.M.C.

Brevet Major... R.A.M.C 2nd London Gen. Ho8p.

Temp. Lieut. ... R..A.:M.r. 37th r.r<.

PART II.

154

Roll of War Service.

Fawssett, p. W.

i'EATHERSTONi:, F. R.
FEATHERSTONE, J. W.

Felce, G. E. W....

Fell, R

Felton, Richard

FINNEMORE, H.

FiSHBURN, J. B. ...

Fisher, H. W.

Fitzgerald, A. H....
Fitzgerald, G. H....

fitzmaueice, a. l....

Flanders, F. G. P....

Flower, N.

Floyd, W

Flynn, W. a.
Forrest, A. G.
Fortesoue-Brickdale,

Temp. Lieut.
2nd Lkut.
Surg. Sub. -Lieut.
Temp. Capt.
Act. Major

Capt.

Forty, A. A.

Foster, R. H.

Capt ll.A.M.C. No. 10 General Hos-
pital, 1915—17. l/5th Loyal
North Lanes, 1917. Prisoner of
war in Germany, 1917. Trans-
ferred home, 1918. No. 54 Gen.
Hospital, li.E.F., 1918—19.
R.A.M.C. Late Surgeon R.N.
Worcestershire Yeomany.

R.N.V.R. H.M.S. Rob Hoy.
R.A.M.C. M.O. H.M.H.S. J^gypt.
R.A.M.C. M.O. 17th Middlesex,
33rd Division. B.E.F., 1915—
16. Kinmel Park Hospital, 1915
— 17. No. 40 Stationary Hospi-
tal, B.E.F., 1917—19. M.C..
1916. Wounded, 1916.
General List. Anti-Gas Departmt.
R.A.M.C. CoUege. 2nd Lieut.
Inns of Court O.T.C., October.
1915— August, 1916. Captain
Chemical Adviser to Northern
Conmiand, August, 1916 — May.
1917.
Surg. Sub.-Lieut., R.N.V.R. H.M.S. Brisk.

Major R.A.M.C. Indian Exp. Force.

O.B.E., 1919.
Temp. Lieut. ... R.N.V.R.

Temp. Surg. -Lieut., R.N., H.M.S. Agememnon and
KiTiross.

M.O Colonial Medical Service. Died

on Seivice.
Temp. Lieut. ... R.A.M.C, Dental. Guards Depot,
Caterham.

Capt R.A.M.C. Surgical Specialist and

0. i/c Surgical Division, Malta
Command, 1917. M.O. i/c Yeovil
Red Cross Hospital, and M.O.
i/c Compton Red Cross Hospital,
1914—18.
. S.A.M.C, DentaL In East Africa

with General Smuts' Force.
. R.A.M.C.
. R.A.M.C, Dental.
R.A.M.C, T.F. 2nd Southern Gen.
Hospital, 1914. 0. i/c Medical
Division, 23rd General Hospital,
B.E.F., 1915. Isolation Hospi-
tal, B.E.F., 1915—16. 0. i/c
Medical Division, 13th Station-
ary Hospital, B.E.F., 1916—17.
2nd Southern General Hospital,
1917—19.
Temp. Capt. ... R.A.M.C. 2nd Northern General
Hospital, Leeds. Attached Nor-
thern Command, 1915 — 18. Men-
tioned for wax services, 1917.
Resident Surgeon, 2nd Birmingham War Hospital.

Capt

Temp. Lieut.

Temp. Capt.

J. M., Capt.,

Roll of War Service.

155

Fostee-Smith, G. T.

FOTHEEGILL, C. T.
FOTHEEGILL, E. K.
FOULSTON, B.
FOUEAKEE, L. F.

Fox, F. L. H.
Fox, H. E. C.

Fox, H. W.

Fox, W. E.

T^EAV'TS. C. ...

Feench, Herbert

Feipp, Sir A.
Fry, L. B. .
Fey, W. K.

Fryee, E. .

Capt.

Temp. Lieut. ...
Temp. Major...

R.A.M.C. 19th General Hospital,
Alexandria. No. 3 Egyptian Sta-
tionary Hosp., Kantara, E.E.F.

R.A.M.C. M.E.F.

R.A.M.C. Ment. for war eervicee.

Feaxcis, R.

H. .

. Temp. Capt.

Feanklin,
Feasee, A.

. Temp. Capt.
. Temp. Capt.

Feasee, E.
Fbaser, F.

L.
C.

. 2nd Lfsut.
. Capt

Feasee, J.

. M.O. ...

Feazer, a.
Feazee, E.

. Temp. Capt.
. Capt

Feazer, F.

. Temp. Capt.

Feemantle,

e. .

.. Lt.-Col.

... R.G.A.
Temp. Capt. ... R.A.M.C, attached East Lanes.
Field Ambulance.

Capt R.A.M.C. M.E.F. H.M.H.S.

Delta.
Surg. -Lieut. ... R.N. H.M.S. Laurentic, Ganget
and Resolution, and R.N. Hob-
pital, Chatham.

Capt R.A.M.C, T.F. Surgeon Specialist

Ear, Nose and Throat, Army of
Rhine.
R.A.M.C. 20th General Hospital,

France.
R.A.M.C
R.A.M.C. Ment. in despatches,

1917.
Tank Corps. Killed in action, 1917.
I. M.S. Mentioned in despatches.

Mesopotamia.
3/2 East AngUan R.F.A. M.O.
i/c Military Auxiliary Hospital,
Eastern Command.
R.A.M.C.
R.A.M.C. M.E.F., 1915—17. i/c

X-ray at Citadel, Cairo.
R.A.M.C X-ray Expert, Cairo

Military Hospital.
R.A.M.C, S.R. Mentioned in des-
patches, Mesopotamia, 1918.
O.B.E., 1919.
Lt.-Col. ... R.A.M.C. Consulting Physician,

Aldershot Command, 1916—19.
Consulting Physician to the
Trench Fever wards, Hampstead
Military Hoep., 1917—19. Mem-
ber of War Oflace Trench Fever
Committee, 1917—19. Belgium
(Ypres Salient), 1917. Member
of the Council of Consultants,
War Office. Joint author of the
following Official War Office Ar-
ticles " Purulent Bronchi tLs " ;md
"Influenza" (both for Official
Medical History of the War.)
Mentioned in despatches, 1918.
C.B.E. (Military Division), 1919
Consulting Surgeon to the Admiralty.
Temp. Surg.-Lieut., R.N. H.M.S. Victory.

Capt R.A.M.C Att. Ist Batt. Royal

Welsh Fusiliers. M.C
Temp. Lieut. ... R.A.M.C.

156

Fuller, F. H.

Fulton, H. ...

Roll of War Service.

Oapt. ...

Lt.-Col.

K.A.M.C. M.O. to Special Brigade
E.E.'s. M.O. No. 2, General
Haspital and 86th H.A.C, 14tli
Corps, Yprcs, B.E.F.. 1917.
Home Service, 1917—19. M.C.
Wounded, Sept. 2l8t, 1917.

K.A.M.C, T. O.C. 12th (Jnd
London) F.A. Mentioned in
despatches, 1917. Wounded.

Gabell, a. H.
Gaffney, E. J.

Galbraith, D. H. a. Capt. ...

Galloway, W. D. ... Surg. Lieut.

Gaedinee, Ivan J. ..
Gardnee, a. Linton..
Garland, J. 0.

Garrard, N.
Gaskell, D. K.
Gater, a. W.
Gater, H. J.

Gathergood, L. S. .
Gatley, C. a. E. .

2nd Lieut. ... 340th Brigade, K.F.A.

Capt K.A.M.C. Dental Officer, Ports-
mouth Garrison.
K.A.M.C. Served in India, Se-
cunderabad Division, 1916 — 17.
110 Combined F.A., 1/1 Gurkhas
2/124 Baluchistaji Infantry, Me-
sopotamian Expeditionary Force,
1917—18. 112 Combined F.A.,
3rd Lahore Div. Train, Egyptian
Expeditionary Force, 191 <S — 20.
M.C, 1917. Wounded, 1917.
H.M.g. CamwalUs. Commended
for service in action at Gallipoli.

Lieut Killed in action, 1917.

Temp. Capt. ... K.A.M.C. Killed in action. 1918.

Capt K.A.M.C Ment. in despatches,

1917, British East African Force.
K.A.M.C

Capt.

Temp.
Temp.

Lieut.-CoL, K.A.M.C

Capt.

M.O. 29th Heavy Bgde

Gavin, L. P. W. ...

Genge- Andrews, G. E.
George, A. L.

George, J. D.

George, W

George, W. S.
German, H. B.

GiBB, C De Wet

Capt

Temp. Capt.

Surgeon to

Temp. Capt.
Temp. Capt.

Temp. Lieut.

Capt

Temp. Lieut.
Temp. Capt.

Major

S.K.
M.O., HaU Walker's

for Officers, 1914 — 15.
F.A.. and 7th Buffs.,
, 1916—17. Wounded.

... K.A.M.C

K.G.A.
... K.A.M.C.
... K.A.M.C

Hospital

55th

B.E.F.
. 1917.
King George Hospital, and five other

Military and Naval Hospitals.
... K.A.M.C. O.B.E., 1919.
... K.A.M.C. Mesopotamia. Ment. in

despatches, 1917.
... K.A.F., MedicaL
... K.A.M.C. M.C, 1917.
... K.A.M.C.
... K.A.M.C Leicester Kegt.

K.F.A. Late Surgeon

Mentioned in despatches,

M.C, 1918. Bar to M.C,

Att.
K.N.,
1917.
1918.

Wounded. Killed in action,
1918.
K.A.M.C. 54th F.A., 1914—15.
15th F.A., B.E.F., 1915—17.
18th Casualty Clearing Station.
1917—18. D.A.D.M.S. 20th

Div., B.E.F. , 1918—19. Ment.
in despatches, 1919.

Moll of War Service.

157

Gibbons, H. V.
Gibson, C. C. G. ...

Gibson, F. G.
Gibson. H. G.

GiE. J. C

Gilbert, L. H.
GiLKES. M. DO. ...

Gill, L

Gill-Carey, C.

Glaisby, K

Glanville, L. S. N.

Glendining, V.

Glover, C ,

Glover. E. ]Sr.

Glover, J. A.
GOADBY, Sir Kenneth

Goble, E. W.
Goble, E. G.
Godding, H. C. ...
GODSiLL, Stanley

Go])SON, F. A.
GOLDIE, E. G.

Goldstein, H. M.
OOODALL, Edwin

GOODALL, E. W.

Goodhaet, G. W.

Goodwin, E. S.
Ooss, J.

•iOUDGE, A. N.
OUGH, B. B.

< rOULD. C. H.
<rOVER, W. ...

Graham, L. A. J.
Graham. S. G.
Granger, E.
Gray, A. C. H.

Gray. E. E. D.
Gray, H. M.

Temp. Lieut. ... E.A.M.C.

Temp. Capt. ... R.A.M.C. Prisoner of War in
Germany, 1918.

Major N.Z.M.C. H.M.H.S. Maheno.

Major ... ... R.A.M.C. Mentioned for war ser-
vices, 1917. Died, 1919.

Temp. Surg. Lieut., R.X. Chatham HospitaL

Hon. Surgeon Auxiliary Military Hospital, Ludlow.

Capt ~ ~

Lieut. ...
Lieut. ...
Temp. Capt.

Capt. ...
Surg. Dent.
Temp. Capt.

R.A.M.C.
N.Z.M.C.
R.F.A. Ki
R.A.M.C.

Rifles.

1918.
R.A.M.C.
H.M.H.S.
R.A.M.C.

S.R.

lied ia action, Nov. ,1917
Attached Royal Irish.
Prisoner in Germany,

Temp. Capt.
Member of

Temp. Ca,pt.
Surgeon

Capt

Lieut. ...

Temp. Capt.
Temp. Capt.

Capt. ...
Lt.-Col.

Lt.-Col.

Temp. Capt.

Plassy.
Ment. in despatches,
Mesopotamia, 1918.
... R.A.M.C. O.B.E., 1919.
War Office Committee for study of

Tetanus. K.B.E., 1918.
... R.A.M.C.
Commander, R.N. H.M.S. Gloucester.
... R.A.M.C. M.C.
... London Regt. KiUed in action,
23rd December, 1917.
R.A.M.C.

A.M.S. 127th Indian Combined
Field Ambulance., E.E.F. Ment.
in despatches, 1918. C.B.E.
R.A.M.C. 2nd N.Z. Field Ambu-
lance. M.C, 1917.
R.A.M.C. O.C, Welsh Metropoli-
tan War Hospital, Whitchurch,
near Cardiff, 1915—19. C.B.E. ,
1919.
R.A.M.C. Grove Military Hospital,
Tooting. Mentioned for war ser-
vices, 1917. O.B.E., 1919.
R.A.M.CT.F. St Marks (No. 2
Gen. Hospital). . Mentioned for
war services, 1917.

Tciup. Capt. ... R.A.M.C.
Temp. Lieut. ... R.A.F.

Lieut R.A.M.C. 8th South Staflfs. Killed

in action, Belgium, 1916.
R.N. H.M.S. Dartmouth.
R.N. H.M.S. Fearless.
R.A.M.C. E.E.F.
R.A.M.C.
R.N.
R.A.M.C
1918.
C.B.E
Surg. Sub.-Lieut., R.N.V.R. H.M.S. Martm
Capt Canadian A. M.C.

Temp. Surg.
Temp. Surg.
Temp. Capt.
Temp. Capt.
Surg. Lieut.
Lt.-Col.

Prisoner in Germany.
Mentioned in despatchee.
1919.

158

Boll of ^

Gbay, St. G. B. D.

Surg. Sub.-]

Greaves, H. N.
Green, Arthur
Green, C. L.

Capt

Lieut. ...
2nd Lieut.

Greene, C. W.

Capt

Greene, J. A. C. ..

Temp. Capt. .

Greene, W. K.
Greenfield, D. G. ...
Greenwood, A. A. ...

Temp. Major
Temp. Lieut.
Temp. Capt. .

Greenwood, E. C.

Gregor, J. B.
Grellet, H. K.

Greves, E. H.

Grice, J. W. H.
Griffin, E. H.

Griffin, T. H.
Griffiths, Chas. T....

Griffiths, H. L. S.
Gripper, G. D.
Grobbelaar, p. E. ...

Grombie. J. M. P.
Groves, H. S.
Growsb. W. ...

GmNNESS, A. F. G.
gwatkin, a. j.
Gwyn-Davies, W.

GWYN, W. p.

M.O.

Surg.
Act. Major

Consulting

Capt

Temp. Capt.

Capt

Temp. Lieut

Temp. Capt.

Capt

Capt. .
Capt. .
Senior

Temp. Lieut
Temp. Capt.

Capt

Lt.-CoL

b., K.N.V.K. H.M.S. Pelorus.

Awarded Koyal Humane Society
Medal for Saving Life from
Drowning.
Canadian A.M.C.

E.A.M.C. 2nd East Angliau F.A.
Essex Regt. Killed in action, 9th

June, 1917.
R. A.M.C. Mentioned in despatches,

Salonika.
R.A.M.C. Attached Weet Yorke.
Regt. M.C., 1917. Wounded.
R.A.M.C, Dental.
R.A.M.C, Dental.
R.A.M.C. 37th General Hospital,
Salonika. Order of St. Sava
(Serbian) and Croix de Guerre.
1919.

I/c Acheson Hospital for Officers,

1916—18. Anaesthetist, St. John
and St. Elizabeth Hospital, 1914
— 18. Commander Special Con-
stabulary, 1914—20. Ment. for
w r services, 1918-19. O.B.E.,
1919.
Sub.-Lieut., R.N.V.R.

... R.A.M.C. Yorks. and JLancs. Regt.

Wounded, 1917.
Physician to Red Cross Hospital,

Bournemouth.
... R.A.M.C, S.R.
... R.A.M.C Att.
land Fusiliers,
in despatches,
1917, D.S.O...
1917; wounded &
... R.A.M.C, Dental,
despatches, 1917.
.-Col., R.A.M.C, T.F. Territorial de-
coration, Hon. Associate of
Order of St. John of Jerusalem.
... R.A.M.C. 1st CCS.
... R.A.M.C German East Africa.
... R.A.M.C, T.F. 1st Scottish Gene-
ral Hospital, 0. i/c Centre for
Treatment for Jaw Injuries,
C i/c Aberdeen ]Military Dental
Centre, 1914—19.
... R.A.M.C, T.

... R.A.M.C 72nd Field Ambulance.
V.A.D. Red Cross Hospital
Kenil worth.
R.A.M.C.

R.A.M.C, Dental.
3rd Batt. The King's Regiment.
A.M.S. Egypt. Mentioned in
despatches, 1918. CM.G., 1919.

12th Nortbumber-

Twice mentioned

M.C and Bar

1917. Wounded,

prisoner, 1918.

Mentioned in

Surgeon

Roll of War Service.

159

Haine, C. F.
Halden, K. J. G.
Hall, A. W.

Hall, E. S.
Hall, Maxwell

Hall, K. W. B. ..
Hallet, L. K. J. ..
Halstead, D. V. ..

Ham, B. B

Hamlton, E. T. E...

Hamilton, G^o.
Hammond, J. A* B.

2iid Lieut.

Col. ...

Temp. Capt.
Pte. ...

Staff-Surg. ..

Capt

Temp. Capt. ..
Temp. Major ..

Temp. Surg.
Capt

Hammond-Williaisis,
Hampton, F. A.
Hanafy, J. Z.

Hant'Ock. a. C.

C. W., Capt., 1/5
Lieut. ...
R.M.O., British

Major

Hancock, E. D.

Temp Major

Handson, L. S. 0....

Temp. Lieut.

Handley, W. Sampson

Capt

Harden, E.

Lieut. ...

Habdenbkrg, E. J. ;F.

Lieut. ...

Hardy, E

Pte. ...

Hardy, G. F.

Temp. Capt.

14th Royal Fusiliers.

Artists' Rifles O.T.C.

A.M.S. Egypt. Mentioned in
despatches.

R.A.M.C. M.E.F.

Artists' Rifles (28th London), In-
fantry, France, 1916—17. R.F.A.
1917—18.

R.^. H.M.S. Dolphin.

5th Royal Sussex Regt.

R.A.M.C, S.R.

R.A.M.C.

S.A.M.C. Mentioned for war ser-
vices German South-West Africa,
1914 — 15. Died on service.

R.N. Ment. in despatches.

R.A.M.C. 24th General Hospital,
B.E.F. Neurological E.M.O.

King George Hospital, 1915 — IG.
1/3 West Riding F.A., B.E.F.,
1916. Anaesthetist and M.O. i/c
Chest Wards, No. 24 General
Hospital, B.E.F., 1916—18. M.O.
i/c Medical Division, Tooting
Neurological Hospital, 1918—19.
Batt. Border Regt. Wounded, 1917.

R.A.M.C. M.C.

Red Cross Society, Order of St.
John of Jerusalem. R.M.O.,
King George Military Hospital,
1915 — 19. Mentioned in des-
patches, 1919. O.B.E., 1919.

R.A.M.C. Att. H.L.I. 9t]i Scot-
tish Division, Aldeivhot, an)d
B.E.F., 1914—19. M.O. lOth
Highland Light Infantry. Bearer
Officer, 27th Field Ambulance.
Mentioned in despatches, 1916.
M.C, 1916, Bar- to M.C, 1917.
2nd Bar to M.C, 1917.

R.A.M.C. Clandon Red Cross
Hospital.

R.A.M.C.

R.A.M.C, T.

R.A.M.C, T.F. Millbank Hospital

R.A.M.C

R.A.M.C.

R.A.M.C M.O. 23rd Brigade,
17. M.O. No. 5 Reserve Brigade.
R.F.A., Catt<'rick, and No. 1
Infantry Command Depot, 1917.
M.O. lith W.'st Yorkshire Regt.
and No. 38 Stationary Hospital,
Genoa, Italy, 1918. M.O. i/c
Troops, Remount Depot, Roumey,
and Repatriation Camp, Win-
chester, 1919. Mentioned in
despatches, 1917. M.C, 1917.
Wonnded, 1917.

160

Roll of War Service.

Hahdy, H. M.

Hare. E. C...
Hakkness, a. H.
Harland, G. B.
Harper, J. .„
Hakper, R. S.
Harrington, F. J.
Harris, H. 0. W.

Harris, L. Prioe

Harris, W. J.
Harrison, E. W. .,
Harrison, Harold . .

Harrison. S. S. B...

Hart. E. R.
Hart, J. A....
Hartnell, E. B.

Harvey, C. P.
'Harvey, J. H.

Ha WES, W. A.
Hawkesworth. H. ..
Hawkins, C. F.

Haycraft, G. F. ..

Haynes, C. G.

Hayxes, F.
Hayward, M. C.

Hearn, R. J.
Hearndex. W. C.
Heasman. H. W.
Heath, F. R. H.
Heath, T. L.

Temp. Lieut.

Col.
Surg.
Capt.
Temp.

Lieut. ...

Temp. Capt.

R.A.M.C. 27th General Hospital,

Mudros and Cairo.
R.A.M.C.

R.N. H.M.S. Emperor of India.
I.M.S.
R.A.M.C.
R.A.M.C.

Hon. Dental Surgeon to Red Cross Hospital, Hin-
ton St. George. Private, 3rd
Batt. Somerset Volunteer Regt.

Major R.A.M.C. D.A.D.M.S. 2/4 London

Fid Am., 1915—17. D.A.D.M.S.
60th Division France, 1916. Sa-
lonika, 1916—17. Egypt and
Palestine, 1917—19. M.C., 1918

Temp. Capt. ... R.A.M.C. M.B.E., 1919.

Temp. Surg. ... R.N. H.M.S. Pembroke.

Dental Surgeon

Hospital,

Major

Temp. Capt.
2nd Lieut.
Temp. Capt

Haetnell-Bbavis, J. Lieut,

to Anglo-Russian

Petrograd.
R.A.M.C. South Staffs. Regiment.

M.C., 1917. Died from gas

poisoning on service, 1918.
R.A.M.C.

2nd East Surreys. Wounded, 1915.
R.A.M.C. London Mounted Bri-
gade. Died at Cairo, 25th April,

1916.
R.A.M.C. Private Hospital work,

Antwerp, France and Serbia.
Civil Med. Pract. A.S.C.
Civil Med. Pract., 3rd Dorset Regiment. O.B.E..

1919.
R.A.M.C, S.R.

I/c Devon & Cornwall Territorials.
R.A.M.C, Dental. M.M., 1917.

Wounded, 1917.
R.A.M.C, T. No. 4 Stationary

Hospital.
Artists' Rifles, B.E.F. 1914. 4th

King's Royal Rifles, 1916—17.

Lieut.

M.O.

Lieut.

Capt. .

Flight
1917.
1917.
action.

Dental Surgeon V.A.D.

Capt R.A.M.C, T.

died from
1916.
... R.A.M.C.
Auxiliary War

Commander, R.A.F.,
M.C, 1916. Bar to M.C
Missing, 1918. Killed in

Hospital, Rugby.

Wounded at Ypres,
wounds, Aug. 23rd,

Capt

On Staff
Temp. Lieut.
Temp. Lieut.
Capt

R.A.M.C

R.A.M.C.

Hospital

Attached R.A.F.
Hospital, Leather head.

No. 40 British General
and No. 40 Combined
F.A. Mesopotamia, 1917 — 19.
Attached 2nd Somerset L.I., Af-
ghanistan and N. W. Frontier,
India, 1919.

Roll of War Service.

161

Heatherley, F.

Heaton, T. 13.
Heckels. G. W.
Hedden, R. ...
Helsham. C. T.

Henderson, H.

J. ...

Temp. Lieut

Henderson, T.

E. ...

2nd Lieut.

Henderson, W.
Hendren, E. S
Henry, A. M.
Henby, C. J.

...

Temp. Capt.
A.B. ...

Surg. ...
Lieut. ...

Herbert. A. S.

Lt.-CoL

Hewetson. H.

Lt.-Col.

Hibberd. C. E.
Hibbert, W. L.
Hickes, Chas.

Hickman, G. H.
Hiogens, Chas.

Hildred-Carljll

Hilliard, M. a.
Hillier. H. X.
Hills, \V. E.
Hillstead. H. T.
Hilton. C. T.
Hilton, n. J.

Hind, (i. R.
Hind, W.

Capt R.A.M.C. Examiner & Chairman

Recruiting Med. Board. M.O.
158th Howitzer Brigade. 20th
D.L.I. 29th Northumberland

Fusiliers. 8th and 9th K.L.R.
M.O. i/c P.O.W. Camp, Leigh.

Capt R.A.M.C, S.R.

Capt R.A.M.C, S.R. Mesopotamia.

M.O. to troops, Honiton.

Temp. Surg. Lieut., R.N. Private, R.A.M.C. T.,
1914. Temp. Surg, and Sub.-
Lieut., R.N.V.R., 1914. H.M.S.
Crusader, 1914—16. H.M.S.

Broke, 1916—17. H.M.S.

Cmwda, 1919. R.N. Hospital,
Haslar. D.S.C, 1917.
R.A.M.C. Attached Essex Regt.

M.C, 1917. Wounded, 1917.
South Staffs. Killed in action,

Aug. 31st, 1916.
R.A.M.C.
R.N.V.R.

R.N. H.M.S. President.
R.F.A., S.R. 1st D.A.C, B.E.F.

M.C, 1918.
N.Z.M.C. M.O. Military Ortlio-
pedic Hospital, Rotor ua, N.Z.,
1915—18. O.B.E.
R.A.M.C Twice mentioned in des-
patches, 1917 and 1918. D.S.O.
Order of St. Anne, 2nd Class,
with Swords (Russian). Order
of Crown of Italy, 1918.
R.A.M.C.

R.A.M.C, T.F. 47th CCS., B.E.F.
A.S.C, Motor Transport.

Expeditionary Force.
R.A.M.C, Dental.
Senior Ophthalmic Surgeon County of London War
Hospital, 1915—19.

R.N. H.M.S. New Zealand,
Battle Cruiser Fleet, 1914 — 16.
Neurologist and Psychiatrist,
R.N. Hospital HaslaT, 1916—19.
Mentioned in despatches.

Lieut R.A.M.C. No. 22 General Hosp.

Lieut R.A.F., DentaL

Temp. Capt. ... R.A.M.C. Egypt. B.F.
Civil M.O. ... Rough Riders.
Temp. Capt. ... R.A.M.C.

Capt R.A.M.C. 30th Stationary lloa-

pital, Salonika.

Surg Stoke-on-Trent Wax Hoepitnl.

Lt.-Col. ... R.A.M.C. O.C. North Midland

Heavy Battery. R.G.A., T.F.,
1916. Transferred to R.A.M.C
Ment. for war services. 1017.
Territorial Decoration, 1917.

Temp. Capt.

Capt

Pte. . . .

Temp. Lieut.

Temp. Surg. Lieut.

162

Roll of War Service.

HiNDE, ]•:. B.

HiNTON, J . il.
HiRSOH, V. R.

HiTCHINOS. D. B.

hodgkinson, r. j.
Hodgson, C. R.

Hodgson, F.

Hodgson, H.
Hodgson, J, W.

Hodgson, Stanley

Hodgson, Stewart
Hodgson, V. J.

Hodgson, W. A.
hodson, j. e.
Hogarth, B. W.

HOGBEN, H. F. T.
HOLBORN, F. M.

Hole, K. H.
Hollands, W. G. ...

hollington, j. j. l.

HOLLIST, G. W. C. ...

HOLLOWAY, G. W. B.

HOLLOWAY, S. F.
HOLMAN, CO.

HOLMAN, H. E.

HOLMAN, R. C.

Holmes, Thas.

Holmes, T. F.
Hopkins, F. G.
Hopkins, H. L.

HOPSON, M. F.

HopsoN, M. F. J. ..
HoPSON, M. G. S. ..

Temp. Major

Capt

Lieut. ...

2nd Lieut.
Capt

Capt

M.O. ...

Commandant,

R.A.M.C, T.F. Meat, in deep.
Isl North Midland Bde., R.A.F.
R.A.M.C. India and Mesopotamia,

1916—19.
lOtJi Batt. South Wales Borderers.
Late Private, Artiste' Rifles, 1914
—16. 10th S.W.B., B.E.F.,
1915—17. 3rd S.W.B., and 53rd
S.W.B., England, 1917—19. Li-
valided Home, Trench Feet. 1917.
. 41h K.R.R. Wounded, 1915.
. Australian A.M.C. 1st AnstraJian
Light Horse F.A. No. 14 A.G.H.
Cairo. Egypt, Palestine and
Syria, 1917 — 19. Mentioned in
despatches, 1920.
. R.A.M.C. East Lanes. Field Am-

o bulance.
. Hants. Carbineers Yeomanry.
M.O. Exmouth Auxiliary Hospital.

O.B.E., 1918.
.R.A.M.C, T.F. 2/1 East Lance

Field Ambulance.
. R.A.M.C. M.O.
. Queen Mary's Naval Hospital,
South end-on- Sea.
Civil Dental Surgeon 3/6th London R.F.A.
Temp. Lieut. ... R.A.M.C.

R.A.M.C, T.F. M.O. to 1st Div.
Bomb. School.

Regt. Killed in Mesopo-
23rd November, 1915.
of London Volunteers.
Dental Surgeon, Tooting

Capt.

Surg.

Major
Lieut.

2nd Lieut.

. Norfolk
tamia,
. County
Civil
Military Hospital
Surgeon Commander, R.N. H.M.S
2nd Lieut.

Thames.

KUled

Lieut. ...
Act. Major .

Surg

Surg. Lieut. ,
Temp. Lieut.

M.O. ...

7th Batt. Royal Fusiliers.

in action, 1916.
R.F.A. Wounded, Messines, 1918.
R.A.M.C, T.F. Home Counties

Field Ambnlance.
R.N. H.M.S. Impregnable.
R.A.M.C
R.A.M.C. 40th General Hospital,

B.E.F.
Attached Fairfield Court Red Cross
Hospital, Eastbourne.
Medical Examiner of Recruits, Midhurst.

Capt R.A.M.C. 5th Southern General

Hospital.
Temp. Major... R.A.M.C
Temp. Lieut. ... R.A.M.C.

Lieut. ... ... R.A.M.C Ment. in despatches.

Killed in action, Oct. 1914.
Hon. Cons. Dent. Surg, to War Hospitals in

London also R.N.V.R.
Surg. Lieut. ... R.N.V.R.

Lieut A.S.C Horse Transport.

Roll of War Service.

163

HORSLEY, L.
HORTON, J. H.

HOUSDEN, C. H.

Howard, C. Keginald

Temp. Surg.
Brevet Lieut.

Hon. Dental
Temp. Capt. ..

Howard, J. A.

.. Kadiographer,

Howe, A. F. A.

.. Capt

Howe, G. H.

.. Lieut. ...

Howe, J. 0. 0.

.. Capt

Howell, J. B.
Howell, J. N. 0.
howells, j. «.•
Hubbard, G. K.
Hudson, E. P.
Hughes, E. C.
Hughes, E. P. L
Hughes, Sidney
Hugh- Jones, K. H

Hull, A. J.

Humpheey, L.

Humphbeys, F. R. ..

HuNOT, F. G.
Hunt, G. H.

Hunt, G. W.
Hunter, P. D.
Huntley, Edgar

Hurst, A. F.

Husbands, F. A.
Hutchinson, F. E.

Hylton, D. Y.

,. R.N.

Col., I.M.S., D.A.D.M.S., 12th Indian
Division. Ment. in despatches,
Mesopotamia. D.S.O. Died on
service, 1917.
Surgeon to Thorncombe Military
Hospital.
R.A.M.C. Attached King's Afri-
can Rifles, East Afirican E.F.
Twice ment. in despatches, 1917
and 1918. Killed 6th September,
1918.
Croydon Militai-y Hospital.
R.A.M.C, Dental.
London Rifle Brigade.
R.A.M.C. 68th Field Ambulance,
22nd Divisional Train, R.A.S.C.
' 100th Bde., R.F.A., Salonika,

1917 — 19. 21st Stationary Hos-
pital, Batoum, 1919.
Temp. Major ... R.A.M.C.
Consulting Surgeon, Cheltenham Red Cross, Hosp.

Temp. Capt.

Capt

2nd Lieut.

Capt

Surg. ...

Capt

Temp. Col. ...

Brevet Colonel,

Major ...

Surg

Brevet Major . . .

Capt

Temp. Capt. ...
Temp. Lieut. ...

Act. Lt.-Col....

Temp. Lieut.
Major ...

Dental Surgeon,

R.A.M.C.

R.A.M.C. ,S.R.

R.F.A., S.R. M.C., 1918.

R.A.M.C, T.F. O.B.E., 1919.

R.N. H.M.S. Crescent.

R.A.M.C. 3rd H.C. Field Amb.

6th, Attached 12th Rifle Brgade.
Killed in action, 20th Sept.,
1917.

R.A.M.C. Twice mentioned in
despatches.

R.A.M.C. CM.G., 1916. Twice
mentioned in despatches, 1918.

R.A.M.C, T.F. O.C. 3/2 London
Field Ambulance.

R.N. Royal Naval Hospital, Cape.

R.A.M.C. 1/2 London C.C.S.,
1914. No. 25 General Hospital,
B.E.F., 1916. Royal Military
Hospital, Devonport, 1916—17.
Royal Victoria Hospital. Netley,
1917. R.E. Experimental Sta-
tion, Porton, 1917 — 19. Ment.
in despatches, 1915.

R.A.M.CT.F.

R.A.M.C.

R.A.M.C Military Hospital, Fo-
vant, Wilts.

R.A.M.C 0 i/c Sealo.-Hayne Mili-
tary Hospital. Wax Office Re-
presentative at Congress of
American Neurological Society.

Northants Mediwil Volunteei- Corp*.

Australian A.M.C. 8th Field Am-
bulance. Egypt. 1916. B.E.F.,
France, 1916 — 18.
Bath War Hospital.

1G4

Roll of War Service.

Ibbotson, E. u. B.

IDE, II. L.

Infield, S. ...
Ingram, P. C. L'.

INSTONE, N. ...
Iredell, A. W.

Irvine, L. C. D.

Temp. Capt. ...
Dispatch Kider,
Temp. Capt. ...
Act. Major

Temp. Lieut.
Surg.

K.A.M.C.

County of London Yeomany.

R.A.M.C.

R.A.M.C, T.F. M.O. 1st Mon-
mouth Regt., 1914. 3rd Welsh
Field Ambulance. 53rd Welsh
Division. Gallipoli, 1915. M.O.
i/c Medical Div., Gren. Hoep.,
Western and Irish Command
Venereal Hospitals, 1916.

R.A.M.C.
Lieut. -Commander, R.N. H.M.S. Victory.
Lt.-CoL, R.A.F.
Surg. Lieut. ... R.N.V.R. H.M.S. Hague. H.M.S.
CornwaUis.

Jackson, F. D. S....
Jackson, R. W. P.

Jacob, E. D.
Jalland, M. T.

James, B. E.
James. J. S. H.

James, W. Culver
Jarvie, J. M.
Jenkins, H. H.
Jephcott, C.
Jepson, A. C.
Jerwood, B. E.

Temp. Major ..
Act. Major ..

Temp. Lieut.

Lieut.

Hon. Surg-. Col.
Temp. Lieut. ...
Temp. Capt. ...

Capt

Temp. Capt. ...
Capt

R.A.M.C.

R.A.M.C. Croix de Guerre, 1917.

M.C., 1918.
Temp. Major... R.G.A., T.F.
Hon. Consulting Surgeon to Military Hoepital,

York.
R.A.M.C, Dental, late Lance-Cor-

poral 23rd Fusiliers (Sports-
man's Battalion).
K.R.R., late Artists' Riflc«. KiUed

in action, Rue de Bois. 16th

May, 1915.
, H.A.C.
R.A.M.C.
R.A.M.C.
R.A.M.C, T.F.
R.A.M.C.
R.A.M.C, S.R.

Anglo-French

port, 1915.

Jessop, p. E.
John, D. W.

Johnson, A. P. L.
Johnson, E. C

JoHNfJON, William

Johnston, W. R.

Johnstone, J. L.
Jones, B.
Jones, C C

Temp. Capt.
Capt

Capt

Temp. Capt.
Major ...

Temp. Lieut.
Temp. Capt.
Capt

Lady Murray's
Hospital, Le Tre-
Mesopotamia and
No. 133 British General Hosp.,
Kut-el-Amara, 1917—20.

2/5 Battalion Loyal N. Lanes.

R.A.M.C, S.R. 8tli North Staffs.
Twice mentioned in despatches,
1917.

R.A.M.C, Dental

R.A.M.C, Dental.

R.A.M.C. 58th Field Ambuhince.
B.E.F., France, 1915—17. Phy-
sician and Neurologist, (i2iid

. CCS., B.E.F., 1917—19. Joint
Author, " Nervous Disorders,"
Official Medical History of the
War. M.C, 1916.

In charge of Ambulance Arrange-
ments for Air Raids, Hull.

R.A.M.C.

R.A.M.C. Prisoner in Germany,
1918.

Uoll of War Service.

165

Jones, C. E. M.

Jones, D. R.

Jones, E. Price

Jones, Evan L.

Jones, E. Shelton

Jones, G. B. H.

Jones, G. H.

Jones, G. M.

Jones, H. B.

Jones, Hugh E.

Jones, H. S.
Jones, H. W.
Jones, J. Gaymer

Jones, J. H.
Jones, J. H.

lONES, J. P.

Jones, J. T.

. I ONES, L.

Jones, M. P.

Jones, R. L.

Jones, R. 0. H.

Jones, R. T.

Jones, R, W.

Jones, Sidney

Jones, T. Lewis

Jones. W. H. T.
JOSLEM, H. ...

lOYNT, H. F.

• lOYNT, M. C.

Capt.

Temp. Lieut.
Capt

Temp. Capt.

Capt

Temp. Lieut.
Temp. Capt.

R.A.M.C, T.F. Att. 1/4 Hamp-
shire Regt. India, 1914 — 16.
Mesopotamia, 1915 — 16. Siege
of Kut, 1916. Prisoner of war
in Turkey, 1916—18.

R.A.M.C. Western Comnd Depot
Chester, attached 54th R.F.A.,
1915. Salonika, 1915—17. 85th
F.A., 1917—18. 1st Suffolk
Regt. Sei'ved in Servia, Struma
Valley and Tm-key.

R.A.M.C.

R.A.M.C. Attached Highland L.I.
Killed in action, 1918.

R.A.M.C. 11th Royal Welsh Fue.

R.A.M.C. 4th Hants. Regiment.

R.A.M.C.

Member of Wax OflBce

Trav. Medical Board.
6th Batt. Welsh Regt. Wounded,

November, 1917.
Hon. Consulting Surgeon to Military Hospitals,

Liverpool, for Diseases of Eai-,

Nose and Throat.
R.A.M.C.
R.A.M.C.
R.A.M.C. Lond. Elect. Engineers,

1914. 4th Bde., R.F.A. India,
1916. Mesopotamia, 1916 — 18.
Egyptian Ex. Force, 1918 — 20.
Ear, Nose and Throat Specialist
Cairo, 1919—20. M.C., 1918.

Canadian A.M.C. Wounded, 1917.

R.A.M.C. Late Staff Surg., R.N.

H.M. Hospital Ships, Newhaven,

1915. St. David, 1915—16. Ne-
vara, 191.6—17. Attached 51st
Stationary Hospital, Genoa and
Salonika, 1918. No. 49th Sta-
tionary Hospital.

R.A.M.C. M.C. and Bar.

A.A.M.C. Ment. in desp., 1917.
M.C, 1917.

Major R.A.M.C.

Fleet Surg. ... R.N. H.M.S. Vivid.

Temp. Surg. ... R.N.

Act. Major ... R.A.M.C. M.C., 1917.

Lieut.

Temp. Capt.
Hon. Capt.
Capt

Temp. Major
Capt

Capt.
Capt.

Capt

Dent. Surg.
Temp. Lieut.
Temp. Capt.

Temp. Capt.

Capt

Act. Major
Capt

R.A.M.C.

1917.
R.A.M.C.
Mile End
R.A.M.C.
R.A.M.C.

East.
R.A.M.C.
R.A.M.C.
R.A.M.C.
R.A.M.C.

Wounded,

Western Gen. Hospital.
^Military Hospital.
Mesopotamia.
Wel«h Hospital in tbe

Indian Service.
Canadian A.M.C.

166

Roll of War Service.

Kearney. S. J.
Keats, H. C.
Keer, J. C.
Keer, K. J. T.
Keith. T. Skene
KELBii, W. E.

Kelsey, a. B.

Kelsey, W. ...
Kemp, J. Wallace
Kendall, J.
Kendall, N. E.

Kennealey, W. J....

Kennedy, Konald S.

Ker, W. P

Kield, W. S. T. ...
Key, B. W. M. Aston

KiDD, W. S.
Kidman, G-. E.
Kid nee, C. H.
Killard-Leavey, F. J.

King, Geoffrey
King, L. A. B.

King, P.

King, K. M.

KiNSEY-MOBGAN, A. . .
KURKLAND, G. B. ,.

KiRKMAN, A. H. B.
KNAGGS, F. H.
KNAGGS, E. L.

Knapp, G. H.

Knight, H. R.
Knight, R. V.

Lieut. ...
Major ...
M.O. ...
Temp. Capt.
Temp. Capt.
Major ...
Temp. Capt.

Lieut. ...
Major ...
Surg. Sub.
Act. Major

Trooper

Major ...

Temp. Capt.
Temp. Lieut
M.O. ...

Temp. Surg-.

Capt

Pte. ...
Capt

Surg. ...
Temp. Capt.

2nd Lieut

Capt

Lieut. ...
2iid Lieut.

Temp. Lieut
Temp. Capt.
Major ...
Lt.-CoL

Temp. Capt.
FHght Sub.-

Knights-Rayson, H. Capt

... R.A.M.C, T.F.

... I.M.S.

... Rendlesham Park Camp.

... l/6th Suffolk Regiment.

... R.A.M.C.

... 6th S.A.F.A.

... R.A.M.C. Drowned in H.M. Hob-
pital Ship Glenart Castle, . tor-
pedoed 26th February, 1918.

... R.A.M.C. M.C. Wounded.

... R.A.M.C, T.F. 1st London CCS.

•Lieut., R.N.V.R. H.M.S. Tuberose.

... R.A.M.C. Mentioned in despatches,
1918.

... Vanderventers Horse, South African
Forces.

... I.M.S. Mentioned in despatches,
1918. M.C, 1917. Bar to M.C,
1918. KiUed in action, 17th
April, 1918.

... R.A.M.C

... I/c Reception Hospital, Porte-
mouth, 1914—19. O.B.E., 1919.

... R.N. Wounded, 1917.

... R.A.M.C, T.F.

... Artists' Rifles. Wounded, 1917.

... R.A.M.C. O.C Addington Park
Military Hospital. M.O. Enteric
Depot, Croydon. M.O. Shoebury
Garrison.

... R.N.

... R.A.M.C, Dent. Dent. Surg, to
Jaw Wounds, Hospital, Aldershot

... East Surrey Regiment. Balloon
Officer, R.A.F. KiUed in action
B.E.F., Aug. 8th, 1917.

... R.A.M.C, Dental. Army Dental
Surgeon. Alexandia, Egypt.

... R.A.M.C.

... Royal West Kents. L'Hopital
Anglo-Frangaise, Le Treport,
1916—18.

... RJ^.M.C No. 11 General Hospital
and No. 12 CCS., France.

... R.A.M.C M.O. Huddersfield War
Hospital. Died 24th June, 1917.

... R.A.M.C. 2nd Northern General
Hospital, Leeds.

... S.A.M.C Mentioned for war ser-
vices, German S.W. Africa, 1914
—15.

... R.A.M.C.

Lieut., R.N.
March,

... S.A.M.C

Accidentally killed, 12th

1917.

1st Military Greneral
Hospital, Wynberg, South Africa,
1916—19.

Boll of War Service.

16:

Knott, F. A.
Knowles, G. F. ..
Knox-Davies, E. a. C.

Kyle, J

Kynaston, a. E. F...

Temp. Surg. ... R.N. H.M.S. Achilles.
Dentist to four Red Cross Hospitals.

Capt S.A.M.C.

Lieut R.A.F.M.S. and Artists' Rifles.

Surg. ... ... R.N. H.M.S. Devonshire. Died of

enteric.

Laborda, F. E. R.
Lacey, B. W.
Lacey, G. E. W.
Lacey, T. W.

Lacey, W. S.

Lamb, C. J.
Lancaster, H. F.

Landon, E. E. B. ...
Lane, Sir W. A., Bt.
Langdale, H. M. ...
Langdon, W. M. ...

Lansdale, W. M. ...

Temp. Capt. ... R.A.M.C.

Temp. Lieut. ... R.A.M.C.

Temp. Surg. ... R.N. H.M.S. Victory.

Temp. Major... R.A.M.C. R.M. Academy, Wool-
wich.

Temp. Lieut. ... R.A.M.C. 140th Field Ambulance.
Died of wounds.

Dental Surgeon, Fortre^ Hospital, Devonport.

Capt R.A.M.C, T.F. 2nd London Gen.

Hospital, 1915 — 19. Hampstead
New End Military Hospital, 1919
—20.

T.F.
C.B., 1917.

Capt

Temp. Colonel,
Staff Surg. ...
Capt

Capt

Lansdown, R. G. p. Major

Larkin, R

Lauder, J. F. L. ...

Laver, B. L.

Laver, C. H.

Lavers, Norman

Lawrence, W. F.
Lawson, F. W.
LawsoN) G. L. L.
Lawson, S. ...
Layton, T. B.

Temp. Lieut
Major ...

Lieut, and

Surg. Lieut.

Temp. Lieut. ...

Temp. Capt. ...
Temp. Surg. ...

Major

Temp. Lieut. ...
Act. Lieut. -Col.

R.A.M.C,
R.A.M.C.

. R.N.

. R.A.M.C, T.F. London Field Am-
bulance.

. R.A.M.C, S.R. Attached Royal
Berkshire Regiment. Killed in
action, 1918.

. R.A.M.C, T.F. 2nd Southern Gen.
Hospital. Royal Humane Medal.

. R.A.M.C.

R.A.M.C. Ment. in despatches.
1917. D.S.O. M.C, 1916. Bar
to M.C, 1918. Prisoner of wai-.

Adjutant, R.F.A. Artisfc' Rifles,
B.E.F., 1914—16. 37th Divi-
sional Artillery, 1916 — 17. Ad-
jutant, 124th Brigade R.F.A.,
1916—17.

. R.N. late Lance-Corporal Artists'
Rifles. B.E.F., France, 1914—
15. Lieut., R.F.A., B.E.F..
France, 1915 — 16.

,. R.A.M.C Physician to Bath War
Hospital.

. R.A.M.C.

.. R.N.

. R.A.M.C, T.F.

.. R.A.M.C, Dental.

R.A.M.C, T.F. O.C 2/4 London
F.A., Oct., 1914— July, 1918.
B.E.F., 1916. B.S.F., 191&— 17.
E.E.F., 1917—19. 27th General
Hospital, Cairo, 1918. Officer
i/c Surgical Division, 87th Gea.
Hospital, Alexandria, 1918 — 19.
Twice mentioned in despatches,
1918. D.S.O., 1918.

168

Boll of War Service.

Lean, F. C.

Capt

. K.A.M.C, Dental, late Gunner,
Cornwall R.G.A,

Lean, J. L.

Bombardier .

. R.G.A. , 479 Siege Battery, B.E.F.,
1917—18. Gassed, 1918.

Lbblano, F. K.

Capt

. R.A.M.C. Bacteriologist at Bag-
dad. Pathologist, No. 1 Slation-
ary Hosp., Rouen. 1919.

Leckie, Mnlcolm ...

Capt

. R.A.M.C. Mentioned in despatches,
1914. D.S.O. Killed August
28th, 1914.

Le Clezio, G. H. L.

Capt

. R.A.F.M.S.

Ledgeii, a. V.

Temp. Capt. .

. R.A.M.C.

Lee, F. W

Temp. Lieut. .

. R.A.M.C. Canadian A.M.C.

Lee, Harry

Capt

. R.A.M.C, T.F. 1st West Riding
F.A., 1914—15. B.E.F., France
and Belgium, 1915—16. Opii-
thalmic Specialist, 6.3rd General
Hospital, B.E.F., 1917. Oph-
thalmic Specialist, 2nd London
Hospital.

Leeming, a.

Act. Major ..

R.A.M.C, T.F.

Lf,kming, a. N.

Temp. Lieut. ..

. R.A.M.C 10th CCS.

Leigh, H. V

Major . .

. R.A.M.C. l/5th Welsh Regiment,

Leipoldt, C. F. L.

Capt.

Le Sage, C. F.
Leviseue. E. A.
Leviseue. H. J.
Levy, A. G.
Lewin, G. ...

. M.O. ...

. Capt

Temp. Surg
Lieut. ...

. Capt

Lewis, C. G.

. Temp. Capt

Lewis, J. L. D. ..
Lewis. R. P.

Temp. Capt
. Lt.-Col.

Liddeedale, J. F...

Temp. Capt

Liebson, a. S.

Capt

T.F., Milford Haven and Firth
of Forth Defences, 1914—1915.
Transferred R.A.M.C, No. 22
General Hospital, B.E.F., 1915.
Section Commander 42nd Field
Ambulance, 42nd Divn., B.E.F.,
1915. M.O. i/c 8th K.R.R.
14th Division, B.E.F., 1915. Re-
gistrar 31st General Hospital,
E.E.F., 1915— 17. Registrar 27th
General Hospital, E.E.F., 1917.
Registrar and 0. i/c Medical
Division 71st General Hospital.
E.E.F. Mentioned in despatches,
1917.

S. A.M.C. Mentioned for war ser-
vices, German S.W. Africa, 1914
—15.

Norfolk War Hospital.

S.A.M.C.

R.N.

R.A.M.C.

R.A.M.C.
R.A.F.

R.A.M.C.
B.E.F.

R.A.M.C.

R.A.M.C, S.R. Twice ment. in des-
patches, 1917 and 1918. D.S.O.,
1918. Wounded, 1917..

R.A.M.C. Ment. in despatches,
1917.

S.A.M.C M.O., 3rd S. African
Infantry. M.C Killed in action.

Mesopotamia, 1916 — 17.
Medical Service, 1918.
No. 10 Field Ambulance.

Moll of War Service.

169

Lindsay. G. P.

Lindsay, W. J.

Lister T. D.
Litchfield, E. M.

Litchfield, P. C.

Lieut.

Civil Suro^eon

Physician
Capt ....

Capt.

Littlejohns, a. S.

Temp. Major

Llaeena, E. F.

2nd Lieut.

Lloyd C. E.

... Capt

Lloyd, E. T.

Surg. Sub.-"

Lloyd, F. G.

... Temp. Surg.

Lloyd, 0. 0.
Lloyd, V. E.

... Pte. ...
Temp. Capt.

Lloyd, W. G.
LOBB, E. L. M.

... Capt

Lockyer, G. E.

Logan, F. T. B.

Long, G. B. S.
Long, H. 0.

LONO, P. S. C.
Longhurst, S. H.

LONGSON, F. M.
Loud. Fnink

Capt.

Hon. Surg.

Temp. Surg.
Surg. -Lieut.

Surg. ...
Temp. Capt.

Temp. Capt.
Major ...

2nd Border Regiment. Served with
Artists' Rifles, 1914—15. B.E.F.,
France, 1915—17. M.C., 1917.
Three times wounded, 1915, 1916
and 1917.
attached R.A.M.C. Ophth. Surg.
Ith London General Hospital,
1915—20. M.B.E.

... Price of Wales Hosp. for Officers.

... R.A.M.C. and N.Z.M.C. Attached
2nd Manchester Regiment. Men-
tioned in despatches.

... R.A.M.C. M.O., 4th Queen's, 1914
. —15. 94th F.A., 1915. 0. i/c.
15th Motor Ambulance Convoy.
B.E.F., France, 1915—18. Men-
tioned in despatches, 1919. M.C.
1918.
... R.A.M.C. Ment. in despatches.
D.S.O., 1917.

... Suffolk Regiment. Killed at Ypres,
20th June, 1915.

... R.W.F. Attached Nos. 38 and 60
General Hospitals, Salonika 1916
—19.

Lieut., R.N.V.R., H.M.S. AfrUe. 6th
Flotilla.

... R.N. H.M.S. Victory. Attached
R.M.A. Anti- Aircraft Brigade.

... Artists' Rifles. M.M.

... R.A.M.C. Attached 1st Leicester
Regiment. M.C, 1918.

... R.A.M.C, Dental.

... R.A.M.C. Surgical Specialist No..
&Q General Hospital, Salonika,
1917. Surgical Specialist Nos.
66, 51, 29 Stationary Hospitals,
and Mos. 9, 39, and 24 CCS.,
Italy, 1917—18.

... R.A.M.C. M.O. i/c 1st Wilts and
12th Hants, 1915. Special work
H.Q., Southern Command, 1917.
Member Medical Board, A.S.C.
Discharge Centre, Winchester,
1917—18. M.O., Rec. Dis. Bttn.
Mentioned in despatches, 1919.

... Foye House Red Cross HospitaL
Died.

... R.N.

... R.N. H.M.S. Cleopatra, 1918—19.
H.M.S. Awora, 1918. R.N. Hos-
pital, Ilaslar. H.M.S. Pem-
broke, Chatham Barracks, 1919.

... R.N.

... R.A.M.C. Inspecting Dent. OflBcer,
Western Command.

... R.A.M.C.

... R.A.M.C, and Susse.\ R.G.A.,T.F.

PART II.

170

LOVEDAY, W.
LOVELUCK, C.

Lowe, E. C.

D. .
A. .

.. M.O. ...
.. Capt

Lowe, F. A.

.. Lieut. ...

Lower. N. Y

.. M.O. ...

Lucas, C. K.
Lucas, R. H.

Hon. Lieut.
.. Act. Major

Lucas, T. C.
Luce, Sir R.

H. '.

Major ...
Major-Gen.

Lucey, H. C.
lumley, f. d.

Lund, H. .,

Lynn, E.
Lyon, H. J.

Roll of War Service.

I/c Red Cross Hospital, Wantage.

N.Z.M.C. Pathologist to No. 2
N.Z. Gen. Hospital, 1917—19.
M.B.E.

R.N.V.R. Collingwood Battalion.
Killed Gallipoli, 1915.

V.A.D. Hospital, Gorton, Radnor-
shire.

R.A.M.C.

A. M.S. Mentioned in despatches,
Italy, 1918. M.C.

R.A.M.C. 62nd Division.

R.A.M.C. A.D.M.S,, 2nd M,T,
Division, Egypt and Gallipolli,
1914 — 16. Western Front. Force,
Egypt, 1916. Imperial Mnted.
Division, Palestine, 1917—18.
D.D.M.S. East Force, and 20th
Corps. D.M.S., E.E.F., Pales-
tine. Mentioned in despatches.

1917. K.C.M.G., 1919. C.M.G.

1918. C.B., 1916.
R.A.M.C.

Commander, R.N. Surgeon and Agent to
Royal Naval Torpedo Factory,
Greenock.
R.A.M.C, T.F. 2nd Western Gen.

Hospital.
Auxiliary Hospital, Woolwich.

Temp Capt
Surg.

Capt. .
M.O.

MacAlister, G. H. K. Temp. Capt.

McAlpin, K. F.
McDermott, B.
Macdonald, W. D....
McDougall, J. T. M.

McGregor, G.

McKay, W. K. M. ...

Mackenzie, Murdo
McKenzie, Alan
McManus, D. M.
McLachlan, a. R.
McNair, a. J.

Maelzer, N. H. S..
Maggs, W. a.

I.M.S. Bacteriologist, Mesopo-
tamian Expeditionary Force.

Machine Gun Corps.

R.A.M.C.

Army Dental Surgeon.

R.A.M.C. 29th Stationary Hos-
pital, Salonika.
Civil Medical Pract., Alexandria Military Hospital,
Cosham.

Royal North West Mounted Police,
1914 — 16, and 1st King Edward's
Horse, 1916—17. British Exp.
Force, France.

3/1 Surrey Yeomanry.
Sub. -Lieut., H.M.S. Gentioan.
R.A.M.C. and Inns of Court O.T.C.

Major ...
Temp. Capt.
2nd Lieut.
Temp. Capt.

Trooper

2nd Lieut.
Surg.

Capt

Lieut. ...
Temp, Capt.

Lieut.
Dent, i

urg.

R.A.M.C. Late Surg., R.N, (Home
Waters), 1914—16. R.A.M.C,
T.C., 1916—19. Surgical Spec-
ialist, No. 2 General Hospital,
Mesopotamia, and No. 9 C.C.S.,
N.W.F. Force, India, 1919.

R.A.M.C, S.R.

King George Hospital.

Boll of War Service.

171

3iag0avax, p. d.
Magrath, C. W. S.

Mahox, E. 31.

Maile. W. C. D.
Male, H. C.
Malleson, H. C.

Mandel, L. ...

Ma AFIELD, G. H. H.

Ace. Major

Manx, H. Corry ...

Surg. -Lieut.

Manning, G. E.
Manning, T. D.
Manser, F. B.

Capt

Temp. Capt.
Major...

Margolies, Ivor
Marriott, H. B. ...

Sergt. ...
Fleet Surg.

Marriott, Oswald ...

Lieut. ...

Marsh, A. P.

Temp. Capt.

Marsh, H. E.
Marsh, H. E.
Marshall, B. G. ...

2nd Lieut.
Temp. Lieut.
2nd Lieut.

Marshall. Claude H. Capt. ..
Marshall, E. S. ...
Marshall, Geoffrey...

Temp. Capt. ... E.A.M.C. Belfast War Hospital.
Lt.-Col. ... R.A.M.C. O.C. troops, Hospital,

Ships Newhaven and Tag us,
President Standing Medical Brd.,
Portsmouth. Mentioned for war
services.

Capt R.A.M.C. Surgeon Croix Rouge

Francais Anglo-French Branch,
France, 1914. R.M.O. i/c Euds-
leigh Palace Hospital for Officers,
1915 — 17. Served in Egypt and
Palestine, 1917—19.
Hon. Capt. ... R.A.M.C, T.F. Wounded, 1917.
Civil Med. Pract., Croydon War Hospital.
Temp. Capt. ... R.A.M.C. Hon. Consulting Dental
Surg, to London War Hospitals.
Surg. -Lieut. ... R.N. H.M.S. Vwid, 191i. H.M.S.
Donegal, Grand Fleet, 1914—16.
H.M.S. CresceTht, 1916—18.
H.M.S. Europa, -Egean

Squadron, 1918 — 19 Served at
Cuxhaven and Jutland.
R.A.M.C. 2nd North Midland

Field Ambulance. M.C., 1916.
R.N. H.M.S. Racer. O.B.E.,

1919.
R.A.M.C.

Dorset Medical Volunteer Corps.

R.A.M.C. Connaught Military

Hospital, Aldershot, 1915—1916.

43rd Casualty Clearing Station,

B.E.F., France, 1916—19.

13th Yorks.

R.N. H.M.S. Egmont. H.M.S.

Resolution. O.B.E.
R.A.M.C. B.E.F. 1918—19, and
Prisoners of War Camp. Bramley
R.A.M.C, Dental. Civil Dentist
to Troops at Seaford. Rye, and
Lydd.
R.F.A. T.F. M.C.. 1917.
R.A.M.C.
3rd Northants Regiment. Killed

in action at Loos.
Uganda Field Ambulance. O.C.
Medical (British) att. Belgian
Troops, Uganda.
Temp. Capt. ... A. M.S. H.Q. StaflF. Twice men-
tioned in despatches. M.C.
1918.
Act. Major ... R.A.M.C, S.R. B.EF., 1914—19.
No. 13 Stationary Hoepit.nl,

1914. 2nd Ambulance Flotilla,

1915. 17th C.C.S., 1915—18.
No. 10 C.C.S., 1918—19. Ad-
viser in Anaesthetics, 2nd Army.
B.E.F., France. Author of
"Anoesthetics," in Official Manual
on Diseases and, In juries of War.
Ment. in despatches. O.B.E.

172

Marshai.l, G.
Marshall, Herbert M.

Marshall, K. P. ...

Boll of War Service.

Capt.

Marshall, W. L. W. Lt.-Col

Marston, a. D.
MARTiisr, A.
Martin, J. Birch

Martin, J. N.
Mash, 0. N.

Mason, J. B.
Masters, J. A.
Mather, Horace

Matson, E. C.
Matthews, G.
Matthews, J.
Matthews, T.
Maurice, H.

Maxted, G. ..

Maxwell, E. J.

Maxwell, J. E.

Maxwell, K.

May, p. M.
May, K. E. G.

May, W. N

Maybury, a. V. ..

Mayer, E. G.
Maynard, E. F. ..
Mayston, J, H.
Meade-King, W. T. P.

Temp. Lieut. ... R.A.MX'.

Dental Commandant, E.N. M.S. KDled accident-
ally. H.M.H.S. China.
... E.A.M.C. Eoyal Herbert Hosp.,
Woolwich, 1915 and 1917. M.O.
35th Heavy Artillery Group,
B.E.F. and Egypt, 1916—17.
No. 53 General Hospital, Wi-
mereux, 1917. M.O., Labour
Camp, Blargies, France, 1917 —
19. Ment. in despatches, 1919.
... E.A.M.C. CO. and Surgical Spe-
cialist War Hospital, Hudders-
field, 1915—19. Twice ment.
for war services. C.M.G., 1917.
Surg.-Lieut., E.N.

Temp.
Major
Capt. .

2nd Lieut.
LieuJ. ...

Temp. Capt.
Hon. Col.
Capt

Capt

Temp. Lieut.
Lt.-Col.
Temp. Capt.
Dent. Surg.

N.Z.A.M.C. Died of wounds.

E.A.M.C. Mesopotamia Exp. Force
1916—18. Eoyal Victoria Hos-
pital, Netley, 1918—20.

A.S.C.

E.F.A. M.C., 1917. Killed in
action, 1st June, 1918.

E.A.M.C.

E.A.M.C, T.F.

E.A.M.C Sling Camp, Salisbury,

1915, Tidworth Military Hosp.,

1916. No. 41

Capt.

pital,

19.
E.A.M.C.
E.A.M.C.
E.A.M.C
E.A.M.C
Eed Cross

Brighton.
E.A.M.C

Salonika

No.

and

B.E.F.,

Stationary Hos-
France, 1917 —

Ment. in despaitches.
Auxiliary Hospital,

50th General Hospital,^

Ex. Force, 1917—18.

2 London General Hospital

0. i/c Ophthalmic Centre,

Ipswich
Temp. Capt. ... E.A.M.C. 29th General Hospital,

Salonika.
Sub.-Lieut. ... E.N.Y.E. Att. E.N.A.S. Killed

in Bulgaria, March 30th, 1917.
Wireless Telegraph Operator, E.N.E. H.M. Yacht

lolaire.
Commander, E.N. H.M.S. Pembroke.

Surg.
Hon. M.O.

Temp. Capt.

Capt

Lt.-Col.
Temp. Capt. ..
Temp. Major ..

Fairlawn Military Hospital, Honor

Oak, S.E.
E.A.M.C Civil Surgeon, Military

Hospital, Eeading.
E.A.M.C, T.F. 26th Field Amb.,

B.E.F.

E.A.M.C
E.A.M.C.
E.A.M.C

lance.
1918.

Ment. for war services.

Attached Border Eegt.

Wessex Field Ambu-

Prisoner in Germanv,.

Boll of War Service.

173

3ieaees, a. l. d...

Medlock, C. H. .
Messenger, H. L. .,

Messext, E. J.
Metcalfe, B. B.
Mew, G. M.
Meyrick-Jones, H. M.

MiCHELL, E. ...
3IICKLEM, T. E.

Miller, A.
Miller, A. A.

Miller, A. H.
Miller, E. A.
Miller, F. C.

Miller, G. S.

Miller, W. H.
Millett, H. ...

MiLLIGAN, E. A.

Mills, C. H.
Mills, P. S.

Mills, T. I.

Milne, J. B.
MiLNEE, A. E.
Milton, E. F.

Milton, Leonard
Milton, W. T.

MiLWARD, J. K.

]\[inett, E. p.

Temp. Capt.
Capt

Temp. Capt.
Temp. Capt.
2nd Lieut.
Capt

Government Dist. Examiner of Ee-
cruits, Sydney, N.S.W.

E.A.M.C.

E.A.M.C. No. 28 General Hosp.
67th Field Amb, 191G— 18. M.O.
i/c 12th Cheshires. 31.0. i/c
22nd Divisional Train. Ment.
in despatches, British Salonika
Force, 1916—19. M.C., 1918,
Bar to M.C., 1918.

Sussex E.G.A., T.F.

E.A.M.C.

1st Eo3^al Irish Eifles.

E.A.M.C. X-ray Specialist, Xo.
15 General Hospital, M.E.F.,
1916. Codford Military Hospital
l916. No. 30 General Hospital,
B.E.F., 1916—17. S.M.O. The
Priory Eed Cross Hospital, Chel-
tenham, 1917 — 19.

E.A.M.C, T.F.

E.A.M.C, S.E. 121 Field Amb.,
Damascus, Mesopotamia.

I.M.S.

E.A.M.C. 24th CCS. Ment. in
despat-ches, Italv, 1918.
Temp. Hon. Lieut., E.A.M.C.
Temp. Capt. ...* E.A.M.C

... Universities and Public Schools
Battalion.

Capt E.A.M.C No, 1 Field Ambidance.

Killed in Action, Sept. 8th, 1916
Surg. Sub.-Lieut., E.N. H.M.S. Fervent.

E.N., late Lieut. Eoyal Maiinee,
E.N.D. Ment. in despatches,
Dardanelles, 1915.

E.A.M.C, T.F., 1914—15. 1st
Eastern Hosp., Cambridge.

E.A.M.C

I.M.S. D.A.D.M.S., M.E.F. Men-
tioned in despatches, 1917.

E.A.M.C, T.F. 2/1 West Eiding
Field Ambulance.

E.A.M.C. Attached E.F.A.

Capt.
Temp.

Capt.

Lt.-Col.
Act. Major

Temp. Surg.

Major ...

Temp. Capt.
Major ...

Capt

Capt. .
Major
Temp.

Capt. .
Temp.
Surgeon

Major ...

Lieut.

E.A.M.C.
E.A.M.C

B.E.F.
E.A.M.C.
E.A.M.C
Sub.-Lieut., E.N

Crimea,

89tli Field Ambulance,

M.C, 1918.

Sea and

V.E. Black

1918—19.
E.A.M.C, T.F. Water Officei', Oth
London Field Amb., 1914—16.
60th London Division, B.E.F.,
1916—16. 60th Division, Salo-
nika, 1917. Officer i/c Water
Supplies, 60th Div., Palestine,
1917. M.O.H. Jerusalem and

174

Roll of War Service.

Mi NEXT, P. r.
Minns, A. G.
Minns, A. N.

Mitchell, D. A.
Mitchell, H. E. H.
Mitchell, H. V. ...

MOBEllLY, A. V.

Moffatt, H. a. ...

Monaghan, p. J. ...

Monk, G. B.

Montgomery, K.
Moon, K. 0.
Moore, A. G. H. ...
Moore, J.
Moore, J. Y.

Moore, L. W.

Moore, P. W.

Moore, R. A.

Morgan, E

Morgan, E. C. deM.
Morgan, M. J.
Morgan, 0. G.

Morgan, W

Morley, T. S.
Morrell, F. H.

MORRES, E

Morris, Arnold

Morris, G. H.
Morris, H. W. G. ...

Morris, LI. A.
Morris, 0. Gwyn .,

Morris, \y. E.
MoRRisn, D. B.

Morrison, J. H. L.
Morrison, J. T. J.

P.M.O., Haifa District, Pales-
tine, 1917—18. M.O., No. 6
Military La,boratory, Egypt, ^918
— 19. Twice in/erit. in d€sp.

Surg. Lieut. -Commander, R.X.

Civil Practitioner, I/c Troops 69th (E.A.) Division.

Capt R.A.M.C. 13th and 39th E.A.

Twice mentioned in despatches
(Mesopotamia and Gallipoli) .
D.S.O. M.C.

Surg. Commander, R.K. H.M.S. Diamond.

Temp. Capt.
Temp. Capt.
Temp. Lieut.
Lt.-Col.

Capt

2ad Lieut.

Capt

Major...

Capt

Temp. Lieut.
Act. Major .

Act. Capt. *.

Capt

Lieut. ...
Temp. Capt.
Temp. Surg.
M.O. ...
Temp. Capt.

R.A.M.C.

R.A.M.C. Resigned.

R.A.M.C.

S.A.M.C. Mentioned for services,
German South West Africa (sur-
gical Specialist.) D.S.O., 1917.

S.A.M.C. 1st Field Amb. South
African Expeditionary Force.

2nd Battalion Royal Warwicks.
Killed in action, 1914.

R.A.M.C, S.R. Mentioned in desp.

R.A.M.C.

R.A.F. Medical Board.

R.A.M.C.

R.A.M.C. Ment. in despatches,
GaUipoli. O.B.E., 1919, France.

Gloucester Regiment. Killed in
action, August 29th, 1916.

R.A.M.C. Ment. in despatches
(Egypt), 1918.

r.g.a"!

R.A.M.C.

R.X. H.M.S. Victory.
Aberystwith Red Cross Hospital.
R.A.M.C. Noj. 9 British Red Cross

Hospital.
Temp. Lieut. ... R.A.M.C,

Mounted
Admiralty Surgeon
Temp. Capt.

T.F. Welch
Brigade Field

Border
Amb.

R.A.M.C. Mentioned in despatches

(Salonika), 1918.
R.A.M.C
R.A.M.C, T.F. Royal Warwick

Regiment. Wounded, 1917.
R.A.M.C
Civilian Dentist to Royal Engineer Camp, Houghton

Regis.
Attached R.A.M.C.
Royal Welsh Fusiliers. Late 6th

Welsh Regt., 1916, and Artists'

Rifles, 1915—16. Wounded, 1918.
R.A.M.C.
King's Own Yorks. L.I. Killed in

action in France, August 18th,

1916.
R.A.M.C, T.F.
R.A.M.C. 1st Southern General

Hospital.

Temp. Capt.
Capt

Temp. Capt.

Dent. Surg
Lieut. ...

Temp. Lieut.
2nd Lieut.

Lt.-Col.
Major ..

Boll of War Service.

175

Mossoi', C. H.

MOTHEESOLE, K. D.

MOTIRAM, G. N.
MOTTKAM, M.
MOYLE, H. H.

mugford, j. l.
Muir-Smith, E. a.
Mum-SMiTH, H.
Muir-Smith, L.

MULLALLY, G. T.

MULLINS. H. R.
MULLINS, R. C.

MUMFOED, W. G.

MUNDAY, R. B.
MUXDEN, M. M.

MuNRO, D. T.

MUNRO, H. ...

Murphy, Sir Shirley

Murray, C. M.

Murray, H. S.
Murray, R. W.

musgrove, e. !!• .

Myott, E. C.

Temp. Capt.
Temp. Lieut.

Temp. Lieut.
Temp. Capt.
Lieut. ...

Lieut. ...
Capt

Lieut. ...
Act. Major

25th General
31 CCS.

Hospital

India.

143rd Field Ambulance,
Salonika Force,

Major

Temp. Major
Temp. Capt.

Temp. Capt.

Prob. Flight
Lieut. ...

R.A.M.C.
. R.A.M.C

and No.
R.A.M.C
R.A.M.C
R.A.M.C

28th Division,

1917.
R.A.M.C (D.)
R.F.A.

1/7 Middlesex and M.G.C
R.A.M.C. 25th CCS. and 32nd

Field Ambulance, Salonika, 1916

—19. Caucasia (Baku), 1919.
R.A.M.C, S.R. Surgical Specialist

No. 8 CCS., B.E.F., France,

] 911—18. Mentioned in
patches, 1916. M.C, 1917

S. African M. Corps.

S.A.M.C. No. 1 S. African
Hospital. Mentioned for

des-

Gen,
war

MUNDEN, W. P. H. Capt...

services
1915.

... R.A.M.C
tioned
1919.

Sub. -Lieut.

... R.A.M.C.
1917.
—18.

... R.A.M.C

German S.W. Africa,

Surg. Spec. Twice men-
in desp., 1918. O.B.E.,

Temp. Surg.
Temp. Capt.
Lt.-Col.

Act. Lt.-Col.

Major ...

Capt

Temp. Capt.

89th Field Ambulance,
2nd Royal Fusiliers, 1917
Belgian Croix de Guerre.
Attached 16th Sherwood
Foresters. B.E.F., France, 1916.
M.O. i/c Reserve Cavalry Alder-
shot, 1917.
R.N.

R.A.F
R.A.M.C Mentioned for war ser-
vices. K.B.E., 1919.
S.A.M.C. Twice mentioned in des-
patches, 1917—18. D.S.O., 1918.
R.F.A.
R.A.M.C. Resident Surgeon, Fa-

zakerley Hospital,
R.A.M.C. South Wales Borderers.

Aden, Arabia, India.
R.A.M.C.

Nash, L. G.
Neal, F. D.
Neely, H. B.

Neely, W. G. S.
Nelson, K. M.

NllWLAND, W. D.

Lieut. ...

2nd Lieut.

Temp. Capt,
Temp. Capt.

Temp. Capt.

R.A'.M.C

3rd Batt, Suffolk Regt, Killed in
action, Ypres, April 25th, 1915.
143rd Field Ambulance.
Mentioned in despatches,
M.C, 1917, Wounded,

R.A.M.C.
R.A.M.C.

1917.

1917.
R.A.M.C

92nd Field Ambulance.

M.C, 1918.

176

Uoll of War Service.

Newlaxd-Pedley, F.
Newman, F. C.

NiCUOLLS. E. C.

.. Lieut

NicnoLLS, F. J.
Nichols, W. If.

.. Anaesthetic ...
.. Capt

Nicholson, C. R. .

.. Major (Act. Lt

Nicholson, J. W.
NicoL, Burton

NiNNIS, R. P.

NOEBUBN, A. E.

NoEMAN, Albert

NOEMAN, T. ...

NORTHCOTT, J. F.

NUNN, G. ...
NUTMAN, B. K.

Dental Surgeon, No. 2 Red Cross Hospital, Rouen.
Temp. Surg. -Lieut., R.N. H.M.S. Commcm/u:ealih.
Mentioned for war services, 1919
Royal Berkshires. Wounded; in-
valided out.
Kempston Red Cross Hospital.
R.A.M.C. Accidentally killed in
India, February 22nd, 1916.
Col.), R.A.M.C. C/o St. Ignatius
Hospital, Malta. Served with
British Hospital attached to Ser-
bian Army. Mentioned in des-
patches, 1918. Order of St.
Sabe, 6th Class, by King of
Serbia.
R.A.M.C. No. 1 General Hospital.
S. African M. Corps. German E.

and S.W. Africa.
R.N. H.M.S. Neptune, Esquire
of Order of St. John of Jeru-
salem.
Bath War Hospital.
Hon. Staff of King George Hospital.
Surg. Lieut, ... R.N. H.M.S. Comus. Mentioned

for war services, 1919.
Surg H.M.T. Mahoa, 1917—19. Em-
ployed in Mediterranean.
Surg. Commander, R.N. Wounded. O.B.E., 1919.
Temp. Lieut. ... R.A.M.C.

Lt.-Col.
Temp. Major

Temp. Surg.

Surg.

Gates, J. L.

O'Callaghan, T. T.
Odgers, N. B.
Ogilvir W. H.

Ogilvte, W. H.

Olivee, C. H.

Olivee, N. ...

Ollis, M. S....
O'Meaea, E. J.

O'Meaea, D. J.
Oeam, R. G....
Oechaed, H. p.
Oed, a. G....
Oedish, F. J.
Oemond. a. W.

... Universities and Public Schools
Battalion, Naval Division. Killed
in action, 1918.

Temp. Lieut. ... R.A.M.C. Karachi, India.

Temp. Major ... R.A.M.C.

Temp. Col. ... I. M.S. Mentioned in despatches,
E.E.F., 1918. C.M.G. Order
of the Nile (3rd Class), by Sul-
tan of Egypt, 1919.

Temp. Capt. ... R.A.M.C. No. 5 General Hospital,
France.

Temp. Lieut. ... 14th York and Lancaster, Machine
Gun Officer.

Temp. Capt. ... R.A.M.C. I/c No. 4 Hospital for
Officers, Ham Common.

Civil Dental Surgeon. H.M.S. Irnpregnable.

Lt.-Col. ... I. M.S. Principal, Medical School,

Agra. O.B.E., 1919.

Surg. Sub. Lieut. R.N.V.R.

Act. Major ... R.A.M.C.

Capt Territorial Force.

Surg. Sub.-Lieut., R.N.V.R. H.M.S. Forester.

Lieut Essex Regiment.

Brevet Major ... R.A.M.C, T. Ophthalmic Spec,
to London District. 0/c Ophth.
Dept. 2nd London General Hos-
pital, 1914 — 19. Ophth. Surg.
Sir John Ellerman's Hospital.

Uoll of War Service.

177

Oe:moxd, S. J.
OSBORX, A, G.

OSBORX. r. A.
OsBrEX, A. C.

OSMAN, A. A.

OwEX, J. H...
OwEX, J. M...
Owsley, G. C,

OZAXXE, R. C.

Ophtli. Surgeon St. Dunstan'e
Hostel for Blinded Soldiers, 1914
—19. C.B.E., Military Division,
1919.
R.A.M.C. Hospital at Alexandria.
R.A.M.C., T. M.O., 4th Battalion
Coldstream Guajds. 2 4 Queen's
(Royal West Surrey Regiment.)
Gallipoli (Suvla Bay), Egypt,
and Palestine, 1915—17. H.M.
Hospital Ship Dxinluce Castle.
East Africa, 1917—18.
R.A.M.C.

R.A.M.C. C/o Field Ambulance.
Twice mentioned in despatches,
1917—18. D.S.O. and Bar, 1918

Prob. Sub. -Lieut., R.N. Destroyers of Grand Eleet
Flotilla. D.S.C., 1918.

Capt R.A.M.C, S.R. Wounded, 1914.

Civil Surgeon to Admiralty, Fishguard.

Visiting Ansesthetist Brook War Hospital.

Brevet Major ... R.A.M.C. 22nd CCS. B.E.F.
Mentioned in despatches.

Capt.
Capt.

Temp. Capt. ...
Temp Lt.-Col.

Packer, H. D.
Packham, G.
Paget, P. ...

Paees. a. E. H.
P.4KES, W. C C.

Pallaxt, H. a.

Pall ANT, S. L.

Palmer, A. H.

Palmer, A. S. M.

Palmer, B. H.
Palmer, F. W. M.

Lt.-Col.

Capt

Lt.-Col.

Temp. Capt. ...
Capt. and Adjt.,

Temp. Capt. ...

Major ...

Temp. Capt.

Temp. Capt.
Capt

Palmer,

H. J.

.. 2nd Lieut.

Palmer,

H. T.

.. Temp. Capt.

Palmer,

J. S.

,. 2nd Lieut.

Paxtin,
Paxtix,
Parfitt,

C. S.
W. L.
F. W.

.. Temp. Capt.

.. Capt

.. Pte. ...

R.A.M.C.

R.A.M.C. India. Territorial De-
coration, 1917.

S. African Union Defence Force.

S.A.M.C 4th F.A. German East
Africa.

R.A.M.C. 1st Loyal N. Lanes.
Mentioned in despatches, 1917.
D.S.O. , 1917. M.C. Wounded.
Brevet Lieut.-Col., R.A.M.C. Twice mentioned in
despatches. D.S.O., 1917.

R.A.M.C, T.F. Died of wounds
at Cairo, May 2nd, 1917.

R.A.M.C Commandant, Red Cross
Hospital, Worthing,

R.A.M.C. 1st Royal Lanes. Regt.

R.A.M.C Cliff Hospital, Felix-
stowe, 1916. Nos. IG and 47.
General Hospitals, France, 1916
—17. 35th F.A., 1917. Medi-
cal Specialist, Xo. 1 CCS.,
1917—19.

D. C.L.I. Killed in action near St.
Quentin, March 29th, 1918.

West African Medical Staff. Ca-
meroon Exp. Force.

2nd Durham L.I. Died of wounds,
1st October, 1916.

R.A.M.C.

A.S.C

178

Parker, W. G.

Parkes, H. p.
Parmiter, B R.

Roll of War Service.

Capt.

2nd Lieut.
Capt

Parry. J. H.

Parry, L. A.
Parry, R.

Parry-Jones, 0. G.

Parry-Price, H.
Parsons. J. E. H.
Partridge, A. H.
Parieidge, W. L.

Passey, R. D.

Lieut. ...

Temp. Capt.
Temp. Lieut.

Capt.

Surg,
M.O.
Red

Lieut.

R.A.M:.C. Nos. 24 and 20 Sta-
tionary Hospitals, Egyptian Ex.
Force, 1916—18. Nt>. 8 P.O.W.
Hosp., Belbeis, Egypt, 1918—10.

R.A.M.C. Connaught Hospital,
Aldershot; No. 15 General Hos- /
pital, Egypt; attached Ctli
R.I.F., Salonica, 1915. 32nd
Field Ambulance, Salonika^
Egypt and Palestine, 1916 — 17.
No-. 15 General Hospital, Egj'^pt,
Nos. 4.S and 67 General Hos-
pitals, Salonika. Attached 3rd
K.R.R.C. and Sth O.B.L. I., Con-
stantinople, 1919.

I.M.S. Hospital Ship Glengorm
Castle.

R.A.M.C.

R.A.M.C. M.O. I/c Auxiliary Hos-
pital, Carnarvon.

R.A.M.C, S.R. Mentioned in des-
patches. Died of wounds.

R.N. H.M.S. Lion.

261st Coy. R.D.C.

Cross Hospital, Sutton.

R.A.M.C.

M.C.

Capt
Temp. Capt

14th Gloucester Regt.

R.A.M.C.
—15.

Gordon

Paul. F. T....

Paul, F. W.
Payne. J. Lewiu

Payne, 0. V.

Payne, W. ^Y.
Peacock, R. ...
Peall, G. H.
Peall, p. a.

Pearce, D. G.

Pearce, F. J.

Pearson. G. B.

Dent
Hon.

B.E.F., France, 1914
Late 2nd Lieut., 3rd
Highlanders, B.E.F.
(combatant commission), 1915 —
17. B.E.F., & Italy, 1917—19.
M.O., 18th K.R.R., "& Bacteriol.
66th General Hospital, 1917 —
19. M.C, 1918. Wounded, 1916.

Major R.A.M.C, T.F. Surgeon, No. 1

Western General Hosp., 1915—
"18. Consulting Surgeon, Western
Command till 1919.
Surg. ... H.M. Hospital Ship Garth Castle.
Consulting Dental Surgeon to Richmond Mili-
tary Hospital and Belmont Mili-
tary HospitaL O.B.E., 1919.
Temp. Capt. ... R.A.M.C 49th Stationary Hos-
pital, Salonika.
Surg. Sub. -Lieut., R.N.V.R.

Killed in action. October, 1916.
East African M.S.
R.A.M.C. City of London War
Hospital.
... 1st East Kent Regiment. Killed
in action, September 3rd, 1916.
Dental Surg, to .Military Hospitals of
London, attached 1st London
General Hospital. Dental Sur-
geon, American Red Cross Hosp.

Capt R.A.M.C. Royal Berks. Hussars.

Wounded at GaUipoli. Egypt.

Capt

Temp. Major

Capt

Hon. Cons.

^oll of War Service.

179

Pearsox, J. D.
Peaeson, M. ...
Peatfield, S. J.

Peaty, A. E.
Pedley, C. F.

Pendlebuky, J. P.

Pedrick, p. Y. G,
Penfold, W. D.

Penny, C. H. G.
Penny, E. A.

Peeceval, J. L.

Percival, H. F.

Peeegrine, H. L. P

Perkins D. S.
Perkins, H. E.
Pern, L.
Peen, Montague
Petee, G. F.
Petees, E. a.
Petley, C. E.

Capt.
Temp.

R.A.M.C.

Surg. -Lieut., R.X.

2ad Lieut.

Temp. Lieut. ...
Surg

Senior IMedical

Hon. Lieut. ...

Capt

Temp. Major

Capt.

Temp.

Surg.

Temp.

Surg.

Temp.

Act. Major

Lieut.
Lieut.
Capt.
Lieut.
Lieut.
Capt.

Roval Berkshire Regiment. Att.
M.G.C. Died of wounds, 1916.
R.A.F., Dental.
Belgian Field Hospital. Chev. de

rOrdre de la Couronne, 1916.
Officer, Ormskirk Auxiliary Military
Hospital.
.. R.A.M.C.
.. Universities and Public Schools

Battalion.
.. R.A.M.C, later I.M.S.
.. I.M.S. M.O. 14th Lancers, Indian

Army. Mesopotamia.
.. R.A.M.C, S.R. 132nd Field Am-
bulance, B.E.F.
Lieut., R.N. H.M.S. Africa. O.B.E.,

1919.
.. R.K". Haslar Hospital, 19J5. H.M.
Hospital Ship China, 1915—18.
att^ehed Grand Fleet. H.M.S.
Orescent, Rosyth, 1918, for oph-
thalmic duties.

H.M.H.S. Goorkhfi.
R.N. H.M.S. Pembroke.

.. R.A.M.C
Commander.
.. R.A.M.C
.. R.A.M.C
.. R.A.M.C.
.. R.A.M.C
.. R.A.M.C.
Rcgrular

Killed in action, 1915.

Piiillipps, W. a.

Phillips, E.

Act. Major

Act. Lt.-Col.

Phillips, E. S.

Temp. Lieut.

Phillips, F. B. W....

Temp. Capt.

Phillips, G. R.
Phillips, R. E. G. ...
Phillips, W. J.
Phipps, J. H.
Pickett, L. R.
Picton-Phillips, W. E.

Temp. Capt.

Capt

Lt.-Col.
Temp. Capt.
Capt

(T.F.), transferred to
Force after Armistice.
2/4" London F.A., B.E.F., 1916.
B.S.F., 1916—17. E.E.F., 1917
onwards. No. 121 Combnd India
F.A. Sanitary Officer Cairo-
Dist. (D.A.D.M.S., Cairo Bde.)
Mentioned for war services,
1917. M.C, 1918.

R.A.M.C. Attached East Kent
Regt., 1915. I/c Medical Divn.
Fort Pitt Military Hospital,
Chatham, until July, 1918. Twice
mentioned for war services.

R.A.M.C. Twice mentioned in des-
patches, 1918. M.C, 1918.
Croix de Guerre, 1919.

R.A.M.C Prisoner in Germany,.
1918.

R.A.M.C 1st Bedford Volunteer
Rog-iment.

R.A.M.C. Wounded, 1918.

R.A.M.C

A A M C

A.'m.c! ' O.C 5th Australian F.A.

17th King's Royal Rifle Corps..

R.A.M.C. M.O. 1st Batt. Welsh
Guards.

180

Roll of War Service.

Pierce, 0. E.
Pigeon, H. W.

PiGGOT, A. p.

Pike, D. R. ...

PiLBEAM, E. L.

Pilbeam, L. S.

PiLCHER, E. M.

Pitman, K. C.
Pitt, G. N. ...

Platt, D. H....

Platt, H.

Plumley, a. G. G.
Plummer, W. E.
Plumptre, C. M.

POCOCK, T. C.
Pollard, C. A.
Pollard, G. S.

Pollock, C. E.

:POLLOCK, R. G.

Pomeroy, J. M.
Ponder, C. \V.

Ponder. R. R. B....

POOCE, G

Poole, S. K.

Poole, T. B.

-portway, r. l.
Powell. J. E.

Powell-Smith, C. ...
poyser, r. c.
Prall, S. E.

Prentice, Z.
;Prentis, J. E.
-Pretoeius, W. J. ...
Price (son of J. Dodds
Price, C. E.
Price, E. S.

Price, H. P.

Temp. Capt.
Temp. Capt.
Temp. Capt.
Temp. Capt.
Temp. Capt.
Lieut. ...
Lt.-Col.

lion. Lieut.
Major ...

Capt

Temp. Capt.
Lieut. ...
Capt

Capt

Major ...
Lt.-CoL

Lt.-Col.

M.O. ...
Temp. Capt.
Capt

R.A.M.C.
R.A.M.C.
R.A.M.C.
R.A.M.C.
R.A.M.C,
R.A.M.C,

Attached R.A.F.

B.E.F.

Dental.
Dental.
R.A.M.C. Mentioned in despatches.

191S. Ment. for war services.

CB. 1918. CB.E. 1919. D.S.O.
R.A.M.C
R.A.M.C, T.F. 2nd London

General Hospital and King

George Hospital. O.B.E., 1919.
R.A.M.C, T.F. City of London

Field Ambulance.
R.A.M.C, T. 2nd
Hospital.

Western Gea.

R.A.M.C,
R.A.M.C
I.M.S.
1918.
R.A.M.C
R.F.A.
R.A.M.C.

M.E.F

iMentioned in
^Mesopotamia.

despatches,

Wounded.

Lt.-Col. 4th Somerset
Light Infantry, 1914. Recruiting
Officer, 1914—16. Taunton Mili-
tary Hosp., 1914 — 15. Medical
Board, 1916—19. V.D.
A.M.S., H.Q. Stafe, B.E.F. Three
times mentioned in despatches.
CB.E., 1919. D.S.O.
Warlingham Camp.
R.A.M.C, Dental.
R.A.M.C. Research in cerebro-
spinal meningitis for Local
Government Board.

Civilian Dentist.
Dent. Surg. ...
Surg

Royal Naval Division.

Duchess of Portland War Hospital.

Chesterfield.
M.O I/c OverclifP Red Cross Hospital,

Westcliff-on-Sea.
Temp. Capt. ... R.A.M.C
Temp. Lt.-Col. R.A.M.C. Mentioned in despatches

D.S.O., 1917.
2nd Lieut. ... Durham Light Infantry.
Temp. Capt. ... R.A.M.C.
Lt.-Col. ... I.M.S. H.M. Hospital Ship Glm-

(jorm Oastle. Mentioned in

despatches, 1917.

M.O No. 70 Kent V.A.D. Hospital.

Temp. Lieut. ... R.A.M.C Alexandria.

Trooper ... King Edward's Horse.

Price), Lieut., King's Royal Rifles. France.

Temp. Capt. ... R.A.M.C.

Capt R.A.M.C. 0/c 3/6 London Field

Ambulance.
Temp. Surg. ... R.N. North Sea, Gallipoli, and

Atlantic Patrol.

Roll of War Service.

181

Peice, J. A. P.

Prideaux, a. E. D.

Peixce, p. C.
Pritchaed, G. B.

PUGK, H. S.

Punch, A. L.
PuEDo:jr, H. N.

purdom, w. b.
puekiss, k. n.

Pye-Smith, C. D.

Ma J 01

Temp. Capt.
Act. Major

R.A.M.C, T.F. I/c Surgery Sec-
tion, Reading War Hospital.

Dorset Volunteer Regiment. Trans-
port Department.

R.A.M.C.

R.A.M.C, T.F. 2/dt London Field.
Ambulance. B.E.F., 1916.

B.S.F., 1916—17. E.E.F.,

1917—19. 121st Combined In-
dian F.A. Mentioned in des-
patches.

Wounded, 1918.
Died in Belgium, 1915.
Deputy Surg. -General
. Hospital, Gibraltar^
1914—16. Deputy Surg. -General
R.N. Hospital, Plymouth, 1916.
Surg. General and Surg. Rear-
Admiral I/c R.N. Hospital, Ply-
mouth, 1917—19. C.B., Civil,
1918. K.B.E., (Military), 1919.

Capt R.A.M.C, Dental. 1st CCS

Temp. Surg. ... R.N. H.M.S. Pembroke.
Civil Dental Surgeon to Troops, Red Cross Hospital,
Clevedon.
R.A.M.C. D.S.O. M.C.
R.A.M.C. 20th Combined Field
Ambulance I.E.F. M.C, 1919.
R.A.M.C. 69th F.A. M.C, 1916.
D.S.O. and Bar, 1917. Twice
mentioned in despatches, 1917 —
18.

Pritgiiett, H. N. .

. Capt.

R.A.M.C.

Peobert, C M.

. Surg.

Sub.-Lieut., R.N.

Pryx, R. H. C

.. Capt.

R.A.M.C.

Pryx, W. R.

. Lieut.

R.A.M.C

Pryx, Sir W. W. .

.. Surg.

Rear-Admiral, R.N
I/c R

Act. Lieut. -Col.
Capt

Lt.-Col.

Rahm.\x, M. a.

Raii'max, W. R.
Ralph, C D. H. D.
Raxd, T. a.
Randall, C N.
Raxdell, R. M. H.

Raxkixe, J. L.
Rankine, R. a.

Ransford, a. C.
RAXsroRD, J. E.
Ransford, L. V. ...

Brevet Major ... I.M.S. No. 12 Meerut Indian
Gen. Hosp., I.E.F. Franc6, 1914
— ^^15. Senior M.O. Sistan Field
Force, 1915—17. D.A.D.M.S.,
Eastern Persian Codon Field
Force, 1918. D.A.D.M.S., L.ofC.,
East Persia Field Force, 1918—
19. Twice ment. in despatches.

Lieut 1st Battalion 10th Gurkha Rifles.

Senior M.O. ... Colonial Med. Service.

Lieut 2nd Wessex R.F.A.

Temp. Lieut. ... R.A.M.C.

Temp. Capt. ... R.A.M.C, T.F. V.A.D. Hospital,
Kent.

Major R.A.M.C.

Temp. Surg. ... R.N. H.MS. Latona. O.B.E,,
1919.

Capt R.A.M.C.

Capt R.A.M.C, T.F. 2/7 Lanes. Fus.

Capt R.A.M.C, T.F.

182

RA^•SFOIlD, W. R.

Rashleigh, H. G.
Rattray, M. G.
Rawnsley, G. T.

Ray, E. R. ...
Raynek, a. E.

Raywood, J. R. I.

Read-W.lson, a.

Reader, N. C. M.
Reader, S. ...
Reckitt, Chas. E.

Reed, J. C. G.
Rees, G. ]I.
Rees, M. J.

Reeve, E. F.
Reeve, H. M.
Reeve, W.

Reeves, Albert

Reid, a.

Reid, Edgar
Reinhold, C. II.

Remington. W.
Rexdall, R. M.
Reynell, W. R.
Reynolds, A. J.
Reynolds, L. G.
Reynolds, L. L. G.

Reynolds, RusseU J.

Reynolds, W.

Roll of War Service.

Act. Major ... l/U Gurkha Rifles. 2nd Lieut..
Indian Army Reserve of Officers,
1915. 10th Gurkha Rifles, Bur-
ma and India, 1915 — 17. Served
as Company Commander, Meso-
potamia, with 5th Gurkha Rifles
(Frontier Force), 1917—18.
N.W. Frontier and Afghanistan,
1919. Medal and Clasp, Afgan-
istan, 1919.

Temp. Lieut. ... R.A.M.C.

Temp. Lt.-Col. R.A.M.C. I/c Field Ambulance.

Lt.-Col. ... A. M.S. Three times ment. in des-

patches, 1916—17—18. Salonika.
C.M.G., 1916. C.B, 1918.

Surg County of London War Hospital.

Act. Major ... R.A.M.C, T.F. Mentioned in des-
patches, 1917. O.B.E., 1919.

Col A.M.S. A.D.M.S., Midland Divi-
sion. 48th Div. T.F.

Temp. Lieut. ... R.A.M.C. Served in Ireland, Bel-
gium and France, 1914 — 15.

Capt R.A.M.C.

Temp. Lieut. ... R.A.M.C.

Temp. Surg. ... R.N. Died at Haslar Hospital,
1917.

Fleet Surg. ... R.N. H.M.S. Thunderer.

Major R.A.M.C.

Temp. Capt. ... R.A.M.C. Wounded October 22nd
while attending wounded under
Fire. Died of wounds, October
1916.

Capt R.A.M.C.

Temp. Lieut. ... R.A.M.C.

Capt F.A. Section, National Reserve of

New Zealand.

Capt R.A.M.C. M.T. Reserve Depot,

A.S.C., Grove Park and Upper
Norwood, 1916 — 19.

Capt R.A.M.C, T.F. 1st London Sani-
tary Company, 1915. O.C 57tli
Sanitary Sect., 1916. Specialist
Sanitary Officer, 1917.

Major R.A.M.C. 3rd Western General

Hospital, Cardiff.

Temp. Lieut.-Col., I.M.g. lUth Indian Field
Amb. E.E.F. Twice ment. in
despatches. M.C

Pte Artists' Rifles.

Lieut R.A.M.C.

Capt R.A.M.C. The Coulter Hospital,

Dental Surgeon to troops, Yarmouth.

Temp. Lieut. ... R.A.M.C.

Lt.-Col. ... I/c 1st Battalion Oxford & Bucks

L.I. D.S.O. Wounded.

Temp. Lieut. ... R.A.M.C. Radiologist to Tooting
and Streatham War Hospital.

Capt R.A.M.C. Canadian A.M.C.

Roll of War Service.

183

Keyxolds, W. L. E. Capt. ..

Rice, H. G. ...

ElCHAEDS, D. 0.

Richards, E. H.

KiCHARDS, E. H. R.

Richards. J. F. G.

Richards, J. G.

Richards, L. P.
Richards, N. L.
Richards, Owen

Richardson, I. K.
Richardson, H.

Richardson, P. L.
Richardson, W. S.

Riches, L. V. H.

RiDDIOUGH, S.
RiGBY, J. A. ...

Riley, C. Meadows
Ring, C. A. E.

RiPMAN, C. H.
RiSDON, T. 0.
Rivers, A. T.

Capt.
Capt.

Ordinaxy Seaman
2nd Lieut.
Capt

2nd Lieut.

Temp. Lieut.
Fleet SuTg.
Temp. Capt.

