WWI 1919 PHYSICIAN IN FRANCE YPRES RAMC SHELL SHOCK GAS

A Physician in France

Wet, Cold And Poison Gas

The weather has been extremely bad during the winters in Flanders and Northern France. In November, 1914, there was a very hard frost which produced a certain number of cases of true frost-bite. The first three months of 1915 were so wet that the country was hall under water and the trenches were flooded. We were then entirely in the low country north of Bethune, and the whole front suffered, for everywhere along the line the men were standing in water. A CO. of a cavalry regiment told me that he had just brought his men out after standing for forty-eight hours in water above their waists. He had not lost a single man, but when they came out they were exhausted to the last degree, and in other regiments some men died of exposure, and some were even drowned in the trenches.

Exposure to cold combined with wet, and inability to keep the circulation active by walking about — for movement was not only almost impossible iii the deep water, but also dangerous from the enemy's fire — produced a condition that we called " trench foot." It did not give the typical picture of frost-bite as it occurs in the dry cold of Arctic countries, but was more like a wide extension and severe degree of chilblain. We all caught chilblains in France. I never had them so badly since I was a child. And it is interesting to find that Larrey, Napoleon's great military surgeon, states that the men's feet were attacked much more when the snow melted than at the height of the cold.

In natural conditions the warmth of the limbs is maintained by the continual circulation of the blood from the central parts to the limbs and back again, and this is greatly assisted by muscular movement. In the present case the legs were not only continuously chilled by the cold water and the circulation reduced by inaction, but they were undoubtedly affected also by prolonged soaking. The feet first became painful and tender, then swollen, cold, and numb, and then red and hot. They often blistered, and in bad cases lost the toes or even a larger part of the foot from mortification.

Combatant officers were at first inclined to make light of it, but they soon found it was a very serious question. One Division which had been rather carelessly handled lost two thousand men in a week. The medical branch knew better, and from the first tried not only to instil the need of care into the minds of Commanders, but also to devise means of prevention.

The trenches had been constructed under great pressure of time, and in circumstances of great difficulty. It was not possible to drain them, for they represented the water-level of the country. The water could be pumped out for a time to a certain extent, but it rose again through the floor and walls. It was impossible at that time to use the various methods by which, when we had more experience, more time, and better weather, the trenches were afterwards improved.

Some of them were abandoned and the troops moved a little backward into better lines. But in most parts the whole country was a mass of liquid mud, and no change of this kind was of any advantage. We urged that the period of duty should be shortened, and this was of use where it could be adopted. But in many places the Germans overlooked our lines, and relieving was so dangerous that it could not be carried out at short intervals, for the loss of life would have been too great. There is also a drawback in very short periods of duty, for the men will not work at the repair of trenches which they are going to leave next day.

To avoid any pressure on the blood-vessels, and so to maintain the circulation as free as possible, the men were ordered to wear their puttees loose, and not to lace their boots tightly, and to lessen the effect of cold they were supplied with two pairs of socks and a larger size of boot. But this measure, excellent for dry cold, was of little use when the legs were wet. Great attention was paid to the feet. Before going up they were washed, dried, and greased. Every twenty-four hours the process was repeated, and after the feet had been rubbed warm dry socks were put on. Leg-drill was ordered in the trenches to increase the circulation.

Again, various suggestions were made for waterproof boots. Sir Arthur Lee (Lord Lee of Fareham) had seen in Japan waterproof stockings of paper, and some such were tested, but they wore out in a day or two. Canadian lumber boots, high boots like the Norwegian field-boot, but with felt leg-pieces, were described to us, and requested. 1 do not think we ever secured any of the proper pattern, but twenty thousand pairs came out which, when unpacked, were found to be the rubber and felt shoes reaching to the ankle that are sometimes worn over thin boots when there is snow on the ground. At last some long waterproof thigh-boots began to come out, and on December 6th, 1915, an A.D.M.S. told me that there were enough for every man in the trenches to have a pair, with about a hundred pairs extra per battalion.

At the same time arrangements were made to supply hot food to the men in the trenches.

All these measures were excellent so far as they went, but owing to the conditions they could not go all the way.

In the Division just mentioned the boots were enough to go round the men in the trenches. But as the reliefs had to march a long way up, partly through wet communication trenches, they arrived wet through, there was no possibility of drying in the trench, and the boots they received from the outgoing men were wet through too. Every now and then the water would be over the tops even of long thigh-boots. Then, again, some trenches were very much isolated and could not be relieved often, or even supplied with food except by night. In another set of trenches the nearest place where it was possible to change and dry the feet was in the bank of a canal a mile or more in the rear. All the dug-outs had fallen in, the firing-step was under water, and the sentries were standing on half wine-vats to keep them out of the water. Where conditions permitted the orders to be carried out great benefit was afforded, and subsequently, as we had opportunity, we improved the trenches very much. We never had so many bad feet after 1915.

The affection does not occur only in the trenches. I have seen a mild case of it in a dispenser who stood all day on a cement floor, and I have seen it, or something very like it, appear in a hospital patient. I believe the flying men never got it, though no doubt exposed to intense cold . . .

 

 

 

. . . The spring of 1915 was a time of depression. No one but Lord Kitchener seems to have realized the magnitude of the war, and we had expected to attack when the summer began. But few troops came out and, worse still, very little ammunition. Batteries were in some cases, I was told, reduced to forty rounds a week. Even what ammunition there was was not wholly reliable. A battery of 4.7 inch guns had to be moved up to 3,000 yards because the shells were bursting short and killing our own men. It was at once heavily shelled, the C.O. wounded, and hardly enough men left to take the battery out. Under those circumstances the effect of Mr. Asquith's Newcastle speech was to produce a great sense of bitterness against the Government.

It was on April 22nd of that year that the Germans first used drift gas. We were at Bailleul in the morning, and hearing that there had been some disaster to the north, drove up to Poperinghe, where we learned that French troops had come through the town in a panic, and thence to Vlamertinghe, where in a Canadian Field Ambulance I found three Algerian soldiers. They said that the Germans had pumped some liquid or other on to the ground and had then set light to it, creating a heavy white smoke which had drifted down on to them. Later and better observation showed that the gas formed a greenish cloud and was not ignited. There was at any rate no doubt about the result. The Algerian troops had bolted en masse, and if it had not been for the Canadians, who had at once turned out and marched to meet the enemy, Ypres would have been in their hands. The Canadians met them about Pilkem and stopped the rush, but that and the next few days were very bad for us. The Canadians and the Northumbrian Division suffered most. There seems no doubt that the Germans were not prepared for such a success. If they had had any large body of troops behind the gas they could have walked over the ten-mile gap between Ypres and the Belgian inundations. We suffered very heavily as it was, but almost entirely from the guns, which the enemy were able to push forward behind the salient we held in front of Ypres.

I did not see any asphyxiated cases among our troops that day, but on April 24th there were hundreds of them in the hospitals, and still greater numbers of men who were not so badly affected were sent down to the Base. There is no need to dwell on the horrors of that day; none who saw that scene can ever forget it. The attacks were repeated up to May 23rd, when the wind became unfavourable for the enemy.

The Germans took elaborate precautions with their gas. They had in every trench a meteorologist, whose business it was to study the wind and the air currents in that particular trench. On some days they had to report every half -hour to H.Q., where the head meteorologist was, and he had the entire direction of the gas attacks. The engineer officers who handled the apparatus were required to consult the local meteorologist on every occasion.

It was imperative to protect the men against such attacks in future. The first step was to find out the nature of the gas used. We followed various clues which failed. But there were many in the Army, both officers and men, who had a knowledge of chemistry, and some of these had been in the way of the gas. They were clear that the green colour and the irritating properties were those of chlorine. This is a heavy gas much used in manufactures, and for that purpose it can be condensed into liquid and stored in strong metal cylinders such as are used for oxygen, in which it is under considerable pressure. On turning the tap the liquid issues in a white vapour which quickly expands into the green-coloured gas.

With the help of the wind this gas drifted along the ground, expanding as it came, until it formed a wall which by some was said to be forty and by others twelve feet high. The height probably depended upon the distance of the trenches, for the gas would tend to diffuse as it came. Local conditions of the atmosphere or obstacles would probably affect it also.

When the gas, which came to be called drift gas to distinguish it from the gases sent over in shells, reached a hollow like a trench, it rolled into it and, being heavier than air, stayed in the bottom. But the main body of the gas passed on, borne by the wind.

Many victims said that the gas, when inhaled, produced a feeling of listlessness and a desire to lie down. This was highly dangerous, since the gas lay in the floor of the trench. It was equally dangerous to run, for in addition to shrapnel, which was poured upon them, those who ran, ran with the gas, and were the longer exposed to it. To stay still and to stand upright was the safest course, and those who did so frequently had their reward. For the Germans, after an interval, followed the gas, expecting to find our trenches empty, and those battalions who stayed beat them back with great slaughter.

At once the means of prevention were sought. The easiest form of protection was by respirators, and thousands of these were improvised. They were at first of the simplest kind, mere pieces of flannel or cloth wetted and held over the mouth and nose. These, being of no use, were as fast as possible replaced by pads of cotton waste impregnated with a chemical antidote and folded in muslin netting. These, again, were supplanted by a helmet of cloth, with gelatine windows for the eyes and loose ends to be tucked into the collar. The whole helmet was treated with the necessary chemical. These took much longer to make, and we had not sufficient to equip every man in the battalions even so late as the end of July.

The military effect of the gas was at that time serious. It was the means of our losing a considerable tract of ground, and it created panic both among the African Corps of the French and among our own men later. But it exasperated the soldiers. They fought more fiercely and more mercilessly afterwards. English soldiers are good-natured, and though they do not mind fighting, they bear little ill-will to their enemy. But treachery, as in the abuse of white flags or the Red Cross, both of which were practised by the Germans, cruelty to the wounded, of which they had good evidence when in the counter we returned to trenches we had lost, and methods which they think unfair, such as this, fill them with a fury which bodes ill for those with whom they fight. There was little complaint after this time that the men were too familiar with the enemy opposed to them.