Casualty clearing station

“ To onlookers there were some of the signs of victory on that day of September 25th—of victory and its price. I met great numbers of the lightly wounded men, mostly “Jocks,” and they were in exalted spirits because they had done well in this ordeal and had come through it, and out of it—alive. They came straggling back through the villages behind the lines to the casualty clearing—stations and ambulance-trains. Some of them had the sleeves of their tunics cut away and showed brown, brawny arms tightly bandaged and smeared with blood. ”

“ I think it is very unsatisfactory that beyond the regimental stretcher-bearers there is no ambulance to bring the wounded back: and how can a dozen stretchers convey 300 casualties five miles? It is a case of sauve qui peut for the wounded: and when they get to the dressing station the congestion is very bad, thirty men in a tent, and only three or four doctors to deal with 3,000 or 4,000 wounded. ”

“ Positions and emplacements are being constantly improved, communication trenches widened or made more secure. Down these trenches fatigue parties are filing, to draw rations and water and ammunition from the limbered wagons which are waiting in the shadow of a wood, perhaps a mile back. It is at this hour, too, that the wounded, who have been lying pathetically cheerful and patient in the dressing-station in the reserve trench, are smuggled to the Field Ambulance—probably to find themselves safe in a London hospital within twenty-four hours. ”

“ The rain pours, the wind is rising to a gale. The road is very narrow. The wheels of the waggon plunge into a deep rut and send a spray of mud up into our faces. Soon we pull up before a little building at the side of the road not far from our firing line. It is the dressing station where the wounded are brought until the waggons can come to convey them to the hospitals out of the fire zone.
"Our captain and the sergeant enter the building, and a corporal in charge of the place whispers, 'Sir, we have one dead here.'
"'One dead! ”

“ Leave the trenches and retire behind the firing line with me. Here we are on roads lined with men on stretchers some dead, scores mortally wounded, hundreds upon hundreds of casualties in one or another degree of collapse. The middle of the roadway is filled by dozens of ambulances after every action; there is perhaps a mile length of hospital trains waiting in a siding to convey the wounded to base hospitals. ”

“ In most places, such as dressing-stations and railway-stations, nothing is provided for them at all, and many men are left for two or three days without food.
I wish I could describe it all to you! These wounded men are picked up after a fight and taken anywhere— [Pg 51] very often to some farmhouse or inn, where a Belgian surgeon claps something on to the wounds or ties on a splint, and then our (Dr. Munro's) ambulances come along and bring the men into the Field Hospital if they are very bad, or if not they are taken direct to a station and left there. ”

“ No other life, and not even an ambulance, is risked in bringing him here. Except for the teleferica, he could not have been sent over until after dark, and the delay would have been fatal. We estimate that from one to three per cent. of the men wounded on a battlefield which, like this one, lies so exposed that they cannot be sent back at once by stretchers or ambulance, owe their lives directly to the teleferica.”
When the cover of the basket was lifted off in the station, the body of a man swathed in a blanket was revealed. ”

“ The men are evacuated from the field hospital to a base hospital in motor ambulances or by a combination of motor ambulances and railway trains. Theoretically, this should be done within a day or two with all cases except the very gravest. In practice, the men frequently lie in field hospitals for weeks before the opportunity of evacuation is found. The base hospitals are in cities or large towns, and serve as clearing-houses. They are well out of the military zone, being from five to fifteen miles behind the zone of artillery fire. ”

“ There were men lying all round and about the wood, and the small ambulance staff had more work than they could do; my cart made three trips, carrying wounded men from the column to the dressing-station. Only ten minutes of fighting, and over thirty casualties ”

“ He was attending the wounded in a temporary ambulance station at the back of the firing line when he realised the danger of the situation. Men and officers were falling all along the line, and it was imperative that their places should be immediately occupied if the position was to be held. On the spur of the moment it occurred to him to call on the least wounded of the men he was looking after to try and help. ”

“ An M.O. from the Clearing Hospital, with a haggard face, asked me if I could give him some eau-de-Cologne and Bovril for a wounded officer with a gangrenous leg—lying on the station. Sister X. and I took some down, also morphia, and fed them all—frightful cases on stretchers in the waiting-room. They are for our train when we can get in. He told me he had never seen such awful wounds, or such numbers of them. They are being brought down in carts or anything. He said there are 1500 dead Germans piled up in a field five miles off. ”

“ The 'casualty' is out of the fight, has had a first field dressing placed on his wound, has been set on one side to be removed at the first opportunity to the dressing station and the rear. He can do nothing more to protect himself or take such cover as offers. He is in the hands of the stretcher-bearers and must submit to be moved when and where they think fit. And in this case the casualties did not even have the satisfaction of knowing that every minute that passed meant a minute farther from the danger zone, a minute nearer to safety and to the doctors, and the hospitals' hope of healing. ”

“ Once out of the trenches a soldier wounded at the front has as much chance now as a man injured in the pursuit of a peaceful occupation.
Once out of the trenches! For that is the question. The ambulances must wait for night. It is not in the hospitals but in the ghastly hours between injury and darkness that the case of life or death is decided. That is where surgical efficiency fails against the brutality of this war, where the Red Cross is no longer respected, where it is not possible to gather in the wounded under the hospital flag, where there is no armistice and no pity. ”

“ There the Société Internationale des Secours aux Blessés established a field ambulance; many wounded received first aid, and thence were dispatched to “fixed” establishments within the city. To reinforce the troops engaged, whose losses were already very great, large bodies of men from those in reserve marched laboriously towards the front. The ground was soaked by rain, their progress slow and difficult, themselves weary, fatigued, and physically weak. ”

“ In one bungalow an operating-room has been installed, in another are the bathing arrangements for the newcomers from the trenches. Every possible device for the relief of the wounded has been carefully thought out and intelligently applied by the surgeon in charge and the infirmiere major who indefatigably seconds him. Evacuation Hospital No. 6 sprang up in an hour, almost, on the dreadful August day when four thousand wounded lay on stretchers between the railway station and the gate of the little park across the way ”

“ I went down to the station one day to see if anything could be done for the wounded there. They are coming in at the rate of seven hundred a day, and are laid on straw in an immense goods-shed. They get nothing to eat, and the atmosphere is so bad [Pg 45] that their wounds can't be dressed. They are all patient, as usual, only the groans are heartbreaking sometimes. We are arranging to have soup given to them, and a number of ambulance men arrived who will remove them to hospital ships and trains. But the goods-shed is a shambles, and let us leave it at that. ”

“ You are as safe in one place as another!"
A direct hit produced a blinding and deafening explosion nearby; a tremendous orange flash followed by pandemonium.
Hatch covers above came crashing down into the bilge, dropping many prisoners thirty to forty feet below. There were screams, cries, groans, and oaths! The air was filled with dust and dirt. Wounded were soon being dragged into our improvised hospital; many with fractures, shrapnel wounds, all covered with dirt.
Just as we were getting the wounded cases moved into the hospital and the dysentery cases out, back came the planes. ”

“ In a moving army the elements of destruction, armed men and munitions of war, have the right of way; and the means of preserving and sustaining even their own lives are left to bring up the rear as they best can. Hence, when the shock and crash of battle is over, and troops are advancing or retreating and all roads are blocked, and the medical staff trying to force its way through with supplies, prompt and adequate relief can scarcely ever reach the wounded. The darkness of night comes down upon them like a funeral pall, as they lie in their blood, tortured with thirst and traumatic fever. ”

“ During that first night and day the wounded men could not filter through the hospital fast enough to let the new ones enter. Always there were three or four Fords lined up before the door, filled with men, perhaps dying, who could not be given even a place of shelter out of the cold. And it was bitterly cold. The mountain roads were frozen; our cars slipped and twisted and skidded from cliff to precipice, avoiding great ammunition wagons, frightened sliding horses and pack-mules, and hundreds of men, who, in the great rush, were considered able to drag themselves to the hospitals unaided. ”

“ It was slow going, for the road was blocked with artillery and infantry and other ambulances, but the driver found a lane between guns and caissons and through the dusty blue columns plodding forward toward the firing line; and at last a white hospital tent glimmered under the trees, and the slow mule team turned into a leafy lane and halted in the rear of a line of ambulances which were all busily discharging their mangled burdens. The cries of the wounded were terrible.
Operating tables stood under the trees in the open air; assistants sponged the blood from them continually ”

“ Over this ground, very slowly and carefully, the stretcher is carried. When the aid-post is reached the M.O. takes charge, assisted by the sergeant or corporal of the R.A.M.C., whom he has always with him, and the 'casualty' is laid alongside others in the dug-out, or cellar beneath some ruined house, that forms the aid-post and battalion dispensary. The first stage in the journey is now over. Soon a couple of cars creep quietly up. One by one the casualties are lifted in or climb in stiffly. ”

“ The advance at first was slow and cautious. When an army has for fourteen days been systematically falling back before an enemy, the only casualties within its ken are its own. It may be assumed—and with every right—that there are also killed and wounded among the pursuing force. But they are never seen. Only khaki-clad figures fill the field ambulances; only khaki-clad figures are left behind in the hospitals, and in the cemeteries and roadside trenches. The ever-swelling roll of "missing" is all on one side. ”

“ We were told that two motor-cars and an ambulance waited at the door, and in a very few minutes we started off for the station. As the night was dark and wet, there was some delay before the cars could find the platform our train was due to start from. We drove into the station by a goods entrance, and the cars halted quite near the train. In addition to ourselves, a large party of wounded soldiers, about 120 of them, were bound for the frontier. ”

“ Our ambulance waggons and stretcher-bearers go out under cover of darkness to collect from the Aid Posts the wounded soldiers, the waggons halting perhaps half a mile away, while the bearers cross fields and roads to the Aid Posts where the wounded soldiers are.
"This is very dangerous and requires much caution; lights are prohibited, as even the flare of a cigarette becomes a good mark for the enemy's snipers, of whom they appear to have many.
"Each regiment forms its own Aid Post. One ambulance unit attends a brigade. ”

“ We find our convoy at the entrance of the town, and we pass through to our camp on the east.
Poor capital! What terror, what disorder shows itself on every side! The shops have been hurriedly shut; men, carriages, riders pass each other in every direction, and the two main streets are encumbered with an interminable string of bullock-waggons. In the market-place and in the market itself an improvised ambulance has been set up, and the wounded are being tended. ”

“ One hundred German prisoners were sent up under escort to act as stretcher bearers, and gradually the field was cleared.
The only difference between the handling of the wounded during actions and during stationary warfare is the fact that in the former more unavoidable congestion takes place, though this is prevented as far as possible in the forward areas by rushing the cases to the rear or to England. In big actions, where many wounded are expected, this is always done. ”

“ Between the trenches the ground is a quagmire, and any advance by either side is out of the question. But a time will come when the ground is just solid enough for a man to stand, there will be a desperate struggle for a few yards of ground, again both sides will subside into new trenches; but now between those trenches will lie perhaps some hundreds of wounded, and how in the world are they to be got? This is the problem with which an ambulance is everywhere faced—the recovery of the wounded from disputed ground. ”