Stafif Surg.
Temp. CoL

Surg. Sub.
Capt

Temp. Lieut.
Lieut. ...
Temp. Major
Surg. Lieut.
Lieut. ...
Temp. Lieut.

R.A.M.C. o6th Field Ambulance,
1915—16. M.O. i/c 7th Batt.
Royal West Kent Regt., 1916—
18. loth Convalescent Depot,
1918. 2nd Cavalry Div., B.E.F.
and Germany, looth Field Am-
bulance, North Russian Relief
Force, 1919. M.C., 1917.
R.A.M.C. Attached Durham Light

Infantry. Salonika. Wounded.
R.A.M.C. 29th General Hospital.
68th Field Ambulance. M.O. i/c
9th K.O.R.L. Regt., Salonika,
1916—17. River Sick Convoy
Unit, M.O. i/c Paddle Ambu-
lance, No. 2, Mesopotamia, 1918
—19.

R.N.D., Crystal Palace. In-
valided, May, 1916.
21st Manchesters. Killed in action

at Croisilles, April 2nd, 1917.
R.A.M.C. loth F.A. Ment. in

despatches. D.S.O., 1918.
66th East Lanes. Divisional Cyclist

Company. T.F.
R.A.M.C, Dental.
... R.N.
... R.A.M.C.
D.S.O.
... R.N.
... R.A.M.C.

Twice mentioned
Egyptian E.F.
Lieut., R.N.V.R.
... R.A.M.C, T.F. Sui'g. Specialist,
No. 29 CCS. Served in Bel-
gium, France and with Army of
Occupation in Germany.
R.A.M.C, DentaL
S.R.
T.D.

Ment. in despatches.

D.S.O.

1918. A.D.M.S.
in despatches.

R.A.M.C.

R.A.M.C

R.N.

R.A.M.C.

Salonika.

Roberts, Astley C... Col

Surg. Lieut. Commander, R.N. Mentioned in des-
patches. Radiographer, Chatham
Hospital.
O.C 2nd Home Counties Brigade
~ India.

B.E.F. Ment.

R.F.A.

Roberts,

S. Lane

Temp. Capt. ...

R.A.M.C

Roberts,

W. 0.

Lieut

R.A.M.C

Roberts,

Temp. Capt. ...

R.A.M.C.

Roberts,

Jones ...

Lt.-Col.

R.A.M.C.

Roberts,

Surgeon Colonel

, National

Roberts,

Temp. Capt. ...

R.A.M.C

Roberts,

J. '.'.'.

CM.P.

CO. Aux

Reserve. V.D.

Y Hospital,
and M.O. i/c Troops,
District.

in desp.

Ventnor,
Ventnor

184

Boll of War Service.

KOBERTS, R. T. F. D.,
Roberts, T. E.

RouERTS, T. H. F. .
Roberts, W. 0.
ROBERT,><ON, E. Guy.
Robertson, G. S. .
Robertson. J.

Robertson, J. C.

Robertson. J. F.
Robinson, F. C.
Robinson, G. C.
Robinson, J. F.

Robinson, J. 11.

Robinson, W.
Robinson, W. B.
Robinson, W. E.
Robinson, W. H.

ROBSON, T. S.
Robson, W. M.
Roche, E. H.
rodgers, x. p.

Rogers, F. E. W

rogerson, f.
Rook. A. F. ...
Rook. H. C.

RooKE. E. M.
RooME, A. M.

ROONEY, J. J. F.

Roper, R. S.
Rose, Percy ...
Rosenberg, I.
Ross, J. Hampden

Temp.
Capt.

Burg- Lieut., R.N.
Haslar

Teinp. Capt.
Temp. Lieut.
Temp. Capt.
Temp. Capt.
Lt.-CoL

2nd Lieut.

Capt
Surg

Capt

Temp. Capt.

action,

R.A.M.C,

Commander, R.N.
R.A.M.C

H.M.S. 8.ydney and
Hospital.
R.A.M.C. T.F. No. 62 Field Aiiib.
B.E.F., 1915—18. No. 5 and
53 C.C.S., 1918. No. 39 Sta-
tionary Hospital, Lille, 1919.
Wounded.
R.A.M.C.
R.A.M.C.
R.A.M.C.
R.A.M.C.

R.A.M.C. Mentioned in despatche;,
1917. Mentioned for war ser-
vices, 1917.
Cameron Highlanders, Killed in
1917.

Ment. in despatches.
H.M.S. Forward.

Died 28tli Oct., 1918.

Lt.-Col.

Temp. Major
R.M.O.

Anaesthetist .
Lieut. ...
Temp. Lieut.
Temp. Major

Capt

Hon

Act. Major

R.A.M.C. 2/2nd South Midland
Field Amb., and 3rd Southern
General Hospital.

R.A.M.C. DA.D.M.S. 2nd Ravval
Pindi Division.

R.A.M.C. Sunderland War Hosp.

Chelsea Military Haspital. Died.
King George Hospital.

R.A.M.C. Mesopotamia, 1916—17.

R.A.M.C.

R.G.A. M.C., 1916.
Dental Surgeon to Auxiliary Military Hosp.^
SouthaU.

R.A:.M.C., T.F. Ment. in des-
patches, 1918.

Temp. Lieut. ,
Temp. Capt. ,
Brevet Major

R.A.M.C.
R.A.M.C.
R.A.M.C.

Temp. Capt.
Temp. Capt.

Lieut. ...

Temp. Lieut.
Temp. Capt.

Pte. ...

Attached R.A.F.
S.R. No. 4 Cavalry
Field Ambulance, 1914, B.E.F.
11th Gloucester Regt., 1915. Ca-
meroon Exp. Force, 1915 — 16.
Ophthalmic Resident, 2nd Lon-
don General Hospital. Chelsea,
1917—18. D.A.D.M.S. Allied
Forces, Archangel, North Russia.
1918 — 19. Ment. for services
rendered in England, 1917.

R.A.M.C.

R.A.M,,C. Attached 1/7 Highland
Light InfantX}'.

4th Lancashire Fusiliers. Attached
to 1st and 10th Batt., B.E.F.,
1915 — 18. Twice wounded.

R.A.M.C.

R.A.M.C

4th Devon T.F. Died of wounds
in Mesopotamia, 5th June, 1916.

Boll of War Service.

185

RouTii, Chas. F.

Rouw, R. Wynne
ROAVELL, G. ...
ROWELL, H. Ellis

Rowland, E. W. S.
Rowland, F. W.

Rowlands.. R. P.

Rowlett, a. E.

liuCK, C. F. L.
RuDD, F. E.

RU.^SELL, G. H.

Russell,. J. W.

Rust, A. B. WiUs

Ryan, T. F.

Rycroft, E. C.
Ryffel, J. H.
Ryle, J. A. ...

Ryley, C. M.

Lt.-Col. ... R.A.M.C. M.O. i/c Med. Section,

5th Southern General Hospital,
Portsmouth. Mentioned for war
services-.

Hon. Con. Dent. Surg-., attached London Hospitals.

Anaesthetist ... King George Hospital. Died.

Lt.-Col. ... 0/c 2/5 :N'orfolk Regt. Territorial

Decoration. Ment. in despatches,
July, 1916.

Temp. Capt. ... R.A.M.C. 3rd Southern General
Hospital and i/c Reading Wax
Hospital, No. 2.

Capt R.A.M.C. Military Hospitals at

Colchester and Woodstock Park,
Epsom, 1915—17. H.M.H.S.
Kalyan, 1917—18, and Arch-
angel, Russia, 1918 — 19.

Capt R.A.M.C, T.F. Surgeon to 2nd

London Hospital. O.B.E., 1919.

Hon. Consulting Dentist to 5th Northern General
Hospital.

Lieut R.A.M.C, T.

Temp. Lieut. ... R.A.M.C . Dental.

Temp. Capt. ... R.A.M.C.'

Major R.A.M.C. T.F. 1st Southern Gen.

Hospital.

Temp

Temp,

Temp,
Capt.
Capt.

Temp.

Capt. ... R.A.M.C.

Malta.
Capt. ... R.A.M.C.

of war
Lieut.... R.A.M.C.

R.A.M.C

(Act. Major), R.A.M.C, S.R.

Details, 1914—15

CO. Dental work at

Missing, 1917. Prisoner
transferred home, 1918.
Dental.
T.F.

M.O. i/c Base
No. 7 Gen.

Hospital, St. Omer, 1915—16.
Medical Specialist, No. 10
CCS.. 1916—18. 91th F.A.,
1918.
Surg. Lieut., R.N.

Salt, H. 0.
Salvage, J. V.
Sampson, B.
Sampson, W.

Samuels, Isidor.
Samut, R. P.

Sam ways, D. W.

Sandfoed, H. A.
Sandison, a.

Temp. Lieut. ... R.A.F., Dental.

Lt.-Col. ... R.A.M.C Ment. for war services.

Temp. Surg. ... R.N. Haslar Hospital.

Capt R.A.M.C 3rd Loudon General

Hospital,
^ledecin Dentiste, Croi.x Rouge Francaise.
Temp. Lieut. -Colonel, R.A.^l.C Kings Own jMalta

Regiment of Militia. Mentioned

for war services.
M.O No. 5 War Hospital Exeter.

1915—19.

Lieut R.A.M.C.

Capt. (T.C)., R.A.M.C Royal ll.-rhert llo<i)ital.

1916. No. 17 G<'n. Hosp., E^ypl

191 6— 17. I?.E F. Fr:inro. 1917

PART II.

Boll of War Service.

Sandoe, M. W. a.

Saner, F. D.

Saner, J. G.
Sanford, D.
Saul, E. R.

Saunpers. S. J.
Saunders, S. McK.

Savage, P.
Savatard, L....

Saw, N. H. W.

Saward, a. H. M.

Sawday. a. E.
schofield, g.
Scott, A.
Scott, B. C...
Scott, D. C.

2iid Lieut.

Temp. Capt.

Temp. Capt.
Temp. Lieut.

Temp. Lieut.
Capt

Lieut. ...
M.O. ...

Capt

Temp. Capt.

Pte. ...
Temp. Major
Act. Major
Temp. Capt.
Capt

Scott, E. D.

Temp. Surg

Scott, G
Scott, M. ..
Scott, P. D..
Scott-Pillow,

H. M.

AnaBsthetist

Capt

Temp. Capt.
2nd Lieut.

Seabeooke, a

Capt

Searle, Chas.

F. ...

Major ...

Seccombe, S.
Secret AN, W.
Sells, H. T.
Sells, R.

H. ...
B. ...

Major ...

Capt

M.O. ...

Surg. ...

— 19. Acting Assifttiiui JiLspector
of Draft-< and President Stand-
ing Medical Board, Boulogne,
and Senior Medical Officer Rest
Camp^, Boulogne.

9th Devons. Served in France and
Belgium, Killed in action May
7th, 1917.

R.A.M.C. Surgeon No. 9 Red
Cross Hospital, B.E.F.

R.A.M.C.

Australian Transport Service.

R.A.M.C. Advisory Dental Officer
Bedford District.

R.A.M.C, Dental.

R.A.M.C. Ment. in despatches,
1917. Sedan.

I.M.S.

I/c Heyesleigh Auxiliary Military
Hospital.

R.A.M.C. M.O. i/c 4th Battalion
Worcester Regt. M.C., 1916.
Killed in action, Oct. 9th, 1917.

R.A.M.C. Hon. Surgeon Richmond
Red Cross Hospital.

Inns of Court O.T.C.

R.A.M.C.

R.A.M.C, Dental.

R.A.M.C.

R.A.M.C
1914.

Ambulance,
1915. let

36th Field
Dardanelles,
West Riding Field iA^mb. B.E.F..
France, 1916. 1/4 West Riding
Regt., 1917. 10th Field Amb.,
attached 1st Rifle Brigade and
1st Somerset L.I. D.A.D.M.S.
22nd Corps, attd. D.M.S. Office,
G.H.Q. Rhine Army. Gassed.
1917. O.B.E.
R.N. R.M.O. Queen Mary's R.N.

Hospital, Southend. O.B.E.
Tooting Military Hospital.
R.A.M.C. M.O. 1st Norfolks.
R.A.M.C.
R.F.C Killed in action, August

8th, 1917.
R.A.M.C Died, 1916, in Meso-
potamia.
R.A.M.C l/4th Northamptons.
Tvrice mentioned in despatches.
M.C, 1917. Wounded.
Australian A. M.C.
R.A.M.C, T.F.

I/c Roeherville V.A.D. Hospital.
R.N. Queen Mary's Royal Naval
Hospital, Southend.

Roll of War Service.

187

vmour-Peice, p. ... Major

Shacklook, G. a. S.
Shaheen, Kersan

Shannon, S. S. H.

SUAEP, H. ...
SHAEr, N. A. D. ..

Sharpe, H.
Shaepe. S a.
Sharpley, T. S.
jJhaw, Gc. D.

Shaw, T. A.
Sheap, E. W.
Shear-wood, A. L.

Shken, a. W.

Sheldon, T. M. ..

Sheldon, T. S.
Shels^ell. a. H. ..
Shknton, E. W. H.
Shepherd, C.
Shelton, H. L. C...

Siiepherd-TurnehaM;
Suerris. C ...
Shipway, F. E.

Shohland, E. T.
S BORLAND, George

SiCHEL, G. T. S.
■SlDEBOTHAM, F. N.

Stlk, J. F. W.

•SlWMINS, A. G.

Temp. Surg.
Surg. ...

Staff Surg.
Hon. Surg.
Temp. Lieut.

Brevet Major
2nd Lieut.
Temp. Lieut.
Lieut ...

2nd Lieut.
Temp. Capt.
Act. Major

Col.

Capt

M.O

Sub.-Lieut.
Radiographer,

Capt

Temp. Capt. .

N. P., Capt.
Capt

. R.A.M.C, T.F. Home, 1914.

Adjutant, 6th London F.A.,
O.C. 3/6 F.A., 1915—17. Brit.
Salonika Force, O.C. E.A.M.C.
Base Depot, 1917 — 18. Registrar,
Nos. 28 and 36 General Hos-
pitals, 1918. O.C, Nos. 2 and
8 Convalescent Depots.

D.A.D.M.S., G.H.Q. Staff,
1919. Twice mentioned in des-
patches, 1918 and 1919.

,. R.N. H.M.S. CoUingwood.

. I/c Ear and Throat Department,
Kasr-el-Ainy Hospital, Cairo.

. R.N.

. Royal Naval Auxiliary Hospital.

.. R.A.M.C. Att. Nigerian Regiment.
Received thanks of H.M. Go-
vernment. M.C.

.. R.A.M.C.

. R.F.C.

,. R.A.M.C.

. R.F.A., B.E.F., France & Italy.
Ment. in despatches, 1917. M.C.

1917. Wounded, 1917.
. R.F.A.

. R.A.M.C.

. R.A.M.C, S.R. 34th Field Amb.
Wounded at Suvla and ment.
in despatches, 1918. M.C, and
bar, 1918.

. R.A.M.C. I/c 34th (Welsh) Gen.
Hospital. Late Consulting Sur-
geon, Bombay. Ment. in desp.,

1918. CB.E., 1918.

. R.A.M.C. 139th Field Ambulance.

B.E.F.
. I/c Park Hall Camp, Oswestry.
. R.N.V.R.

Harapstead Military Hospital.
. Australian A. M.C.
. R.A.M.C. Royal FiLsiliers (Labour

Bat.) Ment in deep., 1917.
Yorkshire Reg. Killed in action.
. R.A.M.C 65th Wing, R.A.F.

Hon. Anassthetist, King George Hospital, Fish-
monger's Hall Hospital, Coulter
Hospital, and others.

Haywood Subsidiary Hospital.

R.N. Died in action on H.M.S.
Invincible, Jutland Battle.

R.A.M.C Mentioned for war ser-
vices, 1917.

R.A.M.C, S.R.

R.A.M.C. Consulting Anaesthetist,
Malta, 1915 — 16. Home Com-
mands, 1916—1919.

R.N. H.M.S. Bdl^rophon.

M.O. ...
Temp. Surg.

Temp. Major

Capt ....
Lt.-Col.

Surg.

188

Roll of War Service.

SlMMONDS, G. W. .

SIMMS, Harold
Simons, G. E. L. .
Simpson, G. S.

Simson, H.
Skelton, W. Bevill.
Slater, W. A.
Slesinger, E, G. .

Small, D. F.

Smart, H. D.

Smedley. K. D.
Smith, A. Ayre

Smith, A. H.

Smith, A. Henry

Smith, C. K....

Smith, D. W.

Smith, E

Smith, E. Bellingham
Smith, E. G.
Smith, F. J.

Smith, F. M. V. .
Smith, G. Warwick.

Smith, H. Joste

Smith, H. L.
Smith, Philip

Smith, W. H. M. .
Smyth, W. J. D. .

Smythe, W

Snell, Herbert

Snell, Norris...

Snow, Chas. F.
Solomon, E. E.
soothill, v. f.

Temp. Capt. ... R.A.M.C. B.E.F.

Civil Dent. Surg., 2nd General Western Hospital.

Capt R.A.M.C, S.R.

Temp. Capt. ... R.A.M.C, T.F. Northern General
Hospital.

Acting Colonel, R.A.M.C.

M.O I/c Fort Gomer, Gosport.

Temp. Capt. ... R.A.M.C.

Temp. Surg.-Lieut., R.N. Gallipoli and France
Meut. in despatches. O.B.E.,
1919. Croix de Guerre, 1915.

Capt R.A.M.C. Attached 15th Cheshire

Regiment. Wounded and miss-
ing, 1918.

Major R.A.M.C. Attached Lanes. Regt.

Twice mentioned in despatches.
M.C. Wounded, 1917.

Temp. Capt. ... R.A.M.C.

Temp. Lieut.-Colonel, R.A.M.C,, T.F. A^istant Di-
rector of Dental Service.

Capt R.A.M.C. Wounded, 1917.

Civil Dent. Surg., 3/4 Welsh Brigade R.F.A.

Capt.
Capt.

Temp. Capt.

Capt

2nd Lieut.

Surg.
Capt.

Capt

Temp. Capt.
Temp. Capt.

Temp. Lieut.
Temp. Capt.
Lieut. ...
2nd Lieut.

Capt

2nd Lieut.

Capt

Major ...

R.A.M.C.

R.A.M.C. Att. 6th Manchester
Regt. Killed in action, Fri-
court, July, 1916.

R.A.M.C, Dental.

R.A.M.C". Egypt and Serbia.

S.A.M.C. Ment. in desp., 1917.

1/4 King's Own Royal ■ Lanes.

Regt., late 4/2 City of London

R.F., and 8th O.C.B. Twice

wounded at Ypres.

Lieut. Commander, R.N. H.M.S. Chaguinola.

Retired, 1918.
A.M.S. HQ. Staff. Twice men-
tioned in despatches, 1917 and
1918. O.B.E., 1919.

R.A.M.C , T.F. East Anglian F.A.

M.C, '1917.

R.A.M.C

R.A.M.C. Twice ment. in desp.
M.C. Wounded, 1915.

R.A.M.C.

R.A.M.C

Lanes. Fusiliers. Killed in action,
9th April, 1917.

8th East Yorks. Regt. Killed in
action, 14th July, 1916.

R.F.A. Killed in action.

R.F.A. Hampshire R.G.A., T.F.

R.A.M.C. 11th Field Ambulance,
4th Division R.E. No. 7 Con-
valescent Depot. 1st Somerset
L.I. 12th and 10th Field Am-
bulance. British Exp. Force,
Belgium and France, 1914 — 19.
Mentioned in despatches.

Roll of War Service.

189

SOPER, A. W.

soper, g. b. s.

southgate, h. w. ...
southwell, c. s. ...
soweeby, v. h.

Spalding, F. L.
Spexcee-Payne, a. L.
Spicer, a. H.

S FILLER, J. E.

Spox, H. J.
Spoxg, E. W.

SPEAGUE, C. G.

Temp. Capt.
Lieut. ...

Surg. Sub.
Lieut. ...
2nd Lieut.

Temp. Lieut
Temp. Surg.
Temp. Capt.

Civ. Dent.
M.O. ...

Lieut. ...

Surg. Lieut.

Spriggs. N. I. ... Capt.

Spureell, W. Koworth Lieut.

Stagey, J. E. B.
Staixer, Claude H.

2nd Lieut.
Lieut. ...

Staley, R. C. W. ...

Temp. Surg.

Stallman, J. F. H.

Temp. Capt.

Stamford, R. B.
Stamm, L. E.

Stamp, L. D.
Staxsfield, T.

Staxavell. W. a. ...
Starlixg, E. C. W.

Starlixg, E. K
Staeung, H. J.

Temp. Capt.
Lieut. ...

Temp. Capt.
Temp. Capt.

Lieut.

Capt.

Lt.-CoL

Capt.

E.A.M.C.

R.A.M.C. Hospital Ship Ebani,
East Africa.
Lieut., R.X.V.R.
... R.A.M.C, Dental.
... Lines. Regiment. Killed in actioin^,

August 1st, 1917.
... R.A.M.C.

... R.N. H.M.S. Roxburgh.
... R.A.^M.C. Mentioned in despatcheg!
1917. Order of St. Anne (Rus-*
si an) 3rd Class.
Surg., Queen Mary's Hospital.
... Private Hospital for Officers.
... R.A.F., Dental. Died on servioe.
Shomcliffe, Oct. 30th, 1918.
Commander, R.N. H.M.S. Thistle.
Mentioned in despatches, 1917.
North Sea, 1914—15. E. Africa.
1916—18. North Russia, 1919.

R.A.M.C. 1/5 Northern Base Hos-
pital.

R.F.A. Artists' Rifles, B.E.F.,
1915—16. R.A. Cadet School,
Exeter, 1916—17. D/170 Bde.
R.F.A. B.E.F., France, 1917 —
18. Wounded, 1917, at Vimy
Ridge.

Killed in action.

Loyal North Lanes. Killed 15tb
November, 1916.

R.N. 19th Royal Fusiliers, 1914
—15. H.M.S. Marjoram. 1918,
42nd Division, B.E.F., France.
1918.

R.A.M.C. Mesopotamian E. Force.
1917 — 18. Surgical Specialist,
8th Indian General Hospital Ta*
noomah-Basra, 1917-18. Venereal
Specialist 21st Indian Gen. Hos-
pital, Amarah, 1918. No. E
British General Hospital Refugee
Camp, Bakuba, 1918—19.

R.A.M.C. South Africa.

R.A.F. M.O., Home Stations,
chiefly Northolt Aerodrome.

R.A.M.C. M.O. i/c 3rd E. Lanes.

R.A.M.C. Att. Manchester Regt.
Mentioned in despatches, 1917.
Wounded 1917.

3rd Lancashire Fusiliers. KiDed
in action, July 9th 1915.

R.A.M.C, S.R. 9th King's Own
Yorkshire L.I., B.E.F. M.C.,
1917. Wounded, 1918.
R.A.M.C. Mentioned in despatches,
1917. C.M.G.

R.A.M.C.

190

Statham, J. C. B.

Stkad, C. C.
Stebbing, G. F.
Steel, R. ...
Steele, R ...

Steele, W. K.
Steele-Perkins, D.
Steele-Perkins, J. S.
Steinbach, H.
Stenhouse, J. R. ..

Stephen, L. H. Y. ..

Stephens, H. F. ..
Stephens, Lockhart

Stephenson, John

Sterne-Howitt, H.

Stevens, John

Stevens, T. G.
Stevenson, C. M.

Steward, F. J.

Stewart, H.
Stewart, J. L.

Steyn, S. S. L.

Stiven, F. W.
Stohr, F. 0.
Stoker, G. M.

Stokes, D. L.
Stone, C. H.
Stone, E. R.
Stone, F. D. S.
Stone, F. W.

Signer, P. B.
Stott, H. ...

Stott, M. ...
Stout, R.
Stout, T. D. M.

Roll of War Service.

Col.

M.O. ...
M.O. ...
Temp. Lieut.
M.O. ...

Lt.-Col.
Temp. Capt.
Act. Major
Lieut. ...
Capt

Temp. Capt.

Temp. Capt.
M.O ...

Act, Major

Capt.
Capt.

Temp. Capt. ..
Capt

Temp. Lt.-CoL

Temp. Lt.-CoL
Temp. Capt. ..

Lieut. ...

Temp. Capt.
Lieut. ...

2nd Lieut.
2nd Lieut.
Temp. Capt.
Temp. Capt.
Hon. Capt.

Capt

Major ...

Temp. Capt.
Capt ....
Temp. Major

R.A.M.C. A.D.M.S. Lines of Com-
munication, Sal<jnica. C.M.G.
C.B.E., 1919.

V.A.D. Hospital, Haukhurst.

Royal Marine Depot, Quceustovvn

R.A.M.C.

Auxiliary Military Ifosp., Hainji-
stead.

R.A.M.C.

R.A.M.C. T.F. R.M.O. 2nd East.
General Hospital.

R.A.M.C. Mentioned for war ser-
vices. ]3icd on service, 1918.

R.A.M.C.

Northlands Auxiliary Hospital,
County Director for Herts of
British Red Cross. C.B.E.

R.A.M.C. B.K.F.. France, 1916
— 18. Twice mentioned in des-
patches, 1917. M.C. and Bar,
1917.

S.A.M.C. S.A.M. Hospital, Rich-
mond, Surrey.

R.A.M.C. Aldershot and London
Commands, 1916 — 19.

R.A.M.C.

R.A.M.C. Trooping, America and
West Indies, 1917.

R.A.M.C, T.F. 2nd London Gen.
Hospital, 1914—19. 53rd Gen.
Hospital. B.E.F., France, 1917

R.A.M.C. Twice mentioned in des-
patches, 1917.

R.A.M.C Gordon Highlanders.

Twice mentioned in despatches.
1918. M.C, Bax to M.C,
D.S.O. Wounded.

116th Brigade, R.F.A. Killed in
action, 1915.

Royal Fusiliers.

R.A.M.C.

R.F.A. 458 Armv Bde.. B.E.F..

1917—18.
Royal West Kents.

L.R.B.

R.A.M.C.

R.A.M.C

R.A.M.C. Mentioned for war ser-
vices, 1917.

A.S.C Salonika.

I. M.S. Mentioned in despatches.
O.B.E.. 1918.

R.A.M.C.

N. Z. Medical Corps.

N.Z.M.C Ment. in despatches.
D.S.O., 1917.

Holl of War Service.

191

Stkanack, W. S. .
Steaxge. E. W.
Stki>'(.eb, L. B.
Strovkr, H. C.
Stuart, H. D.

Stuart, J. A. W. .
Stuart, W. L.
summerskill, w. h

Sl/TTGN, A

Swan, R. H. J.

Temp. Lieut. ...
Temp. Capt. ...

Capt

M.O

Lt.-Col.

Lieut. ...
Temp. Lieut. ...
Surg. Sub-Lieut
Col

Queen Victoria Rifles. Wounded

at Gommecourt, 1916.
R.A.M.C, T.F. 1/3 North Mid-
land F.A.
R.A.F. (Medical), late Surgeon,

R.N., H.M.S. Victory.
I/c V.A.D. Hospital, 1916—19 I/c
P.O.W. Camp, 1916—19.

8tli Lines. Regt. Twice
in despatches. D.S.O.;.

Dental. Salonika;

Major ...

SWAYNE, W. C.

S\MNS, J. L. M.
Symonds, Sir Charter

Major

C.npt

J., Temp

Col

R.A.M.C.
ment.
1917.

R.A.M.C.

., R.N.V.R.

A.A.M.C. 2nd Australian Divsn.
A.D.M.S. C.M.G.

R.A.M.C. Senior Surg, to Royal
Herbert Hospital. Consulting

Surgeon, Woolwich District, Eas-
tern Command, 1914 — 19. Var-
ious Casualty Clearing Stations,
B.E.F., France; Surg., Queen
Mary's Royal Naval Hospital.
Southend; Royal Air Force Has-
pital, 1917. Ment. in desp.,
1917. O.B.E. (Military), 1918.

R.F.A., T.F. V.D. Bristol Uni-
versity O.T.C., 1914. O.C.
N.Z. (Reserve) F.A., 1916.
Attached 2nd Southern General
Hospital, and Standing Medical
Board No. 2 Area S.C, 1917.

R.A.M.C. 88th Field Ambulance.
, R.A.M.C. Consulting Surgeon.
Royal Victoria Hospital. Netley.
Ment. in despatches, Salonika.
C.B., 1916. C.M.G. K.B.E.,
1919.

Symonds. C. P.

("apt.

. R.A.M.C. Medaille Militaire as
Combatant at Mons.

-VMS, G. F.

Surg.

. R.N.

syms. J. L

Lieut

. R.A.M.C, T.F.

Tait, E. S

Lieut.

. R.A.M.C. Egypt

Tanner. W. E.

Capt.

. R.A.M.C. Surg. Derby War iiu>-
pital, Warrington, 1917—8. Sur-
gical Specialist, Military Hosp..
Gibraltar, 19J8— 19.

Taylor, A. D. Vernon

Capt.

. R.A.M.C.

Taylor, A. S.

Capt.

. 2nd Surrey Vol. Corps. Visiting
Surgeon King.^ton and District
Rod Cross Hospital, 1915—19.
Surgeon Oakenshaw Aux. Hosp.,
1914— 18.

T.vylor, a. S.

Temp.

Capt. .

. R.A.M.C.

Taylor, C. D. L. ...

Temp.

Lieut. .

. R.A.M.C, Dental.

lyii

Eoll of War Service.

Taylor M. Bramley Lieut.

Ta\ia)11, Sir E. Stuart, Act. Major, R.A.M.C, T.F. Adviser in Anaesthe-
tics, 5th Army. B.E.F., France,
1916 — 19. Twice mentioned in
despatches. O.B.E. (Military),
M6daille des Epidemics (French)

Tayloe, J. G. ... Temp. Major ... R.A.M.C. Mentioned for war ser-

vices, 1917.
R.A.M.C. Wounded, 1917, at
Langsmarees. M.O. attached
53rd Field Ambulance. M.O.
i/c 7fch Eaet Yorks. Reg., B.E.F.
France and Belgium, 1917.

B. ... M.O Red Cross Society.

P. ... Temp. Lieut. ... R.A.M.C.

R.A.M.C. 2nd Northern General
Hospital.
R.A.M.C.

R.A.M.C, T.F. O.C. 266th Bde.
R.F.A. Mentioned in despatches,
E.E.F., 1918. Territorial de-
coration.

Thomas. A. R. ... Surg. Commander, R.N. H.M.S. Talbot, 1914—15.

Served at Gallipoli (both land-
ings). R.N. Hospital, Malta.
1915—19. North Rrtssian E.F.,
1919. O.B.E. , 1919.

Taylor,
Taylor,

Telling,

Te:mple.
Thomas.

W
W.
W.

P.
A.

H. M

M.O. ...
Temp. Lieut.
Temp. Lieut. -Col.

Lieut. ...
Major ...

Thomas, C. E.

. . 2nd Lieut.

5th East Kent (Buffs). Mesopo-
tamia.

Thomas, F. G.

.. Capt

R.A.M.C , T.F. Ophthalmic Sur-
geon, 8rd Western Gen. Hosp.

Thomas, F. L.

Temp. Lieut. ...

R.A.M.C. Mesopotamia. 21st In-
dian General Hospital.

Thomas, T. M.

.. Major

R.A.M.C, T.F.

Thomas, T. P.

.. Capt

R.A.M.C , T.F. O.C. MiHtary Hos-
pital, Brecon.

Thomas, W. M.

.. Temp. Lieut. ...

R.A.M.C.

Thompson, A. R.

.. Capt

Artists' Rifles. Consulting Surg.,
Grove Military Hosp., Tooting,
S.W.

Thompsox, F. C. L

Lieut

R.A.M.C. Salonika

Thompson. G. G.

.. Capt

R.A.M.C.

Thoaipson. H. Q. "

Anglo-Russian Hosp., Petrograxl.

Thoaipson, I. M.

.. Capt

R.A.F., Dental.

Thoaipson. Robert

.. Temp. Major ...

Australian M.C.

Thomson. C. B.

.. M.o: ... ..

V.A.D. Hospital, Wimborne

Thomson, D. A.

.. Temp. Lieut. ...

R.A.M.C

Thomson, G.

.. Capt

R.A.M.C, T.F. Wounded. 1917.

Thomson, G. Y.

.. Capt

R.A.M.C*. I.M.S. 10 General Hos-
pital. Mesopotamia.

Thoaison, J. M.

.. Surg. Sub-Lieut., R.N. H.M.S. Strongbow.

Wounded, 1917.

Thorn, H. L.

.. Temp. Capt. ...

R.A.F.

TiCEHURST, C. B.

.. Tetap. Capt. ...

R.A.M.C

Ticehurst, G. a.

.. Capt

R.A.M.C. 33rd Field Ambulance.
France, 1916—17. Served at
Gibraltar, 1918—19.

Holl of War Service.

193

TiCE HURST. N. h\

TiLBUEY. A.

Tilbury, K.
Tmpsox. G. G.

Tipper. E. H.
Tipper. F. J.

Tipping, H. .
ToDi.. A. H.

E.M.O.

Capt.

O.B.E.,

believed
Tramyl-

Temp. Lieut.
Temp. Capt.

Senior M.O.
Major ...

Temp. Capt.
Major ...

Toi.nuRST, St. J. A. M. Capt

ToxnuE, E. J.
ToxKiN, B. M.
TonxH, F.

TOTTOX, J. ...
TOAVXROW, V.

TowxsEXT), T. A.

Surg. Lieut. .
Surg. Sub.-I

Capt

Lieut. ...
Temp. Capt. ,
Capt

ioul

Tracey, H. E.

H...

. Temp. Capt

Trail, D. H.

••

Temp. Capt.

Traill, A. ...

Temp. Capt

Traill, K. R.

Lieut. ...

Traill, R. R.

Capt. ...

Tressider, M. E
Trethowan. W.
TporxcE. T. R.

\l.\'.

. Temp. Capt.
Capt

Tubby, A. H.

Col. ...

I/c Auxiliary Military Hospital,

Normanhurst, 1915 — 19. Ment.

War Office List, 1919

1919.
E.A.M.C. Missing,

drowned on transport

vania, May 4th, 1917.
R.A.M.C.

E.A.M.C. No. 6 Casualty Clear-
ing Station, B.E.F. Mentioned

in desp., 1917. Wounded, 1918.
Colonial Medical Service, Nigeria.
R.A.M.C, Dental. Dental Officer,

Royal Herbert Hosp., Woolwich,

1914. Advisory Dent. Officer,

Woolwich District, 1915 — 16. In-
specting Dent. Officer, Eastern

Command, 1916 — 19.
R.A.M.C. T.F. M.O. 1st Batt.

Middlesex Vol. Regt.
R.A.M.C. O.C. R.A.F. Hospital,

Blandford. Surg. King George

Hospital and Lewisham Militaiy

Hospital.
N.Z.M.C. H.M.N.Z. Hospital Ship

Mahins. KiUed in action. May,

1918.
R.N. H.M.S. Egmont.
.. R.N.V.R. H.M.S. Hydra.
R.A.M.C, T.F.

London Brigade R.F.A., T.F.
R.A.M.C.
R.A.M.C . T.F. 24th London Reg.

M.C., 1916. Bar to M.C., 1918.

Order of St. Sava (Serbia).

Wounded, 1917. ^ Missing. 1918.

Reported killed in action at

Rocqunghy, 24th March, 1918.
R.A.M.C. Oral Dept. No. 6 Gen.

Hospital, B.E.F.
R.A.M.C. Civil Surgeon. Military

Hospital. Falmouth.
R.A.M.C. 2/2 W. Riding F.A.

Died on service, 1917.
Royal Berkv«5. R^t. Killed in

action. July 1st, 1916.
R.A.M.C, S.R. I.E.F.

tamia.
Wax Office Secret Service.
R.A.M.C.
R.A.M.C 26th Casualty

Station, Suvla Bay.

Units. B.E.F., France

19. Wounded. 1918.
A.M.S. Cons. Surg, to British

Mediterranean E.F. in Egypt.

Twice mentioned in despatches.

CM.G., 1916. CB . 1917.

Mesopo-

Clearing
Various
1916 —

194

Roll of War Service.

Tuck, E. S.
tuckee, p. a.
Turner, A. H.
Turner, A. Scott
TUHNER, Fulham
Turner, H. M. Sta

TURNE15, J. S.
Turner, Philip

Turner, S. C.
Turner, Thos.
Tui;ner, W. a.

Turner, W. A.

TUIiNEE, W. H.

Tweed, M. B. M,
Tyson. Wilsor.

Tyson, W. J.

Temp. Major

Temp. Lieut.
Siirg-.

Fleet Surg. ... H.N. ll.M.S. Natal.

Lieut '2nd Loudon KegL

Capt R.A.M.C.

Temp. (":ii)t. ... K.A.M.C. 5th East Surrey.

Capt ... K.A.M.C. Adjutant Fargo Hosp.

nley, Major, K.A.M.C. Major F;ilkland Islands Vo-
lunteer Force. Member of Com-
mission's IJoard, R.F.C. Coia-
numded J^'ulldand Ishinds De-
fence Force. Served in Fran(;e
;is Specialist in Dl-ea.se- of Ear,
Nose and Throat. Special Army
Council Medical Board. Men-
tioned in despatches.
... Military R('])r('sentative Pengc Tri-
bunal.
K.A.M.C. 0. i/c Surgical Div.,
Nos. 3 and 22 General Hospitals,
B.E.F. .Ment. in desi)., 1917.
R.A.F., Dental,
R.N.V.R.

Capt R.A.M.C. T.F. Lst Eastern Gen.

Hospital. Surgical Specialist to
the Millicent Sutherland Hi.s-
pital. B.E.F.. 1915. Surgical
Specialist No. 55 Gen. Hospital,
B.E.F., France.

Surg. Sub. -Lieut., R.N. Order of St. Stanislas
(3rd Class).

Lieut R.F.A.

Capt N.Z.M.C. No. 3 Field Amb.

Capt R.A.M.C, T.F. Surgical Speclst.

to the Millicent Sutherland Hos-
pital, B.E.F., France, 1915.
Surgical Si)ecialist No. 55 Gen.
Hospital. B.E.F., France.

Pliysician Royal Victoria Hosp., Folkestone. M.O.
to Sussex Cyclist Batt.. 1917.
M.O. Kent (Buffs) Cyclist Batt..
1918. Examined the doctors of
Kent, Surrey and Sussex for
Military service. 1918. Lecturer
for the Government in Coloene.
1919.

Uhteoff, J.
Underhill.

Underwood,
Underwood.

C
S. W. F.

B. G.
M....

M.O.

Temp.

Surg.
Ptc.

... Brighton Red Cross Hospital.
Surg.-Lieut., R.N. H.M.S. Mold^fivia. North
" Atlantic Patrol, 1917. and Con-

voy Work in Atlantic, 1917 — 18.
H.M.S. Boadicp^i, Nore Reserve
Fleet. 1919.

R.N.

O.T.C

Vallance. H.
Vance, W. J.

Bacteriologist Militaiy Hospital, Colcliester,
Temp. Capt. ... R.A.M.C.

Roll of War Service.

195

Vaxdkemin, H. F...
Van-I'EE-Spuy, W. C.
Vea].i:, R. McKenzie
Vexables, J. F.

Vexugopal, S. V. ..
Vetctue, H. St. H...
Vicars. F. G.
Vicary, W. R.

ViDOT, S.

ViSiCK, Hnbort C. ..,

VisiCK, Ifedley

Lieut R.A.M.C.

Pte Artists' Rifles.

Temp. Lieut. ... A. M.S., DentaL Scotch Command.
Cnpt R.A.M.C. M.O., Military Hosp.,

Swanage.

Lieut I. M.S.

Cupt R.A.M.C, S.R.

Capt R.A.M.C. 322nd Welsh Field Am.

Temp. Surg. ... R.N. H.M.S. VwU.

Capt R.A.M.C, (S.R.). Attached 0th

K.O. Y.L.I. M.C, 1917.
Hon. Dentist, Fairfield Court Red Cross Hospital,

Eastbourne.
Dental Officer, attached R.A.M.C.

Wacher, G....
Wachei^ H....
W.achek, H. S.
Waghorn, L. p.

Waight, H. G.
Wain, D. ...

W/-I.KER, A. ...

Walker, H. ...
Walker, H. F. B.

Walker, J. ...
Walker, James
Walker, Josiah

Walker, T. M.
Wallace, F. H.

Wallace, J. ...

Wallace, J. H.
Walley, Thos. B.
Wallis. A. E. W.
Wallfs, F. R.

Wallis, Herbert

Wallis, M. E. A.
Wallis. M. J. T.

Wallis, T. R.
Wallis, V. M.

Temp. Capt.
Temp. Capt.
Temp. Capt.
2nd Lieut.

Temp. Capt.
Brevet Major

Temp. Major
Capt

Temp. Lieut.
Major ...
Act. Major

Lieut.
Capt.

Major ...

M.O. ...
Temp. Capt.
Temp. Lieut.
Capt

Lieut. ...

Temp. Capt.
Temp. Major

Temp. Capt.
Lieut ...

R.A.M.C.
R.A.M.C.
I.M.S.

Royal Berks.
action.

Regiment. Killed in

R.A.M.C. No. 3 CCS.
R.A.M.C, T.F. 88th Provisional
Batt. Mentioned in despatches,
1918. D.S.O., 1918.
R.A.M.C Ment. in desp., 1917.

Order of St. Sava (Serbian).
S.A.M.C 21st M.B.F.A. in Ger-
man South- West Africa, 1914 —
15.
R.A.M.C.
R.A.M.C.

R.A.M.C, S.R. A.M.S. Staff.
Twice mentioned in despatches,
1917 and 1918. M.C, 1918.
Wounded, 1917.
R.A.M.C.

R.A.M.C,. Special List. Army
Dental Surgeon. Att. Devon-
port Hospital.
R.A.M.C, T.F. Territorial Deco-
ration.
Hopital du Casino, Fecamp.
Australian M.C.
R.A.M.C.

Gei\eral List. Dental Smgeon.
Military Hospital, Tid worth, and
3rd Southern General Hospital.
Oxford, 1916—16. 49th CCS.,
France, 1916 — 18.
R.A.M.C Dental Surgeon R.N.

Division, Blandford Camp.
R.A.M.C.
R.A.M.C 91st Field Amb. Ment.

in despatches, 1917.
R.A.M.C

R.A.M.C, T.F. Eastern Mounted
Brigade Field Ambulance.

196

Roll of War Service.

WALL18, W

WALLI8, W. E.

.. Temp. Capt. .
.. Temp. Capt. .

Walters, W. J. .
Wabd, F

.. Capt

.. Temp. Major .

Ward, L. W.
Ward. P. H.
Warlow, F

.. Temp. Lieut. .
. . 2nd Lieut.
.. Civil Dentist,

Warner. C

.. Temp. Surg. .

Warrick, R. W. .

. . Dresser

Watkin, J. P.
Watkin, p. J.

.. M.O

.. Capt

Watney, H. a.
Watson, C. E. S. .

.. Temp. Capt. .
.. M.O

Watson, C. T.
Watson, D. P.

.. Lieut

.. Major

Watson, J. N.

.. Temp. Surg. .

Watson, L. K.
Watson, M. G.

.. 2nd Lieut.

.. Dent. Surg. ..

Watson, W. E.

Watson, W. H.

Watt, N. L.

Watts, H.
Way, M.

Wearing, D. G.
Webb. A. E.
Webb. H.

Capt

2nd Lieut.

Capt

Temp. Capt.
Temp. Lieut.
Temp. Capt.

Webb. H. J. ...

.. Lieut. ...

Webb, S. J. F.

.. Capt

Webb, W. L.

... Temp. Capt.

Webber, A. M.

.. Temp. Capt.

. R.A.M.C.

. R.A.M.C. Wounded. British Exp.

Force, France.
. R.A.M.C.
. R.A.M.C, TF. Croix de Guerre

(French), 1918.
. R.A.M.C,, Dental.
. North Rhodesian Vol. Force.
Weesex R.E. Hon. Dentist to Red

Cross Hospital, Christchurch.
. R.N. Royal Naval Barracks,

Portsmouth.
. L'Hopital Anglo-Frangaise, Le

Treport.
. I/c 9th Australian A.S.C.
. R.A.M.C. Att. Bedfordshire Regt.

M.C., 1917.
. R.A.M.C. 9th Cavalry Field Amb.
. West African M.S. Mentioned in

despatches. Cameroons. Lost at

Sea, 1918.
, Sherwood Foresteors.
. R.A.M.C. O.C. 48th Field Amb.

D.S.O., 1918.
. R.N. H.M.S. Dunoan. Grand

Fleet.
. Northumberland Fusiliers.
, No. 1 General Auxiliary Hospital,

Brondesbury.
. R.A.M.C, Dental. Dental Surg.

to troops, Bedford District, 1914

— 16. Attached R.A.M.C to

2nd Thames and Medway Bdes.,

1916. Brigade Dental Officer,

32nd Casualty Clearing Hospital,

Egyptian Exp. Force, 1918—19.
. S.A.M.C S.A. General Hospital,

Muttuga, British East Africa.
. King Edward's Horse. Killed in

action.

I.M.S.
R.A.M.C

pital,
R.A.M.C
R.A.M.C
R.A.M.C

and

29th Stationary Hos-
Salonika.
, Dental.
, Dental.

". 84:th Field Ambulance,
attached 1st Suflfolks,
B.E.F., France, 1915. 2nd East
Kent Regt., 1916. 37th Army
Troop, R.E., 1917—18. Salonika,
1916—18. 60th S.A. Brigade
R.G.A., France, 1918—19.
R.N.V.R.

R.A.M.C , Dental. Egypt.
Uganda Medical Service.
R.A.^NL.C Ment. in despatches,
1917. 27th General Hospital,
Cairo.

Roll of War Service.

197

Webber, H. W.
Webster, E. M.

Webster, V. T.

Wedd, B. H.

Weinberg, A....
Weller, C. ...

Wells, L. K. A.
Welton, F. E.
Wermig, M. H.
Wexyon, C. M.

Wernet, a. J.
Westlake, B. B.

Westman, C...

Wetherell, E. C.

Wetherell, M. C.
Whatley, J. L.
Wheeler, E. J.

Wheldon, G. W. ...
Whelpton, L. G. ...
Whitcombe, D. M. p.
White, E

White, K. W.
White, Sir W. Hale

Whitten, M. G.

Whitty, C. J.
Whitafore. S. C. ..

WlTTTWOT^TH, H. P. ..

WicKENDKX, Stanley ^Majoi

Wji.iocks. a. J.

Brevet Colonel, A. M.S.

2nd Lieut. ... Eoyal Berks E^iment. Killed in

action.
Temp. Capt. ... K.A.M.C. Hon. Surg. Bed Cross
Hospital, Aberdare.

Capt K.A.M.C. M.O. Royal Engineers.

Mentioned in despatches.

Pte S.A.M.C. Killed in action, 1918.

Temp. Capt. ... K.A.M.C. 3rd Cavalry Division.

Killed in action, 1917.
Surg. Sub-Lieut., R.N.V.R.
Temp. Capt. ... K.A.M.C, Dental.
Captain, Dental Surgeon, attached K.A.M.C.
Temp. Lieut.-Col., K.A.M.C. Salonika and Egypt.
Twice mentioned in despatches.
O.B.E. C.M.G., 1919.
Fleet Surg. ... K.N. H.M.S. Canopus.
Ttmp. Capt. ... K.A.M.C. St. Patrick's Hospital,

Malta.
K.M.O. ... Swedish War Hoep. for Wounded

Officers, 1916—19. I/c Dept. for
Massage and Electro Therapy,
Viscountess Ridley's Hospital for
Officers.
K.A.M.C. M.O. i/c Belgian

' wounded soldiers, 1914. M.O.
Various Hospitals, Ipswich. M.O.
att. Somerset Yeomanry, li>s-
wich, 1916.
K.A.M.C.

K.A.M.C. Attached R.A.F.
R.A.M.C. M.O. 2nd Batt. Hamp-
shire Kegt., 29th Divn., Darda-
nelles, 1915. Served in evacua-
tion at HeUes and Suvla Bay.
Also served in Egypt and France
5th Royal Fusiliers.
2/4 Royal Berks. Regt.
R.N.

R.A.M.C, T.F. 2/3 West Riding

Field Ambulance.
Surgeon, R.N.

Colonel, A. M.S. Chairman and Consulting
Physician, Queen Mary Royal
Naval Hospital, Southend.
K.B.E., 1919.
R.F.A., T. W^ounded, 1916. Trans-
ferred to R.A.M.C. Dental, 1918.
Hon. Physician, Bath War Hospital.

Major R.A.M.C. Wessex F.A.

Capt R.A.M.C. Att. Scottish Borderers.

M.C., 1918. Died of wounds,
1918.
R.A.M.C. S.R. 48th Field Amb.,
B.E.F., 1914—15. 90th F.A.,
and 45th CCS. B.E.F. Bel-
gium and France, 1915 — 18.
Lt.-Col. ... I. M.S. Mentioned in despatches.

1917.

Capt.

Lt.-Col.
Temp. Capt.
Capt

2nd Lieut.
Lieut. ...
Temp. Surg.
Capt

Dental
Brevet

Lieut.

198

Roll of War Service.

WlLKliS, J. H.
Wjlkinsox, H. B.

Wilkinson,

WiLKS, J.
WiLLAN, G.

J. Cooper
H.
T.

Saddler Sergt... Hon. Artillery Coy.

Capt R.A.M.C. attached to 2nd G.B.

The King's Begt. Overseas, 1910
Served with North Western
(Egyptian) Frontier Force. M.O-
i/c Troops at Imbros, Salonika
Aimy, 228 Bdc., Struma Front.
M.O. i/c Troops, Army of Black
Sea, 1916—19.

Resident Anaesthetist, Horton War Hospital, Epsom.

Temp. Lieut. .
Act. Lt.-Col...

WiLLAN,
WiLLAN,

Richard

Williams, A. D. J.

... Capt

... StaflfSurg.
B., Lt.-Col.

Williams, A. E. ... Capt.
Williams, C. Hammond, Capt.,

R.A.M.C.

Williams, G.

Williams, G.
Williams, J.
Williams, W.
Williams, W.

Williamson

Dent. Surg.

R.A.M.C.

R.A.M.C, T.F. 2nd Home Comi-
ties Field Amb., British Bx-
Force, France and Belgium, 19] 4
—15. O.C. 82nd Field Ambu-
lance, Salonika Forces, 1915- -
18. O.C, 302 Field Ambulance.
England, 1918—19. Mentioned
in desp. b}^ Gen. Milne, 191C.
D.S.O., 1917.

R.A.M.C Welsh Field AmbulanceL

R.N. H.M.S. Phaeton.

R.A.M.C, T.F. Twice ment. in
despatches, 1917 and 1918.

R.A.M.C, T.F.
1/5 Border Rogt. Wounded, 1918.
Bangor Red

T.
H.
A.
R.
G.

Counties
■ Rifles.

F.A.

H.
E.
C...

Wounded and

Willis. G
Wills, A.

Wills, W.

WiLSHERE,

Wilson, A

P. W.

K.
G.
R.

France.

Hos-

Wilson,
Wilson,

F.
R.

WlNCKWORTH, H. C.

Winter, T. B.
Withers, S. A.

Military llo.spital,
Cross Ilosioital.

Temp. Lt.-Col. R.A.M.C. Home

Army Dental Surgeon, late Artists

Temp. Lieut. ... A.S.C B.E.F.

Major R.A.M.C

2nd Lieut. ... Essex Regiment,
missing, 1917.

Pioneer, Chemistry Section, R.E.

Temp. Lieut. ... R.A.M.C. British Red Cross
pital, Netley.

Surg. Commander, R.N.V.R. O.B.E., 1919.

Temp. Lieut. ... R.A.M.C, Dental. Mesopotamia.

Temp. Lieut. ... R.A.M.C. Ment. for war services.
Wounded.

R.N.V.R. H.M.S. Ursvla.
.A.M.C Colchester Military

Hospital, 1914. 10th Field Am-
bulance, and M.O., 1st East
Lanes. Regt., B.E.F., 1915. 7th
Norfolk Regt., B.E.F., 37th
Field Amb., 1915—16.

Temp. Capt. ... R.A.M.C.

Temp. Hon. Capt., R.A.M.C. Mentioned in desp.,
1918. Wounded, 1918.

Major R.A.M.C.

Lt.-Col. ... R.A.M.C. Mentioned for war ser-

Surg. Sub-Lieut.,
Major R.

Capt.

vices.
R.A.M.C, S.R. 22nd Indian
General Hospital, M.E.F.
2nd Lieut. 3rd Lance.

Late

Roll of War Service. 199

Witts, C. J.

Temp. Capt. .

.. R.A.M.C. Mesopotamia.

Wood, C. A.

Capl

.. I.M.S. 1/4 Gurkhas. M.C. and
Bar, 1917.

Wood, C. D.

Army Dental

Surgeon.

Wood, F. T. H. ...

Capt.....

.. R.A.M.C, T.F. Home Counties

Division. San. Sect. Mentioned

in despatches, 1918. O.B.E. 1919.

Wood, G. E.

Temp. Dent.

Surg., R.N.V.R.

Wood. J. A.

Temp. Capt. .

.. R.A.M.C.

Wood, W. R.

Capt

.. R.A.M.C, T.F.

Woodroffe, B. C. ...

Woodruff, K. M. ...

Temp. Lieut. .

.. I.M.S. M.O., I/c Detention Hos-
pital, R.A.F.

W00D"WAB,D. W. A. ...

Cadet ...

... R.A.F.

Wormald, W. J. ...

Temp. Capt. .

.. R.A.M.C.

Worster-Drought, C.

Lieut

.. R.A.M.C

WORTHIXGTON, S. ...

Temp, Surg. .

.. R.N. H.M.S. Pembroke and
Im flexible.

WOTTOX, W. H. ...

Temp. Capt. .

.. R.A.M.C, Dental.

We.\gu, E

Temp. Lieut. .

.. R.A.M.C

Wrench, G. T.

Capt

.. R.A.M.C.

Wright, C. S. E. ...

Act Major ...

R.A.M.C. Twice mentioned in des-
patches, 1917.

Wright, G. A.

Lt.-CoL

. R.A.M.C Mentioned for war ser-
vices, 1917.

WKIfillT, J. A. S. ...

Capt

.. R.A.F. French Red Cross, in
France, 1914—15. R.N.A.S.
(Flight Lieut., R.N.), 1916.
R.A.F., 1918. A.F.C, 1918.

Wright, L. D.

Temp. Capt. .

.. R.A.M.C. Mesopotamia.

Wright, T. J. • ...

Major ...

. R.A.M.C. Twice ment in deep.
Mesopotamia. D.S.O., 1917.

VVyand, E. H.

Wy./vtt, H. D.

Capt

.. R.A.M.C. 13th Yorkshire Regt.
B.E.F.

Wylie, a

Temp. Capt. .

.. R.A.M.C.

W^YLIE, D. T.

M,0

.. 1st Military Hospital, Cowley,
Oxon.

Vereury. E. 0.

Pte

.. Artists' Rifles.

Young, F

Surg. Sub-Lieut., R.N.

Young, J

Temp. CoL ..

. R.A.M.C, T.F. A.D.M.S.

Young, J

Temp. Major .

.. R.A.M.C., T.F. East Lanes. Field
Amb. Mentioned in despatches,
1918. D.S.O., 1918.

Young, J

Temp. Capt. .

. R.A.M.C Attached Durham L.I.
Wounded, 1917.

Young, J. F.

Temp. Capt. .

. R.A.M.C.

Young, W. A.

Temp. Capt. .

. R.A.M.C. M.O., 3rd Surrey Regt.

1914 — 15. Pathologist, No. 14
Stationary Hosp., B.E.F., 1915
—16. 0. i/c No. 16 Mobile
Bacteriological Laboratory, Brit.
Ex. Force, 1916—17. M.O. i/c
18th Hussars, 1918. Pathologist,
Royal Herbert Hospital Wool-
wich, 1919—20.

200

Roll of War Service.

ADMINISTRATIVE STAFF.

Addinoton, J. A.

Andrews, W.

Baker, A.
Baker, Tom

Barritt, W.
Baterip, T. A.
Bishop, H. C.
Bonest, J.
Box, T. H. ...

Bush, W. T.

Chapman, E. W.

Child, B.
Clark, W.
Cole, A.

COOTE, J.

CowiE, Wl.

Farmer, A. ..

FiNNEMORE, H.

Franks, H. D.
Furlong, D. W.

Pte.

R.A.M.C. 77th Casually Cleaiing
Station. liase Depot Egyptian
Expeditionary Force.

Royal Engineers.

Hospital, B.E.F.
Royal Engineers,

Pte 5th Veterinary

Pte Special Corps,

B.E.F. , France.

Corp R.F.C.

Pte 8th Devon Regiment.

2nd Air Mechanic, R.F.C.

Pte Royal Fusiliers. Wounded.

Lance-Corp. ... Northumberland Fusiliers. Killed

in. action, May 4th, 1917.
Rifleman ... 6th City of London Rifles.

StalY Sergt.-Major, R.A.S.C. (Canteen Service).

B:i8ra, Euypt and Mesopotamia.

Mentioned in dcspatche-:.

Pte R.A.M.C.

Pte 26th Labour Co., A.S.C.

Pte 8th Royal Berks Begt. Died on

Service, May 22nd, 1918.

Sgt 24th Queens Regt.

Pte 1st London R.F. Wounded 1916

and 1918.

Corp.
Capt.

Corp. ...
Staff Capt.

1st Army Headquarters.

Greneral List. 2nd Lieut.. Inns

of Court O.T.C., 1915—16.

Chemical Adviser, Northern Com-

maaid, 1916—17. Anti-Gas Dpt.

R.A.M.C. CoUege, 1918—19.
A.S.C.
Adjutant 1st Royal Berks Regt..

later attached H. Q. Staff, 2n<j

Division. Later attached H.Q.

Staff 4th Army. O.B.E., 1919.

M.C.

George, A. J.
Greenwood, F. W. .

. Corp
. Pte.

Hanson, J. F.

. Gunn

Harris, H

Harris, W. A.

. Pte.
. Pte.

Hennessey, P. W. H. Corp

Herbert, E.
Herbert, H.

ilOLTHAM, F. J.

... 8th Royal Fusiliers.

... Duke of Cornwall's Light Infantry

... 112 Heavy Battery, R.G.A. Men-
tioned in despatches.
... 24th Queen's Regt.
... 6th London Regt. Killed in ac-
tion at Loos, Sept., 1915.
... Queen's Regt. Mentioned in des-
patches. Killed in action. July
31st, 1917.
2nd Class Stoker, H.M.S. Pevibroke, Chatham.

Pte Royal Engineers. Wounded.

Pte London Rifle Brigade.

Roll of War Service.

201

Jones, F. W. ... Pte Middlesex Regt.

Kent, F. J. ... Rifleman ... 18th London Rifle Brigade.

Laker, A. A. ... Lance-Corp. ... Military Foot Police.

Lane, E. B. ... Lance-Corp. ... 29th Middlesex Regt.

Lane, W. P. ... Pte 1st East Surrey Regt.^ attached

No. 64 C.C.S!, B.E.F.

Law, S. H. ... Pte Gth Somerset Light Infantry.

Law, W. D. ... Sapper ... Royal Engineers.

LOWDER, E. H. ... Pte R.A.M.C.

Mankelow, H.
Matthews, E .
Moore, T. E.
Morris, W. D.

Mum, F. H.

Nash, 0. A\.
Neal, E. C.

Noble, J.

Ockmore, a.

Pte. . . .

Pte. ...
Lance-Corp.

Corp. ...

Pte. ...

1st CJrenadier Guaids. Wounded.
24th Queens Regt.
7th K.R.R. Wounded.
R.A.M.C. 83rd Stationary Hosp.,

M.E.F.
Machine Gun Corps.

25th Training Reserve.

Grenadier Guards. Wounded, 1916

Prifioner in (xei'maiiy, 1918.'
Labour Corps, B.E.F.

London
1917.

Rifle Brigade. Wounded.

POPHAM, Rev. A. E. Capt

4th Class Chaplain, B.E.F. Men-
tioned in despatches. M.C.

Reeves, H. C.
RUDMAN, G. F.

Stanton, O.
Start, S.

Steele, V.

Stockton, R.
Strkvens, R. p.
Stuckbury, H.
Sutton, R. B.

Thompson, A. W.
Thoenton, H. J.

TlLEY, S.

Flight Sub. -Lieut., R.N.A.S.

Sgt R.A.M.C. British Ea.st Africa.

Pte K.R.R.

Lance-Corp. ... M.G.C. M.1\L Wounded. J)ied

of wounds. 1917.
Lieut R.E. (Special Brigade), late

Hampshire Regt. Wounded.

Sgt R.A.M.C.

Chief Yeoman of Signals. H.M.S. Dhedkilus.

Corp A.V.C.

Pte R.A.M.C. Pathological Assistant

2nd London General Hospital.

Pte A.S.O., M.T. B.E.F., France.

Pte R.F.A.

Gunner ... R.F.A., B.E.F.

Unwin, H.
Whitbread, J. H.
Winston, J. H. E.

Pte 29th Middlesex Regt.

Sgt Anti-Aircraft Gun. R.F.A.. late

29th Div. , GallipuJi. Wounded.

Lieut. (Act. Capt.), 5th Yorkshire Regt. LondMJ
University O.T.C., 1914—16.
P.T. and B.F. Officer. 3rd Line
Northmnbrinn Div., 1916. B.E.F.
France, 1916—18. Pji^oner in
Germany, 1918. Wounded, 1917.

FART II.

202

Roll of War Service.

Guy's Nurses and The European War.
1914 to 1919.

The following list of war services has been compiled from par-
ticulars sent in by Members of the Guy's Hospital Past and
Present Nurses' League.

Queen's Alexandra's

Allen, Gertrude M.

Cheetham, Edith C.
CORBISHLEY, Mary C.

Davidson, Mary E

Davis, Mabel

Greg, B. Mary

Haughtox, Louisa V.

Morrison, Maud

O'Neill, Mary E. ...

Potter, Maxy L.

EOOKE, Rosa M.

Sheldon, Alice
Suart. Hannah

WiLLES, Amy

Imperial Military Nursing Service.

. France.

. France and England.

. France.

.. France and England.

.. England and the Ehine.

. England.

. England and Egypt.

. England.

. Hospital Ship and Egypt.

. England and France.

. East Africa and Hospital Ship.

. England and France.

. France and England.

Queen Alexandra's Imperial Military Nursing Service

Reserve.

Barton, Gladys M Egypt.

Batley, Eva A Gibraltar and Malta.

Baylor, Florence J. ... Malta.

Beesley, Ada M France.

Boll of War Service.

203

Bell, Maj^axet H. ...
Beloe, Ethel F. ...
Bennett, Mabel C...
Blewitt, Clara
BODEXHAM, Emily M.
Boniface, Norah
BOTT, Edith Elton...
Bottomley, Charlotte M.
BOUEDILLON, Mary ...
Beeithaupt, Alice ...
Briggs, Josephine ...
Browne, Annie M. ...

L'AiiPBELL, Mary W....
Cannell, Gertrude E.
Carey, Margaret
Carroll, Violet M....
Carter, Ethel M. ...
Cherry, Ethel
Clarke, Marie
Clifton, Alice
Collins, Ellen
Colston, Mary A. E.
Connolly, Norah . . .
Corder, Grace
Cornwell. Lucy
Cox, Edith M.
CmsFORD, Reenie ...
Custance, Gertrude E.

England and Hospital Ship.

England and France.

East Africa.

Hospital Ship and England.

England, France and Cologne.

France.

England, Hospital Ship and Malta.

M^opotamia.

France.

Malta and Mesopotamia.

Egypt.

England and France.

Belgium and France.

England.

England and Hospital Ship.

France.

France, Egypt, Salonica and England.

France.

England.

Home Hospital, Mesopotamia and India.

France.

Malta and France.

England.

France and Italy.

Salonika and England.

France.

Dale, Catherine
Daniels, Ada M. ...
Daniels, Bessie H....
Dart, Phyllis, M. ...
Dixon, Margaret L....

France.

East Africa and England.

England and Salonika.

Evans, Elizabeth G.

Salonika.

Farah, Aseely
Fare, Ada W.
FiGG, Edith
FiNNis, Florence M.
Ford, Florence E. ...

India.

France.

England.

Prance.

Syria and England and Egypt^

204

Boll of War Service.

Fox. Louisa
Fbaser, Maggie M....
Freeman, Kate R. ...
French. Ettie M. ...
Fuller, Gertrude A.

Egypt.

India.

England.

England and France.

East Africa.

Gerard, Caroline ...
Grant, Ella A.
Gray, Marion L. ...
Gregg, B. Mary

Harris, Kathleen B.
Hepburn, Florence M.
HiCKLiNG, May

Hills, Jane

HOBHOUSE, Mabel E.
HOGAN, Bridget
Howes, Janet H. ...
HuDD, Mabel
HuLBERT, Annie E....
HUTCHINS, Gertrude M.

Jackson, MoUie
Jeistkins, Lily M. ...
Johnson, Mabel
Johnson, Mildred ...
JOLLEY, Lucy E.
Jones, Jessie B.
Jones, Marie A.
Jones, Winifred M....
Jordan, Mina

Keeble, Ida

France.

Hospital Ship and England.

England.

India.

England and France.

France.

England.

Salonika and Turkey.

England.

Hospital Ship, England and Turkey.

France.

France, Salonika and England.

England.

Salonika, Malta and Mesopotamia.

England. Salonika and Constantinople.

France.

Layton, Honoria M.
Lear, Edith M.
Leggoe, Euth
Lend, Minnie

Levy, Polly

LougHNAn, Marjorie...
Lulham, Evelyn V.
LusTio, Constance E.
Lyons, Margaret J. L.

France.

Egypt. Persian Gulf and England.

Egypt,

France.

England and Hospital Ship.

Egypt, Mesopotamia and India.

England.

France.

Itoll of War Service.

205

Macfarlane, Violet K.

.. Salonika.

Macdonald, Flora ...

.. Egypt.

Mackenzie, Katherine

.. France.

Mallandaine, Lucy M. .

. . France.

Mann, Margaret C

.. England and France.

Mansfield, Margaret M. .

.. England.

Marshall, Annie H.

.. England.

Marshall, Helen 0.

.. Salonika and Italy.

Martyn, Gwendoline

,. Ireland.

Masters, Roea M

.. France.

May, Florence B

.. France.

McLaren, Margaret J. .

.. France and

England.

MoMorland, Rose ...

.. France and

Salonika.

Medley, Beatrice C.

.. Egypt and

India.

Miller, EUin M

.. France.

Mitchell, Mary

.. France.

Morgan, Florence A.

.. France and

Belgium.

MOREELL, Mary L

.. France.

MuDGE, Georgetta ...

.. England.

MULLAN, Margaret M.

.. India and

Mesopotamia.

MUTFORD, Ada S

.. France.

Nawn, Josephine ...

.. India and Egypt.

Neale, Winifred

.. France.

Nixon, Cicely

.. Italy and E

ugland.

Noethey, PoUie W

,. England. .

Opie, Dorothy A

.. England.

Orchaed, Emma C. P. .

.. France.

O'RoRKE, Elsa M

.. Ireland.

Paton, Gladys A

.. England.

Pearson, Cecilia

.. Egypt.

Phillips, Agnes M

.. Fraface.

Pilkington, Alice B.

.. France.

PiSANi, Phyllis I

.. France.

Plant, AUce

.. Malta.

Porter, Edith H

.. England.

Preston, Ellen E

.. England.

Priestley, Millicent C. .

.. Hospital Ship and England

Peobeet, Florence M.

.. England.

QuiLTEE, Elsie B

.. France.

206

Boll of War Service.

Rebs, Gladys M. ...
Rbnnib, Ellen B. ...
Rice, Mary G.
RiSDON, Emma J. .«
Robinson, Louisa A.
ROGEESON, Kathleen M.
ROUSSTANO, Angelica...
Russell, Winifred ...

Sawyer, Margaret D.
Selby, Dorothy M. ...
Shann, Claxa L. ...
Sharwood, H. M. ...
Shephebd. Marjory ...
Sherrin, Mary
Shorter, Kathleen ...

Slade, Dora

Somerville, Lilian C.
SouTHCOTT, Frances E.
Southwell, Catherine
Spouncer, Elsie M....
Strange, Constance E.
Stedman, Eliza
Taylor, Hannah
Thaczray, Gladys M.
Tuenbull, Lilian ...
TuENER, Emmeline ...

Vivian,

Wade, Florence ..*
Wadlow, Jessie R....
Warner, Hilda J. ...
Waterman, Agnes W.
Waters, Gertrude F.
Watkins, Ethel F. ...
Webster, Mary A....
Weller, Elizabeth M.
Williams, Beatrice M.
Williams, Ethel
Wood, Marion
WooLLETT, Dorothy M,
Wright, Lilian

England.

Salonika and Italy.

Ireland.

England.

Finland.

England.

Salonika and Constantinople.

East Africa.

France and the Rhine.

Italy.

Egypt and France.

France.

Salonika.

England.

Egypt.

England.

Hospital Ship and England.

The Rhine.

France.

England.

England and Salonika.

England and Egypt.

England and Fiance.

India.

England.

Egypt and Constantinople.

Malta, Italy and England.

England.

France.

Salonika and England.

England and Hospital Ship.

Salonika.

France and Flanders.

England.

England and the Rhine.

England, Egypt and Palestine.

Roll of War Service.

307

Civil Hospital Reserve.

Abraham, Maigaxet K. ...

France.

Adams, Ethel E

France.

Ames, Isabel

Salonika and Italy.

Baker, Edith 0

Salonika and England.

Banbury, Hilda M

France.

Barker, Constance E.

France.

Beardshaw, Mary F.

France and England.

Bishop, Katherine

Hospital Ship and England

BOWDLER. Emily F

France.

Brennand, Florence G. H.

France.

Become, Florence

France.

Browx, Mildred

France.

Bullock, Edith

France.

Cones, Violet R

France.

Cooke, Margaret

France.

COBNWELL, Lucy

France.

Davis, Florence L

France.

DODDS, Frances

Mesopotamia and India.

Druce, Constance E.

France.

Evans, Winifred

France.

Faulkner, Mabel I.

. . France.

Fennell, Winifred A.

.. France.

FiNLOW, Ada B. ...

.. Russia, Malta and Turkey

Frank, Georgina M.

.. Malta.

Fraser, Elsie G. ...

.. France.

Gibson, Sarah J. ...

. . France.

Gladstone, Ethel M.

S. .

.. France.

Glbgg, Marcia E. ...

.. France.

GOODCHTLD, Marianne

.. France.

GowER, Delia W. ...

.. France.

Grego, B. Majy ...

.. England.

Grundy, Dora

.. France and

England.

Hanmer, Maxy

.. England.

Hayne, Kathleen F.

. . France.

208

Roll of War Service.

Hayter, Alice A. ...
HiLBS, Sarah N. B....
HiLLiARD, Miirgaret A.
HOCKIN, Gladys M....

Mesopotamia and India.

France.

England and Mesopotamia.

Johnson, S. Evelyn...

France.

Kiddle, Violet N. .
King, Dorothy

LiTHGOW, Agnes M..
Long, Ada V.

France, Salonika and India.
France and England.

France.
Salonika.

Mackenzie, Katherine
MacManus, Emily E. P.
Maddison, Maud ...
Mannell, Louisa Gr.
Marshall, D orothy . . .
Martin, Bertha
McAra, Amelia M....
McKiNNEY, Margaret
MoORE, Nona
MORiARTY, Evelyn ...

France.

Salonika.

Hospital Ship and France.

France and Salonika.

France.

Salonika.

France.

Nelson. Martha I.

France.

Owen, Margaret R.
Owens, Martha J. .

France.
France.

Parsons, Margaret
Paterson, Jentie
Pearse, Cassandra
Prince, Amelia E.

France.

France and Hospital Ship.
Malta and England.
France and England.

Rae, Mary N. K

Raven, Emily

Richardson, Gladys I. M.
Richardson, Kate L.

Ripley, Margaret

Robinson, Louisa A.

RoussiANO, Marie

ROYCE, Katharine L.

Alexandria, Salonika and England.

France.

Roll of War Service.

209

Sadleir, Angela M.
Savage, Maxgaxet D.
Sawyer, Margaret D.
Self, Mary E.
Shackleton, Eleanor H.
Shaewood, Hilda M. .
SouTHCOTT, Frances E
Spedding, Frances A.
Squire, Edith E. ...
Stone, E. Gladys ...
Steutt, Vivienne M.
Suetees, Sybil E. M.
Symoxs, Mary Langham

Todd, Winifred A. ...
TwosE, Blanche A. ...

Vine, Hilda M.
Vine, Kathleen M. ...

Wade, Frances H. ...
Wolfe, Elsie M. ...

France and Italy.

France.

France and Salonika.

France.

Mesopotamia and India.

France.

Hospital Ship and England.
Hospital Ship and England.

India and Mesopotamia.
France.

The Territorial Force Nursing Service.

Aboher, Jessie A. E.

Ballance, Elaine M.
Brown, Mary A.

Carey, Dorothea
Coward, Amy I. ...

Dickson, Martha McB .

Gill, Eva E.

Halfacre, Mabel F....
Harden, Gertrude F.
HORTON, Emily

Jefferson, Daisy ...

LuLHAM, G-ertrude ...

Macreath, Agnes G.
Marsh, Margaret E.
McKay, Christina A.
Moles, Florence M.

England.

England.
England.

England.

England and France.

England.

England.
England.
England and Salonika.

England.

England and France.

England.
England.
England.
England.

210

Roll of War Service.

Newton, Enid M....
Peaeson, Winifred M.

Ray, Emily

Shepherd, Dorothea M.
Slack, Florence
Staines, Florence ...

Taylor, Kate B. G....
Turner, Lucy

Whittam, Elizabeth
Wood, Edith

England and Egypt.
England.

England and Italy.

England and Malta.
England and Salonika.
England and Salonika.

England.

England and France.

England and France.
France.

The Royal Air Force Nursing Service.

Browne, Florence R. ... England.

Campbell, Mary W. ... England.

CORNWELL, Lucy England.

Cruickshank, Margaret ... England.

Dickson, Martau McB. McI. England.

DOIG, Margaret S England.

Fox, Emily M England.

JOLLEY, Lucy E England.

MOLESWORTH, Winifred ... England.

New, Kate E England.

Petrie, Adeline E England.

Sautoy, Adeline du England.

Scott, Eva England.

Urquhart, G-eraldine L. M. England.

Wellsted, Amy England.

Yates, Ethelreda England.

Boll of War Service.

211

Queen Alexandra's Military Nursing Service for India.

Cones, Violet R. ...
CORFiELD, Eliza R....

Davidson, Lilian M.

Evans, Winifred
ExsHAW, Phoebe

GOUCHEE, Alice

Haet, Alice M.

Iles, Helen L.

Lowe, Alice R.

Macfarlane, Violet

NoRTHEY, PoUie W.

EABBroGE, Mary D. ...

Stebbing, Flora A....

TiPPETis, Melanie ...

Veech, Annie G.

Mesopotamia.
Mesopotamia.

India.

France and Mesopotamia.

India.

India and Mesopotamia.

India.

India and Mesopotamia.

India.

India and Mesopotamia.

India

South African Military Nursing Service.

Brown, Annie M.

...

Africa.

Edwardes, Florence T.

Africa.

Feeshney, Frances H.

...

South Africa and Frajice.

Ledlie, Eva

...

South West Africa.

NOTT, Grace

Africa.

NuTT, Maxy A. M. .«•

Africa.

Ritchie, Ruby S. ..,

...

East Africa.

Nevi^ Zealand Military Nursing Service.

Bates, Jessie M. ...
Gilkes, Maxy R. ...
MORLEY, Sarah E....
ROBBINS, Annie
Shuker, Margaret E.

New Zealand.

France.

Egypt and England, and New Zealand.

New Zealand and France and Hospital Ship

New Zealand and Franc©.

212

Roll of War Service.

American Military Nursing Service.

Collins, Jessie H France.

Queen Alexandra's Royal Naval Nursing Service and

Fbeshney, Mildred D

Mebhan, Eleanor A
Messenger, Chrlstiiie
MiDDLETON, Muriel A

Noble, Maxy A.

Shewell, Dora 0. ..

Reserve.

England.

England and Eastern Waters.

England.

England and Gibraltar.

British Red Cross Society.

Matron-in-Chief, Trained Nurses' Department.
Dame Sarah A. Swift, G.B.E. R.R.C.

Allen, Laura

.. England.

Allcock, Annie

.. England.

Anson, Lucy P. ...

.. England.

Austin, Bessie M

., England.

Baker, Frances M

.. England.

Barber, Ethel M

.. England.

Barker, Mary

.. England.

Bartlett, Muriel E.

.. France.

Baylor, Florence ...

.. England.

Bbvington, Gladys ...

.. England.

Bishop, Elizabeth ...

.. England.

Blenkarn, Edith M.

.. England.

Blenkarn, Mauldi ...

. . England.

Blenkarn, Katharine

.. England.

BouviER, Marie

.. England.

Bowdlee, Emily ...

.. France.

Boys, Agnes F

. . France.

Brakspear, Dorothy M. .

.. France and England

Bbbreton. Florence...

.. England.

Roll of War Service.

213

Bridges, Annie
Bbierley, Alice
Britton, Clara
Broome, Florence ...
Brown, Frances E..„-
Browx, Kathleen ...
Browne, Florence R.
Bryan, Noelle R. ...
Burdett, Mary I. ...
Burton, Fiances M.
Byrne, Josephine

England.

England and France.

England.

France.

France and England.

England.

Egypt.

Cadell, Katherine J.
Caldwell, Jessie L....
Canty, Constance ...
Carpenter, Alice M.
Carpenter, Margaret
CmsHOLM, Alice
Chtttocz, Mabel A.
Clutton, Katie E. ...
Cochrane, Marjory H.
CocKiN, Edith J. ...
COLECLOUGH, Annie M.
Collie, Isabel
Collins, Hilda M. ...
Cook, Katharine
Cook, Marion E. ...
Coombs, Elizabeth J.
CORFIELD, Eliza Eyman
Cornforth, Emma ...
Cronin, Anna M. ...
CUTHBERT, Anna M.

Dale, Catherine
Davidson, Jessr E....
Da VIES, Kathleen
Davis, Florence K. ...
Dean, Amy E.
Dbnney, Henrietta ...
Densham, Constance
Densham, Evelyn ...
Denton, Louisa

France and England.
^ England.

England.

France.

England.

England.
, England.
. England.
. England.
. England.
. Uganda.
. England.
. England.

. England and Egypt.
. England.
. England.
. England.

. France.
. England.
. England.

England.
. England.

England and France.

England.

France and England.

England.

214

Roll of War Service.

DiOKBNSON. Blizubeth

... England.

DiKGLE, Janet .w

... England.

Ddcon, Janet E. ...

... England.

DOTTRiDOE, Sophie C.

... France and England.

BlQLB, Maxy J.

... England.

Edwards, Jnnet

... England.

Fabnham, Dorothy ...

... England.

Farrar, Ada E. ...

... Italy and Russia.

Ferguson, Florence

... England.

Field, Grace

... England.

Fricker, Ada

.. England.

Fox, Emily M.

. . Russia.

Fox, Louisa

.. England. *

Fuller, Vera

., England.

Fuller, Ester A. ...

.. Belgium and England

GooDOHiLD, Marianne

.. England.

Good, Augusta 0. ...

.. England.

Goss, Edith M. ...

.. England.

Gossage, Kate

.. England.

Groom, Effie R. ...

.. England.

Gwilliam, Margaxet L.

.. France.

Hart-Synnott. Violet F.

England.

Ha WARD, Gwendoline M. .

.. England.

Hawkins, Mary

...

.. England.

Healy, Mary ...

...

.. South Africa

Hodgson, Lucy

...

. . England.

HoLMAN, Blanche

.. England.

J0H>7S0N, Mildred

...

. . France.

Jones, Jessie

. . England.

Joyner, Winifred

.. England.

Kelly, Mai C.

...

.. England.

Kew, Edith

...

. . France.

Lane, Ella M.

...

.. England.

Layng, Alice

..■i

.. England.

Leng, Minnie

...

.. France.

Lucas, Cecilia A.

...

. . Canada.

Boll of War Service.

215

Marler, Amy E. ...

... England.

Masters, Roea M. ... •

... France.

Mayes, Mary

. . . England

and Italy.

McLaren, Margaret

... France.

McRae, Margaret ...

. . . England

and France.

Middleton, Muriel A,

... England.

Mulqueen, Agnes M..

... France.

MiLLiDGE Elizabeth...

... England,

Fr;ince and

Moles worth, Wnifrcd

... France.

Morris, Lily

.. England.

Moore, Katie

... Serbia.

Morgan, Mabel T. ...

.. England.

MORRALL. Katt' L. ...

. . England.

Xurse, Elizabeth A.

England.

Patterson, Marion G.

... France.

Pettifer. Wilh(>min:i

... England.

Phillips, Alice M. ...

. . . England

and

France.

Plant, Frances M. ...

... England.

Power, Margaxet M.

. . . England

and

Holland

Priestley, Rosa A.

... England.

Prickett, Sarah A.

... England.

Pryke, Gertrude M.

... England.

Ray, Kate L.

. . . Belgium

and

France.

Randles, Ethel M.

... France.

Richardson, Alice M.

... England.

Rose, Constance L. ...

... England

and

France.

Sheldon, Francos A.

... England.

•

Sleap, Beatrice

... England.

Simpson, Mabel L. ...

... England.

Smith, Violet

... England.

Southey, Edith M. ...

... England.

Stallman, Mary B....

... England.

Stephens, Cecilia C.

... Boulogne.

Sullivan, Hilda M....

... England.

Todd, Const mce E....

. . . France.

Towler, Hilda

... England.

Turner, Emmrlinc M.

... England.

Turner, Helen B. ...

... England.

21G

Boll of War Service.

Ward, Augusta M.
Weston, Kate B. .
White, Gladys L. .
WILK8, Esmeralda V.
Wilson, Lizzie H. .
Wilson, Olive M. .
Wood, Lorna B.

Yell, Minnie L.

. . . India.

.. England.

,.. England and France.

... England.

... Egypt.

... England.

Foreign Red Cross Hospitals and Other Units.

Dbnsham, Evelyn J.

Fletcher, Mice M....
Fletchbb, Gladys H.

Fiance.

Belgium and France.

France.

Hill, Ina F.

. France.

IZAT,, Jessie

.. Belgium.

Jones, Gladys M. ...

.. France.

La VELA YE. Maxie B. de .

.. Belgium and Fiance

Lear, Edith M

.. France.

LuDERS, Valborg ..j

.. Serbia.

Lyndon, Charlotte .«.

.. Italy.

Moles-worth, Winifred

.. France.

Kees, Gladys A. R. :

.. France.

Ripley, Margaret .«

.. France.

Rowlands, Eunice ...

.. France.

Sautoy, Cathin du ...
Spencer-Payne, Ivy S.

Todd, Winifred A. ...
TowLER, Hilda
Tubes, Ellen F.

France and Belgium.
France.

France.
Poland.
France.

Van Weddingen, Madeleine Belgium.
Whittincham, Sarah T. ... France.

Bx)ll of War Service.

217

Auxiliary Hospitals.

Appleton, Margaret

.. England.

Barker, Nellie

.. Basrah.

Barker, Amy H

.. England.

Beard, Ada M

.. England.

Blayney, Edith K. ...

.. England.

Brereton, Florence M.

.. England.

Britton, Clara

.. England.

Brooks, Freda

.. England.

Bryan, Marion

.. England.

BURNSIDE, Grace

. . England.

Chisholm, Alice

.. England.

CoLLiKS, Ellen

.. Serbia.

Cornell, Grace S

.. England.

Davidson, Amy E

.. England.

Da vies, Enid A

.. Serbia.

Dean, Constance

. . England.

Ekins, Alice M

.. England.

Ellis, Sarah

.. England.

Elphick, Mabel

.. England.

Faull, Mary E

.. England.

Ferdinand, Margaret

.. England.

Fenn, Alice P

.. England.

Finnemore, Kate E.

.. England.

Fletcher, Alice M.

Belgium and France

Fletcher, Gladys H.

. France.

Flude, Susanna J. H.

. England.

Ford, Eleanor E

. England.

Eraser, Maggie

. England.

Gallagher, Agnes ...

. England.

Gane, Grace

. England.

(iARNBTT, Mabel

. England.

(iuoDEUHAM, Edith M. a. .

.. England.

Gr.vham, Elizabeth ...

. England.

JlALi'ACEE, Mabel F.

. Enghuid.

Harding, Aguf^s

. England.

PAKT 11.

218

Roll of War Service.

Harmeu, lleloua M.

. England.

HaRRADINE, Beatrice M. .

. England.

HaET-SyNNOTT. Violet F. .

. England.

Haynes, Edith 13

. England.

Haynes, May B

. England.

Hills, Jane

. England.

Hirst, Nellie M\. L.

. England.

Hooper, Alic'e M. ...

. England.

Hopkins, Evelyn ...

. England.

Hop::, Bertha A

. England.

Hope, Edith

. England.

HOPSON, Dorothy F.

. England.

Howis, Gladys J. M.

. England,

Humphrey, Ellen ...

, England.

HuRLBATT, Evelyn ...

. "England.

Hyland, Sarah A

. England.

Illingworth, Marion

. Dinard.

Jenkins, Gertrude ...

. England.

Johns, Josephine ...

. England and Ireland.

Johnstone Evelyn M.

. England.

Jones, Amy M

.. Wales.

Jones, Gladys M

.. England.

Jones, Mary E.

.. England.

Jones, Winifred

.. England.

Keeblb, Ida

. . England.

Kennedy, Annie

.. England.

Kew, Edith

.. England.

Killpack, Annie

.. England.

Krauth, Catherine ...

.. England.

Lane, Ella M.

.. England.

Langley, Marian ...

.. England.

Latham, Ethel M

.. England.

Lavelaye, Marie E. de

. . Belgium

and France

Lawson, Ellen de V.

.. England.

Leach, Gertrude

.. England.

Lee, Florence M. ...

.. Belgium.

Leedham, Eunice ...

.. England.

Lewin, Jessie H. ...

.. England.

Lorraine, Ellen
Lyndon, Charlotte

England.

Roll of War Service.

219

Malkin, Florence ...

. England.

Martin, Bertha

. England.

Maycock, iUice H. F. .

. England.

^Eeehax, Elennor A.

. England.

Messenger, Lily

. England.

MiDDLETON, A. Muriel

. England.

Miller, Annie M

. England.

MORRALL, Kate L. ...

. England.

Morrison, Bertha

. England.

Mullett, Alice M. ...

. England.

Mumford, Maria A,

. England.

MuTFORD, Ada S

. England.

Murray, Jean

. England.

Kaylor, Lily

. England.

Xeville-Cox, Wiaifred A..

. England.

Nurse, Elizabeth A.

. England.

ODonnell, Emma

. England.

O'Eeilly, May M

. England.

Pace, Elizabeth S

. England.

Paterson, Jentie B. N. .

. England.

Patterson, Marion fr.

. England.

Peake, Christina

. England.

Pollard, Sevilla F

. England.

Press, Ellen

. England.

Pryke, Gertrude M.

. England.

Handles, Ethel

, England.

RiTCHTE, Ruby

. England.

Ross, Mairi E

. England.

RowE, Alison

. England.

Ryan, Florence E. M.

England.

Salter, Rose E

. England.

Sautoy, Adeline dii

. England.

Selby, Sarah A

. England.

Self, Mary E

England.

SiLVERWOOU. Sarah A.

. England.

Sinclair, Margaret J.

England.

Skeet, Gladys M

England.

Skinner. Elizabeth E.

England.

220

Jxoll of War Service.

Speller, Marguerite
Spence, Jessie M. ...
Stewart, Rcbocca ...
Stone, Emilic A. ...
Stone, Gladys
Studdert, Emma M.
Sutherland, Lilian E.

Taylor, Kathleen ...
Taylor, Olive M. ...
Ttmbrell, Annie
Todd, Constance
TuBBS, Ellen F. ...

Vallancy, Lney
Vanes, Mary E.
Vivian, Gladys M. ...
* Vivian, Mabel

Wallis, Gertrude V.
Ward, Callierine F....
Ward, FJorenee M.
Watson, Agnes E.
Wetghill, Emma W.
Whittingham, Theresa
Widdowson, Annis ...
WiNDEMER, Evelyn M .
Windemer, Nellie ...
WooDHEAD, Agnes S.
Wright, Alice
Yates, Ethelreda M.
Yell, Minnie L.

England.

Ireland.

England.

England.
England.
England.
England.
England.

England.
England.
England.
England.

England.
England.
England.
England.
England.
.I^iiigland.
England.
England.
England.
England.
England.
England.
Enerland.

American Women's Hospitals.

Birch, Irene M. ... ... London.

EccLES, Lilian ... ... Paignton.

Hughes, Margaret H. ... London.

Illingworth, Marion ... London.

Kilbride, Hester ... ... London.

Kilbride, Kathleen ... ... London.

Lloyd, Alice ... ... London.

WiNDLEY, Dorothy M. ... London.

Ttoll of War Service.

221

Miscellaneous War Work.

Bell, Ellen M.
Bower, FloTonoc C. Nott
Breheton, Katherine B.
BroAVK, Emily Seaman
Burrows, Margnrot. . .
Davies, Enid A.
Ellts, Cntlierine I\r.
CrORDON, Adeline
Ha WES, Alice M. ... •
Joseph, Flora C.
Kayes, Elizabeth M.
Kerr, Daisy E.
Rees, Gladys
Sadleig, Angela M.
Todd, Winifred
OxEORD, Mary N. ...

Eltham Hostels Hospital.

Munition Hovstels, Greojiock.

Food Committee and Militajy Tribnnal.

Munition Works.

Munition Workers' Haspital.

Munition Workers' Ha=!pital.

Board of Agriculture.

Recreation Rooms.

Munition Works.

Women's Patrol.

Censor's Officer.

Canteen. America.

Gas Mask Works.

Mimitions Depot.

Women's Legion.

Author of " Nursinp: in War Time."

Masseuses.

HANrooK, Charlotte IM.
Hirst, Nellie.
Hyde, Gertrude.
Park, Alice M.
Rawson, Emily M.
Roberts, Marjorie.

Rowan. Anita F.
Spreckley, Mildred.
Walford, Edith O.
Waterma>% Bessie M.
WORTHINGTON, Jane F.
Yewdall. Louisa.

Paet III

GUY S HOSPITAL DURING THE WAR.

By
E. P. POULTOK M.D., F.R.C.P.

The history of Guy's Hospital during- the war was a slow
adaptation to "a gradually diminishing number of students, resi-
dents and staff.

At the very beginning a certain number of men at the
Hospital left to take up posts in the combatant and medical
services, and one or two of these tmen fell in the retreat from
Mons. By the time the school year liad begun in October,
1914, still more members of the Junior Staff had left. Senior
members of the Staff", who had taken up their duties as a la
s^ite ofiioers of military hospitals, were naturally oblig-ed to
attend to their hospital duties in uniform, and this added a new
feature to Guy's, wdiich everyone soon became accustomed to
seeing.

Within the first week or two of the beginning of the- war^
the Governors had to decide whether they would follow the
example cf all the other large teaching hospitals in putting:
imiany of their beds at the disposal of the War Office for
wounded soldiers. They felt, however, that the needs of the
civilian population were too great to permit them to do this»
and instead they * offered to erect huts in the Park and to
provide the staff for the extra beds if the War Office wished.
This offer was not utilised. There can be no doubt tlia;t the
Governors acted rightly, because as events showed, it was
months before all the accommodation that the War Office had
at their disposal was utilised. They at once filled up their beds

PART III. A

2 Guys Hospital diwing fhe War.

ill the teacliing hoispitals -with soldiers, Avliile their other hos-
pitals remained emx>ty. The lack of civilian accommodation
showed itself at once in the gxjneral congestion of the beds
at Guy's. However, there can be no doubt that the feeling-
provoked some criticism among Guy's men in general, who
felt that their Hospital was not doing work directly connected,
with the war. Consequently there was general satisfaction when
through Sir Alfred Fripp it was arranged that Guy's should
receive some wounded officers. Within 48 hours the Works
Department had erected cubicles in Stephen Ward, and this
became the Officers' Section in 1914. Each, full Surg^eon was
put in charge of one division of the ward, and« Dr. Faweett
and Dr. Beddard were called in when a Physician was re-
quired. In. order to provido more beds for the corresponding
medical firms, Miriam and John were h.anded over to them,
and in January, 1915, these wards were used for teaching
ward clerks, so that tlie old established Clinical Wards witli
their traditions ceased to exist. However, the post of Clinical
was continued for the time being\ IThe clinicals were given
beds in the medical wards, and were attached to each of the
four physicians.

Just at this time there was* considerable discussion in the
School as to whether students should be advised to finish their
tojedical education and become qualified, or enter the Army
immediately as combatants. Fortunately the first of tliese
courses was adopted, and the length, of the war wdtli the need
for more and more' doctors abundantly justified it. Stipulations
were made that all men should enter the Officers Training
Corps. This was at first under the command of Mr. Lay ton,
but when he left Mr. Eyffel itook over th§ duties. Drilling
used to take place in the park, much, to the delectation t)f
patients and visitors to the Hospital.

In January, 1915, a scheme was prepared by which the
number of residents could be reduced from 21 to 14. There
were to be two House Physicians, four House Surgeons, four

Giu/s Hospital during the War. 3

Out-patient Officers, and two Obstetric Residents, one Ophthal-
mic House Surgeon, one Surgical Out-patient Officer to look
after Patience and Samaritan and Surgical Out-patients. The
night work in the Surgery was to be divided among all the
officers except the Out-patient Officers. Owing to a variety of
circumstances it was not necessary to make such a drastic
reduction in posts for some time.

In October, 1915, the tlu-ee Laboratories on the Medical Stair-
case, built specially for research, were ready. It it needless;
to say that in war time tliey were not used for this purpose.
One of them became the Ward Clerks' Clinical Laboratory when
Miss Grimdy's office had absorbed the old laboratory, and
remains so at present. Another one was used as a sitting
room by massage students, and is now the ClinicaJs* room.
The third one was used as a work room for Physicians and
Assistant Physicians. In the same month for the first time
unqualified Assistant House Sm-g-eons were appointed: ^Ir.
Bates and Mr. Hirsch.

In December, 1915, Dr. Mutch was left sole Medical Regis-
trar till the end of the war.

In March, 1916, Medical Out-patients on Thursdays and
Saturdays were suspended, and in April the Physicians agreed
when necessary to be responsible for their own night work
at the Hospital for five days a week, the two remaining Assis-
tant Physicians being responsible for the week-ends alternately.

At this time the difficulty of staffing the Hospital was becom-
ing considerable. In a letter to the Marylebone Medical War
Committee in January, 1916, it had been laid down that it was
necessary to retain the services of 22 members of the Staff,
all of whom were of military age. This number included phy-
sicians, surgeons, specialists, pathologists and anaesthetists. Tliis
seems a large niunber. However, it must be remembered
that many of them were also acting as a la> suite officers at
military hospitals, so that tliey had less time than usual for
their Hospital work. Further, any considerable reduction would

4 Guy's Hospital during the War.

have serioiiisly impaired tlie clinical teaching-, Isinco every thi^e
months men ^vere entering- the wards from the Anatomical and
Physiological Departments with the intention of getting quali-
fied in the shortest time iiossible. What made things particu-
larly difficult was that members of the junior staff who did
a igreat deal of the teaching and emergency work wem at
times called up for service, and several modifications were made
from time to time to meet ithis state of affairs. The difficulty
was felt more on the surgical Ithan on the medical side since
surgeons w^ere in much greater demand ithan i)hysicians at the
War Office. It will be of interest to i^oord the actual arrange-
ments made when Mr. Tanner, the Kesident Surgical Officer^
was called up about the beginning of 1917. Four Surgeons
in Ichajge of special departments volunteered to sleep week
by week at the Hospital and %o do the w^ork of Resident Sur-
gical Officer — Mr. Mollison, Mr. Thompson, Mr. Chappie and
Mr. Trethowan. Mr. Todd, Surgical Eegistrar, acted as deputy
Resident Surgical Officer. At this time there was no Resident
Medical Officer in Bright Ward, and ih.^ Hoiise Officers under-
took these duties.

In January, 1917, the number of iHouse Officers was reduced
to 11, viz., two House Physicians, four House Surgeons, two
Obstetric Resident Surgeons, two Out-patient Officers, and a
fifth House Surgeon, who also acted as Resident Anaesthetist-
At one -time there were no qualified Out-patient Officers at all.
It was obviously impossible to carry on the Hospital with the
reduced number of men — the Out-patient Department in par-
ticular. Eight new unqualified posts were ttlierefore created —
four Assistant Casualt}^ Officers ,and four Assistant House Phy-
sicians. The Casualty Officers worked in the Front and Back
(Surgery in the da}^ time. The night work was carried on
by the residents, according- to a rota. [Each House Physician
was now responsible to two Physicians, but each Physician
had also an Assistant House Physician, who ^\Qllt round with
him and personally looked after half the bed^, so that the

Guy's Hospital during the War. 5

Hoiiisa Pliyciciaii had actually no more beds liimself than
formerly, although he of course supervised the Assistant House
Phj^sicians. In addition, the Assistant House Phj-sicians car-
ried out all the Out-patient Officer's nsual duties at Medical
Out-patients. While filling these imquaUfied appointments, the
men were, of course, working up for their finals.

The plan adopted by the War Office was to allow a man on
qualification a thi^e months' resident appointment, after which
he was called up automatically to join the Army, or, occasion-
ally, the Navy.

It was soon found necessary to have some rather senior man
on the surgical side i-esident in the Hospital to help the neces-.
earily inexperienced House Officers in special cases. It was
possible to arrange this with the authorities on the plea tliHiti
it was essential to have some experienced resident surgeon to
look after the wounded oncers in the Officers' Section. Mr.
MaKton Avas given a commission in the Navy, and was secon-
ded for this work. He was made Resident Modical Officer in
the Office i-s' Section, and with his other work wa^ probably,
by far the hardest worked man in the Hospital. In fact, it
transpired later on that for about 18 months he had been
unable to leave the Hospital even for a week-end. Although
the Officers' Section took a good deal of his time, his cliief
iwork was in the Obstetric and Gyneocological Departments.
As Obstetric Registrar he had to teach and do Out-patients and
icarry put the emergency surgery, and he also did aU Mr.
Chappie's work when he joined tlie Army. He was also called
upon to advise the House Officers in ease of difficultios in Brig-ht
Ward, and he also acted as Warden of the College.

The Children's Department was carried on three days a week
by Dr. Cameron, who undertook to see all the childi-en whom!
the Out-patient Officei-s had previously treated at " Baby Out-
patients." As may be imagined, the department was filled
to overflowing, and it \whs only jXHssible to get through the work
owing to the kindness of a number of volunteers, among whom

6 Guif-'^ Hoftpital during the War.

the lato Colonel Eoberts, Dr. King- Brown, Mi^. Stewart Robert-
son and Miss Ii'edell may be mentioned.

When Dr. Hurst left, the Neurological Department was put
under the care of Dr. Pitt, then of Dr. Crai^, and later on,
when he left, of Dr. Fothergill.

At the beginning of 1918 the arrangements for carrying on
the (emergency surgery wore altered again. Mr. Todd was
appointed Resident Surgical Officer to act every other week.
Mr. Zamora undertook to do one ;week in four, and Mr. Marston
was also called upon to take yet (another burden on his shoulders
by doing Resident Surgical Officer one rvveek in four. However,
in order to enable him to g-^et away for an occasional holiday,
Mr. Victory, who was House Surgeon, 'was asked to act as his.
deputy. When Mr. Victory had finished his appointment as
House Surgeon he was appointed Resident Surgical Officer and
also acted as a Registrar.

Some relief was experienced at this time by the policy of
the Colonial Governments, who allowed their men to remain at
hospital for one year after qualification provided they were
engaged in work of national importance. By such means the
Hospital succeeded in retaining the services of Mr. Joffe towards
the end of the war, and later on he acted as Surgical Regis-
trar and also carried on Surgical Out-patients. Mr. Debenham
also idid Surgical Out-patients one day a week for a long period,
and he also acted as Medical Radiognapher when Dr. Lindsay
Locke was called up. Help at Surgical Out-patients w-as also
obtained from practitioners outside the Hospital. At one time
Mr. Gardiner was called in for this. Mr. Zamora carried on
Mr. Layton's work in the wards and at Throat Out-patients,
and [when he left Mr. Beevor, 'ixom University College, did
the Out-patient work for a time.

The final "combing out'" of the Staff took place in May,
1918, and a few^ more of its members left. After this, as far
as Surgeons were concerned, the Hospital had reached the limits

Guy's Hospital during the War. 7

and any further depletion would have made it neoessarj?]
seriously to curtail the activities of the Hospital. It would
have been possible to curtail the personnel on the medical side
further, but at this stage of Ithe war physicians were not much
in a^equest, so that the Staff remained much the same from
now till the Armistioe.

The Hospital was much helj^ed during !the war by certain
members of the Staff, who voluntarily remained at their work
although tliey had reached tlie retiring age of 60. These mem-
bers were Sir "William Hale-White, Sir Cooper Perry and Sir
Arbuthnot Lane. The Hospital had to deploi^e the sad loss of
^Ir. Dunn, who died in the middle of his work as Senior
Surgeon to the Hospital.

Within a week of the Armistioe a list had been prepared
of men who were urgently required. Most of them were re-
leased by the War Office with commendable promptitude, and
early in the New Year the tension at Guy's had been to a
great extent relieved.

As has already been mentioned, early in tlie war advice was
given to all men doing intermediate subjects to continue their
work and become qualified as soon as possible. Later on, when
Conscription came in, the War Office adopted the same plan.
No one was to be called up who woidd witliin a short time
be sitting for his intermediate examination. Consequently, the
Medical School was by no means lempty, and its numbers were
increased by wounded and disabled men, by boys from school
who began their medical studies before being called up for
servi9e, and by combatants who were bent back to finish their
clinical work.

Later on in the war a new form of service was started, viz.,
surgeon probationer in the Navy. Men who had passed their
Intermediate were sent away for six months to act as Medical
Officers on destroyers. This was counted as part of their
medical training. While still doing anatomy and physiology,

g Guy's Hospital during the War.

the men were given short courses in minor ' surg-ery and
ansesthetics and venereal diseases, and the Matron g-ave them
8ome instruction in nursing. It was igenerally agreed that the
men did extremely well in the Navy.

In spite of taking this aj)pointment qualification was not
delayed, because the examining bodies shortened the curriculum
by allowing men to sit for their finals immediately after
completing their compulsory appointments. The examinations
were also easier. Not only were ithe questions asked directly
concerned with the work that the candidates would have to do
when they were in the Koyal Army Medical Corps, but there
was a tendency for leniency to be exercised by the examiners,
considering the special need of the Country for more doctors.
Many men took the L.S.A. to ^t through more quickly, and
this lexamination had a sudden outburst of po]3ularity. In
fact, some candidates are at present in course of finishing their
M.B. courses begun during- the war.

Teachers in the earlier subjects were much diminished in
numbers, but thej were helped by 'the appointment of student
jdemonstrators and by the examining bodies dispensing- with
icompulsory lectures for intermediate and advanced tsubjects.
Mr. Evans had Mr. Reed to assist him in the Biological De-
partment. Dr. Fison did his work without a demonstrator.
Professor jLowry, who was much engaged in w^ork for the
Ministry of Munitions, also carried on the Chemical Depart-
ment with the help of one part-time demonstrator. Mr. Zamora
was head of the Anatomical Department with Mr. Reed to help
him. Dr. Pembrey was alone in the Physiological Department,
and ^Iso acted as " Sub -Dean." Sir Cooper Perry became
Honorary Dean when Mr. Bromley left. Dr. Laidlaw carried
on the Pharmacology Department as well as his own. Con-
siderable credit is due to the Medical School for succeeding ;in
meeting all its expenses during the war, without help from
other sources.

Gmfs Hospital during the TFar. 9

As far as tho Nursing Staff Avere concerned, there was no
shortage of nnrses in the Hospital during the war. Short
coui-ses of training were axraijged for V.A.D.s to enable them
to do useful work in military hospitals.

This account cannot be closed without mentioning the various
Zeppelin and aeroplane raids. The Hospital was in a district,
rather favoured by the enemy on these occasions, and many
casualties were admitted. In the early days Guy's was sought
by the neighbourhood as a convenient place of refuge. On
one occasion the Out-patient Hall and the underground passage
were crowded, and it was rumoured that a gramophone had
been produced and dancing had taken place. Subsequently it
was announced that the Hospital would be closed during raids
so that its proper functions should mot be interfered with.
When the famous daylight raid of aeroplanes took place a bomb
was dropped in Newcomen Street, and £25 worth of glass was
broken in the Chemical and Physiological Departments.

Guy's Jloepital and Medical School could only have been kept
up during the war as a going iconcern by its members remain-
ing loyal, by their willingness to do extra work, and by the
avoidance of slackness. Fortunately these qualities were shown
by students and teachers and everyone telse connected with the
Hospital.

CHEMICAL RESEARCH AND MUNITION
WORK AT GUY'S HOSPITAL MEDICAL

SCHOOL.

T. MAKTIN LOWEY, C.B.E., Hon. M.A. (Cantab.),

D.Sc. (Lond.), F.R.S., F.C.G.I.
Professor of Pliysical Chemistry in the University of
Cambridge .
Late Professor of Chemistry at Guys Hospital Medical School.

The story of munition work at Guy's during the war is so
largely a personal one that it is difficult to describe it in any
other form than as a personal record for which the indulgence
of the readers of the Guy's Hospital Reports must be asked.
The first contribution to national requirements of tlie Chemical
Department at Guy's took the form of work on the produc-
tion of anaesthetics under a scheme arranged by the Royal
Society's War Committee to provide supplies which were
urgently needed but which wei-e no longer available from com-
mercial sources. This work was carried out mainly under the
direction of Mr. Harold Rogerson, one of the demonstrators
in the Chemical Department, and war service badges were
issued by the Ministry of Munitions to him as well as to Mr.
R. G. Early and to Mr. W. Haines, who also took part in this
work. The two products manufactured in the laboratories at
Guy's were chlorhydrin (an intermediate product in the pre-
paration of jiovooaine) and beta-eucaine. The quantities handed
over to the Royal Society War Committee were as followTs: —

Glycol (for preparation of novocaine) ... 4j-lb.

[3-Eucaine hydrochloride ... ... ... 6 Jib.

12 Chemical RcsearcJi and Munition Work at

Dr. R. AV. Merriman, demonstrator of chemistry, left tlie
Department early in 1915 in order to assist in the management
of a new plant for the manufacture of oleum or fuming sul-
phuric acid, of which very lar^ quantities were required for
the manufacture of explosives. Mr. Rog-erson, who then carried
on the work of both demonstrators in addition to his work on
the preparation of anaesthetics , also left in the summer of 1916,
to take up a technical post connected with the use of indigo
dyes, an important appointment although not connected directly
with the manufacture of munitions of war. In the summer of
1915 Mr. Victor Steele, my lecture assistant, left to join an
Officers Training Corps. He was commissioned as a Lieutenant
in the Special Battalion Royal Engineers, and rendered im-
portant services in connection with Gas Warfare until he v^as
recalled from France at my request by the Ministry of Muni-
tions for technical work in one of the National Filling Factories.

In September, 1915, when it had become evident that the
programme of high explosive shells could not be filled by the
use of j)icric acid and T.N.T. and must be supplemented by
very large dilution Avith ammonium nitrate, I was called in to
advise the Department of Explosives Supply in connection
with the unexpected qualities which this salt had developed
when manufactured and handled on a large scale. In order
to secure the fullest possible knowdedge of this difficult material,
arrangements were made with the anonymous donor of the
Dental Research Scholarship whereby the joint holders, Mr. R.
O. Early, B.Sc, and Mr. J. N. Vowler, were allowed to devote
themselves to experimental work on ammonium nitrate. As a
result of this work the technical laboratory at Guy's soon estab-
lished itself as the recognised centre from which information
might be derived as to the properties of this most important
salt.

The scheme for the use of ammonium nitrate as the back -bone
of the British programme of high explosives was developed
at the Research Department, Woolwich, where the earliest
experiments were made on the dilution of T.IST.T. with am-

Guy's Hospital Medical School. IS

monium nitrate. These mixtures, whicli were described under
the general name of " Amatol," were of various compositions,
but the most effective w^as one in which the limited supplies of
T.N.T. were diluted wdth four times their weight of ammonium
nitrate and converted into 80/20 amatol, thereby increasing
the weight of explosive five-fold and at the same time giving
a more powerful explosive than the undiluted T.N.T. Too
much credit cannot be given to Lord Moulton, to whom my
first reports -were presented, for having recognised at a very
early stage the fact that this mixture must be the backbone
of our programme in a pi-olonged Mar calling for the largest
possible output of munitions.

Shortly after the Ordnance Board had been reconstituted in
an enlarged form as the Ordnance Committee, I was appointed
as an Associate Member with special reference to the i^roduc-
tion and use of amatol as a high explosive, an appointment
■which I still retain. 80/20 amatol had the property of being
extremely insensitive. It was, therefore, very difficult to
detonate, and unless very great care and skill were employed
a shell filled with amatol was liable to detonate partially,
much of the explosive being scattered about unburnt after the
detonation of the shell. For this reason, when 80/20 amatol
first came into supply its efficienc}^, as judged b^' the weekly
proof of filled shell at Shoeburyness, was distinctly below that
of picric acid, and it was therefore necessary to continue to
manufacture the latter on the larg^est scale that circumstances
would permit. Gradually, however, as the result of incessant
experiments on methods of manufacture and filling, for which
every facility was provided by the responsible officers both
of the Design and of the Supply De[)artments, the conditions
required for successful detonation became clearl>' known, and
steps were taken to ensure that these conditions were main-
tained in supply.

After having been called in, in February, 1916, to assist the
Ordnance Committee in connection with the use of amatol in
shells, I took part, at Lord Moulton's request, during tJie

14 Chemical Research and Munition Work at

spring and summer of that yeai', in two series of investigutions
on the manufacture of ammonium nitrate explosives, one in
connection with alternative methods of manufacturing 80/20
amatol and the otlier in connection with a modification of the
well-known blasting explosive "ammonal" in order to reduce
if possible the quantity of aluminimn used in filling this ex-
plosive ;into trencli mortar bombs as well as for R.E. land mines.
In connection with tJiis extension of the work I secured tJie
assistance of Dr. E. P. Perman, of University College, Cardiff,
and was fortunate in being able to retain him in the Guy's
laboratories until the close of the Avar and the winding-up of
munition work at Guy's.

The result of the experiments described in the above para-
graph w^as tlie adoption of 80/20 amatol for trench warfare
purposes as well ais for shell filling. On the establishment of a
separate Trench Warfa*re Committee, therefore, I was appointed
in April, 1917, as an Advisory Member of thie Committee with
special reference to the use of amatol in trench warfare and
in aerial bombs.

My direct association with the shell-filling factories began in
the spring of 1916. At that time tlie Chihvell factory had
already reached a very advanced stage, and w^as producing
a substantial output of filled shells. It had, however, become
necessary to provide additional capacity in a series of new
National Filling Factories, and at this juncture Lord Moulton,
who was extremely anxious that the use of 80/20 amatol should
not be prejudiced by incomplete knowledg^e of its properties,
put me into touch witli Sir Eric Geddes, to whom I acted as
technica'l adviser until he was transferred to France to re-
organise the railway transport. From July, 1916, to September,
1917, I acted as outside adviser not only to the Department
of Explosives Supply and to the Ordnance and Trench Warfare
Committees, but also to General Mihnan, the newdy-appointed
Controller of Gun Ammunition Filling, on whom rested the
mair responsibility for the efficiency of the ammunition sent
out for service in the field. In order to obtain the maximum

Guy's Hospital Medical School. 15

efficiency of output by the scientific control of manufacture,
General Milnian, at my request, secured from the authorities
of the Medical School the use of certain of the laboratories
in the chemical aiid physiological departments, and provided me
T\-ith a staff of chemists to assist me in this work. These
chemists were all sent to Guy's to acquire some knowledge of
the technique of amatol before taking up appointments in the
factories, and in this way something like 20 Amatol-chemists
must have passed through tlie laboratories at Guy's during tlie
period of the war. The facilities thus afforded by the School
were full}^ appreciated by the authorities, and on terminating
the agreement the following letter was sent to the Dean by
the Controller of Gun Ammunition Filling.

CCOPY.)

2hrd, January, 1919.
To the Dean of the Medical School,

G,uy's Hospital, London, S.E.
Dear Sir,

In view of the winding np of the Experimental Work of this
Department and the dispersal of, the Experimental Stafif, it is proposed
to vacate after Easter ttlie Laboratories at Guy's which are now
occupied on behalf of the Ministry of Munitions. I therefore beg"
to give notice to terminate the present agreement on April 30th, 1919.
lu doing so I wish, to express my appreciation of the services which
you have rendered to this Department by allowing us to make use
of the accommodation of thd School at a time when the provision of
fresh laboratory accommodation has proved extremely difficult. I shall
be glad if yoai will also convey to your colleagues my thanks for
their concurrence in the aTrangements that have been made for carry-
ing on our work in the School. — Yours faithfully,

L. C. P. MILMAN, Brig. Gen.,

Controller! of Gtui Ammunition Filling.

At the beginning of tliis period of advisory work under
General Milman, Dr. A. F. Joseph, Professor of Chemistry
in the Medical School at Colombo, joined me as a voluntary
worker, and remained with me until after the termination of
hostilities. The period was one of very active work, including
the starting up of five big National Filling Factories and most
of the pioneer work whereby the success of their output of 80/20

16 Chemical 'Research and Munition Work at

amatol was fully aud fiually established. During this period
laboratories were erected ia the new Filling Factories, and
chemists were appointed at my request in order that the know-
ledge gained by experiment and research might be applied
effectively in the day b}- day routine of the factories.

In September, 1917, General Milman pressed me to undertake
an executive post in his department, and appointed me as
Director of Shell Filling, a post which I occupied until the
conclusion of the war. This appointment involved the technical
control of the mannfacture and liandling of some thousands
of tons of expletive per week for use in shells, and it was not
long before the filling- of naval mines, of trench warfare bombs^
and hand grenades was also transferred to ihe department^
which thus became resj)onsible for using practically the whole
output of high explosives in the country. On transferring my
principal office to tlie Ministry of Munitions, I arranged for
Dr. Perman to act as Director of the Ministry of Munitions
laboratories at Guy's.

On the entry of America into the .war an urgent demand
was received for information as to the metliods of shell filling
whicli had proved so successful in England. At General
Milman's request, accompanied by Major Armstrong-, I visited
the United States in October, 1917, in order to communicate
to the Officers of the Ordnance Department the methods of
manufacture which had rendered British ammunition equal and
in some respects even superior to that supplied to any of the
other armies in the field. For this purpose I was able to re-
commend to the United States Ordnance Department methods
both of manufacture and of filling 80/20 amatol which had only
recently been developed in Great Britain, but in which I had
sufficient faith to make them the basis of the whole of the
American shell-filling programme. My i-ecommendations on
this subject were accepted immediately, and within a week ap-
proval had been given to adox3t amatol as the standard Ameri-
can explosive, and to erect a series of five very large filling-
factories to handle this work, in addition to providing factories

Guy's Hospital Medical School. 17

for the manufacture of the requisite ammonimn nitrate, one of
which, erected at a cost of 14 million dollars, had already reached
at the conclusion of the war an output of 200 tons per day. At
tlie conclusion of this visit, after filling the first amatol shells
produced in the States, and seeing- tliem fired at Sandy Hook, I
brought back to England an American mission, composed of
eight technical men under an Ordnance Officer, to study English
methods, and from this time onwards a very complete liaison
was maintained between the two services. It is of interest to
note that whereas amatol in England was costing perhaps 8d.
per lb., our French allies, who maintained to the end of the
war their faith in picric acid or " melinite " as the best military
explosive, were purchasing this material in America at a
cost of something like a dollar per pound. The saving to the
United States Government resulting from the adoption of amatol
in place of the explosives recommended by the French experts
must therefore have been very substantial.

At a very late stage in the war a complete liaison was finally
established between the English and French shell-filling depart-
ments. Dming 1918 I had the pleasui-e of receiving two French
missions to England, and of leading two English missions to
the French shell-filling factories. As a result of these visits
amatol w^as adopted in France as an alternative to picric
acid, after trials which proved it to be completely satisfactory,
although manufacture had not yet been imdertaken on a very
large scale at the time when hostilities ceased.

In connection with my technical work on shell-filling, I
also paid a visit to Italy in the spring of 1918 as a member
of Greneral Savile's mission. During this visit again a complete
liaison was established with ihe technical officers of the Italian
Ministry, and during the ooui'se of tlie year I was able to
welcome two Italian missions to England, one to study tlie
English methods of filling shells with high explosives and the
other in connection with the manufacture and use of mustard
gas. As a sequel to these visits I was appointed an Officer
of the Italian Order of St. Maurice and St. Lazarus.

PART III. B

18 Chemical Research and Munition Work at

A very important development during the last months of
the war was the transfer to the shell-filling department of tlie
very urgent work of supplying to the armies in the field shelb
charged with mustard gas, a weapon which had become almost
a decisive factor in the final stages of the struggle. The
manufacture and handling of this material were attended with
very grave danger, in addition to the imminent risk of serious
illness arising from exposure to the vapour. In France, indeed,
where the charging of shells with mustard gas had led to
over a thousand casualties in one factory alone, this was re-
garded as a military operation calling for qualities of endurance
and coiu-age comparable with those required in service in tlie
field. Profiting to some extent by French experience the con-
ditions in England were perhaps less painful, although in tlie
early stages of manufacture one worker was obliged to report
sick for every nine rounds that were supplied to the Army.
In connection with this new work I arranged a technical
mission to France in June, 1918, Avhich had the effect of chang-
ing completely the methods used here in charging this gas into
shells, and revolutionised in the most favourable way the con-
ditions prevaiKng in the English gas-charging factories. In
the autumn of the same year I accompanied deneral Milman
on a visit to all the factories in France which were engaged
in this work, and heard from the Director of one of these fac-
tories the choicest compHment I have ever received when he
remarked at the conclusion of the visit " il y avait un de ces
Anglais qui oonnait rudement ses affaires." Shortly after my
return to England my work on mustard gas was recognised
by an appointment as an Additional Member of the Chemical
Warfare Conunittee.

In connection with the educational work that was required
in order to secure and maintain the highest possible quality
in ammunition filled with amatol, a series of four conferences
on amatol w^as held in the Medical School at Guy's in April
and September, 1917 and 1918. These conferences were very
largely attended, and indeed assumed an international charax3ter

Guy's Hospital Medical School. • 19

owing to the presence at tliem of technical officers fix)m France,
Italy and the United States. For the purpose of these con-
ferences the Committee Boom of the Medical School was placed
at my disposal, whilst the residents in the College very
generously allowed me to entertain our guests at lunch in tlieir
library.

The laboratory at Guy's also became an active oentre of
publication, a long series of technical reports on ammonium
nitrate and on amatol being issued from Guy's and circulated
in the British filling factories and technical departments, and
also in the Colonies and among-st the Allies. In this way
research work carried out at Guy's dming the war has secured
a permanent place in the confidential literature dealing with
the manufacture of 'munitions. Scientific results obtained in
the course of these investigations will, it is hoped, be issued
in due course in the form of communications to the scientific
societies most directly concerned.

In conclusion, I cannot omit to express my appreciation of
the generosity of my colleagues, which allowed me to carry on
so much work of national importance whilst still retaining* my
lectureship at Guy's. In this matter I am specially indebted
to Dr. J. H. Ryffel for undertaking the lectures in Chemistry
during my absences in America and Italy, and to Mr. A.
Greeves for his efficient control of the laboratory work when
most of my time and attention had to be given to urgent
matters connected directly with the war.

OFFICERS' SECTIOiN. GUY'S HOSPITAL,

November 2nd, 1914— December 31st, 1918.

By
J. FAWCETT.

The Officers' Section in Stephen Waxd took shape as a sequence
of the magnificent defence of our old '* Contemptibles " at die
first battle of Ypres, whereby the Empii-e -was saved yet again
at one of the most critical periods in the early stages of tlie
Great War.

The oni'ush of the Him had just been held, but at such a
cost that our accommodation for wounded officer was sadly
insufiicient. One Monday morning, 'November 2nd, 1914, Sir
Alfred Fripp visited the Sux3erintendent to inform him of the
state of affairs. The Treasurer and Sir Cooper Perry at once
decided, as a matter of m'g-ency, that Stephen Ward should be
converted into a ward for feick and wounded officers. This
ward had been renovated recently and a " tile " india-rubber
floor laid down, the gift of the Rubber Growers' Association.
Between 11 a.m. on November 2nd, 1914, and 4 p.m. on the
following day partitions were erected dividing the floor space
into separate cubicles. The Worlds' Department, in addition,
completed the necessary adjustments for jDi'op^r electric light-
ing of the cubicles and for lavatory accommodation. Nurses
were provided straightway, and the patients originally in the
ward housed elsewhei'e. That very night two dozen petienta
were admitted.

It was a triimiph of willing hands, hard work, pnd .good plan-
ning, and everyone, from the Superintendent downwards, who

22 Officers' Section, Guy's Hospital.

had given a hand oonld not but feel thoroughly satisfied with
the result. The cost of conversion of the ward was £28 19s.,
of whidi £13 15s. was for labour^ and £15 4s. for material.
The wooden partitions Avere those originally Uised in the wardi
maids' dormitories before these inaids moved to Tabard House.
The ward remained open in full working order from November
2nd, 1914, to December 31st, 1918.

The four divisions of the ward were allocated to the four
surgeons to the hospital : Sir Arbuthnot Lane, Mr. L. A.
Dunn, Sir Alfred Fripp, and Mr. F. J. Steward, and after
Mr. Dunn's deatli Mr. H. P. Rowlands filled his place for a
time, and later Mr. C. H. Fagge.

Dr. J. Fawoett and Dr. A. P. Beddard acted as physicians,
each to the half of the ward under their control in peace time.

In addition, there were taany others who did sterling world
there, including those of the Assistant Physicians and Assistant
Surgeons who were kept at the hospital; also Mr. Mollison and
Mr. Ormond, Dr. Shipway, Dr. Eyre, and Dr. Iredell, among
others; Mr. Marston, who acted for a time as Medical Officer of
the ward, and all the house officers who, in their turn, loyally
did their best in carrying on the continuous work of the section.

Sister Stephen, Miss Sheild, was placed in charge, and re-
mained so throughout, and to her and to the Nursing Staff
who worked so admirably under what were at times trying con-
ditions the success of the ''section" was largely due. Miss
Sheild was awarded the K.R.C.

The facilities afforded by ihd resources of a general hospital
led to many severe cases being sent to us ; 1,199 officers were
admitted and treated, with 12 deaths only. The amount of
work carried out was great and often arduous, and it was some
compensation tx> have so many old Guy's men, when attacked
by ill fortune in the way of sickness or wounds applying for
admission.

There being no hospital accommodation in London for Naval
casualties, and the numbers of officers and men detained in the

Officers' Section, Guy's Hospital. 23

London area in connection with the Admiralty and the Air
Defence of the Metropolis being- largely increased, the Naval
Authorities were glad to avail themselves of the offer made
to keep a certain number of beds always ready for emergencies.

The Hospital bore the whole cost of maintenance of the ward.

This short history of the ward may iittingly be ended by the
following letter from the D.D.M.S. of the London District
conveying the thanks of the G.O.C. in command to the Presi-
dent of the Hospital when it had been decided to close the
Officers' Section : —

Headquarters, London District,
Horse Guards Annexe,

12, Carlton House Terrace,
London, S.W.I.
17th December, 1918.

To the Chairman, Guy's Hospital.

Dear Sir,

It has been intimated that you are desirous of closing the Officers'
Section, Guy's Hospital, on 31st December, 1918.

The Officer i/c Queen Alexandra's Military Hospital has been in-
istructed to evacuate the patients before that time (i.e. 30/12/18).

On behalf of Major-General G. P. T. Feilding, C.B., C.M.G., D.S.O.,
General Officer Commanding, London District, I wish to ofifer my sincere
thanks and appreciation for the excellent work that has been carried
out there during the past four years, and I should be greatly obliged
if you would be so good' as to convey to the Medical and Surgical
Stai, and the Nursing and Subordinate Staff, our sincere thanks and
admiration for their devoted and excellent work in connection with
the treatment, comfort, and general welfare of the sick and wounded
patients that have been accommodated during this long period.

Yours very faithfully,

(Signed) S. MACDONALD,

Major-General,
D.D.M.S., London District.

H.M. QUEEN MARY'S ROYAL NAVAL

HOSPITAL. SOUTHEND-ON-SEA,

1914-1919.

SIR WILLIAM HALE-WHITE, K.B.E.

Directly after the declaration of war on August 4tii, 1914,
Mr. R. A. Corbet brought to the •notice of one or 'two peoplo
the Palace Hotel, Southend-on-Sea, as a suitable building for
a hospital. Fleet-Surgeon Mundy inspected it on August 8tli
and expressed the opinion that it Avas suitable for a naval war
hospital. Twelve people were got together to form a Com-
mittee, and Her Majesty the Queen consented to become Presi-
dent of the Hosj)ital. The Committee met for the first time on
August 10th, 1914. Dr. "W. Hale-White was elected Chairman,
and occupied this position until the closure of the Hospital five
years later. Mr. R .A. Corbet was elected secretary, a post
he held until January 2nd, 1915, after which date he was liot
•associated with the Hospital, Mr. E. R. P. Homfray being
secretary from January, 1915, until the end of 1919. The
Committee at once proceeded to collect subsciriptions, and
raised £34,822. The total cost for administration and mainte-
nance of the Hospital was £111,000, of which the War Office
and Admiralty provided £82,544, and thei-e were other receipts
from interest and sale of equipment, bringing up the total
i-eceipts to £119,000. Messrs. Tolhurat, the owners, lent the
building rent free, but the Committee paid all rates, taxes and
insurance, and at the end of tlieir tenancy in July, 1919, paid;
Messrs. Tolhurst £6,000 for reparation.

2G TI.M. Queen Manfs lioyal Naval Hospital, Southend.

Tho Coimiiitteo after tlieir first meeting' Tbegan the prepara-
tion of the Hospital, and on October 16th, 1914, received 1G7
wounded Belgian soldiers. As in the early part of the Avar
the Hospital was not required for Bailors, soldiers were received
and on October 30th, 1914, 101 British wounded soldiers were
admitted. The Hospital then contained 270 beds. Oa April
10th, 1915, the beds were increased to 300, and in December,
1916, to 350, at which number it remained until the last
patients left in May, 1919. For the first two years soldiers.'
were received; after then only sailors. The Hospital was al-
most always full, and the total (number of patients treated was
close upon 10,000. The number of operations performed was
2,500, and the deaths were 55.

In the first week of October, 1914, Miss Kate Finnemore,
jformerly of Guy's, was appointed Matron, a post which, she
held until July, 1919. Nearly all the sisters and nurses also
came from Guy's. On October 12th, 1914, R. A. Chisolm, of
Guy's, Avas appointed Eesident Medical Officer, and on May
8th, 1915, Evelyn Scott was appointed junior Resident Medical
Officer. He became senior when Chisolm left in October, 1915,
and Roland Sells became junior to Evelyn Scott. These two re-
mained in office till the last patients left in May, 1919. All
these three were Guy's men.

The following members of the Guy's Staff acted as Honorary
Consultants, and paid hundi-eds of visits to the Hospital: — -
E. C. Hughes, H. L. Eason, A. W. Ormond, C. E. Iredell,
J. W. Eyre, W. Hale -White. The following old Guy's men
also at one time or another acted as Consultants: — R. Jocelyn
Swan, R. A. Greeves, H. Tod Reeve, C. M. Ryley, R. W. P.
Jackson. Dr. A. F. Hurst jgenerously lent /the X-ray apparatus,
and Mr. Schofield, who was trained at Guy's, was the Resident
Masseuse. The Guy's Hospital Minstrels came down at Christ-
mas to give entertainments. The following doctors resident in
Southend acted as visiting physicians atnd surgeons: — S. Bridger,
H. Cleveland Smith, C. Forsyth, A. G. Hiiiks, V. J. Hodgson,
Maxwell W. H. Morgan, J. C. SmelHe.

SOME OBSERVATIONS ON THE SICK

AND WOUNDED FKOM THE GALLIPOLI

CAMPAIGN.

By
CHARTERS J. SYMONDS, K.B.E., C.B.,

Late Consulting- Surgeon to the Mediterranean Expeditionary

Foroe.

Ix responding to the request of the Editors of these Reports
for some account of the sick and wounded fix)ra the campaign
in Grallipoli, it is only possible for me to give a general review.
This I admit is not the type of communication suitable for a
volume which should contain matter for reference only. Though
figures cannot be given, nor any account of the many investi-
gations that went on, the sketch may be of interest as giving
a general impression of the conditions prevailing* in Malta.
I arrived early in July, 1915. The weather was hot, the
hospitals filled with sick and wounded. Colonel Bal lance —
now Sir Charles — had gone out in May, and had borne the
brunt of the rush from the early battles. The g-lare and heat
were very trying, and the hotel noisy. It became a question
of shutting the windows to get some sleep, or being conistantly
disturbed by gossiping people, goats, children, and a horse
stabled on the other side of the very narrow street at the side
of the hotel on to which my window opened. Colonel Ballance
had succeeded by an appeal to the Bishop in stopping the
bell-ringing in the early hours, a concession denied to Napoleon.
The church bells began about 3 a.m., and in Valletta, crowded
as it is with churches, sleep to those unaccustomed to this

28 Soitie Observations on the Sick and Wounded

form of "slumber song," LeLaine impossible. The hospitals were
not so very far apart in a direct line, but as the roads ran by
the sea many miles were added owing to the irregularity of
the coast line. As the transport was unable to supply me with
a car at once, I had to get to and fro by steam launch and
carozzi. This added enormously to the fatigue and exposure
to the sun, and on one occasion caused an attack of momentary
giddiness Avhile walking in the open by a sun-beaten wall.
One dodged into every bit of shade. A car removed all these
troubles, and enabled one to get through double the amount
of necessary work.

When in August the Suvla Bay attack began, the w^ounded
arrived in large numbers. Ab they gathered under the few
trees in the sun-baked Floriana barrack yaixi, eag-er were the
questions asked as to how far we had got. Hopes rose and fell.
Acha baba was ours one day, on another we had made no
progress. Stories of awful hardship, of long periods without
water, of the plague of flies, piled up the miseries of this mis-
taken campaign.

Among the wounded were many Australians, and one got to
appreciate their sturdy manhood, hopeful outlook, and readiness
to return to the line. It was well to see these fine fellows "re-
joicing in their strength," swinging along the front at Slima
with the glorious vitality of youth and splendid physique.
Officers and men were alike in the determination to g-^et back
to the front. " I must be there with the boys " was the refrain
of these men. If these Australians were wanting in discipline
when quartered in Egypt, it must be i-emembei'ed that the
read}'^ access to Cairo exposed men unaccustomed to the life
of a city to great temptation. And of all places in the whole
world it would be difficult to find more depraved surroundings.
Months of inactivity made them restless, and the troops were
allowed to frequent districts in the city which ought to have
been out of bounds. Appeals from those working for the moral
Avelfare of the men were too often disregarded. Once in the
battle line with an outlet for their energy, they proved them-

From the GallipoU Campaign. 29

selves in many a field splendid men, brave soldiers and good
comrades. Impetuous and carried away with tlie lust of fig-ht-
ing, they at times, as in the first landing, broke away from
command. Still, it has been said by some observers, who saw
the effect of tlieir onslaught, tliat could the attack have been
backed up by the support of anotlier division, Gallipoli would
have been won.

The contingent operating in the peninsular was composed of
the pick of the manhood of Australia — ^all volunteers. In the
ranks men of education and wealth were mingled with all sorts.
A solicitor from Sydney, who came in with a wound of the
thorax, related the following incident. On patrol at night, he
lost his bearings amidst the gullies, and stumbled upon the
enemy trenches. Escaping, he found a friendly outpost, com-
posed of tlie son of a leading barrister, a theological student,,
the son of a physician, and the last an expert burglar, also
from Sydney. Association raised this last man's outlook, and
coming later on to my patient, tlie solicitor, asked to be taught
to read. He had, he said, been broug-ht up to steal, and to-
look upon anything he could take from otliers as fair game.
But here he had seen men shai*e everything, not only helping
but dying for one another and bear witliout murmur unheard
of sufferings, and he had determined to strive to emulate tlieir
example. Let us forget in tlieii' splendid sacrifice the few
and at times pardonable lapses of some of the unruly spirits.

The Maoris were fine, broad shouldered men, and bore the
X>ain of their wounds with great fortitude. The Indian 6oldiei*s^
especially the Gourkas, many of whom were badly wounded,
proved excellent patients. One's inability to tallv to them made
association difficult, for the native interpreter failed to convey
any sympathy. Unfortunately, many of these Indian soldiers
had been wounded by the fire from our ships. They had taken
the summit of tlie liill so quickly tliat tliey were mistaken for
the enemy, and our guns continued to fire. It was a very sad
pair of their English officers, both slightly wounded, who ac-
companied a particular batcli of tliese Indians, for the losses

30 Some Ohseri'at'Kxm on the Sick and Wounded

had been terrible in botli offioers and men. The devotion of
these offioers to their men touched one deeply; they accom-
panied them to- a liospital most inconveniently eitimted, declin-
ing* other much more pleasant quarters.

The sick and wounded from Gallipoli were carried to Alex-
andria and Malta, the fastest hospital ship completing the
journey to Malta in 36 hours, others in 48, usually the men
had been wounded four to seven days before arrival. The
urg'ent operations were conducted on the voyage, \X\e majority
of cases, however, requiring operative treatment on arrival.
The accommodation was provided first in tlie one Military
Hospital at Cottenara, which was expanded to receive treble
its usual complement. The barracks, housing in peace time a
garrison of five thousand, were next requisitioned, as all troops
had been sent to the war areas. The small rooms, holding about
10 patients each, were inconvenient for nursing, and rendered
supervision difficult. They were well situated on high ground,
and proved most valuable for the sick and for prolonged
septic cases. St. George's, St. Andrew's and Tigne were close
to the sea, while Imtarfa was inland on high ground close to
the old city, and seven miles from Valletta. Floriana, just out-
side Valletta, though less well situated was airy and convenient.
The old hospital of the Knights of Malta was in constant use
from the first. This medieval building is close to the harbour,
the main ward is 130 feet long, 30 feet wide, and of the same
height. The windows are small and do not reach to within
10 feet of the floor, and are on one side of the building only.
Thus efficient ventilation is impossible, owing to the dead air
below the windows and the absence of cross ventilation. As
soon as possible severely wounded cases were removed from
this unsuitable building.

Further accommodation w-as provided in huts, tents, modern
school buildings, and colleges. One Auberge made a satisfac-
tory hospital, and later the isolation hospital on Manoel Island
w^as handed over. Officers were accommodated in tlie roomy
buildings of the officers' quarters attached to the barracks, also

From the GalUpoli Campaign. 31

in a technical school building- and in the Hospital of the
Blue Sisters. Altog-etlier some 20,000 beds were provided.
The organisation of this gi-eat undertaking \va8 due to the
foresight and energy of the Governor, Field Marshal Lord
Alethuen, assisted by Colonel Sleeman, of the 1st London Field
Ambulance, as Principal Medical Officer. To these two men
belongs the credit of an organisation that met every demand.
When the beds were full on one occasion a cable arrived asking
if a shipload of wounded could be received. The Governor
replied in the affirmative, for, as he told me, better lay these
men on the floor than leave them in a ship. Never did he
refuse a call. Several officers of the Field Ambulance wei-e
appointed as Officers Commanding Hospitals, and thoroughly well
they ruled. Most conspicuous was the hospital at Imtarfa, of
1,000, for enteric, dysentery, and all infectious diseases.
Major Andrew Elliot made this a model hospital, and so well
•were the arrangements for the disinfection of dysenteric and
typhoid stools laid down and carried out tliat during* his
time no member of the nursing staff became infected. The
accommodation was improved and extended on the arrival of
Surgeon-General H. R. Whitehead (now Sir H. R.).

There were special conditions which rendered the Gallipoli
•campaign injurious to the health of the troops. Few men re-
mained throughout the occupation. The majority lasted on an
average four months.

At Hellas there was a fair amount of spaoe. At Anzac,
as one man said, if you stepped back from your trench you
were over the cliff. Exercise, therefore, was almost impossible,
not only from this cause but also from the shell fire. Next,
the heat in July and August was intense, and the flies bewared
description. These two causes operated chiefly in determining
rapid septic changes in the wounds. Water was another difficulty.
Every drop had to be breught from Lemnos, and often — as
at Suvla Bay — when an advance \vas made the men were
without water for two or even three days. The physique of
the troops natui-ally deteriorated under these conditions, and

32 Some Observations on the Sich and Wounded

Ihey became more siLsceptible ta dysentery- and para -typhoid.
These two maladies were always present, and^ as will be appre-
ciated, added immensely to the evil effects of wounds.

Some observations made by Colonel (now Sir) Purvos Stewart
upon men in tlie trenches showed a large percentage to be
suffering from rapidity of the heart and anaemia. Again this
explains the more severe effects of wounds than in those fight-
ing in France. Men have told me that at first tliey could carry
a bucket of water up the cliff with ease, but later had ta rest
more than onoe. And yet these were the men who took their
turn with the rifle in the trenches.

In consequence of these adverse conditions the death rate
was high, and the nimiber of life-saving amputations required
much larger than in other battle areas. A man suffering from
dysentery with a smashed femur stood a poor chance. Efforts
to save such limbs frequently failed on account of the exhaust-
ing effects of this complication. I rennember such a combination
in an Irish lad. The bloiod flowed from the rectum on the table,
and it was a question of immediate^ amputation. As the fracture
could be easily controlled w^e took the risk, and for a time
this' was jujstified, but the recurrence of the dysentery, to-
gether with infection of the knee, compelled us to amputate
later.

Gas gangrene was not frequently seen among these wounded^
but there occurred a fairly large number of cases presenting
all the symptoms of poisoning from the bacillus coli. There
was no obvious g^as in these wounds. The patient became cold,
the hands blue, the pulse rapid and weak, while consciousness
was retained up to the last. Terminal vomiting was common,
just as one used to see in unrelieved strangulated hernia.
Probably some of these men might have been saved had the
routine excision of wounds been carried out as was later adopted
in France. Infection was, however, widespread by the time
Malta was reached, and the best period for carrying out this
method had passed. Every stump without exception was covered
with grey slough, those tliat had been sutured were full of pus.

From the GalUpoli Campaign. 33

We pointed out the evil of closing- amputation to the surgeons
of the hospital ships, and advocated the simple circular or light
gauze packing- when flaps were made.

Compound fractures of the femur, of which there was a
largo number, were treated by Hodgen's suspension splint.
Coming from Guy's, where the first Hodgen was put up in this
country, and having always employed the method and found
it fiiatisfaotory, I ihad a large Jiumber constructed.

In July, 1915, I remember going to the Ordnance Depart-
ihent and asking for one hundi-ed Balkan supports to be made
for these cases. It oould not be believed that more than five
and twenty could be required. We, however, got all we wanted
the moment the chief of the department understood the position.
That was where the consultants facilitated the distribution and
manufacture of apparatus. Colonel Clark of the Ordnance had
400 men in constant employ making hospital furniture, splints,
etc. One had only to explain the position and in the shortest
time one had the splints. Ag-ain, where instruments were needed,
one went to the stores, obtained and carried them in the car
to the hospital

. The Thomas splint was also used for thigh cases. I think
we were fairly early (July, 1915), in establishing for the treat-
ment of fractured thighs extension by weight on a Hodgen or
Thomas's splint with slinging from a Balkan frame. The con-
tinuous irrigation of saline was then in vogue. One of our
most scientific and accurate surgeons, and, I am glad to say,
a Guy's man, then Capt. Camps, now of Teddington, observed
under this method that the wounds did not do so well as might
be expected. He therefore adopted intermittent irrigation and
was, I believe, one of the first to practise the method. Again,
he found it advisable to change the re-agent, using perman-
ganate chiefly.

To Capt. Percy Camps we were indebted for many improve-
ments in apparatus and methods. These were tlie outcome of
close personal attention, and nothing of importance was left
to others. At all times of the day the seriously wounded need

PAilT III. c

^4 Some OhHervallons on the Sick and Wounded

attention, and the apparatus frequent adjusting. One lias only
to maxk the difference in tlie comfoi't of the j)^tient and the
rate of recovery, where this constant supervision is given with
progressive outlook, and the perfunctory morning and evening
visits, everything nearly being laft to the nurses. Camps intro-
duced an efficient method of draining deep pockets and sinuses.
A piece of silver wire was passed, through the tube which was
now doubled on itself at its mid point, where an o])ening was
cut. Irrigation could thus be carried to the deepest part AvithouC
removing the tube. •

Wounds of the knee-joint arriving profoundly infected did
badly. One soon noticed that whenever a large opening existed
in a joint allowing a free escape of secretion there was a fair
prospect of recovery. When the olecranon was blown away the
elbow did well; when the knee-joint was exposed from the loss
of covering skin and capsule we could generally do something;
even in the hip a large posterior wound through which the
head of the femur oould be seen rotating was capable of re-
covery. I have seen such a casie recover with some movement.
We therefore impressed upon the ship surgeons to be content
in all kneo cases with free lateral incisions placed well back.
Wliere this was adopted early sepsis did not spread up the thigK
during the voyage. I had the opportunity — long waited for — of
excising an acutely septic knee-joint. Private H., a Welshman,
was very ill, he had wasted, was in great pain, ran a hig-h tem-
perature, and had suppuration of the knee-joint with oedema of
the leg. He did not want to lose his leg, and, taking tlie risk,
I excised, removing the minimum amount of femur. The limb
was put up in a malleable iron and plaster of Paris splint,
sufficient extension was applied to separate the surfaces, and he
was slung in a Balkan. I had tlie satisfaction of seeing him
go home with a good useful limb. Another excision, made
after some weeks of suppuration, did so well that the patient —
a big Australian — was taking weight on the foot in four months.
Col. Ballanoe (now Sir Charles) went further and pegged the
bones with steel pins. I have done a dozen such cases now,
using steel pins, and with most gratifying success.

From the GallipoU Campaign. 35

Head cases were .numerous, for the steel helmet had not been
introduoed into our army, though employed by the French, and
they did badly except when the dura mater was intact. It was
pitiable to watch these cases, some of them remaining sensible,
and taking interest in things, while the hemisphere was slowly
melting away, I came to the conclusion that it was better in
tliese badly -infected cases to expose fully by the crucial method
and dress as an open wound.

A soldier takes his chance of a wound and of death from
enemy fire, but to be maimed and suffer or to die from other
causes seems a greater tragedy. Such was the effect of the awful
blizzard that swept the peninsula and produced 4,000 casualties.
Cold rain fell in torrents, swept down ravines which sheltered
our men, and carried away everything', men and animals were
drowned, food, equipment, transport, everything went. Then
came a freezing drizzle, followed by snow. It was night, the
enemy trenches Avere near, our men had in some units lost rifle
and ammunition. It was impossible to ascertain how much'
the enemy had suffered, and so Ave had to keep on the alert.
Men stood out that night covered Avitli snow, and it was this
alone that saved them from the fire of the enemy — they were
invisible. Men froze to death during that terrible night, and
hundreds lost their feet from frostbite. Where the flood had
not descended and the cold alone had to be encountered, the
evil effects could be mitigated. The officers and men of Lovat's
Scouts sent coffee to th(»e in advance, and the gillies, accus-
tomed to the cold of the Highlands, took off 'their boots and
rubbed their feet. I saAv no cases from this regiment. I asked
a young captain how he got through the night, and he replied
that he kept his men hard at work digging trenches he did not
Avant. NoAv comes the i-esult of this disaster into Malta, and
Avords fail utterly to describe the sufferings of these poor
felloAvs, or to give any adequate idea of the destruction of life
and limb. Many died soon after arrival from general septi-
caemia; immediate amputation through the thigh was neces-
sary when the gangrene or the tense bluish red area had

36 Some Observation'^ on the Sick and Wounded

reached the upper third of the leg. In the hope that free
ineisioiiiS into this teiLse area miglit check destruction, mc adopted
this method in the case of a man, both of whose feet were black,
and so high had the redness and swelling* extended that i-emoval
tlirough the thigh Avould alone carrj^ one above the area. We
took the risk. Captain Camps amputated through one thigh,
and at my suggestion made vertical incisions into the other leg
in the hope that a below-knee amj^utation Avould suffice later.
The plan succeeded. This man had septicaemia at the time',
and W'O did not like to take the risk of leaving both limbs.
The result, however, raises the question whether it would not
be a sound plan to make an early guillotine amputation, as
low down as possible, in severe frostbite, or to relieve tension
by early incisions. I cannot give the number of amputations
for frostbite. Some idea may be obtained when I say that
one morning in a single lios]3ital I saw six cases inquiring
double amputation. I operated on one leg, demonstrating the
method carefully, assisted the surgeon with the other, and left
him to deal with the remaining cases. In one ward in another
hospital there was only one sound foot among-st eight men.
The problem how ' best to deal with cases of partial ganigrejue
of the foot has given as much trouble in those arising from
so-called "trench foot" in France as it did with our cases directly
due to exposure to intense cold. The trench foot is, so far as
I can judge, due to a slower but similar precess with a like
result if sufficiently i^rolonged. The loss has been generally
limited to the toes, though tlie circulatory effects have reached
higher. I have not seen a whole foot become gangrenous in
any of the French cases.

The desire to save part of a foot lias led to prolonged
invalidism and much suffering, and in a fair number ampu-^
tation has had to be performed after a year's treatment. It
is not alone the loss of the part of the foot, but the conditiion
of the skin and muscles, which liave only just escaped destruc-
tion, that causes the disability. The skin is thin, dry and shin},,
and ver}' tender; the muscles of the sole of the foot are hard

F)t)m the GallipoU Campaign. 37

from fibrous myositis, the scar is constantly bi^aking down.
One lias seen a good many such cases after months of treatment
still cri^Dpled. Amputation at this stage gave the only chance
of a useful limb. Better had the foot been removed early.
I meaji that where in addition to the obvious gang-rene of
part of the foot there is evidence of permanent injury to the
vessels, nerves and other tissues, early amputation is the
soundest practice .

The only surgical complication arising from dysentery was
effusion into the joints. This would occur in men well enough
to be about. The knee was mostly affected, and there were
not many eases. The joint filled up quickly, was fairly tense,
and only slightly painful. In one case I directed the fluid to
be removed by aspiration, and if found opaque the joint was
to be injected A^dth ether. The fluid, I afterwards learned, was
clear, nevertheless the surgeon injected ether wdthout any evil
result. The patient, indeed, felt little or no pain during the
next few days, and recovered completely. Ether has proved
valuable in mild septic synovitis, and can be injected without
an anaesthetic . My usual plan after drawing off the fluid
by a Record's syringe is to inject 10 c.c. and prevent the escape
through the needle until the ether vapourising distends the
joint, when the vapour is allowed to escape. Then another like
quantity is injected, and retained. In a case of recurrent syno-
vitis of septic origin due to secondary infection from a wound
of the lung the fluid wais opaque, and the deposit contained pus
cells. Considerable improvement followed the injection of ether,
and some months after this officer was using his joint freely
while on light duty.

Paraty]3hoid of both varieties was fairly common, and gave
rise to many consultations at Imtarfa as to whether a perfora-
tion had or had not occurred. In some cases where thei-e had
been sudden pain and distension even with collapse, we wei'e
able to distinguish between ulcei-ation of the colon without
extravasation and complete perforation with escape of contents.
''Amongst 1,200 cases avo have had about 50 deaths and there

iW So7ne Observations on the Sick and:* Wounded

were nine cases of perforation with eight deaths. Paratyphoid
B. accounted for five, B. Typhosus for three, and Para A.
for the one that recovered. This gives a mortality of 4 per
cent, with an average of less than 10 per cent, of perfora-
tion occurring- in the whole series. Of the nine cases, two
were admitted with perforation, three perforated the next day
and one on the second day after admission. So that there is
not much doubt but that a considerable number had perforated'
before reaching- Malta. A journey that necessitated transport
from the trendies to the field ambulance, from There to the
clearing station, embarkation, a sea voyage of about four days
with often a rough passage, and finally a motor drive of seven
miles in the case of Imtarfa, must be conducive to a typhoid
ulcer perforating." I quote the above from a j)aper contributed
to the Medical Society in Malta by Captain Rose Clarke.

The case that recovered was operated upon by myself, and
a few particulars may be interesting. Albert W., 29, a stoker,
went sick on December 4th, 1915, with headache and abdominal
pain. Records begin on the 7th with a temperature of 103-4°,
pulse 84. The temperature varied from 101-2° to 104-4° for
the next nine days; pulse 80-86. On December 17th he had
a rigor at 3 p.m., the temperature rising to 106° and pulse
140. At 10 p.m. the temperature had fallen to 99° and pulse
to 68. This was the fourteenth day of recorded illness and
probably later in the disease.

On the 18th, having had a comfortable morning, he was
seized with abdominal pain at 12 noon and vomited twice;
the temperature rose to 103°, pulse to 108, and there was
sweating. At 2 p.m., temperature 102°, pulse 70, pain in
spasms, ^o vomiting, comfortable generally. At 6 p.m., tem-
perature 103°, pulse 104, pain more severe, spasmodic, abdo-
men more rigid. At 8.30 abdomen opened in median line
below umbilicus, and a large quantity of thin sticky greenish
fluid poured out, the colour growing darker as the fluid came
away from the deeper portion of the pelvis, and was finally an
olive green. No gas and no odour. The presenting loop of

From the GallipoU Campaign. - 39

intestine showed lymph, and below this the great omentum
was adherent to the bowel. On raising the omentum a perfora-
tion about a quarter of an inch in diameter was exposed. It
appeared to have been closed by the omental adhesion. The
aperture was closed by a fine silk suture and the omentum
attached to and folded round the bowel. A rubber drain was
inserted into the pelvis. Twelve hours after operation, tem-
perature 98°, pulse 78. By the 27tli the tempeiuture was
normal, the pulse on the 20th was 70 and varied between 64
and 78.

That success followed this operation is due to the early
recognition of the perforation by Captain (later Lieut. -Col.)
Price, and the Commanding Officer of Imtarfa, Major Elliot.
Lieut. Garrow, who gave the anaesthetic, stated the time occu-
pied from the commencement of tlie administration as twenty
minutes.

Other cases were operated upon, but too late or the patient
w'as toe ill from toxaemia for recovery. Early operation is more
•important in these cases than even in perforating duodenal
ulcer, ■ for the blow falls on a man already weakened by
disease, and the extra vasated material is highly infective. The
risks are small if everything be prepared; the perforation will
usually be found in the loop of the bowel first exposed through
a median incision below the umbilicus. In the case recorded
here the perforation was witJiin a foot of the caecum, in others
9 inches and 6 inches. In one it was 2 feet and another 4 feet
from the ilio-caecal valve. In two cases the caecum was per-
forated.

One man died in another hospital through the Medical Officer
mistaking the "period of repose " which follows perforation for
improvement. He had all the signs of perforation during the
night of December ll-12th, 1915. When seen next morning by
the Medical Officer— a Maltese and a careful man— the pulse was
88-90, and there was no complaint of pain. Unfortunately, no fur-
ther visit was mode till 6 p.m., and the rise in pulse rate at noon
to 112, two hours later to 120, and temperature 103-2° were not

40 Some Observations on the Sick and Wounded

reported. At 6 p.m. the pulse was 140 and temperature 103°,
and thei-e was frequent vomiting of green fluid. At 8 p.m. the
perforation was quickly found and closed, and the pelvis
drained. He died on the 13th at 2 p.m. At the autopsy the
peritonitis was limited to the pelvis, the perforation securely
closed >vas nine inches from the csecum. The lower lobe of one
lung was solid from broncho-pneumonia. The missed opportunity
was due in the first place to the report of the night being
taken from the patient, and secondly to the misinterpretation
of the "period of repose." Also and most important in the
rise in pulse not having- been reported.

In a brief sketch like the present it would be out of place
to pursue this subject. I would only emphasise the importanc-e
of the following points: —

1. That the occurrence of any sudden change in the course
of the illness should raise the alarm. In the first case here
referi^d to there was a rigor twenty-one hours before the
perforation, in the second a sudden fall in temperature to 97°
about twenty-four hours before the onset of abdominal pain.

2. That a period of repose almost invariably follows. In
the first case this was manifest in two hours, in the second
completely deceived the observer some eight hours after perfora-
tion. Close observation in this period will often detect slight
signs of progressive peritoneal irritation. There is usually some
pain, if careful enquiry be made, though so slight when com-
pared with that of the onset that the patient makes light of it.
The pain will be spasmodic and slight, will occur after taking
any tiling by the mouth, and sickness Avill be induced by food.
When in doubt my practice has always been to give food in
this period in all cases of suspected perforation from whatever
cause. If vomiting follows in one or two hours tlie existence
of spreading infection is demonstrated. Over and over again
in acute appendicitis I have employed this test, and never with-
out finding abundant proof of the necessity for operation.

3. Seeing that the perforation is in the majority of cases
within two feet of the ilio-ceeeal valve, and can be reached

From the Gallipoli Campaign. 41

through a median incision below the umbilicus, with a mini-
mimi of disturbance, the added danger of an operation is
slight, provided always it be brief and the angesthetic so selected
and given as to be followed by quick recovery. I like my
patient to respond to a question before leaving the table or
within 15 minutes.

4. Time being in these septic conditions of the greatest
moment, the anaesthetic should not be started until the o^x^rator
stands ready with the scalpel in his hand. In these cases also
the frequently associated pulmonary lesions have an important
bearing upon the choice or dui-ation of the anaesthetic (see the
second case). Gas and oxygen given with the modern apparatus
is no doubt the best anaesthetic, as it is followed by a quick
recovery. I have on several occasions been obliged to be con-
tent with chloroform in operating for perforative appendicitis.
Ready to incise the moment the conjunctival reflex was
abolished, even though there was movement of the limbs, I
have been able to complete removal and drainag-e in fifteen
minutes, and I believe in this way determined i^ecovery. There
must be no prolonged post-operative depression; if tliere is to be
success. I once successfully resected two feet of small intestine
in a lady over 80 without any anaesthetic beyond ethyl chloride
localty.

Tetanus, though it occurred, caimot be said to have been a
frequent complication. Several cases arose amongst the Indian
troops; all •were fatal. One English soldier recovered from a
long and severe attack only to die of g-eneral caseous tuber-
culosis.

Though there occuned many cases of acute hepatitis, abscesti
of the live¥ was uncommon. Hepatitis called for not in-
frequent consultations at Imtorfa and other hospitals. The
liver became enlarged and tender; there was some pyrexia, and
the question of abscess or cholecystitis arose. Emetine solved
the difficulty in many cases. It was extraoixiinary how rapidly
the liver subsided in a few da}^. It is unnecessary to dwell
upon the value of this remedy even when an abscess has

42 Some Observatiom on the Sick and Wounded

From the Gallipoli Campaign.

occuri*cd. A very notable instance was that of a yoiin^ soldier
in whom an abscess was suspected, and which it was thought
had burst into the pericardium. He was tx>o ill at the moment
for any operation, though I was prepared to open the peri-
cardium as the lesser of the two risks and the more likely
to give immediate relief. Colonel Archibald Grarrod (now Sir
Archibald) did not press for immediate interference though the
heart was rapid in action and there was a friction rub, and
the temperature was uf). In a few hours this delay was justi-
fied, the cardiac condition improving to one of safety. The
diagnosis of hepatic abscess remained, though the exact posi-
tion could not be defined. Emetine had been administered, and
it was decided to rest content with aspiration as a first measure.
One of the medical officers had some successful cases in China.
Over a dozen punctures into the right lobe yielding- negative
results, and not inclined to explore the left in this way, I
opened the abdomen in the middle line and at once exposed
a large abscess in the left lobe adherent to the diaphragm.
The pus was evacuated by an aspirator, and a large
drain inserted down to the site in case further drainage should
be necessary. The patient recovered without any recurrence
of pus, under the continued use of emetine. The pericarditis
had been due to extension, not perforation. I was asked to see
an abscess in the Royal Naval Hospital, Netley, so large that
the skin was bulging and fluctuation easily obtained. Though
he had been prepared for operation, I suggested emetine and
aspiration, drainage later witb. injection of emetine into the
cavity should the pus re-collect. Even this man recovered with-
out further interference. It is truly remarkable to watch the
subsidence of the enlarged livers under the use of emetine,
and still more satisfactory that its use enables - us to dispense
with drainage in hepatic abscess, except, of course, where a
secondary infection has occurred..

THE WAR WORK OF THE B.R.C.S,
NURSING SERVICE.

By ■

DAME SARAH SWIFT, G.B.E., R.R.C.,

Matron-ill -Chief, British Red Cross Society and Order of St.
John; formerly Mati'on of Guy's Hospital.

The story of the work of the trained nurses of the British
Red Cross Society, of which I have personally seen much on
my tours of inspection, is one of arduous labour, unselfish de-
votion and indomitable courage in many theatres of war.

In August, 1914, not a moment was lost by the British Red
Cross Society and the Order of St. John in org-anising- the
trained nursing service that was at once recognised to be a
need. At St. John's Gate several well-known matrons and
others Avorked with me in forming- a band of trained nurses,
and shortly afterwards the nursing department was co-ordi-
nated under the Joint War Committee of both Societies at 83,
Pall Mall, w^here I have had the honour of w^orking as Mati^on-
in-Chief for five years.

The first step taken was to form a register of nurses with
full hospital training, and send them where tlie need was most
urgent. Later, other registers were compiled of staff nurses
with two years' general training and of others holding Fever
Hospital Certificates. Only three years' general trained nurses
were sent to work abroad, with the exception of tliose to do
infectious work. At this time the staff numbered 2,500.

The whole story of the nurses' work will never be told, but
the following short sketch will give some idea of the extent of
tlieir labours, and of the conditions under which they nursed

44 Tht' W'iir Work of the B.R.C.S. Aiirsing Service.

on the various fronts, as well as in Great Britain, France,
Belgium, Italy, Egypt, Salonika, Serbia, Eussia, Roumania,
and Bulgaria, and later on in Holland, their work being done
in hospitals, casualty clearing stations, surg-eries, rest stations,
ti'ains, ships, barges, factories, and in hostels attached to the
various camps employing personnel.

At first it was very difficult to cope with the work, but in
August, 1914, the first units Avere sent to Brussels and Antwerp
and were at once busy nursing' Belgians, Fi^nch, British and
German soldiers. The bombardment Avas severe, and the nurses
had not only to do their duty calmly, but to reassure their
patients. When the Germans entered, some nurses had to dis-
guise themselves as refugees and make their escape by Charleroi
and Denmark. The stories of the nui-ses' bravery Avere thril-
ling; to give but one example, a slightly -built woman was
seen to lift three disabled men on to a cart Avhen the shed
they were in was being bombed.

The conditions under which our nurses have worked were
both varied and unprecedented; for nurses have had to perform
duties which hitherto have been considered outside their pro-
vince; thus, at casualty clearing stations many of the nurses
gave the anaesthetics and thus gained valuable experience.

In France and Belgimn old barns, engine sheds and empty
buildings were utilised as hospitals ; they had, of course only the
most primitive sanitary arrangements or none at all, no water
supply, no lighting, exoe]Dt lamps and candles, and very poor
heating and cooking arrangements, if any. Not only comforts,
but even medical necessaries, were absent, and thousands of
w^ounded were pouring in continually. The hospitals had no
anti-tetanus serum, little chloroform, and owing to the diffi-
culty of transport scarcely any dressings, clothing or bed
linen. Moreover, in these conditions the nurses had to tackle
not only fearful surgical cases, but entirely new illnesses, such
a^ gas poisoning, gas gangrene, tetanus, trench feet, facial in-
juries, the varied diseases of the eye, as well as epidemics of
enteric and paratyphoid, and later, in the East, typhus, small-
pox, diphtheria, trench fever, and Bilharzia.

The War Worh of the B.R.C.S. Nursing Service. 4.5

Belgium.

The first British Red Cross Society unit to go abroad con-
sisted of a party of 14, organised b^'the Order of St. John, which
left London on August 19th and got into Brussels by the last
train to enter, just as the Germans took the city. Within thi^e
days they were quietly doing the work in hand, nursing Ger-
mans, British, French, and Belgians for about a month, until
they were told that they might leave. Their journey home
through Belgium, Aix la Chapelle, Cologne, Hamburg, Denmark
and Norway was a memorable one. They slept on a cargo of
potatoes crossing to Aberdeen.

As much help as possible was given to Belgium, wliich was
overwhelmed by the sudden catastTophe, and had no proper
hospital accommodation or nursing service. At La Panne, a
little coast town which was swept constantly l:>y enemy shells,
a unit of 10 sisters worked from •November, 1914, at the
Hospital de I'Oc^an for several years, imtil, after some of the
staff had been wounded and killed, they were ordered out of
tliat too dangerous zone. The aj)pi*eciation of their work is
shown by the fact that at a time when it was feared tliey
might be recalled for service with British troops, the Queen
of the Belgians specially requested tliat they might remain,
and the unit was increased to 30. This uiiit wa^ the last one to
work in an Allied hospital. It was under the Belgian Red
Cross, and its 1,600 beds were used entii-ely for Belgians up
to July, 1916, when it was partly taken over; for the British.
In September, 1917, it ^^-as found necessary to evacuate, owing
to the heavy shelling irom tlie German lines only five miles off,
and it was then used as a di-essing station, and the Red
Cross iSisters were recalled.

It was to help the Belgian refugees, too, tliat 82 Red Cross
sisters worked at Malasisse, St. Omer, during an epidemic of
enteric, giving the inceswsant care necessary from (February
to June, 1915, so tliat a serious danger was i-edueed to a.
minimum.

46 The War Work of the B.U.C.S. JSursing Service.

Wliat made the work in the early days so remarkable wa^,
as I have stated, the way in which the nurses met the situa-
tion, treating a huge number of most serious cases in the
most primitive conditions with a lack of all appliances con-
sidered necessary in hospital work. The wounded were wait-
ing— there was no time to organise anything, but just to set
to work. Here is one picture: "One recalls a building, a
former school, with no lighting or heating arrangements, ex-
cept in one room where there was a gas jet and a miserable
stove, the only means of obtaining hot water. Here urgent
operations had to be performed under anything but aseptic
conditions, and case after case would be brought in and placed
on the floor, watching and waiting to take their turn on the
improvised operating table. The other rooms were full of
wounded lying close together on straw, and it was anxious work
by the light of a feeble candle, going from one to the other
watching for hsemorrhage or collapse. The food question was
also a difficulty, even milk being hard to get. The sanitary
arrangements were practically nil, tJie only pretence being an
open gutter in front of the building."

" Another school taken over had been so long unused that
it needed w^eeks of cleaning. Meantime the wounded were
pouring in night land day, to be washed, fed, and have their
w^ounds dressed before being sent to England. The wounds
were appalling, the odour from gas g'angrene cases unbearable,
and the mental condition of the patients added to the strain
of nursing. Sometimes the whole building would be plunged
into darkness or the water supply cut off. Therei was no gus
and very little methylated spirit or alcohol, but the will to do
work overcame all difficulties and in an incredibly short time
many well-organised hospitals were ready."

Another centre of wonderful work was a raihvay engine
shed in Calais fitted with 200 beds where Eed' Cross Sisters
worked during tlie winter of 1914, while in the same: town
another party tended numerous Belgian typhoid cases in a small
house with narrow staircases and no proper drainage. Yet

The War Work of the B.R.C.S. Cursing Service. 47

another hospital for Belgians in Calais was the Baltic and Corn
Exchange Hospital with an enteric annexe. Another hospital
was ithe British Farmers, in huts, on a plot of ground given
by the French; the Matron and 27 sisters composed the nursing
staff. It is interesting* to note that although many different
infections -vvere nursed in only two wards, there were only
two cases of cross infection. The work was carried! on Iduiing
severe air raids, one of which lasted over five hours. The
Hopital Jeanne d'Arc, Calais, was also staffed by the British
Bed Cross Society sisters and did excellent work for many
months. The Isle of Wight Field Barge Hospital w^as another.
Four of the sisters also worked on the Belgian^' Hospital Ships
to and from England.

France.

France -was, of course, the field of most o£ ith© workers, and
France in the early days of the war meant difficulty and dis-
comfort, bitter winter weather, no fires, no facilities for cook-
ing or bathing. '

At Dunliirk three St. John sisters were sent to help in the
station sheds, which had been converted into a sort of clearing
hospital. Dunkirk, being only five minutes by aeroplane from
Ostend where the German stores were, was subject to bombard-
ments from the air, and unless there was a British! warship (in
the harbour it was also bombarded from the sea. The enemy
went back two or three times in the night to Ostend to replenish
their bombs. The last time I was in Dunkirk there was scarcely
a ^^indow left in any building.

One can imagine the scene, the long gaunt shedy the floor
packed with stretchers on which lay French, Turoos, Senegalese
in their picturesque turbans, some on tlie straw down on the
rails, the long French or Belgian trains diuwing up to the
siding-s with the sad freights, the patient and almost terrify-
ing composure of the piou-pious, the picturesque mixture of
races. One sees, too, the kind, busy French Medical Officer, with
his "Mon Brave" and "Mon Petit," always cheery and' hopeful,

48 The War Worl: of the B.R.C.S. Nursing Service.

and courteouis to the group of English doctors, and nui^es wait-
ing the order to start dressings before the reloading^ of the
trains. One of the nurses writes : " Nowhere on earth^ could
one lliave been more privilegied to work, or been more closely
brought into touch with all the stern realities of war. To
realise oneself in dii^ct contact with tlie men straight' out of
the trenches, and to see their wonderful stoicism undei' such ap-
palling conditions covered with mud, bruised, bleeding, maimed,
and dying, and yet expiring joyfully ' pour la patrie ' was to
know that in the end the barbarians were doomed to loosen
their hold on tlie fair laud of France no matter what it cost
their children in blood and tears. To leave the shores of this
island land to work and talk among men audi women who had
seen the deadly peril at their doors and the ' sales bosohes '
at their house -wrecking- \\x>rk would determine the least ooura-
geous of us never to turn back an inch until the Hun liad been
absolutely crushed and rendered too weak to attempt to destroy
the world's peace by such horrible and dastardly crimes ag-ainst
mankind. 'Better still, to feel the welcome given to the^ In.-
firmieres iAnglaises, and the appreciation of the *help given
by our doctors and nurses to the wounded of! our Allies, is 'to
have had a real sliare in trying to do something, however small,
for our brave AlHes."

Sisters !from 'the early units worked in French HospitalSi for
the (first ten montlis of war, until, owing to ^the shortage, they,
were Recalled 'to our own hospitals in France. They liad hard
work land by no means an easy time. Tliey were to bo found
in hospitals at Tournai, Aix-les-Bains, St. Malo, Dieppe (nurs-
ing German prisoners), Compiegne, St. Lunaire, Dinard, Tre-
guier, Nevers, Malo -les- Bains, Fort Mahon, La Conte par Hu-
dain (only ten miles behind the front), Gretz, Caen, Cherbourg,-
Paris. In fact, up to the end of 1914, '582 sisters had re-
ported for duty in France and Belgium.

At St. 'Malo, at the Friends' Hospital, our nurses at first
nursed enteric cases for the French, later the hospital took
g-eneral cases. Here oeciuTed one of the manv instances of

The War Work of the B.R.C.S. Nursing Service. 49

bravery. A report by the Principal Mati-oii says : " Nothing
could (have been finer tlian the cahn way the patients were
dealt with during- lan air raid. It gave me great insight into
what fthe staff went through nigiit after night, yet cheerily
doing ttheir work during* the day as usual. I consider that it
was tlie influence of tlie matron and some of the staff that
tliis calmness was maintained throughout."

Help was given to the French, even as late as December,.
1918, when a unit was sent to Mauberge to nurse French,
civilians from the recaptured districts. Four small hospitals
wei-e established and served 366 patients from about twenty--
five villages.

Work for the British in France.

The British B/ed Cross nunses, tjiough ihey gave so geneix)usly
to our Allies, had also tlie privilegie of caring for our own
men.

As early as September 29th, 1914, No. 1 Bed Ci-oss Hos-
i:)ital opened in the Hotel Astoria, Paris. Excellent work was
done for five months, until the hospital was taken over for
the French.

At Bouen No. 2 Hospital was transferred to the Bed Cross
in September, and shortly afterTV'ards it was reorganised as
an ioffioers' hospital, and was greatly appreciated by the 26,000-
officers A\'ho passed through it.

Other sisters worked in tlie Bed Cross Hospital at Abbe-
ville and four at an Aid Post at Bouen; later, also, at Bou
Seoours where there was a 1,600 bed Belgian Hospital.

The bulk of the work done was at Boulogne. The wounded
■wTei-e Ipouiiugi in; cliaos reigned, and six "pioneer" *Eted Cix)ss
sisters wei-e gladly welcomed by the army authorities and set
to work at the famous " Sugur Shed Hospital " on; tlie wliarf
— No. 13 Stationary; and for some montlis fifty Bed Cross
sisters were hard at work tJiere. The Principal Matron A\Trites :
*' I can remember the sister's sending over to me for food for
their patients. I was only able to iget bread,, butter, and milk

PART III. D

50 Tin' War Worl' of the B.R.C.S. ?iurslng Service.

in the town, but that at least tided them! over a little. The
spirit in Avliich this unit worked cannot be forgotten by any-
one who was associated with the work at the time." The
army lauthorities were more than g-lad to use thef nursing- help
pixDvided by the British [Red Cross Society. Eleven werei com-
mandeered by the Matron-in-Chief, B.E.F., for army hospitals
in Boulogne. Another worker served in the X-ray and Elec-
trical Department of No. 7 Stationary all through the war.

In November, No. 4 Red Cross Hospital, with 100 beds,
was opened at Wimereux with a matron and 19 sisters, many
of whom won w^ell-deserved honours. This hospital admitted
the severely w^ounded from the Aisne and the Marne and
worked to the end of 1915.

In December there was opened at Wimereux No. 5 Red
Cross Hospital staffed by 22 of our sisters; its record is over
14,000 patients.

Meantime our sisters had been staffing the fine hospital iat
Le Touquet, which treated at first all ranks, but later was
reserved for officers and did splendid work for nearly four
years.

The year 1915 saw the establishment of many new Red Cross
Hospitals. That at St. Malo already mentioned, was then used
for British patients and had two wards for naval men; its
record is 2,325 'French and other nationalities and 9,261 British,
besides 202 civilians.

In April the Liverpool Merchants' ^Hospital (No. 6 Red Cross
Hospital) was opened at Paris Plag-e, and moved later tO' its
own huts at Etaples, and in 1918 to Trouville. It had a
matron and a staff of 42 nurses.

In July, No. 7 Red Cross Hospital was opened at Etaples.
In August, at the same place, the largest of all the voluntary
hospitals, the St. John Brigade, "was opened. This hospital
was bombed in May, 1918, with considerable loss of life; the
matron and five of her staff being awarded the Military Medal
for bravery. ,Several hut wards were completely destroyed and
all the glass of the operating and surgical theatres was smashed.

The \yar TFo/7v of the B.R.C.S. JS'ursing Service. 51

One sister -vvas killed instantaneously, and six sisters were
-either injiured or suffered from shell-shock, or both.

In September the Baltic and Corn Exchange Hospital, which
had been Avorking- for the Belgians, opened for British soldiers
at Paris Plage (No. 8 Red Cross), and worked for two: years,
treating over 12,000. It continued its work later at Boulogne.

The end of the year saw the establishment at Calais of
No. 9 Red Cix)ss Hospital. It did excellent work, lived through
many air raids, and had an adventurous career, having tliree
moves jand being forced to trek during the German advance
of 1918. Two of the staff received the Albert Medal. This
hospital had a fine dug-out, sixty feet deep, in case of need
for patients and staff.

In 1916, No. 10 Red Cross Hospital w^as opened for British
officers hi Le Treport, and did g*ood work for over two years.

In 1917, the hospital at La Pamie, already referred to, was
transferred to the British on the taking over of tliat part of
the line. 'Three of the British IRed Cross staff were asked to
go to a Field Ambulance and Main Dressing Station, the
Director-General giving his permission, although it was out
of order for women to be at such an advanced post. The
matron with three sisters remained there for six weeks doing
most excellent work. They Avere highly recommended by the
Officer Commanding for the valuable services rendered to g^as
eases. There was an arrangement in tliis Clearing Station
Avhere fifty gassed cases could be placed in an enclosure at a
time and treated by inhalation. One tlioueand cases could' be
taken in, and in case of bombardment the building- could be
cleared in less than three-quarters of an hour. Owing" to
these gOB cases having immediate nunsing- treatment many lives
Avere saved. The Dressing Station Avas prettily situated in the
grounds of a farmhouse near Coxyde, Belgium, and Avas shelled
in September and quickly evacuated.

In April, 1918, the Anglo-French Committee of the British
Red Cross Society transferred its personnel to the Fi-enoli Rod
Cross, and those working for the Belgians came under the oon-

52 The War Worl- of /he /,'.///'. S'. Nvr.shir/ Servifp.

ti-ol of tho Joint War Committee. Tiie year was trying ais well
as Iheavv; worlr M^as diKorg-anised by the retreat. la June the
hospitals weixi bombed, and there were evacuations; our advance
followed quickly, and the hospitals still intact had a very heavy
time. October wa8 tlie lieaAiest time of all, as' in addition to-
heavy convoys, there were epidemics of influienza and pneumonia.
With the armistice the hospitals Avere closed down, and in.
April, 1919, the Joint War Committee staff Avere demobilised.

Trains.

Another sphere of activity was in the Ambulance Trains.
One of ithe fiiist began its career in April, 1915, and took its
first load of wounded from Hazebrouck to a basfe. Here is the
sister's description : ''Poor thing's! Some of them were in an
awful condition, some dying, some haemorrhaging', and others
soaked in blood and stuck tightly to the sti*etcher by their
clothes. We 'turned to and did as much as. ever we could for
the men on our downward joiirney, cutting- off clothing, i-e-
clothing, and doing dressings, feeding the men, and, if pos-
sible, washing tiieir faces and hands. I had ninety under my
care in three w^ards of thirty beds each. In! three weeks tlie
train carried 8,000 wounded." *No wonder the sister says :
" It was this train that carried some of thei first awful load jof
gassed tmen." Here is an account of a day's work : " During
the loading of the train the sisters make a note of each patient,,
diet them, and fix them up comfortably. This enables them,
directly the loading is finished, to give a list of the diets to
the head orderh" of each ward, (and he takes the diet sheets*
to the stores sergeant, wdio issues the food accordingly for each
meal. The sisters receive a list of treatment from the Imedioal
officers, and if the load is a heavy one they are kept busy lall
the journey with dressings, irrigating Carrel tubes, taking off
wet and dirty clothing, re-clothing and nursing serious cases.
The sister in charge of the sitting- cases has a. busy time, as
her patients come up in relays to the treatment room to be ii*e-
dressed, and this mav mean as manv as two, or three hundred

The War Worlv of the B.R.C.S. yiirsing Service. 53

dressing's ^vheii there is a pusJi on. Journejs take any lime
from isix hours to thirty houi-s, according* to which! part of the
line the train is running- from and to which baise it is evacuat-
ing. Also tlm time varies very much according- to whether there
is much pi-essure of traffic on the line. We have brought down
patients from most of the big- n3attles — Ypres, Hill 60, Loo«s,
the Somme — in July, 1916, and all the autumn of 1916; Arras,
1917; and from Ypres and the Jiorthem section in July, August
and October, 1917. We did not get much rest either, as there
was the train to be cleaned, blankets to be shaken, beds to be
made and dressings to be prepared. If we helped, it en-
couraged the orderlies, who were not used' to day and^ night
^\x)rk and were most of them raw recruits."

Another train was equip2)ed with four Red Cross sisters in
December, 1914. It had an excellent record and came out
second for merit of the B.E.F. Ambulance Trains.

Another was the train presented by the United Millers of
Great Britain in 1915, M-hich had the honour of being first for
merit of the B.E.F. trains; and still another was No. 16,
built by the G.W.R. Company in tlie same 3^ear. This train
was bombed in March, 1918, on its way down from Amiens,
with 700 severely wounded patients and 30 sisters as passen-
gers. Two orderlies were injured and the train was damaged.
For five hours the sisters worked Avith electric torclies, and
the fitful light of a blazing shed, cheery and to all appearances
unconcerned, while 'plane after 'plane unloaded its bombs amid
the crack of " Archies " and the manias clatter of machine
guns. The officer in charge submitted the names of the sistem
for the Military Medal. From that time gas masks and helmets
were kept in readiness for the almost nightly excursions^ to the
nearest dug-out. On May 31st, 1918, the train was again
bombed at lEtaples and set on fire; at the oitier of the officer in
charge the sisters sheltered in a ditch. During Mai'shal Foch's
great offensive on the Marne this train was at Criel; later it
carried repatriated prisoners from Germany. After the German
retreat of 1917 the nursing staff were the first women to

54 The War Work of ike B.R.C.S. Nursing Service.

enter Miraumont and Beaumont Hamel, where they had an
entliusiastic welcome from the troops.

No. 11 train was bombed. A sister wrote : "A bomb got
us fair; it was terrific, and we all thought we were done for,
windows smashing' all round. At once tlie train was inflames.
The O.C. said we must g-et out. This wei did, and among the
falling slirapnel and bombs we saw a bank which we scaled
and lay flat on the ground. This was surely a merciful Pro-
vide noe watching over us."

Embarkation.

The 'British. [Red Cross Society was, it is believed, the first
of the women's corps in France k> have an. embarkation and
transport representative. It was a jxjsition entailing much
work and worry.

Other Work.

In addition to all the work already described, our nurses-
staffed various Convalescent Homes for Officers and men as well
as fthe Convalescent Home for Army and Red Cross Sisters at
Hardelot; later this was transferred to Cannes and later still to
Boulogne .

The Principal Matron visited all the hospitals under the-
Joint War Committee and looked after the housing and general
welfare of the sisters. At first those who fell sick were treated
in their billets, a very difficult arrangement; afterwards a
Sick Bay w^as attached to the headquarters at the Hotel Christol
and later at the Chateau Maurician, Wimereux.

Italy.

The activities of the Bed Cross nurses were not confined to
England and France. Among the mountains of Italy, where
warfare was carried on at incredible heights, they were to be
found at their work of " mending the men."

In May, 1915, a unit was sent out and a hosi^ital was opened
at 'Villa Trento, on the Trentino VaUey, about 12 miles from

The War Worh of the B.B.C.S. Aurshig Service. 55

the firing- lines. It contained 100 beds and was a First Line
hospital for the Italian wounded. There was a motor unit
attaclied to this hospital and it carried all the wounded from
the firing* lines to dressing- stations or hospitals. There were
hostels at Cosmo ns and along tlie Corse. The work' was medi-
cal and sm-gical, and the metliods of the English nurses wei-e
much appreciated by the patients, who even in sickness are
forced to lead hard lives, and are unaccustomed to luxuiies or
even the necessaries. i

The Italian hospitals had no women, except in a few where
there were V.A.D.'s or whei-e Eng'lish nurses had been sent
to help from 'Home, and tliere were no niu-ses on the trains.

The patients were g-iven bread and cofifee as they came jdown
wounded from the battlefields, and the British Eed Cross
Society liad kitchens and personnel at different stations for the
purpose of distributing this bread, coffee, cigarettes, chocolates,
etc., to the men. The hospital was evacuated in 1918 at the
great retreat.

The 'British Red Cross Society had a convoy of ambulances
fitted with the newest X-ray apparatus, and there were* expert
operators and nurses who went along! the Front for' the pur-
pose of examining the wounded and localising the bullets.
These operators were so hard pressed that they had' not time
to take any photographs. The Italian surgeons simply operated
immediately on the diagnosis. This method of localising saved
many thousands of lives, and was much appreciated by the
Italian surgeons. There wei-e also installations placed at various
receiving liospitals, and here the operators attended for the
sake of localisation.

Egypt and the Soudan.

At the time of tlie GallipoU Campaign units were sent out
to Alexandria and Caiix). A Red Cross Hospital was opened —
the Sai'dia Schools, Giza, being commandeered for the purpose.
Tliere were also hospitals for officers, recreation hostels for the
nurses and other personnel, and after a time the Sultan lent

56 The War Work of the B.R.C.S. Nursing Service.

the beautiful Montaza Palaoe at Alexandria to the British
Red Cross to be used as a Convalescent Home. There were
2,000 beds.

During the fighting the cases ^vere chiefly surgical witli com-
plications of every description, aggravated by fever and other
medical ailments. A good number of the native cases; suffer-
ing from (Bilharzia were treated successfully with tartaremetic.
With this treatment, careful nui-sing and observation were re-
quired.

The Giza Red Cross Hospital closed in 1918, and the Mon-
taza Convalescent Home in 1919.

Serbia.

In May, 1915, at the request of the Serbian Government, a
large unit was sent out and a building in Vrorjatch Ka, Baija,
was commandeered for the purpose of a hospital. Tliisi unit Avas
completely British, and the patients treated were Serbs.

The staff had to work very hard, as dj^entery and' fever
was very prevalent amongst tlie surgical patients. The unit
eontinued to work for the Serbs, who were most gTateful and
thankful, until the entry of the enemy in February, 1916.
The mayor of the place and most of the' residents made tlieir
escape, but the unit stood by the hospital and the j)atients.
The matron, who could speak German, French, and Serbian
fluently, went out to meet the enemy and informed them that
they w^ere British people and tJiat the' Orderlies — who were
Auistrians — intended to stand by tliem. This had' its result,
as the Germans allowed them to escape, minus tlieir belongings
and hospital equipment, and they arrived in England in March,
1916.

Other units were also sent out to Serbia.

[Russia.
In Russia a very larg^e proportion of the work done omder
the auspices of the Ruissian Red Cross Society w'as organised
by the County Associations. The Union of Zemstvos was/ re-

The War Work of the B.R.C.S. Nursing Service. 57

sponsible for providing* enormous funds for the upkeep of
the Red Cross Hospitals at the Front and in the Interior,
dressing stations, flying anibulance columns, bath trains, hos-
pital trains, canteens and feeding stations, refug-ee collecting
stations, military fever hospitals, isolation points and vaticina-
tion stations, depots for clothing, dressing, instruments and
medical comforts of all kinds. The medical and nursingi staff
for these various activities were chosen by the Red Cross So-
ciety.

The Russian Red Cross sisters are trained at various. " obs-
chenas," or communities, each community having its special
dress, customs and rules. The term of training varies fix)m
2 J to 4 years, and this always includes a course in the dispen-
sary. Most of their time is taken up in learning, surgical work;
indeed, some of the training schools in Petix)grad take no medical
caises at all. The result is, of course, that the bandaging and
dressing is most exquisitely done, while the art of nursing,
as we have it in England, is — apart from the woimd — almost
unknown. At the end of her hospital training there is aji
examination and the sister receives a certificate.

It wa;s in 1915 that we w^ere first allowed to assist the work
of the Russian Red Cix);ss. Several of our sisters; worked in a
hospital in Warsaw before it fell. One of the sisters says :
''The orderlies slept on stretchers in the hall, putting their
beds down every njight and heaping them up in a great pile
every morning. At first the hospital was small, but it was
eventually built to accommodate over 1,000 patients. Some
large beds were lent to the hospital, and these were put in
rows down the corridors, and two patients were put into each
bed. Two severely wounded patients in one bed are not very
easy to nurse well, as may be imagined, but the men helped
by being charming to eacJi otlier, and they always lay face
to face, never back to back. Dying cases were put alone a»s
far as possible, but one of the men wx>ke up one night and
found his comrade cold. He had died more than an hour
befoi'e without a sound or a groan.

58 The War WorJc of the B.R.C.S. Nursing Service.

The rapid inci'ease of patients wais not accompanied by tin
increase of staff, and the sisters had to work very hard. The
hospital was fortunate in having for a matron a sister who
had been through tlie Russo-Japanese war and who was
quite accustomed to coping- with any emergency. Even the
arrival of a convoy of three or four hundred badly wounded
men in the middle of the night did not perturb her in the
least. Everj'one Avas called and was in their appointed! place-
and everything Avent like clock-work.

The nurses' had to get up each morning at 6.30, breakfast
was at 7.15, and consisted of coffee and bread and butter, and
they went on dutj- immediately after. Nominally the work was
supposed to be finished by 3 o'clock, when the bell rang for
dinner, but actually the dinner was often postponed till 4, or
even 5p.m. when they were busy. The long interval between
breakfast land dinner was very trying at first imtil the nurses-
got accustomed to it. Dinner consisted of soup, followed by
meat, except on Friday when fish or vegetables took its place^
and cheese or an apple, followed by several glasses of de-
licious tea. There was a break until 5 p.m., and then the
dressings began again, and after supper at 8 p.m. prepara-
tions were made for the next day.

From 1916 to 1'918 we had for a hospital onef of the Royal
Palaces at Petrograd. It was evacuated at the timei of the
Revolution in Petrograd, and the hardships at this time were
great. Any of the staff coming down country could have a
bed, but there was no bread available; if they brought their
bread they were welcome guests.

The patients were extremely well looked after and were very
grateful for all that was done for them.

ROUMANIA.

To be sent to Roumania meant a long journey by sea to
Archangel, then across 'Russia to Odessa and thence to Halatz.
Here a hospital was established in a school and was named
after the little Prince Mercia of Roumania who was poisoned

The War Work of the B.BC.S. Nursing Service. 59

through eating sweets dropped by an aeroplane into the Palace
grounds where he was playing-. The work was very heavy
as *the wounded arrived by slow transport and had^ not been
attended Ito for days. A sister wrote : " Many of our patients
reached us from distances by means of very slow trains or by
boats and barges into which they had been hastily loaded from
places near the firing line, and often they had been days mth-
out attention before coming to our care, arrivin<>- in a condition
of filth that is indescribable. As we had cases of gas gangrene
among 'them it will be readily understood that the atmosphere
of the wards from the evil-smelling cesspools outside became
very foul and almost unendurable; and it was not altogether la
matter for sm-prise that many members of tlie staff suffered
from diarrhoea and bowel troubles during our ten weeks' stay.
The benefit of our paratyphoid inoculation manifested itself
thus early on our journey."

After iten weeks, retreat was necessary, and the party joined
the poor starving refugees on the quay, waiting for hours in
rain and cold wind. Thence by barge to Reni and by train
back to Odessa, weary, travel -stained, and more than half
frozen. In February, 1917, half the unit was detailed to Is-
mail '(Bessarabia) and half to a field hospital just behind the
Front in Moldavia. There was accommodation for 220 patients
in ^nts and three officers in the house. Thei tents were full,
and the staff worked at high pressure for four months. In
the summer, work w^as rendered more difficult owing to the
plague of ffiee. A nurse wrote: "With such swarms of
carriers we were anxious always about the spread of infection,
for did we but loosen a bandage a batch would be all round
the fwound in a moment, and we lived in fear of the spread of
er^'sipelas by the pests. However, it is a matter for congratu-
lation that no epidemic attacked us or our patients." The
following graphic description is from the same pen: " In an
English newspaper I read tlie words * On the Sfereth' there has
been artillery action.' A plain simple statement, but" what
tragedies are hidden behind that small curtain of words! A

'♦;o The War Wor/,' <ff the B.H.C.S. Nursing Service.

g^roat Eeapei' l»u>y at his fell task, gatJiering liis harvest of
jX)or 'l)roken bodies, cut down in the full vigour- of young and
histv manhood, and a full quantum of ghastly wounds, eyes
blinded, limbs bloAvn off or rendered useless, heads smashed
like eggshells, abdomens ripped and torn by shell splinters,
horrible mutilations, bodies drilled through by bullets from
rifle land machine gun. The brave silent work of the stTetcher
bearers, i-isking life and limb in their efforts to recover and
succour the wounded soldiers; the hurried work at the dressing-
stations; the quick scrutiny of the seriously wounded and
maimed; ^he prompt inoculation for preventive purposes with
tetanus serum; the labelling* of the patients; the loading of
ambulances; and then the speedy rush of the convoy across
iJie country to the first field hospital situated a few kilometres
behind the fighting line where membens of the unit were
ready at all hours of the day and night to receive them and
give of their very best in skill and attention in their endea-
vour to alleviate the sufferings of these poor maimed creatures.
Such is the portion of the picture conjured up' in the minds
of those whose duty and privilege it was for four months to
serve in the British Red Cross Society Field Hospital esta-
blished at Tecuci, Houmania, and attached to the Russian 4th
Army."

In August the hospital had to be evacuated and eight sisters
returned to England.

The members of the. units going to the East were provided
with one-piece overalls from head to feet, to protect them fi'om
lice, which were the chief means of carrying the infection
of typhus.

Holland.

In 1917 it was decided that a Trained Nurse should accom-
pany each boat sailing between the Hague and London bring-
ing convo5^s of released prisoners of every nationality, taken
over from the German lines. The nurse who filled this post had
to be able to speak Fi-ench and German fluently, undertake 46
hours' duty at a stretch, and manage lunatics. This work "Was

The War Worl^ of the B.R.C.S. Nursing Service. 61

suc<5essfully carried on till the Armistice was signed, when
the nurse became head of a Receiving Hospital in London.

After the Armistice it was found that the convoys were much
larger and that tlie prisoners handed over were in such a
desperate condition, mentally and phj^sically, tliat a hospital
was opened at Clingx3ndaal for Officers. Later when our own
trains were able to go into Germany for the men, there was
a 1,000-bed hospital opened at Rotterdam for those who were
unable to embark direct for England. Here they were fed, re-
clothed, and made in a fit condition to return to their own
countr3^

*
Great Britain.

In this country the conditions were, of course, better, but
owing- to the scarcity of medical men the niirses had great
responsibilities. Many of their achievements have been brilliant,
and all liave given devoted, patient and helpful work. Shell-
shock patients, for instance, require sxvecial care, and the nurses
have had to help their patients mentally and physically bj
taking part in their recreations and their re-:education. More-
over, owing to the continued demands of the authorities for pro-
bationers, nurses have had the additional burden of training
V.A.D. members during the whole war. One example; of the
value of their work is the fact that owing to the success of
the beautiful hospital at Brockenhurst for Indians, the India
Office has given permission for the first time for native hos-
pitals to be staffed with ti-ained women nurses.

A general in France said the other da}^ that the war could
not have been won without the help and moral influence of
the women; the knowledgie of this fact will, I know, be suffi-
cient praise or reward for the women of Great Britain — laity,
trained nui-ses and V.A.D. members.

In this country no fewer tiian 2,050 hospitals were estab-
lished under the Joint War Committee, employing one trained
niu-se to every twenty patients. Their record is to be foujid
in our i-eports, and certain it is that without them it would have
been impossible to caix) for the Avounded in this country. They

62 The War Work of the B.li.C.S. Nursing Service.

ranged from a large hospital like the King George V. in Stam-
ford Street, Avitli its 2,000 beds, to large and small honsea
generously given up by their owners all over the four king-
doms, schools, public buildings supplemented by huts and tents,
where space, water supply and drainage Avould allow.

I hjave spaoe only to speak of one or two doing special work.
At St. Duns tan's Hostel for the Blind, nurses- are in charge of
the Suj'gery, doing dressing-is and irrigutioms, giving electric
treatment in certain cases, syringing noses and ears, and dress-
ing wounds. Then there are fits to treat as well as influenza
and minor troubles. There are three trained nurses at each
house. ,

Another special class of hospitals is the Maxillo- facial for
jaw cases — these are slow cases requiring continual dressing
and syringing. " No one who lias not nursed these cases,"
says a sister employed there, " can. rea,lise how much has to
be done. Many patients arrived with terrible wounds, and septic
mouths, and the nurse quickly got satisfactory results from
frequent irrigation, often every two hours day and' night. All
food had to be specially prepared, solids being "finely minced
and served very liquid. Many wonderful plastic operations were
performed: the jaw restored by bone -grafting, or lipi or chin
replaced by a skin graft. Massage and electric treatment also
did much to loosen scars and restore function."

Finally let me mention one other special work — that of the
factory nurse. Taking Chilwell as an example, the little hos-
pital was situated right in the dang-er zone of the factory. A
matron and tliree or four sisters had to be prepared to deal
with accidents at all hours of the day; and night. There were
about 10,000 workers, and the cases included toxic jaundice,
dermatitis, burns, accidents, etc. In July, 1918, a tremendous
explosion took place: many were killed and several hundreds
wounded. The staff of nurses had to render first aid in the
open before the injured were removed. They are justly proud
of itheir share of war work in a factory which turned out more
than ;50 per (cent. of the output of heavy shell in this country
during the war.

OPHTHALMIC PRACTICE IN

THE MEDITERRANEAN AND EGYPTIAN

EXPEDITIONARY FORCES. 1915-1918. *

H. L. EASON, C.B., C.M.G., M.D., M.S.,

Late Lieut. -Colonel, Royal Army Medical Corps, and Consulting

Ophtlialniic Surgeon, M.E.F. and E.E.F.

''The thing that hath been, if is that which shall he; and
that whicJi is do tie, is that which shall he done; and there is
no new thing under the sun. Is there anything ivhereof it niay
he said, 'See, this is new.'''

Egypt, Palestine and Syria have been the cradles of many
civilizations, the battle grounds of some of the world's great
conquerors and the graves of many armies. The palimpsest of
history is there for everyone to read. This recent war has given
added point to the wisdom of the old and weary Jewish King,
for the world's battles in 1914 to 1918 have been fought in
places which have been battlefields since the beginning of
history. And as with battlefields, so with disease. Although
knowledge may advance and methods of treatment alter, disease
in various countries remains little changed fix)m century to

♦Portions of this paper have aheady been published in the British
Journal of Ophthalmology, August, 1917, and in the Transactions of
the Ophthaimological Society of Greati Britain, Vol. XXXVIII., 1918.

64 Ophthalmic Practice hi the Mediterranean and

oeiitury; and the campaig-iis of nearly all tho oouquerors iit
the East have been gi-eatly influenced by disease, as is evident
fix)m all historical records.

The fate of Sennaclierib's army, when besieging" Jerusalem^
is graphically described in the Book of King-s: " And it came
to pass that night, that the Angel of the Lord went out, and
smote in the camp of the Assyrians mi hundred and fourscore
and five thousand,: and ivhen they arose early in the morning,
behold they were all dead eorp&es. So Sennacherib, King of
Assyria, departed and went and returned, and dwelt at
Nineveh.'"

Eiohard Cceur-de-Lion got as far as a distant view of Jeru-
salem, but failed to reach the city as his army was stricken
with fever; Louis XI. landed in Egypt but lost a great portion
of his host from dysenteiy and scurvy; and in recent times
Napoleon, in one of the swiftest campaigns, marched across
Sinai and besieged Acre; but plague, fever and ophthalmia.
beset him, and he returned defeated, as did Sennacherib.

In September, 1918, the British Army left the areas in which
it had remained in front of Jerusalem for months, protected
by every modern mietliod of sanitation. In the conquering rush
that ended in the capture of Damascuis and Aleppo it passed
through the plains of Sharon and Esdraelon, down the deadly
valle}^ of Jezreel to the plague-stricken depths of the Jordan.
Within a month hundreds were dead of malignant malaria and
thousands were sick. If the advance had not been so swift
and so crushing, AUenby wouM have met the fate of Richard
CcBur-de-Lion.

