The treatment of wounded and sick soldiers
This page describes the main medical functions in a complex chain that processed the casualty from the front line back to hospitals at home. It is in a simplified format. Many men missed stages altogether, and of course many wounded soldiers were in no condition to know which of these units was caring for them.
Aid and Bearer Relay Posts
The casualty is likely to have received first medical attention at aid posts situated in or close behind the front line position. Units in the trenches provided such posts and generally had a Medical Officer, orderlies and men trained as stretcher bearers who would provide this support. The Field Ambulance (see below) would provide relays of stretcher bearers and men skilled in first aid, at a series of "bearer posts" along the route of evacuation from the trenches. All involved were well within the zone where they could be under fire.
This was a mobile medical unit, not a vehicle. Each British division had three such units, as well as a specialist medical sanitary unit. The Field Ambulances provided the bearer posts but also estabished Main and Advanced (that is, forward) Dressing Stations where a casualty could receive further treatment and be got into a condition where he could be evacuated to a Casualty Clearing Station. Men who were ill or injured would also be sent to the Dressing Stations and in many cases returned to their unit after first aid or some primary care.
There was no hard and fast rule regarding the location of a Dressing Station: existing buildings and underground dug-outs and bunkers were most common, simply because they afforded some protection from enemy shell fire and aerial attack. The Dressing Stations were generally manned by the Field Ambulances of the Royal Army Medical Corps.
Once treated at a Dressing Station, casualties would be moved rearward several miles to the Casualty Clearing Station. This might be on foot; or on a horse drawn wagon or motor ambulance or lorry; or in some cases by light railway.
The next three images are from the war diary of 76 Field Ambulance, a unit under command of 25th Division, and relate to its time in the Ypres area during the Third Battle of Ypres offensive in August 1917. The diary reference is WO95/2239 and the images are Crown Copyright.
Casualty Clearing Station
The CCS was the first large, well-equipped and static medical facility that the wounded man would visit. Its role was to retain all serious cases that were unfit for further travel; to treat and return slight cases to their unit; and evacuate all others to Base Hospitals. It was often a tented camp, although when possible the accommodation would be in huts. CCS's were often grouped into clusters of two or three in a small area, usually a few miles behind the lines and on a railway line. A typical CCS could hold 1,000 casualties at any time, and each would admit 15-300 cases, in rotation. At peak times of battle, even the CCS's were overflowing. Serious operations such as limb amputations were carried out here. Some CCS's were specialist unit, for nervous disorders, skin diseases, infectious diseases, certain types of wounds, etc. CCS's did not move location very often, and the transport infrastructure of railways usually dictated their location. Most evacuated casualties came away from the CCS by rail, although motor ambulances and canal barges also carried casualties to Base Hospitals, or directly to a port of embarkation if the man had been identified as a "Blighty" case. (In 1916, 734,000 wounded men were evacuated from CCS's by train and another 17,000 by barge, on the Western Front alone. There were 4 ambulance trains in 1914 and 28 by July 1916). The serious nature of many wounds defied the medical facilities and skills of a CCS, and many CCS positions are today marked by large military cemeteries. CCS's also catered for sick men. Generally, considering the conditions, the troops were kept in good health. Great care was taken in reporting sickness and infection, and early preventive measures were taken. The largest percentage of sick men were venereal disease cases at 18.1 per 1000 casualties; trench foot was next with 12.7. Until mid 1915, the CCS was known as a Clearing Hospital. Generally there was one provided for each Division. From the CCS, the casualty would be evacuated to a Base Hospital.
Ambulance Trains and Barges
Casualties would normally be moved from the CCS to a Base Hospital,by specially-fitted ambulance train or in some circumstances by barge along a canal.
Once admitted to a Base Hospital, the soldier stood a reasonable chance of survival. More than half were evacuated from a General or Stationary Hospital for further treatment or convalescence in the United Kingdom. The Stationary Hospitals, two per Division, could hold 400 casualties each. The General Hospital could hold 1040 patients. They were located near the army's principal bases at Boulogne, Le Havre, Rouen, Le Touquet and Etaples. The establishment of a General Hospital included 32 Medical Officers of the RAMC, 3 Chaplains, 73 female Nurses and 206 RAMC troops acting as orderlies, etc. The hospitals were enlarged in 1917, to as many as 2,500 beds.
Existing military hospitals were expanded; many civilian hospitals were turned over in full or part to military use; many auxiliary units opened in lareg houses or public buildings; and many private hospitals also operated.
Once discharged from hospital men were sent to various locations for convalsecence, depending on their circumstances. MAny went to teh military Command Depots: