Royal Army Medical Corps

“ The value of that registration of B.R.C.S. members by the War Office is not quite obvious at present, for the War Office appears to disclaim all responsibility for the Red Cross. There are even rumours that a large portion of its personnel is to be greatly reduced and eventually sent from the base. In fact, no one's work or position is clearly defined.
The work of the Royal Army Medical Corps, the Nursing Service, "Q.A.I.M.N.S.," Reserve, Indian and Territorial, was well defined enough. Field ambulances, clearing stations, stationary hospitals (so-called because they are movable!) ”

“ A man of the West Yorkshire Regiment had been badly wounded, and was lying in the open unable to move, in full view of, and about 300 to 400 yards from, the enemy's trenches. Corporal Stirk, Royal Army Medical Corps, and Private Caffrey, at once started out to rescue him, but at the first attempt they were driven back by shrapnel fire. Soon afterwards they started again, under close sniping and machine-gun fire, and succeeded in reaching and bandaging the wounded man, but just as Corporal Stirk had lifted him on Private Caffrey's back he himself was shot in the head. ”

“ This staff should be presided over by a Surgeon-General who should be second only in rank to the Director of Medical Services in the field, and who with his staff should be armed with authority so far as the taking of steps for the prevention of disease is concerned. At present the medical officers in the Australian Medical Service are entrusted with dual functions, the prevention and the treatment of disease.
So far there has been no Military School for medical officers in Australia, and until they are properly trained the prevention of disease will not be as effective as it might be. ”

“ It is pleasing to those of us who co-operated in the movement, to have the assurances of the Surgeon General that the establishment of the Medical Reserve Corps has been of actual benefit to the regular Army Medical Department. While the military rank to which its members found themselves suddenly elevated was not so lofty as to cause any attacks of vertigo, none having been up to the present day reported, it at least gives us satisfaction to realize that help may thus be afforded from private life, and that a closer rapport has been effected. ”

“ Secretary, Royal Victoria Hospital, Netley, 1894-96; P.M.O., China, 1896-99; P.M.O., Western District, 1899-1902; Surgeon-General, 2nd Army Corps, [374] Salisbury, 1902-3; raised with Mr. Cantlie R.A.M.C. Volunteers, 1883; founded, 1884, Medical Officers of Schools Association, London; and, 1886, drew up scheme for Army Nursing Service Reserve; Member, Committee International Health Exhibition, 1884; Member of Council, Royal Army Temperance Association, 1903; President, Poor Law Medical Officers’ Association; contested (L.) Woolwich, 1886, Fareham Division, Hampshire, 1906, and Brighton, 1910 ”

“ In the hurry and confusion of a war, and amidst the pressure of hundreds of new cases in a day, what can the surgeons of the hospital be expected to do for science, or even for the improvement of medical and surgical practice?—The answer is seen in the new arrangements in England, where a statistical branch has been established in the Army Medical Department. Of course, no one but the practising surgeon or physician can furnish the pathological facts in each individual case; but this is what every active and earnest practitioner does always and everywhere, when he sees reason for it. ”

“ Were all these changes made there is no doubt that the efficiency of the administration would be increased and the burden of the work lightened.
As regards clinical work other desirable changes might be made. Senior men who have been in full practice, and who come to a base hospital as physicians or surgeons with the rank of lieutenant-colonel, are apt to be entrusted with the detailed administration of medical or surgical wards. They are often unfitted by training for such administration and are frequently disinclined [192] to undertake the work. ”

“ Unless ample provision is now made by Congress to put the Medical Corps where it should be put disaster in the next war is inevitable, and the responsibility will not lie with those then in charge of the War Department, but with those who now decline to make the necessary provision. A well organized medical corps, thoroughly trained before the advent of war in all the important administrative duties of a military sanitary corps, is essential to the efficiency of any large army, and especially of a large volunteer army. ”

“ Owing to the prolongation of the war the supply of newly qualified men is drying up; casualties among medical officers have been numerous, the medical service in this respect coming next after the infantry. The French mobilization scheme provided that a medical student in a certain stage of the curriculum, reached usually at the end of the second year, should, when called up, be appointed médecin auxiliaire, a grade unknown in the Britsh army, but corresponding with that of surgeon probationer in the Royal Navy, which itself is the revival of the old grade of surgeon's mate. ”

“ It is difficult to draw distinctions between the various classes of personnel, but it may perhaps be said in general terms, at the present time, that the most difficult qualified personnel to secure is the medical officer. The Public Health Service was peculiarly fortunate in assembling a large Reserve Corps. At the close of the war, many medical men who had been in the military forces were demobilized. Finding themselves somewhat adrift, and having broken completely old associations, they were inclined, if opportunity offered, to continue in the Government service. ”

“ In addition to the work being done for the Red Cross, which is a separate institution, the Army Medical Corps has enlarged its personnel from 8,000 to 106,000, including orderlies, stretcher bearers, and ambulance drivers. Its 900 doctors before the war are now increased to 18,000. It had 375 army nurses a year ago; now it has 7,000. It had no ambulance service; now it has 6,000 drivers in training. Reconstruction institutions are being provided in the United States on a more comprehensive scale than any other nation at war has attempted. ”

“ Working in close association with the medical committee of the Council of National Defense and the Red Cross and in constant and helpful contact with the medical activities of the British, French, and other belligerents, the Surgeon General has built up the personnel of his department and taken over from the Red Cross completely organized base-hospital units and ambulance units, supplemented them by fresh organizations, procured great quantities of medical supplies and prepared on a generous scale to meet any demands of our Army in action. ”

“ Many of the war-born institutions would come to a close — but not the Army Medical Museum. It would continue its mission of showing, by specimens, preparations, and illustrations, the nature and form of disease and injury, and teaching ways and procedures to alleviate suffering and lessen mortality according to the medical lights of the time.
↑ Duncan, Louis C: Evolution of the Ambulance Corps and Field Hospital, p. 4. In The Medical Department of the United States Army in the Civil War. Washington, 1911. ”

“ He also says, "It must be remembered, for the sake of our honor as a profession, that the army medical service, though an absolutely essential part of His Majesty's forces, has not only never been granted a proper place in the administration of military affairs, but even now [early in 1917] has no representative on the Army Council."
The medical profession cannot be held primarily responsible to the British nation for errors in the vital question of the rum ration and the medical and surgical care of soldiers. ”

“ Major Callender also pointed out that the Medical Department of the Army was in far better position to conduct a medical museum than was any other government service or an independent organization. "This is true," he said, "for preventive medicine and hygiene, as well as for pathology. Army officers have, since the advent of modern means of disease control, led the field in preventive medicine and hygiene. ”

“ No portion of the military service has been more misrepresented than the medical department. An opinion seems to prevail quite extensively that the army surgeon is generally a young graduate, vain of his official position, who cares little for the health of the soldier, and glories in the opportunities afforded by a battle for reckless operations. ”

“ Troops of both nations used the hospital as long as it was open, and there was no difficulty in serving both masters. Inspection by highly placed officials of both Armies was constant; and these visits were often a source of amusement to the medical staff.
Senior officers of the British Army seldom came to Paris without including the Women’s Hospital in their round of inspection. Especial care was taken to receive these gentlemen with ceremony. The Médecin-en-Chef always took them round herself, and whenever possible the Chief Surgeon assisted too. ”

“ Broadly speaking, the base hospitals of the army are organizations recruited and equipped in America by the Red Cross, and transported to France, where they become units of the army, under army discipline and direction, and supplied by the Medical Corps stores except in cases where these are inadvertently lacking, or unprovided for by the strictness of military supervision. In any case, where sufficient supplies are not forthcoming from the Medical Corps, they are given by the Red Cross. ”

“ Our Medical Corps is especially entitled to praise for the general effectiveness of its work both in hospital and at the front. Embracing men of high professional attainments, and splendid women devoted to their calling and untiring in their efforts, this department has made a new record for medical and sanitary proficiency. ”

“ During the war over 200 patients were treated in the clinic daily. It was inspected by the Director- General Army Medical Service in March 1915 and subsequently became the model for the massage and electrical departments in the convalescent hospitals and command depots throughout the United Kingdom. Early in 1915 the War Office officially recognized the Corps by making it the body to which all masseuses and masseurs engaged for service in military hospitals must belong. ”

“ Such a center, the Committee reported, was an "urgent and immediate" need, due to the "comprehensive and global nature of modern military medicine" if the Medical Department was "to fulfill its mission of protection and care of troops, to keep pace with worldwide developments of significance to military medicine and to maintain a productive relationship with the medical profession at large * * *. The Army Institute of Pathology and medical museum are presently housed in an antiquated building which seriously limits the important functions of this institution. ”

“ Initial triage, EMT, and decontamination are accomplished on the "dirty" side of the hot line. Life-sustaining care is rendered, as required, without regard to contamination. Normally, the senior health care sergeant performs initial triage and EMT at the BAS. Secondary triage, ATM, and patient disposition are accomplished on the clean side of the hot line. When treatment must be provided in a contaminated environment outside the CPS, the level of care may be greatly reduced because medical personnel and patients are in MOPP Level 3 or 4. However, lifesaving procedures must be accomplished. ”

“ This department of an army, next to the commissariat, is the most important of all the non-combatant sections. The surgical treatment of the wounded in actual fighting, and still more the combat with disease engendered by crowding, unhealthy stations, and the reckless habits of the soldiery, necessitate a large medical staff; for, on an average of the whole army, it is found that the rate of sickness is at least quadruple that for the civil population. In the British army every battalion, when at home or in the temperate zone, has a surgeon and an assistant-surgeon ”

“ With a skilful, energetic man as medical director of the army, giving his orders to medical directors of corps, and these carefully superintending surgeons-in-chief of divisions, who, in turn, held the surgeons and assistant surgeons and officers of ambulance corps to a strict accountability for a careful performance of their duties, while the latter fortified themselves by judicious oversight of their subordinates, the result [308] was to place this department of the army on a footing which endured, with the most profitable of results to the service, till the close of the war. ”

“ The Medical Corps enlisted men were naturally not sinners in this respect. The routine work of the base hospitals all fell to them. It was usually a sergeant of the army—though he was never a veteran—who attended the reception-rooms, kept account of symptoms, clothes, and first and second names, and did the work of orderly in the hospital. It was the privates who kept the mess and washed the dishes and changed the sheets. ”

“ Institute set up an extensive service, making study sets available to all Army laboratories, to keep medical officers throughout the Army informed about the pathology of the diseases prevalent during the war. ”

“ A field hospital, for about 200 patients, has 5 surgeons, 1 apothecary, 9 hospital stewards, and 12 attendants with 6 wagons. In the United States the sanitary organization of a corps proper comprises one medical director and a reserve of hospital corps men and material for about 2000 patients; a division has a bearer company, an ambulance company, and a field hospital for 500 patients; to each division, brisade, battalion, squadron, and battery is assigned a medical officer and a certain number of non-commissioned officers and privates of the Hospital Corps. ”