All this is by way of preamble, and is not really in m.j_
j)rovinco as an ophtlialmic surgeon; but history is fascinatingv
especiall}^ in the East, only in so many cases the records are so
tantalizingly incomplete. One would give anything to know
definitely what plague defeated Sennacherib, or the details of
the fever that crippled Richard ICoeur-de-Lion. Luckilj^ for us
■^^'e do know more of Napoleon, for of all the armies that hav'?

Egyptian Expeditionary Forces, 1915—1918. 65

entered Egypt, none has left a more complete record of its work
than, his, and the memoii*s of his famous Surgeon-in-Chief,
Larrey, are a model to all medical historians.

But to come to my own subject. Egypt is the home of the blind,
the squinting and the one-eyed. Little childi-en lie in their
mother's arms with their disdiarging eyelids ringed with flies,
and hardly a grown man or woman has two clear sightly eyes.
Ophthalmia has been the curse of the oountrv^ since history
began to be written, and it remains so to this day; and as it
was in the time of Napoleon, so it is now. My object in
writing this article is to put on record some account of the
injuries and diseases of the eye among the British Army in
Egypt in the recent campaign, and, in the matter of ophtlialmia,
to contrast my experience with Larrey *s just over a hundred
years ago .

I propose, therefore, to give a short general account of oph-
tliahnic surgery in Egypt for the four years 1915-1918, dealing
almost exclusively with our own experiences and without refer-
ence to eye work in the other theatres of war, giving tlie most
attention to the affections which were the most important from
the military point of view.

Orgaxisatiox.

I arrived in Egypt in September, 1915, and after a short
preliminary tour of inspection among tlie hospitals in Egypt
discussed with the Director of Medical Services, Force in Egypt,
and the Principal Director of Medical Services, Forces in the
Mediterranean, the general Hnes of policy upon which I should
act.

There were two main alternatives: (a) that a special oph-
thahnio hospital should be established in Cairo, which should
be under Imy general control, and to which all cases of gun shot
injury should be &ent, and (b) that I should act strictly as a
consultant and, not being attached to any one hospital, should
be available for advice or assistance in any area or institution
as occasion arose.

PART III. ^

66 Ophthalmic Practice In the Mediierranean and

After oonsideration of the various arguments I advised in
favour oT t!lie latter alternative on the following grounds: (a)
that under existing conditions it was almost impossible to collect
all the operative eye work at one hospital without much delay
and trouble,^ (b) that as far as my experience of twelve montlis'
war work at home showed, ophtlialmic injuries Ave re but a small
percentage of the total cases, and that the main duty of a mili-
tary ophthahnio surg-eon wajs the comparatively dull, though
very essential, work of testing defects of vision and errors-
of refraction, (c) that to collect all the cream of the work for
myself at one institution and to leave all the routine work to
others seemed to me hardly fair, and at the same time not
conducive to the establishment of an efficient or keen ophthalmic
medical service.

It seemed to me tliat every effort should be made to ensure
that all ophthalmic specialists were competent and that they
should then be encouraged to take the responsibility for all
the work that chance brought their way, my services being
available for advice or assistance if necessary.

It soon also became quite apparent to me that the great problem
of the campaign would be the standardisation, as far as possible,
of all opinion and treatment, so that invaliding and classifica-
tion should be uniform in every area. This end could not be
achieved by regulations or instructions, as it was a matter of
varying professional opinion, but only by a general interchange
of views and personjal influence. This would necessitate my
travelling continually, seeing the ophthalmic specialists at
their work, and talking over matters with them informally.

The Director of Medical Services, Force in Egypt, and the
Principal Director of Medical Services, Forces in the Mediter-
ranean, agreed with these views, and it was arranged that
I should act purely as a consultant, visiting hospitals at regular
intervals to see cases on Avhich my opinion might be asked,
and advising the Directors of Medical Services on matters of
g-eneral principle. It was also arranged that, as far as possible,

Egyptian Expedithnarf/ Forces, 1915—1918. 67

no officer or man should be invalided liome from Egypt for
any affection of the eye Avithoiit my having seen the case and
written a report for the Invaliding Medical Boards, which
heretofore had often come to widely diffei-ent decisions on iden-
tical or similar cases.

This principle of unity of standard was later on extended
much more Avidely by the general Standing Medical Boards
in Cairo, Alexandria and Palestine, but am- account of those
is outside the scope of this a,rticle.

During the Gallipoli campaign considerable anxiety was felt
hj the medical authorities in Egj-pt and in Mudros as to the
ti-eatment of ophthalmic injuries, both as to Avhetlier cases of
gunshot; wounds of the eye were being treated sufficiently early
after the injmy, and also whether any risk of sympatlie^i^
ophthalmia was being inctu'red owing* to undue delay in the
removal of damaged eyes. For this reason I ^vas, shortly,
after my arrival in Egypt, instructed to proceed to Mudros
and i*eport on ophthahnic arrangements there. On arrival at
Mudros I found tliat owing to the prevailing naval and mili-
tary difficulties it was purely a matter of chance where |[i
soldier wounded on tlie Peninsula eventually ai-rived at a lios-
j)ital. He was x^ut on a hospital ship and might be put off at
IMudros or be carried on, without disembarking, either to
Alexandria or Malta, in Avhich case he might not arrive at a
hospital where he could see an eye specialist until a week or
ten days had elapsed after the injury. As success in the
treatment of injuries of tlie eye depends almost entirely on the
rapidity with which the treatment is commenced after the injury,
it seemed to me essential that all cases of ocular injury should
be put ashore at Mudros, and not brought down to Egypt
or Malta. There was at Mudros, in the 3rd Australian General
Hospital, a most efficient ophthalmic dei^artment, under the eaiva
of Major Lockhart Gibson, a Avell-known ophthalmic surgeon
of Brisbane. The department Avas equipj)^d with a Haab's
magnet, and an extensive outfit of instruments, and there was a

68 Ophthalmic Practice in the Mediterranean and

skiagraphio department adjacent. It was apparent, therefore^
that the ideal aiTangement would be for all eye injuries from
the Peninsula to be put ashore at Mudros and sent to the 3rd
Australian General Hospital, where tliey would quickly receive
skilled treatment under the best auspioes. On my making
repiesentations to tliis effect to the Principal Director of Medical
Services, Mediterranean Expeditionary Force, instructions were
at onco issued that this should be done, and, until the evacua-
tion of the Peninsula, every case of injury to the eye was, as
far as military and naval exigencies permitted, disembarked at
Mudros.

Ophthalmic Work at Mudros.

The following* extracts from Major Lockhart Gibson's report^

written just after the evacuation of the Peninsula, give some

idea of the work done at Mudros in the last three months of

the Gallipoli campaign: —

The records of 126 eve cases (in-patients) have beea preserved.,
I am of opinion that a good many have gone astray.

These cases may he classified into two large groups, viz., (1) Cg-ses
neither directly nor indirectly attributable to explosive weapons, and
(2) those attributable to shrapnel, bombs, 'and bullets, or to the
indirect injuries (excoriations of the conjunctiva and cornea) from
parapet sand and gravel, and the impaction of fragments of such sand
and gravel in the cornea. Both groups are approximately equal,
about 60 cases occurring in*^ each.

Classifiea more particularly into anatomical groups (with an addi-
tional group for foreign bodies in the eye and another for enu-
cleations), it is found that no case of much importance falls outside
one or other of these heads. As many eyes were injured in more
than one part, ,such grouping brings the number of caseis up to 200
or more. They weire as follows:— Conjunctiva 44, cornea 51, iris
11, lens 13, vitreous and fundus 13, Bclerotic 7, lids 8, orbit 5,
anterior chamber 4, foreign bodies 30, enucleations 14.

There were 16 intra-oculax foreign* bodies, if we include two which
were within the ©clerotic coat, but perhaps not witjiiu the choroid/
Of these, six (6) were removed. Three from' the anterior chamber,
one through the sclerotic wound and from the vitreous chamber close
to it: this one, a piece of steel, was not from an explosive weapon.
Two removed were within the sclerotic, but probably not within the
choroid. Six foreign bodies were left in situ.

Egyptian Expeditionary/ Forces, 1915 — 1918. 69

Of the six cases from which intra-ocular foreign bodies were re-
moved, four saw as well as before, one saw 0/18 only, because other
small erosions on the cornea had interfered with its transparency..
One had a traumatic cataract and required further discission.

Of the six eyes retaininj^ their foreign bodie?, two had useful sight,
viz., 6/12 and 6/18. One might regain sight after the lens had finished
being absorbed, subsequent to further discission. One had no sight.
One had no sight and would probably have, to come out. One, a
Greek, Tefused to have the eye removed, although warned of the possible
danger to the other eye. The eye contained two foreign bodies, had a
partial traumatic cataract, and showed ciliory irritation at t/imes. He
could count figures only. The Haab magnet failed to attract the
foreign bodies.

The remainder of th© 30 cases of eyes containing foreign bodies,
included foreign bodies in the cornea and under the sclerotic and con-
junctiva. Several of the eyes had iseveral foreign bodies. Many ocular
foreign bodies were removed from out-patients who continued to be
treated, if necessary, as out-patients. A peculiarity of the foreign
bodies in the cornea was their depth. Many had practically reached
Descemet's membrane, and it was with the greatest difficulty that
they were removed. A spud in many cases was not sufficient, the
point of a Graefe's knife being necessary. Another peculiarity was
their minute size. Their size and Vilepth demonstrated the great force
with which they had been projected, in contrast to the experience of
civil practice, where small fragments do (not come with sufficient force
to be embedded deeply in' the Cornea. Thej were composed of steely
lead, nickel, and sand or gxavel. ihe eyes all did well, but the deep
foreign bodies left permanent opaque scars.

Two fair sized foreign bodies were found in the orbit. One, a piece
of steel, had entered at the inner end of the eyebrow and was detected
by X rays under thei roof of the orbit and fairly far back. The giant
magnet pulled it forward under the conjunctiva of the upper fornix
and then, the lid being everted, pulled it, without an incision being
necessary, across an inch of space. The other foreign body had grooved
the edge of conjunctival surface of the lower lid. The scar had
healed, but there was discomfort in turning the eye up. An X ray
detected the foreign body above the floor of the orbit and fairly far
back. The giant magnet failed to icause any feelings of discomfort and
failed to attract the foreign body. The discomfort gradually subsided,
and the man rejoined his unit retaining the foreign body, his sight
unaffected.

The fourteen enucleations were all cases of eyes injured by pro-
jectiles. They all did weU, although several had other injuries in
addition to the eye injury.

In no case had I to remove both eyes, but in one case the remain-
ing eye was badly injured, and its retina became detached. It was
blind, but might be kept and was not disfigured.

"ii* Ophthalmic Pracfifc tn the Mecliterraneait amt

In another, the second eye, like ,the one removed, also contained
pieces of wood, 'and certainly required 'to .be excised, although the
pieces of wood were removed.

All the Pterygia (8) were large ones, and all in members of the
A.I.F. Except in one case, where the growth was entirely removed,
the lower half only was Temoved 'and tthe upper half detached, turned
dowIl^vards and fixed tin the wound so left. This metliod was intro-
duced, I believe, by Thos. Evans, of ,Sydnejy, and has been followed
by me for many years when the pterygium is a large one. It en-
sures against return, and should be the operation of choice.

A severe case of isymblepharon had been operated on in England by
transplantation of skin. The result was bad. A graft of lip mucous
membrane, transplanted after removing the scar and the bunched up
skin, held and the result was good.

The cases of corneal ulceration were due to injury, to phlyctaenular
inflammation, and to the results of acute conjunctivitis of a catarrhal
nature. No cases of Gonorrhoeal Ophthalmia were seen.

Three due to injury proved to be .severe infective ulcers, spreading
and accompanied by hypop\''o,n and cjieniosis. One I failed to arrest
even with the electro-tcautery. The eye had to be removed. ^ One,
a Greek's, where the ulcer occupied fully 2/3rds of the cornea, with
hypopyon and chemosis, was arrested by the electro-cautery, and a
subsequent optical iridectomy gave the eye useful sight.

The third case, in wliioli the ulcer was smaller but the chemosis
extreme, and the hypopyon very marked, responded very quickly
to the electro-cautery, and regained excellent sight.

Injuries to the lens were accompanied by other injuries to the eyes.
Amongst out-patients there were some peculiar lens opacities which
may not have been congenital but due to shell concussion. There
were also a good many cases of ordinary congenital lamellar cataract
amongst the English troops.

Under the head of Irisi were several icases with other injuries also.
Tiie five most interesting were two operative and three iritis cases.
Of the two operative cases, one was the Greek's eye above mentioned,,
the other an eye in a young officer suffering from intermittent attacks
of glaucoma. It was due to a penetrating injury to the upper cornea-
scleral margin "during child birth." The pupil was occluded- and
drawn up. A Very fine pin point slit at the edge of the occlude
pupil allowed imperfect intraocular circulation, but at times became
blocked, resulting in an attack of glaucoma with a shallow anterior
chamber and bulging iris. These attacks had been vtry frequent
latterly, and were becoming more Isevere. When comfortable the eye
had minus tension. During the attack the tension was plus 1.

An iridectomy not onh* relieved Mm from 'attacks and gave the eye
a normal tension, but also, srave some isiglit to an eve which had never

Egyptian Expeditionary Forces, 1915 — 1918. 71

seen more than bare light. It counted fingers at several yards, and
might improve further. The patient was able to re-join his regiment
without fear of other attacks.

One lad who had been invalided back from Gallipoli had a central
scotoma due to a subhyaloid hgemorrhage at the macula. He was
admitted, and after a few days mild attacks of tertian malaria de-
veloped and were confirmed by Miajor C. J. Martin's examination of
a blood specimen. Be responded lat once to quinine. The subhyaloid
haemorrhage may have been nothing more than a coincidence. The
prognosis, judging from othea- cases of isubhyaloid haemorrliage in my
experience, is hopeful regarding sight. Another case of haemonhage
in the fundus occurred in an O.C., aged 51 years, of another unit.
He had several haemorrliages into each retina and into one disc. No
cause could be discovered. His urine was normal in every respect.
It was surmised that the antiscorbutic or waii-beri-beri constituents of
his diet may have been insuflBcicnt. He was treated accordingly, and.
of course, invalided home.

The conjimctival cases were catarrhal, phlyctaenular, traumatic and
pterygial. Only one specimen of catarrhal secretion was sent to the
pathologist, and was negative. The cases were often severe, and were
frequent amongst the Greek population of the island, both adults and
children. Some corneal ulceration wasf present in some of the Greeks
and also in some of fthe troops when they were under observation.
A lotion containing sulphate of zinc grains iii and boracic acid grains
xii to the ounce of water acted practically as a specific. It caused
improvement at once, and when the cases were not of long standing
rapid cure resulted. Many catarrhal cases suffered, also, from phlyc-
taenular conjunctivitis, and required yellow oxide of mercury in addi-
tion.

1 met with no case of Trachoma occurring in Lemnos. The lew
cases seen had come from! Egypt, or were cases of recrudescence :ji
Australians who had previously suffered.

Although I can only say that two foreign bodies were removed
by the giant magnet (one from the interior of the eye, and one ftom
the orbit), which would have been diflScult or impossible to remove
without so strong a magnet as llaab's, the knowledge and help given
by it in other cases were so great that I should have been imperfectly
equipped without it. Until it arrived I had only a Hirchberg's hand
electric magnet (8 volt dry cells), and that enabled me to rescue
one piece of steel from; an anterior chamber. But at least two cases
might have been benefited had t(he giant magnet arrived sooner. That
X rays also were not available during the first few weeks was a con-
siderable handicap.

The failure of hospital ships wliile in harbour to get tran.^porfc
to land casualties diminished the numbjer of cases of injured eyes whioh
should according to orders have come to mo from Gallipoli,

72 Ophthalmic Practice in the Mediterranean and

Two things militated against the greater usefulness of the giant
magnet, viz., the timje which' always elapsed before the cases arrived
at Lemnos, and the minute size of the foreign bodies. In the case
of small bodies the force with which the magnet attracted them was
slight, and consequently any plastic lymph anchoring them in the
eye was able to hold them. This was clearly demonstrated in the
cases of a minutei pieces of steel lying between the lens and iris and
attached to each by lymph. The magnet failed to bring it into the
pupil's area. The lymph stretched, but did not relinquish its hold
on the foreign bodyj. Itl was picked out of the anterior chamber by
forceps after a" small iridictory.

The only two eyes removed after failing to attract the contained
foreign body by the giant magnet contained respectively a piece of
lead and a jxiece of copper.

The out-patients who came froni lother units and hospitals on the
island and from] the ships in the bay averaged about 20 per day
from 10th Septembier' to the first week in January. Notes of 1,004
new ophthalmic out-patients were taken during that time. A large
number of these were casesi of refraction, many of whom I found to
be so benefited by glasses as to (be made efficient, whereas before they
could not have been so. Most of fthem stated that no attempt had
been made in England toi test their vision. I find that 254: prescrip-
tions for glasses were given. I found after a time that many of these
were not made use of, (and refrained from giving prescriptions unless
the C.O.s said those given would be feent to an optician. Latterly
the prescribing of spectacles was put on a very, satisfactory basis;
partly, I think,, ;as a result of pay representations to General Bab tie.
He ultinaately prevailed on the (War Office to supply the men with
cylindrical as well as spherical glasses.

The routine proposed by Greneral Babtie after consultation with
Lieut. -Colonel Eason, whjo had also discussed the question with me,
and adopted during my last few weeks in Lemnos, met all objections,
and was as follows: — Prescriptions were sent to the Base Medical
Depot at Alexandria, and were also entered in the last page of the
man's pay book together with a statement of the amount of his vision
without and with coTrection. Two 'pairs of spectacles were sent to
the man's O.C. Breakages or loss were replaced by the man himself
and without his return to the base.

Major Herschell Harris gave me most valuable help by taking X
ray pictures of eyes and foreign bodies or possible foreign bodies.

Owing to the generosity of the Queensland Bed Cross Society, who
cabled me ^200 to London for the purpose of equipping mj depart-
ment, I was able to get all the instruments I required, including
a Haab's magnet.

Egyptian lExpeditionary Forces, 1915 — 1918. 73

Egypt and Palestine.

In Egypt the problem was, as I Iiave mentioned above, more
one of man power, standardisation and invaliding than of active
surgical treatment, and during the three and a-half years that
I was attached to the Egyptian Expeditionary Force my efforts
were directed to passing forward to the front line as many
men as possible who, by tlie provision of suitable glasses for
errori^ of refraction, might be made fit, and to preventing the
passage down to the base of those complaining only of trivial
injuries or defects.

Owing to the location in Egypt of the big base general
hospitals and of the base depots, the greater part of the eye
work was done in Cairo and Alexandria; but as the campaign
developed, and the Egyptian Expeditionary. Force advanced
through Sinai into Palestine, an ophthalmic surg-eon was kept as
near railhead as possible both to prevent cases of trivial or exag-
gerated defects from g-etting down the line and to afford speedy
treatment to ophthalmic casualties.

At the time of the pause before the last advance from the
neighbourhood of Jerusalem to Damascus the position of the
ophthalmic specialists Avas so marked in the map (p. 74). The
advance on Aleppo was followed so rapidly by the armistice
and the cessation of hostilities that the map may be taken
as showing the final stages in the organisation for dealing with
ocular casualties and for the treatment of disea;8es of the eye.

Statistics.

Chart (1) shows oondensed statistics of nearly 33,000 eye cases
seen during part of 1916 and the whole of 1917 and 1918.
They are by no means exhaustive, as owing to the movement
of units and changes in personnel any complete record was
impossible to obtain. Such as they are, however, they illustrate
very well the nature of the ophthalmic practice in Egypt and
Palestine, and the proportion of the various cleusses of case

74 Ophihabnic Practice in the Mediterranean and

1 V)

• 0

• r

•9S 1

« (0

% E

1 cc

z
<

kl
2
<

2 !:/

Egyptian Expeditionary Forces, 1915—1918. 75

seen was so striking-lj constant at the various hospitals that the
statistics may be fairly taken as accurately representative of
the whole number of cases.

Chart 1 .

^*- 5*
'^^ ^ r:

:* -.

-fei^fe^l^^^^^^^^^^^^^^fe^ ••'

My observations on tliesC statistics will hi' ^^Mieral only and
individual cases will not be quoted; for it is to be borne ia
mind that I personally only acted as a consultant. While I

76 Ophthalmic Practice in the Mediterranean and

liad a general and extensive survey, the aotual work was done
hj others, and I leave to them the publication of any detailed
clinical information with reference to the ca^es under their care.

Errors of Refraction.

It will be seen at once tliat cases of error of refraction and
cases in which visual defects were oomplained of, but found on
examination to be trivial or negligible (" nO' appreciable disease "
or "N.A.D.") number 18,008 or 54-6 per cent. As in civil
life, the foundation of the military ophthalmic surgeon's work
is the estimation and correction of errors of refraction; but it
is particularly with reference to refraction work that the medical
officer accustomed solely to civilian practioe finds it difficult
at first to look at the situation from a military point of view,
for the following reasons: — When a patient presents himself
for examination in civil Ufe, it is usually because he has some
visual defect which he wishes corrected, either to gain an ap-
pointment or to pass an examination, or because he suffers from
some secondary affection, such as headache, which he wishes
relieved. Under tbe circumstances he tries to see as well 'as
possible with his glasses, he is anxious to be improved, and
his frame of mind is one of active assistance to the surgeon.
The converse is usually the case with the soldier. The visual
defect from which he is suffering is often used by him as a
possible means of avoiding active service, or if not actually
of avoiding all service, of getting some lighter duty at the base
or on the lines of communication. He therefore makes the
most of his defect, instead of the least, and is not actively
oonoerned with getting it improved with glasses.

It was a source of great concern to some ophthalmic medical
officers, on first taking up military work, to find such a sur-
prisingly low average of visual acuity among-st the soldiers,
especially when it was associated with a striking absence of
high errors of refraction, or of organic disease. Experience
soon showed that this low visual acuity was not to be con-

Egyptian Expeditionary Forces, 1915 — 1918. 77

sidered seriously, and that if one found no great error af re-
fraction, or organic disease, the strong presumption was that a
man's vision was normal or tliereabouts, whatever he might
say to the contrary.

In this connection it may be remarked that the great diffi-
culty of military ophthalmic practice is that in the majority of
cases one is dealing with symptoms and statements only; defec-
tive vision, headache, night blindness, intolerance of light, shell
bHndness, all the common military ocular complaints, are diseases
in which, one finds symptoms only with practically no physical
signs.

In cases of defective vision, not total bKndness, there jis
no means of telling how much, a man sees, except from his own
statements, and if he does not mean to see test types on a
wall nothing will make him do so, and a proof that he doe^
see with any definite degree of visual acuity is almost im-
possible. On general considerations, and by various dodges,
one can form a very fair opinion of a man's hona fides, but
there is seldom any proof which could be demonstrated to a
third person. The decision is always one between what the
ophthalmic surgeon thinks the soldier ought to see and what
the soldier will confess to seeing, and between these two con-
flicting opinions there may be no demonstrable judgment.
Fortimately, in the estimation of ewom of refraction, retino-
soopy affords a rapid and purely objective means of estimating
the approximate extent of the soldier's visual defect, an(i if his
statements as to his vision do not bear some relation to the
nature and amount of his error he may in most oases be classi-
fied a& a malingerer.

The same considerations apply to nearly all the other con-
ditions mentioned above. There is in every case the assertion
of the patient as to what he can or cannot see, and a total
absence of physical signs. Any decision as to the real facts
of the case merely depends upon the credibility of the witness
and the credulity of the observer. ,

IS Ophthalmic Practice in the Mediterranean and

For 1113' owji pill i, my experience during my Service foiu* yeai«
(certainly an experience limited to a special class of ca-ses)
has been to convince me of the profound truth, in another sense,
of tlie old leg-al aphorism that " what the soldier said is not
evidence"; the ophthalmic sui'geon who believes all that he
is told by soldiers and writes papers on war diseases which
consist solely of symptoms is merely writing romance.

Spectacles.

Our experience in Egypt was in general that obtained by
the ophthalmio surgeons in France.

Unless a soldier gets an obvious improvement in vision by
the use of spectacles he will probably nqt trouble to wear tbem.
Myopes of moderate degree are most benefited by spectacles,
and are the most grateful for them. Hypermetropia and astig-
matism up to about two dioptreis make very little difference
to the visual acuity, and even with high degrees of mixed
astigmatism vision without glasses may be as good as 6/12,
as anyone may ascertain . from actual experiment with the
appropriate lenses.

Men witli low degrees of myopia and myopic astigmatism
saAv well in the brilliant light of Egypt and did not complain
of glare, but soldiem with hypermetropia and hypermetropic
astigmatism did suffer to a considerable extent from the sun
and from reflection from the sand.

In my opinion the standards of vision for A class men as
laid down in tlie pre-war regulations and in subsequent Army
Council Instructions were much too stringent in view of tlie
demand for men, and on my advice the Director of Medical
Services, Egyptian Expeditionary Force, in 1916 agreed that
for serving soldiers the standard of vision in Egypt for A class
men sliould be as follows: —

// a man, in the opinion of the medioal officer, can see
6/24 with or withoiU glasses in the right eye and can count

Egyptian Expeditionary Forces, 1915 — 1918, 79

figures at 3 feet or niore wUh the left eye and there is •}ii7
organic disease of the eye, he shall be considered fit for
Class A.

This was issued, with other informatiou, in a pamphlet en-
titled " Regulations with reference to the Prescription of Spec-,
tacles in the Eg^^ptian Expeditionary Force," and was in force
for over two years, with the result that many men hitherto
classified B were re-classified A, and serTed satisfactorily in
front line units.

In December, 1917, in response to an enquiry from the War
OflSce as to why so many spectacles were being supplied to
soldiers in Egypt, I drafted a memorandum, in which I in-
formed the Director of Medical Services that there wei-e three
factors which affected or controlled the demand for spectacles
in the Army in Egypt: —

1 . The necessity for man-power, or for making every possible
man fit for Class A.

2. The quality of the drafts from England and the thorough-
ness with which their visual defects had been corrected in
England. •

3. The necessity for as much economy as possible in the
prescription of spectacles, both in view of the difficulty of
obtaining supplies from England, and of the cost to the public.

The first factor was, in my opinion, of paramount importance.
The great demand for the supply of spectacles was due, in
the experience of both Colonel Barrett and myself, acting as
Presidents of Classification Boards, to the widespread and
thorough overhauling of all imits in Eg;>^pt as the result of the
Man Power Report.

At the Classification Boards there came before both of us
larg-^e numbers of men who had hitherto been classified, nearly
always in England, B Class for defective vision, with no entiy
in their paybooks as to the amoimt of the defect. These were
all referred at once to the ophthalmic surgeons, and if any

80 Ophthalmic Practice in the Mediterranean and

serious defects of vision were found, spectacles were ordered,
either to make them fit, witli specitacles, for Class A, or in
Class B for guard duties either day or night. If this were not
done, many men drifted automatically into Class B(3), where
they were practically Uiseless as soldiers.

The drafts from England arriving in the later years of the
war were not up to the former physical standard in any respecti,
and the percentage of visual defects among them was higher.
This entailed an increased supply of spectacles for the purpose
of remedying the visual defects which should have been cor-
rected in England before^ the men were sent overseas. If
recruits had been examined in England and their visual defects
corrected there, the demand for spectacles in Egypt would have
been very greatly diminished. I also made the following
Criticisms on the visual standards then in force for A class
men: —

The latest standard of vision for A Class men is that laid
down in Army Council Instruction No. 211 dated 4th February,
1917, viz: that if a man's vision is 6/24 in one eye, without
glasses, and his right eye can be brought up to 6/12 with'
glasses, he will be considered fit for Category A.

The standard of vision mentioned above is, in my opinion,
much too stringent, and is still in the nature of a timid com-
promise between the old pre-war standard of 6/24 in each eye
without glasses, and modern conditions where glasses are per-
mitted and are supplied at Grovemment expense.

If spectacles are permitted, the vision of a soldier without
glasses is immaterial, for his vision with glasses is the only
thing which matters. Probably some standard of vision with-
out glasses is still clung to, owing to the fear that if a soldier
loses his glasses he will lose himself or become utterly helpless.
This fear is entirely groundless, for there is practically no error
of refraction, excluding ocular disease, which will be sufficient
to stop a soldier finding his way about until a new pair can
be obtained for him, and even supposing he were incapEicitated'

Egyptian Expeditionary Forces, 1915—1918. 81

for th.o time being, he is no woise off than a soldier with a
sprained ankle, or other trivial injury which prevents hini getting
about. My oontention is that the degi-ee of error of refraction
and the vision without glasses are immaterial, and that so long
as a soldier has good vision with glasses, and has no organic
ocular disease, he is fit for A Class duty. Moreover, tlie
standard of vision 6/24 in one eye without glasses is inconsis-
tent with the regulations as to the limits of spectacles per-
missible. For example, to quote my own individual case,
which illustrates the difficulty very well. I hav^ -75 Dsph with
•75 Dcyl of myopic astigmatism, and witli this my unaided
vision is just about 6/24. According to the War Office regula-
tions, I could not be ordered tlie necessary spectacles to bring
my vision up to Q/Q, as spectacles of this strength are not
allowed by para c (1), Ai-my Council Instruction No. 1371
Qf 6th September, 1917.* With any higher amount of myopia,
or myopic astigmatism, I should be permitted to have spectacles
at Government expense, but owing to the fact that my visual
acuity would in that case not reach 6/24 in either eye without
glasses, I should not be considered fit for duty, Class A.

Hence it is evident that no myopes for whom glasses can
be ordered under War Office regulations can be Class A,

♦Limits of spectaxiles to be supplied to soldiers at the public expense.

(a) No simple spherical lens will be supplied of a less strength
than 1-00 dioptre, or of 'a gT€ia;t©r strength than 18-00 dioptres.

(b) No simple cylindrical lens will be supplied of a less strength
than 1-00 dioptre, (or of a greater strength than 6-00 dioptres.

(1) One of its component parts less than OoO dioptre, and
the other component part less ifchan 1*00 dioptre;

(2) A combined strength greater than 18-00 dioptres; or

(3) A cylindrical strength greater than 6-00 dioptres.

(d} No sphero-cylindrical lens will be supplied with a concave
spherical surface and a convex cylindrical surface.

(e) No quarter-dioptre lenses will be suppUed above 300 dioptres,
and no half-dioptre lenses above 6-00 dioptres.

CA.C.l. No. 1371 dated 6/9/17). ' ,

PART III. F

82 OphflHthi/ir Prncfice in the Mediterranean and

though thoy, of all classes of men sufferino- from visual defecte,
are the most henefited by spectacles, and are the most useful.
A myope can, at any rate, read easily without glasses, while
a man with a mixed astigmatism or h} permetropia not only
does not see well at a distance, but cannot read well.

Hence, in view of the urgency of obtaining all the available
men for Class A under the Man Power Report, the medical
authorities in Egypt have agreed, on my advice, to modify the
stringent Class A standard laid down in Army Council Instruc-
tion No. 211 dated 4tli February, 1917, and have ignored the
soldier's vision witbout glasses, paying a.ttention solely to his
vision when properly corrected. If the Army Council Instruction
in question had been rigidly observed in Egypt, hundreds of
soldiers Avho are serving quite efficiently in Class A would have
been automatically graded as Class B.

As 6/24 was sufiicient vision in the old days before the war,
when the Army could pick and choose its men, why limit Class
A to men -vVhose vision is not less than 6/12 with glasses?
I entirely agree Avith. tlie remarks of the Director General of
Army Medical Services* with reference to glasses and consider
that in modern warfare a man with vision of 6/24 witli glasses
has quite sufficient sight for Clasis A.

♦Extract from War • Office Letter No. 24/Gen. No./4906/(A.M.D.3.)
dated 15/5/1916.

"1. With reference to the Scheme for the issue of spectacles to
troops, I am directed to inform you that in many cases it would appear
that soldiers are ordered glasses quite unnecessarily. I am accord-
ingly to submit the following remarks for the guidance of all con-
cerned, and to point out that the conclusions arrived at are the result
of the experience gained by ophthalmic surgeons at the front in France,
after the examination of many thousands of men sent down from the
firing line complaining of defective visioin.

2. As far as infantry are concerned, this is at present chiefly a
war of ' bombs ' and hand and rifle ' grenades,' and a high standard
of marksmanship in every individual infantryman is not essential; some
good marksmen are required as snipers, but the company officer has
always a sufficient nuni'tj.er of men under his. command for that puxpose^
It should also toe borne in mind that battalions are, as a rule, only
9 or 10 days in the trenches, and are tihen 6 or 6 days back beihiad
the firing line ' resting. ' As regards artillery, and the requirements of
vision of gunners, shooting is dcme by map and telephone."

t^gUptian Expeditionary Forces, 19] 5 -1918. 83

Finally, and by no means the least important question, it
mii^t be remembered that a man's vision a/s determined by test
types is no more and no less than what a man chooses to
admit; and too much stress should not be laid on apparently
poor visual acuity, especially when a man is being tested for
classification purposes. Much more importance- should be
attached to the Medical Officer's opinion as to tlie presence
or absence of any great error of i-efraction, or of organic disea-se
as determined by objective examination; the presumption being
that in the absence of disease a man with a properly corrected
error of refraction should see enough for Army purposes.

In August, 1917, another Director of Medical Services, not-
withstanding the fact that hundreds of officei^ were at tliati
time serving satisfactorily as " A " Class wearing spectacles
and with vision below that of the old pre-war standard, directed
me that " The standard of vision for candidates for Commissions
is as laid down in the regulations for the Royal Army Medical
Service, and must not be departed from," (i.e., the old pre-war
standard). •

In May, 1918, a subsequent Director of Medical Services in-
structed me that the regulations with regard to vision for " A "
Class men Avhich had hitherto been in force in Egj^pt must b©
abandoned, and that the Army Council Instructions must be
strictly adhered to. In reply to this Jettiar I wrote that I deeply
regi-etted this decision, for, b}'^ a stroke of the pen, \he policy
of the last two and a-half years in Egypt would be abandoned.

England had been at war for nearly four years, and was
fighting, to a certain extent, with its back to the \vall, and
depending above all thing-s on man-iK)wer, or the necessity of
obtaining for the fighting line every man Avho was fit for that
pui'pose. It was from this point of view, and this point of
view alone, that I had e\^r since I arrived in Egypt looked at
the problem of soldiers' vision, and it was for this reason that
I deplored a decision that would have the result not only of
removing thousands of men from front line units in Egypt to

84 Ophthalmic Practice in the Mediterranean and

Garrison Battalions and i-earward formajtions, but also of pre-
venting hundreds of men in Egyi>t and thousands of men in
England from being justlj raised from a lower categorj^ to
Class A.

I informed him that in 1917 over 6,000 soldiers were tested
in Egypt for defective vision, and were in the great majority
of oases ordered spectacles either at their own or at the
Government expense. For reasons which I have mentioned
above practically all soldiers suffering from myopia or myopic
astigmatism would be affected by the decision. Over 2,200
myopes were examined during 1917, and in the great majority of
cases raised to Class A by the provision of glasses. A fair pro-
portion of the remainder, who would now be B, were also
made into " A " Class men, so that it was probable that the
number of men in the Egyptian Expeditionary Force then " A "
Class, and, as far as my experience went, serving in thali
capacity satisfactorily and well, was over 3,000, and all these
would, if his instructions were carried out, be turned into " B"
Class men forthwith. These figures, relating to a comparatively
small theatre of war, were^ to me sufficiently serious to justify
my asking him to request the War Office seriously to re -consider
the question of revising the standards of vision for " A " Class
men, to make them accord at any rate to some extent, with
existing needs and oonditionjs, and with reasonable views of
how defective vision due to errors of refraction really affect
a soldier's efficiency.

I also said that I viewed with dismay the attitude of the
War Office in persisting in a standard of vision which, in these
days of necessity, was far too stringent and entirely out of
date; a standard which, as far as I knew, was not
adhered to in any other .Continental Army. My experience with
German prisoners was that the Germans, wise in their genera-
tion, had accepted the logical position which I had always
urged, that provided a soldier saw sufficiently with glasses
and had eyes that were free from disease, his vision without

Egyptian Expeditionary Forces, 1915—1918. 85

glasses did not matter in the least. In view of the existing
necessity for man-power, urgent in England and at lea^t as
urgent in Egypt, I did not wish as Consulting Ophthalmic
Surgeon to the Egyptian Expeditionary Force, to have any
responsibility in, or let pass without emphatic protest, a regula-
tion which, in my professional opinion, was depriving the fight-
ing forces of the Army in Egj-pt and Palestine o'f thousands
of entirely efficient soldiers.

Fortunately for the Army in Egypt, a new Army Council
Instruction (No. 421 dated April 21st, 1918) arrived almost
immediately, and Avent a long way towards meeting my objec-
tions.

In particular the last paragraph entirely justified my attitude.
It was as follows: —

" In re-testing the vision of serving soldiers the standard
will be the same as for recruits, hut men who Tiav^ heem
found capable \of carrying out their duties efficiently need not
necessarily be placed in a lower category on account of their
eyesight "iwt being equal to the standard laid down for the
category in which they are serving.''

Thus in one short sentence it was admitted that soldiers with'
vision belov.- the standards laid down could be efficient soldiers,
and the result of the paragraph was virtually to negative the
standards to which it referred.

Thus matters stood at the time of Uie Armistice, and in my,
opinion it is a matter of the utmost importance that, in view
of the' information gained in this war some new regulations
should be drafted with reference to soldiers' vision which should
be in accord with modern conditions of warfare.

Ophthalmia.

Ophthalmia in Egypt. — Traclioma is endemic in Egypt and
is practically universal. According to the reports of the Public
Health Department of Egypt approximately 80 per cent, of

86 Ophthalmic. Prarfirp in the Mediterranean (iiid

population sutior, or liavo isuft'ered, from traclioiua, and 20 per
cent, are consid-ered to be infectious. In the fourth annual
report of the Ophthalmic Section of the Department of Public
Health (1916), by Dr. A. F. MacCallan, Director of Ophthalmic
Hospit-als, it is stated that the percentage incidence of trachoma
in primary schools inspected by him varied from 80 per cent.
at Assiut to 100 \yeY cent, at Shebin-el-Kom. Of 68, .'304 ]>ati9nts
treated at the Public Health Department Ophthahnic Hosjiitals
during- 1916, 63,051 were found to be sufferino- from trachoma.

Acuto non-trachomatous ophtlialmia in Eg-y])t is due to the
Koch-Weeks bacillus, the diploooocus of Morax Axenfeld, or to
the g^nococcus. Of 7,804 bacteriological examinatioiiis of cases
of ophthahiiia in the Public Health Department Ophthalmia
Hospitals in 1916, 3,648 or 46 per cent, were found to be due
to the gonococcus, and 1,842 or 23 per cent, to the Koch-Weeks
bacillus The Morax- Axenfeld diplobacillus was found in 801
cases, or 12 per cent.

The gonococcus is rarely met with in the winter months,
January, February, March and April; its activity becomes
awakened in May, and this increases in June, July and August,
reaching a maximum in September. Afterwards a fall occurs,
which persists until the end of the year. A comparison of the
ciu?ves of temperature and of gonococcal incidence shows tliat
the change in temperature precedes by two montlis the chang-es
in gonococcal activity (Chart 2).

No relation can be made out between gonococcal activity
and the relative humidity or the level of the Nile, though the
rise of tlie Nile is approximately coincident with seasonal
increase in ophthalmia.

The activities of the Koch-Weeks bacillus and the Morax-
Axenfeld bacillus, Avhile showing sieasonal variations, do not
show coincidence with the variations in temperature.

The acute non -trachomatous ophthalmia of Egypt is very
destructive, and leads to a high percentage of blindness, owing
tjo corneal ulcer and perforation, leucoma adherens and subse-
quent glaucoma.

Egyptian Expeditionary Forces, 1915—1918.

Chart 2.

OPHTHALMIA. IN ECVPT

Curves showing Variations of TemperaUire and Gonococcal Conjunctivitis

(MacCallan)

! P<r ccnt*cttcs
i Tolil 47*1

FEI

HtR.

AM.

MIT

JUKI

1
juir luc

${fl •-

NOT

0(C

Temp
. C

1 30

*_-

' 28

2«

■\

24. 1

)

<1\

i»

1 9

^ _/

/ V

4 A

\
\

-f ■ ■

( 2

)

\
\

t
, 1

1 10

J
f

6 1

•

"7^

,..,

•«^-

-•

— 1

Temperalure in degrets centigrade, 1917

Per cent of cases in each month o( total 4791. 1917.

88 Ophthalmic Practice in the Mediterranean and

According to Dr. MacCallan's figureiS for 1916, of his 68,304
ophthalmic cases there were 3,699 cases of simple ulcer of the
cornea, 303 of hypopyon ulcer, 1,330 of perforation of the
cornea, 28,568 with simple leucoma, 4,982 with adherent leu-
coma, 2,462 with total opacity of the cornea, and 1,257* case^
of staphyloma. There were 129 cases of panophthalmitis.

Ophthalmia among Napoleon's Troops^ 1799-1801. — It is a
matter of common belief that tlie epidemic of ophthalmia, which
affected so disastrously Napoleon's troops in his Egyptian cam-
paign, was trachomatous in character.

In his well-known text book on ophthalmology, Fuchs says:

It was at the commencement of the last century that Trachoma
began, to attract the attention of physicians to any great degree*
It was then that thei disease first ishowed itself as an epidemic among
the European Armies (Ophthalmia Militaris). People were of the
opinion that it had been introduced into Europe from Egypt (hence
Ophthalmia Aegyptiaca) by Napoleon I. For wlien the latter, in
July, 1798, landed in Egypt with an army of thirty-two thousand men,
most of the soldiers were very soon attacked by a very violent Oph-
thalmia, and these were supposed to have brought with them in their
return to Europe the disease which was formerly confined to Egypt.
Subsequent historical researche;s, however, have ehofvvn that the disease
had already been endemic in Europe since iantiquity. It is mentioned
in the Ebers papyrus and in a pseudo-Hippocratic manuscript. Celsus
gives a good description of the roughness fof the lids and the purulent
discharge that it occasions. Eor treatment, the ancients employed
scarification of the conjunctiva, which is still to-day made use of by
some, and which wag accomplished both by means of various instru-
ments and also by friction with fig leaves.

From time immemorial, then, trachoma has existed in Europe as
an endemic disease. But when by reason of the Napoleonic wars the
armies came so repeatedly in contact with each other and with the
civil population, the disease became inore widely disseminated and
occurred in epidemics. In some countries it became frightfully pre-
valent. In the English Army, during the year 1818, there were;
more than 5,000 on the invalid list, who had been rendered blind
as a consequence of trachoma. In the Prussian Army from 1813 to
1817, 20,000 to 30,000 men were attacked' with it; in the Eussian
Army, from 1816 to 1839, 76,811 men were subjects of the disease.
In Belgium in 1840, onei out of fevery five soldiers was affected with
trachoma. The French Army, which was supposed to form the starting
poiat of the disease, wasi just one that relatively speaking was least
attacked. The armies disseminated trachoma among the civil popula-

Egyptmn Expeditionary Forces, 1915 — 1918. 89

tion througli the discliarge of soldiers affected with eye disease^,
through the quartering of troops, etc. Wjhen they had so many tra-
chomatous soldiers in the Belgian Army that they did not know what
to do, the Government applied to Jungken, who was at that time a
celebrat-ed ophthalmologist in Berlin. He recommended them to dismiss
the trachomatous soldiers to their homes. By means of this fatal
measure, trachoma soon became diffused in Belgium to an extent that
has been observed in no other European state.

With reference to the epidemic of Ophthalmia which affected
Napoleon's troops in , Egypt a little over 100 years ago, I have
consulted the original accounts. These are given in ^reat detail,
and in picturesque language by his famous Surgeon-in-Chief,
D. J. Larrey, afterwards made a Baron of the First Empire
and Senior Surgeon to the Old Guard.

A copj; of Larrey 's work, " Memoires de Chirurgie Militaii-e
et Campagnes " (Paris 1812), is in the Library of the Kasr-
el-Aini Medical School at Cairo, with a dedication in his own
handwriting, " Offert au premier medicin de S.A. le pacha
d'Egypte, hommage de I'auteur D. J. Larrey."

Larrey was appointed Surgeon-in-Chief to Napoleon's Egyp-
tian Expeditionary Force in 1798. He says that, realising
the importance of being made Surgeon-in-Chief to an expe-
ditionary force of 30,000 soldiers, his first step was to collect
a medical staff, which he did hj writing to the schools of
medicine of Montpellier and Toulouse. By this means he col-
lected 108 medical officers.

Before leaving Marseilles he gave them a preliminary course
of instruction, and collected, as far as he • was able, a full
equipment of medical stores and instruments. The expedition
left Marseilles on the 13th May, 1798, and arrived at Toulon
on the 19th May. From Toulon it took 21 days to reach Malta,
where the army disembarked on the 10th June. They left
Malta on the 18th June, and arrived 12, days later before
Alexandria, which was stormed and taken next day. In this
action General Kleber was wounded, and he was subsequently
left behind in command of the garrison which remained at

90 ()it/i/h(f/inic I'ntcHrc in the Med'tlerranean and

Ak'xundiiii. On tli« Gtli July Napoloon, and with liini Laiiey,.

started out for Cairo. To use Larrej's own words: —

The army sot out without provisions and without water, into the
arid deserts which border Lybia and only arrived with greatest diffi-
culty, on the fifth day of the march to the first place in the interior
of Egypt offering any resource-!, Damanhour. Never has an army had'
to endure such privations or undergo such dangers. Stricken by the
rays of a burning sun, marching on foot on sands still more burning,
crossing immense and dusty plains, where there were to be found onh*
a few ditches of muddy water, almost isolid, the hardiest soldiers, con-
sumed by thirst and heat, succumbed under the weight of their equip-
ment. • ' '

Napoleon i-eached the Nile at Rahmaneah, and proceeding
by tJie left bank of the Nile reached Chebreissa on the 13th
July. A further march, then the battle of the Pyramids near
Embabeh, a suburb of Cairo, and on the 25th July Napoleon
toolv posiseission of Cairo and of the Citadel. Larrey went
off to the Sharkieh Province with Napoleon in pursuit 0f
Ibrahim Bej^, and on liis return to Cairo, a few weeks later,,
heard the news of the Battle of the Nile at Aboukir, and
of its disastrous results to the French Fleet. On his return
to Cairo he organised the Surgical Service, and formed in the-
principal hospital a school of practical surgery for the young
siu'g^eons in the Army. In his own words, writing in 1812:—

I supervised with care the 'trea,tment of the wounded and of those
affected by diseases oif tjiiei eyie, for ophthalmia had already appeared'
and commenced to spread (it was the time of the overflow of the
Nile). Desaix's Division, which remained a long while embarked on
this river in Upper Egypt, furnished the greater numbetr of cases of
ophthalmia. The physicians land Isurgeons who had to treat this disease-
were not in agreement as to the causes which produced it or the means
it was necessary to employ to deal with it. The quacks, who prac-
ticed in the country, pretending that they alone understood an affec-
tion due to their climate, imposed on the credulity of many soldiers
who were attacked, and this caused many of them to lose their sight.
These considerations led me to publish, on the subject of this malady,
a memoir which I addressed to my colleagues, the Senior Surgeons,,
to define the treatment by which it was necessary to deal with the
disease, and this I communicated to the Institute of Cairo. I am now
offering the contents of the memoir with some additions I have had
occasion to add /subsequently. The principles which it embodies were-
put into practice after publication, with so Inuch success that these-
diseases became in consequence, even in the hands of junior medical'
oflScers, most simple and easy to treat.

Egyptian Expeditionar?/ Forces, 191 o -1918. 91

After some prolong^ed stay in Cairo, Napoleon started for
Syria on tlie 9tli February, 1799, and marched fii-st into the-
Sliarkieh Province. After the battle of Salhieh, on the eastern
edge of tlie Delta, Larrey went with a company- of Camel Coq^s
to El Arish to join the advance g*iiard and to look after some-
casualties which had; occurred in the attack on El Arish itself.
On the 28th Februarj, Napoleon arrived at El Arish and started
for Syria, passing through places whose names are familiar
to all who have fought their way across Sinai into Palestine
in the present campaign. He passed through Rafa, Khan
Yunus and Gaza, and, by way of Esdud and Ramleh, arrived
at Jaffa, on the 5th March. On the lotli March he left for
Acre, Larrey having- accompanied him the whole way from El
Arish. There is no room in this short article to give any
account of the siege of Acre, which ended so disastrously for
Nai^oleon's Syrian campaign, of the harassing waHare to which
he was subjected by the Arabs, or of the outbreak of plague
which so seriously affected his troops. It is only interesting*
to note that Larrey relates that all the wounded were evacuated
during this period, as they have been in this camfpaign, to
Egypt, and that by the timfe the Army eventually evacuated
Syria 800 had been &ent across the desert of Sinai by cam(el
convoy, and 1,200 had been sent by sea, the miajority being
embarked at Jaffa. On the 21st and 22nd May, Napoleon's
army finally left Syria for Egypt, passing on its way through
Caesarea, Jaffa, Gaza, El Arish, Katia, Salhieh, and Bilbois.
Napoleon returned to Cairo, and tlien, on hearing that an army
of 20,000 Turks had descended on Aboukir, left for Alexandria.
The land battle of Aboukir was fought, and subsequently on
the 22nd August Napoleon, on the pretext of making an in-
s]>ection of the northern coast of Egy[)t, embarked and left
surreptitiously for France. Larrey remained in Egypt with
Kleber, and he relates that in the month of Juno, 1801, the
troops outside Alexandria Avere once more severely attacked by
ophthalmia. Ajs he says: —

The occurrence of a north-north-west wind, and the overflow of
Lake Ma'dvch. who^o wntors innnflMt<vl onr o:im|>. rnn^od fi ].r<.Mnnnccd

92 Ophthalmic Practice in the Mediterranean and

outbreak of ophthalmia, and morei than 3,000 individuals passed suc-
cessively through the hospital. This outbreak was treated promptly,
and with great success, but was foUowod by an outbreak of scurvy.

In August, 1801, the English and Turks attacked Alexandria
and on the Slst August Alexandria capitulated and an armistice
■was signed. Larrey took this opportunity pf visiting the English
Camp, and obtained from Dr. McGregor an interesting report
as to the losses of the European and Indian troops during their
stay at Rosetta and Alexandria. It appears that of 7,886 men
who composed the English Expeditionary Force, 158 had been
sent home to England either blind or crippled. On October
17th Larrey left Egypt with the Army for France, tuid
Napoleon's Egyptian campaign was over.

Throughout his description of the expedition, Larrey em-
phasises the fact that ophthalmia was one of the most serious
affections ta which the Army was subject, and, in his subse-
quent memoir, he discusses the symptoms in great detail.

To quote his actual words: —

The eyes, having been struck isuddenly by the blazing light of the
sun, either direct or refl.ected from the glaring white soil of Egypt!,
have immediately felt the effects of the stoppage of the cutaneous
perspiration during the cold nights, land the result has been an obstinate
ophthalmia, and, with a fair number of persons, complete blindness.)
1 will enumerate the symptoms which arose. Swelling of the lids and
of the conjunctiva, and sometimes of the coats of the eye; extreme
local pain, attributed by the patjient to the presence of grains of
sand (these are dilated vessels); diminution of vision and inability
to stand a bright light. To these first symptoms soon succeeded
violent headaches, giddiness and insomnia. The few tears which are
secreted are bitter and irritate the lids and puncta lachrymalia. All
these symptoms are aggraved and lare frequently followed by fever,
sometimes even by delirium. The disease reaches its crisis on the third
or fourth day, sooner with some individuals, later with others. The
termination varies. When it is inflammatory and is left solely to the
resources of nature, there form ordinaa-ily towards the sixth or seventh
day points of suppuration on the edges of the lids, on the external
surface and at the angles. The ulcers spread by degrees on to the
conjunctiva, attack the cornea and often perforate it. Sometimes the

Egyptian Expeditionary Forces, 1915 — 1918. 93

cornea gives way suddenly, without Tilceration ; I have seen several
such cases. The rupture occurred within the first 21 hours, when the
conjunctiva was hardly red, and it is difficult to understand the cause
of this rapid and spontaneous trupture. We content ourselves with ob-
sei'ving the phenomena which hav€| occurred in Egypt, and the effects
which have been produced. The opening which resulted is round and
of a diameter almost the sajne vi all the patients who have been at-
tacked. It allows the passage of a portion of Descemet's membrane
or of the iris, and forms a hernia, known by the name of staphyloma.
The swelling formed by Descemet's membrane is a dull grey {gris
terne), that of the iris of a darker colour. This swelling is painful
to the lightest toluch of outside objects, and to %h.Q rubbing of tho
lids. The vision during the early days is more or less diminished,
according as the pupU is partly or entirely obscured; but generally
the staphyloma shrinks by degrees, goes back into the anterior cham-
ber, and the membranes resume their previous positions. Sometimes
there remains a small portion outside, ,which is strangled by the closing
of the aperture, loses its sensiitiveiaess, and acquires a certain tough-
ness, or else it Swellsf aad divides into several globules and takes on
a, carcinomatous character, especially if there is any complication of
venereal disease.

Larrey proceeds to reoount that the perforation was often
followed by the loss of the lens and the viti-eous, and that
the eye subsequently shrinks.

Hyopyon was rarely present. Leucomata were frequent,
often complete, and followed by total blindness. The tarsal
cartilages mere rarely affected* In general, the ophthalmia
weakened the sight, and predis]30sed to catai-act, lachrj^mal
fistula and glaucoma, and was often followed by night-blindness
and " gutta serena." (In tlie cases of night-blindness and
glaucoma, they employed with success a moxa on the principal
branches of the lesser sympathetic nerve (nerf fascial) ).

Larrey attributes the ophthalmia to tlie burning heat of the-
day, the reflection of the rays of the sun from the eartih,
immoderate consumption of alcohol and venereal excess, the
dust in the air, and the checking of the cutaneous perepiration
by the cold night air. He notes that blonde men were more
frequently attacked than brunettes, and that the right eye was-
affected more than the left. Xeai-ly all who lost tlie sight of

♦The italics are mine. — ^H.L.E.

•94 (}ph/h(ih/ii( Pidc/icc III IIh' Mcditcinnirdn. and

Olio ayQ lost. tliJ si<?ht of the lig-lit. He attributes this in part
to the fact that, as most paople sleep on tha right side, tliat part
is most affected by the humidity of the earth.

()j>litlialinia was also most prevalent during the overfiijw
of the Nile. It was also remarked that suppression of gonorr-
hoea frequently produced ophthalmia, and that the best way to
establish a cure was to re-establisli the urethral discharge. The
ti-eatment advocated included bieading, leaches on the temples,
hot footbaths, a lotion of a strong deooction of linseed, poppy-
heads and saffron, also compi-esses of tow soaked in white of
^^^^ and rosewater and some grains of sulphate of alum and'
camphor, applied every evening. In the later stag^es, lotions
of acetate of lead, mercuric chloride, sulphate of copper, or
sulphate of zinc were used.

Ulcers of the lids were treated with an ointment for which
he gives the following prescription: — *

Cerate of wax and almond oil, oz.i.

Red oxide of mercury, gr.iv.

Oxide of zinc, gr.xvi.

Camphor dissolved in the yolli of an Qg^, gr.iv.

Cochineal paste, gr.viii.

Oriental saffron, gr.vi.

Lari-ey says that ophthalmia hardly spared anyone in 1798,
■ and nearly all cases were inflammatory. In 1800 a few soldiers
w^ere affected, and the cases were less severe and more
easily treated. The severe outbreak Avhich occurred again in
1801 near Alexandria has already been mentioned. It was
jioted that the malady presented various characteristics, but
in general it was inflammatory, with symptoms less intense
than those of the outbreak of 1798.

The English on their arrival in Egypt were not exempt from
the disease. After some time they followed the French practice
as laid down by Larrey, Avhich they found in a memorandum
left at Rosetta, and from that moment they saved the sight
•of the greater number of their patients.

Egyptian Expeditionary Forces, 1915 — 1918. 95

Larrey also notes that many Frencli soldiers avIio escaped
-ophthalmia were struck ahnost immediately on returning to
France with a more or less complete blindnoss, which " appeared
to be due to paralysis of the visual org-an, consequent on the
sudden passage fix)m the tropical climate of Egypt to that of
France in the winter season."

Ophthalmia in the British Army, 1915-1918. — Ophthalmia or
conjunctivitis caused about 12 per cent, of the total eye cases,
and this proportion was practically constant at every hospital
and in every year. Trachoma caused 342 cases, or about 1
per cent. The incidence of ophthalmia compared Avith the
total number of troops was very low. The maximum number
of troops in Egypt and Palestine at any one time (excluding
labour corps, native orderlies and substitutes, etc.) was approxi-
mately 250,000. Taking the yearly average at 200,000 and
the yearly average of cases of conjunctivitis and trachoma as
1,300 and 114, the percentage incidence of these diseases works^
out at approximately -5 and -05 respectively.

In the British Army the conjunctivitis was seldom severe,
and there Avas never anything approaching a generaf or even
local epidemic. During the j>eriod under review only five eyes
were lost from perforation, staphyloma or panophthalmitis.

Owing* to the presisure of work on the bacteriological labora-
tories for more urgent military needs, not many bacteriological
«xaminatioas were made, but of 178 cases which were examined
76 were due to the Koch-Weeks bacilhis, 87 t6 the Morax-
Axenfeld diploooccus, 7 to staphylococci and streptoeocci, 5 to
the pneumoooocus, and 3 to the gonococcus.

Clinically, gonorrhoea! ophthalmia was very rare, only eight
cases being reported.

The opbthahnia generally was of the simple catarrhal type,
in the more serious cases resembling the acute mucopurulent
conjunctivitis of the Koch- Weeks type, clearing up rapidly
under treatment. No special remedy calk for any comment,
all having been used Avith about equal suooess; but the ex-

96 Ophthalmic Practice in the Mediterranean and

perienco of both Egyptiau oculists and of the R.A.M.C. officers
working in Egypt was that zinc sulphate, except for the very-
acute oases, was of all ophthalmic antiseptics by far the most
efficacious for the conditions prevailing in Egypt. This was
the independent experience of Major Lockliart Gibson in
Mudros.

In view of the commonly accepted account of the cause of
tlie spread of trachoma in Europe, and of tlie prevalence of
trachoma among the civil population in Egypt, every precaution
was taken to prevent an epidemic among the British troops.

Shortly after my arrival in Egypt the following regulations
were issued: —

1. Trachoma is an acute infectious disease, and must in-
variably be treated as such.

2. All cases must be isolated in a separate room, or tent,
or on board ship in a separate cabin or ward. Infectious
patients must not associate with their comrades, even during
recreation or exercise.

3. Special attendants must be detailed to look after cases
of trachoma, and must be warned to pay particular attention
to personal cleanliness, always washing their hands after dress-
ing a case. For this jpurpose a basin of disinfectant Inust
always be kept in the ward.

4. The instructions given to attendants on cases of typhoid
or any other infectious complaint are generally applicable in
the case of trachoma.

5. Separate specially marked feeding utensils must be
supplied.

6. A separate latrine and urinal must be set apart for
trachoma cases. If these are few in number a night stool for
their use will suffice.

7. All dressings used m^lBt be placed in disinfectant and
burnt at the earliest possible opportunity. If eyeshades are
used they must be burnt when discarded.

Egyptian Expeditionary Forces, 1915 — 1918. 97

8. Dark glasses must be sterilised by boiling.

9. Pieces of linen and cotton rag should be issued instead
of handkerchiefs, and when discarded treated in the same way
as dressings.

10. Hospital clothing and bedding must be disinfected before
being sent to the wash.

11. Officers conmaanding' Hospital Ships carrying cases of
trachoma must notify the same to the disembarking Medical
Officer.

Fortunately the experiencie of the first year showed that
trachoma was not infectious in an Armj^ with British standards
of personal cleanliness and with the protection of modern mili-
tary sanitation. Of the 342 cases of trachoma reported only
68 were reported as recent; 203 were cases of old trachoma
acquired before coming to Egypt, and 72 were unspecified
as te whether they were recent or old. Of tlie recent cases
a high proportion was found among Australian soldiers, for
trachoma is commoner in Australia than in Eng-land.

On consideration of these figures and of th& fact that for
three years the British army had been living in a country'
where trachoma is ahnost universal, that it had been working
side by side with the Egyptian Labour Corps, almost all in-
fected with trachoma, that native servants had been employed
in messes and as pei'sonal servants, and that hospitals had
been largely staffed by native orderlies, one is forced to tlie
conclusion that with modern standaxds of sanitation and clean-
linesLS trachoma is no long^er to be dreaded as a military epi-
demic.

In May, 1917, when tlie Egyptian Labour- Corps was being
sent to France, the War Office expressed some alarm at the
prevalence of trachoma in it, and cabled that, of the Egv^tian
Labour Corps personnel sent to France, 5 per cent, had been
found to be suffering from acute trachoma and 15 per cent,
from subacute trachoma.

PART III. Ot

98 Ophthalmic Practice in the Mediterranean and

The AVar Office instracted that more stringent examination
\vas necessary at the time of recruitment, and that men with
definite granulations or with any acute oonjunctivitis should
not be enlisted or embarked, and that inspection at the port
of embarkation should be carried out by an ophthalmic specialist
who had experience of the disease.

As a result of this cable the Director of Medical Services
instructed me to take the necessary steps for the examination
of all Egyptian Labour Corps drafts leaving Egypt for
France. This I did, both at Alexandria and at Kantara. After
one inspection at Kantarai I informeld the Director of Medical
Services that I had examined there 3,704 Egyptian Labourers,
who were under orders to embark. I reminded him that
trachoma was endemic and nearly universal in Egypt, and that,
as noted above, according to information supplied by the Public
Health Department approximately 80 per cent, of the population
suffered or had suffered from trachoma, and 20 per cent, were
considered to be infectious.

In view of these facts I assumed that it was not desired to
reject every Egyptian labourer w^ho showed evidence of
trachoma, as this would have resulted in such a high percentage
of rejections that it would have been impossible to raise
Egyptian Labour Corps drafts for France. In examining these
labourers I had acted, therefore, on the definite instructions of
the War Office as contained in the telegram, and had only,
rejected, those suffering from obvious trachoma granulationis
or conjunctival discharge.

On these grounds I rejected 814 men or approximately 22
per cent., a figure which agreed very closely with the percen-
tage given by the Public Health Department as infectious,
and with the percentage of Egyptian labourers found to be
unsuitable on examination in France. I passed as fit those
men who, though affording evidence of old trachoma in the
shape of scar tissue or thickened lids, showed no conjunctival
discharge or definite granulations. In my opinion, in the

Egyptian Expeditionary Forces, 1915 — 1918. 99

absence of sucJi granulations or discharge, there was little risk
of infection.

I understaud that the Chinese Labour Corps in France was
also seriously affected with trachoma, but whether the presence
of these trachomatous drafts of labourers infected either the
armies in France or the civil population is at present uifknown
to me.

Ophthalmia among Turkish Prisoners. — Though, as has been
seen, the British Army suffered practically not at all, eithejl
from trachoma or from severe ophthalmia, the case was un-
fortunately far different with the Turkish prisonens captured
during the conquest of Palestine and Syria. Before the Avar
ophthalmia was, next to malaria, the most prevalent disease in
Palestine. From conversations I have had with Turkish and
Syrian doctors who werer attached to the Turkish army, it
appears that ophthalmia did not occur until the troops reached
the neighbourhood of Jerusalem and Gaza, where the climatic
conditions and the habits and customs of the natives more nearly
approach those of Egypt than do those of the population of
the more mountainous country further north. I am told that
there were numerous outbreaks of purulent ophthalmia among
the Turkish troops in these districts, and they were severe in
character. We had evidence of these conditions when Jerusalem
was occupied, for of the 78 Turkish prisoners suffering from
«ye disease who were received into a Prisoners' of Wai* Hospital
in Cairo from a Turkish Hospital in Jerusalem where they
had been left behind, there were 29 cases of corneal ulcer.
Of these 15 had perforated the cornea and 14 had not. In
addition 30 cases were blind in one or both eyes.

The Turkish oculists also found that gonococci occurred in a
large percentage of oases, though the ophthalmia was not quite
of the same clinical type we are accustomed to see in associa-
tion with urethral discharge in England and other European
countries. The swelling of the lids was not so pronounced,
though the tendency to perforation of the cornea was quite

100 Ophthalmic Practice in the Mediterranean and

as marked. This is also the experience in Egypt, as may be
fieen from Dr. MacCallan's reports.

Chart 3.

1918
N93. Prisoners of na/ar hospital, Kantara
N9 OF Ophtmalm'a cases admitted monthly

,4if JfARJ^lHAV

1 ^ •

~\-A

ffl

ifl

W:'\

~B'. \

ffi

8^'''

pfc*

•^;;^

tSuJl:

t^c ■

pic

;:::!••„•:

■:vS\\:\:

i-:

liiiisi

M^^ ■

^m-\

^r^'- \

ffiiiir^'

^^'

1; ...^^

.JB

iinii

■

lii

Among- the Turkish prisoners in Egypt there was no serious
outbreak of ophthahnia until August, 1918, when an epidemic
of purulent ophthalmia started at Kantara. Chart (3) in ite

Egyptian Expeditionary Forces, 1915 — 1918. 101

upward curve is almost exactly a replica of that showing the
Beasonal incidence of g-onorrhoeal ophthalmia in Egypt (pub-
lished in Dr. AlacCallan's report for 1916), but it is exag-
gerated for the later months of the year owing to the fact
that during the five weeks from September 19th to the end
of October the British advance from the neighbourhood of
Jerusalem to Damascus, Homs and Aleppo resulted in the
capture of about 87,000 additional prisoners, many suffering
from acute oplithalmia. In 1918 the number of prisoners with
oplithahnia admitted monthly to hospital at Kantara rose from
practically none in the early months of the year ' to '400 m
September, 1,000 in October, and 2,000 in November. By
December the epidemic had begun to abate, only 200 cases
being admitted.

At the Prisoners of War Hospital, HeUopolis, the epidemic
followed much the same course, the average nmnbers under daily
treatment rising from about 100 in July to 400 in August, 500
in September, 1,000 in October, and 1,200 in November. By
December the average number had dropped to 500, and by
the end of the year the cases were comparatively few (Chart 4).

The prisoners on arrival were underfed, exhausted, in a
pitiable condition, dying from pellagra, enteritis, dysentery,
broncho -pneumonia, influenza and tubercle, and they had very
little resistance to the ophthalmia.

The type of ophthalmia, clinically, was that of the acute
Koch- Weeks type, there being little of the brawny swelling
of the lids so characteristic of gonococcal ophthalmia, but, as
in Egypt and in the Turkish Army, bacteriological examina-
tion showed a high percentage of cases in which gonococci
was fomid. The characteristic of the epidemic we^ the rapidity
with which the cornea was affected, and the high proportion,
of corneal ulcers, perforation and panophthalmitis. In general
Larrey's description of the results of the condition remains ac-
curate to this day, and panophthalmitis and staphyloma caused

102 Ophthalmic rracticc in the Mediterranean and

the total destruction of a gi-eat many eyes. For examploj at
tlie Prisoners of "War Hospital, Heliopolis, where most of the

Chart 4.

1918
Prisoners of war Camp heliopolis.
average number of ophthalmia under treatment

i;HiHJHHtniP;l;h;i::d;i-t::::li:.:t-

:ltiid!:;ili;;it-iil

jjiiiiais^agifeggM^^

patients eventually arrived, the number of eyes removed monthly
in 1918 was as follows: —

Egyptian Expeditionary Forces, 1915 — 1918.

103

January, 1; February, 3; March, 2; April, nil; May, 1;
June, 30; July, 39; August, 34; September, 17; October, 39;
November, 218; December, 29 (Chart 5).

Chart 5,

1918
N?2. Prisoners of War hospital. Heliopolis
H° OF Eyes removed monthlv

It is inij)0S8ible to arrive at the exact number of prisoners
affected, as owing to the progressive transfer of batches of

104 Ophthalmic Practice in the Mediterranean and

prisoners down the line the same cases were undoubtedly
counted twice or three times over in any statistical figures that
I have, so that I have contented myself with giving* representa-
tive figures from two important Prisoners of War Hospitals.

There appears little doubt that in Egypt and among tJie
Turks the gonocoocus can live in the conjunctiva and be
transmitted from eye to eye over and over again, without
the CO -existence of venereal disease, and that in these altered
conditions it loses some of its characteristics and is not identical
in its action with the gonococcal infections directly transmitted
from the urethra. There Tvere two small outbreaks of typical
gonorrhoeal ophthalmia, in two Prisoners of War Camps in Egypt
early in December, but these w^ere directly traced to prisoners
with urethral discharge, and with segregation and treatment
of the venereal disease the epidemics were rapidly got under.

As to treatment, there is little to write. Experiments w^ere
tried with all the well-known antiseptics, but there was no
evidence that any one was more efiicacious than another. The
whole value of any treatment of purulent ophthalmia depends
more upon efficient and frequent irrigation than upon the actual
nature of the antiseptic.

Bandages were entirely forbidden, as there was a tendency
among many Turkish, Syrian and Egyptian doctors to tie
their cases up, with or without fomentations, with disastrous
results. Silver nitrate, especially in the early stages, or in
patients with little recuperative power, seemed rather to destroy
the conjunctiva and lead to further infection and sloughing
of tissues, and was only used in selected cases, and not allowed
as a routine treatment; cauterisation with pure carbolic acid
for corneal ulcers was equally useless in many cases.

In camps where outbreaks of ophthalmia occurred, regular
prophylactic daily treatment of every prisoner, whether suffer-
ing from conjimotivitis or not, with zinc sulphate and boracic
acid drops was carried out with great success, and the epi-
demics had almost en'tirely died down 'by the end of 1918.

Egyptian Expeditionary Forces, 1915 — 1918. 105

As evidence of the bad state of nutrition of tlie Turkish
prisoners, it may be mentioned that in the ophthalmic compound
of one Prisoners of War Camp there were at one time 172
cases of xerosis of the conjunctiva with night-blindness, associa-
ted Avith pellagra and all forms of intestinal malnutrition.
These cases were put on a more generous an.ti-pellagra diet,
and the xerosis rapidly cleared up.

In evidence that the ophthalmia was almost entirely due to
the personal habits of the prisoners, it may be mentioned that
there was no epidemic of ophthalmia at all in contiguous camps
among German or Austrian prisoners, or among interned civilians,
though unfortunately a German orderly lost the sight of one
eye from gonorrhoeal ophthalmia contracted during the per-
formance of his duty among Turkish prisoners.

I can hardly leave the subject of ophthalmia in Egypt
without making a few remarks upon the oontrovei'sy which
has raged for over a hundred years as to the identity of the
ophthalmia which ravaged Napoleon's troops in Egypt and as
to the source of the great epidemic of trachoma which spread
among tlie armies and peoples of Europe in the early years
of the Nineteenth Century.

I have quoted from Larrey at some length, for I feel that
justice has not quite been done to his desoription of the
epidemic in Egypt. Boldt* says of Larrey 's account, " These
accounts, derived from French Physicians, were received by
contemporaries in other countries with, some suspicion. Many
like Eble and Jager, inclined to the opinion that the principal
reason why the French army surgeons had not diagnosed the
disease correctly was due to the decline of ophtlialmology in
France at that time. On the other hand, we must accept it as
a fact, quite authenticated, though as yet inadequately ex-
plained, that the French army which returned from Egypt
suffered relatively little from trachoma in the following years

♦Boldt. Trachoma, translated by J. Herbert Parsons and Thomas
Snowball, London, 1914.

lOG Ophthalmic Practice in the Mediterranean and

during- wliicli the war laisted. If the disease had been even
approximately as oontagdoiis as it wats subsequently in the-
armies of Eng-land, Italy, Prussia, and other nations, it musft.
necessarily have been noticed." Boldt also says, "From the
description of the disease given by the authors during- the
first decade of the last century, there can be no doubt that
Egyptian ophthalmia included not only the trachoma of the
present time, but several quite different diseases, such as simple
catarrh, follicular swelling and follicular catarrh, blennorrhoea."
It is freely acknowledged that the French army, which should
have been the most seriously affected remained comparative^
immune. That Larrey was not unmindful of trachoma is showni
by the statement that I have italicized on page 93 that the
tarsal cartilag^es were not affected. Trachoma also did not break
out in the European armies till several years after the return
of the armies from Egypt. It appeared in the British Army
in 1804, in the Prussian army in 1813, in the Austrian army
in 1813-1820, in the Russian army in 1818, in the Dutch and
Belgian armies in 1815, in the Swedish army in 1813-1815,
and in the Danish army not until 1848. There is no doubt
that the British Army was severely attacked by trachoma and
purulent ophthalmia in 1803-1806, and Vetch's account leaves
no iincerfcainty that a large proportion of the cases were tracho-
matous; but it also appears from a letter from Dr. Fergusson
at Portsmouth to the Inspector G^eneral in 1809,* that there was
a great deal of factitious ophthalmia in the army, principall}^
among new Irish recruits who had never been in Egj-pt, but
who w^ere under orders for enibarkation for foreign service.
Boldt tsums the matter up very fairly in the following passage:
" Although, therefore, trachoma was well know^n in Europe
before Napoleon's time, yet its extraordinary dissemination in
the French, English and Italian armies must undoubtedly be
attributed in great measure to their infection in Egypt. On
the other hand, there is no doubt that the armies of other

*Kindly brought to my notice by my colleague, Mr. A. W. Ormond.

Egyptian Expeditionary Forces, 1915—1918, 107

European nations remained almost entirely free from Egyptian
opthlialmia, in spite of tlieir frequent intercourse with the
French troops. Good examples were found in the Austrian
army, which was often engaged with the French from 1799 to
1890, land in the Prussian army up to 1813, which fought witli
a Russian against the French in 1806-7. These incontestable
facts refute the view which finds wide acceptance even at tlie
present day, that the transmission of trachoma into every army
and ioountry in Europe was entirely the result of infection from
the French ai-my in Eg3'pt. The latter, on the contrary, as has
been remarked, did not suffer to any si^preciable extent after
its return from Egypt, and within the next ten years it marched
through almost the whole of Europe wij^hout producing demon-
strable epidemics of trachoma anywhere." My own conclusions
are, that whether trachoma was or was not introduced into
Europe by Napoleon's army on its return from Egjpt, there
is no doubt whatever that thQ epidemic of ophthalmia which
so disastrously aSected the army of Egypt in 1799-1801 was a
mixed gonococcal and Koch-Weeks infection. The French army
arrived in Egypt in the middle of the season in which, accord-
ing to McCallan's reports, gonococcal ophthalmia is most pre-
valent, and Larrey's account of the epidemic describes quite
accurately the symptoms of the ophthalmia which ran through
the Turkish prisoners in Egypt in 1918. That the epidemic!
in 1799 w^as not trachomatous but gonococcal is tlie view,
not only of Dr. McCallan but of all the ophtlialmic surgeons
who have served in Egypt in the recent campaign.

Finally, I think it may be accepted that trachoma will not
be re-introduoed into England by the troops returning from
Egypt in this war. With modern standards of cleanHnes®
and feanitation trachoma has lost its terrors. A large Eui-opean
population lives permanently in Egypt and does not contiuct
a disease which is practically universal among the native popu-
lation, and the British Army, Mhich has for four years been
intimately associated with Egyptian Labour Corps personnel,

108 Ophthalmic Practice in the Mediterranean and

hospital orderlies, native servants and drivers, has been affec-
ted only to an infinitesimal extent. But that ophthalmia is
still a sotiroe of real danger among a population with eastern
habits, the severe epidemic among the Turkish prisoners very
forcibly reminded us.

Corneal Ulcers.

Corneal lilcers were common, especially among troops camped
on the desert. They were probably caused in the first instance
by abrasion of the cornea with particles of sand, the abraded
surface subsequently becoming infected by some of the con-
junctival lorganisms. The ordinary corneal ulcers reacted quite
well to treatment, and were very seldom complicated by
hyopyon.

There were, however, an unusually largie number of dendritic
ulcers of the cornea, associated with corneal anaesthesia. These
were very intractable and prone to relapse, lasting sometimes
for months and reacting to no treatment. All the ordinary re-
medies, such as the usual antiseptic ointments, pure carbolic
acid, tincture of iodine or absolute alcohol, were tried, but in
the majority of cases the progress was extremely slow. The
corneal epithelium grew over a shallow superficial mass of par-
tially necrotic tissue forming a very weak scar, and even when
the ulcer did heal, it often broke down almost immediately if
the patient was discharged to duty.

Generally it was found that the cornea did not heal satisfac-
torily in the sandy atmosphere of Egypt, and men were invalided
home in the hope that the sea voyage and treatment in England
might result in a more rapid cure.

The causation of these dendritic ulcers was obscure. Bysom©
observers it was held that they were associated in some way with
malaria, by others it was supposed that they were due to the^
large doses of quinine given to cure the malaria. No evidence
produced ever seemed to me sufficient to justify these statementis,
and I pe-rsonally attributed them to the climatic conditions of
heat, sand and wind.

Egyptian Expeditionary Forces, 1915 — 1918. 109

Lt.-Col. Sir J. W. Barrett, R.A.M.C., a well-known oculist
of Melbourne, told me that dendritic ulcei-s were, in his own
experience, common in those parts of Australia where the oc-
currence of sand, wind and heat produced a climate resembling-
that of Egypt. He also told me that malaria does not occur in
Australia. In view^ of these facts I remain sceptical as to anv
association of dendritic ulcers with malaria and I am also in-
clined to doubt the truth of the assumption that tliese ulcers are
due to some affection of the fifth nerve; apart from the anaes-
thesia of the cornea there is never any evidence of involvement
of other branches of the fifth nerve, such as is found in true-
ocular herpes, and my own opinion tends to the view that den-
dritic ulcers are due to a local external infection.

Gunshot Wounds .

Gunshot wounds of the eye and its neighbourhood numbered
564, or approximately 1 in every 600 eye cases.

These cases may be classified as follows : —

Gunshot wounds of the globe, excised ... ... 129

Gunshot wounds of the globe, not excised ... 163

Other injuries, principally traumatic cataract ... 148

Injuries to the lids and orbit ... ... ... 124

I have very little to say about these oases which has not been
better said by those who have had a much larger experience in
France. In Palestine and Syria fighting was never so continue ils
or intense as on the Western Front, and injuries due to small
fragments of metal, stone or sand in the eye due to high ex-
X:)losive or bombs were certainly not so c-ommon. The majorit}-;
of the cases were injuries due to rifle bid^ets, in which the whole
eye was hopelessly destr03^Ted, or in which, the eye, though not
actually hit by the bullet was so injui-ed by the concussion of
the impact in the neighbourhood tliat all sight was desti'oyed.
We became familiar in Egypt with the clinical picture, practi-
cally unknown before the war, of tlie I'esidts of the impact of a
rifle bullet in the neighbourhood of the eye. The ruptures of

110 0/)]ithalmic Practice in the Mediterranean and

choroid and retiim, the numerous larg^e retinal hsemorrlia^es
scattered all over the fundus, the greyish rodema of tlie retina
and the subsequent absorption of the blood and the develop-
ment of pigmentary degeneration were the same as on the
Western Front, as were also the cases of profuse intra-ocular
hsemorrhage followed by the formation of fibrous tissue and
^'retinitis proliferans."

Injuries of the eye due to the impact of particles of sand
upon the cornea were numerous; and in some cases the number
of grains of dust embedded in the cornea was extraordinary,
and they penetrated to a great depth. A large number of cases
•of traumatic cataract were due to this cause.

During the first two years a Haab's mag-net was available
either in Mudros or in Cairo, but the number of. cases for which
it was required was very small. When the 3rd Australian
Oeneral Hospital left 'Egypt they took the Haab's magnet with
them. After their departure it was practically not required,
^s hardly a single eye with a metallic foreign bodj^ in it was
seen in a condition in which it could have been saved.

In the period under review there was, as far as I am aware,
only one case of sympathetic ophthahnia.

Certainly, as far as the campaign in Egypt was concerned,
our experience of gunshot and bomb wounds of the eye was
negligible compared with that of ophthalmic surgeons on the
Western Front.

Plaistic surgery of the face was also very uncommon, as most
•cases were invalided home to England as soon as possible owing-
to the urgent demand for beds.

Night Blindness.

There is no doubt that night blindness occure in all armies
after prolonged fatigue, especially if the soldiers have been on
restricted rations. That it is a common symptom of malnutri-
tion is shown by its occurrence in Russia after prolonged fasts.
But it is also one of the many complaints of the malingerer.

Egypttan Expeditioimry Forces, 1915 — 1918. Ill

In the early iiiontlis of the Avar in Egypt many soldiers, botli
British and Indian, complained of night blindness. Careful
examination was always made, but very little actual disease
has "been found. A few cases of genuine retinitis pigmentosa
wei-e seen, but no cases of conjunctival xerosis among the British
troops, and in the great majority of cases no ocular disease was
found, and the men appeared to be in good condition and well
fed.

In two very interesting cases, both offioei-s, the night blind-
ness was only transitory, the failure of vision coming on at
twiUght and lasting for about two hours. At the end of that
time the retina had adapted itself to the diminished illumination
and vision wa.s as good under the circumstances as that of nor-
mal persons.

In both cases the condition was congenital, the fundus showed
a widespread pigmentary changie, not the typical spider cells of
retinitis pigmentosa, but more Irnnpy and aggregated, with
numerous small peripheral white patches, resembling retinitis
punctata albescens.

This delayed adaptation of the retina to the dark was also
observed in some cases of high myopia, in which there was a
thin choroid and a deficiency of retinal and choroidal pig-ment,
and no doubt the intensity of the sunUght and of tlie glai-e from
the sand in desert stations was the cause of tliis unusual and
exaggerated retinal fatigue.

In the great majority of cases nothing abnormal was found,
and careful observation led to the conclusion that the night
blindness was either grossly exaggerated or a fiction. The men
alleg-ed to be so afflicted managed never to injure themselves
in the dark, and on being told they would not be invalided for
the condition, nothing more was heard of it.

In this connection I may remark that I attach no importance
to the restricted field of vision so often observed, not only in
association with night blindness, but also with shell shock.

112 Ophthalmic Practice in the Mediterranean and

To chart a field of vision accurately, even in a definite lesion
of the field, requires considerable intellig-ence and attention on
the part of the patient, and at the best of times tlie chart is
merely approximate, while in functional cases, such as shell
shock, a chart of vision is of no value whatever.

I have often delmonstrated that a patient, whose field of yision
as charted was much constricted, could thread his way among-
chairs and avoid obstacles in a darkened room, in a way that
would be impossible for a man with a field of vision so con-
stricted from an organic lesion. And I have, the refold, relied
more on the patient's general power of moving about without
accident than on a perimeter chart.

Among the Turkish prisoners night blindness was much more
common and was undoubtedly caused by malnutrition. As I
have mentioned before (page 105) there w^ere at one time in
the Prisoners of War Camp at Heliopolis 172 cases of pronounced
xerosis of the conjimctiva with night blindness, associated with
pellagra and other forms of intestinal disease. These cases all
cleared up with rest and a generous diet.

Shell Shock.

As will be feeen from the statistics, shell blindness was neg-
ligible in the army in Eg^pt. There were a fair number of
cases from the Gallipoli Peninsula before the period covered
by these statistics, but in the later years of the war it practi-
cally did not occur. I always held the view that shell blindness
was a subject, not for the oculist, but for the neurologist or the
psycho -therapist, it being only one of tlie protean forms of
traumatic neurasthenia in a pronounced form.

As to the various merits of isolation, suggestion, psycho-
therapy, or of the comparatively frequent miracles reported in
the daily press, I feel incompetent to speak.

" 'Tis an awkward thing to play with souls.
And matter .enough to save one's own."

Egyptian Expeditionary Forces, 1915—1918, 113

My lexperience had been small, and as I Mas not trained in the
understanding' of the normal or abnormal -workings of the mind,
I did not feel justified in attempting the cure of others.

Malaria. .

One fact I tliiiik should be put on i^ecord in this connection.
Malaria, Inalignant and benign, was almost a j)estilence in both
the British and Turkish armies in Palestine. Larg^ doses of
quinine -were given, both in intensive methods of treatment and
spread over long periods. I made inquiries everywhere, but I
was not able to find a record of a single case of quinine am-
blyopia.

Other Eye Diseases.

Of the remaining eye diseases there is nothing to say. They,
were the ordinary affections such as would be met with in civil
practice, and in much the same proportion, among a body of
men in the healthiest period of life. '

CONCLUSIOX.

As will have been g*athered from the foregoing account, the
principal duty of the oj^hthalmic surgeons in Egypt was tlie
investig-ation of errors of i-efraction and the treatment of oph-
thalmia. If I have dilated upon these subjects at excessive
length it is merely because they were, in actual practice, our
chief preoccupation. And I have no doubt that in any futiu*e
campaign in the Xear East they will still hold a predominant!
position.

I have attempted in this short paper to give some general
account of military ophthalmology in Eg^'pt, as we saw it in
1915 — 1918 in tlie hope that it may be of interest or assistance
in similar circumstances in the future. I am convinced that a
hundred j-ears hence conditions in the imchanging East will be
much \he same as they ai-e now. To quote my text once more,
" The thing that hath been, it is that which shall be."

PART III. H

114 Ophthalmic Practice in the Mediterranean and
Egyptian Expeditionary Forces, 1915 — 1918.

Ill ooncliision I sliould like to express my gratitude to Dr.
H. P. Keatinge, C.M.G., late Dii^ctor of the Cairo School of
Medicine, for access to the Kasr-el-Airii Library and to Larrey's
works; to Dr. E. C. Fischer, Professor of Ophthalmology in the
Cairo School of Medicine, for much valuable information con-
cerning diseases of the eye in Egypt; to Dr. A. C. MacCallan,
Dii-ector of Travelling Ophthalmic Hospitals, D.P.H., Eg;ypt,
for his invaluable statistics and iznrivalled information on oph-
thalmia; and last, but not least, to the ophthahnic speciaHsts in
the various hospitals, who, unmentioned and un honoured (such
is the Army way), did all the laborious and valuable work which
I have so roughly reviewed.

THE DEVELOPMENT OF CASUALTY
CLEARING STATIONS.

OWEX RICHARDS, C.M.G., D.S.O.,

Late ConsultiDg' Siirg-eon, B.E.F. ; Director, Egyptian

Government School of Medicine.

Apart from the genei-al advance of surgery, three measures in
the war have probably done more than anything eke to save
life and diminish suffering. One wais the substitution of motor
ambulances for the traditional "retui^ning* empty supply wagons"
and horse transport; another was the routine early applica-
ition of Thomas' splint; and the third Avas the development ^of
the Casualty Clearing Station from a Avaiting room for wounded
into a fully-equipped hospital, where any operation whatever
could be performed within a few hours of the man being
"Avounded.

In the so-called " collecting zone " from the trench to the
Eield Ambulance, all Avas done from the beginning of the Avar
that pluck and hard Avork could accomplish. And at tlie Base
the best of treatment and accommodation Avas always I'ead}-.
But in the ai-ea betAveen tliese tAAO the greatest development
took place, for from being a mere " distributing zone " it be-
came ultimately the chief centi-e of surgical AAOrk.

When I joined a Casualty Clearing Station in January, 19 lo,

Ave had two or three hundi-ed sti-etchei's, a few beds collected

locally, and four sisters Avho had recently been added as an

.experiment. The outfit of instruments consisted chie% of

116 The Development of Camalty Cletirlnfi Sfaflfn/s.

catheters. One table in a back kitchen, witli just luom to
move round it, i-epi-esented the theatre. A small spirit steri-
liser served for knife and forc-eps, largier instruments and all
dressing's had to be boiled in dixies on the fire.

The operation record for the last five months showed eighteen
operations, several of them amputations of the finger. The
Casualty Clearing Station had, in fact, acted solely as a place
where casualties could be fed and tended pending- the arrival of
an ambulance train, and nothing- more had been expected of it.
The same Casualty Clearing Station three years later had hos-
pital beds for 100 cases, and could accommodate up to 800 if
necessary. There was a matron and stafi^^ of sisters, a full and
good Buro-ical equipment, an X-ray outfit, a pathological labora-
tory, and 12 operating tablefe arranged in pairs in a roomy
theatre. There was a receiving room to take 200, and a re-
suscitation ward with a six)cial team for this work. Instead of
the five or six harassed medical officei's who struggled with the
rush of wounded at the time of Xauve Chapelle, a dozen or
more extra officers coidd be drafted in as re -inf or cements
before any g-eneral engagement, so that work could be carried
on in shifts day and night.

The same chang-es had, of counse, taken x>lace in otlier units .
As the surgical work, done at first under the diflSculties de-
scribed above, began to show i-esults, equipment was gradually
forthcoming. At the beginning of the war all very bad cases...
such as chests and abdomens, used to be kept on a regime of
morphia and sips of Avater for days in the Field Ambulance.
This was the South African tradition, and operation was con-
sidered hopeless. In the early simimer of 1915 a localised effort
was made to get these cases down a.s quickly as possible for
operation. When it was seen that this change resulted in an
obvious saving of life it was extended and became general in.
the autumn, an^d later the worst cases pi every kind were usually
sent direct from the advanced dressing stations to the Casualty,
Clearing Station without going through the Field Ambulance
at all.

The Development of Casualty Cleartnr/ Stations. 117

Surgical specialists wore first appointed to Casualt}- Clearing
Stations in the spring- of 1915, but it was not till some three
years later that tlieir position was recognised by the grant of
field rank. They had meanwhile improved much in quality, as
the Avork in this zone began to appeal to the keener sm-geons^
and by the end of the war man}- of the best operators in the
Army were holding these posts.

Tl^e team system was also gTadually developed. As time went
on it became increasing!}- evident that it was wasteful to keep
good men idle in a f^uiet part of the line while their opposita
number's in a busy sector were getting no sleep. The supply of
sui'geons had to be mobilised and set to flow in the direction of
the gTeatest x)ressure at the moment. At first this was confined
to the occasional loan — usually after the need was over— of
three or four medical officers not specially selected. Then the
practioo was instituted of sending a certain number of " teams "
to help the Casualty Clearing Stations who expected a rush, and
their usefulness was increased by sending them before they were
needed instead of after. Each team consisted of a surgeon,
an anaesthetist, -a sister, and a couple of theatre orderlies, all used
to working together. As men got scarcer the anaesthetistsi were
commonly women, and very good they wei-e. As manj^ as
80 teams w'ere sent on one occasion to helpl an army heavily
engaged, but this was only possible if the fighting was localised.
The t^ams wei-e draw-n hxtm other Casualty Clearing Stations
in quiet sectors, or irom the base, and they took their place as
shifts in the Casualty Ck^aring Station they wei-e attached to,
taking charge of one table and the beds occupied by the cases
they had operated on.

The question of the most economical shifts Avas at one time
much debated. Eight-hour shifts — eight lioui-s on and four
hours sleep — enabled thix30 teams to keep two tables running
night and day — ^and this could be kept up for about a week,
but hardly longer. The general result of exjierience was in
favour of twelve-hour shifts Avith a short rest in the middle of
the day or night, after the chief meal.

118 The Devdopinent of ('a.maliy ('learbnj Sf at ions.

Another development of interest was the establishment of
advanced operating centres. It was found impossible to ope-
rate usefully, except for certain emergencies, in a Field Am-
bulance with the ordinary staff and equipment. But mem ajid
equipment were sometimes attached to Field Ambulances for
this special purpose, and special units were formed and put
in convenient places near the line to deal with abdominal
and other urgent cases. The idea was an attractive one,
especially to the surgeon, but it had certain disadvantages.
For example, such a unit had to be well and fully staffed,
or it was soon swamped with work, except in quiet times.
This happened to me when I was attached for this pur-
pose to a Field Ambulance at the Battle of Loos, with ;no
other surgeon. And if many men, and those the best men, are
detached for this purpose it weakens the Casualty Clearing
Stations very much, while there is always a loss of economy in
splitting up personnel. Moreover, the wounded have n^ot only to
be operated on, but kept for a week or so, and it is not sound
or humane to keep wounded men imder any but the most occa-
sional shell-fire. So that the place had to be' free from shel-
ling, and if this was so it was usually possible to put a Casualty,
Clearing Station there. In any case the time occupied in going
in a oar from such a Icentre to the nearest Casualty Clearing
Station was usually not great, a small fraction of the time
which had already been spent in getting them down; froni tjli,e
line by hand carriage along a communication trench. So that
although under certain conditions these imits did very good
work, and although they were very intei-esting professionally,
they were not, as a rule, economical. i

The distanoe of the Casualty Clearing Station from thel line
depended partly on the position of rail-head, and partly om tlie
kind of fighting in progress. In. stationary warfare they were
pushed up to a few miles from *thle line, ini any place that was
not Hkely to be shelled. At the cost of a few hurried retreats
this worked well; the more advanced units got their cases
early, and got the pick of tliem, and did ver}^ well. But in

The Development of Casualty Clearing Stations. 119

the Gnerman advance of 1918 it was impossible ix> get all the
nwre axivanoed ones away, for a Casualty Clearing' Station fully
equipped requires anything- over 30 lorries to move it. So in
some of the later fighting* a more cautious policy was^ adopted,
•and Casualty Clearing- Stations found themselves as much as
20 jmiles behind our line. They then advanced io,' turn, travel-
ling OS light as possible, and shedding in hastei much of the
material they had accumulated at leisure. But even so they
never reverted to their original state, but remained hospitals
to the end. • i

The greatest change which took place in their internal ar-
rangement (occurred when they went imder canvas. In all the
early part of the war they were installed by preference in
buildings, chiefly schools and monasteries. To fit them in
required la good deal of ing-enuity, and no general system] was
possible. Later, in some armies earlier than others, they were
driven to plant themselves in the open. This was a blessing"
in disguise (in winter a very complete disguise), for it enabled
them to be planned and laid out for the work they had to do.
It was difficult without huts to ma*ke a good theatre, and for
wards the British tents left mudli to be desired. But in com-
pensation there was freedom of desigto, and out of the many
possible arrangements a type was gradually evolved. Many
men (claimed to have originated it, really it was: the result of
combiaed experience, and was adopted with slight variations
by 'nearly all units.

The (method adopted in busy times was usually as follows —
Two Qarge compound tents were provided for reception work,
holding up to 200 each, one for walking cases and the other
for stretchers. In these the clerks took down the partioulara
and the men got hot drinks and food. At tlie far end of them
junior medical officers under the supervision of some one
senior man examined each case thoroughly on trestles in a
good light, and decided their disposal. Those that required
no interference were dressed anjd sent straight to tlie evacua-
tion wards, which were cleared en masse whenever there was

120 The Development of Casualty Clearing Stations.

a train. Of the othens, some were marked by tickete or any
other device to "'remain," some for "operation," and some
for "resuscitation." The latter went to the resuscitation ward,
where a special team took chargie of them, and passed them o{q
to the theatre when they wene fit for it. The operation cases
went to the general ** pre-operation ward," were dealt with in
turn by the teams on duty in the theatre, and wei-e then sent
either to the evacuation ward or to the ward; of the surg-eon
who had operated on them. The cases marked " i-emain " wei-e
cleared out from time to time to the evacuation; wards as tliey
became fit to travel. To work this system required' a number
of tents so arrang-ed as to facilitate this sorting, and a body
of men used to, working rapidly and methodically. Given these,
it was found that an enormous nimiber of wounded could he
properly dealt wdth without any fuss or confusion.

The most important duty was undoubtedly the original sort-
ing, on which the man's fate largely depended. The realisa-
tion of this led many of the best surgeons to leave the actual
operating to the visiting teams, and to devote themselves to
the less spectacular but more important work of sortingj and
supervision of the pre-operation wards. In the theatm the
teams were fed in rotation from the cases awaiting operation.

If the greatest difficulty arose in sorting-, the greatest delay
was undoubtedly in the theati-e. Of course, a few surgeons
were incompetent, and some men would always keep urgent
cases waiting while they toiled for houi's over hojTeless abdo-
mens. But the vast majority of siu-g-eons were sensible, and
developed a good rate of speed. This work, like everything
else, became gystematised, and an experienced' surgieon Awrking
on Avell-selected cases with his own team, and " twin " tables,
eo that the next case was always cleaned up' and 'anaesthetised
before the first was finished, could g-et through an astonishing
amount of work. Gas and oxygen saved both time' and shock,
and by the end of the war loss of time in the tJieatre wa.«j
reduced to a minimimi.

The Development of Casualty Clearing Stations. 121

A g'ood clearing- station working under pressure was as
good an example as one oould find of organised^ team work.

The X-ray equipment was one of the developments which
took some time to establish. The first effort ia' this direction
was the provision of one mobile X-raj- unit for each army.
Units had to apply for its services to the Army Headquarterts .
"This was almost useless, for in nine cases out of ten the pa-
tient had to be operated on or evacuated long' before tlie
X-rays could be got to him. Accordingly an effort was made to
provide each Casualty Clearing Station, or at any rate each
group, with an outfit of its own. The fii^t hospital outfit of
tliis kind that I saw was towards the end of the Somme fight-
ing in 1916. These outfits were so useful, especially in sci-een-
ing "cases for the immediate removal of i^tained rnissiles, that
towards the end of the war they were considered indispensable.

The pathological laboratories were in the same way pro-
vided to serve a number of hospitals, and to some extent shared
fthe disadvantages of the army X-ray outfits.

But one of the many advantages of getting the Casiuilty
•Clearing Stations out in the open was tliat it was then pos-
sible to gi'oup two or three of them in the same place. And
(under these circumstances they could all have the same labora-
tory available at all times. But quite apart from this minor
advantage the grouping of the Casualty Clearing Stations,
Avhen it was possible, led to gi^at saving of confusion in recep-
tion iand evacuation, and to a good deal of healthy rivalry and
■exchange of views, which was less easy when the units were
some miles apart.

Two developments which inci^eased the Mork of the Cas^ualty
"Clearing Stations in the latter part of the war were the scientific
treatment of shock, and the thoroug-li cleaning and immediate
<3losure of wounds. Both were well worth doing, but consumed
a great deal of time. Much good work was done on shock, of
which Cowell's is, perhaps, the best known, and a very sensible
«ystem was established at the Field Ambulances which led to
the wounded coming down in much better condition. Blood

122 The Develftprnenf of dnmnlty Clearinr/ Staflons.

transfusion was worked out and systematked with excellent
results.

Experience also showed tliat while the nature of the dressing
applied to the outside of a wound made very little difference
to its fate, it was possible by a thorough cleaning in the theatre
to obtain primary healing' and closure in a number of cases.
Special Casualty Clearing Stations were at first devoted to this
work, and a good deal of it was done in others. But it took a
good deal of time, commonly about three-quarters of an hour,
to clean a wound of any size scrupulously, and for military
reasons the plan had to be adopted of sending most of the
lighter oases directly to tlie base. Here, even after an interval
of a day or more the same methods proved unexpectedly suc-
cessful. Of the first 500 eases of this kind arriving at one ba«e
about one-quarter were considered suitable for this treatment.
The rest were either too slight or too grave, or were very
often only technically '' wounded." But of this quarter, 80 per
cent, were closed and healed by first intention. In this way
the Casualty Clearing Stations were relieved of a qiiantity of
work and could devote themselves to the more urgent cases.

The Thomas' splint organisation deserves a special notice.
This splint was introduced in 1915, I believe chiefly by Wal-
lace, and proved a great advance on the official splint, the
Long Liston. It was soon realised that the only satisfactory
way to treat a fractured femur, or for that matter most other
fractures, was to apply a splint of this type as soon as the
man was picked up, and to keep it on till he reached the base.
Once this was gTasped, the method of application was taught
systematically by lectures to all ranks of the forward units,
and teams even competed in applying it rapidly by numbers,
as a sort of drill. The splints were issued to all Advanced
Dressing Stations, Aid Posts, and Motor Convoys, and anyone
who failed to use them properly vras asked the reason why.
This simple measure saved a vast amount of life, limbs and
suffering, .and was a good example of what can be done by;
standardising, instruction, and team work.

The Development of Casualty Clearing Stations. 123-

But the Avliole history of Casualty Clearing Station work Ss
an inetance of how much oan be done by pooling experience,
and -then standardising the results. Most of our progress was^
due to the combined experience of a number of men who cheer-
fully put into the conmion stock what they could, without mak-
ing any fuss about their personal credit or priority. And the
actual work was done by teams working together, each doiag
wliat others thought he could do best instead of what he him-
self preferred to do. The result was amazingly good ; it remains-
to be seen how much of this spirit will survive in civil life.

THE WAR NEUROSES AND THE
NEUROSES OF CIVIL LIFE.

By
ARTHUR F. HURST.

I . — Introduction .

At an eai-lj stag-© in the Great Wai^ functional nervous dis-
orders became so common that it was clear that some special
organisation -was required to deal with them. AHi first sections
of general hospitals and later whole hospitals were devoted
to the care and treatment of soldiei-s sufferingf from these con-
ditions. After my return from Salonica in August, 1916, I
was in charge of the Neurological Section at Oxford, and from
Deoemberof the same vear tlielarg-er Section at Netley. Finally
I was in charge of the Scale Hayne Military Hospital near
Newton Abbot from the date of its opening inl April, 1918,.
until it was closed in June, 1919, witli Major J. L. M.
Symns, and subsequently Major J. F. Venables, as second in
command. In this hospital we had about 350 beds, all of which
were reserved for soldiers suffering from war neuroses.

I was always fortunate in being associated with medical
officers who were keenly interested in tlie subject. The ma-
jority of these were Guy's men — ^R. Gainsborough, who assisted,
me at Oxford, Major J. L. M. Symns, who was witK me at
Netley and in Devonshire, and Major J. F. Venables, Captain
W. R. Reynell, Captain C. H. Ripman, and Captain G.
McGregor, who were with me at the Scale Hayne Military,
Hospital. The Scale Hayne Neurologicul Studies, which were

126 The War Neuroses and the Neuroses of Civil Life,

published in 1918 and 1919, contained original articles by each:
of tthese officers. 'My earliest observations on hysterical blind-
ness were made in 1915 with Major A. W. Ormond, and on;
fcyisterioal deafness in 1917 mth Captjain E. A. Peters.

Several other Guy's men have done important work in; con-
nection with the vrar neuroses. Major W. Johnson, M.C., was
in command of a special Casualty Clearing- Station in France
for ithe war neuroses, where they were successfully ibreated in
their earliest stages. Surgeon H. Carlill, R.X., was in diarge
•of the Neurological Wards at Haslar, where he did valuable
work on syphilis of the nervous system as well as on the
neuroses. Captain Wonster-Draught at Woolwich, Captain C.
P. Symonds at Aldershot, and Laughton Scott, at a pensioners'
clinic in London, added their contidbutions to the subject.
Finally, Lt.-Col. Maurice Craig was largely responsible for
•organising the hospitals for war psychoses.

II. — The Causes axd Nature of the War Neuroses.

The two conditions which, led to the g-reat frequency of
neuroses in soldiers oompared Avith their comparative rarity
in men under peace conditions were exliaustion and emotional
strain. The exhaustion caused by long days of forced marching
or strenuous fighting followed by nights with little or no sleep,
combined in some cases with insufficient food, and in eastern
campaigns with a great variety of infections and exposure to
extreme heat, naturally led to a more profound neurasthenia
than is commonly seen iu civil life. In spite of this the in-
tervals of rest and opportunities of i-elaxation, which became
increasingly common as the war progressed, tog'ether with the
admirable supply of food in most cases and the freedom from
epidemic infections on a large scale owing to the excellence of
the sanitary arrangements, except at Grallipoli and ini the earHer
part of the Mesopotamian campaign, prevented it from being as
widespread or as severe as might have been expected. Moi^
important perhaps than the actual production of neurasthenia
were the increased liability to the development of psychoneu-

The War Neuroses and the Neuroses of Civil Life. 127

roses, such as livsteria and psychastheiiia, and the ag-gravation.
of incipient organic diseases, such as general paralysis and
tabes, which resulted from exhaustion.

A few lucky individuals are born with a temperament which
does not allow them to know what fear means. " Hunger and
thirst could not depress them," ^\ToiG the Student in Arms,
"rain could not damp them; cold could not chill them. Every
hardship became a joke. They did not endure hardship, they
derided it. . . As for death, it was, in a way> the greatest
joke of all." The y^^t majority of men, however, including
many of the bravest, Avere terrified when first exposed to the
Jiorrers of a bombardment. The majority became accustomed
to it in time, but sooner or later the exhaustion of active ser-
vice often resulted in a gradual failui-e of this adaptation, so
tliat not only the constitutionally timid — the martial misfits —
but some of those who for anonths or even j^ears had faced the
life cheerfully and even with enjoj^ment ultimately broke down
from the long-continued emotional strain.

The emotion of fear acts in thi-ee ways. In the martial misfit,
who is by nature very suggestible, it gives rise at once to
severe physical symptoms, which often become perpetuated by
auto-sugg-estion a^ hysterical tremor, mutism and paraplegia;
in other cases it gradually leads to the development of psy-
chasthenia; and finally it may result in such a disturbance of
the suprarenal and th^'roid glands that the condition I have
called functional hyperadrenalism-h3perthyroidism results.

Apart from the fear which is caused by tlie general condi-
tions of a f>i'olonged bombardment, the more acute emotion
caused by a single exceptionally terrifying experience leads
to such a chang-e in the individual's nervous system that he
becomes for a short time extremely liable to develop hysterical
symptoms by suggestion. This is particularly true if tJie ex-
X^erience has led to actual physical i-esults; however evanescent
these may be, they are likely to be unconsciously perpetuated
and even exaggerated by the patient under such conditions.
Thus a man who is gassed may develop hysterical blepharo-

128 The \\'<u- \et.(ro.se.s and the Neuroses of Civil Life.

Bj)iasm, ptosis, and blindness after the initial conjunctivitis lias
dieappoai'ed, Jiysterical aphonia after the disappearance of the
laryngitis, and Insterieal vomiting after the disappearance of
the gastritis. If la man is blown up or buried, the amnesia,
headache, hemiplegia, convuLsionis, and deafness which may
I'esult fix)m the concussion of tiie brain, and tlie paraplegia aad
incontinence of urine, which may develop as a result of the
concussion of the spinal corpd, may be peri)etuated as hysterical
Bymptoms after the actual changes in the nervous^ system have
so gi'eatly diminished in degi'ee and extent that the symptoms
should have oompletely or almost oompletety disappeared.

Ill . — Neurasthenia .

Neurasthenia is a functional disorder, resulting- from ex-
haustion of the nervous system anicl j)robably of certain endo-
crine glands, especially the suprarenal, whieli nxanifests itself
by abnormal mental and physical fatiguabiHty, and irritability
of the nervous system.

The conditions which ga^e rise to it duringj the war produce
actual exhaustion changes in the cells of the brain and the
suprarenal gland. The importance of the changes in the latter
has onty become fully realised I'ecently; physical exhaustion and
infections, such as paratyphoid fever, bacillary dysentery- and
malaria, cause profound degeneration in the suprarenal gland,
and the similar effect of severe and prolonged emotions is
described in a later section. Thus neurasthenia has an organic
basis land is not strictly a fimctional disorder, though' the struc-
tural clianges are evanescent, regeneration of the cells occur-
ring with rest and removal of any toxaemia which may have
been present. i , (. ;

The symptoms of neurastlienia observed in soldiers during
the war were the same as occur in civilians, the chief being
abnormal fatigaiability combined witli an irritable state of the^
nervous system, which ^manifested itself in the appearanoe of
a variety of abnormal visceral sensations and reactions, the-
most important of which were circulatory.

The War Aeuroses and the Neuroses of Civil Life. 129

"With the exception of a comparatively small proportion of
cases, -which depended upon over-action of the sympathetic ner-
vous system with functional hyperadrenalism-hyperthyroidism,
as described in a later section, so-called disordered action of
the heart, — the D.A.H. which was one of tlie chief medical
causes of disability in soldiers, was really due to neuras^-
thenia, though a moderate degree of cardio -muscular inefficiency
caused by the same toxins as those which affected the nervous
sysi3em was often added to the group of symptoms -j)roduced by
nervous exhaustion. General muscular fatiguability was always
present in addition to the circulatory symptoms. The latter
were partly the result of weakness of the vasomotor centre and!
partly of the abnormal irritability of the nervous' system, which
led to very slight derangements of cardiac activity, which a
normal tman would ignoi^, being felt with sucB.^ great clearness
that the individual was often led to fear (that his heart was
seriously diseased, a fear w^hich was generally aggravated by
the unfortimate diagnosis of D.A.H.

Insomnia was constantly present, and was often accompanied
by nightmares, which will be more fully discussed' under tlie
head of psychastlienia. This naturally aggravated the symp-
toms of exhaustion and complete recovery was impossible until
it had been overcome. An uncomfortable, heavy sensation in
the head, which rai^ly amounted to actual pain, was often
present. Tlie patient became incapable of sustained mental
activity, and was disinclined for either mental or physical work.
The excessive physical fatiguability resulted in acliing of the
limbs and still moi-e frequently of the back, which was often
increased by his inability to relax his muscles icompletely, even
though lying in bed. A fine tremor of the hands was often
present when tliey wei« outstretched; this was secondar^^ to
the rigidity, and disapi>eai'ed as soon as tlieT patient learned to
relax his muscles. Anorexia was g^enerally present, whicli was
increased by the unappetising food and by tlie still more un-
appetising* way in which it was served.

PART III. I

1.30 The Mdr ScnrascK and the Sck roses of Cir'il L'ii(>.

The exliaiistioii of active service not infi^equently lod to tem-
porary; iiMj)otenoe. The disco very of this Mheii on leave after
a long" period of abistinence often came as a consideral)le shock
to Imen who had expected that their sexual functions ^\ullld be
unusually active. Rest and a further period of abstinence, to-
gether with i-e-assuring- explanations of the i>hysiological cause
of the trouble and, in some cases, sug*gestion under liy]^-
jiosis invariably resulted in a rapid cure.

Uncomplieat/ed aieurasthenia in soldiers required no treatment
beyond a period of i-est away from the sights and sounds of
the front. It was soon found that a week or ten days in bed
was amply sufficient, and that this must be followed at once by
a period of Iphysical training in the open, air. Men who were
eent Ito convalescent homes, and particularly to luxurious V.x4..D.
hospitals run by over-sympathetic women, invariably did badly,
and often became permanently unfitted for further military
service. Drugs were never required, except perhaps a small
dose of bromide at niglit, and in severer cases of insomnia
medinal and aspirin. But the more experience we had' the
less we used drugs for insomnia, as we found that psychothera-
peutic conversations, cou]3led in some cases with direct sug-
gestion under hypnosis, generally led to the return of natural
sleep in a few days.

IV. — Hysteria.

Hysteria is a condition in which symptoms are pi*esent, which
have been produced by suggestion and are durable by psycho-
therapy. This definition is novel in not recognising aai hys-
terical condition apart from the presence of definite hysterical
symptoms. Charcot believed tliat hysteria manifested itself in
two ways : by the symptoms that were obviousi to the patient
and about whicli he complained, and by physical and mental
stigmata which were present before the obvious symptoms ap-
peared and which, persisted after their removal.

Investigations carried out with Major J. L. M. Sj-mns have
confirmed the teaching of Babinski that the so-called physical

The TTV/;- \euroses and the Xeurose.s of Civil Life. 131

stijTiiiata of liysteria are always produeed by tho imeoiiseious •sug-
gestion of the observer. The mental stigma, which is regarded
as most characteristic of hysteria by the majority of writers and
which is the only one accepted by Babinski, is abnormal sugges-
tibility. But our investigations have proved conclusively that
although labnormal suggestibility renders a man unusually j^i-one
itb develop hysterical symptoms, there is no one who is so
devoid of sugg-estibility tliat he may not develop them if the
suggestive influence is suihciently pOAverful. Whether a person
w ill develop hysterical symptoms under given conditions depends
on the degi^ee of his susceptibility and the streng-th of the
fiiiggestiou. It is clear therefore that abnormal sug-g'estibility
is simply a predisposing fa-ctor and is no more a part of hys-
teria than a tuberculous family history is of phthisis. Many
cases of gross hysterical symptoms occurred' in soldiers who
Ihad no family or personal history of neuroses, and who were
perfectly fit until the moment that one of the exceptionally
powerful exciting causes, such as occur comparatively rarely
apart from Avar, suggested some hysterical S3anptom ; and after
its disappearance as a result of jisychotherapy the man was
once more perfectly fit, and' his subsequent history show^ed that
he remained no more liable than any of his companions to
■develop new symptoms.

As soon as it is recognised that although certain mental
fitigmata predispose to the development of hysteria they are
not themselves a part of hysteria, it becomes obvious that
many cases of hysteria will be missed if it is only looked foi*
in so-called hysterical persons. AVhen, on the other liand, it
is remembered that there is nobody who may not develop h3rs-
teria if tthe provocation is sufficiently great, it tmust follow that
hysteria is infinitely more widespread tlian has genemlly been
supposed .

Hysterical symptotns following the emotion of fear. — In the
majority of cases very little difficulty is exiwrienoed in dis-
covering the nature of the 8ugg>estion which gives rise to hys-
terical symptoms. In the first place there are the symptoms

132 The TfV/r Neuroses and the Neuroses of Civil Life.

which follow the einotion of fear. Extreme terror gives vise
to certain familiar symptoms : the individual becomOvS shaky,
"paralysed with fear," and unable to speak — "his tongue
cleaves to the roof of his mouth." Under ordinary conditions
the cause of fear is momentary and the physical results disappear
in a few seconds. But during a heavy bombardment a man
often remained terrified for hours. If the tremor, inability to
move the leg-s and speechleissness persisted all this time, it was
natural that these physical expressions of fear, which Mere
not sin any way hysterical, should make such an impression on
the individual's mind that when the original emotion had dis-
appeiared the tremor, paraplegia and mutism persisted as hys-
terical symptoms.

In the first two years of the war eases of this kind were^
given the unfortunate name of "shell-shock," in the belief that
they were organic in origin and due to the actual concussion
caused by the explosion of powerful shells. Consequently no
attempt w^as made to cure them by psychotherapy, and the
treatment by rest and sympathy helped to j)erpetuate them; this
unsatisfactory result was inci^ased by the use of the word
"shell-shock," w]iich gave the patient the idea that he was
suffering from some new and terrible disease. "When at last
the true nature of the condition was recognised, it was found
that psychotherapy not only resulted in the immediate dis-
appearance of the symptoms, when they were treated in the
special ladvanced hospitals o^^ened for the j)urj)ose by the Britislii
and French, such as the Casualty Clearing Station of which!
Major W. Johnson was in charge, but cases of two, three and
even foui* years' standing were also fi'equently cured at a single
sitting in hospitals in England'. Although this form' of hys-
teria was most common in neiux)tic individuals, a large pro-
portion of the patients treated within the fii-st forty -eight houna
recovered so completely that they were able to return to the
firing line and showed no tendency to i-elapse. A few of the
patients, whose condition had pei-sisted for many montlis before
coming under treatment, could not return to France, but even

The War Netimse^^ and Ihc Neurosm of CwU TAje.

Fifi. 1,

Hysterical ptosis of Jeft eyo w^th spread of paralysis to whole of
left side of face, hysterical spasm of right eye with spread of spasm
to whole of right side of face, and hysterical amblyopia: a sequel of
gassing, and cured by psychotherapy in a single day.

rig 1 (a). — Position at rest, Fig 1 (b). — Same as (a) with

showing double ptosis, right-sided left eyelid raised so as to see;

facial spasm and left-sided facial this could not be done with the

paralysis. right eye owing to spasm.

Fig. 1 (c). — Voluntary effort to open eyes, resulting in over-action
of left frontalis, though left side of face is paralysed, and spasm of
right side of face including platysma.

The ^yar Neuroses and the Neuroses of Civil Life. 133

such men Avere ahvays able to go back to their old civil occu-
pation and often had no undertying- mental condition requiring
further treatment, althoug'h in some cases the hysteria was as-
sociated with neurastlienia or psychasthenia or both. Indeed
many patients at once lost such sym]3toms as headache, de-
pression, insomnia and nightmares, which had troubled them
for months or even years, directly the obvious pln^sical symp-
toms, such as mutism or stammering, tremor and paraplegia,
were removed by explanation, persuasion and re-education.

We now believe that stammering in civilians as well as sol-
diers is h^^sterieal and should be curable by psychotherapy
with far greater rapidity than we formerly believed' to "be
possible. Most of our cases during the last nine months of the
war wei-e cured at a single sitting-, and recently Major J. F.
Venables taught two soldiers, each of Avhom had been almost
inarticulate from stammering since early childhood, to talk
fluently in less than half an hour.

Hysterical symptofns which followed gassing. — The second great
group of hysterical symptoms in soldiers resultecl from' gassing.
The irritation of the eyes, throat and stomach caused conjunc-
tivitis, laryngitis and gastritis, the latter being due to the
swallowing of saliva in which the gas Avas dissolved. The
pain caused by the conjunctivitis induced the patient to refrain
from opening his eyes Avith his levator palpebrae superioris; if,
however, he tried to open them, his attempt Kvas frustrated by
a reflex pi-otective spasm of his orbicularis palpebrarum. Under
ordinary conditions the conjunctivitis had improved sufficiently
at the end of three weeks for tlie eyes to be opened without
difficulty, but if the patient was led to fear for his vision on
account of previous weakness of the eyes, the previous lotss of
one eye, as in two of our cases, or too prolonged ti^atment with
local applications, bandages, dark spectacles or eye-shades, the
voluntary inhibition of the levator might be perpetuated as
hj^terical ptosis and the reflex spasm of the orbicularis as hys-
terical blepharospasm (Fig. 1). As the uneducated layman
associates the idea of blindness with inability to open the eyes;

|.">l T Ik War Xcuro.sr.s (nhI I he \rtu()srs of Crttl IJjc\

imijiy of these patients thouj^lit they were blind. Consequently
when they were taug:ht to o^^en their eyeis, it was found that
they could only see indistinctly, as they had liysterical paralysi*
of acoonnnodatiou. or tess frequently they could not see at all,
as they Imd become so convinced that they were blind that
tliey had ceased to look, and, not looking, they could not see.
Simple explanation followed by i-e -education in looking- resulted
in (permanent recovery.

In the same ^\ay the whisi)ering in cases of laryngitis, which
was originally in part voluntary in order to avoid pain and in
part due to a protective reflex, was frequently perpetuated' as
hysterical aphonia. This aitbjs most commonly the ease when
an expert laryngoscopic lexamination had revealed the presence
of some abnormal congestion which led to intra laryngeal medi-
cation, as both tJie diagnosis and treatment afforded the neces-
sary suggestion to perpetua^te the idea in the patient's mind
that his voice was permanently lost.

When these patients were taken away from their unfavour-
able surroundihgs and treated by explanation, persuasion and
re-education, without any recourse to suggestion by elec-
tricity, anaesthetics or other means, they invariably re-
covered. Each one of a series of 100 patients treated at the
Scale Hayne Hospital was cured at a single sitting, although
the average duration of the aphonia before admission was 205
days. 'About one third of these cases were not caused by gas-
sing, but by ordinary laryngitis, or they followed mutism, which
had disappeared either spontaneously or after treatment which
had been discontinued too soon. The 101st case was recognised
to be organic by the timbre of the voice, a view which was
confirmed when one coixi was found to be paralysed and an
aneurysm of the aorta was discovered. We believe that the
liability to relapse is greatly reduced by our simple method of
treatment and the avoidance of suggestion.

In la much smaller number of eases other hysterical affections
of respiration, such as tachypnoea, hiccup, and spasms of the
diaphragm resulted from gassing. .

The War yeuroses and the Neuroses of Civil Life. 135

•

The gastritis caused by gassing- resulted in vomiting, a pro-
tective reflex Avhich fulfilled its object by removing! the irritant
from the stomach. The actual g-astritis rapidly disappeared,
and -whenever the vomiting persisted for more thani three or
four -weeks it -was always hysterical. A ivery large number of
soldiers wei-e invalided from the service for so-called gastritis,
the lonl}' symptom of -which -was vomiting. We' (found that cases
of this sort could be cured by a sing-le (Conversation, if this
■was "Continued until tJie patient was obviously quitef convinced
that he was not longer suffering from gastritis, and that he
could eat an^-tliing witliout fear of vomiting, even' if he had
vomited after every !meal for tmany tmonths and' bad' been kept
on a strictly flilid diet. Captain W. R. Reynell published an
account of a number of caises of this kind in the Seale Hatpie
Neurchgkal Studies.

Hysterical vomiting is mucli (more common in civil' life than
is jgenerally suj^posed. The vomiting* in chronic appendioitis,
wliich may continue even after the removal of the appendix,
and that of phthisis, are often in gi-eat part hysterical. We
saw several examples of these conditions in soldiers, and' also of
hysterical vomiting, following the vomiting caused by various
infections, sucli as influenza and bacillary dysentery.

Hysterical symptoms following tiPwidl wamids of limbs. —
Perhaps tlie most common of the hysterical conditions) in sol-
diers were the i)aralysis and oontractures which followed com-
paratively trivial wounds of the limbs. A great many dif-
ferent forms were observed, and in Imajiy cases' the paralysis
and oontracture were associated with marked vasomotor dis-
turbances, including* cyanosis or pallor, a pulse of small am-
plitude, oedema, and trophic changes in the skin, nails ajid
bones. At the same time the muscles showed amodeiute degree
of atrox)hy, accompanied by an increased irritability to me-
chanical stimulation and certain chang^es in electrical reactions,
which id id not, however, amount to the reaction! of degeneration.
These changes were often most easily observed under' a genci'al
anoDsthetic, which did not residt in complete relaxation' of the

136 The War Neuroses and the 2^ mioses of Chnl TAfe.

»
epasm until a stage of anaesthesia -was reached beyond that in
•which oonsciousness is first lost. Babinski and Froment expe-
rienced considerable difficulty in producing any improvement
in the paralysis and contracture b}^ x)sychotherai)y. Impressed
by this and by the fact that the associated vasomotor and tro-
phic conditions oould not possibly by hysterical, as they Avere
obviously neither capable of being- produced by sug-gestionf nor
cured by psychotherapy, they concluded that the paralysis, and
oontracture were ailso not hysterical. They revived the old
theory of reflex nervous disorders, with which Vulpian and
Charcot had sought to explain the muscular atrophy and spa.sm
that often accompany diseaises of joints. They ascribed' both
the muscular symptoms and tlie associated vasomotor and tro-
phic disturbances to some obscure form of reflex action.

Our experience has led us to believe that there is no founda-
tion for this theory of IBabinski and Fromentj and that all the
cases they described as reflex are really hysterical. The immo-
bility" and spajsm [may arise as a voluntary or reflex response
to pain, or [they may be due to localised tetanus, or to the ap-
lication of splints or bandag-es; the abnormal posture and the
immobility and spasm are perpetuated by auto -sugg-estion after
ihe primary cause has disappeared, and to this is very often
added the he tero -suggestion involved in treatment hj electricity
and inassage. The hysterical paralysis and contracture which
result (could invariably have been prevented by persuasion and
re-education directly the condition of the wound made active
movement permissible.

The hysterical nature of the paralysis and contracture is
proved by their rapid cure with psychotlierapy (Figs. 2 toi 5).
In a Bieries of 100 consecutive cases treated ati the Seale Hayne
Hospital, the majority, if not all, of which might have been
diagnosed las reflex, as each one of the cases shown in the illus-
trations of Babinski and Froment's book was i^epresented in our
series, ninety-six were cured at a single sitting of an averag-e
duration of fifty-four Iminutes, and the remainder were' cured
in four days (two leases), two weeks and four weeks respectively

The War, Neuroses and ihc Neuroses of Civil Life.

Fig 2 (a). — Hysterical contracture of liand persisting thirty-five
months after wound near elbow.

Fig. 2 (b). — Same hand as Fig. 2 (a) after half an hour's treatment,
showing depressions formed in palm by pressure of Jiails (Captain C. H,
Kipman).

The War Neuroses and the Neuroses of Civil Life.

Fig. 3 (a). — Ilystorical coiiti;ietu:c of six years' duiatiou foilowing
amputation of a fiager.

Fig. 3 (b). — Recovery after one hour's treatment (Major J. J<. M.
Symns).

The War Neuroses and the Neuroses of Civil TJfc.

V'v.r. I (a). — Ilysbarical caiitractur
duration.

e of foot of fourteen inunlhs'

Fig. 4 (b).— Half an hour later, after psychotherapy.

i.^V^i -^j^--

Thf War Neuroses and fhe Neuroses of Civil Life.

Fig. 5 (a). — Hysterical contracture of toes assocjated with hainmcr-toe.

Fig. 5 (b). — Same case as Fig. u (a) cured after halt* :m hour
treatment

The ]Viir Ncumsc.s (iiul ihi* Neuroses of Civil Life.

Fig. 6. — Atrophy of index finger of left hand, compared with normal
finger of right hand, resulting from hysterical contracture of fingers
of eighteen months' duration, drawn after recovery from the contracture.

Fig. 7. — Skiagram of right and left hands, showing increased trans-
parency of the bones of tlie left hand, taken immediately after recovery
fioin hysterical paralysis of sixteen months' duration.

The War Neuroses and the Xeuroses of Civil Life. 137

altlioiigli the average iduration of ti^eatment before admission
was eleven months. In April, 1919, Major J. F. Venables cured
a man with a completely useless hand, dating from a wound
received in October, 1914, in just over five minutes. It is clear,
therefore, that the ]3aralysis and contracture are hysterical, as
they are caused by suggestion and cured by psychotherapy.

Disuse of a limb, whether caused by organic disease' or hys-
teria, leads to deficient circulation. This by itself is enough
to explain the cold, blue and sometimes oedematous extremities,
as they are most marked in cold weatlier and in individuals
who have always had a feeble peripheral circulation. They
disappear temporarily, as Babinski and Froment showed, by
artificially increasing the circulation by the application of,' heat,
and permanently, as we have repeatedly observed, by restoring
the power of toovement by means of psychotherapy.

Deficient circulation gives rise to deficient nutrition, so that
the skin and subcutaneous tissues become, atrophied (Fig. 6),
the bones decalcified as shown by the X-rays! (Fig. 7), and the
nails thin and brittle. In a striking case, in which some tro-
phic fclianges had developed as a result of hysterical paralysis
and contracture of over a year's duration, and in which the
power of movement was restored at a sing:le sitting, the nails
subsequently showed a very definite horizontal Hne separating
the opaque, vertically ridged, thin and brittle parti wliich grew
during the period of disuse, from the pink, smooth and other-
wise normal part, which began to grow immediately recovery
took place (Fig. 8, opposite page 139).

The (changes in mechanical and electrical reactions and in
the deep i-eflexes were also shown by Babinski' and' Froment to
disappear Avhen the circulation was tempomrily improved by
immersion in hot water, and we found that immediate and per-
manent restoration followed recovery from the paralysis and
spasm as a result of psychotherapy. These chang>es, tliere-
fore, are nothing more than the functional effects of deficient
circulation on muscular tissue.

l',\H The \\<ir Xciirosc.s and the Neufo.se.s of ('id/ Life.

Ill th<3 sajuo ^vay tJio rigidity of the fiiigor joints, observed
both in cases of organic nerve injury and in hysterical paralysis
and oontracture, which persists under deep anrosthesia, has
always been regarded a.s due to adhesions or fibrous contrac-
tures, wliich only give w^ay under forcible manipulation witJt
sounds of tearing- and i^sultant effusion. Tliis condition k
really the resxilt of some <3oagulative process in the fibrou>^
tissue caused by the aecumulation of products of metabolisni,
which are normally removed by tJie blood when the circula-
tion is efficient. It is well known that a slight increase of
mobility of such joints follows tiie application of warmth to
improve the circulation, and we have found that complete and
immediate restoration of mobility followed the return of tho
natural circulation as a result of the rapid curei of the para-
lysis and contracture. This must have been due to the removal
of waste pix)ducts permitting the temporarily coagulated fibrous
tissue to return ot its normal fluid consistence.

It 5s thus falear that the so-called reflex nervous disorders of
Babinski land Froment are really hj^sterical, and that the as-
sociated vasomotor and toxjpliic disorders are caused by the
resulting idisuse.

A C B D

Diagram 1,

Diagram 2.

We have often noticed that when a mian is- rapidly cui'ed of
a bontracture by psj^chotherapy, he continues to keep his limb
in the same abnormal position as before, although he is capable
of tooving it without any difiiculty in every direction. I be-
lieve that tills is due to the developmieniti to a new " postural'
length." If AB in DiagTam 1 represents the normal length of
a muscle when at rest, it can shorten to AC on active contrac-

Till W'lif Neuroses imil Ihc XcuroscH of Civil FAfe.

V'\'j:. <S.- I iiipiovt'd mil rilioii of nail, drawn six weeks after sudden
riH'overy willi p ;ycliol!i(Ma|iy f,o:u hysterical i)araly.-i-:, whicli had lasted
over a vear.

Fig 9 (a).— Ai)ii()rinal jxvaure persisting after complete recovery
at a siiigh', sitting from hysterical contraction and paralysis of sixteen
iir-nths" duration.

Fig. I) (b).^ — Same as Fig. iJ (a). Keturii of normal posture after
th-ec day,r re-education of postural tone.

The Mar Xeuro.ses' and the yeuro><es of (icif Life. lo9»

tion land leng-tJien to AD on active relaxation, relaxation being
just as active a proeess as (conti-action . All muscles adopt an
intermediate leng*tli of this kind, the exact lengfth dei>ending:
upon the habitual ^xxsture of the limb. Thus! the fingers are-
slig-htly flexed ^vhen at rest, both during oonsciou^ness aaid
during sleep and anseistheisia. In order to extend theni tlie
extensors c^Iiorten and the flexors [lengthen, and in order to flex
them the flexons shorten and the extensoi-B lengthen. If as a
result of the continued oontra^ction of one group of muscles,,
whether as a result of organic disease or hysteria,; a new pos-
ture is assumed for a long period, their anatomical structure
becomes altei-ed, so tiiat the postural lengtli of tlie contracted
muscles is abnormally short (e.g., AE 'in Diagi'am; 2) and that
of "the O]>posing muscles is abnormally long*. AVhen recovery
takes place, even if this occuns almost instantaneously in an.
hysterical 'case, the muscle AE cun contract to AC and relax to
AD, but it always returns to AE when at rest. Consequently
the abnormal posture remains during sleep and under anaes-
thesia to the same extent as when the patient is awake. It is
in lio sense hysterical, but is organic, although' the structural
condition lipon which it depends ought never to be permanent.
As isoon as complete mobility is i*estored, the patient should be
taught to keep his limb an the normal jnos-ture by an effort
of will tlii*ougliout the day and he should walk up and dbwai
in front of a looking glass to see that^ he maintains it. In the
coui-so of two or three days this training results in a return
to the normal iKJstural length, and the patient' tlien no longer
requires to pay any attention to his posture. (Fig. 9).

Orthoi^sx'dic surgeons have long known the importance of
using si^lints to maintain a g-ood ^x^tui-e after nerve injurj-.
It has generally been thought that this hasf tlie object of pre-
^•enting tlie paralysed nniscles being overetretched, as their
contractility might otherwise become impaired. In all iii'oba-
l)ility, however, the splint really acts by maintaining^ the nor-
mal postural length of both the paralysed and opposing
muscles. That this is the auorc likely explanation is shown.

140 The War Neuroses and the J^euroses of Civil Life.

hy the improved i-esults obtained (reoently in cases: of droppe<[
wrist due to musculo -spiral paralysis, the extreme hyper--
•extension [formerly used having been replaced by modei-ate
"extension which keeps the postural length of the muscles
■normal instead of increasing that of the flexors and reducing
i;hat of the extensors. The abnormal postures ondf gaits, which
are often adopted after a painful wound hiajs completely healed,
are probably also due to the development of abnormal postural
lengths of muscles whilst the position of g-reatest comfort was
maintained before the wound had healed. The condition is
-often described as hysterical, but it is not( ^produced by sugges-
tion, land is really organic, tthough easily curable by re-
education.

Hysterical sympfoms following injury or disease of the
nervous system. — This group of cases is, I think, the most
important, because it is one which is very common both in
soldiers and civilians, though its truei nature is comparatively
rarely recognised. It consists of conditions, which are primarily
x)rganic and due ito an injury or diseasei of the nervous system,
but which are eventually in part or completely hysterical.
When the structural changes produced by an injury: or acute
disease of the nervoujs system gradually diminish in extent
owing to the disappearance of the vascular and other tempo-
rary changes, which surround the comparatively small area of
"total destruction, if indeed such an area is present at all,
the symptoms caused by the throwing' out of action of the
parts controlled by [the nervous tissues primarily involved should
disappear pari passu. Just as the physical signs in slowly
progressive diseases, such as tabes and disseminated sclerosis
often precede the onset of symptoms, so in tbese cases the
physical signs are generally still present when the functional
capacity has returned to normal, and if the( lesion does not dis-
appear completely they may remain as permanent evidence of
a past organic lesion.

In many cases, however, a man does not realise that his func-
tional capacity is improving. If he has been hemiplegie, he

The War Nenrofies and the Is^enroaes of Cwil Life.

1^10. 10.
Hysterical hemiplegia of two years' duration following organic hcmi-
plogia caused by nephritis, with persistence of organic physical signs.

Fig 10 (a)- — Before treatment.

Fig. 10 (b). — After two and a-hnlf hours' treatment

Fig. 10 (c). — After six months' treatment (Major J. L. M. Symns).

The War Neuroses and the Neuroses of Civil Life. 141

has ill the early days made repeated efforts to move liis para-
lysed limbs, hut without success, and he finally gives up the
attempt and reconciles himself to the idea of permanent Ihemi-
plegia. If his physician is too much concerned' witli the pos-
sible dang-ers of early piovement, he will exaggerate the pa-
tient's own fears of permanent disability, with th«^ result that
the organic hemiplegia is gradually replaced by hysterical
hemiplegia, instead of slowly disappearing as the org-anio lesion
becomes more and more reduced in extent. A time may even-
tually arrive when tlie hemiplegia is entirely hysterical, but, as
already pointed out,, the physical signs of organic disease,,
such as extensor plantar reflex, ankle-clonus, exagg^erated deep
i-eflexes and lost abdominal reflex, may still be present on the
affected side (Fig. 10).

A number of additional signs have been described, particu-
larly by Babinski, Avhich depend on the^ fact that the behaviour
of the paral^Tsed muscles in organic hemiplegia differs in various
i^sx>ects from what an average layman would expect, so tliat
a tman with hysterical hemiplegia, the exact nature of which
must depend on his own conception of howl "his muscles would
behave if they wei*e paralysed, fails to show these signs. But
if [the hysterical hemiplegia was suggested by an organic hemi-
plegia, these signs would be present, as the patient would be
trained by his own organic symptomis to maintain them in an
imaltered forai when they were no longer organic. Thus while
the upper part of the face is unaffected, the lower, including
the platysma ( Babinski 's platysma sign, Fig. 11, opposite pag«
142), would be paralysed, and Babinski's pronation sign and the
combined flexion of the thigh and pelvis (Babinski's "second
sign") would be present. In the (same way tlie characteristic pos-
ture of the arm and leg in organic hemiplegia would be perpetua-
ted. "W'e should thus be face to face widi a case following an injiuy
c»r idisease which is known to result in organic hemiplegia, and
in which incontestible physical signs of organic disease, such
as the extensor plantar reflex, as well as the characterestic pos-

J 42 Tin \V<(i Xi'it roses (uid I he Scuroses of Civil IJje.

tui'O and the mx^assory sigiiis der^ciiljed hy Babinski and otliers,
are j) resent, altliou^h the lieniii)Je<>ia is entirely hysterical.

Such oases can only be diagnosed by experimental psycho-
therapy. If, as occurred in numerous cases under our care,
more or less recovery takes plaoa — ^although, of course, the
permanent physical signs of organic hemiplegia persist — it is
clear that the paralysis is almost entirely hysterical, although
g-rafted on an organic basis.

The old method of diagnosing bet^^een organic and hysterical
paralysis Ithus breaks down, as tlie physical signs of organic
disease (do not, as is too often assumed, indicate that the para-
lysis is entirely organic, but simj:>h' that thei^ is an organic
•element in the case, which may be quite insignificant in pro-
portion to the hysterical. Moreover, it is nO' help in such cases
to consider whether the patient is or is not neurotic, as the
large Inajority have no personal or family history of neuroses,
and are in every way normal except for the particular symp-
tom from wdiich they are suffering. No more powerful sug-
gestion of hysterical paralysis could be imagined^ than orgianie
paralysis, and no abnormal degree of sugg-estibili ty is necessary
for its development.

We have seen cases of homon3'mous hemianoi)ia. persistent
headache, amnesia, aiid epileptiform convulsions develop after
head injiuues; paraplegia and persistent incontinence of urine,
after spinal injuries ; paralysis and anaesthesia after nerve
injuries in the exact distribution of the peripheral nerves, the
ana3sthesia even resulting in accidental bums (Fig. 12); all of
which were primarily organic and showed the characteristic
features of symptoms caused by an organic lesion, although the
recovery with psychotherapy proved that they Avere hysterical.
In many cases, of course, recovery Avas incomplete, the pi'Opor-
tion of hysterical to organic incapacity depending on the extent
of permanent damage done to the nervous tissue.

In /the same, way we have found that the well-recognised as-
sociation (of hysteria with disseminated sclerosis is even more
<!ommon than is generally supposed, that an; hysterical element

The War Neuroses arid ilie y^K roses of Civil Life.

Fig. 11 (a).— Same case as Fig. 11 (b).— After forty-five

Fig. 10. Upper neurone type of miuutei;" treatment for face,
facial paralysis before treatment.
showing paralysis of platysma.

Fig. 12. — Hysterical anaisthe^sia in median nerve distribution, with
uiif(>lt accidentnl burn. (Roprocbicod by permission from the BrUi:li
J our mil of Surgery).

The M'<u- yeufoses and the yeuroses of Civil Life. 14.3

is frequent in tabes and may occur in such a disease as Fried-
reich's ataxia. A soldier suffering- fix)m the. latter disease, who
had been unable to walk or stand without assistance and had
been unable to feed himself or write for several months, im-
proved to such an extent as a i-esult of a Aveek's psychotherapy
that he Avas able* to Avalk steadily and use his hands for all
ordinarA' purposes, although, of couree, the physical signs re-
niainod unaltered and the ultimate prog-nosis Avas as hopeless as
before.

I believe that the same" principle should be applied to all
organic diseease, A\hatever part of the body is affected, and
the possibility of an hysterical and thei-efore removable ele-
ment should be considered, hoAA-ever normal the mentality of
the patient may ajppear to be. Our (experience further sIioavs
that the ideal method of treatment in sucJi cases is a rapid
one— by explanation in languag-e suited to the intelligence o£
the individual, combined, Avhen necessarj^, with persua^sion and
re-education.

Hysterical deafness. — In order to hear, it is necessary to
listen, listening being' as active a process as moving. Perhaps
the dendrites of the nerve cells are tliix)AA'n out at each cell
station in the auditory tract Avhen an individual listens and ai'e
AvithdraAA-n Avhen he is inattentive. If a man has become tem-
porarily deaf OAving 'to a loud explosion or continuous gunfire,
lie anay become so convinced that he Avill never hear again that
Jio ceases 'to listen. This is the origin of hysterical deafness.
It is consequently a true nerve deafness; the patient's voice
alters like that of a deaf man, he may spontaneously learn lip-
reading, and in seA^ere cases the auditory-motor i-eflex, in which
ilie tpupils dilate and eyelids bHnk in response to loud noises,
iiiay idisappear OAving to the blocking produced at ihe lower as
Avell as the higher auditory centres by the withdrawal of the
<Iontrites Avhen inattention is extreme. The only signs of
organic deafness of any value ai-e those Avhich indicate vesti-
l)ular disorder, as this never occurs in hysteria, and an organic
l^^sion Avhich is sufficiently severe to cause complete deafness must

144 The War Neuroses and the Neuroses of Civil Life.

always involve the vestibule or vestibular nerve or nucleus as
well as tlie coclilea or cochlear nerve or nucleas.. All cases of
concussion deafness, even if the drums are ruptured, are at
any rate partly hysterical, and recovery occurs as soon as tlie
patient is taught to listen onoe more, tlie auditory-motor re-
flexes reappearing at the same time. '

I believe that the question of attention is of very great im-
portance, and many patients with partial deafness from oto-
sclerosis or other causes can be greatly benefited' by being
taught to listen and to nse whatever power of hearing they
still possess to the greatest advantage.

Hysterioal hemianopia. — It has generally been taught that ho-
monymous defects of vision, such as hemianoj)ia, is always
organic. But we have observed such defects resulting from
wounds of the occipital region, which were due to the hysterical
perpetuation of a condition which was originally organic. The
loss of function having been largely due to concussion and:
other transient changes, vision returned spontaneously, but the
individual having become temporarily blind in one or more
homonymous quadrants of his fields of vision had ceased to
look in the corresponding directions and re-education was re-
quired to teach him to do so, the rapid recovery wliich followed
this metliod of treatment x^roving that the condition was realb'
hysterical.

Hysterical headache. — Persistent headache due to concussion,,
whetlier caused by direct injury or a shell explosion, is often
if not always of the same nature, as it disappeai-s with psycho-
therapy when all other forms of treatment have proved useless.
Major J. F. Venables cured each of two cases of constant
vomiting following concussion by a single psychotherapeutic
conversation, neither patient vomiting again, altliough they
were given a full diet after heaving been tunable to keep down
the whole of a single meal, even of peptonized milk, for over
a year.

Hysterioal fits. — Hysterical fits are, I believe, much more
common than is g*enerally believed, and they may very closely

The War Neuroses and the Neuroses of Civil Life. 145

feimulate epilepsy. Such symptoms as passing urinei and biting
the tongue may occur, especially in a man -who has at one time
suffered from true epilepsy, as nothing is more likely to suggest
the occurrence of fits in an emotional individual during times
of stress than the memory of true fits in the past. The fits
resemble the early ones in those features which the patient
remembers or with which he is familiar from what liis relatives
have told him.

I have seen a small number of cases of Jacksonian epilepsy
following head injuries which were perpetuated as hysterical
fits; they resembled the original attacks in every detail, but
persisted when the primary cause was no longer operative,
and, being hysterical, they were cured by psychotherapy.

Hysterical inGontinence of urine. — Incontinence of urine was
very common in soldiers; it was almost always hysterical, and
rapidly responded to psychotherapy. I believe that the enuresis
of children must be hysterical, as many of these cases were simply
relapses under the strain of active service of a condition which
had been present in childhood, and in a few cases the inconti-
nence had never ceased, but was none the less cured by explana-
tion, persuasion and re-education, even if it was diurnal as well
as nocturnal.

The incontinence which follows spinal wounds and spinal
concussion has always been regarded as organic, but we have
had several cases which were cured by psychotherapy after last-
ing many months or even a year or two. These were generally
associated with paraplegia, which was similarly due to the
hysterical perpetuation of a condition originally organic.

V . — PSYCHASTHENI A .

Psychasthenia is a functional nervous disorder, characterised
by inability to oo -ordinate the mental processes, which I'esults
in inability to regulate the ideas and actions in a logical
manner, together with difficulty in concentration and, in more
severe cases, in obsessions and emotional crises. It is a pure
psycho-neurosis, and has no organic basis of any kind. It is

PART III. K

I-|(> 'ihc War .\<'urns(\s (ntd f/w Xcuroscs of Clri/ Lije.

the i-esult ol' keeping- painful iiieiiiuriL's and eonHieting- instinctr!
ill the subliminal consciousness by more or Jesi^ \'(jluntary
repi'esaion .

Psychasthenia is jiiost ooinmon in individuals Avitli a neuio-
pathio inheritance and generally shows itself in a mild form
from childhood. It is most frequent among the educated classes,
and is often associated Avith the so-called artistic temj)orament.
Psychasthenia was thus most common among the martial niis-
Hts, individuals who were canstitutionally unsuited to the life
of a soldier. Definite psychasthenic symptoms are likely to
develop when a predisposed individual is exposed to emotional
strain; as the former was g^enerally greater in officers than in
men owing to their responsibility, psychasthenia was most com-
mon in officei*s. Mental and physical overwork do not of them-
selves cause psychasthenia, but the neurasthenia to which they
often gave rise under war conditions made men abnormally
liable to develop psyoliasthenia.

An officer becoming psychasthenic found it difficult to adapt
himself to changing conditions. He hesitated when called upon
to decide between two possible lines of action^ and A\hen at last
he had adopted one he was full of doubts as to whether he had
not made a mistake. His power of concentration became defi-
cient, and an abnormal effort Avas inquired to recall past events.
Without fully realising it, his mental energy was largely taken
up in repressing- painful thoughts and conflicts, kept in the
background of his mind in order to avoid distress. As a i-esult
of this he showed a want of confidence in all his doings, and
was often fearful that he would be unable to perform his duties
when an emergency arose. Thits his sense of duty urg-ed him
to keep at his work, and was in acute conflict with his instinct
of self-preservation, which urged him to get awaj^ from his
hateful surroundings. When in the day-time his mind Avas not
fully occupied, an emotional crisis might ariiste, in Avhich he Ava.s
overwhelmed Avith an apparently causeless emotion, such as
dread, horror or terror, associated Avith their physical accom-
paniments of tremor, j)alpitation, sAveating, and even diarrhoea,

The IIV//- }\enr<).se!f and the yeioo.se.s of Civil Life. 147

and ut* laughter or Aveeping, poj)iilarly culled '"hysterics."
Owing- to the need of active thought lo kin^j) tJie disti'essing
memories and mental conflicts buried, he often found it difficult
to fall asle'Cj), and Avhen at last he slej)t, the controlling influence
over his thoughts Avas i-elaxed and they came into conscious-
juvss in a distorted form of nightmai'es, Avith a i-esult that he
Avould Avake in a cx)ndition of terror, though often unaAval^3
<jf its cause. The disturbed nights lovd to exhaustion and
so(!ondary neurasthenia, Avith headache and tendency to mental
and Ijodil}- fatigue. It ^\as then often impossible to disentangle
the neurasthenic and psychasthenic elements of the composite
clinical pictui'e Avhicli the Avar-Avorn soldier presented. In
sevei"© cases obsessions develoi)ed, an obsession being an in-

idequate idea or unsubstantial fear — commonl}^ called a phobia
- -which intrudes itself into the consciousness in an irresistible
manner Avithout completel}- Ailing or dominating it.

The prognosis depended u]3on the durati:)ii of ihe symptoms
and especially upon Avhether the individual wss otherAvise normal
Avhen the circumstances arose Avhich gave rise to his psychas-
thenia. When, as Avas frequently the case, he had always been
of a nervous disposition, the outlook Avas less good, as although
the symptoms might be gi-eatly relieved there often remained a
tendency to i-elapse Avith a return of mental strain.

Except for the associated neurasthenic; symptoms the treat-
iuent of psychasthenia should be entirelv mental, and the old-
fashioned rest cure and the administration of drug-s are useless.
The flrst essential is to gain the patient's complete confidence,

o that he becomes Avilling to speak about his most intimate
thoughts and to discuss affairs Avhich he has kept hidden from
everybody. It Avas quite impo,ssible to treat such patients during
ail ordinary Avard visit, and good results could only l)e obtained
when the conversation betAveen the patient and liis medical
(itiioer tcx)k place Avithout Avitnesses in a private room. The man
is encouraged to search his memory for the real origin of his

ym])toms and to face bravely the memories and conflicts ho
lias been repressing. An investigation into liis thoughts Avhon

148 The War Aei(rof<e-^ (ind llic Xcuros,'.-^ of Civil Life.

he lies awake at nig-Iits and into the subjects of his dream*
was often of gi-eat vahie. He is helped to solve his difficulties
and he is made to realise that a free discussion of the thoughts
he has been attempting to repress, however painful they mav
be, will cause his nightmares to disappear and his condition
during the daj- to improve. It is remarkable how rapidly
persistent nightmares, long-standing phobias, hitherto inexplic-
able emotional crises, and other psychasthenic symptoms dis-
appeared directly the patient thoroughly understood the mental
processes which had given rise to them.

The analysis of his mental state mig-ht appropriately have
been called psycho-analysis, were it not for the fact that the
term has unfortunately become attached to the special teaching-
of Freud, who believes the suppressed psj'chical origin of the
condition to be invariably sexual. Although sexual phobias were
occasionally present in soldiers, in the vast majority of cases there
was absolutely no sexual element at all. Perhaps the term 'psycho-
logical analysis might be employed. When the cause of the
symptoms has been removed, the patient should be given mental
exercises in order to restore Ms memory and powers of con-
centration. These quickly return, as he can now avail himself
of the mental energy previously used up in futile efforts con-
nected with his worries.

VI. — FuNCTioxAL Hyperadrexalism-Hyperthyroidism.

The emotions of fear and anger manifest themselves in
physical phenomena which respectively j)repare the individual
to fly and to fight — ^the natural sequels of these emotions. Most
of these physical phenomena are the direct result of the stimula-
tion of the sympathetic nervous system by the emotions. Thus
the blood pressure rises and the pulse is accelerated, the blood
supply to the muscles being thereby increased. The coronary
and cerebral arteries do not take part in the vasoconstriction,^
and consequently the heart and brain also receive the additional
supply of blood they will require. The bronchioles dilate in

The War yeuroses and the JSeuroses of Civil Life. 149

order that respiration should be unimpeded. The secretory;
and motor activity of the stomach and intestines is inhibited
and the sphincters contract, and digestion consequently ceases;
the blood supply of the alimentary canal can therefore be cut
down by the general vasoconstriction for the benefit of the
skeletal muscles, which would be undesirable if digestive activity
continued.

The experimental work of Cannon, Elliot and Crile has shown
that one of the most important results of the sympatihietio
activity caused by fear and anger is the secretion of the supra-
renal glands Avhich it calls forth. Adrenalin has the effect of
stimulating all structures supplied by the sympatlietic nervous
system, but not those supplied by the cranial and pelvic auto-
nomic nerves. Consequently the stimulating effect of the
emotions on the sympathetic nerves is enhanced by the
adrenalin. But adrenalin has other properties, which are
of great value for an individual preparing to fly or fight. It
increases the output of sugar by the liver and so provides the
muscles with, an additional supply of the chief source of their
energy, and it destroys the fatig'ue substances produced by
muscular activity, so that the muscles can continue to work for
a longer period than Avould otherwise be possible.

At the same time the cervical sympathetic, which as part
of the general sympathetic nervous system is stimulated both
directly by the emotions and indirectly by the adrenalin, causes
increased thyroid activity, as Crile w-as the fii-st to suggest
and as Cannon has recently proved by experiment. This results
in a general stimulation of metabolism and a further re-inforce-
ment of the activity of the cervical sympathetic, which is the
only part of the sympathetic system activated by the thyroid.
The pulse is further accelerated, but apart from this the value
of the results to the individual is not much moi-e obvious than
is the increased metabolism. Possibly the dilatation of tlie pupils
widening of the palpebral fissures and proptosis, together with
the erection of the hair, which province a typical picture of
terror, have in turn the object of inducing terror in the heart

{.'»{) I'hc \\((r Xcintj.scs and I he XfH/'osc-s of Cirif Lift'.

of tlio ciicniy; but, useful as this may bo to eats, it has louo
lost any iiiiportaiioo it may once have had in irian.

The physical i-esuUs of fear are uever of any vahie to tin
soldier, who may not run away; the physical i-esults of angler
help him if lie is attacking-, for

'' When the burning- moment bi-eak.s,
And all things elwe are out of jnind,
And only Joy of Battle takes
Him by the throat and makes him blijid,"

he may be able to perform prodigies of «trongth and endur-
ance, of which under ordinary conditions he would be totally
incapable.

The j)hy.sical results of fear, if prolonged for a sufficient
period, result in exhaustion of the nervous system, including the
vaso-motor centre, and ultimately the heart and skeletal muscles.
This was an important faotor in the production of neurasthenia
and one form of so-called disordered action of the heart in
soldiers; it is discussed in the section on neurasthenia.

If the i-esj^onse of the sympathetic nervous system to feai
w as so excessive as to incapacitate the individual, "who was
unable to respond in the natural Avay — by flight — to his emotion,
the over-activity generally disappeared after a few hours' rest,
directly he Avas i-emoved from the source of fear, the front line.
But occasionally his fears were still aroused in nightmares,
and in severe ca,ses the ]3atient also pictured to himself all
through the day the terrors which he had recently experienced.
In such cases the physical results of the emotion became per-
petuated, and the patient presented a picture of combined
hyper adrenal ism and hyperthyroidism, which has been de-
scribed by most writers as simply hyperthyroidism, as the sym]^-
toms of the hyperadrenalism, which is the more important and
in the absence of which the thyroid activity would be much less
marked, ai*e at first sight less obvious. The i^icture differs in
certain important i-espects from that of Graves' disease, which
depends upon over-activity of the thyroid g-land caused by

The Mar Xeinoses and the yeiiroses of Civil Life. 151

structiu-al eliaiig-es in its secretory tissues and is not, like the
functional hypemdrenalism-hyperthyroidisni of soldiers, simply
one of the results of general sympathetic over-activity. Thus
^veil-marked hy]^)ertropliy of the gland is never present in the
latter cases, though there is occasionally a slight enlargement,
l)robably due to vasodilatation, Avhich disappears with the other
evidence of sympathetic over-activity when recovery takes place.
The eyes are often slightly prominent, but there is never the
extreme degree of exophthalmos often seen in Graves' disease.
The prominence of the eyes varies greatly from day to day and
even from hour to hour. It may be exceedingly obvious for a
few minutes if the patient is exoited, although immediately
before and again shortly afterwards it is hardly recognisable.
This is due to the fact that the symptoms depend entirely upon
the emotional state of the patient, which contrels the sympa-
thetic activity and through this tlie suprarenal and thyreid
secretions. The blood-pressure is normal in Graves' disease,
but in this condition it is always high at the onset, when it
may even be as much as 200 m.m. Hg. in a man of twenty,
but it quickly falls to normal as improvement takes place,
though it remains liable to sudden elevation with emotional upset,
just as is the case ^ith the exophthabuos ; the high blood-
pressure is partly due to direct sympathetic action, but is mainly
the result of the secondary hyperadrenalism . The difference
is explained by the fact that although thyroid extract acceler-
ates the puLse it does not raise tlie blood pressure, Avhereas
the rise in pressure is the most striking effect of adrenalin.
A few experiments on the effect of hypnosis in these cases,
some of which were carried out with Captain G. H. Hunt,
showed that the blood-pressure and pulse rate fell rapidly
to normal when the patient lost consciousness, and the general
asi)ect of hyi^rthyreidism disap])eared, pro\ing that there is no
constant over-activity of the tliyroid gland as iu Graves' disease,
but that the whole condition is maintained by emotional activity.
There is always marke<:l vasomotor and pilomotor instability;'
the latter i< shown by the frequency with which the hair stands

152 The War Neuroses and the Neuroses of Civil Life,

constantly on end, as first observed by Major John Fawcett,
and by the brisk cutaneous pilomotor reflex.

The functional hyperadrenalism-hyperthyroidism responds
Batisfaotorily to rest, combined with psychotherapy directed to
the relief of the nig-htmares and disturbing" day-dreams, as
described in the section on psychasthenia. As the condition is
not due to structural changes in the thyroid gland, treatment
with X-rays or by operation would obviously be useless. As it
generally occurred in men who were of a nervous temperament,
it was seldom possible for them to return to duty at the front.
'But the majority recovered sufficiently for home service, whilst
the remainder were eventually discharged from the Army, but
not before they were fit enough to return to their civil occu-
pation.

Functional hyperadrenalism-hyperthyroidism has not hitherto
been clearly recognised in civil Ufe. But many of the so-called
iormes frustes of Graves' disease, emotional patients with tachy-
cardia, vasomotor instability, excessive sweating and tremor, but
without any marked enlargement of the thyroid or exophthalmos,
and some cases of so-called idiopathic hypertension in nervous
individuals, are probably of this nature, and an investigation
into the origin of their emotional instability followed by appro-
priate psychotherapy would doubtless be much more effective
■than simple medical treatment with rest and drugs, whilst
X-rays and thyroidectomy are clearly contra-indicated.

VII. — Organic Disease of the Nervous System.

There has in the past been much controversy as to whetlier
physical exhaustion and emotional strain ever resulted in the
development of organic nervous diseases. In recent years it
has been generally agreed that tliis does not occur, but both
factors have been regarded as important in hastening the
development of diseases already present in a latent or early
stage, and possibly as the deciding factor in causing such a
disease to appear in a man predisposed by the essential in-
herited or acquired factors, whatever these may be. The ex-

The War Neuroses and the Neuroses of Civil Life. 153

haustion and emotional strain caused by tlie war has given an
opportunity, such as has never been known before, to investigate
these problems.

Paralysis agitatis and disseminated sclerosis are the two
diseases of unknown origin, in which the influence of mental
strain seemed most probable. About five cases were sent to us
with the former diagnosis and twenty with the latter. In spite
of the fact that in many instances the resemblance was very strik-
ing, all of these cases except two of disseminated sclerosis proved
to be hysterical, as they recovered wdth psychotherapy, and any
organic physical signs which persisted proved to be due to
slight organic change caused by concussion of the spinal cord
in cases which had followed burial. We saw only one case of
very early paralysis agitans in a soldier in spite of the larg-e
numbers of middle-aged men who were on active service,
especially in labour battalions, and onty about half a dozen
eases of disseminated sclerosis. All of these were early cases,
and in every instance the first symptoms either preceded tlie
w^ar, when active service did not seem to have had any effect
in accelerating the development of the condition, or if it had
appeared after enlistment the patient had never been exposed
to great physical or mental strain. Major J. F. Venables sub-
sequently observed a ca^e of true paralysis agitans, which
appeared to have developed as a direct result of being blown
lip by a shell, and Captain C. Worster-Drought described two
or three oases in which the development of disseminated sclerosis
appeared to have been accelerated by war service. It is clear,
how^ever, that mental and physical strain must be an almost
negligible factor in the causation of paralysis agitans and
disseminated sclerosis.

A soldier, 25 years old, whose brotlier \vas completely in-
capacitated with Friedreich's ataxy, had been unsteady when
walking in the dark for two years. He rapidly beccume very
ataxic whilst on active service, and when admitted he was
unable to stand or walk Avithout assistance and could not write.
Captain \V. R. Reynell treated him so successfully with psycho-

].'}{ I'hr \\((r XcNrfjsrs (otil ihc Xenroscs of Civil lAfe.

therapy that in twxMity-fuur hours ho could wtcind and walk
without assistance, aiul at the end of a ^\eok lie Mas only very
slightly ataxic, tlic condition ot* his hands having also greatly
improved. As all the physical signs of the disease were still
piNjisent tlieix) could be no doubt about the diagnosis, and it
is clear that what Mas i-emoved was a superadded hysterical
element. This is a point of the utmost importance in civil
life, as it would have been quite impossible M'ithout trying the
effect of psychotherapy to have recognised that there was any
hysterical element pi^esent, as the patient was not in the least
neurotic and presented a cpiite characteristic picture of Fried-
reich's ataxy. I believe that a mild degree of ataxy or paresis
caused by organic disease is very likely to become greatly
exaggerated by auto-suggestion, and this posisibility, with the
corollary that considerable improvement Avill result from psycho-
therapy, should be remembered and the effect of psychotherapy
tried in all cases of such apparently hopeless organic diseases
as disseminated sclerosis and Friedreich's ataxy.

There is no doubt that the mental and physical strain of
war had a marked influence on tabes and general imralysif.
Many patients, whose symptoms were so slight that the true
nature of their condition had not previously been recognised,,
rapidly became incapacitated on active service. In other cases
there did not appear to have been any sign of the disease before-
the war, though it is obvious that the spirocha^tes must have
been lying dormant in the central nervous system. That the-
strain accelerated the onset of the disease in these cases, in
some of w^hich it might perhai)s never have become manifest
undei' favourable conditions, Avas shown by the interval between
the primary infection and the first symptoms of tabes or general
paralysis being on an average definitely shorter than that
observed in civil life. The concussion caused by the explosion
of a big shell was sometimes the exciting cause of the onset
or sudden aggravation of symptoms. In one case a shrapnel
wound of the head led to the immediate development of oph-
thalmoplegia and symptoms of general paralysis, the diagnosis^

The War yeuro-ses (utd the Xeuro.se.s of Civil Life. \'^'^

being- toiifirnied hy ihQ positive Wassermann reaction and excess-
of lymx>hoc'ytes in tlie eerebro-spinal fluid, although the patient
^vas fit in eveiy wa^- until the moment he was wounded.

The severity of the symptoms observed in these oases of
tabes and g-eiieral paralysis does not give an acciu^ate indication.
of the severity oi tlie pathological process, as tliei*e was an even
greater tendency' than in civil life for slight symptoms to
suggest severer ones, so that a large hysterical element waa
often })reseiit. Rapid improvement up to a certain point con-^
sequently occurred Avith psychotherapy in spite of physical signs
and changes in the eerebro-spinal 'fluid which could leave no
doubt as to the accuracy of the diagnosis. It was hoped that
prolonged .treatment with intravenous injections of salvarsan
until the AVassermann inaction disappeared might arrest the
progress of the disease itself, as owing to the conditions under
which the symptoms appeai-ed a diagnosis was often made at
an earlier stag-e than is generally posisible in civil life.

It might be ex])ected that active service Avould increase the-
frequency and severity of fits in epilepsy, Avould lead to i^lai>^e-
in apparently cui-ed cases, and might even produce the disease
in individuals Avho wei*e predisposed by heredity. Among the-
enormous number of men sent home diag-nosed as epilepsy
it soon became clear that almost all of tliose avIio had no per-
sonal or family history of the disease Avere really suffering fronii
hysteria. Later investigations showed that even Avith a strong-
family history or a history of epilepsy in childhood the fits
Avere ahnost invariably hysterical, though i^ossibly in a very
small number of cases severe Avar strain led to the development
of true epileptic fits. Finally Ave discovered that even in men
Avho had had regular fits up to the time they enlisted the in-
creased frequency which often resulted from active service Avas
to a great extent only apparent, as true epileptic fits Avere little
or no more common than before but Avere noAv often associated
Avith very frequent hysterical fits. The mode of origin, diagnosis
and treatment of hysterical fits in these cases is deacribed in
the section on hysteria.

SOME EXPEEIENCES OF THE WOKK OF
GENEEAL HOSPITALS IN FKANCE.

By
PHILIP TURNER, M.S., F.R.C.S.

I HAVE been asked to give some account of the General Hoe-
pitals of the Expeditionary Force in France, and of the work
done in them. Since the subject is a very large one, and the
spaoe at my disposal is limited, I shall give a short account
of the organisation and working of hospitals, of which I had
personal experience, and then, if space permits, give a brief,
outline of the surgical work we were called upon to perform.

In 1914 the War Establishment of a General Hospital -was
520 beds. This number ^vas found to be too small and was
soon increased, so that hospitals moving abroad in the spring
and summer of 1915 were provided with accommodation for
1,040 patients by the simple process of doubling the entire equip-
ment of the original establislmcient. Later on, the nmnber
of beds was still further increased as the site of the particular
hospital permitted. Thus at No. 3 General Hospital thei-e were,
in the autumn of 1915, 750 beds, which were subsequently^
increased to 1,000, and eventually, with emergency accommoda-
tion, to 1,350. Other hospitals with larger sites were enabled
to increase to 1,800, and some of the later hospitals were pro-
vided with 2,000 beds or over. " Emergency " beds as the name
implies were designed to meet the. requirements of sudden
rushes of ^wounded men, but thei-e was always a tendency for
emergency accommodation to be i-egarded eventually as part

158 Some Kjperlnfce.s of the }\'ork of

of the normal aoeoiiiniodation of tlio hospital. Tliest) oimn-
geiicy b«d« weiie obtained in the following: ways: (1) By puttinj^-
lip additional hos])ital marquees on any vacant <ii()nnd (2) by
addinj^- additional beds to exiistin<>' wards an^l huts ; thim <n\v
lints orig-inally fontained 30 bed« but this A\as pormanenTly
increased to 84 and on occasion« to .'J(> and o8: (o) when a
permanent bnildin<y tsuch as an hotel or casino fonnod j^art of
the hospital, exti'a beds were put in Avards, and rooms used for
•other purposes, and also in corridors; (4) church huts, Y.M.C.A.
and other i^ecreation huts, canteens, cinemas, c^'c, were tem-
porarily fitted up as waixls. Needless to say emerg-ency beds of ten
•consisted of mattresses and blankets on trestles or stretchers,
or even on the floor; hence as far as possible light cases only
^\'ere sent to these beds, and it was astonishing- how comfortable
i;he men. made themselves.

Stationary hospitals originally provided only 200 beds, but,
in the later years of the war, many of these became indis-
tinguishable from g-eneral hos]3itals botli as regards size, equip-
ment and the amount and the character of the work they were
called upon to perform.

In the first year of the war general hospitals were compara-
tively mobile, and though some were lodged in permanent
buildings, such as hotels, casinos or schools, many were en-
tirely under canvas, and so were easily able to move if required.
As it became certain that the position of the armies would
not alter to any great extent for some time, canvas w^as re-
placed by huts, and the hospitals became comparatively fixed
and permanent institutions. As an example of the movement;
which might be required in the early days. No. 3 General
Hospital in August, 1914, was sent to Rouen. When this town
was evacuated during the German advance it was hurriedly
moved to St. Nazaire ; being subsequently transferred again
to Rouen after the German retreat aiid then, after an interval,
to Treport. After the Armistice was sig*ned this hospital was
attached to the Army of the Rhine and sfatibnod near Cologne.
As also preparations were made for moving during the German

General Hospitals In F/;ance. 159

advance on Amiens in March , 1918, I t^uppuse that this hospital
Jiad as mnch ex^ieiienee of moving as any with tlie Expedition-
ary Force in France. The early history of No. 3 General
Hospital is of considerable intemst, and was described by
C'ol. S. F. Clarke, A. M.S., who Avas then in command, in the
R.A.M.C. Journal*

The first liospital to which I was attached, No. 22 General,
left Southampton for Camiers at !the end of May, 1915. Though
this district afterwards became such a large and importautJ
centre, the hospital camp was then only beginning to be laid
ont, and there Avas no sign of the extensive railway sidings
and other camps which were subsecjuently formed in this
district. Several other Guy's men were attached to this hospital^
and I daresay they will recall our feelings when, after a long
and trying journe}^ we were shown a cabbage field as our
'site." However, we set to work, and in a fortnight a hospital
of 1,000 beds had arisen and was ready to receive patients.
Our first admission was one of our own orderlies w'ho was
knocked down by a passing train and got a depi-essed fracture
■of the skull, but a few days later we took a share of a convoy
<jf wounded. In those days there wa^ no siding at Camiers; the
trains had to be unloaded at Etaples, four miles away, and the
patients brought to us by motor convoy. The camp at Camiers
was situated on gently rising ground boimded on the west by
the main Boulogne -Paris railwa}- and on the east by a steep
line of chalk hills. Beyond the railway across some two miles
of sand dunes is tliespa. The soil of the camp was very saiidy,
which i-endei-ed it difficult to fix tent pegs securely with the
result that even in summer time during bad weather tents
and marquees were constantly collapsing. I believe that ill
the winter of 1915 the camp was practically evacuated. There
Avas also difficulty with the water supply, but during the next

*The :N[obilisation and Early Careoi- of No. 3 General Hospital,
15.E.F., R.A.M.C. Journal, 19K3, vol. 2, p.ol2.

Also A General Hospital Changing Base, R.A.M.C. Journal, January,
1920. • ,

IGO Some Ikcperlences of the M'oric of

year this was overcome, huts were erected in place of marquees ^
and, as is well known, a great amount of excellent work was-
done here until the end of the war.

At first we were provided with two operation tents, which
were too small and not very convenient; artificial light was-
given by acetylene biu-ners which attracted moths and other
insects in enormous numbers. Earwigs in particular were a
dreadful nuisance, and made their way everywhere, even into
the sterilised dressings. After a few weeks an operation hut
was provided containing two 0]3eration rooms, X-ray rooms, a
pathological laboratory, and a small ward. It was not a well-
designed hut, and I believe this particular type was soon
given up. On© of the chief defects was that it was onlr
possible to enter the pathological laboratory by g'oing through
the X-ray room, which led to a wordy warfare between the
officers in charge of these departments. Eventually the patho-
logist, with the help of old boxes and packing cases, con-
structed a staircase which provided an additional entry to the
laboratory via the window.

At the lend of July No. 22 Gneneral was handed over to an
American unit from HCarvard. This was not, however, the first
British hospital to be staffed by American medical officers for
a few weeks before a g'eneral hospital at Etaples was handed
over to a unit from Chicago. The Harvard Unit was composed
of a number of well-known physicians and surgeons from
Boston, who came provided with an elaborate outfit and equip-
ment with which tiiey did extremely good work. Of course, this
was long before the United States were at war witJi Grermany,
and hence the officers were unable to wear the American,
uniform, and, as they did not hold commissions in tlie
British Army, could not wear the British uniform. They
were provided with a uniform closely resembling our own,
but without rank badges and with, a very much modified
R.A.M.C. badge. Apparently the French authorities were not
informed of this, with the result tliat shortly after their arrival
in Boulogne thirteen were arrested on suspicion by the French

General Hospitals i7i France. 161

police, and another was afterwards detained by a British mili-
tary policeman at Etaples. Fortunately, like the good fellows
they were, they regarded this as an excellent joke, and ,one
rather timid member of the party who would not leave the
camp diuing- sultry days in July and Aug-ust unless he was
wearing ia mackintosh to conceal his tell-tale tunic was a source
of much merriment to the rest.

After a sliort stay with the Harvard Unit I was transferred
to No. 3 General Hospital at Treport. This hospital had
been at work since the beginning of the war, and had been
established on the position it then occupied for some montlis.
It occupied a large and imposing hotel, providing* accommo-
dation for about 500 'patients and a number of marquees with
beds for about 250 patients. In addition there were a number
of huts under construction providing another 160 beds and
barrack accommodation for the R.A.M.C. x^ersonnel. Ad-
joining wei*e two other g^eneral hospitals, one Canadian, and
one British, and a convalescent depot. In 1916 a foiu'th
general hospital was added, and also a Red Cross Hospital
of about 60 beds for officers. There were thus about 6,000
beds in all, with a convalescent depot capable of accom-
modating about 2,000 convalescents. The whole formed a
compact and well defined camj) Avith, even when emergency
beds were in demand, plenty of space for gurdens and re«
ci-eation giounds. The site was on a cliff about 350 feet high^
some half a mile from the town, on area about to be developed
for building purposes and known as " Les Tierrasses." Only
two or three small villas had been erected, and these were used
as offices by the R.E. and the A.D.M.S. One advantage of
the site was that a few roads had been ix)ughly laid out, which
formed a good basis for communications between the various
parts of the camp. The site in simamer, and in fine weathea*,
was ideal, but as it extended along the cliff edge and was
exposed in all directions without shelter except perhaps to
the south it will be seen that in the winter and in stormy
weather it had serious disadvantages. In a gale from the west

PART III. L

162 Some Experiences of the ^yorlc of

or north-west the force of the wind was terrific, and tlie
probability was that many marquees and tents would be des-
troyed. In No. 3 alone from 12 to 20 hospital marquees were
on several occasions destroyed in a sing-le night. The ropes
and pegs could be made to hold, but Avhen the canvas had
been exposed to the weather for some time it tore into ribbons
and the poles were frequently broken by the force of the wind.
In the worst gale we experienced in November, 1915, practically
all the marquees of all the hospitals were blown down or
destroyed, but fortunately the huts were then practically com-
pleted, so that the work was but little interfered with. The
severe cold in January and February, 1917, was very trying
in such an exposed place. For six weeks the temperature did
not rise above freezing point, and on five occasions in the
open air in the convalescent depot zero Fahrenheit was re-
corded. Owing to the non-arrival of coal ships there was a
great shortage of coal, very little being available for heating
purposes. In addition the electric light failed completely for
three weeks, and the Avater supply was very pi^ecarious owing
to the freezing of pipes, so that, since the hospitals were full,
chiefly with sick, the general discomfort fend inconvenience can
be imagined.

One of the first considerations in discussing the suitability
of a site for a hospital camp is its relation to railways and
the presence of suitable sidings for ambulance trains. Though
it should be conveniently situated with regard to the railway
it should not adjoin it, since railways and sidings are legitimate
objects of attack from the air. The Treport camp was situated
about half a mile in a direct line from the station, but, a»
the latter was at the sea le^el, the approach was by a road
about two miles in length which rose steadily with some sharp
turns, but without any ideally very severe gradient.

The railway Iconnections wei^ g'ood, lines running direct to
Dieppe, Beauvais, and Abbeville, the latter joining with the
main Boulogne-Paris line. At first all were single tracks, but
these were doubled during 1916. This was fortunate for, after

General Hospitals In France. 163

the German advance in March, 1918, for about four months,
these lines formed the only railway communication between the
Boulogue district and Paris and the south. From Abbeville a line
ran to St. Pol, Arras, Bethune, Avith connections to all the raiUieads
•:ai the northern X3art of the front. W^e were thus in connection
with^ and received convoys from, the Avhole of the British line.
A striking example of this was seen after the first German
"mustard gas" attack in the smnmer of 1917, which took
place On the Belgian coast, but the majority of the gassed cases
were sent to Treport. Another important point in the selection
of a hospital site, and one which, perhaps, was not fully
realised in the earlier days of the wax, is that it should noti
too closely adjoin railway sidings, dumps, aerodromes, base
depots, or other legitimate objects of attack from the air: the
camp at Treport Avas on the whole satisfactory in this respect.
There was at one time a French coast defence battery between
one of the hospitals and the cliff edge, but on representations
being made this was removed to a short distance beyond the
boundary of the camp; also toAvards the end of the war pre-
parations Avere made for erecting a larg*e aerodrome only a
few hundred yards aAvay. OtherAvise the nearest camps Avere
a large tank reinforcement camp and an aerodrome each
about tAvo miles aAvay, Avliile a small tOAvn about the same
distance Avas used as a divisional headQ^uartera.

A igood supply of pure Avater Avas obtained from an artesian
Avell at the foot of the cliff, the AA-ater being pumped up into
tanks, from Avhich it Avas distributed to the Avhole camp.
Though the supply Avas ample the pumps were not of suffi-
cient strength, and hence economy ahvays had to be observed,
while occasionally the pumps failed for a longer or shorter
period, causing a good deal of incon\-enience, and, on one or
tAvo occasions, rendering it necessary for Avater to be brought
up by motor Avater tanks. Though the AA-ater from the well
Avas pure, there Avere several sources of conTamiuation possible
Ivefore it arrived in the camp, and, as these could not be Avith
certainty eliminated, the Avater had to be chlorinated

164 Some Experiences of the Work of

Electric light ^vas supplied by the local company, but their
plant was unequal to the extra demand upon it, with the
i-esult that the light was very uncertain. This was a great
annoyance in the operating rooms, the only alternative being
acetylene burners, but eventually the Koyal Engineers started
an installation which supplied current sufficient for essential
lights, such as those in the operating rooms, when the main
current failed.

Laundry work w^as carried out by contract by a French
laundry at Dieppe, all articles being taken there and returned
by A.S.C. motor lorries. Looking back one cannot help think-
ing that it would have been better both as re^rds economy
and efficiency if, from the first, a laundry and independent
electric lighting installation bad been started for the camp
together with a more powerful pump for distributing water
to the various hospitals. As it was, efficient pumping engines
arrived in October, 1918, and w^ere being fitted at the time of
signing the Armistice. I suppose that in the earlier days there
was some uncertainty about the permanence of the camp, and
'that later it was 'hoped that a speedy termination of the war
might render these undertakings unnecessary.

One may, perhaps, say something here as to the relative
merits of marquees, huts, and permanent buildings such as
hotels and casinos for hospital purposes. iBefoi-e having any
practical experience of either I should have been strongly in
favour of the permanent building, but, having* worked in all,
I can say — and I think that every one who Las 'had oppor-
tunities of icomparing them will agree — tliat for comfort, con-
venience and simplicity of administration the hutted hospital
comes easily first. Marquees are very satisfactory and com-
fortable, even for serious cases, in the summer time and during
fine wea'ther, but in 'flie winter or during bad weather, es-
pecially in exposed situations, difficulties in lighting, heating,
and ventilation, quite apart from the liability of damage, render
them far from satisfactory.

General Hospitals in France. 165

The following' are the chief disadvantag-es of buildings, and
should be considei^d before taking- over any building for thia
purx^ose: — 1. Drainage. The drainag-e of most hotels on the
continent, even of the most modern and up-to-date description,
is often very primitive. A large x^roportion of the beds of
No. 3 General Hospital were contained in a large modern
hotel completed only two years before the war, and though so
near the sea the only drainage was into a cesspool. Though
doubtless sufficient when used for perhaps 200 visitors, for
three months in the summer it was wholly insufficient when
the building was used as a hospital for 500 patients all the
year round. In the autumn of 1915 a state of affairs arose
which rendered the construction of several new pits imperative,
and after this there was no further trouble. 2. While the
public rooms provided three or four really imposing and
spacious wards there were a great number — about 160 — of small
rooms used for patients. These mostly communicated with,
one another by double doors with the idea I suppose of pro-
viding suites of rooms, and also ox^ened into a corridor, the
result being a regular labyrinth. The rooms were provided
with from one to six beds according to size, and each wing
on each floor formed a ward of about 110 beds. This corres-
ponded roughly to three huts, but any medical officer would
prefer to look after six huts than one of these wards. Though
light cases were as far as possible put into these rooms, it
was often necessary to send quite bed cases to them, and the
difficulties in nursing can be imagined. Alany of the doons,
too, would not take stretchers. Another drawback was tliat
the labyrinth offered great opx:)ort unities to men who wished
to dodge the Medical Officer, and also supplied these ehisive
patients with an excuse when they were finally found. 3.
Danger of fire. The French building laws as i>egards pro-
tection from fire must be very different from those gf this
country. This large building with three stories and over 200
rooms was provided with only one staircase and a smaller stair-
case for servants adjoining this. There Avere two lifts, one

166 . Some ExperiemeH of the Worl: of

for passengiei's and one for luggage (but neither able to take
a stretcher), also situated at the side of the stairs. Thero ^^•el■^
no outside staircases and no means of descent from the u^iper
stories except by the ways already mentioned, and which in
the oase of a serious fire might have been easily i*endered im-
passable. To remedy this Ave had sent over one of the old
pattern fire escapes as used by the L.C.C., and canvas chutes
for the upper floors. Fire drills were held weekly, as well as
many surprise alarmis. The importance of these was shown on
one occasion when, in a hose about 50 yards long, a hole
gnawed by rats through which one could put a fist was found
about a yard from the standpipe. Danger from lig'htning also
had to be considered. There was no lightning- conductor, but
the buildins" was of reinforced concrete,, and I suppose, owi^ig*
to the framework of girders, the w^hole structure was practi-
cally a lightning conductor. At any rate, though the building
was observed on several occasions to be struck no damage was
done either to the structure or any of the inmates. 4. Heating,
again, was a difficult problem. There was a system of central
heating, but as the brilding* was intended for use only during
the summer months the radiators were few in number and not
very efficient. As the same boilers provided the hot water
supply it was often found that in realty cold weather the
radiators refused to work or were only jiLst warm. This
difficulty was to a certain extent overcome by using a number
of closed stoves in the larger wards and in the corridors and
a few of the smaller rooms. 5. There was a good deal of
difficulty over repairs and renewals, since many parts and
materials were naturally required which were difficult or im-
possible to obtain during the war. On the other hand, I believe
that the rent paid compared very favourably with the cost of
erecting a hutted hospital.

At first the whole camp was under the administration of
the Senior Commanding Officer, but later the district was en-
larged and put under the control of an A.D.M.S. The latter
was a much more satisfactory arrang-ement. for though we were

General Hospitals in France. 167

certainly very fortunate in oui^ Senior Medical Officers, yet it
is difficult, when the administmtor is in command of one of the
hospitals, for him to avoid unduly favouring his own unit, and
so to cau^e a certain amount of friction.

The natui-e and objects of the work of a general hospital may
be summed up as follows : —

(1) 'To ti^at all severe and serious cases, and to get them in a
fit tondition for transfer to home hospitals as quickly as possi-
ble; (2) to treat all slighter cases, and to get them fit as soon
as possible for retm'u to base depots for duty, or for return
to duty after a stay at the convalescent depot; (3) to co-ordinate
the hospital accommodation with the demands likely to be
made upon it; (4) to carry out clinical and pathological inves-
tigations, especially in all new or imusual injuries and diseases;
to try, and to investigate, all new forms of treatment; to devise
new means of dealing with unusual conditions ; and generally
to endeavour to advance and improve both the practical and
scientific aspects of military medicine and sm*g-ery.

The importance of the fii-st of these is easily miderstood,
but, as regards the second, its great importance was only fully
apx^reciated in the later days of the war, w^hen the cost and
difficulty of transport became so marked, and when the vital
importance of "man power" was more fully appi-eciated. If
lig-htly wounded men had to be transferred to home hospitals
it was usually many weeks or even months before they were
retui'ned for foreign service, whereas if they could be kept in
France, either in hospitals or in convalescent depots, they could
be returned to duty in a very much shorter time. Of course,
when large nimibers of womided were arriving at the hos-
pitals these lighter cases had to be sent away, and if they
could not be accommodated in convalescent camps or in other
hospitals they had to be sent to hospitals at home. Though
this fact is obvious, it did not api>ear to be alwaj-s recognised!
by the administrative authorities in England.

The co-ordination between the accommodation and the
demands likely to be made upon it was naturally of the gi-eateslr

168 Some Experiences of the Work of

importance. In times of severe pressure the work of a general
hospital closely approximated to that of a Casualty Clearing-
Station. During such times, under favourable circumstances,
perhaps 10 per cent, of all cases of wounded were operated
upon at the Casualty Clearing .Station, but during the German
advance in 'March, 1918, the proportion was considerably less.
The remainder were treated and operated upon in general
hospitals when this was urgently required, and these cases
as soon as they were fit to travel were evacuated to home
hospitals. During these times of severe pressure many cases
where operation was desirable but not urgently required had,
owing to the necessity of at once making beds for further cases,
to be transferred for this purpose to other hospitals eitlier in
France or at home. There was every stage between thesei
strenuous times and comparatively slack periods when no active
military operations were in progress, and it was possible to keep
patients in for a long time and render a large proportion fit for
return to duty without evacuation to home hospitals. It will be
seen that the essential means of effecting this co-ordination was
by regulating the duration of the stay in hospital, and by vary-
ing the type of cases to be selected for evacuation.

What may be termed the scientific aspect of the work was
of very great interest since so many of the injuries and diseases
were rare or not met witJi in civil practice, so that newi
mechanical and other methods of treatment had to be improvised
to deal with them. The great drawback to this work was that
during times of pressure, when the opportunities most fre-
•quentty occurred, the amount of work, and especially of routine
work, rendered it difficult for investigations to be carried out.
This was to a considerable extent overcome by making notes
and observations at the time and working these out when there
was more leisure. This work was gTeatly helped by the forma-
tion of a Medical and Surgical Society on similar lines ,to
those at other large centres. The meetings were held in the
winter months w^hen, generally speaking, the pressure of work
was less. Cases of unuisual interest were shewn and papers

General Hospitals in France. 169

were read, many of the latter being afterwards published in
the various medical journals.

We were fortunate in having in Major G. Richardson, R.A.M.C.,
and Captain H. Noel, R.A.M.C., two pathologists who were
very keen on pathological preparations and specimens, with
the result that a large number of the specimens in the Royal
College of Surgeons collection came from No. 3 General Hos-
pital; many of these were sent long before any official interest
was taken in the matter. Hospitals were not allowed to form
pathological collections, but as specimens were sent off at
intervals when a number had accimaulated we generally had
a small collection, which was of great interest to any visitors
who liappened to be interested in this work. As an example
of Buch a, series I may mention a collection of 17 preparations
of injiu'y to the spine, each with the corresponding spinal
cord showing the injury to that structure and the membranes
as well as the fractured vertebrae. These were mainly from
C-rerman prisoners, of whom we had a large number with wounds
of the spine in the summer of 1918.

Major Richardson, in addition to providing on all desired
occasions wet specimens for immediate investigation and demon-
stration, elaborated a method of rapid preparation of dry speci-
mens of injuries to bones and joints. By this method it was
possible in 48 hours to have the bones not only separated
from soft parts and dry, but bleached, with fat extracted, witli
fractured fragments joined b}' g*lue and lines of fracture marked
out, the joints articulated by wii-es, and mounted as a finished
inuseum specimen. Many specimens thus prepared are at
present in the collection of the Royal College of Surgieons.
The educational value of this Avas very great, for, suppose one
liad to amputate a limb for some injury to bone or joint,
it was possible two or three days after the operation, while
linical and operative details were fresh in one's mind and
he patient still under close observation, to see tlie exact nature
and extent of the injury. I cannot help thinking that this
-ystem might be adopted with advantage in civil hospitals

170 Some Experiences of the Worlc of

where such specimens ai-e often stored and do not appear on
museum shelves until years have elapsed from the time of
injury or operation.

The X-ray Department, under the charge of Capt. M. H.
Watney, iR.A.M.C, got through a vast, amount of work, but
during- very busy times in this, as in other departments, th,e
amount of Avork was really more than could be dealt Avith.
Gi'eat attention was paid to stereoscopic radiography, and large
numbers of really excellent stei^oscopic plates of fractures, in-
juries of the joints, and especially of the skull and chest were
prepared. When patients were transferred to home hospitals
prints of any plates were sent ^vith the index card and notes,
unless the result of the examination was negative, when a reijort
to this effect was sent.

These prints rarely did justice to the excellence of the nega-
tives, and in many caises can have conveyed little or no
information. At various times I made a large number of
tracing's of X-ray plates of interesting fractures, and in this
way a permanent record is quickly and easily obtained. As
this is much quicker and far more economical than printing,
I suggiested that these tracings might larg-ely replace prints
but the suggiestion was not adopted. The objection, of coiu^se,
13 that the tracing instead of being a piece of impartial evi-
dence naturally conveys and emphasises the interpretation of
the person who makes the tracing:, but I am not sure tliat
this is not reallj an advantage.

The iaccommodation of a general hospital is divided into a
medical and a surgical division, but the line of demarcation
between the two could not be sharply defined. While sevei^
fighting' was in progress, g-enerally during the spring, summer
and early autumn, the surgical division expanded while the
medical division shrank, sometimes almost to vanishing point.
On tlie other hand, g-enerally in tlie winter, when no. active
military oj^erations were in progress, or during an influenza
epidemic, or when there were a large number of gassed cases,
the medical division increased at the expense of the surg-ical.

General Ho.sijitaI-'< h/ Fr mce. 171

Most general hospitals had to provide aeeommodation for thfe
whole oi' certain special gi-oiips o£ patients or classes of casen
who were sent to theii- particular district. Thus Xo. 3 Goneral
was tlie special hospital for the folloAvino-: —

1. Up till the smnmer of 1916 all sick and wounded officers
were accommodated. From then until the end of the war officers
were also sent to No. 10 Red Cross (Lady Murray's) Hospital,
as far as possible from alternate convo^^s. Xo. 3 provided
beds for 100 officers, afterwards inci*eased to 150. The largest
niunber of wounded officei-s we had to deal with at one time
was 279. Capt. D. Wood, R.A.M.C., and Capt. C. M. Dickin-
son, R.A.M.C, each had a long period in charge of the Officers'
Ward.

2. All eye cases. The number of beds set apart for these
varied according- to necessity, but the averag-e was about 15. In
addition thei-e was a ver}^ considerable out-patient dex>artment.
From 1916—18 Capt. G. Viner, R.A.M.C, was ophthalmic
surgeon.

3. All mental cases. These were treated by a mental expert,.
Capt. A. L. Taylor, R.A.M.C, in a si>ecially constructed hut
providing accommodation both for officers and men.

4. All "shell shock" cases who were also in charge of the
mental expert and treated as far as possible in a special wai'd.

o. All Sisters, membei-s of the Q.M.A.A.C, and other
women's organisations.

6 . All officers and men of the allied armies, except Americans .
From time to time we had a nmnber of French, Belgians, Por-
tuguese, natives of India, and Chinese. THie natives of India were
transferred as soon as possible to the Indian hospital at Rouen.,
and the Chinese to the Chinese hospital at Xoyelles. One Rus-
sian, who was a prisoner with tlie Germans and was at work
in tlieir advanced trenches and was wounded while escaping into
our lines, was also admitted. On one occasion about 100 Portu-
guese sick and wounded were admitted, and as none of tliem
spoke EngUsh or French, and, of cpui^e, no one at the hospital
spoke Portuguese, considerable difficulty was experienced in deal-

172 Some Experiences of the Work of

ing vrith. them until a Portuguese medical oflScer who spoke
French was sent to us to act as interpreter.

7. All Grerman prisoners. The number of these varied con-
siderably. In the early days they were something of a curio-
sity, but in 1918 there was accommodation for about 400 in
marquees in a barbed wire enclosure as well as a ward for
the more severe cases. This accommodation was most severely
taxed in spite of rapid evacuation. The largest number undsr
treatment at one time was 550. At the end of March, 1918,
when the German threat to Amiens was most serious, (six
prisoners evaded the sentries and broke through the wire and
were not recaptured for two days. After this the barbed wire
cage was greatly strengthened and the guard and sentries in-
creased, with the result that there were no further attempts at
escape.

In addition to the above the following cases were taken for
a time only.

8. All cases of hernia, varicocele, and similar cases requiring
operative treatment. These were only taken in the -winter
months and when the hospital accommodation was not required
for wounded men. The number of these was considerable, and
in the winter 1916 — 17 I operated on over 150 cases of hernia
alone. Later these operations were performed at all hospitals,
and in 1918 large numbers of them were sent to the hospitals
at Trouville. .

9. For a short time in 1916 all cases of fracture of the fieanur.
This Avas before the days of sj^ecial hospitals for these fractures,
and the order was soon rescinded.

The number of officers on the establishment of a g*eneral
hospital, of course, varied with the size of the hospital. The
number allotted to a hospital the size of 'No. 3 was 25, but
this was never reached except, perhaps, during the summer of
1915. The number really necessary for the efficient running of
the hospital was 15. If the strength was below this it became
difficult to get all branches of the work efficiently carried out,
while if it rose much above, the division of work soon became

General Hospitals in France. 173^

artificial, so that whereas some Avei^ overworked others had
but little to do. The arrangement of work is, of course, muohl
easier in a uniform hutted hospital. The busier the hospital was,
the fewer were the medical ofiicers available. This was owing
to the fact that g-eneral hospitals were continually called upon
to furnish i-einforoements for front line units. The lowest num-
ber ever i-eached was eight during the first battle of tlie iSomme.
As this number included pathologist, radiographer, ophthalmic
surgeon, i-egistrar, and mental expert, it is obvious that, with!
convoys aniving daily, it was impossible to carry out the work
satisfactorily. From that time until ih.Q signing of the armistice-
there wei-e not sufiicient R.A.M.C. ofiicers available for the
efficient t<taffing of the hospitals, the deficiency being lessened
by officers supplied by American and Canadian units which, as
a rule, were provided M'ith larger staffs than the British. From
the summer of 1916 I suppose about one-third of the officers
attached to No. 3 belong-ed to the C.A.M.C. or the U.S.A..
Medical Corps. Xeedless to say, during times of pressure, the
pathologist, mental specialist, ophthalmic surgeon and radio-
grapher had to take cliarg-e of surgical wards in addition to
their own special work. A quite false idea of the number of
officei-s was sometimes given owing to the fact that medical officers
admitted to hospital as patients wei-e, on discharge, attached
to the strength of the hospital before returning to their units.
The^o officers remained, perliaps, for a day, or perhaps for so
long as ii week, but as it naturally takes some little time for
anyone to beeome acquainted witli their duties, especially when,
as was g-enerally the cajse, these wei*e regimental medical officers
who had liad no exi>erience of the work of general hospitals, it
will be seen that it was not much good putting them in charge
of wards. Many of them, however, did admii-able work as an-
nesthetists. As a matter of fact, the continual rearrangement of
work which was necessary during strenuous times was very
trying. It is no exaggieration to say that eveiy other day some
change was required which was very trying to the officers and
not conducive to the interests of the patients or tlie work of tlie

174 Some Experiences of the Work of

hospital. Similar, and even more frequent clianges took place
among- the sisters and jmrses.

Of course, a certain amount of changing- and transferring of
medical officers and sisters Avas absolutely necessary, but one
camitjt help thinking that these might have been less fi-equent.
It must be remembered that quite apart from strictly speaking
medical and surgical work, there Avas a great deal of routine
duty for ward medical officers. The days for duty as Orderly
^Medical Officer and Garrison Field Officer soon came i-ound, and,
in addition, there was a gi-eat deal of clerical work in\olved in
tilling up field medical cards, index cards, diet sheets, case
sheets, ship's labels, and very probably other returns, not to
mention the routine giving of anti-tetanic sermn and days for
anaesthetic Iduty. In busA^ times it was no unusual thing- for a
^Medical Officer to have as many as 100 patients pass through
his hands in addition t;0 operations and dressings, so that the
extent of these duties can be understood, as AAell as the diffi-
culty of keeping the routine work of a Avard up to date AA-hen the
Medical Officer had to be changed eA-ery feAv days.

The number of ambulance ti-ains arriving A^aried very con-
siderably. When little or no fighting AA^as in progress there
might bfe only one or tAAO per AAeek, Avhile during 'times o^
pressure there might be four or five or more in a day. The
trains accommodated from 400 to 550 or more patients. There
Avere four hospitals in the camp, and each train AA^as, as far as
possible, divided betAveen tAAO of them, so that each took from
alternate 'convoys. This, of course, did not apply to tlie special
eases, these being sent from CA^ery train to the appropriate
hospital. Thus, as a rule, there Avould arriA-e from one train a
large number of men, say about 250, and from the next a small
number of cases belonging to the groups mentioned above, say
'SO or 40. When, hoAAever, the hospitals Avere-A^ery full it was
often necessary to make use of Avhatever accommodation Avas
available at all the hospitals.

A couA'Oy consisted of "cot" cases and "sitting" cases. As
a general rule the former Avere the moi^ severe, but not alwaA's

General Hospitals in France. 175

to. Occasionally lig-lit cases Avere conveyed as " cot " cases in
order to make use of the whole of the accommodation on the
train. Not infrequently, too, unexpectedly severe wounds were
found among the sitting oases. As an example of this we
received one motor convoy of 500 sitting cases from Albert
during the first battle of the Somme among which were no
less than 20 cases of depressed fracture or penetrating womids
uf the head.

The details of the admission of a convoy naturally varied to
a certain extent in different hospitals. At No. 3 the arrange-
ment was that large convoys should be admitted by the Officers -
in-charge of the medical and surgical divisions, while the small
convoys from alternate trains should be admitted by the Orderly
Medical Officer. As convoys generally arrived between the
hours of midnight and 5 a.m., this was often rather trying,
especially when trains were arriving nightly or at more fre-
quent intervals, for an undisturbed night in bed was then an
unusual luxury. There were, however, many advantages iu
this plan which more than compensated for the inconvenience.
For instance, one knew from one's own observation the g-eneral
character of the convo}-; whetlier composed chiefly of "sick"
-^•r wounded; whether the latter were septic or in a satisfactory
condition; the proportion of severe cases, and the probable
luunber which Mould require operation. Also one knew tlie
wards to which the severe ca.ses Avere sent and also could arrange
that any particular cases were seiit under the cai'e of medical
officei's who were specially interested in them. In this way a
considerable lamount of work was saved on the following day
which could be devoted to operating and seeing the serious
cases.

