| > > What
happened when Tommy was wounded? |
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| 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. |
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| One man's experience |
The
initial shock of being wounded is illustrated here by one
man's experience. He was Private Tom Bluette, and a former
journalist for the Grimsby Daily Telegraph and a member of
A Company, 1/5th Lincolns in 138th Brigade, 46th (North Midland)
Division. On the evening of the 10 May 1915 the battalion
had already assembled for the relief at One Tree Farm (in
the Messines Ridge sector near to Spanbroekmolen). They could
hear the noise and could see the star shells rising into
the air. Tom Bluette was among those waiting at One Tree
Farm. His experience of that night was relayed to those at
home in a published letter later that month. |
‘…we
went up to relieve the 4th Leicesters, and, as we were
lying down near the supports just prior to moving up, a
particularly heavy rifle fire commenced. Instantly we were
aware that something untoward was happening and quickly
came under order to take off everything except the bare
fighting order. We were served out with additional respirator
in almost as few moments as it takes to mention the fact….The
rifle and artillery fire was incessant and every man was
prepared for business as everything pointed to hot work.
I never noticed the slightest sign of the “white
feather” and I do honestly believe that our lads
were keen and anxious to get to close quarters. Then we
learnt the news! It appears that a party of German bomb
throwers had crept up to the advance breastwork and hurling
in the bombs had made a mess of nearly every man in the
trench. Although we stood to arms all that night, nothing
else happened'. |
On
the last day of the trench tour, 14 May, Tom became the
21st member of the battalion to be wounded since the beginning
of the month, two of which lost their lives. His injury was
rather unfortunate. The men had become understandably rather
jittery since the bombing incident. Private George Wilberforce,
a comrade in Bluette’s platoon had been taking pot-shots
over the parapet. Wilberforce’s rifle had a round still
in the breach and somehow it managed to fire as he was lifting
it, the bullet passing through Bluette’s hand and thigh.
Colonel Sandall asked for an investigation into the incident
and a report from the Medical Officer. The conclusion was
that the incident was an accident and no punishment was dealt
out. The M.O. concluded that the wounded man would soon recover
and would be able to resume his duties in due course. Bluette
described in a letter the evacuation process which would become
familiar to so many of the men in the months ahead: |
…I
realised I had been accidentally shot. Aid was soon forthcoming.
My cloths were cut away and bandages applied, while later
my comrade, who was quite upset offered his explanation and
apologies. I was obliged to remain in the trench from 9 a.m.
until nightfall before I could be removed to the dressing
station at the end of the communication trenches. Just before
tea the Germans sent over a few shells that knocked over
our parapet. This was, I must confess a very very trying
time for me, as I felt the position very keenly. |
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The
'dressing station' that Tom referred to was a Regimental
Aid Post.
Here
is a RAP in open ground near Monchy-le-Preux, 1917
Front-line
units, such as infantry battalions, were able to provide only
the most superficial medical care. Located near the front line,
often in a support or reserve trench, was their Regimental
Aid Post, attended by the Battalion Medical Officer and his
orderlies and stretcher bearers. A wounded man would either
make his own way there if possible, or be carried there. The
facilities were crude and often just sufficed to carry out
light first aid, give the casualty a drink, or just pass him
down the chain to the Advanced Dressing Station. The RAPs were
manned by troops of the infantry or other unit.
Casualties
moving on to the ADS were moved by hand carriage, wheeled stretchers,
trolley lines, etc as conditions permitted. Those wounded men
who could walk, did so. From 1916, relay posts for stretcher bearers
were established every 1000 yards or so. To avoid congestion,
certain communication trenches were allocated for the removal
of casualties. |
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| One man's experience,
continued |
Just
as it became dark Bluette was carried away by two stretcher
bearers. Even though the communication trenches had been
improved considerably it was still a difficult journey
which took three hours to complete, eventually reaching
the Advanced Dressing Station after
several stops: |
‘Here
I was tallied with a label stating name, regiment, particulars
of wounds, and as my wounds had already been dressed, they
despatched me to a field hospital near to our billets. I
was detained here for one night and my wounds were again
dressed and an injection against septic poisoning given….(The
next morning) I was moved once more to a hospital about five
miles further back, the chaplain visited each patient and
offered assistance in informing relatives of their injuries.
The next hospital was an extensive building where men were
deposited from miles around. I was only kept here for the
evening as only the serious cases are detained' |
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The
Field Ambulance attached
to the infantry brigade provided one or more Advanced Dressing
Stations
in reasonable proximity of the front lines. The ADS was better
equipped than the RAP but could still only provide limited medical
treatment. Men's wounds could be dressed, and some emergency
operations
carried out. In times of heavy fighting, the ADS would be overwhelmed
by the volume of casualties arriving. Often, wounded men had
to
lie in the open on stretchers for a considerable time. The wounded
man would be passed on down the line to a CCS, often by the wagon
transport of the Divisional Supply Column. Buses, charabancs,
light and broad gauge railways were also used as conditions allowed.
In
addition to the ADS, the Field Ambulance was also responsible
for the stretcher bearer relay posts, walking wounded collecting
stations, sick collecting stations and rest stations. A larger
version of the ADS, the Main Dressing Station, was often provided
for the Division. |
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| The
next stop for most casualties was the Casualty
Clearing Station: List
of all CCSs, with locations |
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The
CCS was the first large, well-equipped medical
facility that the wounded man would visit. It's role was to retain
all serious cases that were unfit for further travel, treat and
return slight cases, and evacuate all others. It was usually a
tented camp, although in the static trench areas the accommodation
would sometimes be 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
CCSs' were specialist units, 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 casualties came
away 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; 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 hospital. |
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| General
and Stationary Hospitals in France
List
of hospitals |
Once
admitted to a Hospital, the Tommy stood a reasonable chance of
survival. More than half were evacuated to the UK from a General
or Stationary Hospital for further treatment or convalescence.
The Stationary Hospitals, two per Division, could hold 400 casualties.
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. |
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| A
casualty's chances
of survival in France |
| Admissions
of wounded men to Hospital, Western Front 1916 (Source: Official
History) |
|
Number
of men |
%
of total admitted |
| Died
in hospital |
36,879 |
7.3% |
| Returned
to duty after treatment |
169,842 |
33.6% |
| Evacuated
to UK for further treatment |
290,461 |
57.5% |
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| Expansion
of the medical facilities |
The
medical support for the Army developed rapidly as the size
of the army grew, and as the nature of the wounds, sickness
and other ailments faced in this war became clear. The lessons
learned in the early phases of the war included those concerning
the need for speedy treatment of wounds. A casualty's chances
of survival were much greater if he could be attended to quickly. |
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Numbers of medical troops (Source: Official History) |
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August 1914 |
July 1916 |
November 1918 |
|
Officers |
200 |
10,669 |
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Other Ranks |
9,000 |
114,939 |
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Nurses |
516 |
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6,394 |
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| Treatment
in Blighty |
Casualties
whose wounds permitted them to travel would often be moved back
to the United Kingdom for treatment. This chance of seeing home
and family was more attractive to many men than remaining unwounded
in the trenches. Men would hope for a 'Blighty one'. Click
here for a list of medical facilities in the United Kingdom.
One of the final destinations for a recovered wounded soldier was
a Command Depot: last stop before
the return to hell. |
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