All particulates of the patients were taken by the clerks in
the reception hall, and the average time for tlie admissiou of a
'•onvoy was about two houl^s, even when the number admitted
was four or five hundred.

Before having any experience of the arrival of a convoy of
wounded men one would have expected that immediately after

176 Some Experiences of the Work of

admission Ithere would have been a larg^e number who would
have required operation at once. As a matter of fact, how-
ever, one found that what most of the men required after their
experiences was a rest in bed, and hence, except for changing
soiled dressings, re-adjusting splints, and giving hot drinks,,
and otherwise attending to their comfort, they were given a
few hours' rest befoi'e investigating* the wounds and commenc-
ing treatment on the following morning. The only cases ope-
rated upon at once were those w^here there was haemorrliage or
some other really urgent condition.

As feoon as a convoy had been received and the patients had
been examined, the probable dispasal of the ea^es had to be
considered, for the cry, especially during times of j)ressure,.
was always for beds — more beds. Generally speaking, slightly
wounded anen, w^ho after a short period of treatment would be
fit for return to duty or for transfer to the convalescent depot,
were kept and treated; severe cases and those requiring ope-
ration were kept and treated until they were fit to travel and
then 'marked up for evacuation; other cases who would not
soon be rendered fit for return to duty and who were fit to
travel were put on the " England roll " at once. The correct
and rapid disposal of patients "was of the g-reatest importia,nce,
and 'unless carefully attended to resulted in the accommodation
of the hospital not being j)ut to its best use. It naturally took
a Medical Officer unacquainted with the work of a general hos-
pital some little time to fully grasp the importance of this, and
it also required some experience to know the correct method of
dealing- with the great variety of wounds and diseases under
his icare. This was one of the reasons why frequent change
of toiedical oflSoers was so trying, especially when the pressure-
on the hospital accommodation was severe. In order to meet
this difficulty, at ihe sugg'estion of Lieut. -Col. S. H. Fairrie,
K.A.M.C., the Commanding Officer, we drew up a series of
" Instructions to be followed in the selection of cases for Eva-
cuation," founded upon the various general and local orders in
force. A copy of these instructions, which were first issued in

General Hospitals in France. 177

1915 and subsequently revised on .several occasions to bring- it
up to date, was given to every Medical Officier on first joining
the Unit in order that he might at once make himself familiar
with the system. The following extract from these instructions
will give some idea of the method adopted and of the safe-
guards to prevent severe cases being* transferred before they
wei-e fit to travel, and to eiisiu^ that whenever possible slight
cases should be sent back to duty without midue delay : —

No. 3 General Hospital. Procedure in the Selection or Cases

FOR Evacuation.

The following instructions are to be regarded as a general guide to
the disposal of patients on. 'discharge from this hospital. Modifications
or alterations may be introduced from time to time depending upon
the pressure on the hospital accommodation and the military situation;
such alterations will cancel or inodlfy any of the instructions given
below.

Selection of Cases for Evacuation to England." — Under ordinary con-
ditions cases wiU be proposed for evacuation to England if they are
not likely to be convalescent in, say, three weeks. During active
operations in the field and pressure on the hospital accommodation
this period may have tpf be shortened or the cases otherwise disposed
of. On the other hand, when the pressure is less, the period may be
extended. However, in any case, slight cases should not be proposed
for evacuation, but sho:uld be accommodiated in tents, or transferred
to the convalescent depot, whenei, during times of pressure, the treat-
ment of mild cases may !>€ undertaken. Cases for evacuation are
divided into the following groups, which should be indicated by writ-
ing the appropriate abbreviation on the index card of the patient
when fit to travel.

" Eng. xi." Mesa who reqfuire special attention and accommodation
during the journey. Only the most serious cases, such as wounds of
the spine, serious heaid wounds, compofund fractures of the thigh or
leg, and those recovering from! serious illnesses should be so marked.

" Eng. B." Men who are doing well and do not require special
attention but who require to be transported lying down. Men, how-
ever, in this class should not be absolutely helpless, but in case of an
emergency on the hospital ship ishoiuljd be able to walk upstairs or
to a boat with assistance.

"Eng. B. Helpless." Similar cases to the above, but who would be
unable to help themselives in an emergency. Cases of severe wounds
of the leg, especially those wearing splints, and cases of fracture
of the arm with the limb abducted, will be included in this group.

PART III. M

178 Siome Experiences of fhe Worh of

•• Eng. C." Men who can walk tolerably well, but for whom it is
desirable that lying down accommodation should be provided during
transit.

"Eng. D." Men who are able to walk, and who require only sitting
accommodation on hospital tra;ins and ships.

Doubtful cases should not be marked for England until the Officer
in charge of the Division has been consulted. Cases dangerously ill
must not be proposed for evacuation, but cases on the serously ill ilist
may be proposed and transferred as such. Kecent cases of gun shot
wounds of the skull or brain, wounds of the chest involving the intra-
thoracic organs, or of penetrating wounds of the abdomen should
not be proposed. Cases of acutely septic wounds, or those with in-
sufficient drainage or those thought liable to secondary haemorrhage
should on no account be proposed. Metal fragments should, as a
rule, be removed before evacuation is proposed, but when, on account
of small size, inaccessibility, or for any other reason, this has not
been done the fact should be recorded both on the index caxd and
the field medical card. Cases of compound fracture should be kept
until the condition of the wound is satisfactory, pyrexia has subsided,
and the danger of secondary haemorrhage has passed.

Cases of acute illness, those showing serious pyrexia, cases suffer-
ing from complications which have not cleared up, cases in which
there is any suspicion of infectious disease, \will on no account {be
proposed for evacuation.

The index cards of patients proposed for evacuation to Englami,
together with the field medical cards, will be submitted to the Officer
in charge of the division for his initial and approval. All cases able
to walk attend first at the office of the division and afterwards at
the C.O.'s office for inspection and final approval before being included
on the England roll. All " Eng. C " cases who are up and (about
should attend at th^ Divisional and the C.O.'s offices. Personal ex-
planations should always be made when asking sanction for the
evacuation of special or doubtful cases.

In the event of any relapse or of any complication arising after
evacuation has been sanctioned, such proposal must be cancelled and
notice sent to the C.O.'s office in order that the name may b©
lemoved from the England roll.

Before evacuation the M.O. in charge of the case must see that
the ship's label and any special ones requiired are duly fiUed up,
signed, and attached to the patient.

Disposal of cases in France. — The attention of Officers is directed
to the important fact that slight cases of sickness or of wounds
should not be evacuated to England. Every effort should be made
to render these men fit and to discharge them either to the conva-
lescent depot, or to their Base Depot for duty. Cases who will not
be benefited by a period at the convalescent depot, and, though not

General Hospitals hi France. 179

fit for duty at the front, are able to carry out duties on the, Lmes
of Communication ar at the base, may be sent to the Base for a.
medical board with a view to their being given Base duties either
temporarily or permanently. Cards of patients for Base or Conva-
lescent Depot must be completed and signed, and the men parade
at the Divisional and the C.O.'s offices as in the case of men fjfxc.
evacuation.

For the Convalescent Camp (marked " C.C."). — Only cases which
ai-e expected to improve fairly rapidly and become fit for duty in
a month or less should be sent to the convalescent camp. Men thus
disposed of must be able to wear boots and to walk tolerably well,
and to take ordinary diet. Helpless cases must not be sent, and ^tihe
men must be able to dress and to attend to themselves. Men who
are wearing splints (except finger splints), those who require fomen-
tations or who have deep or septic wounds, or where removable metal
fragments are still present, are not suitable. Dight dressings are
undertaken at the convalescent camp, but the wounds should be such
as may be expected to heal quickly. Perforating 'wounds of the leg
should not be sent until healed on account of the liability of these
to become septic raid for inguinal adenitis to develop.

Local admissions, when fit, should be marked " Duty," and are re-
turned direct to their units.

Men other than Local Admissions who are fit to return to duty are
to be marked " Base A." Such must require neither dressings or

treatment.

Men who, owing to age or to some chronic disability not amenable
to treatment, are not fit for duty at the front are to be marked
" Base for Med. Board." Many cases of varicose veins, chronic knee
troubles, and deformities of the feet which interfere with matching are
examples of this type of case.

The clLsposal of officers Avas on exacth' similar lines. The
disposal of German prisoners varied from time to time, but
generally speaking' slightly wounded men Avei-e treated imtil
they could be sent to the Prisoners of War Base Depot, whence
they were transferred to Prisouei-s of War working companies.
Severely wounded cases were transferred as soon as fit to travel
to hospitals in England.

The method of disposal of soldiei-s of the various Allied armies,
and of special cases, such as mental ca.ses, eases of self-inflicted
wounds, infectious diseases, and venereal disease were also
iriven .

180 SonH' Experiences of the Wor/r of

It was also felt desirable to include in these instruotioas some
indication of tlio lines on Avliich certain very common diseases,
such as licrniu, varicose \'eins, varicocele, ap[)endicitis, syno-
vitis of the knee, piles, boils, " I.C.T.," etc., should be treated
as well as their subsequent disposal.

It lias already been pointed out (that when tliere was a
continued, presising, and iirg^ent demand for beds the only way
of providing" the required accommodation was to shorten the
dumtion of the stay of patients in hospital by transferring^
serious cases to home hospitals as soon as fit to travel and by
sending the slighter cases either to convalescent camps, to other
hospitals in France, or by evacuating them to England. We
have also seen that an important function of a general hospital
was to return as many men as possible directly to duty witli
their units. It v^i\l readily be understood that this latter func-
tion was of less importance in times of severe i)i^'6ssure thatn
the adequate supply of beds. With a view to co-ordinating tlie
accommodation of the hospital with the demands likely to be
made upon it, I drew up a series of " Scales of Evacuation."
These were four in number, and Avere as follows : —

Scale A. — Keep hospital as clear as possible. Severe cases requir-
ing operatioh to be operated upon, and to be proposed for evacua-
tion as soon as possible. Other severe casas, if fit to travel, to ba
marked for evacuation at once.* Only cases not fit to travel to be kept
and treated, and these to be evacuated as soon a& fit. Light cases to
be transferred to Convalescent Camp in, say, three or four days otr
less. If likely to be quickly fit for duty these cases may be perhaps
kept for a few days longer, but it may be necessaiy to transfer at
short notice all light cases to the United Kingdom, or, if the arrange-

*In times of pressure it was often imperative to evacuate many
serious cases. Every care was taken to avoid transferring those who
might be adversely- affected by the jarring and jolting inseparable from
transport on motor ambulances, trains and ships. As full notes as
possible were provided for the information of Medical Officers in
charge of these patients en route. Of course, a certain additional
amount of risk was unavoidable, but the rarity with which one heard
of any harm happening to these men speaks volumes for the care
and attention they received on hospital trains and ships. It was often
mucli safer to transfer recently wounded men at an early stage, say
after two-four days than after ten-fourteen days when, for instance,,
secondary htemorrbage was more likelv to occur.

General Hospitals in France. 181

ments can be made, to hospitals in other areas in Frauce. No opera-
tions to be performed on hernias or other " sick " cases unless urgently
lequired. These cases should be proposed at once for transfer to
the Convalescent Depot, or to other hospitals, or for home hospitalsi

Scale B. — Severe cases iiro to be disposed of as in Scale " A," but
a slightly longer stay in hospital is allowed, especially for cases who
have been operated upon in this hospital or wlio have had a seveite
operation at a Casualty Clearing Station. Light cases may be kept
and treated up to ten days if they will then be fit for convaleiscent:
depot or for duty. If not considered likely to be fit in this time they
should at once be proposed for evacuation. Every effort is to be miade
to keep really light cases in France, and if possible arrangements will
be made for transfer of light cases to hospitals in less congested areas.
•' Sick " cases will not be operated upon except for urgent symp-
toms, but should be disposed of as in Scale " A."

Scale C. — Severe cases, whether requiring operation or not, to be
kept until sepsis has subsided, the danger of secondary lij^morrhage
has passed, and the general and local conditions are satisfattory-
Light cases who will be fit for duty or for convalescent depot in,,
say, three weeks to be kept and treated here. Light cases which will
require a longer period of treatment and convalescence to be proposed
for evacuation to the United Kingdom as soon as it is certain that
they will not be fit for duty or convalescent depot in this time, but
every effort is to be made to kesp light cases in France. Suitable cases
of hernia, varicocele, and other " sick " cases, who will be fit for duty
after about three weeks in hospital and three weeks in convalescent
depot, may be operated upon. Such cases requiring a longer period
of treatment and convalescence should be proposed for transfer to
special hospitals or to the United Kingdom.

Scale D. — As few cases as possible of any description to be evacua-
ted. Only those who will be permanent invalids, or who will require
a long period of convalescence to be proposed for evacuation to the
United Kingdom. All light cases to be kept and treated until fit for
duty or the convalescent depot. " Sicfc " cases fi-eqiiiring opei-atiou
to be kept and treated here provided that in a reasonable . time they
will be " Class A " men or will be better able to carry out the duties
upon which they were formerly employed.

Of these " Scales," Scale " C " may he taken as the one in
general use and was fully explained in the " Procedure in the
Selection of VCases for Evacuation." In the t^piing, summer, and
autiunn Scales " A " and '' B " wei-e frequently neoes-sary.
Scale " D " ^vas seldom required, hut was occa**ionally in force
in the winter time as well as on two or three occasions after
ci'oss-channel hospital ships had heen attacked or sunk.

182 Some Experiences of the Work of

General Hospitals in France.

The chief difficulty was that often, OAving to inexpKcit or
contradictory instructions, one was uncertain as to which scale
should be put in force. In order to remedy this I made a sug--
gestion, which was not adopted, but which, as I think it would
have tmado this important part of our Avork much simpler and
easier, I repeat here. It was that these, or similar "scales"
should be officially recognised so that, when the occasion de-
manded, insti'uctions should be definitely issued to the various
hospitals as to the scale of evacuation necessary to meet the
situation. During periods of severe fighting one often found
that whereas the hospitals in one area might be extremely
congested, those in another area might have but little to do.
Under these circumstances the hospitals in the first area might
have instructions to evacuate according to Scale " A " while
in the second area they might be ordered to evacuate according
to S<3ale " C." At the end of the period of pressure the first
area bnight have definite instructions to revert to Scale " C "
while, if pressure was anticipated in the second area, they might
be 'warned to change their Scale to "A" or " B." As it was
the termination of a period of pressure often had to be deduced
by the arrival of a letter complaining that cases of too slight
a kind were being sent to England, or that cases of too severe
a kind were being transferred to the convalescent depot.

I had hoped that it might be possible to have given sojme
account of the clinical work of the hospital, the kind of cases
which had to be treated, the means of dealing with them, and
the results of treatment, but even a brief account would take
a great deal of space which is not at my disposal. I hope,
however, that the outline I have given of the work of a
general hospital in France will give some idea of the nature of
the work as -w-ell as the methods of dealing with some of the
problems of militarv suro^erv.

MESOPOTAMIA, 1916-1919,

E. DAVIES-COLLEY, C.M.G., M.Ch.

The Editors of the "Guy's Hospital Reports" have insisted
that theii- War Memorial Nuimber cannot be complete without
a history' of the surgical work of the Mesopotamian Campaign,
and that is my only excuse for attempting to compress into the
following" short account the cliief impressions, w^hich a three
years' sojourn with the army on the banks of the Tigris'- have
left with. me. If I have been able to set dowm little or nothing'
that can be called an addition to our knowledge of surgery, it
i^ because we were, sui-gically at least, a very healthy force,
and the available material, except in one or two directions,
was scanty; or perhaps it may be that the lethargy of tlie East
prevented us from making the best use of the opportunities
that were given to us for the study of djisease. It is certainly
true that much of our time was passed in idleness, but that is
one of the necessary evils of service in a war ai'ea, and I fail
to see how it can ever be overcome.

I have said little about tJie surgery of wounds, because so
many excellent papers, dealing with every type of wound in.
France and elsewhei*e, have been pubUshedy that it seemed to
me superfluous to swell their number with conclusions based
on the relatively small nimiber of cases which we dealt with
in this campaign. So I have confined myself to a few pointe
ill which the wounds in Mesopotamia differed more or less
strilcingly from those in Europe.

The dreary monotony of the ti*ench warfare in France throug-h-
out 1915 induced many besides myself to jump at the oppor-

184 Mesopotamia, ] 916— 1910.

tunity of joining: the Indian divisions, wJiich were transferred
to the East at the end of that year. I sailed from Marseilles
with the fag end of the Lahore division early in December,
and we wei'e dodging submarines in the ^lediterranean when
the first news of the retreat from Ctesiphon reached us; feo
that any hopes, with which we may liave started, of a victorioui-^
entry into Baghdad were dispelled long before we landed in
Basra on January I9th, 1916. I doubt if any of us, however,
expected things to be as bad as we actually found them. Every-
thing was at its worst. The casualties from the miserabl<3
efforts to relieve the force locked up in Kut were heavy, and
the medical arrang-ements for dealing Avith them were hope-
lessly inadequate. I was in France diu-ing the first battle of
Ypres, and had seen something of the effects of an ill-equipped
medical service, short of supplies and jDersonnel ; but tlie
knowledge which had been gained during- the first year's
fighting in France had apparentfy not reached the lofty mind
of Simla. The Government of India., I have heard it said,
is capable of thinking only in terms of gTains of rice, and
any action is, or was before the war, determined by prece-
dent. No precedent existed for the enormous casualties of
this war, so no j) reparations could be made for them. It was
quite simple. And the answer to the incessant demands of
the army struggling in the Tigris mud was, " Not available;
carry on."

It was fortunate that the gas gangrene and tetanus, which
pla3-ed such havoc with the Avounds in Europe, were practically
unknown here. If they had been added to the horrors of the
campaign at this stage the mortality of our wounded would
have been colossal. It was quite a common thing for a man
to arrive in Basra in these days with sup23urating- wouaids
covered by the first field dressing, wMeh had been applied
sometimes as much as a fortnight or even three weeks before.
Even if there had been an adequate supply of dressings on
the river boats, it would have been quite impossible for the

Mesopotamia, 1916—1919. 185

medical officer in charge to attend pro])erly to tlie dressingis
of his patients. How oould he, with his meagre staff of or-
derlies? He was usually busy from morning to night doling
out food supplies, which Ave re short like everything- else. A'
very large proportion of the patients, too, had dysentery, which!
enormously increased his work.

It would be difficult to conceive of anything more uncomfbrt-
able than the river transports, which plied between Basra and
Sheikh Saad at the beginning of 1916. There wei'e no beds,
and the sick and womided were laid in rows upon thei decks
with, as a rule, nothing but a blanket or a thin quilt to s.eparate
tliem from the boards, and so crowded tog-ether that it was
almost impossible to pick one's way between them. Soaked
by the frequent storms of rain, from which the deck awning-s
afforded only a very scanty protection, and chilled to the marrow
loy the bitter winds, which blew continuously from the snows
of the Caucasus and Pusht-i-kuh, it was a constant source of
wonder to me that the men did not all develop pneimio-nia.
As a matter of fact, I hardly saw a case of it among the
Avounded. all the time I was in the country.

The 'hospitals were only a little better than tlie boats. About
half the patients were housed in solid brick buildings; the i-est
were in tents and huts, which Avere draughty to the last degree
and by no means rain-proof, and the patients in them lay ou
sti^etchers or bed-boards, which raised tliera only a few inches
from the Avet ground. T^e supply of bedding Avas miserable^
and the staffs of medical offic-ers and orderlies Avere less than
half strength. As for the equipment of tlie operating theati-es,
those Avho have liad to opemte Avith tlie flimsy tooN ])ixivided
in the regulation surgical instrument cases knoAv the difficulty
of the task; and feAv of the hospitals had anything else. Splints
Avere almost unobtainable in the forwaixl ai*ea, Avheix) eA'eiy
available piece of Avood Avas needed for firing, and fractui>e8 used
to be sent doAvn with scarcely any support. Even in Amara
and Basra imagination did not soar above a long Liston fioT

186 Mesopotamia, 1916—1919.

a fractured fomur, and I believe tliat some Tiliomas's knee
splints, which I had made for me in the Bazaar at Amara,
were the first to be used in the country, though they had been
in routine use in France for more than a year.

Such Mas the state of affairs at the beginning of 1916, and
so it remained, with but little improvement, until the fall of
Kut in A23ril put an end to the fighting. The surgery during
these months was necessarily of a rough and ready description^
but the cases did not do badly on the whole. Tlie vast ma-
jority were fortunately bullet or shrapnel wounds, and their
most striking feature was their comparative freedom from in-
fection. I have said tJiat gas gangrene and tetanas were
almost unknown. With the arrival of divisions from France
at the end of 1915 and the beginning of 1916 a few^ cases of
gas g-angrene began to appear, and I think that the victims
must have brought the infection with them in their clothes,,
for I never heard of a case occurring in a man who had come
straight to Mesopotamia from India, and I do not believe the
organisms are endemic in the country. They are scarcely likely
to be in one where cultivation is so scanty and the soil is never
treated Avitli manure. A few cases of tetanus occurred later on,
chiefly among the Turkish prisoners, but routine injections of
anti-tetanic serum were never really needed.

Tihe arrival of nursing sisters was the first step towards com-
fort and better management in the hospitals, and I should'
nke here to pay a tribute to those brave pioneers of the ISTurs^
ing Service, who did so much by their untiring energy^ to alle-
viate the sufferings of the sick and wounded at a time when
tilings were going so badly Tiheir mere presence in the wards
gave a sense of comfort, which only a man, who has not seen
a white woman's faoe for many months, can appreciate, and
their constant supervision of the orderlies' work made a dif-
ference, Avhich was obvious from the moment that they took
charg-e of the wards.

Mempoiamia, 191(J— 1019. 187

Witli tlio fall of Kilt and tlie advent of the hot weather
siu'g-ery came practically to an end, and gave place to dysen-
tery, para-typhoid and cholera, which filled the hospitals to
overfloAving- throug'hoiit the summer montlis. T(his was the iaos>t
depressing- period of the campaig-n, and we were reaping* witlil
a vengeance the fruits of the mismanagement of the previous
year, I can only speak with personal knowledge of Amara
at this time, but conditions at Basra were much the same, and
those at Sheikh Saad were infinitely woi-se. In the winter we
lacked the means of keeping warm, and now^ in the summer we
had nothing wherewith to oombat the heat; and the high rateof
mortality in the epidemic of para- typhoid, which raged througii
the four hot months, was directly due to this fact. There was
an old native ice -factory in Amara, which was capable, when in
working order, of turning out about 700 pounds of ice a day,
but 700 pounds of ice do not go far among 6,000 patientef,
and the supply was usually exhausted Avell before the hottest
part of the day. There were no fans, and anyone with a high
temperature ran a grave risk of heat-stroke. It is i-emarkable
tliat among the (thousands of cases of typhoid and para-typhoid
that passed through our hands during those months there was,
as far as I can remember, only one case of perforation. The
explanation is that the severe cases, who would have been the
most likely to perforate, usually succumbed to the effects of
heat within the first week or ten da.^^ of tthe disease, before per-
foration Qould be expected to occur. Sir Victor Horsley's death
was an example of the tragic termination of pai*at\"phoid, so
common at this time. He came into hospital on July loth,
having had for two days a slight p^^rexia, which had not pre-
vented him fixwn leading his usual energetic Hfe. It so hap-
pened that that night was the hottest of the year, tlie tliermo-
meter on the ihospital balcony standing at 105° at midnight, and
by the following morning Sir Victor liad all the symptoms of
heat-stroke, from which he died towards the end of the day.

But depressing though the conditions were in the summer of
1916, there was now at last some hope of better things. The

188 Mempoiamia, ]i)](>— 1})]9.

War Ottice had .superseded Simla in the inanag-ement of tlio
campaign, and a new Medical Headquarter's Staff, who had
had experience of the fighting in France, had arrived upon the
scene, and were re -organising the medical service in the country;
drafts of medical offi eel's were pouring in, and the parcimonioiLs
policy to which we had become so used was now giving place
to extravagant expenditure.

At the end of July I was invalided to India with pava-*
typhoid, and when I returned to Mesopotamia in January,
1917, exactly a year after my first landing there, the transition
stage had been completed. Tfhe development of a new country
is a fascinating studj^, full of surprises, and I could not have
believed it passible that the few months of my absence could
have brought about so complete a transformation. Basra had
now all the appearance of a busy, up-to-date port, with several
miles of solidly constructed wharves along the river bank, on
which swarm.s of coolies were at work, and the broad reach of
the Shatt-el-Arab was as full as the Pool of London ^vith a
heterog-eneous collection of shipping, which included tyj)es rang-
ing from Sinbad's Mahailah to the most modern liner. River
steamers from almost every navigable stream in the world
seemed to have found their way there, and even the penny
steamers from the Tliames had been pressed into the service,
and in their new coats of Navy grey looked as much at home
in the muddy waters of the Tigris as they ever did off the Old
Swan Pier. Amara had become a busy hospital centre with
some 6,500 beds, besides tAvo large convalescent depots;, and
all were housed in good buildings. Ttlie hospital staffs and
equipment were sufficient, and the medical stores depots were
well stocked with dressings, splints and surgical instruments.
Above all, electric light had been installed, and the buildings
were all supplied with fans. The whole atmosphere was
diffei'ent; the dejection of the previous year had vanished,
altog-ether, and the spirits of the men were rising wdth the
rapidly developing success of the new oft'ensiv^e at Kut.

Mesopotamia, J 916— 1919. 18»

From February 1st, when I first took up inv duties las-
Consultin<^ Surgeon. Juntil the (end of May, when the hot ^veather
again put an end to the fighting, we were kept constantly occu-
pied, and it woukl be well to consider here wliat were the lessons^
that our experience of- the treatment of wounds taught us.
It must be remembered that Amara was situated some 150 miles
from the figliting* zone in tlie early stages of the offensive,,
and a great deal moi-e as the army advanced, so tliat it was
exceptional for us to see cases within less than four or five
days after the wounds liad occurred, and we had no opportunities
for earl}' excision, as practised so widely in the latter part
of the war in Europe. Bj- tJie time we saAv them our cases;
were usually either already in a healing state or suppurating*
freely.

The two chief problems ^\hicli Me had to face were tJie-
treatment of sepsis and of fractures, especially from ih^ point
of view of transport. I have already mentioned the compai'a-
tive freedom from infection of the wounds in the earlier fight-
ing round Kut; but in the new offensive, which began in the
autumn of 1916 and ended ^\ith the capture of Samarra in
May, 1917, there was a CK)nsideral)le increase in the proportion
of infected wounds, though they never became the rule. Tfliis
increase was due to several reasons, of which the two most
important were the relatively higher percentage of shell and
l)omb wounds, and the larger proportion of ground under cul-
tivation as the fighting drew nearer to Baghdad.

The one essential in the treatment of sepsis was, of course,,
as it always will be, the provision of adequate drainag-e, and the
skill of a suigical specialist could be measured fairly accu-
rately by the number of secondary h£emoiThag>es in his A\ards.
I have often heard men recounting cases of secondary hivmorr-
hage as tliough they were a question of luck. They are not
a question of luck, but simply one of bad surgery, and they
do not occiu' if no pockets of pus are left uudrained around
the larsre vessels.

aOO Mesopofawht. HMO— ID] 9.

The most satisfactory antiseptic for all purposes wa« un-
doubtedly eusol, and various modifications of the Carrel-Dakin
method of flushino- the wounds Avith it were used with excellent
i-esults. It haiS the disadvantage that bleaching- powder will
not keep in a hot climate, and supplies must be constantly
renewed or the eusol solution tends to become too weak for
efficient action. I also found bismuth and iodoform paste a
most useful dressing-, especially for badly comminuted fractures,
where it saved the patients from much painful manipulation of
the wounds. It is particularly usieful when the eases have to
be transported for long- distances and anything which simplifies
the dressings is of the greatest value. I never saw a case of
bismuth or iodoform poisoning follow its use.

Lack of space forbids me to i-efer to fractures in any but
the briefest terms. For the treatment of fractured femurs I
have yet to see any form of splint to equal a Hodgen. In my
experience it is more comfortable and more easy for nursing-
than a slung Tiliomas, and its one disadvantage is that it must
be changed for a T!liomas when the patient is moved to another
hospital. The many elaborate and highly ingenious contri-
vances for slinging- limbs which I saw in France in the early
days of the War were, to my mind, quite unnecessary aaid
merely a waste of time and labour. In any case they were an
impossibility in a country like Mesopotamia, where w^ood was
60 scarce. Our experience of fractures of the other large bones
was much the same as in other theatres of the War, and needs
no special mention. The diflSculty of their transport was, as
I have said, our main problem, and it Avas a very real difficulty
in the case of Indians. Indians seem to have a diaboHcal
knack of wriggling out of their splints, and in the case of
fractured forearms, for instance, if one finger Avere left free you
could be perfectly certain that, before an hour was out, tlio
splint would liaA^e slid out of place.

Wounds of the knee-joint Avere A^ery rarely septic, owing
probably to the fact that the men fought ahnost alAA^ays in shorts,

Mesopotamia, 1916—1919. 191

and there was little likelihood of pieces of clothing*, etc., being-
carried in by the missile. It is impossible to form any very
definite opinion on the few oases of suppiu*a,ting- joints that wei^
ti-eated in the Amara hospitals, except that, as it was found
elsewhere, the insertion of drainag-e tubes into the cavities of
joints gave the woi^t possible I'esidts. THie main difficulty, I
think, was to decide when the condition of the joint was so
hopeless that the limb must be sacrificed, and I am quite certain
that in most eases amputation was ^xnt off longer tlian it should
have been. * !

Abdomen, thorax, and head wounds came very little our way
in their early stages. T(lie shifting nature of the fighting made
abdominal surg-ery practically hopeless, and only a very few
cases survived to reach Amara. At one time we considered the
advisability of providing special units for their treatment close
to the Fix)nt, but came to the conclusion that it was useless to
make the attempt, and I do not tliink that with a rapidly ad-
vancing force it would ever be practicable. In the early days,
when the fighting w^as stationary round Kut, the medical ar-
rang-ements were in too chaotic a condition even to think of it.

The Mesopotamian Campaign was unique in having water
as its only means of transport — at least it was the onl}'^ means
tmtil railways were laid between Basra and Amara and between
Kut and Baghdad, and, as far as the sick and wounded were

uncerned, it was always the principal means — and we had ample
opportunity of judging what was the best type of vessel for
ilie purpose. I have no hesitation in saying that the elaborately
titted hospital ships, which made their appearance on die Tigris
in 1917 and 1918 were simply a waste of money, except in ko

ar as tliey may have served to allay the misgivings 'of tlie
public at home. Tliey were certainly not the most comfortablo
type of vessel for a sick man to travel in, and some of them
were so hopelessly incompetent to deal with the swift current
of the river that they were never even used. Tllie large paddle
steamer of the type tliat ^va3 built for the Tigris in 1916 —

192 Mesopotamia, 191G— 1919.

the P.-S. 50-cIa«a, in Mesopotamian terminology — Avas far tlie
best. On the wide upi^er decks of these boats tliere was ac-
commodation for an enormous nimiber of patients who could be
made perfectly oomfoi-table either on trestle-beds or on mat-^
tresses laid on the decks. They oould also be used for tJie
transport of troops uj) the river, and so were fully employed on
both journeys. Fixed cots occupy so much room that much space
is bound to be wasted, and the cots of the upper tier are sc^
near the deck awning-, that the heat is apt to be well-nigh in-
tolerable in the hot weather. The loading and unloading, too,
especially of fracture cases, is always an awkward basiness, and
sometimes dangerous.

The actions of May, 1917, proved to be tlie last iseriou^
fighting of the campaigii, and for the remaining two years
of my stay in the oountiy the surgery was almost entirely] of
a non-military character. T^o diseases stand out as being
particularly worthy of mention, because, tliough not peculiar
to Mesopotamia, they are diseases of tropical countries, and
they formed between them a very large percentage of the total
admissions to hospital: I mean Baghdad Boil and Dysentery.

Baghdad Boil, or Oriental 3ore, is produced by the inoculation
of Leishmania Orientalis, and the bites of various insects have
been held responsible for the infection. I see no reason to-
doubt that, at any rate in/a large number of cases, tan insect bite
is the active agent, tliough whetJier any particular insect is the
guilty one has yet to be discovered. But an insect bite is not
the only cause. I can I'emember two cases in w^hich typical
ulcers containing the protozoa followed euts on the fingers, and
I think it is quite Hkeh^ that many 'are (caused by scratches from
thorns, etc. The well-known liability to infection of exposed
parts of the body would fit in just as well with this theory. I
think also that the cases of multiple sores on the trunk, whiclt
one occasionally sees, may be the result of inoctilation of patchei*
of "prickly heat" from the clothes.

Mesopotamia, 1916—1919. 193

The troatment of Baghdad boil was tlie subject of manv a
heated discussion, and tlie methods in use were almost as
numerous as the hospitals in tlie countr}'. Intravenous injection
of tartar emetic had a- great vogue at one time, but it had
little effect except in the dry, non- ulcerating fype of case.
When there was an open sore it was useless. Tlie best residts
that I saw Avere obtained by the local application of an ointment
containing o per cent, of antimonium tartrate for four days
followed by boracic fomentations. In a series of thirty cases
treated in this Avay at one hospital cure was complete in an
average period of "thirteen days, which was very much less than
T\'a> achieved by any other method that I saw used.

The surgical aspect of dysentery was confined mosth* to tbe
ti-eatment of amoebic abscess of the liver. I have little to add
to the text-book descriptions of this disease, but one or two
impi-essions that I formed may be worth recording. One was
the gTeat value of X-rays in the diagnosis of abscess. Of all
the cases Mhich I saw examined by X-rays, not one, in which
pus was afterwards found, failed to show limitation of move-
ment or complete fixation of the right cux)ola of the diaphragm,
and when, unconvinced by the X-ray demonstration of a freely-
moving right cupola, I needled the liver for. pas, I never once
found any. In this connection I might mention that in several
instances, in which thorouo:h needling: of the liver failed to
show pus, the symptoms of liei)atitis rajjidly subsided after the
operation, and apparently as the result of it, so that my efforts
to find an abscess were not altogether wasted. In the treatment
of hepatic abscess, open drainage appeared to give the best
results. Aspiration in my hands was disappointing, and almost
always liad to be followed by the open operation. Perhaps
the acute type of abscess, with whicli we were confronted, is
less amenable to aspiiution tlian are the more chronic forms,
ft certainly seems reasonable to expect that a chronic abscess,
in the walls of which the amoebee ihave long ceased to be active,
^ill be likely to i-espond more readily to simple evacuation of

PART III. N

194 Mesopoiiimki, It) 10 — J'JIO.

its contents than an acutely sp leading- one bounded by semi-
necrotic liver tissue.

Few disea,se8 react more quickly tlian dysentery t» appro-
priate medical treatment, when it is caug-ht in its early stages,
and surgical interference should never be necessary for the
intestinal ulceration. Now and then, however, either because
the patient does not report early enotig-h or because the disease
is not taken in hand with sufficient energy, the ulceration gets
into a chronic and most intractable state, and surgery may
do some good. In the cases on which I operated I found that
coecostomy either had no effect or produced only a transienfj
improvement, and latterly I gave it up in favour of complete
section of the lower part of the ileum wdth the formation of
an artificial anus. By these means tJie large gut obtained com-
plete rest, and in two of the three cases, in which I used the
method, the immediate improvement which followed the opera-
tion was most noticeable. Both patients lost tlieir pyrexia
within a day or two of the operation, and began rapidly to put
on weight, and I was able at the end of two months to re-unite
their intestines ; and complete cures resulted. Tlie thii^d case
was moribund w-hen I did the operation, and only survived for
two days. Not much can be argued from these three cases,
but at least I think the method is deserving- of a more ex-
tended trial.

The remaining surg-ery was of the type usually seen in. tlie
hospitals at home, herniae, apj)endicesi, loose cartilages, ete.,
and there is little to he said about it, except that a remarkably;
larg-e number of men, who had recently undergone operationis
for hernia, in England, presented themselves soon after their
arrival in Mesopotamia Avith their hernial sacs still intact.

I was also struck by the frequency of bad results from ope-
rations on varicoceles. Men often reported with chronic oedema
or atrophy of the testis or (cysts of the epididymis from this cause,
and thoug'h these were probably the result of faulty technique,
it is surely time that the Public Services ceased to insist oil

Mesopotamia, 191 fJ— 1919. 195

their recruits imdergoiug- operations wJiieli 80 fi'eqiiently do
more harm than good, and wliich ai'e, as a matter of fact,
only very rarely needed.

A point which interested me a good deal, and which crops
up frequently in the writings on sui^gerj^ in India and othen
hot counti'ies, was the effect of the climate upon operations.
I have operated many times in theati-es in which the tempe-
rature was well over 100° F., and sometimes as much as 120°
F., but the only ill effect to the patient that I have seen was
post-anaesthetic bronchitis. Tlie high rate of incidence of
bronchitis after operation, especially after laparotomies, was
so striking that I took to giving prophylactic doses of tincture
of belladonna after all abdominal opei^ations during the hot
weather. It was not due to ether, which was very seldom used
OAving to its volatility, and I came to the conclusion tliat it Avas
probably caused by the draught set uji by the overhead fansi
with which all the wards wei-e fitted.

Another anticipated source of danger was the dust. If
ever there was a dusty place, it was Mesopotamia, and when-
ever there was a wind the air was full of it: and even the most
iaborate precautions could not keej) it out of the buildings j
But I never saw any wound infected b}^ it, and I doubt if au}^
pyog-enic bacteria can i*emain for long- in a flourishing state,
when exposed to the blaze of a tropical sun.

And now one Avord more, and I shall have finished. It was
most noticeable wherever one AA-ent dui'ing tiie Avar, that seai'cely.
in one single instance was the post of surgical specialist to a
hospital held by an officer of the regular R.A.M.C. The i-easou
^'f course is that hardly any members of the Corps had, befoi-e
Tlie war, any exj^erienee of surg-ery. It is the fault of rlie
-vstem, and the i-esult, Avlieii, as in the earlier stages of the
Mesopotamian campaign, the officei's of tlie regular R.A.M.C.
re called upon to operate, is bound to be disastrous. Some
t the things I saw done in the name of surgery, Avhen I
iirst arrived in Mesopotamia, were i-eally appalling. I am not

196 Mempofamta, 1910—1919.

criticisino- the Indian niiits. Tlie I. M.S. sur^'oii.s ha\t' at lea.st
an opportunity in peac^ time of practising their craft, tliough
they may not always keep exactly up-to-date in tlieir metliod>
But the R.A.M.C. officers have no chance of keeping in
touch with surgery unless they happen to hold one of the very
few surgical posts in the military hospitals at home. There
is not enough siu'gerv" in the Army in peace time to go round,
and if the Army is e^-er to i)assess exx)ert operators material
other than military must be found for them to practise on.

I have ofteii wondered Avliether the enormous mass of
material in the Poor Law Infirmaries coidd not l)e utilised
for the purpose. I see no grave reason why R.A.M.C. office i^
should not be seconded for service u]>on the Infirmary staffs.
and the added inducement of practical surgery and medicine
would probably attract better men to the Service.

The Sanitary- and Administrative Departments of the Corps
are both excellent, and it seems to me tJie greatest pity that
simply from lack of opportunity the departanents of practical
medicine and surgery should lag sc» far behind them.

DENTAL SURGERY AND THE WAR.

By
MONTAGU F. HOPSON.

Ix Avritiug, however briefly, of Dental Surgery and the Waj\
it is unfortunately necessary, at the outset, to comment on .the
official attitude of the War Office towards a dentaJ service.

' Orthodoxy has ever been the Bourbon of the world of
thought. It learns not, neither can it forget." The orthodox
Director General of Medical Services has never recognised the
value and importance of Dental Surgery, 5ior the obvious
relation which exists between oral and dental disease and
geneml affections of the body; facts which have been a oommon-
place of informed medical science for many years past.

Just as the Dii-ector General in the Crimea, when Florence
Nightingale was endeavouring to teach the elements of pre-
ventive medicine, scoffingl}^ asked what a soldier needed with
a toothbrush, so the Director General at the outbi'eak of the
war, having leai*ned nothing from the experience of the South
African campaign, but remembering the dictum of his pre-
locessor, Sir Robert Hall, in 1855, stubbornh' refused assist-
ance from the British Dental Association to establish an efficient
Dental Service, and at the end of 1915 informed the Recruiting
Department of the War Office that, in his opinion, dentists aa
1. class should not be excused from combatant militai-y service,
and that the system of Local Tribunals was sufficient to meet
the case.

In the naii((iiiil emerg"ency whieli Jial arisen the role of the
skilled Dental Surgeon Avas: —

1. To render recruits dentally fit for service.

198

iJental Surr/en/ and the War.

2. To iiiaiiitaiii dental fitness in the field.

3. To co-operate with the surgeon in the treatment of

wounds of the face and ja\^s.

4. To meet the needs of the civil j)opulation.

To cope with this task there were available about 4,500 dental
surgiej)ns in the whole of the United Kingdom. If ever there
were a time calling for thorough, careful and efficient organi-
sation it was then. Yet all offers of help from those possessing;
special knowledge, and from bodies having facilities for effect-
ing organisation were declined. For three whole years the
Government remained indifferent to the value and importance
of the dental surgeon as a national asset, and no provision!
was made to utilise his services in 'his professional capacity;,
like any untrained individual he was subject to the caprice ofl
ignorant tribunals; the dental schools were depleted of their
students, with the exception of those who were within twelve
months of qualification, so that, in 1917, thei^ were only 153
male students as against 1,000 in 1914.

Despite the large nimiber of applications, only 20 dental
officers, ranking as temporary Lieutenants on the General List,
were appointed during 1914. Hoav pressing w-as the need is
shown in the following official table relating to the condition
of the teeth, of recruits in the Northern Command: —

Age Group.

•

18 and
under.

19-24

25-29

30 and
over. 1

Per cent, of men examined with all

teeth sound
Per cent, of men examined with

decayed teeth
Average No. of decayed teeth per man

19-8
64-0

4-5

4-9

84-0

7-3

4-1

83-2

6-S

3-2

80-7

6-5

From the point of \iew of Public Health, most of the men
examined would require dental treatment. The percentages of
tliose who could be considei-ed as "dentally fit" from the
Public Health standpoint, compared Avith those who, under the

Dental Surgery and the War.

199

present Army standard (under which only the minimum of
|ti*eatment which will enable a man to masticate, and under
which of necessit}^ many teeth Avhich are savable are allowed
tc< become unsavable), were actually passed as " dentally fit,"
are shown in the following table: —

Dentally fit.

16 and

under.

19-24

25-29

30 and
over.

Public Health Standard

Army Standard

Per cent.
330

57-0

Per cent.
10-3

490

Percent.
13-0

520

Per cent.
140

54-0

At the i"equest of the Air Ministry the writer, with a
collea^ie, inspected the members of the Officers Cadet Unit at
Hastings, numbering some 5,000 men, with the following result:

RATIO PER CADET.

E.Ktractions.

Fillings.

Fillings with

Root
Treatment.

Scalings with

simple

Gingivitis.

Pyorrhoea or

severe

Gingivitis.

Required
Artificial
Dentures.

1-74

3-14

•28

•69

•04

•13

In connection with the above, it must be borne in mind' that
the men came from the upper and middle classes, and that
most of them had been in the habit of receiving i-egular dental
treatment.

In peace time the Army Regulation was " The acceptance
or rejection of a recruit on account of loss or decay of teeth
will depend on the consideration of the relative position of
sound teeth, and the physical condition of the recruit; tlius tlie
l'>ss of many teeth in a man of indiffei^nt oonstitution would
point to rejection, whilst a robust recruit who has lost an
equal number might be accepted. Too much attention cannot
be paid to this latter point." Civilian dental surgeons were
occasionally employed at a fixed rate of remuneration to nmk©
a likelv i-ecruit dentallv fit. -

200 Dental Surgery and the War.

At the ontbi-eak of the war dental practitioners banded them-
selves together and arranged for the gratuitous treatment of
recruits otherwise suitable, who might be rejected on account
of defective teeth. Majiy thouxsands wei'O thiLS rendered fit
for service. Dental Hosj^itals and Institutions also rendered
very valuable and extensive voluntary service in this way. In
aid of this work the i trustees of the late Sir William Duam
(The Commercial Union Assurance Company) made a g'enerous
contribution to Guy's, | enabling' that Institution to treat a very
large number of service men; over a thousand artificial dentures
were jmade free of charge. The carrying out of tliis work
was only rendered possible by a call upon old Guy's dental
men to come and work in the Department of their old School,
a call which was nobly responded to. 'Mention must also be
made of the great work done under the auspices of the Ivory
Cross Fund.

Later on a system was adopted for the treatment of soldier.f
by civilian dentists at a fixed scale of remuneration paid by
the Government. It was found, however, that a civilian scheme
was too costly; it lacked in efficiency owing to the want of
central organisation coupled with inspection.

Still the War Office hesitated and procrastinated in tlie matter
of granting Dental Commissions. At the end of 1915 the nimi-
ber of officers was only 179, and even these were working-
not under the direction and supervision of senior dental officers
but under junior medical officers who did not pretend to possesisi
any special dental knowledge.

The fine example set by the Dominion Governments in estab-
lishing thoroughly equipped and well org-anised Dental Corps,
to render their troops dentally fit during training and to accom-
pany them and maintain that fitness whilst on active service-
was ignored by the Home Government, which, however, did
not hesitate to employ the Dental Surgeons attached to Dominion
troops to ti-eat English soldiers in France until i\\<i Dominion
Dental Officers protested.

Dental Surgenj and the War. 201

The following wa,s the proportion of Dental Surg-eonS' to
men ^mong-st the Dominion Forces: — Canadian, 1 per 1,000
men; Xew Zealand, 1 i^er 2,500 men: AiLstralian, 1 per 2,600
m^n. The United States Army also had a proportion of one
Dental Surgeon to each thousand troops.

With the ever increasing demand for troops men of a lower
idegi'ee of general and dental fitness were enrolled. This
brought into prominence the very difficult question of the supply
of artificial dentiues, which Avas ultimately, satisfactorily and
economically solved by the establishment of Army Dental
Laboratories in the various home commands and at certain
bases on the different fronts, dental mechanics serving as
combatants being transferred to the E.A.M.C. for this purpose.

Still with a shortage of Dental Officers, and with, none of
senior rank with power and authority to org-anise and direct,
the dental service, such as it was, muddled along. The ti-eat-
ment of troops, instead of being commenced immediately on
enlistment, was necessarily delayed until near the end of theiij
training, with the result that large numbers left for tlie fronti
either untreated or with Avork unfinished, to swell the number
of men in a similar condition. This led to troops on active
service being rapidly incapacitated, and consequent congestion
at the bases where the few overworked Dental Officers Avere
stationed. Hence a large and unne(*essary Avastage of man
power. There never Avas a Senior Dental Officer in charge in
France. At the end of 1915 a feAv Dental Officers Aveie ap-
pointed Ins]i>ecting Dental Officers, both at home and abroad,
but Avith no executive ])owers. Some of these I'eceived the I'ank
of Major in 1917.

In the middle of 1917 the President of the Local Government
Board (established a Dental Service Committee, composed of
dentists and ie))re.sentative8 of certain inteiested Governmenti
departments, Avith limited powers over dentists of lio years
of age and upAvards, and those lunder that age Avho were unfit
for general service. At the time of the establishment of that

202 Denidl Sunjern and the War.

Conuiiittcc thei-e were ap])roximately 1,000 dentists .serving'
in the Forces. The number of Arniy Dental Surg-eons was
530 (as compared with 250 in the Canadian Army Dental Corps
alone); 160 were acting- a.s Medical Officers in the R.A.M.C.;.
100 wei'e serving- in the Navy, chiefl}'^ as dentists, surgeons^
Biid surgeon ]^i*o^>^tioners, etc., whilst 250 ^vere serving a»5^
combatants.

In November, 1917, a Parliamentary Committee of 13 mem-
bers, presided over by Mr. D. F. Pennefather, investigated the
position, and after hearing evidence published a report and
made the following- recommendations: —

COMMITTEE'S EECOMMENDATIONS.

After careful consideration we have come to the conclusion that the
efficient man-power of our Army would be increased and preventable
sickness and suffering to our soldiers reduced: —

(1) By much greater attention being paid to the teeth of soldiers
while training in this country prior to being sent abroad, particularly
in regard to " conservative " treatment, t.e., treatment calculated to
prevent unnecessary extractions.

(2) B}^ increasing the number of qualified Dental Surgeons at base
camps and casualty clearing stations, and also by the use of travelling
dental lorries or ambulances.

(3) By detailing a larger number of specially skilled Dental Sur-
geons, to co-openate with Army medical officers in the . treatment of
jaw wounds.

(4) By , withdrawing from combatant and other non-dental services
(other than medical and surgical services) all qualified Dental Surgeons
who are now in the Army or may come up for recruitment, detailing
them to dental work in order to carary out the dutiifes mentioned ini
the preceding paragraphs, and providing the necessary numbers of
dental mechanics.

(5) By placing the organisaition of the Military Dental Service
under the general direction of one or more experienced Dental Sur-
■geans with special authority over Army dental officers of all ranks
and an advisory position in regard to dental supplies and equipment;
such Dental Director or Directors and Officers to be under the orders
of the P.M.O. of the E.A.M.C.

Signed on behalf of the Committee,

D. F. PENNEFATHER, Chmrman.
House of Commons.

December 12th. 1917.

Dental Surgert/ and the IT

203

In March, 1918, an Advisory Dental Offic-er, with the rank
of Lieut. -Colonel, was appointed on the «taff of the new Dii-ee-
tor General at the War Office. Although this officer pos-sessed
no real executive powers a very marked i^iiprovement in dental
organisation Avas effected. As late as October 26th, 1918, an
Army Council Instruction (No. 1187) on Dental Treatment was
issued, the first paragraph of Avhich reads: '* In order to pro-
vide adequate dental treatment for troops required for service
oveiiseas and to ensui-e uniformity, the following instructions
have been drawn up, and will come into operation forthwith.
Dental Officers will be appointed as may he necessary.''

A confession and a promise — a justification of professional
claims, four years too late. AVithin a fortnight the enemy was
suing for peace.

Three months previously a Dental Tribunal had been ap-
pointed, to which all dental surgeons of service age were
made amenable. This tribunal was an enlarged Dental Service
Committee, and possessed pOAvens Avhich enabled it to enforce
the national professional service, military or civil, of any dental
surgeon who came Avithin the provisions of the National Ser-
vice Act. Further, such dental surgeons as A\ere serving as
combatants in the ranks Avere offered Dental Commissions. The
tribimal Avas actiAely engaged upon its duties Avhen the Armis-
tice came.

Thei-e are no available figures as to the amount of routine
dental Avork done by English Dental Officers, but the folloAving
table of that accomplished by the Canadian Army Dental Coi'ps
alone gives some idea of the gigantic nature of the task set
them.

CANADIAN ARMY DENTAL CORPS.
July 15th, 1915— June 30th, 1919.

Fillings.

Treatments.

Dentures. '. Prophylaxis.

Extractions.

Teeth
Devitalizad.

1,007,257

393.720

173,179 ; 225,105

545,220

99,948

.204 Dental Surgerf/ and the War.

At tlie oessation of hostilities about 1,300 dental 8urg-eoii.s
were serving in H.M. Forces; 831 as Army Dental Surgeons,
83 as Naval Dental Surgeons (R.N.V.R.), and 61 as Dental
Siu'geons, Royal Air Foroe. About 120 -were still serving as
combatant officei-s, and the remainder were serving as Medical
'Officei-s in Navy and Army.

In many inspects the most important services rendered l>y
-dental surg-eons wei-e in co-operation with the general surgeon
;in the treatment of gunshot wounds fof the jaws and face.
Hei-e ag-aiii it has to be recorded that the War Office showed
culpable negligence in rejecting the oft repeated warnings
and offers of help tendered by those best qualified tO' advise.;
It is true that in 1914 a number of Dental Surg-eons attached
to teaching institutions were asked to 6>ct in an honorary con-
•Bulting capacity in these cases. But, as not infrequently
happens Avith other consultants, they were hardly ever consulted.
No provision was made for the early dental treatment of jaw
oases ,on the various fronts. The patients were distributed
haphazard in large and small hospitals throug-hout the country
where pkiUed attention was unobtainable. In Gallipoli the
-conditions were appalling. The result was that a large num-
ber of cases came into the hands of the Dental Surgeon when
the opportunity of rendering any efficient service had long
passed.

In August, 1915, the writer with two of his hospital colleagues
-visited a number of French hospitals in the Paris area which
'had been set aside for the special treatment of jaw injuries.
On their return they reported fully to the War Office the results
•of the experience afforded by their visit, and urged once again
the necessity of segregating this type of injury, and the insti-^
tution of special jaw centres at home and abroad. This was
feventually done, but only after prolonged opposition on the
part of the Army Medical Service, and when the matter had
become one of the minor scandals of the war. The chief jaw
xaentres were situated at Sidcup, Croydon, Millbank, 1st and

Dental Surijery cmd the War. 205-

old Territorial General Hospitals. London, at King George
Hospital, the Maxillo -Facial (Red Cross) Hospital, Camberwell,
and in the provinces at Birmingham, iManehester, Liverpool,
Leeds, Edinburgh, and in Ireland. In the main, the dental
staffs were composed of visiting civilian consultants, together
with resident Army Dental Officers. There were also centres
at three bases in France, and in Egypt and India.

It is a pleaisure to add that in the end the provision, for
the treatment of wounds of the jaws and face reached a stage
of [perfection iinsuiT^assed amongst the Allies.

No reference hais been made in tliis short article to special
cases or to treatment. A bibliography of the more important
contributions on " Dental Surg-ery and the War/' culled from:
English journals, is appended.

REFERENCES TO WAR INJURIES OF JAWS
AND FACE, etc., 1914 to June, 1920.

Aymard, J. L. Some principles of plastic surgery. — Lancet, 1917,.
II., 847.

Badcock, J. H. Early splinting in gunshot wounds of the inaudible.
— British Medical Jounml, 1917, II., &o.

Baldwin, Sir H., and Payne, J. L. Discussion on war injuries of
the jaw and face. — Proc. Rot/. Soc. Med., 1915-lG, IX., Odont.
Sect., 63.

Bennett, N. G. Orthodontic methods in the treatment of fractures
of the jaws. — Dental Record, 1910, xxxvi., 660.
Idem. War injuries of the jaws. — Practitioner, t^ll, xcix., 201
(4 plates).

Billingtox, W., Parrott, a. H., and Eound, H. Bone-grafting- in
gmishot fractui-es of the jaw. — Proc. Roy, Sao. Med., 1918-19,
xii., Odont. Sect., oo; also Briti-ih Medical Jourruil, 1918, II.,
679.

Bock, J. Simple appliance-s for distending jaw muscles and ligameurs
in cases of trismus. — Britsih Dental Jouriwl, War Supplement,
1916.

Bowman, F. B. Ulcero-membranous stomatitis among the troops..
— British Dental Journnl. 1917.

20*i Denial Surf/crt/ (fud the War.

Bbyan, W. a. Plastic surgeiy of the face. — British Dental Journal,
War Supplement, 1916.

BrBB, C. H. Some technical details in the treatment of jaw injuries.
— British Dental Journal, War Supplement, 1910. Deformities
ijf the jaws resulting from operation or injury. — British Dental
Journal, War Supplement, 1916. Some principles involved in
the treatment of mandibular fractures. — Proc. Roy. Soc. Med.,
1917-18, xi., Odont. Sect., 27.

Campion, K. B. Some notes on seventy-two cases of gunshot wounds
of the face with fracture of maxillas. — Jour. Royal Army Medical
Corps, 1916, xxvii., 106.

Gavalie, — . A method of procedure in the treatment of fractures
of the mandible. — Dental Record, 1916, xxxvi,, 205.

Chexet, H. The use of continuous elastic traction in one jaw only
in the treatment of mandibular fracture. — Dental Record, 1918,
xxxviii., 69.

Chubb. G. Case illustrating the need for conservative treatment of
bone fragments in compound fractures of the mandible. — Proc.
Roy. Soc. Med., 1919-20, xiii., Odont. Sect., 59.

Clewer, D. a contribution to the study of fuso-spirillary marginal
gingivitis. — British Dental Jourwtl, 1919.

Cocker,. A. B. Treatment of acute septid gingivitis. — British Dental
Journal, 1919.

Cole, P, P. Deformities of the jaws resulting from operation or

injur}-. — Brituh Dental Jouriml, W^ar Supplement, 1916.
Idem. Non-union of war fractures of the mandible. — Lancet, 1918,

• I., 459.
Idem. Plastic repair in war injuries to the jaw and face. — Dental

Ree&rd, 1917, xxxvii., 281; also Lancet, 1917, I., 415.
Idem,. The operative treatment of ununited fractures of the mandible.

— Proc. Roy. Soc. Med., 1917-18, xi., Odont. Sect., HS.
Idem. Scalp flaps and depilation in plastic surgery of the face.

—Practitioner, 1918, C, 461.
Idem. Treatment of wounds involving the mucous membrane of

the mouth' and nose. — Lancet, 1918, I., 11.
Idem. Ununited fractures of the mandible; their incidence, causation

and treatment. — British Journal of Surgery, 1918-19, vi., 57.
Idem and BuBB, C. H. Bone-grafting in ununited fractures of the

mandible, with special reference to the pedicle graft. — Proc.

Roy. Soc. Med., 1918-19, xii., Odont. Sect. 13; also British

Medical Journal, 1919, I., 67.

Colyer, Sir F. A note on the treatment of gunshot injuries of the
mandible. — British Medical Journal, 1917, II., 1.
Idem. The treatment of guhshot injuries of the jaws, — Jour. Royal
Army Medical Carps, 1916, xxvi., 597 (8 plates).

Dental Surgery and the War. 207

Idem. Fractures of the mandible: methods and treatment and
results. — British Dental Journal, War Supplement ,1917.

Idem. Injuries of the mandible. — British Dental Journal^ War
Supplement, 1917.

€OMTE, E. Six weeks' study at the Val-de-Grace Military Hospital,
Paris. — Dental Becord, 1917, xxxvii., 424, 492.

Daehler, 31. W. A case of union of fracture of the mandible after
30 months' treatment. — Dental Becord, 1918, xxxviii., 170.

Dalton, F. J. A. Sodium hypochlorite in the treatment of septic
wounds. — British Dental Journal, War Supplement, 1916.

Davenport, W. S. Multiple fracture of mandible"; lost structure re-
stored by bone graft. — British Dental Journal, War Supplements.
1916.

DoLAMORE. W. H. Gunshot injuries of the jaws and face. — Medical

Annual, 1918, pp. 274-294; ibid.. 1919, pp. 215-224 (plates).
Idem. The ' prevention of deformity following fracture or resection

of the jaw. — Brituh Journal of Surgery, 1915-10, III., 520.
Idem.. The treatment in Germany of gunshot injuries of the face

and jaws. — British Dental Journal, War Supplement, 1916.
Idem. Metal cap splints for fractured jaws. — Brituh Dental Journal,

1915.
Idem. Further experiments with the use of bone grafts. — British

Dental Journal, War Supplement, 1917.
Idem. Treatment of the face and jaws at Diisseldorf Hospital. —

Brituh Dental Jourrutl, War Supplement, 1917.
Idem.. War injuries of the jaws. — Medical Anniud, 1917, pp. 299-

317 (plates).

DouBLEDAY, F. N. Case of gunshot wound of the mandible with ex-
tensive loss of tissue treated by the Colyer method. — Proc.
Roy. Soc. Med., 1918-19, xii., Odont. Sect., 101.
Idem. Cases of gunshot injury of the face and jaw, with special
reference to treatment. — Proc. Roy. Soc. Med., 1916-17, x.,
Odont. Sect., 51.

EccLES. H. A. War injuries of the jaws. — Proc. Roy. Soc. Med..,
1916-17, X., Elect. -Ther. Sect., 2.

Edwards. D. S. P. Treatment of fractured jaws in military practice.
— British Dental Journal War Supplement, 1917.

EvE, Sir F. Some surgical procedures in gunshot fractures of the
mandible. — Practitioner, 1916, xcvi., 447 (plate).

Fisher, A. R. Chloramine treatment of wounds of the mouth and
jaws. — British Dental Journal, 1916.

FREYi. F. Restorative prosthesis in mutilation of the face. — British
Dental Journal, War Supplem^it, 1916.

208 Dental ^urgenj and the War.

Fry, W. K. a fe^^' iiote.s oa the treatment of gunshot wounds of

the mandible and maxilla. — Dental Record, 1918, xxxviii,, 73^

also Lancet, 1917, II., 852.
• Idem. The restoration of the function of the mandible. — British

Dental Journal, War Supplement, 1918.
Idem. Prosthetic treatment of old injuries of the raaxillx'. — Proc.

Roy. Soc. Med., 1918-19, xii., Odont. Sect., 73.

Gernez, — . and Lemiere, . — On the conservation and use of cica-
tricial bands in the treatment of fractures of the j'aws, with
. extensive loss of tissue.- — Dental Record, 1918, xxxviii., 326.

Gillies, H. D. Two cases illustrating plastic and dental treatment.
— Dental Record, 1918, xxxviii., 39.
Idem and Kixg, L. A. B. Mechanical supports in plastic sui'gery.
— Lancet, 1917, I., 412.

GljLMOUE, W. H. Xptes on visit to military hospitals at the base in
France and some hospitals in Paris. — British Dental Journal,
1916.

Grandison, W. B. Treatment of jaw injuries at Southern General
Hospital, Birmingham. — British Dental Journal, War Supplement,
1918.

Graxt, J. D. Facial plastic surgery, laryngology and stomatology, in
French military hospitals. — Lancet, 1915, I., 926.

IGreen, K. J. Two cases of gunshot fractures of the mandible witli
loss of substance. — Lancet, 1917, II., 422,

Hern, W. Wax injuries of the jaws and their treatment contrasted
with those of civil practice. — British Defital Jouriud, War Sup-
plement, 1916.

Hett, G. S. Methods of repair of wounds of the nose and nasal
accessory sinuses. — Proc. Roy. Soc. Med., 1918-19, xii., Larvn.
Sect., 136.

Harrison, H. Wire splints. — British Dental Jowrnal, War Supple-
ment, 1917.

HtLTON, — . Multiple wounds of the face from a trench mortar bomb.
— British Journal of Surgery, 1916, IV., S9.

Holt, H. M. Diets in use at Croydon War Hospital. — British Dental.
Journal, War Supplement, 1916.

HopsoN, M. F. Treatment of jaw injuries.— ^owr. R.A.M.C, 1915.

Idem. War injuries of the jaws and face: appliances and splints -
— British Dental Journal, War Supplement ,1916.

Idem. Presidential address — British Dental Association. — British Den-
tal Journal, 1919.

Johnson, E. Ulcero-membranous stomatitis occurring among the troops.
— British Dental Journal, 1919.

Dental Surgery and the War. 209

Johnston, H. M. The value of skiagraphy in the surgery of facial
injuries. — Lancet, 1918, I., 10 (plate).

Jones, R. Transplantation of bone and uses of the bone-graft. — British
Dental Journal, War Supplement, 1916.

Kazanjtan, V. H. The department of oral surgery of the Harvard

Surgical Unit. — British Medical JourTial, 1917, II,, 3.
Idem. Immediate treatment of gunshot fractures of the jaws. — Brituh

Dental Journal, War Supplement, 1916.
Idem. Splints combined with sutures through the bone for the

immobilisation of extensive fractui-es of the lower jaw. — Proc.

Roy. Soc. Med., 1917-18, xi., Odont. Sect., 67.
. Idem and Buerows, H. The treatment of giinshot wounds of the

face accompanied by extensive destruction of the -lower lip and

mandible. — British Journal of Surgery, 1918-19, vi., 74.
Idem. Treatment for maxillary fractures. — British Dental Journal,

Wai- Supplement, 1916.
'. Idem and Burrows, H. The treatment of hasmorrhage caused by

gunshot wounds of the face and jaws. — British Journal of

Surgery, 1917-18, V., 126.
Idem. Some problems of prosthesis as a result of destruction of

the superior maxilla. — British Dental Journal, War Supplement,

1918.

Keith, A. and Hall, jNI. E. Specimens of gunshot injuries of the face
and spine. — British Journal of Surgery, 1919-20, vii., 55.

Mackaness, C. L. Diseases of the gums affecting troops in France.
— British Dental Jouriwl, War Supplement, 1916.

^SIakins, Sir G. H. Bomb wound of the face. — British Journal of
Surgery, 1915-16, iii., 502.
Idem. Bullet wound in the face, with explosive effect at the
aperture of exit. — British Journal of Surgery, 1915-16, iii., 505.

^Iaurel, G. Anatomical peculiarities of caUus in war fractures of
the symphysis of the mandible. — Dental Record, 1917, xxxvii.,.
635.

]Mendleson, B. Treatment of gunshot wounds of maxillae at a CCS.
— British Dental Journal, 1916.

Military Centre for jaw cases at Lyons. — British Medical Journal,

1916, II., 535.
^luMMERY, S. P. Successful case of bone-grafting (severe shell wound
of face). — Proc. Roy. Soc. Med., 1919-20, xiii., Odont. Sect.,
78.
Idem. The treatment of jaw injuries. — Practitioner, 1916, xcvi., 73,

(two plates).
Idem. The treatment of jaw injuiies. — Jour. R.A.M.C., 1915.

:Munby, W. M., Forty, A. A. and Shffford. A. D. Notes on the
principles and results of treatment in 200 cases of injuries to
the face and jaws. — British Journal of Surgery, 1918-19, vi., 86.

PART III. O

210 Denial Surrjcf// iiud thr Wdr.

NORTHCEOFT, G. A shoit aooouut. of a year's work at one of the
Jaw Injuries Centres of the London Commaud. — Proc. Roy.
Soc. Med., 1917-18, xi., Odont. Sect., 6.
Idem. A short review of another year's work at a Jaw Injuries
Gentxe.—Ibid, 1918-19, xii., Odont. Sect., 7.

Oliver, M. W. B. Gunshot wound of face; loss of left eye. — Proc.
Roy. Soc. Med., 1919-20, xiii., Ophthal. Sect., 34.

Parrott, a. H. Jaw injuries at Southern General Hospital, Birming-
ham.— Britvth Dental Jonnuil, War Supplement, 1918.
Idem. Fracture of the maxilla (complete) with or without fractnre
of mandible. — Brituh Deyital Jonrnal, 1919.

Payne, J. L. The treatment of jaw injuries. — Jour. R.A.M.C., 1915.
Idem. Fractures of the jaws. — Britkh Dental Journal, 1915.
Idem. War injuries of the face and jaws. — Brituh Dental Jourwd,
War Supplement, 1916.

Pearce, F. J. The treatment of jaw injuries. — Jour. R.A.M.C., 1915.

Peglee, L. H. Shrapnel wound of nose and cheek. — Proc. Roy. Soc.
Med^, 1915-16, ix., Laryn. Sect., 21.

Pickeeill, H. p. Arthroplasty of tempero-mandibular joint for anky-
losis.— Proc. Roy. Soc. Med., 1917-18, xi., Odont. Sect., 87.

Idem. Methods of control of fragments in gunshot wounds of
the jaws. — Deyital Record, 1918, xxxviii., 435; also Lancet, 19IS,
II., 313.

Idem. Treatment of fractured mandible accompanying wounds. —
Brituh Medical Journal, 1916, II., 105.

PiPERXO, A. Modern methods of treating fractures of the jaws. —
British Dental Journal, War Supplement, 1916.

Platt, H., Campiox, G. G. and JIod-vvay, B. J. On bone-grafting in
gunshot injuries of the mandible. — Lancet, 1918, I., 461 (plate).

POLLITT, G. P. Comminuted fracture of the mandible. — Proc. Roy. Soc.
Med., 1916-17, x., Odont. Sect., 41.

Pont, A. Note on bone grafting in cases of loss of tissue of thei
mandible. — Dental Record, 1918, xxxviii., 401.

Ide7n. Alae and Lobule Ehinoplasty. — British Dental Journal, War
Supplement, 1916.

Idem. Cheiloplasty and nasal prosthesis. — British Denial Journal,
War Supplement, 1916.

Idem. Reports on cases treated at the Lyons Stomatological Centre.
'—British Dental Journal, War Supplement, 1916.

Idem. Oculo-facial prosthesis. — British Dental Journal, War Supple-
ment, 1916.

Pope, W. H. Retaining apparatus in cases of fractured mandible. —
Brituh Dental Jourmil, War Supplement, 1917.

Dental Surcjenj and the TTV/>-. 211

EoDAVAY, B. J. The treatment of gunshot wounds of the face nnd
jaws. — Dental Record, 1915, xxxv., 717.

Roy, M. and Martixiee, P. The treatment of war injuries of the
maxillary -facial region: some methods of technique used by the
Committee for treating soldiers wounded in the jaws and face.
— Dental Record, 1916, xxxvi., pp. 323, 435, 477, 550, 610, 672.

-EBILEAU, P. The healing of fractures of the mandible due to war
injuries. — Dental Record, 1917, xxxvii., 128, 178, 233.

EMPLE, Sir D., Price-Joxes, C. and Digby, L. Report of Inquiry
into gingivitis and Vincent's angina occurring iu the Army. —
Jour. R.A.M.C., 1919.

^HEFFORD, A. D. E. General observations on gunshot injuries of face
and jaws. — British Dental Journal, 1919.
Idem. Results of bone grafting operations in treatment of ununited
fracture of mandible. — British Dent-al Journal, 1919.

^FILLER, J. E. The restoration of lost parts by prosthetic appliances.
— British Dental Journal, War Supplement, 1916.

STEPHENS. B. M. Report on treatment of a case of shrapnel wound
of the mandible, in which bony union was re-established after
great loss of substance. — Proc. Roy. Soc. Med., 1916-17, x.,
Odont. Sect., 46.

-TL'ART-Low, W. BuUet wounds of face and neck. — Proc. Roy. Soc.
Med., 1915-16, ix., Laryng. Sect., 18.

Trotter, W. Suggestions towards a systematic operative treatment of

gunshot wounds of the mandible. — British Medical Journal, 1918,

I., 49.
Turner, H. W. Surgical prosthesis of the jaws. — British Dental

Journal, 1915.
\'aladiee. Sir A. C. A few suggestions for the treatment of fractured

jaws. — British Journal of Surgery, 1916-17, iv., 64.
Idem and Whale, H. L. A report on oral and plastic surgery and

on prosthetic appliances. — Brituh Journal of Surgery, 1917-18,

v., 151.
Villain, G. Post-elevator mandibular fractures. — Dental Record, 1918,

xxxviii., 122, 218, 274.
Whale, H. L. Case of injury principally to lower face and mandible.

— Proc. Roy. Soc. Med., 1914-15, viii., Laryng. Sect., 131.
Wood, F. D. Masks for facial wounds. — Dental Record, 1917, x.xxvii.,

396; also Lancet, 1917, I., 949 (plate).
Vylie, a. Bullet wound of the face. — Proc. Roy. Soc. Med., 1915-16,

ix., Laryng. Sect., 21.

THE COMMITTEE OF REFERENCE.

By
SIR WILLIAM HALE-WHITE, K.B.E.

(
The Hon. Secretary of the Committee of Reference was Mr.
F. G. HaUett, who was indefatigable in the work he did for it,
and it is to him that its success is largely due. When I men-
tioned to him that the Editors of the Guy's Hospital Reports
had asked for an account of its work, he kindly supplied me
with the following extract.

In March, 1916, at the request of H.M. Government, thi'ough
Lord Sydenham, Chairman of the Central Tribunal, the Royal
Colleges of Physicians aaid Suigeons appointed a Joint Com-
mittee consisting of the President and four members of each
College " to advise the Government Depai-tment concerned
therein, through the Central Medical War Committee, on any
case affecting the .seveiul Medical Schools sand Hospitals during
the war in respect of medical men on their staffs (including!
residential ajod teaching staffe) ^vith regard to whom the ques-
tion arises as to whether a particular individual is indispen-
sable or would suffer excessive personal hardship if requii'ed
to enter Militaiy Service, and further similarly to advise on
the case of any other medical !man in England or Wales in
respect of whom the Central Tribunal iunder the Military Ser-
vice Act of 1916 or the Central Medical Wai- Committee thinks
it desirable that the Advisory Committee should be consulted."

The Conomittee originally consisted of Dr. Fi-ederick Taylor,
President, Dr. William Pasteui-, Dr. Sidney Martin, F.R.S., ajid
Dr. James Galloway, repi^senting the Royal College of Physi-

214 I'hc ('onnnittee of Beierence.

ciaas; Sir Watson Cheyiie, Pi-esident (or, in his absence, Sir
Rickmau Godlee), Mr. W. F. Haslam, (Mr. D'Arcy Power, and
Mr. Charles Ryall, repi^senting tlie Royal College of Surgeons.

Later on this Committee became known las the Committee of
Reference.

The tprimary duty of the Committee was to decide which
members of the staffs of the Metropolitan Hospitals and Medical
Schools ishoiild be required to enter H.M. Forces and which
should be retained for the j)i^i'po*® 'of safeguarding' the interests,
from a health point of view, of the Civil Community.

In June, 1916, the Committee became a Statutory Committee
under the Military Service Act, Session 2, 1916.

Various questions arose from time to time which, although
not officially within the reference of the Committee were felt
to be of such importance as to wiarrant investigation and in
order that the Committee might have (power to deal with such
questions, they requested the Ro3'al Colleges of Phj^icians and
Surgeons to extend the terms of appointment so as to enable
the Committee " to consider either independently or in con-
junction with other Bodies urgent medical questions arisino:
out of the war, such as ithe treatment of Disabled Soldiers and
if neoes&ary to advise the Grovernment thereon."

The Committee, having received the additional powers, dealt
with the foUoAving subjects: —

1. The calling up of Members of Staffis of Hospitals and
Medical Schools.

2. Appeals from such members.

3. Matters relating to the calling up of Members of the
Profession of joint interest to the Committee and the Central
Medical War Committee.

4. The Treatment of Discharged Disabled Soldiers,
o. The Treatment of Dischargeable Disabled Soldiers.

6. The Grouping of Hosintals.

7. Board of Assessors under the Local Government Board.

The Committee of Reference. 215

8. Food Control.

9. Demobilisation.

On the 1st November, 1916, Dr. Hale-White became a repre-
sentative of the Royal College of 'Plnsicians on the Committee
in place of Dr. William Pasteur, who had been appointed Con-
sulting Physician to the Forces in France, whilst Dr. Tiimey
and. Dr. F. W. 'Mott also joined the Committee as i-epresentingf
the Eoyal College of Pliysician.s. Mr. (F. F. Bm-ghard, C.B.,
became a meml>er of the Committee in January, 1917, whilst
in July, 1917, and April, 1918, Sir George Makins, President
of the Royal Colleg'e of Surgeons, land Sir Norman Moore,
'Bart., President of the Royal CoUeg^e lof Physicians, became
"ex officio" Members of the Committee.

The Committee from time to time obtained returns of the
staffs of all the hospitals and schools in London and considered
the Cionditions of each Imstitution as to the nimiber of staff
required to maintain a reasonable service imder the conditions
of war, and at the same time decided which members of the
staff ought to be spared for service in H.M. Forces.

A Sub -Committee was ajopointed to go through the lists of
members of the staffs of the hospitals and to determine whidli
of these men should be called upon to serve, and lists were
piierpared for consideration by the Committee of Reference.
The Committee, having considered these lists, calling up notices
were sent, and each man had the right of submitting a per-
sonal statement to the Committee of Reference. The Committee
then yjonsidered such statements both as they bore on the
reqiuiements of the hospital in regai-d to its staff and on the
private circumstances of tlie applicant. In several cases Gov-
ernors of Hospitals attended before the Couunitbee and ex-
plained why a member of the Staff should not be spared.

The work of the Sub-Committee in going thixjugli and weigh-
ing the claims of the hospitals and individuals wafi extremely
onerous, and for a long period the Sub-Committee met once
and sometimes twice a week. Altogether some 560 cases were

216 The Committee of Reference.

investigated by the Committee after a still larger number had
been considered by the Sub -Committee.

Arrangements were oome to with the War Office by which no
one attached to the staff of a London Hospital was to be
called up without the sanction of tbe Committee. This arrange-
ment was made in order that the Committee might be in ^
position to decide whether or not the work of the hospital could
be icarried on with the remaining staff, and was referred to
in correspondence between Guy's Hospital and the Loeal Gov-
ernment Board in May and June, 1917, when the hospital called
attention to the danger of the calling up of all doctors of
ImiUtary ^ge. Lord Rhondda in his reply to £he Hospital
pointed out that the Committee of Reference had been set
up to deal with members of the staffis of hospitals with a view
to meeting this express difficulty.

In January, 1917, as the pres-sure b}' the War Office for
additional Medical Officers continued to be acute, the Committee
^commenced the consideration of a scheme for grouping the
London Hospitals into areas with a view to economy of mail
power. In order to make use of the whole profession in the
best interests of the State, it was suggested that tlie Hospitals
should, if necessary, be grouped, and to each, group a minimum
Cnumber of Physicians, Surgeons and Specialists should be
allotted, that some hospitals should be temporarily closed or
attached to other hospitals, and that part-time doctors should
be employed as full-time men. /Various sections of the Royal
Society of Medicine were consulted by the Committee as to tbe
tnumber of Specialists in various subjects who would be re-
quired to staff the several groups of hospitals and valuable
advice was received from that Society.

As the war proceeded the question of the arrangements for
treating sick and wounded officers in small Sectional or Aux-
iliary Hospitals came under consideration in regard to the
iwastage of nmn-power involved in this arrangement.

Later on, in April, 1918, the approval of the Ministry of
National Service was asked for the grouping of hospitals and

The Committee of Reference. 217

the sclieine was being- worked out in detail wlien the Armistice
rendered further procedure unnecessary.

Amongst the matters dealt with the Conmdttee, in November,
1916, presented a report to the Prime Minister and other
Members of the Government, putting forward a scheme for
-dealing with Discharged Disabled Soldiers.

In December of that year the Committee adopted a report
of the Sub -Committee of Joint Ropresentatives of tlie Committee
of Reference and the Central Medical War Committee on the
treatment of Dischargeable Disabled Soldiers, and this was sent
to the Prime Minister and the Secretary of State for "War.

Towards the end of 1917 the Local Government Board pro-
posed to set up eleven Appeal Tribunals throughout the oountr\-
and the Board i-equested the Committee of Reference to nomi-
nate eight Assessors, four Physicians and four Surgeons, to
the Appeal Tribunal in London.

Amongst the Physicians so nominated was Dr. Hale-Wliite.

Later on further Assessors were nominated and ultimately
the rota- of Assessors was established and the administration
of the Board of Assessors was undertaken by the Committee.

The work of the Boards of A^sessoi-s became so onerous that
a Special Sub-Committee was appointed to deal with tlie Boai-ds,
consisting of Dr. Sidney Martin, as Chairman, Dr. W. Hale-
White, and Mr. Charles Ryall,

The work of the Assessors continued incessantly until the
date of the Armistice.

In March, 1918, on the resignation of Sir Fi-ederick Taylor,
Bart., Dr. Sidney Martin was elected Chairman of the Com-
mittee of Reference.

The question of tlie seconding of newly qualified doctoi-s to
assist the hospitals for three months after qualification Avas
taken up by the Committee with two objects: (1) to facilitate
the working of the hospitals in the interests of the civil com-
m,unity, and (2) to increase the value of the newly qualified

218 TliL' Committee of Reference.

doctor oil CMiteriiig the Army by 'giving- liim three months hos-
pital exi)erienoe. The Committee succeeded in obtaining this-
concession from the War Office.

In . September, 1917, the Committee called the .serious atten-
tion of the Government to the 'shortage of doctors, and they
ji'eeommended (1) that medical ^tudents now serving in the
Army as officers or privates who have already passed the
examination in Anatomy and Physiology for a Medical Quali-
fication should be demobilised and returned to their ^Medical
Schools to complete their studies, (2) that medical students now
serving in the Army whether as officers or privates who have
not passed the examination in Anatomy and Physiology should
be seconded to their Medical Schools 'for a i^easonable period
to enable them to pass that examination, and that, if succ-essful,.
they should be demobilised to complete their studies. The con-
dition's under which medical students could be allowed to return
to their Medical Schools to complete their studies were subse-
quently adopted by the War Office.

The establishment of the Ministry of National Service in
1917, with Sir James Galloway as Chief Commissioner for
Medical .Service, brought * about considerable change in the
procediu'c of the Committee, inasmuch as all questions dealing*
with the calling up of doctors was settled through the Minis -
.try, and the most harmonious working between the Ministry,
and the Committee of Reference continued imtil the termina-
tion of the war.

As the resiilt of an interview between the Chairman (Sir
Frederick Taylor) and Lord Hhondda in Janiiar}^, 1918, a joint
Sub -Committee of the Committee of Refei-ence and the Central
Medical War Committee was formed to advise the Food Con-
troller on doubtful points of Medical interest, consisting of Dr.
Hale-White (Chairman), Mr. D'Arcy Power, Dr. F. W. Mott,.
and Dr. Charles Buttar, to which were co-opted Professor E.
A. Starling and Dr. Robert Hutchison.

The Committee of Iteierence. 219'

This Siib- Committee considered, various matters referred to
them by the Food Controller, and [^resented sevei-al report* to
the DeiDartment in reference to (a) extra rations in ease of
patients suffering from certain di^ases, (b) the advice to be
given to doctors in issiiing cortificates for extra rations, (c)
priority supply of dried, condensed or c>weetened milk for
children, (d) tlie supply of gluten flour, etc.

At the conclusion of the Armistice the Committee was re-
quested by the Ministry of National Service to deal with the
question of Demobilisation so far as it related to members lof
staffs of tlie hospitals. The Committee thereupon applied to
the hospitals to forward lists of the membei-s of the staff
whom thej^ desii-ed to be demobilised at the earliest date. Lists
were compiled by the Committee showing- the order of urgency
specified against the various cases for demobilisation and for-
waixied to the Minister of National Service. Generally speaking
these lists were dealt with in a satisfactory manner except
where officers were serving in Salonika, Egypt, Mesopotamia
and India, where considerable delay occui'red, iand some cases
of hardship \^^re brought to the notice of the Committee on
account of the difficulty of supplying- vacancies in the Medical
Staffs. In the same way delay took place in regard to the
Medical Officers in the Army of Occupation, and tlie Committee
did wliat was possible to facilitate the i-eturn of members of the
Staffs asked for.

At the conclusion of the business of the Committee a letter
from Sir Auckland Geddes, Minister of National Service, was
received by the Chairman expi^ssing his high appreciation of
the services that the Committee had rendei^ in association
with his Medical Department, and conveying his personal thanks
and tlic tlianks of the Government to H\e Member's o\ iflie Com-
mittee of Refeiience for the important national work which thej
had done.

THE LATE SYMPTOMS OF GAS
POISONING.

G. H. HUNT, M.D., F.R.C.P.

In the early days of the war two of the most potent causes-
of prolonged invalidism were trench fever and trench feeit,
two diseases which, because of their novelty, had never been
considered. Towards the end of 1915 a third cause was added
to these, and this forms the subject of the present paper.
Poisoning by asphyxiating g&js was responsible for a con-
siderable number of deaths, but it also (diminished the fighting
strength of the Allies by incapacitating men for a considerable
period after they had passed the dangerous stage of their ill-
ness, and were thought fit for discharge to a convalescent camp.
It was, in fact, at the convalescent camps that it was finst i-e-
cognised that the effects of gas-poisoning might cause a man
to be quite unfit for duty long after the acute pulmonary symp-
toms were over; the medical officeiis attached to these camj^s^
kept on finding that men, who were on ordinary clinical exa-
mination apparently perfectly soimd, often complained of being
unable to march more than a short distance, and that if they
were put to an actual test their statements -were perfectly cor-
i*ect. They found, in fact, that in many men slight physical
exertion caused very genuine distress, often sufficient to make
any continuance of work impossible. In the summer of 1916-
a large number of " gassed " men were sent to the hospital,
to whicli I was attached, to find out the pix)portion of men
who were suffering in this way, the signs showing that the
supposed incapacity was genuine and the best way of treating it.

222 The L<ifr Sf/nipfonis of Gas Poisoning.

In a few patients tliei'e was evidence of jiersistent bronchitis^
but the real difficuhy arose in patients who looked perfectly
well, and in Avhom physical examination revealed nothing ab-
normal. In the^^e I found that the only way to demonsti-ate
any disability Avas by tosting their response to exercise. In
some a walk of a hundiW yards caused obvious exhaustion,
djTspnoea and tach}- cardia ; others onl}- showed these signs after
walking half a mile or more. Those who exhibited these signs
complained that exercise brought on palpitation, pains in the chest,
dizziness and headache. The clinical picture was, in fact, iden-
tical with that met Avitli in cases of effort syndrome, a condition
which was at that time being investigated at the military heart
hospital by Lewis. In addition, however, a certain number
■of patients suffered from attacks of acute dyspnoea at night,
the cause of which was very obscure. Tlie patient would be
awakened by a feeling of suffocation, and would sit up- in bed
to get i-elief; when seen during an attack, the patient looked
anxious rather than acutely ill: his breathing was rapid and
shallow^ but not difficult; his pulse was sometimes slow and full,
sometimes rapid and almost impalj)able; it was rare to find
any rales or rhonchi in the chest, and the dyspnoea resembled
that seen in cases of ui'femia much more than that in cases of
bronchial asthma. (All these patients had been gassed by
chlorine or phosgene; in subsequent cases suffering- from mus-
tard gas poisoning true bronchial asthma AA^as often seen.)
The cause of these attacks was very puzzling, but a partial
•explanation of the j)atho logical condition underlying them wae
eugg-ested by the condition of the blood; I was very fortunate
in having the help of an old Guy's man. Dr. C. Price Jonesy
who had a wide experience of blood examination, and he in-
vestigated a large number of my j)atients. He found that those
who suffered from dyspnoea at night nearly ah^-ays had a raised
haemoglobin percentage with a corresponding increase in the
red cell count, the haemoglobin sometimes being over 120 per
cent. Patients who simply suffered from effort s^-ndrome and
whose sleep was undisturbed, on the other hand, had a normal

The Late Si/inptunis of Gas Poisoning. 223

blood count. The discoveiT of this poheythfemia invited a
comparison between " gassed " patients and dwellers at high
altitudes; in both we find the following features, dj^spnoea and
tachj'cardia on exertion, disturbed sleep, ijohcvthsemia and
some alteration in the mental condition; the last is well known
among the dwellers at high altitudes, and a striking feature in
many " gassed V men Avas mental depression; acidosis, too,
is found in both. The s^-mptoms of mountain sickness hava
l>een definitely shown to be due to an insufficient suppty of
oxygen to the tissues, and disappear completely on a I'eturn
to the sea-level, Avhei-e the oxygen tension in the alveolar adr
is greater. Mr. J. Bai'croft accordingly sugested that the

■ gassed " ])atients were suffering from anoxaemia, and that they
might be benefitted by continuous inhalation of an atmosphei-e
licli in oxygen. AVe investigated this later on at Cambridge,
but before describing the results a rather moi^ detailed de-
scription must be given of some of the commoner features of
chronic gas-poisoning.

By chronic gas poisoning is meant these late effects of gas
poisoning which are present after the acute symptoms of lung
irritation are over. Two classes of gas were used b}' the enemy,
the suffocative gasses, of wliich chlorine, chloropicrin and phos-
gene weix) the most frequent, and the vesicant gas, dichlorethyl-
sulphide or ' mustard gas." Both grouj^s act on the lungs, but
the former acts primarih' on the alveoli producing oedema of
the lungs and capillary thrombosis Avith but little bronchitis,
whereas the latter primarily attacks the bronchi, causing bron-
chitis and in sei^ere eases bronchopneumonia. In both cases
the patient passes through a j^eriod during which he isuffeiis fi*om
deficient aeration of his blood with consequent anoxtemia, and
it is believed by some physicians that the late effects of gas
poisoning are due to the changes in the tis^^ues that this anox-
comia produces. Although the pathological process in the two
groups is somewhat different, the late effects, from the clinical

ispect, are very similar. The chief symptoms complained of are
as follows : — •

224 The Late Symptoms of Gas Poisoning.

1. Dyspticea. — In severe cases this may be obvioiLs, even when
the patient is at rest, but, as a rule, patients only complain of
it on exertion, and then it varies very much in degree; some
patients are short of breath when walking quite slowly along
the level ; others can walk slowly on the level, but become
short of breath when they quicken their pace or walk uphill.
Associated with this dyopno3a there is tachycardia, and the
effect of exercise on the pulse rate is so important in esti-
mating the severity of the case, that it requires a detailed de-
scription. If a healthy, well-trained man takes exercise, hm
pulse rate rises, and when he stops the pulse I'eturns after an
interval tcj the pre-exercise rate. After a walk of a mile iii
15 minutes, for example, a healthy man's pulse returns to its.
original rate within a minute after the walk is over. In the case
of the " gassed " man the pulse remains quickened for a longer
period after the walk, and may take two, three or several
minutes to return to its original rate. In general it may be
said that the longer this period and the gi-eater the dyspnoea
produced by the walk, the g-reater the patient's disabilit^v.
Having in this way some standard of the patient's incapacity,
the physician is in a position to estimate the effect of his treat-
ment; if he gives the patient the same exercise as a test before
and after treatment, and finds that after treatment the exercises
causes less dyspnoea and the pulse returns to its original rat©
more quickly, he has evidence that the patient has improved-
The dyspnoea at night has already been described.

2. P€iin. — Patients frequently complain of pain in tlie chest;
sometimes it is situated behind the sternum and on both sides
of it, and is aggravated by coughing or taking a deep breatli;'
in other cases it is pi-ecordial, and is brought on by exercise;:
it is occasionally so intense that it simulatas angina pectoris.

3. Cough. — This may be due to chix)nic bronchitis, a condi-
tion more often the result of poisoning by mustard gas than
by gasses of the suffocative class. Some patients get a varying
amount of haemoptysis, and in such cases the diagnosis is often

The Late Symptoms of Gas Poisoning. 225

a matter of difficulty; the blood may come from ulcers of the
bronchi, such as are occasionally cauised by mustard gas poison-
ing; on the other hand, it is quite certain that gas poisoning
may light up a quiescent patch of tubercle. In some patients,
however, there is no evidence of bronchitis; in these cases the
cough is of a dry ringing charaoter, and is due to irritability,
of the upper air passages.

4. JSWvom Symptoms. — Many " gassed " patients are neurotic,
and this is shown in various ways. Some patients are mentally
depressed, and have a fixed idea that they are never going to
recover completely ; this idea of permanent incapacity often
makes tlie treatment of such patients very difficult. Headache
and dizziness are very common symptoms, and in many cases
it is impossible to find any organic cause. Photophobia is
always present with the conjunctivitis of the acute stage, and
may persist long after all inflammation has ceased. Functional
aphonia may follow the laryngitis caused by mustard gas.
Vomiting very often starts soon after the patient is " gassed,"
and may continue for months without there being any evidenoe
of alteration in the gastric secretion or motility; after being
absent for some time vomiting may recur as the I'esult of some
mental shock.

So much, then, for the symptoms. The pathology of the
condition is very obscure. Attention has already been called
to the presence of polycythsemia. Barcroft and others have
shown that this is sometimes associated with acidosis, but we
are still in the dark as to the morbid anatomy underlying both
conditions. In some cases chronic bronchitis is the outstanding
clinical feature, and here the pathology is similar to that of
chronic bronchitis from other causes. The number of autopsies
on patients dying- more than two months after gas poisoning
is insufficient for any general conclusion to be drawn, but in
some cases fibrosis of tlie lung and emphysema has been found.
Radiographers have described appearances diuring life sug-
gestive of fibrosis of the lung, but here again the evidence

PART III. P

226 7//r Ijtir Sf/iH/)f(j///s of Gas /'(/isointifj.

is not very conclusive. Tlie majority of patients liave no
physical signs of disease, but closely resemble men suffering
from "effort syndrome." Unfortimately the resemblance does
not solve our problem, since we know nothing of the essential
pathology of "effort sj-ndrome."

Treatment. — The symptoms calling for treatment can be
divided into three groups : (1) Inability to stand exertion, or
symptoms of "effort syndrome" ; (2) Chronic bronchitis; and
(3) Functional disturbances.

(1) InabiKty to stand exertion. — There are onl}- two metJiods
of treating this: (a) graduated exercises, and (b) continuous
inhalation of oxygen. The best results are obtained by a com-
bination of the two methods.

(a) Graduated exercises on the lines practised at the militafyj
heart hospitals have been extensively used, and at first tJiis
was the only method of treatment available ; many patients,
however, recover completely Avith tliis treatment alone. It
consists of "training" patients by gradually increasing the
amount of exercise they take, and this may be done by making
them march for increasing distances, by giving them a gradu-
ated system of physical drill, or by making them play games,
at first games which involve little muscular exertion, and later
ooaore vigorous games. It is important that all patients so
treated should be kept under strict medical supervision, other-
wise harm may be done by increasing the amount of exercise
too rapidly.

(b) Continuous inhalation of oxyg^en.

The i^asons suggesting* that benefit might be derived from
treatment wdth oxygen have already been given. It was first
carried out in the physiological laboratory at Cambridge, and
an account of tlie first patient ti'eated illustrates very well the
results obtained. He was a man aged 47 who was " gassed ""
in a munition factory about a year before he came to Cam-
bridge. He recovered from his acute symptoms after a few

The Late Symptoms of Gas Poisoning.

'I'll

days, but since that time had suffei-ed from shortness of bi-eathi
on exertion and attacks of djspnoea at night; these ocom-redi
every night, and .sometimes lasted thi-ee houi-s, with the result
that he had not had an undisturbed night's sleep for twelve
months. iN'otbing- abnormal was found on ordinary clinieaJ!
examination, but his i^d cell count was 6-1 millions; after doing
a test exercise up and down stairs he became very short of
breath, and his pulse did not return to its original rate for
52 minutes. He was kept in an air-tight chamber made of
glass and iron of about 800 cubic feet capacit}^ for the greater
part of four days and nights. The chamber contained an at-
mosphei^e of about 45 per cent, oxygen, and the carbon dioxide
and water vapour were removed by passing the air over soda-
lime and calciimi chloride. The effect of treatment was excellent.
He slept on an avemge eight hours every nig-ht, and did not
have a single attack of dyspnoea. His response to exercise im-
proved considerably; he was given the same test exercise after
treatment, and said he found it much less exhausting. His
statement was born out by objective signs, for his dyspnoea
was obviously much less, and his pulse i-etui'ned to its original
rate six minutes after the exercise, whereas before treatment
it did not return for 32 minutes. His red cell count fell to
0-2 millions.

About thirty patients were treated in ilus way, and 90 per
cent, showed improvement; in most of the patients Avho were
traced this improvement persisted, but in some there was a
disappointing relapse.

(2) Chronic Bronchitis. — The treatment of this condition does
not differ from that of chronic brenchitis due to otiier causes.

(3) Fimctional disturbances. — It is most important to convince
the patient that he is going to be completely cured, for the
chronic depression from which many of them suffer is a serious
obstacle to their recovery. Patients with functional photophobia
should be discom-aged from using darkened glasses. Functional
aphonia mu>st be treated by persuasion and breatliing exercises.

228 The Late Symptoms of Gas Poisoning.

or by the applioation of a strong faradic current to the larynx.
Functional vomiting is very difficult to treat; suggestion and
washing out the stomach will sometimes effect a cure.

It has only been possible in this short sketch to outline
briefly the main features of the late effects of gas poisoning.
It must be admitted that the true pathology of the condition
is but little understood. Some progress, however, has been
made in estimating the degree of disability from which these
patients suffer, a very important matter when the question of
a pension is under review. The results of treatment, too, are
on the whole very satisfactory, for by sidtable measures relief
can be given in every case, and in many a complete cure effected.

EXPERIENCES OF A CIVILIAN AMONG
THE NAVAL MEDICAL SERVICE IN WAR.

By
Sir ALFRED D. FRIPP, K.C.V.O., C.B., M.S., F.R.C.S.

Jack Tar's bed continues to be referred to as a "cot" and
his Medical Board as a "survey," but there is little difference
between the method of handling the naval and military casualty
from the moment he arrives at the hospital train or the base.
Before that haven is reached a variety of considerations special
to the demands of a sea service have influenced those responsible
for his welfare. The object of this article is to record the im-
pressions upon a civilian working during war with the Naval
Medical Service afloat.

Before the war broke out, the Medical Director General had
been given leave by the Board of Admiralty to engage the ser-
vices of seven Consultants. Sir Humphry Rolleston was the
only physician among- them, and he was kept very busy
travelling, here there and everywhere, to the various ba^es
used by the Fleet, as well as to the large naval hospitals.-
Sir Watson Cheyne, Sir William McEwen, Sir George Turner,
Sir Lenthal Cheatle, Mr. G. Edmunds and I were the six
Consulting Surgeons. To each of these five colleagues waa
allotted either a large naval hospital or an ai'ea on the coast;,
while I was appointed to the Hospital Ships serving die
Grand Fleet and given for my headquarters tlie Hospital
Yacht Sheelah, stationed just above the Forth Bridge. The
yacht was fitted up for ten officer casualties, Avith an excellent
opei-atLng theatre and X-ray apparatus, and a staff consisting of
a House Surgeon (a post held successively by three Guy's men
— Mr. A. J. McNair, Mr. L. B. Stringer, and Mr. G. L.

jj;jO /'^.r p<'ri<'//f rs oj <i C/rl/itnf ntnnntj the

Preston), two civilian nurses and an X-ray operator. Lyin^
close by in the harbour there ^\a's always at least one Hospital
Ship. There was also tlie Naval Hospital at South Queenft-
ferry (early enlarged to upwards of 200 cots), and the railway
sidingy for accommodating- the Xaval Ambulance Trains.

The Medical Director General at the outbi'eak of war was
Sir Arthur May, and he quickly brought his fleet of hospital
ships up to 12. Half of these were not so fully equipped and
staffed, and were given the less dignified title of Hospital
Carriers, and disappeared one by one as more perfectly equipped'
vessels became available. Each Hospital Ship had two or three
hundred cots, and a little later extra equipment was added, so
that upon emergency double that number could be acicommodated
and some smaller vessels were added, and were reserved for
isolation cases.

It is easy for a Hospital Ship to carry emergency equipment
for emergency oases, but not so easy to arrange for the adequate
service of a surplus of casualties. The staff is limited and
cannot be suddenly augmented. (Similarly upoji a fighting &hip
it is not possible to make good any dej)letion of tlie medical
staff which may occur during action. At Jutland, for example,
44 per oent. of the medical staff of the Lion were hoi-s de
combat.) This fleet of Hospital Ships were distributed by the
Medical Director General among the seveml sea forces, and
the Commajider-in-Chief of each force (the Grand Fleet was,
of course, many times largier than any other) disposed through
his Principal Medical Oflicer of the Hospital Ships allotted to
him. Sir Robert Hill, the present Medical Director General,
^as Principal Medical OflScer to the Commander-in-Chief of
the Grand Fleet tliroughout the war, and therefore ordered the
going and coming of those Hospital Ships with which I was
conoerned. The general idea was always to have available for
the use of each section of the fleet at least one Hospital Ship
in each harbour, ready and capable of taking a considerable
number of casualties on the retm-n of the fleet after its long
or short absence in the North Sea. By tlie time one Hospital

Kaval Medical Service in War. 231

Ship was full, another, empty, would go into the harbour, and
the full one would carry its load to one of the large naval
base hospitals, Chatham, Haslar, or Plymoutli, or to one of the
smaller ones, e.g., South Queensferry or Invergordon, or Deal
or Queen Mary's at Southend (for tlie inception, organisation'
and staffing of which men and women trained at Guy's were
so largely responsible), or to a dock, where a naval ambulance
train wa;s in waiting to receive the sick and woimded, and to
complete their journey by land. The Hospital Ship thus evacu-
ated was immediately refitted and cleaned during its return
journey, and was thus ready for anotlier relay of casualties.
Any inteDtion thei-e may originally lliave been to ship the
wounded or sick direct to the base was abandoned, however,
as soon as mines and submarines became a menace.

Every service vessel, from the smallest motor launch with
its two or three hands to the biggest battle cruiser with its
possible thirteen hundred liands — besides the hundreds, nay
thousands, of auxiliary craft engaged in this war upon supply,
munitioning, and other services of tlie fighting ships — was liable,
of course, to medical as well as surgical casualties, and had
to be covered by the Medical Service of the Navy.

Now any and every ship belongs to one or other of the basea
to aaid from which it is constantly working, and the fii-st duty
of the responsible medical officer upon its return to harbom- is
to evacuate any sick men, either to a Hospital Ship or to one
of the numerous smaller naval hospitals distributed around the
coast.

Anybody who wishes to know the details of the fitting up,
administration and activities (governed by tlie International
Red Cross Convention) of the Hospital Ships cannot do better
than consult the excellent little book which was written by;
Surgeon Captain Edward Sutton after he had been in command
of the Drina and the Flassy during three and a quai-ter yearn
of war. Tliis book is entitled ** The Fitting Out and Adminis-
tration of a Naval Hospital Ship," and is published by Messrs.
Simpkin, Marshall, 1918.

232 Experiences of a Civilian among the

Having Bignalled her requirements in advance, the two things
a -warship does before anything- else on return to harbour are
to re-fuel, and to evacuate the sick and wounded, so as to
be fit for action again at once. As a matter of fact, it was
no uncommon thing after each of the three big battles for
the Hospital Drifter and the collier to be alongside the return-
ing warship before she had completed her mooring, and the
Medical Officer was on de<^k with the talty of his oases, and they
were all conveyed on to the Hospital Ship and snugly housed in
a wonderfully short space of time.

Each cot case, secured in a " carrying-cot," is hoisted into
the hold of a Drifter, a small, open, barge-like vessel, w^hich,
when full, proceeds from the side of the warship to that of
the Hospital Ship, and then each carrying-cot is hoisted up,
swung on board, and lowered through wide hatchways, often
fitted with lifts, to the wards on the different decks. This
transference of the wounded is carried out with the exemplary
gentleness and despatch which we all associate with the handy-
man at his best.

But after a modern battle the wounded who survive to reach
the harbour are stirprisingly few; even such an action as
Jutland, in which 6,014 perished outright (5,550 of them
drowned), only provided 674 wounded, and many of them, of
course, quite slight cases.

Casualties.

Sir Eobert Hill, in his address at the inaugural meeting of
the new War Section of the Royal Society of Medicine in
November, 1919, gave an interesting retrospect of naval medical
conditions, and he authoritatively presented for the first time
the oaBualties at the Battle of Jutland. He said:

"During the period 1795 — 1849 the Medical Service of ihe
Royal Navy does not appear to have been a popular one, and
difficulty must have been experienced in obtaining an adequate
number of medical men, except for the ships cruising in home
waters. In the days of the old sea battles the Medical Service

Naval Medical Service in War. 233

laboured under manifold disadvantages as compared witli the
profession on shore, for sick berth attendants do not appear
to have been employed until 35 years after Trafalgar, separate
messes for the sick on board seagoing ships did not come inta
existence until 1804, and probably "vvere not universal untdi
after Trafalgar, the sick being messed in their sleeping-places
before then, and the earliest mention of first-aid instruction
was in 1855.

It is remarkable how few have made any record of the pre-
parations for reception and treatment of the wounded at sea.
The duties of the surgeon, during and after an action, must
have been very arduous. He had to imdertake all operative
work on board his ship, and would consider himself fortunate
if an early opportunity presented of sending his patients on
shore for further treatment.

Ix THE '"Lion."

MacLean and Stephens, Medical Officers in ihQ Lion at Jut-
land, -svrite: — 'Nearly all tJie casualties occurred within the
first half -hour. A few cases found their way to the foremost
station, but the great majority remained on tlie mess deck.
During the first lull, the medical officers emerged from their
stations to make a tour of inspection. The scenes that
greeted us beggar description. Most of the woimded had
already been dressed temporarily. Tourniquets had been ap-
plied in one or two instances, but we were able to remove
these later. Haemorrhage, on the whole, wajs less than we
anticipated. . . . The battle was thrice renewed during tiie
evening, but in the lulls all the wounded were carried to tiae
mess deck. ... At 7.30 a.m. on June let we were informed
that it would be safe to bring the wounded up fromi below.
The Vice-Admiral's and Captain's cabins were cleaned, dried
and thoroughly ventilated. The Captain's bath-room was rigged
as an operating theatre and by 8.45 we began. . . In all
51 cases were dealt with, and a general anaesthetic, chloro-
form and ether in equal parts, was administered to 28. . . .

234

Experiences of a Civilian amonfj the

Only urgent operations were attempted. Oui' work wa*!i severely
Iiandioapped by having- 44 per cent, of casualties among" the
medical officers and sick bei'th staff.' The Lion had 95 killed
and 31 wounded, representing- 11-87 per cent, of complement.

Tables of the casualties at the Battles of Camperdown, the
Kile, and Trafalg^ar are of intei^est when compared with a
table showing the casualties at the Battle of Jutland : —

Battle of Camperdown.

Total

Ships.

Comple-
ments.

Killed.

Wounded.

casualties
per cent,
of comple-

ment.

Russel

584

1-19

Director

485

1-44

Montagu

584

1-36.

Veteran

485

515

Monarch

593

100

22-93

Powerful

584

15-06

Monmouth

485

5-56

Triumph

634

13-24

Venerable

587

13-11

Ardent

485

107

30-51

Bedford ;

584

12-15

Lancaster

485

4-32

Boldgueux

485

21-23

I3is

338

6-80

Totals

203

622

Total force at Camperdown, 8,221.
Total casualties per cent, of force, 10-03.

Battle of the Nile.

Goliath

584

10-61

Zollous

584

1-36

Orion

584

7-19

Audacious

584

6-16

Theseus

584

5-99

Vanguard

589

17-99

Minotaur

634

13-72

Defence

584

2-56

Bellerophon

584

148

33-73

Majestic

584

143

33-04

Swiftsure

584

4-96

Alexander

584

12-22

Leander

338

4-14

Totals

■•

—

218

678

—

Total force at the Nile, 7,985.

Total casualties per cent, of force, 11-22.

Naval Medical Service in War.

23S

Battle of Tiiafalgar.

Ships.

Comple-
ments on
October 21,

1805

Killed.

Wounded.

Total
casualties
per cent,
of comple-
ment.

Victory

815

102

19-50

Royal Sovereign

811

17-38

Britannia

786

6-61

T^meraire

711

17-29

Prince

679

—

Neptune

595

7-39

Dreadnought

703

4-69

Tonnant ... '

664

11-44

Belleisle ...

556

22-66

Revenge

610

12-95

Mars

621

15-78

Spartiate ...

599

3-83

Defiance

582

12-02

Conqueror

622

1-92

Defence

568

6-33

Colossus •

617

160

32-41

Leviathan

592

4-39

Achille

605

11-90

Bellerophon

569

123

2G-36

Minotaur

586

4-26

Orion

543

4-41

Swiftsure

557

3-05

Ajax

668

164

Thunderer

556

2-87

Polyphemus

461

1-30

Africa

475

1305

Agamemnon

475

2-10

Euryalus

273

—

Naiad

•275

—

Phoebe

294

—

Sirius

258

—

Pickle

—

Entreprenante

—

Totals

—

449

1,242

—

Total force at Trafalgar, 17,772.

Total casualties per cent, of force, 9'51

236

Experiences of a Civilian among the
Battle of Jutland.

Killed

Total
casual-

Complements

Total

Names and Class

outright

Total

casualties

of Ships.

wounded

May 31,

per cent, of

drowned

ties

1916

complement

Battleships :

Barham

1,124

6-04

Colossus

884

1-01

Marlborough

1,119

0-35

Malaya

101

1,032

9-78

Valiant

—

1.063

0-09

War spite

1,048

3-91

Battle Cruisers ;

Lion

146

1,229

11-87

Princess Royal

100

1.202

8-31

Tiger

1,281

515

Queen Mary ...

1,258

1,264

Ship sunk

—

Invincible

1,026

1,027

> • > »

—

Indefatigable

1,017

)> t >

—

Cruisers :

Defence

902

> 1 ! )

Warrior

101

832

1213

Black Prince

856

Ship sunk

—

Light Cruisers ;

Calliope

363

9-91

Caroline

338

0-59

Castor

356

10-67

Chester

424

18-39

Dublin

460

652

Southampton...

498

17-87

Flotilla Leaders :

Broke

200

41-50

Tipperary

184

188

Ship sunk

—

Destroyers :

Acasta

Ardent

Ship sunk

—

Defender

—

Fortune

Ship sunk

Moorsom

—

Nessus

Nestor

Nomad

—

Obdurate

Onslaught

—

Onslow

. —

—

Petard

Sparrowhawk

—

— •

—

Spitfire

—

Shark

Ship sunk

—

Porpoise

Turbulent

—

Ship sunk

—

Totals ... 6,014 | 674 | 6,688 | -

Total force, Grand Fleet, about 60,000.
Total casualties per cent, of force, 11*14."

Naval Medical Service in War. 237

Sir Robert's fignres stow that the easiialties in the British.
Fleet at Jutland were 11-14 per cent, in a total force of 60,000,
and that this percentagie is almost identical with the casualties
in three other great naval battles: —

Trafalgar, 9-51 per cent, out of 17,500 personnel (about).

Nile, 11-22 per oent. out of 8,000 personnel (about).

Camperdown, 10 per oent. out of 8,000 personnel (about).
But though the big naval actions with which the publio be-
came familiar in the Great War T\^re few and far between,
and the wounded survivors fewer than had been anticipated,
there was a constant and large volume of other work for the
hospital ships to do. Day by day every squadron provided
accidents, bums, crushes, and fractures, as well as medical
cases; and no casualty must be kept upon a fighting ship
longer than is absolutely essential for his welfare; he is a
nuisance and a handicap, and must be got rid of. Epidemics
also at times throw stress upon ih^ Hospital Ships, cropping
up especially on those ships which are fresh from dockyard
hands, and spreading like wildfire omng to the close quarters
of the mess deck and the impossibility of effective isolation.
Acute abdomens, too, were sometimes so numerous as to make
one wonder whether there must not be some relation between
the nerve strain of modern naval warfare and the incidence of
such affections ais perforating gastric and duodenal ulcers.

I have some memoranda written just after the three iNorth Sea
battles which convey a good impi-ession of the nature of the
surgical work entailed by a naval action, of the difficulties
under wliich it is done, and of the considerations which are
prominent in the minds of the medical staff. These considera-
tions vary considerably from tliose which dictate the organisa-
tion for surgery during and after a land battle.

Memo A.

"1. The Drifters for conveyance of tlie wounded were along-
side as soon as the returning sliips had moored; in fact, they^

238 Experiences of a Civilian among the

like the colliers, were lying in -wait close to the berth each ship
was to take up.

2. The (actual transference of the wounded from the war-
ships to the Drifters was accomplished w-ith great speed and
little or no inconvenience, the cots being most considerately
and adroitly handled. On arrival alongside the Hospital Ship
Plussy the cots were swung in smoothly, and, as all io\vc
hoists Avei'e working simultaneously, this part of the work and
lowering them through the hatches to the various Ward Decks
was accomplished rapidly.

3. 192 serious cases were thus handled without any detri-
ment, and without any undue stress upon the staff, but their
efficient tending entailed very hard work for tlie next few
days."

When in harbour every warship is at a definite " time-
notice " — " half -hour notice " in times of liveliness — which
means, of course, that full pressure in the boilers must be
available within that time, and all landing parties must
be within easy recall by signal.

It had been hoped before the war that Hospital Shii3s
would be able to attend the fleet in action, but experience soon
showed that this w^s impracticable. We had to wait what
seemed an interminable time for tJie first action in the Bight
-of Heligoland. At last it came, on the 28th August, 1914;
but 400 miles from the base, and it was foug-ht at such a high
speed that nothing in the nature of a Hospital Ship, even
had one happened to be about, could hope to keep in touch
with the fighting line, nor could it, even hovering- miles away,
be anything but an anxiety to the Commander-in-Chief. Each
sliip had, on this occasion, to carry its own ^-ounded back io
port, and it was obvious that this would be the rule in future
actions, and that Hospital Ships would really function as '' Base
Hospital Ships." If occasionallj- it proved possible to dispatch
the casualties in one of the lighter and faster of the fighting
ci-aft (i.e., a light cruiser or destroyer), the transhipment of

Saral Medical Sercice hi War. 239

t]ie casualties in the open sea is, under the best possible con-
ditions tedious, and dangerous from the risk of enemy attack
by submarine, and in a heavj- sea it is impossible. Fui'ther,
the decks of the small and swift ships are cramped and cum-
bered, and it is ver}- difficult to get wounded to or from the
cabins, there being no large companions. It therefore came
about that such transliipment was hardty ever undertaken unless
a ship was sinking, and that Hospital Ships alwa}^ received
the wounded in the calm waters of the harbours, and iherefoi*e
for them it was not necessary to maintain "Short notice" after
the early days; "Six hours' notice" was substituted. The
^ledical Department owed it to the fine work of the Naval
Intelligence Department, under Admiral Sir Reginald Hall, that
there was always ample warning of any probable action, and
extra beds were arranged in case of overfloAv — e.g., in Edin-
burgh Infirmary and many other large civilian hospitals.

With regard to first-aid upon the hundreds of destroyers it
early became apparent that some steps must be devised to
supply each with more skilled attention than is represented by
a seaman or two with a smattering* of experience of the sick-
bay. Until after the " Battle of the Bight " such a first-aider
was the only individual on board these craft (which carry about
i hundred men, and are in the thick of every fight) who had had
any experience whatever of tending a casualty, so that the
wounded, however serious, got, in that battle, no trained atten-
tion for upwards of 24 hours. It is imjiossible for either of
the two Medical Officers carried by the two flotilla " Leaders '*
to leave his ship for casualties occurring u,pon one of the 14
to 16 destroyers which make up tlie flotilla. The shortage of
qualified men was so great that one could not be spared' for
each destroyer, so the Medical Dej^artment acted upon what
proved to be a very happy thought, and appointed sufficient senior
but unqualified students as siu-geon-pi-obationers. Great credit
should be given to the M.D.G. for having* recognised so early,
that theie was scope for such officei-s, and incidentally to the
authorities at Guy's for having taken a leading part in supply-

240 Experiences of a Civilian among the

ing them. The plan was a gi-eat success; these surgeon-
probationers proved efficient and i^sourceful, and well earned
the praise which has been forthcoming from their seniors.
In the later stages of ih^ war the class of " almost-qualified "
men was exhausted, and reliance had to be placed rather
prematurely upon the " just-entered-the-wards " class, hastily
put through an intensive course of training at a Naval Base
Hospital.

The desirability of vocational selection in order to minimise
misfits in industry is coming to the fore nowadays as one of
the methods of increasing the efficiency of the population, and
along this line of thought it is a matter for serious considera-
tion, in arriving at plans for the mobilisation of our profession
in any future emergencies, whether greater use should not be
made both of the unqualified medical and dental student and
also of the large class of civilians who in peace time are trained
and experienced in hospital management.

That there was no bar to the commissioning of unqualified
men in the R.A.M.C. is proved by the fact that two at least
who* had never had any connection whatever with tlie medical
profession were given commissions on the recommendation of
the D.G. in the persons of Major Brand, who presided for
years over the allocation of wounded officers arriving in London
to the various hospitals, and Captain Jeff Cohn, who served
on the Staff of the D.G. in France.

Such measures would go far to conserve medical man-power
and to prevent that shortage of doctors of which we heard
so much during the war.

And now that the smoke has cleared away and the visibility
is returning to normal, we shall probably realise that it will
be more economical if the transport of sick and wounded is
committed in the future to the care of that Service which has
to do with ships, viz., to the Navy rather than to the Army
{vide Second Report of Dardanelles Commission).

Then, as regards the Medical Staff apportioned to the fight-^
ing units, each battleship, or battle -cruiser, carried three qiiali-

Naval Medical Service in War. 241

fied medical offioers, eacli cruiser two or one according to com-
plement, each destroyer " leader " one. It was suggested during
the acute shortage of doctors that no ship should have so many
as three, it being urgied that for ten to thirteen hundred men
in the prime of life and liealth one doctor is suflficient, especially
as he has the opportunity almost daily of evacuating on to a
hospital ship any of his ships company who chance to go sick.
Undoubtedly there was great difficultv' in " putting in your
time," and medical officers on tlie fighting ships got " fed up "
with " doing nothing " month after month, and wei-e glad of any
job — even that of censoring the correspondence of the met3s
deck. But the Medical Department, with Sir William Norman
now at its head, rightly continued to provide personnel upon
the assumption that these great engines of war had to be
kept constantly ready for instant action, also that the doiotor
may himself go sick, and that it may be manj* houns befoi'e
his substitute can arrive on board. One has only to refer again
to the memoranda to realise that the M.D.G. was entireJy
justified in refusing to countenance any diminution in the
medical staff carried by the fighting imits of tlie Fleet.

Memo. B.

" The j)atients received by the Plassy after Jutland came
chiefly from four ships: the Lion, the Princess Royal, tJie
Tiger, and the Southampton, each of which had borne a
prominent jrnrt in the cngag^ement, and had suffered sevei-e
iisualties. They provided, therefore, a good test of what it
IS possible for surgery to achieve under c-onditions of extreme
difficulty.

The first really instTUctive action at sea was tlic Dogger
Bank fight of January, 191u, when British and German "alU
big-gun" ships came into contact for the fii"st tiii^e. Fire wa.s
opened at more than 20,000 yards (about llj miles), and the
BlUcher had her engines disabled by British shells fired at
18,0U0 yards. This result was an eye-opener to all concerned.
It meant that tlic "decisive rangxj " — at which a capital ship

PART III. Q

242 Experiences of a Civilian among the

could use lier guns with deadly effect — was nearly twice as
great as the pre-war estimate, and, consequently, that prevail-
ing tactical ideas bajsed on the 10,000 yaixi limit had to he
i-ead justed. Another i-evelation of this encounter was that
two or three hits by high -explosive shell might prove fatal
to the largest and strongest man-of-war. The Blilcher was
put out of action by two projectiles plunging almost vertically
through the deck and exploding among the boilers. On the
British side, H.M.S. Lion w^as forced to leave the line after
receiving one hit below the armour belt.

In the interval between tlie Dogger Bank fight and the Battle
of Jutland each navy paid marked attention to the development
of long-range gunnery, with the i-esult that a great improve-
ment w^as notic-eable in the firing on both sides when the fleets
met for the last time on May 31st, 1916. The battle -cruiser*
part of this action was fought at ranges varying from 17,000
to 24,000 yards (13f miles), and, in spite of the great distance,
a large percentage of the shells reached their mark. Paradoxical
as it may seem, a naval cannonade at long range is liable to be
far more dangerous than one at medium range, assiuming
accurate aim in both cases. For whereas at medium range
the trajectory of ih& projectile is almost horizontal, and a
liit, if one is registered, will be against the side of the ship,
where the armour is thickest, at very long* range the projectilei
descends at a steep angle, and is therefore liable to strike the
deck, where armour is thin, and penetrate to the vitals of the^
ship, exploding in the machinery or the magazines. Although
the precise circumstances wdll never be knoA^-n, it is generally
agreed that the three battle -cruisers, Quezon Mury, IndefaUguble,
and Invincible, were destroyed in each oaise by shells striking
the thinly -armoured roof of a barbette, bursting inside, and
sending a stream of fire into tlie magazines below. The German
ships were beitter armoured than ours, and had so many water-
tight compartments as to be practically unsinkable; but thisi
immunity was purchased by a sacrifice of speed and: gun-
power. It is now know^n that the German battle -cruisers re-

yaval Medical Service in ^^ar. 243

eived more hits than tliej inflicted, and their thick armour

ind minute sub-division, though it kept most of them afloa4i,

iftoixled little protection to the crews. In the Luetzow, which

ank during- the iiig-ht, thei-e were 620 casualties out of a total

omplement of 980. The Seydlitz, which was battered out of

recognition and had to be beached near Wilhelmshaven, had

500 killed and wounded. Other German ships suffered almost

as severely."

A German officer rescued from the Litetzow, which was sunk,
admitted after the armistice that the British shooting at Jut-
land Avas magnificent. " The Luetzow;' he stated, " was hit
twenty-eight times in one hour, all by shells of the larg'esi^
calibre. Our armour and multiple bulkheads kept us afloati
till nightfall, but the havoc among the men was awful. Fires
were blazing everywhere, and no sooner had we got the flames
subdued in one place than afresh shell started them in anodier.
When we were not actually hit, the salvos fell so close along-
side that torrents of Avater descended on the ship, sometimes
extingaiishing fires which we were unable to conquer by other
means. At times every tiling reund about us was blotted out
by columns of water and the smoke and flame of bursting shell.
Other missiles roared overhead, and the air seemed to be full
of flying splinters of steel. Though the sea was calm we were
rolling heavily, which I atti'ibuted partly to the concussion of
our own guns, but still more to the hits we were receiving.
Once as we lurched over towards the enemy a whole bunch of
pix)jectiles struck the deck, pas^sed tlirough it, and exploded
down below. After this we had to steam with only one set
of engines. None but those witli nerves of ii-on C€ui endm*a
the ordeal of a modern sea-fight. It is too appalling' for
Mords. ..."

Nearly all the officers and men are behind armour, which
means that they see nothing of the action, though they enduro
an appalling din, and nearly all of them work by artificial
light.

244 K.I I'-i' " ( irU'iiiu iiition'J fill'

After an actioTi thn sin'<>-ooiis ou \\[i\>\\i[).> liav<.' to work under
great diffieiiltk's. Ir hoiim- <j(iilo iiijj)<AS.sibl8 to operate during
action, tlie euc^^edino- lioiins are strenuous in the extreme.
With very limited ajsisistanoe (no female numes, of ooui-se),,
great deficiencT of such essentials as . light, hot water, and
adequate space, oftein the sick bay or operating I'oom, or both,
cleared out by a shell-burst, the Medical Staff has to impro-
vise. The best plaoe one surgeon oovM find as a. substitute for
his destroyed quarters w-as the stokers' bathroom! Another
hjad the water so deep upon the floor that it was over his high
boots! And another found that some of the row of "swunded
had to be shifted because a list in the ship brought the -v^ater
a foot deep where they were lying! Yet in spite of all this,
and much more, excellent oonservative surgery was achieved,,
and the greatest credit is due to the Naval Surgeons, not only
for wliat they did, but also for the discretion they showed in
not doing too much.

Memo C.

" The work of the Medical Staff on the Lion and Tiger was
evidently extremely well done under cii-cumstanoes of extra-
ordinary difficult^'.

In both ships tliere was a failure of tlie electric light, and
in one ship a failure of the water supply. Emergency lamps-
and tins of water had been provided, vet the medical ofRcei's-
A\ere reduced to the use of candles for some of tlie operations,,
tlie emergency lamps having been requisitioned for the dark-
ened j)assages, wliich, becoming obstructed by displaced metal
of various sorts, provided very difficult ' going ' for the wounded
and those who were acting as carriers.

There were many cases of asphyxiation, but tliose that re-
covered did so quickly. The burns, which for the most part
were only extensive in the sense that each patient had multiple
lesions {e.g., face and both \^^6 and both forearms;, seldom
went deep.

Savid Medical Serclce in War. 245

(As a result of the experience of tlie burns received in the
Jutland Battle there was a g-eneral issue of helmets, gauntlets
And seaboots for protection in any future fi<^hting.)

There were very few eases of hreniorrhage among the survivors,
but enougli to demonstrate that operation for its arrest is almost
impossible under the conditions which prevail during an action,
iand that tourniquet must be relied upon until tlie severe jolt-
ing of the ship from its own heav}' gnii>, and the impact of
i;he enemy's shells had ceased.

The Neil Robertson stretcher Mas found ver}- useful in the
transport of woimded through hatches and narrow passages,
along which the bearers had to grope throug-ih darkness, smoke
and manifold obstructions. One of tlie Dressing Stations had
the misfortune to become the popular urinal for the ship's
company, when they found their usual latrine shut off by the
'(^losing of a water-tight door.

Experience jiroves that on a shij) of war the dead are liable
to be brought to the Dressing Station tog^ether Avith the living
casualties. This is probably due in part to the darkness and
in part to the ignorance of the untrained bearers. It is some-
what embarrassing to the Medical Staff.

The hircliing of the ship was enoug-h to lead to tJie immereion
■of one of the wounded after he hsui been dressed."

The Hospital Ship is in for as bus}' a time as any CCS. for
s. gieat many hours after an action, and as she only carriets
four nursing sisters, and pmcticalty all cases, owing to the
burns, are going to need frequent dressing, and many of them
Hie very severely shocked, considerable cai'e has to be taken
in the selection of the most urg-ent work. For instance, thougli
the giving of aperients may rank as a minor matter, under
Nuch circumstances it is quite easy to over- work your staff
if two or thi-ee hundred (Xjt cases are given castor oil on the
same evening after forty-eight hours or more of neglect during
tlie homeward voyage of their' ships.

The length of stay of each patient in the Hosj>ital Ship will
vary according to the severity of his wound, anrl the orders re-

*2\(i Experiencefi of a Civilian among the

oeived by its medicel officer, but the oou trolling idea is, as on
land, to evacuate as soon as possible to the base, and, of course,
in a few days man^^ will have become walking cases. The
graver cajses would reside for long in one of the three largo
Base Hospitals (Haslar, Chatham, or Plymouth), or if officers,
.they frequently went to one of the niunerous smaller Officers'
Hospitals ; we, at Guy's, for instance, kept a proportion of
the beds in our " Officers' Section " at the disposal of the Naval
Medical Department, and received a hearty letter of thanks from
the Lords of the Admiralty for the work done there.

Memo. D, by the S.M.O. of the Tiger.
"General Medical Arrangements.

(a) Forward Distributing Station.

(b) After Distributing Station.

(d) One or two of each of the 5inch gun's crew trained in
First Aid, with a Neil -Robertson stretcher placed at each end
of the 5inch batteries, on both sides. Each turret was sup-
plied with a First Aid bag, and also a hypodermic syringe,
Wildey's pattern, attached to left side of breast of responsiblei
officer with a solution of morphia (in a " Jena bottle " also
attached to breiast near to the syring-e), which, when the syringe
was filled, gave a dose of Jgr. One of the Fii'st Aid ratingis
was taught how to give a hypodermic injection, but was only
allowed to administer it on the orders of the officer of the
turret.

Tl}e First Aid ratings at the 5inch guns were similarly
supplied. (Other Medical Officers only allowed sublingual
morphia unless an M.O. was present.)

Forward Distributing Station is situated almost immediately
below " B " turret. The ship's armour at the side is Ginches
thick at least, varying- with the class of ship, and tliere is a
3inch casing round the Station itself with an armoured door.

^aval Medical Service in TTVir. 247

Except for its unpleasant proximity to the 13-o inch magazine
it is probably the safest place on the ship.

It is properly fitted witli hot and cold water, electric and
emergency light, medical store-room and cupboards, opeiarfing'
table, instrument chest, etc.

Prior to the action tlie whole Station had been sterilized,
and painted out, and the corticine on the floor covered with
shellac varnish. The Station would be better with the addi-
tion of a sink, but to supply this would entail cutting through
the armour.

Personnel attached: — Staff surg-eon, surg^eon, fleet paymaster,
chaplain, one sick berth steward, two sick berth attendants^j
two writers, one cook, one officer's steward.

After 'Distributing Station. This is on the main deck almost
under "X" turret, and is simply an open athwartship spaoe.
It is protected by the 6inch armour of the ship's side, and
is surrounded b}^ officers' cabins, in which the wounded could
be laid.

It is fitted with a No. 1 medicine chest, dressing cupboard,
hot and cold water, operating table, instrument table, and!
lotion stand.

Personnel attached: — Surgeon, sick berth steward, two sick
berth attendants, two cooks, two officers' stewards, one writer.

Action of the Dogger Bank.

The ship went to action stations at 7.15 |a.m., and the Stations
were fully 'rigged, everything that could be foreseen being-
provided for. About 8 a.m. the ratings were allowed to stand
easy. At 9.3 a.m. the first shot waiS fired, whereupon we all
went to Stations and remained there until some time after the
action, which lasted three hours, was over.

I had first intended to do each patient tliat waa brougihfi
down thoroughly, placing the case on the operating table and
going methodically over it and doing what was requisite as
one would do it in hospital, but I very soon recognised that

248 Experiences of a Civilian among the

the violent, oonciission from " B ' turret would make any,
operative ti'eatment impossible, and accordingly arranged for
First Aid ti-eatment only until the action was over.

The wounded commenced to arrive in the Distributing Station
within ten minutes of the first casualty, and thereafter there
was a steady flow.

About 9.30 a.m. I had considerable difficulty with a dockyard
workman who was brought down to me in a fainting con-
dition from fright. He recovered from the faint, but rolled
about the deck in an agony of fear, shouting and sci-eaming.
. As this was threatening the morale of my own staff and
the ratings employed on the deck round about, I dealt with
him by tying him up in a Neil Robertson stretcher, giving
him a hypodermic injection, and concealing him in the medical
store room.

At 10.50 a.m. I got a telephone message from 'Q' turret
asking for a Medical Officer and an ambulance party. I had
already decided with the Gunnery Lieutenant that any man
who could not help himself must remain in the turrets until
the end of the action, as it wais impossible to handle men in
stretchers through the working chambers, and going upon deck
was not to be thought of. An 11-2 shell, exploding in ' Q '
turret, had blown tMO men' to bits, and the wounded readily
found their way to the dressing stations themselves.

About 11.30 a.m. another 11-2 shell entered the Distributing
Office on the upper deck where the bridge messengers, canteen
staff, and some stokers (who ought to have been below) were
collected. This shell was very destructive, as it blew up the
trap hatch in the roof of the Distributing Office which com-
municated Avith the gun control tower, killed Captain ,

who^ was standing on the hatch, seriously wounded Sub-
Lieutenant , and severely scorched the face of Lieutenant

, and injured Midshipman — . It also killed six

men, and wounded five, and in the port 6inch gun conffcrol
killed Boy , and injured two boys.

JSaval Medical Service in War. 349

An urg-ent telephone message uas received from the gxin
ontrol tower, and an ambulance party was sent off in charge
jf Siu'g-eon to see Avhat could be done.

This party had considerable difficulties, ^s the lights had all
j:one, and the alley was wrecked, and the escape up past tlie
Distributing Office, Avhich was the only possible route, was
'jlown to bits and threatened by fire from the IntelligieBK^:
Office, which was immediately below the Distributing Office,
rhanks to tlie heroism and bravery displayed by the Sick Berth.
Attendant , Boys and , all the cases men-
tioned, except , who was discovered after the action.

was over, were brought down to the Forw^axd Distributing
Station.

When they arrived seven were dead, or expired as they)
were laid on the floor. Their injuries were frightful, heads,,
chests and limbs being pulped or incinerated. The dead werei
laid on one side as decently and quickly as possible, covered
with a flag, and the wounded attended to. First Aid dressing-s
Avere applied with the utmost despatch. By the time this was,
done it was 1.15 p.m., and the action had been over for au
hour and a quarter.

I went to the forebridge and asked the captain's permission
to open up the sick bay, but lie informed me tliat that would
be impossible until we were out of the danger area. So the
wounded were made as comfortable as possible, and the dead
Avere separated out and taken to the upper deck.

In the case of the killed the injuries were all of such a
jVightful nature that death was practically instantaneous.

All cases were suffering severely from shock, which was
<'ombated by giving them all Jgr. morphia, hot drinks such
IS bovril and ooooa, hot bottles, and plenty of blankets. After
i. little time most of them became quite comfortable and went
to sleep. There was a complete absence of moaaiing or com-
plaints.

About 4 p.m. I got permission to ojKjn the sick bay, and
on my arrival tliere found absolutf^ly l^f^ damage to tJie bay,

250 Experiences of a Civilian among the

although there was considerable damage to breakable stores
from the oonoussion of the guns.

The operating theatre was cleaned and rigged, and we got
to work, the cases being brought one by one, placed in the
theatre, thoroughly overhauled, dressed and cleaned, and put
to bed.

The explosion of the T.N.T. in the shells caused a black,
oily, sooty deposit on the skin of nearly all tbese patients.;
This was readily removed with turpentine, but nothing else
seemed to have any effect. Soap and water and spirit were
useless.

The ' Neil Bobertson ' modification of the ' Japanese '
stretchers were of great service, and it would have been
almost impossible to remove the injured men witliout them
from the more inaccessible parts of the ship."

I cannot recall any bullet wound among the wounded, and have
never heard any evidence of poison gas having been used in the
shells. Many of the most grievous injuries were inflicted by
some fragment of shell or of the ship, or by the patient}
being blown violently against the walls, or against some promi-
nent machinery. Practically all the wounded were burnt aa
well, especially, as said before, on the face, back of hands,
and front of legB, in addition to their other injuries. Thei
momentary heat of the initial " flash " is probably the most
intense; it is equally disabling in the open, and caused many
casualties on the lig^ht cruisers, and it is reported to have
even travelled down a voice tube and burned anyone in the
vicinit}' of the other end of such a tube. The following
" flame " persists for seconds, and is due to ignition of cOrdite.
The casing of the electric cables in the passages was often
melted throughout a radius of several yards from a shell burst.
Often the ship is thrown into darkness by the failure of cur-
rent. At all tinies the parts behind armour depend upon arti-
ficial light, and the emergency oil lamps and candles cannot
possibly be adequate. One notes, too, that the thud caused

A' aval Medical Service in War. 25 i

by enem}- shells stopped by the armour was almost as detri-
mental to delicate manipulations as the tremor caused by the
ship's own big g-uns, though these were severe enough to
break up the porcelain fittings of the lavatories in a big ship
which was not struck at all. The water also may fail, so that
an emerg'ency supply of metal vessels was filled before action,
but these are liable to be upset and smashed.

The Lion had such a list after the Dogger Bank action in
January, 1915, that the getting of her home at all is alwaya
said to rank as a great feat of seamanship: she came some
300 miles, and under speed so greatly reduced tliat she was an
excellent target for the German submarines which were in
chase. What would they not have given to have sunk the
flagship of our indomitable Battle -Cruiser Squadron? They
were only kept off by a large number of our destroyers racing
round her in circles at top speed w^hile she slowly made her
way home.

All the wounded after the big actions of August, 1914, and
January, 1915, and half of the wounded in the Tmttle of Jutland
were brought into the Firth of Forth. In its calm home waters
the great ships, more or less limping from their battle in-
juries towards the great Naval Dockyard at Ros^i:!!, made
signal in confirmation of their wireless, and the appropriat»
Hospital Drifters were alongside, and the transference of
wounded, already collected on deck, began even before their
engines were stopped.

In .the early days of tlie war this great estuarj' was
undefended except by shore batteries, quite ineffective
against submarines. Later a series of obstacles was of
course contrived. It was a never-to-be-forgotten hoiu* when
the wounded and listed Lion threaded her way through gates,
which could be tempoiurily opened in these obstacles, and
slowly passed her more fortunate portnei-s in tlie fight of
yesterday already lying snugly at their moorings. Sir David
Beatty and his staff were on the topmast bridge. It waa
early on a fine winter's morning, the haze almost shut out

J252 KjLperiences of a Civilian among the

the high laud on the north and south bankw, but the sun wa«
Btniggling* througli Avitli obvioiLs succeiss, and as the flagship
kboiu-ed slowly to her berth, each ehip in the harbour Avas
manned and gave thi'ee ringing cheers, and band after band
placed "Rule Britannia."

The Medical Department of tJie Admiralty has to its ei-edit
many an advance in methods of treatment during the war; to
mention one only, we owe to it the popularisation of the so-
called "Ambrine," or "paraffin treatment," of burns since intro-
duced and largely employed at Guy's and other civilian liosi)itals;
and while thus keeping an eye upon the Avheat, the successive
M.D.G.'s had the sense to leave the chaff and not to get
obsessed with any of the speculations such as the " Simpson
Rays " which found their op])ortunity in tlie turmoil of war,
nor were they taken in by that incomparable farce known as
the '' Share Rays, ' so prematurely boomed in the lay press.

The " Surveys " were efficiently arranged, reasonably carried
out, and not too frequently repeated, so that they earned no bad
re})ute. In short, there was a striking exhibition all round of
that (plasticity and adaptability to altered circumstances wliicli is
not too commonly found in Government Departments. The re-
sult was a very large measure of confidence in the justice of the
authorities, and of contentment with their lot on the part of the
temporary medical officers, in spite of the long period of mono-
tonous life on board ship Avith, perforce, too little to do, and no
hope of change in the deadly dull routine of their Avaiting duty.

Before closing- this short account of the points which most
impressed a civilian with previous war experience in South Africa,
I should like to bear testimony to the consideration shown by
the Medical Department of the Navy for the civilians who were
temporarily serving under it. Not only were the professional
interests of the medical officers consulted, e.g., their natural
ambition to present themselves for their final University,
examinations was facilitated to the utmost, even though it
entailed consideiable trouble upon Sir Daniel McNabb and the
other officials of the personnel branch, but great pains were

Saved Medical Service in Mar. 253:

taken to allocate to each avS far at? possible a suitable job, so
that after the early weeks of rush and hurry one seldom, if
ever, heard of a square peg in a round hole. In matters in
which their civilian colleagues could be of use advice was wel-
comed, without suspicion, and that advice was acted upon, not
shelved; the civilian profession was given credit for some of that
altruism for which it is famous, and for a willingness to help.
the State without self-seeking, and was never subjected to any
make-belief or "eye-wash" treatment.

The lessons of the pa.st were taken to heart, for instance,
that dentists and unqualified medical students could be used
with good efi'ect had been demonstrated in the South African
War. The importance of an efficient dental service was i«e-
cognised and pro\4ded for in the Navy from the first, and, as
we have seen, the most appropriate work was allocated to stu-
dents. And the lessons of this war were quickly assimilated, so
that it A\as early realised that the painting of a Red Cross on
the side of a Hosjntal ship would not confer immunity from
submarine attack any more than, it would from minefield.

In peace time each Naval Medical Officer si>end8 such a largo
part of his time afloat, and aw^aj from professional relations
or oi>]i<»rtunities of any sort, that it is very difficult to till and
to oiganise an efficient service. During the war the Naval
Medical Service may not have been perfect, but at least it
evolved leaders who could and did steer it clear of adverse
criticism.

Sir Robert Hill, the 'present M.D.Ct. of tlio Navy^
expiusis-ed the hope in his inaugural addiesvS at the Royal Society
of Medicine tliat for the futuie the new *' War Section " would
form a liaison between his Service and fclie civilian professsiou .

Xuw the Army Medical Service had already in existence <when
war brt)kC' out a very effective liaison. It was known us " Tlia
A h isory Board for Army Medical Services," and it \\as ci*eated
1 Parliament in 1901 as a i-esult of the Report of the Com-
mittee appointed by Mr. Brodrick, then Secretary of State for
"' :> consider tlie reoriranisati^n of tlio Army Mcdif-Ml Sf-r-

254 Experiences of a Civilian among the

vices. This Board was in active operation for several years, and it
has never disappeared from the "Army List," but neither of the
D.G.'s considered it desirable to call it together during the war,
which was the occasion when it would have been of the greatest'
value.

It is interesting to observe with what regularity the necessity
for a liaison between the service and the civilian branches of
-our profession, such as the Advisory Board presented, is re-
discovered by any Committee that investigates the difficulty of
providing adequate medical services for the forces (vide Sir
James Barrett in "A Vision of the Possible," page 165).

The present D.G. has recognised this necessity, and has re-
viyed the function of the Advisory Board for Army Medical
Service so that it is again in being, and there must be plenty
for it to do. It does not seem too much to say that it is the
duty of all who desire the welfare of the fighting forces to work
for the perpetuation and strengthening of the revived Board.

Let those who would essay to scheme an extensive State Ser-
vice for the civilian population remember ere it is too late that
the days are past when our profession was content to bow the
knee to "authority." These are progressive times, and our
profession is rightly rebellious against established routine, and
is seeking and finding new methods of treatment where the old
ones failed. There is no room for bureaucracy, for it tends to
the prevention of progress, nor for obsequiousness and deference

The report of Mr. Brodrick's Committee re-organised the E.A.M.C.
and brought it under an Advisory Board Nvith. tihe D.G., A. M.S., in
the chair, the D.D.G. in thei Vice-Chair, two civilian surgeons and
two civilian physicians, specialists from the E.A.M.C. for Sanitation
and Tropical Diseases, the Matron-in-Chief, Q.A.I.M.N.S., and repre-
sentatives of the War Office and the India Office. Tm-ther, it brought
the Army ]\Iedical School up from Netley to Millbank, and so put it
into touch with the Civilian Schools lin the Mettropolis, it gave the
School a new Army Hospital at Millbank, it instituted improved
scales of pay, promotion for meritl, and study-leave, and removed
other disabilities with the result that there was a most encouraging
influx of officers of greatly improved clasis. It also amalgamated the
Army Nursing Service and the Indian Nursi,ng Service into the
Q. A.I. M.N. S., which worked so splendidly in the Great War. That
the credit for all this is often given elsewhere is no disparagetnent
to the lasting value of the work of the first Advisory Board A. M.S.

]^aval Medical Service in War. 255

to rank in the present-day order of scientific advance, and any
>ystem attempting to erect a medical service in which promotion
and success will depend upon the vote and selection of the
-eniors will either fail, or will put back medical and surgical
jjrogress for many years.

With rank recognised and paid for by the State there will
always go a perpetuation of that anti-scientific practice known
as " heel-clicking." a sort of mental and moral goose-step,
utterl}' repugnant to the spirit of any progressive profession.
It tends — and must always tend — to the deterioration of the
■scientific sipirt in the commander and the commanded. It is
stunting to any individualism and paralysing to any spirit of
progress.

Thus the- Times, in a leader upon " The ' Health ' Bill Re-
jected," comments upon the ^' Muddle " which results from
" clumsy amateur legislators ! " and " meddlesome subordinates "
and calls the throwing out of the Bill, ^'A warning to autocratic
and domineering Ministers and their departmental heads."
" Tricks have been played," it says, and so on. (The Times,
December 15th, 1920.)

Truth is very often troublesome, but neither the world nor
tlie individual can get on without it. Surely, with the world
as it is, truth is more than ever essential to-day to the re-
instatement of our nation. Given truth, education, freedom, and
health, our Empire will lead the world, but we shall not attain
the maximum health of the race by means of a medical service
based upon rank and authority and a pension-earning wage.
Backed by propaganda and legends and stimuli to "keep on
smiling," these may carry us through a few years, but it is
not by such methods that we shall ever succeed in " winning
the peace."

MOBILE LABORATORIES.

By
Major A. C. H. GRAY, O.B.E., R.A.M.C.

It is interesting to see "vvliat countries, other than our own,
had done before the Great War to afford mobile laboratory
equipment for their field armies as a protection against epi-
demic disease.

In the Russo-Japanese War (1904-05) the Japanese had no
Field Laboratory units, as unite, but in one of the Divisions
of the Japanese Army at any rate tliei^ was considerable bac-
teriological equipment. Major-General Sir William Macpherson
in his Medical and Sanitary Reports on .the Russo-Japanese
War says "all the Field Hospitals of the 4th Division ai"e
supplied, from Divisional funds, with a Leitz microscope and
a special bacteriological cabinet." " Early in the campaign
the Medical Officer in charge of No. 1 Field Hospital of the
5 th Division had improvised a bacteriologicial equipment for
himself: and no doubt tliere were many other instances of suck
pecial equipment in the field." In an appendix to Report No.
Ii2 are given the details of this equipment. The microscoi)»
and reagents were packed in one case, the i-est of tlie bacterio-
logical equipment in another; neither of them weighed md'e-
than twenty pounds. General Maci)hei'son draws special atten-
tion to the completeness, compactness and mobility of all the
equipment of the mobile Field Hospital units.

Tiio RiLssians ^eem to have gone even fui-ther tlian the
Japanese, because, as General Macpherson ix)inted out to me,
tiiey had Mobile Laboratories as indei)en<lent units. In a rex)ort
by Major J. M. Home, of the 2nd P.0.\\'. Giukhas ou Russian

I'ABT lie, R

2o8 Mobile Lnhoraiories.

Medical Administration in the Field, \\g learn tliat five special
Sanitary detachments were formed. Each detachment was to
consist of four bacteriological 8])ecialists and to be furnished
with a laboratory in Avhich the most minute bacteriological
investigations could be carried out. These detachments owed
their origin to the initiative of the Commander-in-Chief, their
object being to prevent epidemic diseaises. They were all to
be stationed on the railway, south of Haxbin. In the event
of any doubtful case of epidemic disease occurring, the nearest
sanitary detachment Mould proceed to the spot and carry out
the necessary bacteriological investigations. No description of
the actual equipment of these sanitary detachments is given,
nor is it stated how the equipment Avas packed or carried.

In the German campaign in South West Africa (1904-06),
mobile laboratory outfits do not seem to have been iLsed. Bac-
teriological and chemical laboratories Avere provided at each
base. A mobile pack-up laboratory equipment was, however,
part of the medical equipment of th% German Army at this
time.

The Turkish Army Medical Service wa8 re-org-anised in 1910,
by Dr. Vollbrecht Bey, Lieut. -Colonel in the Pnissian Army
Medical Service. In his scheme the Sanitary Officers at Army
Headquarters were to be provided with a microscope, a bac-
teriological case, and a box of chemical reag-ents, just as in
the German Army.

In March, 1911, shortly after mobilisation for manoeuvres
at Sail Antonio, Texas, the Chief Surgeon of the United State.?
Army gave orders for the formation of a Mobile Bacteriological
unit. Lieutenant G. B. Poster, Medical Corps, United State?*
Army, was in charge, and got tog-ether the equipment.* Lieu-
tenant Foster claims that his laboratory was the first of its
kind to be operated by the Medical Department of any Army
under conditions approximating those of war, but says tbat the

*Militari/, Surgeon, Vol. 31, page 408.

Mobile lMbonitorie.s. '2o^J

Japanese Avere eoiKliioting a similar Jaboiutory at Tieutsiii about
the same time. The entire equipment packed into five chests.
The wliole weio-hed 550 pounds, and filled one-third of a wagon.
Two tables, four iron buckets, and four hospital tents completed
"the load. The equipment was subjected to severe tests, and
-was transported over fifty miles of i*ough road. The wagoai
liad no springes. The only breakagie ineuri*ed was one flask.
The entire equipment Avas unpacked and assembled in a ho«-
})ital tent by two i>ei'sons within three hours of its aiTival
in camp. One thousand and forty examinations were made
•during the four months that this " Manoeuvre Division Labom-
tory " was in oi)eration. In his conclusions Lieutenant Fostei^
lays stress on the necessity of tin containers for gla^^s-stopperedl
•bottles and of special chests for the eqiupment which should
be streng, iren bound, with hinged lids and hasj>s and uniform
in size. He considered the field laboi-atory not only practicable
but in this era of scientific sanitary endeavour a necessity.

The Austrians had Mobile Field Laboratories equipped by
the Austrian Red Cross Society. Sixteen of such units with
a s]>ecially trained staff were available in 1913.* In August,
1915, twenty -one mobile laboratories were said to l)e in the
service of the entire Austrian Army.f It seeins, however, that
the equipment of tJieir earlier units Avas not very satisfactory
OAviiig to excessive weight. A neAv tyi>e Avas intiwhu'ed in 1914,
designed by Stabsarzt Pjofessor Dr. R. i^oerr and Dr. Josef
Winter Avhich Avas easily tmnspor ted on two pack animals. There
as a good account of it by Colonel J. V. Fori-est, A. M.S., in
the Ji.A.M.C. Journul.X Each laWratory consisted of foiu^
chests all of the same size. The Aveight of each caise Avas no
inore than 45 kilos, and they Avere made so tliat chest A and B,
€ and D balanced ea<*h other. Their construction Avas very in-

*l)a» Rote Kreuz, No. 8, 1913, page 169.

t" Sanitary Service of the Anslro-lfuiiirarian Army in r:iijipai>rii. '
by Major J. H. Ford, Mififan/ iSun/i*on, Vol. 10. page 650.

tH.A.M.C. Journal, Vol. 2H, page 651.

2G0 Mobile Laboratories.

g«nious. The outfits on tiie two pack animals were independent
of each other. Chests C and D contained all that was neoessaiy
for mioi-<jso(»i)ic and sero-diagnostie investigations and for pre-
paring saline infusions and would accompany the investigating
Medical Otfioor in the first place. The other pack would onlv
be taken if a more prolonged investigation were anticipated.
The equipment included 64 Petri dishes, flasks, pipettes,
200 agglutination tubes, a large sterilizer, disinfecting bath,
a case of instruments for operating or animal post-mortems,,
etc., a large stock of Doerr's dried media, diagnostic sera,
special tubes of bile for blood culture, etc., and a small in-
cubator—in fact, a remarkably complete and easily transport-
able laboratory equipment.

Even from the above short and incomplete account it is
evident that other eountTies have considered some sort of easily
transportable Field Laboratory Equipment a necessity. The
most recent pattern introduced by the Austrian Eed Crosis
Society seems to me to be particularly good.

Let us now see Avhat has been done in our own Empire.

One must go a long way back into Army Medical history
to find the first " Mobile Laboratory Equipment " made for
the British Army. I am indebted to my friend, Lieut. -Colonel
A. Bruce, of the Army Medical Department of the War Office,
for information on the matter. The "Chemical Cabinet" was-
made for the Army b}- Messrs. Savory & Moore, and wim
probably first taken into use about 1875. Colonel Bruce i-e-
members it well. He tells me he passed an examination ou
its contentvs in 1879. It was intended for water analysis, and
was beautifully made. Each bottle and piece of apparatii*
fitted exactly into its partition lined with green baize. It.
was made of polished teak, bound with metal, and fitted into
an outer case for transport. It was very heavy, but could be
lifted, by two men. A neAv pattern of cabinet was introducedi
in 1807 of tlie same general character and dimensions as tlie
old one, the contents, however, were altered and improved.

Mobile Laboratories. 261

Tliese cabinets were used both at home and abroad. Thejr
went to Egypt with tlie Army in 1882, and to South Africa in
1899. They wei-e sent out to Fmnce in 1914, but I doi not
tlnii^ tliey were used in the Great War. General Hospitals are
mobile units in the British Army, and laboratory equipment was
prepared for them when our medical equipment was overhauled
after the South African War. Dming the South African War
Base Hospitals wei-e provided with microsc-opes and with labo-
ratory equipment Mhen demanded, but there was no standard
equipment. Smaller and more portable 'Water Analj^is Cases"*
were made for use in the field.

The first real mobile laborator}- appeared in the Southern
Sudan, but had no connection with the Army.

In 190G, Dr. Andrew Balfour, Dii-ector of the Wellcome Re-
search Laboratories, Khartoum, conceived the {idea. At his insti-
g-ation a two-decked barg-e Avas built by the Sudan Govern-
ment and was fitted out by Mr. Wellcome, with every possible
requirement and convenience. Early in 1907, this floating
laboratory was ready for use. A full account of it is given in
the " Third Report of the ^^'ellcome Research Laboratories
1908," by Dr. C. M. AVenyon. In Jiis i-eport he says " The
large laboratory, with its two long benches, water taps and
sinks, with water supply from a carbon filter on the upper
deck, ample cupboard room for bottles and glass wore, the
incubators and ovens, the balances and centrifuge and all
otlier equipment, reminded one more of a laboratory at liome
than the accommodation one would expect to find on one of
the upper tributaries of tlie Xile in somfe remote corner of
the Sudan. The advantages of such a laboratory with every-
thing at hand, with solid benches on which to stand one's
microscope, with a good supply of clean water, will be suffi-
ciently evident to anyone who has tried to work in a dusty-
tent, with apparatus stowed away in bo.xes, with the micro-
scope on a rickety table, and with a limite^l supply of AAtiter.

2G2 * Mobih' LahoraforieH

The floating labomtoiy is, aiS far as I know, the first of its-
kind. Tliough further experience may introduce improvements ,.
those who originated tlie scheme and those wlio were far
sighted enoug-h to carry it into effect, are to be congratulated
as being the finst to introduce this mode of sciieutific investiga-
tion." To compare this, the first floating mobile laboratory,
with the type of motor mobile laboratory Avhich Ave used in
France, Salonica and Egypt is perhapts hardly fair; the latter
had to be strictly limited in size and weight and had to cope with.
roads of the roughest description, whereas the former could
be of generous Bimensionis and travelled over the C'ompai'atively
smooth waters of the Nile; yet this the first laboratory of its
kind designed fourteen years ago is still in constant use, aud
has not been surpasised since or perhaps even equalled. No-
other laboratory has yet been designed which could and did
function while actually on the move. Incubators and sterilisers
can hardly be kept going- Avith safety in any type of motor
laboratory, when travelling- over even moderately good roads.

The first sugg-estion that I can find with regard to field
bacteriological equipment for the British Army is in a pa]>er
by Lieut. -Colonel U. H. Firth (now Colonel Sir Eobert Firth)
written in 1909 on "Sanitary Companies- — Tierritorial Force.*'*
In discussing the details of these Sanitary Companies, which
are Army Ttoops, Colonel Firth says that a microscoj)e and a
limited bacteriological outfit must foiin part of their equipment.

The first suggestion of a fitted motor mobile laboratory for
use with the British Army in the field was made by Major
S. L. Cummins (now Colonel S. L. Cumminjs), R.A.M.C., in
his Parkes Memorial Prize Essay written in 1912. f He says "The
early diagnosis of typhoid fever is a matter of blood culture.
This requires skill, care and deliberation, but not an elaborater
outfit of bacteriological appliances. Our idea is that a mobile
laboratory consisting of a closed motor vehicle, containing the

*B.A.M.C. Journal, Vol. IH. page 548.

^B.A.M.C. Journal, Vol. 20, page 635, and Vol. 21, page IVJ.

Mobile Laboratories. 265

appamtiis for pi-eparing- media, incubating cultures, and for the
neoeeeary microscopic Avork and other work of isolating bac-
teria', should be atta<?hed to each Division and accompany this
formation as a part of the Divisional Headquarters. A Specially,
trained, offic-er Avith two trained oixierlies (one as batman) and
a driver (A.S.C.) should constitute the staff. Regimental
^ledical Officers and Officers Commanding Field Ambulancea
siiould be directed to co-operate with this officer by sending
to hiir. all suspicious cases for blood culture and such other
work as may be necessarj-. At present his work is allocated
to the laboratory at the Advanced Base or Railhead (vide
R.A.M.C. Training, Para. 147, iii). Our plea is for a Mobile
Laboratory marching- and working with the Divisions."

It was soon evident to our Headquarter Medical Staff in
the field that a Mobile Laboratory was a necessity. The Great
War was not much more than a month old when a telegrami
was sent to the War Office asking tliat such a unit should be
sent out. The matter w-as referred to Sir William Leishman,
Adviser in Pathology to the War Office, who asked the Director
of the Lister Institute, Dr. C. J. Martin, to staff and equip
a Motor Laboratory as quickly as ix)ssible. The work was
soon done. The late Major S. R. Rowland, of the Lister Insti-
tute Staff, was appointed to take charge of the laboratory, and
it was he who chose the all important vehicle. He had seen
a cai- of the type he wanted at the Motor Show of 1914^
It was probably the only vehicle in existence which could have
served his purpose, and after an exciting hunt it was found.
It was a huge car of enormous AA-eight and power. The body;
was a luxuriously fitted cai*avan, with water tank and water
closet complete, the roof carried any amount of extra luggage.
It originally belonged to Mr. Dii Cros. The chassis was, I
believe, specially built in the Austin works. The internal
dimensioiLS of the body of the van Avere as follows:— Height
6ft. 7in., length 12ft. 6in., Avidth 6ft. 9in. The car was taken
to the Lister Institute Serum Dei>artnient at Elstree and Avas
there fitted out. Di'. Martin, .Dr. Lodingham an.1 "Mi^-^ TT ri)i<k

264 'Mobile Laboratories.

&11 helped Major Eowland in the choice of his equipmient.
Work bench, autoclew^e, Koch's steamer, incubators and sterilisers
■were screwed into their places; the experimental animals in
their cages were hoisted on to the roof, and the unit set out
for France on Odober 9th, 1914.

The next Motor Bacteriological Laboratory to go to the
front was given to the War Office by an anonymous donor.
The car was known as the " Princess Christian Motor Labora-
tory." I had the privilege of taking it to France. It con-
sisted of a large van shaped body, divided into two eompai't-
ments, on a 20-30 h. p. Clement Talbot chassis. The internal
construction, fittings and equipment were devised and carried
out by Messrs. Baird & Tatlock. The work room was 6ft. 6in.
by 6ft. The smallier compartment, 6ft. by 2ft. lOin., shut
off by sliding doors, housed the incubators and sterilisers^
etc. There was an electable fan to aid in ventilation, and^ a
powerful lighting outfit. A good illustrated account of it
appeared in the Lancet of January 23rd, 1915. The weight
with its driver was 3 tons 8 cw^t. I think the chassis was
-carrying more than 30 cwt.; it was a surprise to me how^
well it went. There was an overhang at the back of four
and a-half feet. The weighty contents had to be carefully
arranged to get the heavy things w-ell forward and between
the wheels. The water tank was emptied before a journey.
The generous donor, at my request, added a powerful motor
bicycle and box side car to the unit, which much increased its
usefulness. The absolute necessity for a light " tender " for
Mobile Laboratories was recognised later on, and all were
provided with 10 h. p. Singer cars.

A similar laboratory was taken to France by Major J. W.
McNee — he started a few daj^s before I did but had only gx)t
as far as Havre when the springs of his "bus" flattened out
and ho had to come back. His unit was subsequently known
as No. 3 Mobile Laboratory.

It was soon evident that these last two were over-Mcig^hted;
such a load spread over such a large area of floor space was

Mobile Laboratories. 265

too big for any car that had not been specially made, so, after
these first three, all motor laboratories used by us were lorries
and not cars. This was an improvement, but the fact that
these laboratories were now on solid instead of heavy twin
pneumatic tyres made it necessary to pack th^ contents moi-e
securely than before. The late Major Rowland knew a gt)od
deal about motor cars, and I i^member that he considered a
good chassis for a motor laboratory should be long-, with as
little overhang as possible; tha-t the driver should be seated
over the engine to give extra body length, a point which has
been adopted in the latest type of motor omnibus; that the
width of the body should be increased by building it to over-
hang'the wheels. In his opinion large twin pneumatic tyres
were a necessity. With regard to the fittings inside, he con-
sidered there should be a definite place for everything, but
all apparatus should be capable of eas}^ removal so that if
thought desirable it could all be quickly taken out and put
into a room, and as quickly put back again; in fact, his plan
was to use the van as a large packing' case on wheels, but
to leave as much free space in it as possible, so 'that it could
be used as a work room when necessary. Major Rowland
had got the one motor caravan whicli fulfilled all the conditions
and it had been specially made. To have built otliers would
have probably meant a great delay. The two-ton Daimler
lorry chassis was adopted, and proved satisfactory.

By the end of January, 1915, there were then three Mobile
Bacteriological and one Hygiene Laboratory in France, this
last in charge of Captain M. Coplans, an old Guy's man.
I think in the opinion of General Headquarters they were of
real value, because in May, 1915, the scale was increased to
two Mobile Bacteriological Laboratories per Army, and later
on thei'e were even more.

Xo. 1 Laboratory started work at St. Omer. No. 2 waa
ordered to Bethune, but soon back to Lillers as BeUiune was
rather heavily shelled on January 23rd. No. 3 opened out at

266 Mobile Laboratories.

Bailleul, and sooji ^pmad into a convenient building-. No.
4, tJie Hygiene Ijaboratory, wa«, I think, at Bailleul too.

How ^\v\[ I i-eraember tliase early days at Lillei"s. tt Ava«
Army Headquarters then and <'orretspondingly .important. Major
D. L. Haixiing- was in command of the C.C.8. which ^ave me
welcome, and it wa^s he who guided me aright along- the un-
familiar paths of War. It was tliere I first met Captain Adrian
Stokes. At the time of the Battle of the Aisne, Captain Stokes
had been sent to Paris to buy what bacteriological equipment
he could find, and had broug-ht it back to the line in a motor
cycle and sidecar — neither of them new. Without any special
name to his laboratory, and with very little equipment, Captain
Stokes had been doing the work of "mobile bacteriologist"
to the whole Expeditionary Force for weeks before even Major
Rowland ar*rived on the scene, and had been doing it thoroughly
well. When I arrived he g^ave up his room ix) me, and in obedi-
ence to oi-dei-s joined No. 1 Mobile Laboratory at General Head-
quarters. It was a first floor room in a little side street just
opposite the school Avhich formed part of No. 4 CCS. It
made a g-ood laboratory. My "bus" was in the street below,,
supplied me with electric light, and was used by my Staif-
Serg-eant for the preparation of media, etc. At first I used
the bus as a laboratory. The body was " jacked up " on to
wooden blocks which gave the necessary rigidity for microscopic
work, but the position of tlie vehicle up against the side of a
wiall did not allow of much daylight getting in. Any otlien
I)osition would have blocked the street. Again, when my
Staff -Serg-eant was using the sterilisers tlie steam condensed on
tlie lenses of the microscope — also he had to move about to-
do his work, and that meant vibration.

Major Rowland used his car as his " microscope room " for
some while; all his sterilising and media preparation was done
elsewhere.

Captain R. L. Thornley, who came out later in charg^e of
No. 20 Mobile Laboratory, always used the " bus " as his

Mobile Labomtor'iefs. 267"

laboratory, and preferred it to a hut. No. 21 Mobile Labom-
tory, in cliarg^e of Captain Emryis Roberts, came out early in
1916, and was at Bethune. His laboratory was, I think, tlie
most magnificent in France. It wa^ given to the Army by
Dr. Lynn Thomas (no^^ Sir John Lyim Thomas), and was
very much larg-er than an}- of the others. It was a caravan
mounted on a large lorry.

We had plenty of Avork to do in France; quite half the dviy,
and sometimes half tlie night was spent in the ojien air
journeying between the Field Ambulances and Clearing Stations^
collecting specimens from "suspected" cases. Messrs. Baird
& Tatlock made me a most convenient case containing* all the
necessary implements for blood eultm-e, etc., with special com-
partments for sterilised syringes, large tubes of extra thick
glass containing the solution of peptone and bile salt, metal
spirit lamp, sterile swa]|)s, etc. It was always kept ready, and
was in daily use . For making blood cultures in the field I found
that large very thick glass test tubes plugged with a sterile-
rubber bung were the best; no amount of shaking could harm
the contents. As soon as I got home to the laboratory the
rubber bungs were changed for woollen plugs, and the tube*
placed in the incubator. I always carried at least half a dozen
all gla^j syringes of 2 c.c. and 5 c.c. capacit}', ready fitted
with their needles, each syringe in a large thick test tube well
plugged with wool. These were sterilised in the autoclave
just as they were, and it was very i^arely tliat one got broken
in the process. My Staff-Sergeant's first liit\ when I f^me
back from the daih^ round was to clean the syringes, re-
sterilise them, and fit up my travelling case with fresh tubes
of media, etc.* It was then i-eady for any urgent call. • The
day's work began with an examination of the prerious day'ei
culturee, the reading of the results, and the 'despatching of
mmierous telegi'ams; each positive case of typhoid fever oa*
otlier serious infectious disease had to be notified by telegi-am
to the O.C. of the Field Ambulance or CCS. in which he had
been seen, to the A.D.M.S. of tlu^ mun'> Division, to the

268 Mobile Laboratories.

D.M.S. of the Aiiny, and finally to General Headquarters. In-
fectious disease notification forms (A.F. W.3110) had also
to be completed in duplicate, and then all details entered in
one's own laboratory note -books.

By eleven o'clock a good number of telephone messages
and telegrams would have arrived demanding one's presence
at various units. The bicycle and sidecar was got out, and
the round staxted. I wonder what the columns of marching
men one passed in the narrow roads thought of the little box
which went bouncing past attached to the motor bicycle with,
its anxious looking dusty driver. I think I was |generally
looked on as a new sort of postman or else was given the credit
of burying stray corpses. I. found it much better to go to
the case myself than to ask for " swabs " or samples to be
sent. By the time the "sAvab" had reached the laboratory
it was cold and uninviting, and, with the exception of those
fi'om diphtheria suspects, generally quite useless.

I arrived in France just at the beginning of the ''cerebro-
spinal " scare, and the examination of " contacts " soon b8can:ie
a serious business. I did not mind how many individuals
arrived to be examined or how many I went to see; these
1 could deal with, but bundles of "swabs" taken the day
before, or even earlier, came in by post and by motor-cyclist.
They went? generally relegated to the lysol bowl.

I think it was "sAA^bs" from "doubtful ladies" taken by,
civil practitioners w^hich recj^uired the greatest mental effort.
I never returned them with sarcastic comments partly because
my French was not good enough and also because I was so
afraid of being asked to go and see the case myself. I always
hunted through the slides, perhaps with a mental bias towards
the positive. In my opinion the "mobile bacteriologist" is
best serving his country when journeying' about seeing every
case and every " contact " himself — if he once begins to sit
in his laboratory and merely examine samples taken by others
his work wdll deteriorate and his opinion lose its value.

We all of us, I think, fitted up some sort of apparatus which
kept Petri dishes warm on our journeys. Swabs were then

Mobile Laboratories. 269

taken on the spot — tlie platets wei-e spi>ea(i and put back into
their ''hot box." It was not necessary to examine all the
(3ontacts of a ease of cerebro -spinal meningitis, we had per-
mission from Headquarters to make our own selection. The
actual oases of disease presented fai- less difficulty; these we
could lumbar puncture, blood culture or otherwise deal with,
and one was sure of getting a clear cut result.

Mere records of the number of cases of each disease exeunined
are of little interest. We were all very* busy. I think the
hunting out of a paratyphoid oai-rier in the 2nd Royal Sussex
Eegiment, when in rest at Noeux-les -Mines, gave me tha
hardest work. The thing had to be done quickly as the regi-
ment was due back in the line. The regiment was well inocai-
kited against typhoid, but luckily, from my point of riew^
paratyphoid inoculation had not yet been started. The out-
break was definitely Paratyphoid B. I had seen all eleven cases
myself, and had got positive blood cultuies from many of tliem.
In all the infecting organism presented identical characters in
the various sugar media, and with the stock laboratory anti-
sera gave the 8am.e results. There was not time to take a
blood sample from every soldier in the i-egiment, so I contented
myself with examining all the recent arrivals and all those wha
had h»een to hospital sick. There were about ninetj^ of them.
A bumple of blood was taken from each and carefully labelled.
There was not time to put up more than one dilution of each
serum against the infecting organism. I chose a dilution of
one in a hundred as likely to show something definite, and it
did. One mans serum of the ninety examined gave a marked
result. I wiied to the A.D.M.S. of the Division that lught
to isokite him and send him to a Field Ambulance. The mans
eto<:)ls were plated, and at the second attempt, after a generous
doc^e of physic, the Paratyphoid organism was found, identical
iti e\-ery respect with that found in the actual coses. Of course,
there may ha^e been anotlier carrier amongst those I did not
oxamine, but after the removal of tliis man tliere were no more
c^ses in that rejjriment.

:270 Moh'tle Lahoraforles.

Oil)' work ill <Iio field was co-ordinated hy Colonel (now
Major-Oeneral) Sir ^^'illialn LeiNliinan, who visited us at i-e-
o-ular intervaJs. To liim we ])ouied out our troubles, and he
always o^ave us a Hynipathetio Jieariiig. I am sure that my con?
fi-ercs will agree /with me in saying tliat any isucoesis we achieved
was chiefly due to his inspimtion and advice.

Onr Consulting Physician too, Colonel (now Major-General)
Sir Wihnot Herringhani, Avas deeply interested in us. He often
<^ame to my laborator3^ just as he did to the others, and his
ripe ex})erience Avas always at our disj)osal and his suggestions
were invaluable.

Best of all, l)ecause we Mere daily at their beck and call,
our Directors of Medical Service shoA\ed they relied on us by
giving us plenty to do.

When big things -were happening, such as the battles of
Neuve Chapelle and Loos, we "doMiied tools " and guve a hand
to the nearest C.C.S. Everyone Avho could put on a dressing
■or give an anaesthetic was A\-anted then, and the "sick" were
simply not to be found. Soldiem did not go sick at times
like these, but preferred to stick it out however bad they felt.

What of our patients? Were we popular witli them? No,
that I am afraid could scarcely be expected. The man who
sticks a needle into his suffering bix)ther cannot look for popu-
larity, but ])erhaps later, when convalesce nee gave life a rosier
look, Ave got credit for doing our best.

My personal experiences with a Mobile Laboratory only lasted
until July, 1916. It Avas then a case of the biter bit, for I
contracted Paratyphoid A fever and had to retire to bed. I
had been Avell inoculated against typhoid and also againsti
Paratyphoid B, but not against the third variety. When I at
last arose from a bed of sickness, I Avas, at my OAvn request,
gi\'en the command of another unit. No. 2 Mobile Laboratory
Avas rather unfortunate in the Avay of illness. Captain A. L.
TJrquhart, Avho joined me early in 1915, first Avent down witli
measles of the most Airulent description, and then, after braveh

Mobile Lahoratones. 271

(}xperimentiiig- on his own Ixxly Avitli lit^^ from fever patients,
liot Tl^ncli Fever. Captain UrqiiJiai't has not yet had the <!Tedit
he deserved for this, the first experiment. After his recovery
lie took a ^'lobile Laboratory to Salojiioa. Thei-e Avei-e otliei-s,
liowever, wlio gave all they liad. Major Rowland died of
i-ei-ebro -spinal meningitis eaug-lit fi-om tlie ver}- patients he was
Tryingvto help. Cax^tain T'. Strain, of Noi. 6 Hygiene Labora-
1 ory, died from an accident when working w ith dangerous gases
at Lillers. •

The ti*a veiling laboratory has, I think, come to stay. In
..some form or other it was used by all Armies in the Gi-eat
War, and it might be used to advantage by Civil Authoritieri
ixx>. ,

When epidemic disease breaks out ajid " contacts " have to
be examined in large numbers, such examination can only be
effectively done at a laboratory. If the expense is not pro-
hibitive, it is surely better to take the laboratory to the " oon-
tiicts " rather than to move numbei's of possibly infected i>eople
.about the (X)iintry, and one travelling- laboratory mig^ht take
the place of several permanent ones.

The type of motor laboratory that Ave used in t-lie Great War
<eems to me to have been too cumbersome and too heavily
<'quip]>ed. Something after the French Colonial Model which
was designed by Dr. Tilmont and' fitted out by Messi-s. Bairdi
& Tatlo(^k, would, I think, be more generally nseful. Tliis
type was fitted to a Ford chassis.

If all media were prepared in some central labomtoiy and
distributed to the various field units, most of the heavy equip-
ment in the latter could be dispensed witJi.

For use in countries where a Ford car could not go, the mobile
laboratory would have to he ])ackofl for animal trans j)ort or
even in fifty i)ound loads if it had to be ciU'ried by natives,
but it seems to me tliat large armies could not opei-ato in such
countries, and there would be no neod to have many of thiH
latter type.

SOME IMPRESSIONS OF A DIVISIONAL
SANITARY OFFICER IN FRANCE.

C. D. EDWARDS, M.C., M.D.Camb., D.P.H.

That all life is arrested by accumulation of its own waste pro-
ducts is one of the fundamental laws of existence. It applies
to all living" orgunisms equally, from the lowest to the highest!,
from bacteria to man. In the case of the former, vigorous
growth only proceeds at the circumference of a colony, while
among" men healthy development ceases in the overcrowded
slimis of our great cities. The efforts of sanitarians have, during
recent years been specially directed to the solution of this diffi-
culty, and costly schemes have been launched with much ex-
penditure of public money, with the result that the health of
our large towns has greatly improved, and compares favourably
^sith that of less crowded areas.

That the importance of these measui^es was recognised by the
lower animals for countless ages before it impressed itself on
man is somewhat disturbing to our assumption of superiority,
but it is none the less true.

Study of the life and conditions of bees in a hive has showa
that an average number of 10,000 of these insects can maintain
their Ihealth and vigour in an exceedingly confined space, and
that during the five coldest months of the year they only om
\'ery rare occasions leave tlie hive. It has been shown tliat tho
interior of the hive is at all times kept scrupulously clean, and
that (even after many weeks of close confinement there is com-

PART III. 8

274 Some Impremons of n Divisional Sanitary Officer in France.

plete labsence of faecal matter, and that healthy bees never de-
fcecate in or in the immediate neighbourhood of their hives.
The presence of faeces in the hive or on the alig-hting board is
a sure indication that serious disease lias already overtaken the
inmates. In the same way it lias been demonstrated that
beaveiTS, during the long winter and its necessar}'^ confinement,
keep the interior of their limited quarters in a thoroughly sani-
tary condition.

" It's a foolish bird that fouls its own nest,"^ is an old pro-
verb that indirectly reflects honour on tlie scavenging instinct
of the parent birds, who manage in the few short intervals they
snatch from the labour of ministering to their offsprings' vora-
cious appetites to remove the natural results of such a generous
dietary. Instances of the superiority of the lower animals over
man in matters of sanitation might be multiplied indefinitely,
and lead one to the somewhat mournful reflection that the
human race is probably more deficient in natural sanitary in-
stinct than any other members of the animal kingdom.

This is borne out by the fact that one of the earliest records
we have of an effective sanitary measure, contained in the
Mosaic law, w^as a direct adaptation of the manner in which
dogs and cats had disposed of their excreta for countless gene-
rations. With the natural increase of the world's population,
and [the Iconsequent overcrowding in the most favourable por-
tions, it is obvious that those races that are most sanitary, are
the races that are going to survive. This is well illustrated in
the history of the Jews, who, in spite of their numerical inferiority
and icon&tant persecution, are still a power to be reckoned with,
and [have the proud distinction of being the first people with a
simple but effective code of sanitary laws. One is struck by
the wisdom displayed in the framing of these simple laws for
the disposal of faeces, washing of hands before feeding*, and
abstention from pig-meat, for it is by their very simplicity,
which should always be the aim of the sanitarian, that they
have retained their hold over the Jewish race for nearly 4,000
years.

jtne Impressions oi a Divisloiml Sanitanj Ofjicer in France. 2lo

The effect of civilisation with its elaborate systems of conser-

incy has merely served, in the ca«e of the average citizen,
- dull the natural sanitary instinct and produce a state pf
rrophy through disuse. This attitude is well described by
Lelean in " Sanitation in War," as limiting the acquaintance
of an ordinary household with conservancy methods to the daily
pulling of a handle, and the weekly listening to the opinion
of the dustman i-egarding tlio dryness of his job. In warfare
there is a sudden revulsion to primitive conditions, and the very
perfection of the sanitary measures enjoyed by a community
becomes a snare and a delusion when its citizens have suddenly
to dispose of their own waste products, and to evolve such other
methods for the preservation of health as their altered ciroum-
fitanoes admit. It is, thei-efoi^e, no matter for surprise that in
previous wars the mortality from disease, and what we now
consider to be preventible disease, has far exceeded that fix)m
wounds.

In the American Civil War, 1861—1866, of 431,237 men
engag-ed, there were 75,368 cases of typhoid (175 per 1,000),
and 27,056 deaths (57-78 per 1,000). In the Franco- Grerman
War of 1870 the German army of 815,000 liad 73,396 cases of
typhoid and 6,965 deaths, and 35,652 cases of dysentery with
2,380 deaths.

In the war with Spain the Americans had 192 cases of ty-
phoid per 1,000, and in the German expedition against the
Herreras (1905-1907) out of a force of 18,116 there were 3,146
cajses of typhoid. In the Boer War we had 57,000 cases of ty-
phoid with over 8,000 deaths, and 38,000 cases of dysentery
with 1,342 deaths in an army of an average strength of about
250,000. The deaths fix)m disease wei-e 22,450 and the number
•of those killed by the enemy was 8,590.

In our wars of the last thirty years the deaths fmm disease
liave been nearly five times as many as those from wounds, and
for every man killed by the enemy there were forty admissions
to hospital for disease. In the Boer War disease alone accounted
for a loss of 86,000 in dead and invalids.

276 Some Impressions of a Divisional Sanitary Officer in France.

If to the death roll due to the inci-eased deadliness of lejiial
^v©apons employed in iXie latest Great War had been added
the previous mortality due to disease, the havoc produced would
have been too horrible to contemplate.

To tlie Japanese in their war with Russia is credit due for
the first really successful attempts to reduce the scourge of
disease in warfaix). For some years our ixdlitary authorities had
recognised the gravity of the problem, and much excellent work
had been done among troops on a peace footing. It was, how-
ever, evident that the conditions during peace and war were so
diverse that the best laid schemes wei« liable to break down.
When tin 1914 the Great War was upon u.s, a ^\ar that was i-e-
c-ognised to be a life and death struggle, and one in which we^
should Inquire all our strength of manhood, it was early seen
that the previous arrangements for tlie preservation of a satis-
factory sanitary condition in warfare ^\Qm inadequate. Some-
thing Analogous to the provisions made in civil life, and whicJij
had so greatly reduced the death rate of oiu* larg-e cities, wa.>
obviously required. It was Mith tliis idea in viaw that Divi-
sional Sanitary Sections were inaugurated and a training centre
established in Chelsea by the London Territorial Forces.

The first intention was apparently tliat the Commanding
Officers of Sanitary Sections should be medical men with a^
special qualification ir Public Health, but tJie supply was foujid
to be unequal to the demand, and a large proportion of these-
officers were chosen from the ranks of sanitar;y- engineers, ar-
chitects, surveyors, etc. It is with no wish to depreciate the-
very valuable work that has been done by Commanding Officers
of iSanitary Sections without a previous medical training, th^t
I here record my opinion tJiat these officers should al"w^ys be-
medical men with the D.P.H. The matters with which they
have to deal are so essentially medical, the problems, especially
with TOgard to infectious disease, so technical, and the demand
for instruction in the preservation of health to the troops under
their care so insistent, that I am unable to believe that anyone-
without a previous and very thorough training in these sub-
jects can fail to be at a serious disadvantage.

Some Impressions of a Divisional Sanitarfj Officer in France. 277

The Sanitary Section consists of four N.C.O.'s and twenty-
one men. These are clraAvn from Sanitary Inspectors, men en-
gaged in any sanitary work, carpenters, tinsmiths, plumbers,
clerks, etc. Their duties are theoretically merely inspectional
and instructional, and they are not supposed to perform any
constructional work outside their own unit; in practice I believe
that every Sanitary Section, worthy of the name, has done much
constructional work for units that were unable to do it for
themselves, and especially for those in the* trenches and for-
ward areas. One soon, however, recognised that certain imits
expected too much of the Sanitary Section, and were too ready
to shift the duties of their own sanitary squads on to their
shoulders. This tendency had to be strongly resisted, as it
would have seriously interfered with the main object of Sani-
tary Sections, namely. Inspection. For the same reason I felt
it necessary to protest very forcibly ag-ainst employing the
members of my Section in Divisional baths. The supply of
Divisional baths is the duty of the Quartermaster Staff, and has
nothing to do with the R.A.M.C. I was always ready to advise
and help in the eonstTuction and running of the baths, ajid
planned and supervised the erection of a large number in
various parts of Fi^noe, but I am glad to say that my obstinaty
was successful in rescuing my section from the fate of more
than one Sanitary Section, and of becoming merely a Divisional
Bathing Section. In the early days of the Somme ofifensive in
July, 1916, in which my Division did such great things and
Buffered so severely, when there was little work possible for a
Sanitary Section except to lend a hand, I am proud to say that
my Section erected excellent baths in Albert, and for sevei*al
days worked from 5 o'clock in the morning till 10 o'clock at
night bathing the worn-out troops as they were relieved, hoiir
ironing their clothes, supplying them with a fresh change of
underclothes and disinfecting their verminous garments. On
one day alone they dealt with close on 3,000 men. These duties
w^re carried on for several weeks after the Division had re-
tired to its hard-earned rest, and it was only when conditions

278 Some Impressions of a Divisional Sanitary Officer in France,

had ireturned to a more normal state, and I found tl]ie work of
inspection kieteriorating, that it became necessary to protest.

Having- in view the small numerical strength of a Sanitary.
Section and the important duties it had to perform, namely, in^
spection of the whole of a Divisional area, varying from a few
square miles to as much as a hundred square miles, and troop&>
varying in numbens from 20,000 to 40,000 or more, it soon be-
came evident that strict economy of the resources at one's dis-
posal must be exertjised to obtain the full value. It should be^
recognised tliat the various duties concerned in the running of
a section, such as cooking, sanitation, clerical work, offioer*s ser-
vant, workshop, etc., absorbed a large part of the strength, and
it was generally found that there were at the most sixteen left
for the purpose of inspection. I therefore found it necessary
to divide the area occupied by the Division into ten or twelve
parts, making one of the members of the Section responsible
for leach sub -division. Each man was provided with a map of
the 'portion he was responsible for, and had to send in a daily
report of the condition of all units visited by him. In this way
I 'was able to keep an eye on the work done by the N.C.O.'a
and men under my command, and to become at once acquainted
with any unsatisfactory conditions in the Divisional area, that
required a personal visit. Moreover, by frequently paying sur-
prise visits to the different units one was able to test lihe accu-
racy of the reports handed in, and soon learned to know the
men, who were reliable or the reverse.

Sanitary Sections, as previously mentioned, were an entirely
new liepoiture, and like all new brooms raised a considerable
amoimt of dust. It was one's duty, as a very junior officer, and
the duty of one's N.C.O.'s and men to visit and inspect, at any
time, the hallowed precincts occupied by the various units, and
if necessary to criticise the sanitary arrangements and other
matters that concerned the health of the troops. To every Eng-
lishman, and from experience I am inclined to think equally so
to every Scotchman, " his home is his castle," and for the time
being the billet, or camp, or trench, occupied by a unit was its

Some Impressions of a Divisional Sanitary Officer in France. 279

home, and until he recognised the necessity and usefuhiess of
inspectional visits, the O.C. of that unit looked on them as an
unpardonable intrusion. I well remember numerous battles-
royal with a peppery old Scotch Colonel in command of a
battalion of his countrymen, which afterwards earned immortal
fame on the Somme and on many other battlefields. To put
it mildly his ideas and those of his adjutant on sanitary matters
differed very widely from my own, and both in England before
embarkation, and in the early days of 1916 after arriving in
France, led to a hurricane of winged words on more than one
occasion, which made me as a junior officer, who was unable
to reply with adequate force, recognise the invariable wisdom
of my old hospital motto. 'Knowing that my objections were
backed up by Routine and Divisional Orders, I remained ada-
mant, and when my suggestions met with a flat refusal, or were
merely ignored, I had the unpleasant duty on several occasions
to report adversely to Divisional Headquarters as a last but
never-failing resort. To his honour be it noted that he never
bore me any ill-will, and this very gallant officer afterwards be-
came one of my best friends.

Of all the qualities necessary for the equipment of a Sanitary
Officer the most desirable is that of Taotfulness. He may be
XX«sessed of zeal capable of removing mountains, but without
tact he will be "as a sparrow on the house-tops," and "his
enemies will reproach him all the day " long. The first tiling
that one has to recognise is that every CO. is responsible for
the sanitary condition of the area occupied by his unit, and
that every good CO., and most of them are good, has fixed
ideas of his own on this matter.

These views may be different from your own and may be
obviously wrong, and in this case it is up to you to gain his
confidence, and direct his energies in the right way. Nevei*,
except in very rare cases, that cannot otherwise be dealt with,
condemn w ithout a hearing, or without first offering advice. The
vast majority of CO.'s know the importance of preserving the
health of their units and ai^ only too ready to give assistance

280 Some Impressions of a Divisional Sanitary Officer in France.

if they see that your efforts are to help and not merely criticise.
It is necessary to appreciate the difficulties of preserving a
satisfactory sanitary condition during warfare, especially in
forward areas, and to remember that a CO. sometimes has
other things than sanitation to worry about.

After nearly two and a half years' experience as a Divisional
Sanitary Officer I can look back with extreme pleasure to the
practically invariable courtesy of the officers of all ranks with
whom I came in contact. It was a very rare occasion for me
to be in my own mess for lunch, as the distances one had to
traverse were too great, and the time wasted in retracing one's
steps too precious, but one was always sure of a welcome at
Battalion or Company Headquarters, whether in billets or
trenches, and I regard the insight gained on those many very
merry meetings as invaluable. It was then that one obtained
the intimate knowledge of the officer of the Division that made
one's work so easy and such a delight.

I believe that this feeling of esprit de corps is of extreme
value in the work that falls to the lot of a Sanitary Officer,
and that my misgivings were shared by a large number of
Divisional Sanitary Officers when in February, 1917, Sanitary
Sections were torn from their Divisions, were allotted to areas,
and placed under Corps Administration. My experience of this
regime was short, and distinctly unpleasant, and it was with a
feeling of great relief when in April, 1917, I was enabled to
return to my old Division, and was again appointed Divisional
Sanitary Officer with power to form a new Section from such
material as could be spared. That Sanitary Officers of areas
under Corps Administration are desirable I do not question, but
that they can replace Divisional Sanitary Officers or hope to
fulfil their duties efficiently, I fail to understand. After all,
the health of the Division is of primary importance, and I
maintain that no Sanitary Officer can adequately perform his
Inspectional duties, who is not intimately acquainted with the
units he has to supervise.

Some Impressions of a Divisional Sanitary Officer in France. 281

In the ease of an attack on the enemy, and a subsequent ad-
vance, I believe that a Divisional Sanitary Offioer with a Divi-
sional Sanitary Section is especially necessary. The troops
have been subjected to a severe strain, possibly for days; they
are exhausted and particularly liable to disease; sanitarj^ re-
quirements must perforce take a secondary position in their
minds; water supplies are of uncertain value and may have
been ttampei-ed with by the enemy; the dead, both of men and
horses, require satisfactory burial, and the condition of insani-
tary chaos, such as no one, wha has not witnessed the effects
of a modern intensive bombardment, can appreciate, quickly
bringing into one of at least comparative order. Some regi-
mental M.O.'s may be trusted to initiate measures for the pro-
tection of their units under the most difficult cii-cumstances,
•others, through inexperience, or lack of energy, or simply fi'om
overwork and strain imposed on them by care of the wounded,
■often in very exposed positions, seem unable to turn their atten-
tion to these matters. It is at such a time that a Sanitary
Offioer, who thoroughly knows his Division, and the capabilities
of the M.O.'s of the various units can be of especial value to
render advice Avhen asked, help when i-equii^ed, and pressure
where necessary. He moves with his Division, and at once
tests water supplies, marking those that are fit for drinking
purposes with their degi-ee of purity, and condemning those that
are unsatisfactory, and i*eports to Divisional Headquarters on
particularly insanitary conditions, suggesting- the amount of
labour and material required to remedy them. The prevention
of the spread of disease at such a time depends on the taking
of measures that are simple, effective, and immediate; delay
from the inertia of organisation, or the complexity of elaborate
sanitary contrivances must entail a considerable amount of spo-
radic disease, which at any time may become epidemic.

I believe that both these causes of delay ai-e inherent in the
system of Sanitary Officers of Areas, for it is difficult for such
a Sanitary Officer to suddenly shift his area and l)ecome mobile,
and it is equally difficult for him to nbandon the more ambitious

282 Some Impressions of a Divisional Sanitary Officer in France.

devices, that are both ix^ssible and advisable in j^ermaneiit
areas, for those that ai-e neeeLSisarily makesliifts and whose oliieiB
merits consist in speed of execution, and simplicity combined
with efficiency. In addition to these disadvantag-es, and I regard
this as of paramount importance, tlie Sanitary Officer of an Area
is unlikely to be acquainted with the units, with which he has
to deal, and at a time when they are overworked, and in a
frame of mind least tolerant of interference from a strang-er.
Where Sanitary Officers of Areas would appear to be particularly
required is at important points on the lines of communication,
and in those localities behind the firing line called "rest are&s,"
whither tired Divisions repair at very infrequent intervals to
recuperate and prepare themselves for anotlier long- spell in the
forward zone. The special requirements of rest areas are com-
fortable, clean, and healthy billets, good sanitary provision,
pure and ample water supplies, and well-equipped and easily
accessible baths capable of dealing- with all the troops and
gi^dng them a reasonable opportunity of being deloused in the
short time at tlieir disposal. My experience of these so-called
" rest areas " has been tbat they rarely fulfil any of tliese re-
quirements, and that the weary troops have to turn to and set
their house in order. Billets are often dirty and uncared for,
sanitary appliances are insufficient, water supplies are ill-pro-
tected, and baths are badly arranged and defective. The con-
sequence of this want of preparation is that time is wasted, and
much of the benefit that would have been derived is lost, espe-
cially when, as has so frequently occurred, Divisions have been
brought back for two or three weeks well-earned rest and have
had to be sent back to the firing line in as many days. An
efficiv'int Area Sanitary Officer would make it his business to
see that these rest areas were in reality places where the war-
worn troops could be recreated with as little labour as possible
to themselves.

The ordinary sanitary duties and chlorination of drinking
water for a unit are carried out by the Sanitary Squads ana
water duty men of that unit, the numbers in each ease being

Some Impressions of a Divisional Sanitary Officer in France. 283

laid down by army regulations in accordance with the full
strength. It would appear to be quite obvious that the sanitary
duties and the purification of drinking water should be kex)t
quite separate; it was, however, frequently my experience, es-
pecially in the smaller units and those of recent formation, to
find tlie same N.C.O.'s and men discharging both duties. An-
other cause of trouble was the practice of chooising the K.C.O.'s
and men for these very important duties from the ranks of
those, who were physically or mentally, and often both physi-
cally and mentally unfit for responsible work of any kind. Soon
after joining my Division, and while still in England, I re-
ceived orders from the A.D.M.S. to give a course of instruc-
tion to sanitary squads and water duty men, and afterward?
to examine them and report on tlieir proficiency. In this way
one early came into touch -with the various sanitary squads and
water duty men, and was able to weed out the incapables, and
insist on the full complement. Whenever the Division was in
an area for a sufficient length of time a sanitary school was
organised and sanitary squads and water duty men were given
a course of lectures and instruction in practical work. It was
always my aim to impress on them the supreme importance of
the duties they were engaged in, and to rouse their enthusiasm.
The Sanitary man is often looked upon somewhat askance by
his fellows, especially as he is excused certain parades and-
obligations that would interfere with his work, but j)robably
more particularly because he receives an extra 4d. per day for
his unsavoury duties. This attitude is well expressed in the
experience of the zealous sanitary man, who while removing,
buckets from the latrines to a suitable spot for burial of their
contents was met by a squad of his comrades; one of the latter
raising the cry, "What did you do in the Great War, Daddy?"
was echoed by a ribald chorus of "Carried ." I weU re-
member in my early days a;s Divisional Sanitary Officer how
often, when one visited a unit and introduced oneself to the
Adjutant, he would in his cheery, helpful way, say, "Oh, y^,.
you have come to see Uie latrines! Here they are! ! ! " and tliis

284 Somr I iHinrss'ioiis oi n I >'i rtsional Sanliarf/ Officer in France.

"vvith such an air of finality as to impress one with the opinion
that he considered one's jurisdiction be^n and ended in these
temples of Hygeia. I Avais, therefore, very soon able to sym-
pathise with the feelings of the unfortunate sanitary man men-
tioned above, and to appreciate the necessity of arousing in all
engaged in these duties a feeling of pride and emulation. By |
frequently meeting these men in classes, and listening to their
tix)ubles, one was able to gain their confidence, and often to
adjust unfair conditions that lessened the value of their work.
Labours of sanitary and water duty men are too important, and,
if carried out properly, too onerous to admit of the attendance
at all the ordinary parades, while the carrying of the full equip-
ment of an infantry man when engaged in their duties is an
impossibility. Moreover, the "going over the top" during raids,
•or at any time except on occasions of dire neoessity, leads to thei
loss of men, who have been carefull}^ trained in special duties,
ai-e necessary for preserving the health of the unit, and cannotj
be rej^laeed at a moment's notice. All of the above disabilities
are provided for by special regulations, which are not, how-
ever, always complied with. One fully recognises the troubles
of a Commanding Ofiicer M'hose unit is I'educed to half strength
or even lower, and who is at his wits end to know where to
turn for men to perform the various combatant duties allotted
to him, and it is not always easy to persuade him that th&
work of the sanitary and Avater duty men is unusually im-
portant at such a time of stress. Difficulties of this descrip-
tion rarely occurred M'ith officers of experience, but when
owing to the heavy casualties, and the constant call for more
officers for our rapidly increasing armies, mere boys were
often placed in positions of great responsibility, it was not
surprising that the demands of sanitation were occasionally
sacrificed in the endeavour to maintain the combatant strength.
After the Somme offensive, when the Division was in course
of reconstruction, and numbers of young officers were coming
over to fill the places of those who had fallen, I received in-
structions to give lectures on sanitation to all hevvly-arrived

Some Impressions' of a Divisional Sanitary Officer in France. 285-

Company Officers and Non-commissioned Officers. Later I had
the privilege of giving a course of lectures at the Corps School
to the Medical Officers of my own Division, and of one Aus-
tralian and one New Zealand Division. It was witli some
trepidation that I faced members of my own profession iu>
discourse on matters of which they probably had preconceived
ideas, but with them, as witli the company officers, I always
found a most attentive audience, and learned much from dis-
cussing their difficulties with them. Classes of this description
would appear to be invaluable as a means of spreading the
general interest in sanitary aims and methods, and bringing-
the Sanitary Officers into touch witli those who are responsible
for the health of their units.

The brilHant results achieved in tlie prevention of disease
during the Great War are without doubt mainly attributable
to the diffusion of sanitary knowledge combined with a system
of organised inspection. Immense as are the effects of anti-
typhoid inoculation in affording protection from the chief
scourge of modern warfare, it must be recognised that that
protection is only relative, and that without efficient sanitary
provision the incidence of diseases of the typhoid group would
unquestionably have been serious.

The prevalence of diseases of this description among the
uninoculated was nearly six times as great as among the
inoculated ; while the admissions i>er tliousand for these disease*
in the Boer War were 87 times as great, and in the German
army in the Franco- Prussian War over 53 times as great as
in the British Expeditionary Foiye in France and Belgium.
After giving full credit to the restraining influence of anti-
typhoid inoculation in the prevention of epidemics and the
consequent reduction of the amount of infective material to
which the susceptible were exj)osed, it is difficult to believo
that such a marked reduction could have occurred tJirough
this agency alone, and a very large balance of the credit must
stand to the account of the general sanitary measures.

286 >n,,n Iii//>ir.ssh))/.s nf n Dirisinnal Sanitary Officer in France,

To form a true estimate of the value of improved sanitation
•in the reduction of disease it is necessary to examine the
statistics regarding bacillary dysentery, which in recent wars
has shared a numerical importance only slightly inferior to
that of the typhoid group. For this disease no protection was
provided except that embraced in the maintenance of a pure
water supply and careful sanitary precautions, yet the results
achieved were almost as striking as in the case of typhoid.
In the Boer War the admissions for dysentery per 1,000 were
forty times as great as in the British Expeditionary Force in
France and Belgium, and in the Franco- Prussian War ;the
admissions were twenty-five times as great. The statistics
of the incidence of dysentery in the British Expeditionary Force
in France and Belgium for the different years are exceedingly
suggestive, and are as follows: —

1914 0-05 per 1,000. strength.

1915 003

1916 4-09 „ „

1917 3-76

1918 0-79

It will be observed that during 1915 when our armies were
practically stationary and efficient sanitary supervision \\q.s
possible the admission rate for dysentery became almost negli-
g'ible, but that during 1916 and 1917, when our armies were
engaged in active operations, followed by local advances and
insecure tenure of occupied territory when effective sanitary
measures were almost impossible, the admission rate for dysen-
tery suddenly increased more than a hundredfold. In gauging
the importance of the great reduction of cases of dysentery
in the British Expeditionary Force ais compared with previous
wars it is necessary to remember that the presence of this
disease in any appreciable amount is invariably accompanied
by a far higlier percentage of cases of diarrhoea, A^ich though
insufficiently severe to be classified as dysentery considerably
reduces the strength of the units attacked, and is therefore
a factor of supreme importance in warfare.

Some Impressions of a Divismml Sanitary Officer in France. :287

On more than one occasion I have heard it suggested that it
it unfair to draw conclusions regarding the prevalence of disease
durins" the Boer War, as the conditions were so different from
those obtaining in Fi^noe and Belgium. Personally I am of
the opinion that had careful sanitary provision not been made
the results would have been far more serious than they wei'e
in South Africa. In the first fifteen months of the war the
French armies had 95,809 oases of typhoid with 11,680 c^eatlis,
and it was only by adopting a more thorough system of inocu-
lation and improving their methods of water supply and general
sanitation that disaster was averted.

It should be remembered that our new armies were 'drawn
frOm a population that for years had been guarded by an
almost perfect sanitary system, that they lacked the protection
afforded by the discipline of regular troops, and the immunity
from intestinal diseases acquired by those living under less
perfect sanitary conditions. They were suddenly dumped into
a country where sanitary provision was conspicuous by its ab-
sence, where intestinal diseases were very prevalent, and
carriers abundant. In Havre, where so many of them first set
foot in France, the recorded annual mortality from typhoid
was 115 per 100,000, and this would probably be considerably
higher were notification compulsory. The fact that we were
fighting in a friendly country naturally led to a much freer
intercourse with the inhabitants, and greatly increased the
danger of contact with carriers, especially among the children.
My experience of water supplies is that they all gave evidence
of fsecal contamination, and anyone who has enjoyed the shelter
of an ordinary billet in France or Belgium w'ill agree with me
that this was apparently the object aimed at in the faulty
construction of well and privy and their mutual proximity.

I call to mind one well in which the loose masonry that
eurroimded it was all that sepamted it from the badly con-
structed privy, and numberless others where a few feet of soil
of moro than questionable purity formed the only protection
from the same danger. A sanitary officer in search of a

288 Some Impressions of a Divisional Sanitary Officer in France.

domestic privy soou learned that he wais on a hot scent when
he had found the well. Another apparently inevitable law in
the construction of welLs in the farmhouses of France and
Belgium, which were the usual billets selected, was that they
should be sunk not more than 10 or 15 feet from the midden^
which occupied the greater part of the central courtyard and
received all the manure, slops, and houisehold refuse for at
least 12 months before being* removed to fertilize the land.
These middens served the double purpose of giving a distinctive
flavour to the water supply, and forming an excellent breeding
ground and nursery for myriads of that chummy little house-
hold pet — the domestic fly.

The country generally had for j-ears been under intensive
cultivation, which in other words meant that the land liad
been treated with organic matter to ^-ery nearly the full extent
of its nitrifying capacity, and required very Little additional
fouling to produce overstrain. Moreover, the practice of
spreading the contents of privies and cesspits over the gardenSj.
often in the immediate vicinit}- of ill-protected wells, was
a constant source of danger, especially as the subsoil water:
in the north of France and Belgium, from which the drinking
supplies were usually drawn, was rarely more than two or three-
feet below the surface.

In a country of the above description it was necessary to
concentrate our armies to such an extent that overcrowding
habitually occurred to at least five times the amount per-
missible in the worst quartere of our great towns. Over and
above " this, the troops were frequently exposed to wet and
cold under conditions that made it impossible to provide any
remedy, while fatigue and the harrowing effect of constant
shell fire in muddy trenches, only reKeved by short spells of
rest in ill-lighted, damp, and airless dug-outs, and the irrita,-
tion and sleeplessness produced by vermin were sufficient tO'
reduce the resisting power of the hardiest to the inroads of

Some Impressions' of a Divisional Sanitary Officer in France. 289

Such lioonsiderations, I Iniaintain, were calculated to produce a
nightmare of the worst description for any responsible sani-
tai'ian, and the results achieved under conditions so unpromising
reflect the greatest credit both on the system and on all those
officers, non-commissioned officers and men who early reoognised
the supi-eme importance of efficient sanitation, and by loyal
co-operation, often in circumstances of extreme difficulty, made
such results possible.

PART III.

REMINISCENCES OF A PRISONER OF
WAR IN TURKEY,

By
C. E. M. JO:n'ES, Captain R.A.M.C.(T.).

On April 29tli, 1916, the garrison of Kut-el-Amara, at the end
of a siege whioh began on Decemher 5th, 1915, surrendered to
the Turks. It had been obvious for some' time that the food
supply would not hold out beyond a certain date,, and the daily
ration, which had been gradually diminishing, during the last
three weeks of tlie sieg-e, had consisted of four ounces of bread
and twelve ounces of horse or mule. When the last of the
grain Avas finished, the end came. At the end of the siege
about 30 taien per day were dying of! starvation, and the gar-
rison were weakened from lack of food and diseases such as
dysentery, malaria, and scurvy. We moved up-stream to- Sham-
rau, where the main Turkish camp was situated, and on the
journey up, a Turkish medical officer, a Pasha, I'equested our
Regimental M.O.'s to select those men who were specially
weak or ill in order that extra food should be given them. We
found, however, on ariiving at our destination in the evening
that no food of any sort had been provided for anyone. The
next morning, after lu'gent representations had been made,
three Tiu'kish army biscuits were issued per man. These
biscuits are fearfully and wonderfully made; they are circular
in shape, about three inches in diameter, and lialf an inch
thick; as hard as rock, and about ns palatable, and required
^0 be stamped on, or hit Avith a hammer, to be broken. Never-

292 Jleminl^< I'll' ■■■ of a Prisoner of War in Tiirl'eij.

theless, tlioy were easerh- devoured by ili • tioup.s, who wei*e
ravenous. The eaiinu- of these biscuits was followed by very
unpleasant results: when soaked in "\\ater they swell to about
twioe theii* size ; this fact, and the fact that they were mostly
mouldy, caused most men ^vlio ate them to develop a trouble-
some enteritis. About this time, also, we had several deaths
from what very closely resembled cholera, if it was not actually.
Men would be seized with labdominal pain, diarrhoea, and mus-
cular cramp, and would be dead in a few hours. The Turks^
being absolutely unable to feed us, guve permission for our
people down stream to send a boat up with' food, etc., for us:
and canteen and mess stores, tinned milk, etc., arrived. In
the j<)y of lonce again eating a really satisfying- meal we tem-
porarily forgot our sorrows. The result of i-eturning' suddenly
to ordinary diet was, as had been foretold, that a good many
men developed jaundice, but everyone agreed that it was worth
it! After a few days A\-e were told that the officers would be
separated from the men and would proceed by boat to Bagdad,
whereas the men would march. Representations having been
made to the Turkish Commandant that the men w^ere weak
from lack of fooid, and from disease, and were consequently
quite unfit to undertake a long march in tropical heat, an order
was given for Ilegimental M.O.'s to select any cases that they
considered unfit to march in order that they might be examined
by a Turkish doctor. The sick were paraded, and a sorry sight
they were! The inspection by the Turkish doctor was charac-
teristic of Ottoman methods; he selected a very small number
for Itransportatian by boat, and said tliat the remainder would
march. On being l-emonstrated witli, and being told that the
men were weak and quite unfit to undertake the march, he
replied that starvation is not a pathological condition, and
scores of men weakened by lack of food, and debilitated by
malaria and dysentery, and even men with legs swollen from
Beri-Beri, w^ere compelled to start on a march which, for such,,
could have but one ending. As to who was responsible for
ordering the men to start on this march, I don't know, but this^

Reminiscences of a Prisoner of War in Turkey. 293

he miist have known, that such men Avei-ei being- made to mai*oh
about oOO miles, in tropical heat, through country where water
was often scant and brackish, and where the most primitive
arrangements only were possible for feeding- them. Such a
march imder these conditions Avould have tried thd fittest troops,
and in the cas-e of the Kut garrison it was simply sending*
scores of men to certain death. Shortly after the men had
started on their march, the oflBicers and their servants left for
Bagdad by boat in two parties, each consisting of about 100
officers and an equal number of servants. On; board our boat
we found about half a dozen Germans, junior officers, and war-
rant officers, and one could not help remarking that the Ger-
man and Tiu-kish officers held aloof from eachj other. I found
this to be the case wherever I happened to be ; the Germans
and Turks hated each other so cordially that I often mar-
velled that they held together as long as they did.

On reaching Bagdad we disembarked at what was formerly
the British Consulate, and used at that thne, as a Turkish Hos-
pital. The offioere w-ere here f alien-in in order of seniority,
and then marched through the sti^ets to the Cavalry Barracks.
The most noticeable thing in connection with our mai-ch through
Bagdad was, that altliough the streets w'ei-e throng-ed with
spectators, they remained absolutely silent, and made no- hos-
tile demonstration Avhatever. This may have been due possibly
to an oi-der from the Turkish authorities, but more probably
owing to the fact that a very larg-e section' of the inhabitants
were anglophile.

We remained two days in the Cavalry Barracks; at Bagdad.
We Avere inforjned tliat we should be limited to 45 lbs. of kit
each, so we proceeded to try and sell any superfluous clothing,
etc., to the various Jews and Armenians who came into the
barracks. These gentry were out for something for nothing,
and it wofl amusing, even if somewhat undignified,i the way in
B "which we haggled over the prices. We had, however, practi-
H oally no money, and a long trek ahead of us, so could not affoitl

294 liemimffcences of a Prisoner of War in Tiulx'ey.

not then realised tliat practically every Turkish officer is also
a merchant, if opportunity offers, and always on the look-
out to buy and sell at a profit. A Turkish lieutenant came
in and asked to be introduced to a British cavalry officer ;
when one was produced the Turk informed him that he had
been anxious for a long time to meet a British cavalryman,
and lasked him^ if he would sell him his spurs for sixpence,
he was quite disappointed when the offer was refused.

We /were eventually given some money by thei Turkish autho-
rities, the amount varying according to rank. A captain was
given 10 lira, four in gold and six: in paper. A lira is 100
plasties, land is worth 16s. 8d., theoretically. One adds the
word theoretically because the paper lira was only worth one-
fifth of the gold lira, as we found to our cost, and the Arabs
would not usually accept paper money at all.

On leaving Bagdad we proceeded by rail to Samara, which
was then the railhead, distant about 80 miles from Bagdad.
Here we remained for another two days before starting on our
trek of about 350 miles across the desert. Each officer was
given a mule or donkey, and we 'had no! other transport, and
our Servants were given no transport. We worked' in pairs;
one donkey carried the kits of two officers and their servants,
and the other was ridden. The trek took us about three weeks.
After [the lapse of three years much of the detail remains only
as (a confused memory, but the heat, the lack of water, and its
often lindifferent quality when obtainable, the difficulty in buy-
ing food, and the fact that one had not recovered from; the
effects of the siege and was not fit, all contributed to make
this Itrek one of the most unpleasant " stunts " I have ever
been on, and if those days were unpleasant for us, what Imust
have been the lot of the ranlv and' file, who were unprovided
with transport and marched every yard of th^ distance; who
were, to all intents and purposes, penniless, and' for whom no
adequate amangements for food had been made; and' who
were often subjected to barbarous treatment -by their guards.
The icondition of tlie survivons at the end of the march on their

Beminiscenc'es of a Prisoner of War in Turkey. 295

arrival at Ras-el-Ain gavie one some Binall idea of what thej
liad Tjeen through.

After about ten days we reached Mosul, where we remained
two days in the barracks. We were allowed to go out for our
meals to two restaurants. At our first meal we went straight
through the " a la carte " menu, and drank coloured mineral
waters but of real tumblers. At Mosul we were each given a
post card and (told we might write home. We eagerly availed
ourselves of this privilege, though we felt doubtful as to
whether our cards would ever reach England; as a matter of
fact they did, and these cards, received in England on July
14th, were the ^rst communications which our friends had re-
oeived from; us since the previous December.

We made the journey !from Mosul to Ras-el-Ain in nine da3n5,
a distance of about 150 mliles, and the whole trek had occupied
us about three weeks. Everyone was thankful that we liad
onoe more reached the railway. At !Ras-el-Ain we met three
or four Germian officers, and learned from them; of the death
of Lord Kitohener, and the battle of the Skagerrak. That
afternoon a message came from the Turkish Commandant at
Eas-el-Ain saying that he wished to see all the imedical officers.
Ten of us in all went to his quarters, and to our horror learned
that we were to be kept there for the purpose of looking
after about 3,000 Indian troops who were coming to work on
the trailway. Oilr feelings, on hearing that we were to remain
in this loathsome spot, can be imagined! However, nothing
could be done, and the next morning we saw the rest of our
party go off by train; it was a big wrench saying good-bye to
many good friends, and we left the station feeHng* thoroughly
miserable. 'Eas-el-Ain was little more than a large Arab vil-
lage, the houses being made of mud; it had one main sti'eet,
which was almost nine inches deep in dust; ite sole redeeming
feature was its water supply, which came from two or three
springs, and there was a really delightful pool in which we
bathed every morning and evening.

296 Reminiscences of a Prisoner of War in Turkey'.

"Wo were at first quartered in a dilapidated marquee, but we
complained to the Commandant that we could not stand the
heat, w^hich was very great, and we -were promised a house.
After some days' delay we were given new quarters. Four of
us fend our servants were given two roomsi in a house occupied
by an old man and his wdfe and children. The house was built
of mud, and consisted of three rooms built along one of the
walls of a compound about twenty yards squai^. The man
and his family objected strongly to our presence when we
appeared on the scene, but, finding* that we were there by the
Commandant's orders, he quieted down, and eventually became
quite friendly. Our room was about 15 feet by 8 feet and
about 8 feet liigh, and was totally devoid of anything in the
shape of furniture. The four of us occupied this room, ajid
the second room was utilised as a kitchen and for our servants.
In Ithis salubrious spot we spent four of the most awful months
-of our lives; w^e had nothing to do, practically nothing to read,
^nd (nothing to look forward to except our next meal and our
bathing. Food was not easy to obtain always aad the heat w'as
Tory trying; the Commandajit was a perfect beast, half a
Turk and half a Kurd; altogether not a very desirable spot.
Portunately we w^ere able to buy tobacco.

We could do nothing in the way of treating the sick Indian
troops, as the building which was euphemistically called the
Turkish hospital boasted practically no drugs. One morning
there w^ere 60 men suffering from diarrhoea, and the total drugs
available for the whole 60 consisted of 15 grains of Bismuth,
J gr. per man, and when that was finishedi there would be no
more. To add to our joys w^e all got ill with sand-fly fever,
and we had all been troubled with a sort of chronic enteritis
for months.

A little temporary excitement was occasionally provided, when
all ten of us were sent for to go to the Commandant's office;
this happened several times, and it usually meant that we were
required to go and examine someone who was- sick. This was
often some Turkish official who was doing his best to plead

Reminiscences of a Prisoner of War in Turkey. 297

sickness as an excuse to be sient away from Has-el-Ain. We
pointed out that it was hardly necessary for ten of us to see
the patient, but to no effect. One day, however, we were all
sent for, and on our arrival at the office we found the tempo-
rary Commandant cutting* up ten small squares of paper; he
marked three of these squares, and folded all the squares of
paper, and held them in his hand. Wei each, drew a piece of
paper, and I and tw^o others drew the three marked squares.
We were then informed that we three were to go to the Amanuis
mountains to look after the British prisoners of war who had
had a lot of sickness. We knew nothing of the Amanue moun-
tains, but were convinced that they could not be worse than
Ras-el-Ain, and we were delighted to be off. We left the
next day. After travelling for three days we arrived at
Bagt<jhe, in the Amanus district, the latter part' of the journey
being on the small-gauge railway. Just before reaching Bag-
tche we passed through the tunnel which was. bored throug*h
the mountain at Airan. This tunnel is about 2,500 metres long
but it took us four hours to get through it, as work was still
going on and blasting was in progress. Our train consisted
of smaU open trucks, and the brakesmen on the waggons carried
acetyline lamps. When the blasting took place we felt pres-
sure on the drums of our ears, and' all the lamps were blown
out by the explosion.

At Bagtohe we found some Englishmen still left, but the
majority had recently been sent away, owing to the great
amount of sickness. I should explain that Bagtche was one
of several stations of the Bagdad Railway Construction Com-
pany. This company was a German civilian undertaking; when
-w^ar broke out the railway extended from Constantinople as far
south as Bozanti, where the Taurus Mountains stopped' it. In
the Taurus and Amanus districts there Avas no' line, which re-
commenoed at Islahie, a few hours* run from Aleppo, and ran
as far as Bas-el-Ain. Tunnelling operations in the Taurus and
Amanus had commenced about two years before the war, and
the work continued whilst the Avar was in progress, and prisoners

298 lieminiscences of a 'Prisoner of War in Turkey.

of ivar were sent to work on the line. Both the Taurus and
Amanus districts are very malarial in the summer, and at
Bagtche the men had suffered a great deal from malaria and
dysentery, and in the course of three months about 200 had
died, I was told.

At Bagtche we remained two days, and tlien I continued my
journey, having been told I was to go to Belemedik, in the
Taurus; my two oompanions remained at Bagtche. After
about (thjpee days' travelKng by rail and motor lorry, the latter
over about 30 miles of vile roads, I reach Belemedik on the
29th October, 1916; here I found Major P., of the I.M.S.,
whom I had last seen as lie passed through' Ilas-el-Ain. There
were also a number of British prisoners of war from Gallipoli
and Mesopotamia. (Belemedik was the Headquarter Section of
this locality, and was the most civilised spot I had seen for la
long' time. The building-s were practically all of the wood
bungalow type and of European design. I was quite- courte-
ously received by the Turkish Commandant, a colonel, and by
the second engineer of the company. The next morning I was
taken by the Commandant to the hospital and presented to
the Cerman doctor in cliarge; hjer© I was given the first cigar
I had smoked for months ! It was decided that I should be
sent to Hadjkiri, the out-lying section of thei division of which
Belemedik was the headquarters, and I was instructed to re-
port myself to the engineer and the Armenian doctor, on my
arrival, the next day. Major P., who lived in the hospital,
took me down to the quarters occupied by the British, where I
made the acquaintance of the senior non-commissioned officer
of the camp, who was a naval petty -officer, and' some others
who happened to.be in at the time. My clothing at this time
was neither plentiful nor in good repair, and I took the oppor-
timity of purchasing a shirt at the company store. Petty -officer
S. also presented me with some woollen underclothing which
had been sent out in some parcels of Haval comforts, and this
w^as most acceptable. The next day I started o£^ on my jour-
ney to Hadjkiri, distant about nine miles, over the mountains.

Reminiscefrces of a Prisoner of War in Turlcey. 299

I rode a small ponv, my valise was carried by another, and
my escort, a gendarme, ixxie a mule, The road across tlie
mountains was uneven and stony, but the scenery was very
picturesque and a pleasant contrast to the dead level plain at
EaiS-el-Ain; but I was destined to become very sick of these
mountains! I passed through two of the sections, and met
some more British, and finally reached Hadjkiri, where I was
fated to spend the next two years and two months of my
existence. It struck me as being a thoroughly dreary spot,
and my hopes, which had risen somewhat on. seeing Belemedik,
fell. My guide took me to the engineer's house, and we ulti-
mately discovered him near by; he was dressed^ in blue over-
alls aiid a German peaked cap — ^rather a contrast to the more
elegantly attired individual I had seen at Belemedik. I was
taken to my room, which proved to be in the same bungalow
as the Commandant, and on my arrival there the Commandant
was still in possession, and was lying on his bed. He was a
lieutenant, probably an ex-ranker, but quite civil. He re-
moved his furniture and I was left in an empty room with my
vaUse. It Avas about 4 p.m. (and I had eaten nothing since
bi-ecikfast, so I proceeded to glo out in search of the hospital
and a possible tea. I met a woman who addressed me in Eng-
lish, and asked me if I was the English' doctor, and informed
me that she was the Armenian doctor's cousin. I was taken to
the hospital, a somewhat fearsome structure, and was given
some tea, during the consumption of which I was introduced
to various Armenian hospital oflficials, such as pharmacist, ward
orderlies, secretary, etc. All these greeted me cordially, but
I afterwards found them, for the most part, very undesirable
gentry. Whilst I was interviewing these creatures the Armenian
doctor arrived, and expressed himself as delighted to see me.
He was a youngish man, quite good -mannered, but like most
Armenians I have met, I found him very two-faoed. He had
a Ifiair knowledge of medicine, but was utterly ignorant of sur-
gery. The news of my arrival had been noised abroad, and a
naval chief petty -officer, who was the Senior N.C.O. of tlie

•300 Ji( liui/i^m/rcM of a Prlsoi/rr of War in Turkey.

British at Hadjkiri, came to see me. I went with him to the
barracks, and saw the men, about 50 in number, and nearly all
looking weak and ill from analaria; the majority; of them had
■done practically no work for about three months. A servant
wms found for me, a New Zealander, Private G.; he was one of
the best fellows in the world, and his kindness to me I shall
always remember. The hospital at this time was a small
building- containing about 14 beds; this number was quite in-
adequate, and there were also two wooden buildings, stables,
which were converted into an extension of the hospital. In
the hospital proper two patients slept in one bed, and they
slept in their ordinary, day -clothes; the feeding might have
been worse, but it might also have been better, and by com-
plaining' to the Armenian doctor we got it much improved.

The Armenian pharmacist was also in charge of the feeding
arrangements; he Avas paid 9 piastres per head per day for
the patients' food. This money was paid by the company; he
spent about 3 or 4 piastres per head per day, and kept the
rest for himself. He and tlie Armenian doctor also sold a
certain amount of drugs, which were sent out by the head-
quarter hospital at Belemedik. I found that onO' reason why
the British weye so sick with malaria was that often no qui-
nine Avas obtainable at ,the hospital, and a man who ^\aB feeling
rotten with an attack of malaria did not feel very inclined to
walk half a mile to the hospital only to find that there was no
quinine. The quinine pills which the Pharmacist made were
also probably at least 50 per cent, flour. I therefore obtained
a kilogram of quinine from Belemedik, and gave it out to
Chief Petty-Officer A., telling him to issue it out morning and
-evening to any sick man. This plan, together with the issuing
of some tonic in the same way, produced a marked improve-
ment at the end of a fortnight As C.P.-O. A. put it : " The
men are a lot better, sir; a fortnight ag'O tlie barrack was as
silent as the grave in the evening, nobody wanting to talk,
w^hereas last night I actually heard two men arguing ! " About
a fortnight after my arrival, all the men, with the exception of

Reminiscences of a Prisoner of War in Turkey. 301

hjalf-a-dozen, were sent away to a prisoned of war camp at
Afion--Kara-Hissar, being considered unfit for work with the
company.

In the spring of 1917 a new hospital was built, and a nurs-
ing sister, recently arrived from Grermany, came out to take
charg-e of it. There was an immediate improvement in every
way directly the control was taken out of the hands of the
Armenian doctor and pharmacist; the sick were cleaner, better
fed, and obtained an adequate amount of drug®;' and the cap-
able administration of this sister undoubtedly saved many lives.
The Company managed to obtain a good supply of drugs etc...
from Germany, which wa^s fortunate for us, as the Turks had
practically none. Some ^months later we began to receive con-
signments of certain medicines and medical comforts, which
were despatched by a committee of ladies working at Hove.
These medical comforts, consisting of condensed milk, Glaxo,.
Ovaltine, Bovril, Oxo, Brand's Essence, etc., were of very great
value to the sick, who greatly appi'eciated the kindness of those
who had worked so well on their behalf. Tlie number of
workmen in Hadjkiri section was about 3,000, and there wei-e
about 70 beds in the liospital, which were usually full, exoej^t
in the months of April land May, which wei-e the healthiest
months of the year. July, August, and September produced
many sick, this being the malarial season; and there was also
a good deal of dysentery. When tlie weather became colder,
in November and December, and tlie Greek, Armenian, and
Turkish workmen consequently gave up washing themselves and
became covered with lioe, then typhus would begin and last
more or lees until the weatJier again becamei warmer in March
or April. "We had about 30 cases of typhus my first winter
there, with a mortality of about 20 per oent., and at the head-
quarter section the number of cases was mucli' greater. The
following winter the usual epidemic was almost avoided omng
to all the workmen being compelled to go tlirough a bath once
a Meek, and their clothing and bedding was stoved at the same
time. Undoubtedly malai-ia was the greatest scourge, and

302 Reminiscences of a Prisoner of War in Turkey.

many cases Ave re of the analignant type. I found that the in-
travenous injection of 7 grains of quinine gave the best re-
sults; many of the malarial cases developed nephritis, but
this usually cleared up Avith quinine and suitable diet.

Fourteen languages were spoken in Hadjkiri, so it was not
always easy to converse with tlie patients, but we most of 'us
knew a little Turkish, so mana^d somehow. One's chief
trouble Avas the appalling monotony of one's existence. My
work occupied about two hours per day and the remainder of
the time had to be be passed somehow. During practically the
W'hole of my time at Hadjkiri there were only six British there.
The Senior N.C.O., a sergeant in tlie Australian Light Horse,
and incidentally a gentleman, AA^as a charming felloAv, but un-
fortunately he was Avorking all day in the blacksmith's shop
at the works near the mouth of the itunnel. However, in the
eA^enings he would sometimes come to my room, with my ser-
vant, and we would smoke land drink tea, and I would trans-
late the Turkish paper, printed in Frendh. We' were, of course,
alloAA'ed no neAvspapers from England, and had to rely on the
Turkish and German papers. These Avere, naturally, hopelessly
inaccurate, but one' oould glean some sort of general informa-
tion from them. At other times I would goi down to the men's
barrack, Avhere a kindly welcome was always given me. About
once a month I Avould' go and visit Major P. at Belemedik,
and we usually spent the eA^enin^ chatting Avith' a fcAv of the
Senior N.C.O.'s, discussing the latest war neAvs, and wondering
Avhen we AA^ere going to get out of Turkey. Occasionally one
or two captured British officers from the Palestine Front would
pass (through, and we sometimes had an opportunity of chatting
Avith them and learning tlie latest news that they could give us.

And teo the months rolled on. In September, 1918, we were
following AUenby's advance in Palestine with intense interest,
and we also managed to get neAvs of our great advance in
France. Our hopes rose daily, and when Grermany aad her
satellites asked for an armistice we felt thaii the end of our
troubles was in sight. During October we saw every day trains

Reminiscences of a Prisoner of War in Turkey. 303

pass through loaded with Germans and Turks from Palestinej
and early in iNovember, when we heard that, Turkey had signed
the (armistice, we felt we were free men again and the British^
French, Italian, Russian, and Serbian flags were hoisted over
their respective barracks. The time between the signing of
the armistice and our departure on December 7th' seemed to us
terribly long, but everything is said to come to him who waits,
and when we eventually received orders to leave, Ave departed
in high spirits and Union Jacks flj'ing from* every waggon on'
the train. We travelled by rail to Mersina, where a boat
awaited us, and we embarked, thankful once more to set foot
on iBritish soil. We were landed at Port Said, and after wait-
ing for ten days in a Rest Camp we sailed from Port Said on
December 2Gth for Taranto, travelled up through Italy and
France to Calais, and landed at Dover on January 9th, 1919.

So ended our captivity in Turkey!

A PRISONERS-OF-WAR LIBRARY

Being the

HISTORY OF THE BRITISH OFFICERS' LIBRARY,
STRALSUND, GERMANY.

MAJOR LUXMOORE NEWCOMBE, <
Sub-Librarian, University Collegie, London,

AND

LIEUT. JOHN H. E. WINSTOX,
Late Wills Librarian, Guv's Hospital.

It may be of interest to Librarians who have not had tlie
privilege of being guests of the Ex- Emperor of Germany at
one of his Homes of Rest for British Offioei's to have a few
details of the foundation and development of a Library in a
Prisoners-of-War Camp.

It is very difficult to con\'ey to the mind of anyone who lias
not lived in a Prisonei-s-of-War Camp any idea of the numerous
difficulties with which one had to contend in orgunising a
library or any otlier bmnch of Camp life. For the firet thi-ee
montlLS of our captivity, befoi-e we' i-eoeived oui- food parcels
from England, we wei-e practically starved, and everyone was
so cxti'aoi'dinarily weak that \'ery often the walk of some
three hundi-ed yards from oui* Barrack to the Libi-ary was
sufficient to incapacitate us for the rest of the day. We found
that two hours' work daily was as mucii as we could do.
This in itself made progress very slow.

PART III. U

306 A Pris<)}i('rs-()j-\V<ir Lihrarj/.

Botli llio writei's ol* this sxrticle Avere captured on the Chemin
des Dames on May 27th, 1918. A fortniglit later we reached a
temporary camp at Rastatt, whore there Avere some four hun-
dred British and several hundred French officers.

Apart from eating the very small quantity o:^ excessively
unappetising food which we were given by the German Govern-
ment, there Avas very little to be done all day. We had no
facilities for doing any kind of work or playing any games,
so tliat time hung very heavily on our hands. Everyone felt
tlie need of something to read — even if that something was
only a copy of the Army List or Bradshaw's Railway Guide.
Unfortunately, the only available reading material Avas
a feAv volumes of tbe Tauchnitz Edition, Avhich Ave re on sale
at the Camp Canteen. Had these foAv books been some of
tlie best of the many excellent v^olumes published in the
Tauchnitz Edition they Avould liave been very welcome, but
unfortunately they Avene, almost without exception, a collection
of the AA^orst and most uninteresting Avorks in the whole series.
Added to that draAvback the Cantieen price was excessive,
being 3 Marks 50 for a volume published at 1 Mark GO.
As very feAv of us had any money — any Ave originally had
having been borroAved by Brother Fritz on our capture — it was
difficult to buy these books.

It Avas Boon apparent that there Avas a great need for some
kind of organised library; at the same time it was obvious
that it was no use attempting to start one until VA-e reached
a permanent camp, Rastatt being only a distributing station
Avhere everyone Avas liable to depart at a few hours' noticei
for another camp.

The only possible way for officers to obtain a variety of
literature was by exchanging AvitJi one another the foAv books
they had been able to purchase at the Canteen. This did not
X3rove a very satisfactory method. The books, all of Avhich
AA^ere iinbound, soon became very dilapidated and had a habit
of losing some of their pages, usualty toAvards the end of the
book, so that the Avretched reader did not discoAor their absence

A FrisonerS'OJ-War Library. 307-

tintil he had read the bulk of it. ^laiiy of tlie books were in
two or more volumes, but you Meix3 a lucky man if you ever
Baw more than one volume of a work!

CTn June 27th we formed part of a batch of four hundred
officers who were i-e moved to a new permanent camp on the
Island of Danliolm, near Stralsund. Hei-e everything was put
on a business basis, and various conmiittees Avere formed. The
Library Committee consisted of a Chairman, a Secretary and
Treasurer (Major Newcombe), a Librarian (Lieut. Winston),
and a representative from each Barrack in the Camp.
Later the Pi-esident of the Education Committee and an Officer
who took charge of the Binding Department were added.
In time there were eighteen membei-s on the Committee. As
this was rather a large body, a Sub-Committee was formed
to ]:)urchase books and superintend the minor details in con-
nection Avith the Library. This Sub-Connnittee consisted of
the Chairman, the Secretary, tlie Librai'ian, tlie President of
the Education Committee, and one other member.

Our preliminary difficulties were nimaerous. In the first
place wo liad considerable trouble in inducing tlie German
authorities to allot us a room for the Library, but eventually
they gave us a room which had formerly been a canteen — care
being taken to i-emove all the beer befoi« the Library Com-
mittee entered it! This room was an ideal one for the purpose.
It (Contained a large bay, which we used as a book store and
circulating department, the remainder of tlie room being set
side as a reading room. When we took over the room it
jOontained five long tables and a sufficient quantity of chairs
and forms. We used the forms for making bookcases for some
of the larger books. The German authorities promised to
let us have thirty small bookcases, a pi-omise which cheered
us lip immensely. But, alas, it was only after I'epeated worry-
ing that we actually received any of these cases. Evontuall;5^
"we obtained eleven, which, after all, was a considerably bettor
result than in the case of most of the German promises! The
following plan gives an idea of the general arrangement of
the room.

308

A PrisonerS'of-War Library.

We Lad some difficulty in arrang-ing* suitable hours for the
Library to ha open. During- ma-it of the afternoon tlie room
was wanted by the Education Committee for some of their
classes. Then the hours of meals had to be studied in oi'der
to allow the nuemhei-s on duty 'to obtain their small portion
of mbbagie soup, which formed tlie main article of oiu' diet.
As the meals wei-e worked in thi^ee shifts they took up a
considerable portion of the day.

8f?(TISH OfflCERS
UBRARV, ^TRALSUND.

It Boon became evident that tlie hours of cii'culation would
have to be inereaised, as day after day for the first week or
two of the Library's existence there wei-e long queues of
more or less — mostly less — patient members waiting* to excliangie
books. As the days be<jame shorter this difficulty was increased

A Prisoners-of'War Library . 309

as after dark about half the officers Mere not allowed to 9X>
aci'oss to that part of the Camp where the Library was situated,
so that it was impossible to open the Libraj.y in the evenings.
This considerably reduced the hours of circulation.

The opening of the Library was delayed for over a fortnig-ht
on account of the Camp Commandant ordering all officers to
be " deloused " whether ih^j required that treatment or not.
The inhabitants of each Barrack went in turn to the Delousing
Station on the other side of the Island, where the delousing
process took three days. This necessitated having to Avait
until the last Barrack had been done before we could call
in the books then in the Camp. The books so called in formed
the nucleus of our Library.

The Library was finalty opened on July 24th, 1918, with a
membership of 467, and a stock of 993 books, of which 528
were English, 217 French, and 248 German. Of this total
all the foreign works and 90 of the English books were lent
to the Library by the German Authorities. These volumes
had formed part of a Camp Jjibrary collected by Russian
Officers ^vho were prisoners of war on our Island in the earlier
days of the War. Of the remainder of the English books,
60 had been joresented by the Berlin Y.M.p.A., and the balance
had been given by Officers in the Camp, principally as part
payment of their entrance fees. Although a Library of 528
English volumes sounds quite a respectable one, so many of
the books were odd volumes or had pages missing, or if they
happened to have escaped these drawbacks their subject matter
was often of a very trashy description, that the actual read-
able material was lamentably small.

A few days before the Library Avas due to open we bumped
up against an unexpected trouble by some of the German
Guard marching into the roo;m, pitching us out, locking the
door, and taking away the only key we had. It took us a
couple of days to get this key back again. We balanced
oui- account on this point by finding another key of the room,
which, we regret to say, we stole without the slightest hesita-

310 -1 l'iis(,ii('rs-(,f-\V(ir Lihronj.

tion or ((Uiilius of {oiisciciicc! A sad example of the depths
to Avhicli u Jahrariaii iiiay .sink under certain eircurastanoes.

The rules of Ihe Library wei-e as follows: —

1. Member ship. — Onh^ members of the Library are nllovved to use
the Library Koom.

2. Subscription. — The subscription is Fifty Pfennigs a month, pay-
able on the 1st of each month. An entrance fee of Two Marks will

-be paid. Each member on joining will contribute one book to the
Library or pay a further entrance fee of Two ^larks.

3. Borrowing. — Only one (in September the word " English " was
added here) ' volume may be borrowed at a time; works of more
than one volume which entail the reading of each volume consecu-
tively will be counted lai s one volmne. (At the end of September when
the number of volumes in the Library enabled us to do so the follow-
ing paragraph was added). In addition to the English volume one
foreign book may be borrowed.

4. Return of Books. — Books must be returned within the following
times from the date of borrowing: English books, 7 days; foreign
books, 14 days. If, on the expiration of the above period, the book
is not wanted by anyf lother member, it may be renewed for a further
period of 7 or 14 days. (At the end of September members were
allowed to retain English books also for a period of 14 daj^s).

5. Fines. — Any member failing to return a book on or before the
date due for its return will be fined: — 10 Pfennigs per day up to a
total of seven dayai; 1 Mark per day after the seventh day. (The
latter part of this rule was rescinded kt the end of September, when
the larger stock of books; in the Library made it less important that
books should be returned quickly).

6. Exchange of Books.-^All books must be exchanged through the
Library, and not passed from one member to another. Books may
be exchanged at the following hours: — Weekdays, 9.15 a.m. to 10.15
a.m. ,and) 7 p.m.. tO) 8 p.m.; Sundays, 2 p.m. to 3 p.m. The Library
is open for reading at the following hours: — Weekdays, 9.15 a.m. to
12 noon and 7 p.m. to 8 p.m.; Sundays, 2 p.m. to 5 p.m. (Later,.
for various reasons, these hours) had to foe altered as follows: — Week-
days, circulation and reference, 9.15 a.m. to 11.15 a.m. and 2 p.m. to
4 p.m., reference only, 6 p.m:. to 7.45 p.m.; Sundays, circulation
and reference, 2 p.m. to 4 p.m.).

7. Waiting List. — Any member wishing to reserve a book which
is already in circulation may do so Iby entering details in the Wti;it-
ing List Book. (This rule had to be cancelled almost immediatel\%
as it was found to( be unworkable owing to the very limited number
of books in the Library. Within a week the majority of the books in
the Library appeared in the Waiting List!).

A Fr'tsoners-of'War L'tbrarif. VA\

8. Suggestions. — A Suggestion Book is kept in the Library. Any
member wishing to recommend a book for purcliase will write fall
particulars in the Suggestion Book. When making suggestions it should
be remembered that, with very few exceptions, only books published
in Germany (e.g., the Tauchnitz Edition) are obtainable. Any sug-
gestions for the improvement or general working of the Library should
be made in the Suggestion Book.

9. Bejerence Library. — Certain works of reference are not allowed
out of the Library, but may be consulted in the Library by any
member.

10. Access to Books. — ^Xo member may have access to any of the
bookcases containing fiction. The bookcases containing works of refer-
ence and educational w-orks aref open for inembers wishing to consult
the books.

Although we should have liked to catalog-ue the Library
ou the card index system, we had to be content witih the
material at our disposal, which consisted of quarto exercise
books, each contedning 120 pag^s. We allotted four of tliese
books to the Author Catalogue of English books, one each
to the Catalogues of French and German books, and one each
to the Subject and Shelf Catalogues.

Our cataloguing- rules were as simple as possible, each book
being catalogued under the author's surname, full Christian
name when possible, short title, place of publication, date,
and press mark. Cross -i-eferences were made when necessary.

Later on, after some difficulty, we were able to obtain
cataloguing cards on which the titles of all the English boolvs
were eopied. These cards Ave re used in iihe following manner.

AVe tmade a number of small wooden tiuys, each capable of
holding about 200 cards. These trays were lettered on the
outside to show what cards each contained. We made also a
tray long enough to contain a thousand cards .

The method adopted was tliat when a member wished to
borrow a book he consulted the small boxes which contained
all the cards — ^in alphabetical order — of all the books actually
in the Library at the time. Fix)m these boxes he took out the
card for the book he wanted and gave it to one of the assistant
on duty. The press mark being on the card, the assistant wafi

312 A Prisoners-of'War Library.

at once able to go to the elielf and liand the book to the mem-
ber, "vvho gave it to another assistant to enter on the borrower's
sheet, at the same time returning the book he had out. The
first assistant then put the card into the long tray — or did so
later if he was too busy at the time — which contained the cards
for all the books at that time in circulation, arranged in nu-
merical order according to press marks.

Tho advantages of this system were the saving' of a con-
siderable amount of time to both members and assistants. The
member wasted no time in compiling a list of books and finding
them all out, and the assistant had not to look for endless books
which were in circulation. The member knew that if he found
a eard in one of the small boxes the book was in the Library.
The one drawback to this system was that members would take
cards out of the small trays and put them back in the wrong
plaoes, thus necessitating constant resorting of the cards. When
a book was returned the corresponding card was transferred
from the long tray to the appropriate small one.

The Borrowers' Register was made out of a number of quarto
exercise books, the pages of which we cut out, thus forming
a rough loose-leaf- register. At the top of each sheet we had
the name, rank and initials, Barrack and room number, and
the. Library number of the member to whom the particular
sheet belonged. JEach side of the sheet was ruled into two
parts of four columns each. These columns were headed as
follows: — (1) Date of Issue, (2) Press-mark, (3) Date of Return,
(4) Fines. When a book was issued to a member the assistant
marked oft" the returned book, if any, collected any fine due,
and entered the date of issue and the press-mark of the book
which was being taken out. The borrowers' sheets were kept
in alphabetical order in rough folders consisting of the covers
of the exercise books from which we had taken the sheets,
each letter having a separate folder. Before returned books
were replaced on tlie shelves their cards were sorted into tlie
appropriate small tray.

A TrisonerS'of-War Library. 313

We had four sets of press-marks; the English books being
uumbei*ed from 1 onAvards consecutively, the French books
being marked F.l etc., the Grerman G.l etc., and the Eeference
R.l etc. At first these press -marks were written inside the
covers of bound books and on the outside of unbound
books. Later when we were able to obtain some small labels,
we also i^ut a press-marked label on the back of each book.
The gaim used for fixing these labels cost us 6s. 6d. for a small
bottle! To facilitate the rapid finding of boolcs we allotted
one shelf to every 50 boo lis. We could easily do this, as most
of the books were small and a g-reat many were always in
circulation. As Ave were unable to procure a stamp for the
books the name of the Library was written on the title pa^
of each.

After we had put the Library into working order we handed
over the Circulation Department to members of the Committee,
who took duty in pairs. Although it would have simplified
matters to have had two ofiicers permanently on duty this
was impossible owing to educational classes and other affairs
in the Camp. Having relieved ourselves of the minor duties
in connection with the Circulation Department, we were free
to devote our time to cataloguing and superintending the general
routine of the Library.

Although all the officers who took duty in the Library
were very Iceen and energetic, we found that even in a small
Library, such as this, the entire lack oi any practical libi^ary
training was a serious drawback. It took us quite a long time
to impress upon some of them the importance of putting books
back in the same place. Many of the assistants had an
unpleasant habit of issuing odd volumes of a work, much to
the annoyance of a member who had waited patiently in a
long queue to obtain a book, which he found on reaohing
his Barrack was Volume 3 only of the work he wanted — or
«ven of la work he did not want. Some of the assistants had
a very vague idea as to the class of book they were issuing.
For instance, there was the case of a man who asked for

31.4 A Pr'/soiicis-oj-Wdr Ijhnuij.

"any g-ood novel," and was given an antiquated Ijoolv entitled
"How to keep house on a pound a week"; a most excellent
book no doubt, but not mueli i«;e to a man who wanted a
novel in ^ Prisoners -of -War Camp where grocers, butchers,,
and bakers shops were non-existent. Then thei^ was the case
of the rather solemn man who asked for one of the British
classics, and was given Elinor Glyn's "Three Weeks"; whereas
the man who probably would have appreciated the latter work
was sent on his way rejoicing with a copy of Robeitsou's
Sermons !

Wo endeavoured to improve the standard of the literature
in tlio Library bj' introducing more books by standard authors
and works of an educational character, at the same time
easting out some of the trashy novels presented in the early
days of the Library, Vhen we were only too glad to extend the
heartiest of welcomes to anything that had ever seen a printer's
press .

We obtained through the Prisoners -of -War Book Scheme
many hundred volumes of an educational and technical nature.
These books were issued on permanent loan to men pursuing
their professional studies. Many of these volumes were tlie
principal text books on the various subjects and their value
to the Camp as a whole cannot be over-estimated. The ^-reatest
praise is due to Sir Alfred Davies and the other promot€a^s of
this Scheme, which was practically the only available source
of supply open to men wishing to continue or commence their
professional studies. Most of the boolis were used in con-
junction with the many excellent classes org^anised by our
Camp Education Committee.

In addition to these books we obtained some 150 grammars
of various European languages, which were supplied at a very
low figure by the Berlin Y.M.C.A. It is interesting to note
that the German authorities would not allow us to obtain any
Eussian grammars, as they said that no doubt after the war
England would have a good deal of commercial intercourse with
Russia and they did not want to encourage the study of the
language by prisoners -of -war!

A Frisoners-of'War Library. 315

Oiu' tg'i-eatest difficulty — we liad inaii^^! — was the acquisition
of boolvs. Practically the only books we could purchase Avei*^
those published in the Taudmitz Edition. As we have already
stated, wo started with a total of 993 volumes in the Library,
which number we endeavoured to augment as rapidly as possi-
ble. We asked every oflScer in the Camp to present to tlie
Libraj-y any books he might I'eceive from time to time, and
we ordered 200 volumes of the Tauehnitz Edition throug-h a
(rerman bookseller who visited the Camp for orders. We had
to pay 5 marks per volume for these. Thei^e was also a civilian
clerk in the Camp from whom we purchased 159 volumes
for 262 marks.

It is a matter of interest to note that Avhen we went to?
pay the clerk for these books he refused to take cash, imploring*
us to let him have food instead as soon as our food parcels
arrived. The fact that a man in his position, with a Avife and
children to support, was willing to sacrifioe so large a sum as
£13 for an uncertain amount of food at some indefinite date
in the future shoAvs hoAv greatly the Germans were in need
of food at that time.

In addition to these books we obtained t^o splendid dona-
tions, one of 500 volumes of the Tauclmitz Edition from the
Danish Red Cross and one of 255 similar volumes from the
Berlin Y.M.C.A., as well as many more German and French
books on loan from tlie German authorities. We later received
a few books from the Camp Library.

In these and other smaller ways we g^*adually increased our
Library until when it was disbanded on the 20th of November
it contained 1,893 English books, 311 French books, and 372
German, books.

As so many of the volimies in the Library were in paper
covers, many of which were in a sad state of dilapidation on
their first appearance in the Library, it was soon evident that
unless we oould bind books on a fairly large scale our Library
would soon disappear in Avaste paper. Fortunately Ave had
in the Camp an English orderly Avho Avas a book-binder by

31 G A PrisonerS'Of'War Library.

trade, and who would have been exceedingly useful to us
had we been able to obtain the necessary material to enablei
him to carry out the work. We were allotted a very small room
as a bindery, and were given sufficient apparatus to enable
us to bind the small books we had; the only other things we
needed were cloth, boards, thread and cord, none of which
articles we were able to obtain. Whenever we asked the Com-
mandant to assist us in obtaining these materials — for which
we were, of course, willing to pay — we were always met by
the stock answer " That we were unable to obtain them owing
to the efficiency of our own blockade," a cheering if not alto-
gether satisfactory explanation. After a time we were able
to obtain 200 metres of black thread and a small quantity of
boards and cloth. String fi-om our food parcels made a fairly
satisfactory substitute for cord, so that one way and another
w'e were able to tackle a few of the worst cases of binding
casualties.

As soon as we had sufficient books in tlie Library we were
al)le to admit the orderlies, of whom there were some 250,
as members. They were given the same facilities as the officers,
but were charged no entrance fee or su"bscription, although they
were sulDJect to the usual fines for the non-return of books.
Another important development was tlie regular weekly service
of books to British officers and orderlies in the hospitals in
Stralsund. An average of about 50 books w^ere exchanged
weekly amongst the patients in tlie four military hospitals.
Arrangements were made with the German authorities for
these books to be sent by the orderlies Avho had to call at tlie
hospitals once a w^eek.

All tlie books before being handed over to tlie Library were
censored by the Camp Censor. Fortunately this censoring was
more or less eye-wash, as several books trickled through con-
taining sentiments of anything but a pro-German nature.

Early in October the Germans adopted the most offensive
practice of stripping the binding off all books that came into
the Camp. The reason for this was that a book had been dis-

A Prisoners-of-War Library.

317

covexed containing- maps and Grerman notes of considerable
value concealed in the binding. These of counse had been sent
with the object of assisting' officers to escape. Fortunately we
persuaded the Commandant not to adopt this malicious practice
in the case of books for the Library.

W© will loonclude our remarks with a brief statement of the
financial side of the Library. The assets consisted of the
original entrance fee of 4 marks, or 2 marks in the case of
those members who g-ave a book as well. The monthly sub-
scription was 50 pfennigs, but this was suspended from October
onwards. The only other source of income was from 'fines.
The available funds were allocated as follows: — 25 per cent,
to books of an educational character, 26 per cent, to EngHsh
classics, and 50 per cent, to modern fiction and to the expenses
of administration.

Apart from the purchase of books the main items of expen-
diture were 20 marks a month to the orderly who cleaned the
Library, 20 marks a month to the orderly who assisted in
the Bookbinding Department, books for catalogues and
borrowers' register, 3,000 cataloguing cards of a very inferior
qualitj^ at the exhorbitant price of £5 15s., and 18s. 6d. for
a miserable broom which had evidently never heard of either
Mr. George R. Sims or Mr. Edwards.

The following is a copy of the last balance sheet: —

BALANCE SHEET.

Income.

Expenditure.

Entrance Pees and Sub-

Purchase of Books

1262

scriptions

:m8

Carriage on Books

Fines

121

Books for Catalogues, &c.,

and Stationery

Cards for Catalogue ...

115

Sweeping Brush

Library & Bookbinding

Orderlies

160

Balance presented to

Y.M.C.A

Marks ...

1576

Marks ...

3239

t318 ,1 Pr}s()H(')s-()j-\V(ir Lihidry.

Wo coiiisidei'ed it iiecu.ssiiry to kc.")) ;i I'airly large balance
ill liaiid to raeot any pos>iI)lo <i(Mii;ni(U tor conipensation for
daiiiag.' done to the referonee hooks lent hy the Germaai
authorities. Fortunately, OAviiig- to the Aruiiistiee and the chaos
existing- when we left the Camp, they did not demand any
damag^es. The balance ^\■iiH therefore brought back and handed
to the National Council of the Y.M.C.A. as a mark of appre-
eiation for the many books they had given to tlie Library.

When tlie Library was closed on November 20th, 1918, it
contained 2,576 volumes, apart from those issued to members
under the Prisoners-of-War Book Scheme, and had a member-
ship of 1,174. These volumes, except those lent by the German
authorities, were distributed among the members when the
Library Avas closed.

And that was the end of A\liat AAas in all probability, the
largest Library of its kind in the world.

THE WAR AND GUYS NURSING
SERVICE.

By
Miss F. A. SHELDON.

In presenting a brief account of the effect of the War of 1914
to 1918 upon the Matron's Department, a simple statement of
the events as they occurred during those memorable years will
show that the problems to be solved in a large London train-
ing school were very real and far reaching. Material embar-
rassment was delayed for some time, but the outbreak of war
brought immediate loss of personnel which continued until the
armistice, and involved the Matron in, perhaps, the greatest of
her difficulties.

From August, 1^14, many of the Sisters and the nurses from
the Private Staff and District joined up; their places had to be
filled and the training of the Probationers and the manage-
ment of the wards maintained, all of which became an increas-
ingly serious matter, continuing to the present date owing to
post-war conditions.

The splendid list of Gu3''s women published in this volume,
who worked at home and abroad, speaks of the individual desire
for service and the support given by the Hospital towards its
achievement. The Assistant Matron and the Sisters held de-
monstrations of practical nursing for all men who Avished to
attend, and at this time the Matron's Office was busy with in-
terviews and arranging for courses of training, from three weeks
to three months, for ladies who applied in large numbers either

320 The War and Guifs Xursli/f/ Service.

to attend daily or to be resident. Nearly all these workers were
extremely good and intellectually keen and courteously amenable
to Hospital regulations, but they naturally wanted " intensive "
instruction in nursing and treatment, and had not realised that
so many hours in the wards are spent in quiet routine work.
A visitor who came to see one of these ladies was disappointed
to find that operations did not "go on all night." Several
of these workers opened their homes later as private hospitals,
and showed their appreciation by choosing their staff from
Guy's.

The regular nursing staffs of the Naval and Military services
were, of course, infinitesimal compared with the numbers re-
quired, and the AVar Office applied to the civil hospitals for
trained women, suitability and health to be guaranteed, and
this brought to those w^orking in the Matron's Office still more
arduous work. Many Guy's parties Avere gathered together, and
eventually seen ofl: at Victoria Station.

Miss Haughton had for some time represented the Civil Hos-
pitals upon the Nursing Board of the Q.A.I.M.N.S., and this
position now entailed very lengthy attendances at Whitehall.
This valuable service Avas acknoAAdedged later Avhen in 1917
the Eoyal Red Cross Avas bestoAved upon Miss Haughton.

The most superficial knoAvledge of the nursing world Avould
connect the Crimean War and the name of Florence Nightingale,
the Lady of the Lamp, Avho brought light and healing to disease
and pain unspeakable. We hope that future generations Avili
connect the year 191G of the European War with another great
advance in our Profession, that is, the founding of the College
of Nursing. The increasing roll of army nurses and the
activities of the Red Cross Society in opening hospitals at home
and abroad led to the discomforting disco A^ery that the nursing
profession Avas entirely disorganised, AA-itli no central authority,
standard, or even register. Each hospital Avas a laAv unto itself
and Avas virtually unconcerned Avith the professional and economic
life of the nurse Avhen she left its walls.

The War and Guy's Nursing Service. 321

We owe to The Hon. Sir Arthur Stanley, G.B.E., C.B., a
deep debt of gratitude, for as he became aware of this condi-
tion he conferred with Dame Sarah Swift (Matron of Guy's
from 1901 to 1909) and Sir Cooper Perry, and they were joined
by several leading matrons and other interested persons. As
the result of an incredible amount of thought and labour there
will be seen this year the foundation of a College Building fit
to' house a noble profession, on a site adjacent to The Royal
Society of Medicine, Wimpole Street.

This is not the place to detail all that the College stands for,
but its beginnings were in the war, and Guy's men and women
should be proud of the fact that Dame Sarah Swift, R.R.C.,
Miss Haughton, R.R.C., and our present Matron, Miss Margaret
Hogg, and Sir Cooper Perry have had a distinguished share
in its building. Miss Margaret Hogg, C.B.E., and Sir Cooper
Perry are at present serving on the Council and many Com-
mittees of the College.

The year 1917 brought many difficulties to the Ward Sisters.
The Residents were often doing double duties, and the depleted
ranks of dressers added to the Sisters' responsibilities. Guy's
has never been really short of probationers, but as so many
girls naturally joined in war nursing, it became difficult to
entirely maintain our usual standard. The scrubbers and ward
maids rapidly disappeared to take highly-paid government work,
and the shortage of equipment, especially of glass and china,
made itself felt. In the closing of many Convalescent Homes,
the Sisters lost the pleasure and satisfaction of adding to the
health and recovery of their patients. In the Matron's De-
partment the rise in the price of uniform, bed-linen and blankets,
and all materials used in the laundry became an increasingly
serious consideration, and, indeed, it became difficult to run the
laundry as so many of the workers left for better paid posts.
Another great trial was the food rationing, which was not ac-
cepted without a good deal of criticism by both staff and pa-
tients. However, many people in England failed to perceive
any connection between shortage of bread, meat, and sugar and
a European War.

PART III. ▼

322 The War (uul i^u/.s Siusnifi S<>rvice.

Tlie nursing and organisation of the Ofticois' Section were a
great triumph, the extra cooking required being undertaken
in the Avaid and by the Hospital kitchen staff. Several volun-
tary workei'S added greatly to the comfort of the patients by
assisting with their meals and taking charge of books and
flowers. All workers in the Section received the appreciative
thanks of the Naval and Military Authorities, and the Royal
Red Cross was bestowed upon Miss L. G. Sheild, the Ward
Sister.

The Massage and Electrical Departments developed tremend-
ously during the war in response to the increased demand for
treatment, and the Guy's Massage School stands second to none
in the kingdom. The work of the Private Kurses during the
war was carried on with real difficulty and often hardship. Re-
stricted travelling, the shortage of cabs or taxis, coal, light,
and food, and in many houses the entire absence of even daily
domestic help, was a heavy addition to their professional work.
The influenza epidemics were real ti^agedies. Many Guy's
nurses, however, remained to carry on this specially useful
branch of public service and earned the gratitude of their pa-
tients. The Nursing Profession has in common with the whole
world to face the strange perplexities of post-war conditions.
Many of the old ideals appear to have vanished, and great
faith and courage are required to link the spiritual and material
for the mutual benefit and help of the nurse of the immediate
future and her patient.

Modern conditions ask for all organisation of training with a
reasonable economic outlook for the future, and for the first time
in its history the nursing profession is faced with these most
righteous demands. The difficulty is world-wide, and women
now are not taking up nursing as a career. It is unthinkable,
however, that the spirit to serve and succour has disappeared;
it only awaits the opportunity to flow through new channels.

THE 2ND LONDON GENERAL HOSPITAL,

By
F. J. STEWARD, M.S., P.R.C.S.

The 2nd London General Hospital was one of the four Terri-
torial Base Hospitals in London which were called into being
on the outbreak of the War.

The preliminary arrangements as to the formation of these
hospitals were made, and a la suite officers were commissioned
long before the war, in fact at the end of 1908. The a lu suite
officers of the 2nd London General were drawn from the staffs
of Guy's, the London, and St. Thomas's Hospitals, tiie members
of the Guy's Staff being Drs. W. Hale-White, G. Newton Pitt,
L. E. Shaw, and J. Fawcett, and Messrs. C. J. Symonds, W.
A. Lane, F. J. Steward, C. H. Fagge, and R. P. Rowlands. v

Two days after the declaration of War with Germany the
members of the a la suite staff were summoned to meet the
CO. at St. Mark's College, Chelsea, which, together with the
adjoining L.C.C. Schools, were the buildings taken over for the
establishment of the Hospital, and within a very short space
of time the equipment of the Hospital was carried out, and all
arrangements made for the reception of patients, the first convoy
of wounded from France being received at the hospital on the
29th September, 1914.

From this time until March 31st, 1919, when the last patient
left, the work of the hospital was continuous, the number of
patients received reacliing the total of 40,039, of these, 4,058
were officers, and 35,981 non-commissioned officers and men.

824 The 2nd London General Hospital.

It is not necessary to dwell upon the working of the Hospital,
which differed but little from other Hospitals of the same class,
nor upon the many difficulties — ^some of them unavoidable, but
many avoidable — under which the work was carried on, as this
note is principally concerned with the placing on record of the
names of the large contingent of Guy's men who worked at the
Hospital.

The 2nd London General had, however, one special feature,
which was its Ophthalmic Department. From the first a large
proportion of the cases of wounds involving the eyes or eyesight
were sent to the Hospital, and an ever-increasing number of
beds were allotted to the Ophthalmic Department, reaching at
one time a total of 500. Altogether 4,503 eye cases were ad-
mitted to the Hospital, including 1,008 men blinded in the war.

There was also a large Ophthalmic Out- Patient Department
to which men were sent from a large number of camps and
hospitals in and around London, for testing eyesight, recording
vision, working out errors of refraction, ordering glasses, fitting
artificial glass eyes, etc., the total number of out-patients seen
(not including second and subsequent attendances) being 11,081.

At first Mr. A. W. Ormond had sole charge of the Ophthalmic
Department, but as the work increased he was assisted by a
number of eye specialists, four of whom were Guy's men — H.
Lee, G. Maxted, H. C. Eook, and H. Sharpe. *

The members of the Guy's Staff who served on the a la suite
staff of the 2nd London General Hospital were as follows : — Sir
William Hale-White was in charge of the Medical Division
throughout the war, whilst Drs. and Messrs. G. Newton Pitt».
J. Fawcett, A. W. Ormond, F. J. Steward, and R. P. Rowlands
also served during the whole period, and Sir Charters Symonds,
Sir W. A. Lane, and Messrs. C. H. Fagge and E. C. Hughes
served for short periods early in the war. Further, Mr. R.
Wynne Rouw did dental work at the Hospital in an honorary
capacity. Dr. C. E. Iredell had charge of the Electro-therapeutic

The 2nd London General Hospital. 325

Department, Dr. G. W. Goodhart was in charge of the Bacterio-
logical and Pathological Departments, Dr. H. F. Lancaster was
an anaesthetist to the Hospital, and the following Guy's men
also served at the Hospital at various times (some as civilians
and some as officers in the R.A.M.C.) — H. W. Gushing, P. L.
Du Verge, F. D. S. Jackson, H. Lee, A. Magill, G. Maxted,
L. Milton, C. E. Petley, B. Ramirez, W. Robinson, H. Sharpe,
N. A. D. Sharp, and A. N. Taymour.

(

WORK IN THE BACTERIOLOGICAL
DEPARTMENT, 1914-1919.

By
JOHN W. H. EYRE.

It wouJd be an exceedinglv difficult matter to compile a com-
plete and precise account of the various activities of the Guy's
Hospital Bacteriological Department throughout the course of
the European War, and it is hardly less difficult to present even
a brief synopsis for the simple reason that the obvious historian,
the Head of the Department, was the only qualified member of
its staff who was continuously employed throughout the whole
of that period — ^indeed, for more than half the time, for a total
period of two ^ears and three months, to be exact — he was
without qualified assistance of any kind. In this connection,
however, tribute must be paid to the unremitting and whole-
hearted service rendered by the Head Laboratory Attendant,
who was likewise on duty throughout the whole of that period,
without whose expert assistance few of the extensive investiga-
tions that were undertaken could have been initiated, much
less completed.

In the following pages, however, I have endeavoured to give
an outline of the work that was carried out during the period
from the declaration of war on August 4th, 1914, to the declara-
tion of peace, June 28th, 1919.

328 Work in the Bacteriological Department, 1914 — 1919.

Personnei- of the Department.

The declaration of war caught the Department in the midst
of the holiday rota. The Head of the 'Department was ostensibly
oil' duty for the entire month of August, although, in point of
fact, his absence was limited to fourteen days. The Junior As-
sistant, Mr. Skene Keith, a keen Territorial, was in Training
Camp with the 4th Queen's "West Surrey Regiment, and wag
promptly embodied. Dr. Lucey, the Senior Assistant, volunteered
at once, received a commission in the R.A.M.C. and reported
for duty at the end of August. From this point onwards the
Department was consistently understaffed; the Director was re-
peatedly declared by the Committee of Reference to be indispens-
able, and so perforce remained on duty continuously for the
duration. During the remainder of the time no less than six
medical men and one medical woman were associated with him
in the Laboratory for various short periods, ranging from two
to seven months, and only during one period, from January to
May in 1917, were any two present together. The needs of the
Army were so great that so soon as a man had had a few montlis
training in the Laboratory he was promptly called up and placed
in charge of a Bacteriological Laboratory elsewhere. From
August, 1914, to January, 1915, was one of those periods when
no assistance was available. Mr. Sampson then came on, and
from January to May was trained in the Laboratory. In May
he was commissioned, first of all in the Naval Medical Service
and subsequently in the South African Medical Corps, for La-
boratory work. Then occurred another break from the beginning
of June, 1915, until the end of April, 1916, but for much of this
period very valuable assistance was rendered by Dr. A. Watson
Munro (Physician to Sydney Hospital), who became an Honorary
Temporary Assistant in the Department. Mr. Burnside was
appointed Assistant Bacteriologist in May, 1916, and remained
working in the Laboratory until the end of August, 1916, when
he also received a commission in the Naval Medical Service.
Mr. Knott succeeded him in November, 1916, and remained in

Work in the Bacteriological Department, 1914 — 1919. 329

the Laboratory until May, 1917, when he, too, entered the Xaval
Medical Service.

In Januar}', 1917, an experiment was tried of appointing a
lady Medical, who, however, only i-emained on duty until the
end of May of the same year, when she joined the Cbnnaught
Hospital at Aldershot as Pathologist. The next appointment
was made in February, 1918, Avhen Mr. Bamber came on and
remained for the two months, February and March, before join-
ing the K.A.M.C.. In May, 1918, Mr. Grace was appointed as
Senior Assistant Bacteriologist, and in October of the same year
Mr. Ralph was appointed to the Junior post. Mr. Grace retained
his position until the end of March, 1919, when he was appointed
Laboratory Director to the Clinical Research Association, and
Mr. Knott, demobilised from the X^avy, returned to the post of
Senior Assistant. In September, 1919, soon after the declaration
of peace, Mr. Ralph resigned, and Mr. Keith, now demobilised
from the R.A.M.C., to which he had been transferred, was ap-
pointed to the Junior post.

It will thus be seen that the assistance rendered to the
Dii-ector by qualified men during the period of the war was
of the very slightest, none of them holding the post sufficiently
long to be really adequately trained, so that, throughout their
tenure of office they needed constant tuition and supervision,
and, to put it plainly, except for the presence of a qualified
iiiedical man in the Laboratory during the absence of the Director,
the occupancy of Assistant Posts involved increased work.

The staff of Laboratory Attendants Mas fortunately efficient
and adequate for the greater part of the war period. Mr. J.
C. Turner, the chief attendant, with fourteen years' experience,
was a tower of strength, and without his assistance it would
have been Avell nigh impossible to carry on the work of the
Department. Fortunately — owing to the work the Laboratory
was carrying out for the A.M.D. — it was found possible to
obtain an "indispensable" badge for him, and he remained
on duty continuously throughout the war, and I would again

{VoO Worl: in the Bacteriological Department, 1914 — 1919.

take the opportunity of expressing, in no measured terms, my
ajjpreciation of the loyalty and energy he displayed during- this
strenuous and trying period. Mr, Sugden, the second attendant,
was also similarly badged on medical grounds, but towards
the end of 1916, was secured by the Lambeth Infirmar}^ as
Head Attendant of its newly -insUtuted laboratories ; he was
succeeded by Ottewill, who only became eligible for- military
service about the time of the Armistice, and who consequently
still holds the post. Mayo, the third attendant, was transferred
in April, 1916, to the Laboratories of the Seamen's Hospital at
Greenwich, and was subsequently called up. Miss Pincott, who
was trained in the Laboratories, gave valuable assistance also
from the beginning of 1915 up to the early part of 1918, when
she took up V.A.D. work. Other Laboratory boys were Lockyer,
Shepherd, and Clark, the last named of Avhom is now the third
attendant. All stuck nobly to their work in the Laboratory,
cheerfully working overtime when necessary and always render-
ing every assistance in their power. The clerical work during"
the war was carried out successively by Miss Cowell until the
middle of 1915, when she was succeeded by Miss Wilson for
the following year, who in turn gave place to Miss Clark, who
was on duty up to the end of 1918, and was then succeeded
by Miss Peretz, who is still responsible for this work.

Laboratories.

In August, 1914, the Bacteriological Department was still
housed in Petersham Building in the quarters it had occupied
since 1892. The construction of new laboratories had, however,,
already been commenced in January, 1914, the plans having been
previously passed by the Governors. By July little more than
the shell of the new building had been completed, but in anti-
cipation of the completion of the laboratories by the end of
the year, all the equipment had been ordered, was well in hand,
and a large order for glass-ware of all kinds, estimated to cover
the consumption of about five ^^ears, had been ordered direct

Woj'k in the Bacteriological Department, 1914—1919. 331

from works in Jena. This glass-^are was duly invo-icerl to the
Hospital in July, 1914, but beyond one large crate containing
fluted tunnels, which came through at the end of July, failed
to leave Hambu^.

The constructional work was pushed on with vigour during
the early days of the war. All the ordinary equipment, made in
England, was received, and the new laboratories were occupied
at the beginning of February,; 1915. (A full description of thd
laboratoiies appeared in the sixty-eighth volume of the " Guy's
Hospital Reports," pp. 145— 165.) The .sjjace thus available
was severely tested during the following years, but prov€'d equal
to all the demands made uponi it. ; ;

Hospital Roltixe Work.

The routine bacteriological work for the Hospital, which had
steadily increased from the institution of the Department in
1893, when eight specimens were investigated, to 1913, when the
number of specimens dealt with totalled 6,681, sufl'ered a slight
diminution during the last five months of 1914, but in spite of
this the specimens for the entire year reached the respectably
number of 6,839. In 1915 and 1916 the numbers were well
maintained, such fall as took place being chiefly attributable
to the scarcity of clinical clerks and dressers upon whom de-
volves the duty of collecting specimens. In 1917, however, the
London County Council undertook the administration of the
Local Government Board scheme for the treatment of Venereal
Disease, and Guy's became a recognised Clinic. All the labora-
tory investigations entailed under this scheme were provided for
by the Bacteriological Department, and a notable and inunediat©
rise took place in the nuniber of s^jecimens examined in the
Laboratory, as will be seen from the accompanying table. It
may, therefore, be considered that the volume of purely civilian
work carried out by the Bacteriological Department underwent
no diminution, but quite the contrary, during the war period.

332 Work in the Bacteriological Department, 1914 — 1919.
HospiTAi, Specimens by Quarters.

Year.

1st Qr.

2nd Qr.

3rd Qr.

4th Qr.

Total.

1914

1905

1985

1621

1328

6839

1915

1670

1335

1287

1328

5620

1916

1359

1305

1310

1278

5252

1917

1964

2039

1937

2018

7958

1918

2131

2420

21.S3

2112

8796

1919

2492

2853

2837

2952

11134

Compared with

1913

1598

1552

1790

1741

6681

War AVork.

Although, as already mentioned, the declaration of war found
many of the Departmental Staff actually on holiday, a letter
was at once addressed to the Army Medical Department of the
War Office placing the Laboratories, in part, or as a complete
Unit, and the services of the entire personnel, individually or
collectively, at its disposal. This step was taken with the
sanction and approval of the Superintendent and Governors.
With characteristic War Office courtesy, no reply was vouchsafed
to this offer.

The difficulties, administrative and otherwise, which confronted
the Hospital and School Authorities in the early months of the
war, when everyone was eager and anxious to volunteer for
active service, rendered it difficult to do other than merely carry
on the routine work of the Department, but in October another
offer was made to the Army Medical Department, as it became
olear at this point to all thinking individuals, that the war was
not likely to terminate quickly, and if adequate pathological
a,nd bacteriological assistance was to be given to the wounded
who were returned to this country, it Avould be well to devise
some scheme which would take advantage of existing laboratories

Work in the Bacteriological Department, 1914 — 1919. 333

and existing- facilities in order to cope with the work. But,
again, not even an acknowledgement of the offer was made by
the War Office Authorities.

By December 30th the completion of the new Laboratories was
in sight. The amount of available accommodation was consider-
able, and it would have been possible to accommodate four,
five, or even half-a-dozen Army Pathologists and provide them
with all necessary equipment, etc., had the Military Authorities
desired to take advantage of our offer. Consequently, a letter
was again addressed to the Army Medical Department in
slightly different terms from those of the former ones, and to this
a reply was received from the D.G., thanking the Director of
the Department for the Hospital's offer, and asking him to repeat
the offer to the D.D.M.S. of the London District, who might
be in a position to accept it. This was at once done, but in
spite of the glaring and obvious insufficiency of bacteriological
accommodation and the scarcity of previously trained pathologists »
the D.D.M.S. replied on the 5th January, 1915, that he could
not accept the offef as all the hospitals were so fully supplied
with bacteriological and pathological experts that under the
circumstances no suitable work could be found in the London
District Command for the Guy's Bacteriological Department.

This decision was accepted as final, and no further offers were
made to the Army Authorities.

During the early months of 1915 typhoid and para-tj^phoid
became prevalent in the Expeditionary Force in France, and
owing to an Army Order, which stipulated that every case of
typhoid before being discharged from hospital should give a
negative result qua B. typhosus on the examination of stools
and urine, a vast amount of work was poured into the labora-
tories attached to the General Hospitals in the London District,
so much, in fact, as to swamp all other investigations.

Towards the end of April the pressure on the Military La-
boratories, as might have been anticipated, became acute, and
Sir Shirley Murphy, who was attached to tlie D.D.M.S. as Chief

334 Work in the Bacteriological Department, 1914—1919.

Sanitary Adviser, rang up the Director of the Department at
Guy's and asked whether he was willing to repeat his offer
of assistance, particularly in connection with the typhoid in-
vestigations. The answer was naturally in the aflSrmative, and
arrangements were at once made to deal with typhoid material.

TyrHoiD, Paka-Typhoid and Dysentery Investigations.

An interview with the D.D.M.S. of the London District Com-
mand followed, when it was explained that it was essential to
obtain three " negative " results after examination of the excreta
for specific organisms, from every convalescent before the man
could be returned to his unit for active service; this number
of " negatives " was increased to six by an Army Order in
January, 1916. The Department was asked to supply details
as to how many specimens could be dealt with, the probable
cost of material, and other administrative details in connection
with the work.

Fortunately some years previously I had been commissioned
by the Asylums Committee of the London County Council to
investigate the incidence of typhoid and dysentery in certain
of the London County Council Asylums, and had then devoted
a considerable amount of time to comparing the various methods
for dealing with those excreta in which the specific organisms
are most readily found. Finally, a routine method had been
standardised based upon plate cultures on a modification of the
Conradi-Drigalski medium, termed Guy's nutrose agar, which
enabled specimens to be dealt with satisfactorily and rapidly,
and had been in use in our Department since 1906. On this
experience we expressed our willingness to handle specimens
of excreta from typhoids, etc., and contacts to any number
up to 1,000 per quarter, and we stated that the cost would not
exceed 2s. per specimen, this figure to include all materials,
labour, stationery, etc., the Director, of course, giving his
services in a purely honorary capacity; this cost was quoted
to the A.M.D. in spite of the fact that Dulcitol, one of the

Work in the Bacteriological Department, 1914 — 1919. 335

essential sugars in the differentiation of the members of the
typhoid group Avas missing from the market, and the War Office
Avas scouring England for supplies at any price. (Incidentally,
it may be mentioned that owing to some research work that had
been carried on by Mr. Rogerson in the Chemical Department,
there were ample supplies of Dulcitol in the Guy's Labora-
tory, and after retaining all that we were likely to need for our
own work, no matter what stress was thrown upon us, we were
able to allow the War 'Office to purchase 100 grms. for a few
pounds.) Our offer was immediately accepted, the Director of
the Department became a War Office Contractor, and prepara-
tions were made for dealing with the work.

Printed forms were prepared to be filled up by the Medical
Officers in Charge, giving the necessary details for identification,
*tc., for the specimens from each patient. Wooden boxes were
made to contain all specimens to be sent to Guy's from the
various hospitals, and the whole of the routine detail for dealing
^vith large numbers of specimens w^as carefully worked out.

On enquiry it was stated that, of the London General Hos-
pitals, No. 1 was able to cope with most of the specimens that
it received, No. 2 was hardly able to deal with any. No. 3 could
only deal with a portion, and No. 4 with none at all.

The Pathologists in Charge at these various Hospitals were
notified as to the manner in which the specimens should be
^ent, and everything appeared to be in trim, when a peremptory
wire, followed by several telephone messages from the office of
the D.D.M.S. put a stop to all work. It appeared that in
spite of the assurance that the inclusive cost per specimen
would not exceed 2s., that Official feared that the printing
bill for the specimen forms and the cost of carrying boxes
would form an additional item to that sanctioned by the War
Office, of which he himself would probably have to bear the
cost. A certain length of time elapsed before this misunder-
standing was cleared up, and it was somewhere about May, 1915,
that the first specimens arrived, and it was not until July that

336 Work in the Bacteriological Department, 1914—1919.

the specimens really arrived in numbers sufficiently large to
cause any serious inconvenience in the Laboratory. But from
June, 1915, until December, 1916, a total of 1,172 specimens for
examination for the presence of B. typhosus was received from
No. 1 General Hospital, 2,093 from No. 2, 2,781 from No. 3,
and 1,385 from No. 4, tog-ether with similar specimens from
other Hospitals distributed over the quarters of these two years,
as shown in the following table.

Specimens for Typhoid axd Para-Typhoid.

1915

1916

Quarters

1st

2nd

3rd

4th

1st

2nd

Srd

4th

No. 1 General

—

880

140

126

—

. 2

—

308

741

470

265

215

« 3 „

—

280

2418

—

• 4 „

—

332

627

426

—

City of London M.H.

—

214

395

211

Fulham M.H.

—

200

—

Hammersmith

—

— ■

—

Sandown Park

—

102

—

Metropolitan

—

Inns of Court O.T.C.

—

880

1017

2269

3461

473

119

431

4166

4484

This work undertaken by the Director of the Department,
acting in an honorary capacity, was continued on these lines -
until November, 1915, when I was appointed as a Civilian, (^
Pathologist in the London District Command and continued to
serve in this capacity up to the end of the September quarter, .
1918.

Worli' in the Bacteriologiral Depnrfmenf, 1914 — 1919. 337

As soon as the typhoid work was well in hand at Gny's (May,
1915), Sir Walter Fletcher, of the Medical Research Committee,
asked whether we would be willing: to make comparative tests,
in dealing with the material at our disposal, of two methods
for each of which was claimed superiority over other methods
then in vogue for the isolation and differentiation of typhoid and
para-typhoid bacilli, viz.. Professor Dreyer's method of expos-
ing inseminated plates to the rays from a silver arc lamp and
Dr. Carl Browning's method of preliminary enrichment of the
excreta in a telluric acid and brilliant green medium. This I
agreed to do, and the Medical Research Committee on its part
agreed to defray the cost of the instalment of the silver arc
lamp and all laboratory costs incurred in the investigation, also
the cost of a further Laboratory Assistant up to a sum not
exceeding £50. The Electrical Branch of the Guy's Hospital
Works Department was at once instructed to prepare the silver
arc lamp. Unfortunately, shortly after this Dr. Fletcher was
incapacitated for several months by a severe attack of pneu-
monia, so that his original intentions were never carried out,
and the expenses of the investigation were borne in part by a
grant from the Desvigny Research Fund, but chiefly by the
Director of the Bacteriological Department. Further assistance
was arranged for, and in a very short time the arc lamp was
completed and installed at a total cost of £18, and the tri-
plication of the examination of the typhoid specimens was at
once proceeded with. By triplication I mean the study of
suspected excreta by three separate and distinct methods : —
Dreyer's silver arc lamp method, Browning's brilliant green,
and my own routine Nutrose Plate method. After some months'
work, the silver arc lanij) was discarded as useless, and later
on it was decided that the brilliant green method possessed no
outstanding advantages over the nutrose plate method.

Indeed, the result of all these observations confirmed the
opinion previously formed that there is no royal road to the
isolation of pathogenic bacteria. The isolation of any specific
organism from pathological material can only be successfully

PART III. W

338 Work in the Bacteriological Department, 1914 — 1919.

carried out by careful and precise methods combined with long
experience of the particular method employed; and when a
worker has made a careful comparative study of a number of
methods devised to attain a particular end and selected and
adopted one of them for routine work, that method will give,
in his hands, results equally successful with those produced by
another equally competent worker employing] a totally different
method.

The results obtained in this particular investigation were of
considerable interest, since out of the 1,100 convalescents and
contacts, material from less than 5 per cent, of them was found
on examination to "carry" the specific organism of the disease
from which the patient had originally suffered.

In connection with these investigations it may be recalled that
at the end of 1916 or the beginning of 1917 the Army Medical
Department recognised that the addition of paratyphoid A. and
paratyphoid B. to the typhoid vaccine was unlikely to interfere with
the eflficiency of this last-named. Thereafter a vaccine "T.A.B."
was issued containing 1,000 million typhoid B. and 750 millions
of each paratyphoid A. and paratyphoid B. as one mixture,
and instructions were issued that a first injection of half a cc.
of this mixed vaccine was to be followed by a second injection
of 1 ce. eight to ten days later, wherever possible. Where two
doses were impossible, then a single dose of 1 cc. was to be
given. With the introduction of this vaccine, paratyphoid dis-
appeared from the army in the field, just as typhoid had done
in the earlier days with the typhoid vaccine.

Prompted by an appreciation of the experimental basis of
Castellani's work with the quintuple vaccine (in which the
typhoid and the tAvo paratyphoids were mixed with cholera
vibrios and the micrococcus melitensis), it may be mentioned
that from the very first days of the institution of the R.F.C.
Hospital in Ma v. 1915, T.A.B. vaccine was invariably employed
for such officers of the R.F.C. as w^ere inoculated there, so

Work in the Bacteriological Department, 1914 — 1919. 339

that the triple prophylactic was in vogue iu this particular Corps
for eighteeu months to two years before theii* colleagues in other
branches were similarly protected.

Cerebro-Spinal Fever.

At tlio end of April, whilst the question of examination of
material for the presence of typhoid bacilli was still under dis-
cussion, Ool. Keece enquired whether we would be willing to
participate in the examination of contacts of cerebro-spinal fever
cases. On receiving an answer in the affirmative I was asked
to proceed to the German prisoners' internment camp at Stratford,
to investigate a batch of prisoners who had recently been brought
in from Southampton. 1 at once collected the necessary kit and
proceeded to Ritchie's factory, but on arrival, owing to some mis-
understanding, was informed that all the prisoners had already
been examined. On my return to London it transpired that
none of the prisoners had been examined, and the following
day Col. Reece called for me at the Hospital and accompanied
me to the Internment Camp, when I collected post-nasal swab-
bings from about 100 of the prisoners, and R.A.M.C. oflScers
specially detiiiled from Woolwich dealt with the remainder.
Of these contacts it is interesting to note that the percentage
of positive meningococcus carriers was nil, and in the remaining
five or six hundred investigated by the R.A.M.C. Patholo-
gists less than one per cent, carriers were detected. It is
somewhat remarkable in view of the importance attached to
the " carrier " by the Anin Medical De|)artment at that time
that no really reliable history Avhich would stand the test of
strict enquiry has ever been recorded of direct contagion in con-
nection with this disease; and) it is of further interest to recollect
that in the early days of the present century, somewhere in 1902,
we had no less than nine cases of so-called spotted fever in con-
tiguous beds in Mary Ward (in the midst of ordinary, medical
cases) many of which were fatal and all very severe, without
any spread of infection to other patients in the ward, or to any

340 Work in the Bacteriological Deparlment, 1914 — 1919.

of the medical or nursing 8taii'.s or to students. The only in-
stances that have come to my knowledge where direct contagion
might have been inferred have been nmltiple cases occurring
in, for example, a single army hut, but here again the evidence
is not above criticism since the onset of the disease in these
nmltiple cases has only varied by a few hours.

The bacteriological examination of the post-nasal space in
acute cerebro-spinal meningitis occurring in the civilian popu-
lation during the war period yielded a negative result in practi-
cally 50 per cent, of the cases I examined, and although, I am
perfectly aware that it has been stated that as high a percentage
as 50 or (50 positive meningococcus carriers occurs in contacts and
that meningococci are almost invariably found in the post-nasal
space of acute cases, I find considerable difficulty in accepting
such figures as accurately representing the true position. More-
over it nmst bo remembered that these high percentages were
recorded mainly in the early days of the war, and then
largely by junior pathologists with limited experience of bac-
teriological investigations in general and with little more
than a passing acquaintance with the meningococcus itself, de-
rived from a short course of instruction in the C'entral Cerebro-
spinal Laboratory. That there is at any rate a substratum
of truth in this criticism is obvious from the way in which the
carrier percentage dropped as the years went on and the general
body of Avorkers acquired experience and the equally noticeable
diminution in the volume of evidenc-e put forward as to the
danger of contacts in this particular disease.

For my own part I have not the least doubt that, like pneu-
monia, typhoid and other specific infective diseases, cerebro-
spinal meningitis is primarily a septicaemia, in the course of
which the meningococcus becomes localised to the tissue of
election, namely, the cerebro-spinal membranes, and just as the
pneumococcus is frequently, but not invariably, present in the
post-nasal space in cases of lobar pneumonia, so the meningo-
coccus is occasionally present there in cases of spotted fever.

Work in the' bacteriological Department, 1914—1919. 341

Rkd Cross Auxiliary and Private Hospitals in the London

District.
With the disappearance of typhoid and paratyphoid from
what may be termed urgent investigations in connection with
patients arriving* at the London District Command, I was re-
quested by the D.D.M.S. to act as Pathologist to a number of
Red Cross Auxiliary and Private Hospitals within the area, and
during 1916, 1917, and 1918 I acted in this capacity to several
of them, and from the third quarter of 1917 prepared such auto-
genous vaccines as were needed for the purpose of treatmenti
in such hospitals. The amount of work thus entailed was not
very great and the distribution of the specimens will be seen
from the following table : —

Hospital.

1915

1916

1917

1918

Total.

Spec. Vac,

Spec. Vac.

No. 2 General

249 5

115 0

218 3

182 1

764 9

Various Small Hospitals

19 0

17 5

3 0

—

39 5

Oakenshaw

0 1

3 0

—

3 1

Berkhamstead

0 2

—

0 2

Park Lane

7 4

—

7 4

P. S. Hospital

1 0

—

1 0

War Office, No. 5

1 0

6 0

—

7 0

War Office. No. 11

—

1 0

3 0

4 9

Lady Carnarvon's

—

1 0

—

1 0

O.T.C., Inns of Court ...

—

14 6

R.A.M.C. Hospitals

—

2 0

—

2 0

Birkett

—

1- 0

30 2

31 2

Countess Lytton's

—

22 1

29 0

51 1

Lady Inchcape's

—

3 0

10 2

13 2

Lady Montgarret's

—

2 1

1 1

3 2

Mandeville

,—

—

19 1

1 0

20 1

Military Orthopaedic

—

10 2

43 9

53 11

Portman

—

4 'O

5 2

9 2

Southwark Military

—

68 11

50 27

118 38

Cadogan Square

—

1 0

—

1 0

Kcclcston

—

3 0

—

S 0

]\Irs. Georges'

—

1 0

—

1 0

Grosvcnor

—

1 0

—

1 0

Millbank

—

1 2

Park Street

—

3 0

Portland Place. 83

—

1 1

Prince of Wales'

—

U 1

11 1

Princess Club

—

1 1

—

1 1

R.N.A.8. Hospitals

—

3 1

—

3 1

Campbell

—

1 1

Fishmongers' Hall

—

3 1

Latchmere

—

1 0

Meynell

—

' —

—

1 1

Swedish Quarantine

—

95 0

Totals

276 12

164 11

386 26

452 47

1267 95

342 Work in Ihe Bacteriological Department, 1914 — 1919.

The total cost of iiivestigatioiLS i'or the ontirc period during
which assistance was rendered to ihe London District Command,
and which comprised the investigation of 9,900 specunens and
the preparation of 95 vacines, tliat is, from the beginning of
the second quarter of 1915 to the end of the third quarter of
1918, amounted to £1,012 lis. This sum covered all outgoings
in the way of laboratory material, glassware, stationery, postages,
and all sundries, together with payment for overtime work of the
Laboratory Staff, which at one time or another comprised twelve
separate individuals, the work itself being carried out without
the routine bacteriological Avork of the Hospital and its con-
tained " Officers' Section " being in any way curtailed or ne-
glected.

Still W'ithin the London District area other activities were in-
didged in.

From its inception in 1915 I acted as Honorary Bacteriologist
to the Coulter Hospital in Grosvenor Square, defraying all ex-
penses incidental to the work. But early in 1918 the expense
became too heavy for me to bear, and I was reluctantly com-
pelled to resign this post at the end of the second quarter of
1918. Similarly from its inception I also acted as Honorary
Bacteriologist to H.M. Queen Marys Royal Naval Hospital at
Southend, defraying all its incidental expenses with the excep-
tion of those incidental to the transport of specimens, until
June, 1918, after which date I continued the work as part of
the routine of the Department, and Queen Mary's Hos^jital re-
funded the cost of materials directly to Guy's. The total
number of specimens examined at each of these institutions is
shown in the next table.

R.F.C. Hospitals.

Early in 1915, Mrs. Paynter, a patient who had derived
considerable benefit from vaccine treatment was transferred to
the care of Dr. Atkin Swan at a time when her gratitude
required some tangible outlet ; and as a result of numerous

Worh in the Bacteriological Department, 1914—1919. 343

discussions with him she herself provided a considerable sum of
money and collected a still larger sum amongst her friends and
acquaintances. With the money thus available certain beds
were provided in Netley House Nursing Home for the accom-
modation of Officers of the Flying Corps in need of Medical,
Surgical, or Vaccine treatment. Committees were formed and
funds were rapidly acquired and No. 37, Dorset Square bo-
cauie the Headquarters of the Royal Flying Corps Hospital.
With the phenominal expansion of the Corps and the increased
need for further hospital accommodation, No. 35, Bryanston
vSquare was placed at the disposal of the Committee of the
Hospital by Lad 3^ Tredegar, and when this, in turn, became
too small, No. 32, Eaton Square was acqiiired in addition.
Captain Tremayne next offered his house at Helinger, in Corn-
wall, as a Convalescent Home for cases transferred from the
Flying Corps Hospital. Shirley Park Golf Club was next
absorbed, and by the end of the war the Grosvenor Hotel at
Swanage had also been utilised as a Convalescent establishment.
To all of these institutions I was attached as the Consulting
Physician Bacteriologist, until the dissolution of the Hospitals
at the end of 1919.

American Woaten's Hostitat- and American Red Cross.

On March 21st, 1917, the American Women's Hospital for
Officers, London, was formally oj)ened by ihe American Am-
bassador and Mrs. Page. Immediately ]>revi<>usly to this I
had received an invitation to join the Consulting Staff of the
Hosj)ital as Honorary Bacteriologist, which I accepfxMl. 1 re-
tained this post until January, 1918, when all the American
War Entm-prises in France and Great Britain were co-ordinated
under the American Red Cross, and the control of the American
Women's Hospital passed to the American Red Cross (\)mmis-
sioner for Great Britain, who requested mo t<. continue to act
MS it^ Honorary Pathologist while under his administration. This
1 (lid, l)ut (.n Sep'toniber 1st, 1918, ll.c Hospital was transferro<l

344 Work in the Bnderiologiml Department , 1014 — 1919.

to the United States Army Medical Service. It was then attached
to tlie United States Base Hospital, No. 29, at Tottenham, the
Medical and Surgical Officers of which then assumed control,
but as the nearest United States Army Laboratory was at Win-
chester, I continued to assist the Authorities by carrying out
such pathological and bacteriological work as was required until
the Hospital was closed down in June, 1919. Throughout, all
expenses were defrayed by the American Women's Relief Fimd
and the American Red Cross respectively.

The tale of specimens from these four sources is shown in
tabular form : —

Hospital.

1915

1916

1917

1918

1919

Total.

Coulter

Spec. Vac.
32 11

Spec. Vac.
169 39

Spec, Vac.
150 31

Spec. Vac.
43 9

Spec. Vac.

Spec. Vac.
394 90

H.M. Queen Mary's

(R.N.)
R.A.F. Hospitals ...

26 7

149 49

393 24

323 26

88 5

979 111

15 6

82 47

235 54 1183 47

148 43

663 197

American Red Cross

—

61 5 105 17

32 0

198 22

Totals

73 24

400 135

839 114 654 99

268 48

2234 420

Joint Women's V.A.D.

At the request of the Joint Women's V.A.D. Department (of
the Territorial Force Association, the British Red Cross Society,
and the Order of St. John of Jerusalem) the training of V.A.D.
workers as laboratory assistants was instituted. Miss Warner,
who was in charge of this section of the Red Cross work, and
subsequently Miss Griffiths, drafting the volunteers to us, usually
three at a time, for a three months' course of laborator}'^ train-
ing. This work was continued as necessity arose during the
next year and a half, and although many were found totally
unsuitable for laboratory work and were returned to the Joint
Committee, during that time the Hospital passed through its
Laboratories to various other jobs, at home and abroad, many

Work in the Bacteriological Department. 1914 — 1019. 345

excellent workers, of whom the following V.A.D.'s may be spe-
cially mentioned : —

Mrs. Cecilia Bishop, and the Misses L. Carr Cook, T. Irwin,
Margaret Leeke, Alice Oakland, E. M. Thomas, and Grace
Wylie.

Special Investigations.

To avoid any monotony from routine work other and special
investigations were undertaken at various times at the request
of A.M.D.2. Thus in the early months of 1917, Colonel, then
Major, Herbert French reported to the D.G. that numerous
cases of an unusual type of lung infection characterised by
bronchitis associated with purulent expectoration and deep cy-
anosis were occurring in the Aldersliot Command, and re-
quested assistance for a bacteriological investigation in connection
with this disease. This was followed by an interview with the
D.G., Sir Alfred Keogh, as a result of which I was instructed
to report for duty to the D.D.M.S. of the Aldershot Command.
•The subsequent investigations showed that the cases of purulent
bronchitis to which Colonel French had drawn attention were
due to infection by Pfeiffer's bacillus associated with the pneu-
mococcus, and formed the advance guard of an epidemic of
influenza which ravaged the entire world during this and the
next two years, repeating in its features, even to the " shock "
paragraphs in the daily papers, the previous big epidemic of
1889 and 1890, an epidemic which stands out as my earliest pro-
fessional recollection.

As a result of the work carried out in this direction (which
was fully described in a paper by Drs. Abrahams, Hallows,
Colonel French and myself in the Lancet, September 8th, 1917),
I was requested in the following year to assist the New Zealand
Headquarters Medical Staff to investigate an outbreak of measles,
attended by a serious mortality, which occurred in the N.Z.E.F.
on Salisbury Plain during the winter of 1917—18. From this
time onwards I acted as Consulting Patholopicnl Advisor to

PART HI. X

346 Work in the Bacteriological Department, 1014 — 1919.

the N.Z, Headquarters' Medical Staff. This proved to be a series
of cases of measles complicated by a purulent bronchitis, iden-
tical with those previously investigated in Aldershot, except
that here B. influenzae was associated with hsomolytic strains of
streptococci instead of pneumococci. As the result of my in-
vestigations I was entrusted — together with Captain E. Cronin
Lowe — ^in February, 1918, with the duty of preparing a pro-
phylactic vaccine for use throughout the N.Z.E.F. in England
and France. This work we at once proceeded to put in hand,
and prophylactic vaccination was commenced in the N.Z.E.F.
in March, 1918.

This was at first tested on a nominal roll of 1,000 men, the
initial reactions carefully watched and the subsequent behaviour
of the inoculated individuals in the presence of the big "wave"
of influenza in the following summer noted. The results were
recorded in an article by Captain Lowe and myself in the
Lancet, October 18th, 1918, and amply justified the wholesale
vaccination of the N.Z.E.F. which was instituted about the
middle of October, 1918, the result of this prophylactic mea-
sure being subsequently also recorded in the Lancet, April 5th,
1919.

The prophylactic vaccine itself was prepared in the Bacterio-
logical Department of Guy's Hospital, and the rank and file of the
N.Z.E.F,, to the extent of some 64,000, received one or two
prophylactic inoculations, whilst an enforced control to a number
of 16,000 received no inoculation. The results were distinctly
satisfactory, and the experience thus gained justified one in
supporting the proposal to adopt prophylactic vaccination against
influenza at a War Office Conference convened by the D.G. in
October, 1918, as a result of which an Army Order was issued
stipulating the size and dosage for prophylactic vaccination.

In order that this measure might be carried out without
delay, several laboratories were invited to co-operate in the
preparation of a large quantity of prophylactic vaccine at short
jiotice. In response to this request the Bacteriological De-

Work in the Bacteriological Department, 1914 — 1919. 347

partment at Guy's was able to place nearly half a million doses
of prophylactic vaccine at the disposal of the Army Medical
Department of the War Office inside seven days, without in any
way disturbing our routine work, and smaller quantities to the
Admiralty Medical Department and other bodies.

Just before this, however, two transports containing reinforce-
ments for the N.Z.E.F. arrived at Plymouth with a large
number of serious cases of purulent bronchitis and giving a
history of an appalling number of deaths on the voyage. At
the request of the Now Zealand authorities I proceeded, with
Oaptain Lowe, to Salisbury Plain and then on to Plymouth to
enquire into this remarkable mortality.

The history of the outbreak was very interesting, in that it
appeared the transports containing the N.Z.E.F. reinforcements
were met off the West Coast of Africa by a British Convoy and
the Captains of the N.Z. Transports, together with Wireless
Operators, were invited on board a British Cruiser for the
purpose of a conference and to receive instructions as to the
route to be followed on approaching this country in order to
escape the submarine menace. Several fatal cases of influenza
had occurred on board the cruiser, and 48 hours after the
conference the Captain of one of the N.Z. Transports and his
Wireless Operator were down with influenza, and from that
moment onwards ilio disease ravaged throughout the Transports,
so that at one time hardly a soul on board could bo regarded ns
sound and healthy.

As a part of my association with the N.Z. Medical Stafl", T
from time to time received into my laboratory members of the
N.Z. M.S. for instruction in bacteriological investigations. Some
of them only remained a very short time, whilst others, like
Captain Robertson, worked in <ho Laboratory for some months.

War Offtck Trencti Fevrr Committrr.

In April, 1918, I was invited to join the War Office Com-
mittee on Trench Fever, and from this (late up to the beginning

348 WorJv in the BanfrrJoJor/lrnl Drparfmrnf, 1014 — 1010.

of 1920, attended the almost weekly meetings of this Committee
in addition to performing- a niimbor of experiments in connection
with Trench Fever in the Bacteriological Department at Guy's.

As is now common knowledge, the English Committee, almost
simultaneously with the American Red Cross Committee, which
was investigating the same disease, proved that its transmission
was due to the ordinary body louse, and worked out the incuba-
tion, period, etc., but, like its American colleague, quite failed
to implicate any specific micro-organism, so that the etiological
causa sausants still remains an unknoAvn quantity.

The amount of M^ork that was done in connection with ex-
perimental Trench Fever at the New Hospital, Hampstead, was
truly colossal, and exemplified to the full the value of highly-
trained and expert team work when the investigation of any
particular disease is needed to be carried through in a minimum
time.

BINDING SECT. MAY " 8 1979

RC Guy*s Hospital, London

31 Reports

L8G9

ser.3 S^

V.55

Biologicai
& Medical
Sctiah

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