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The expansion of the permanent organisation, however, would have been quite impossible but for the heavy sacrifices of the doctors in Canada who, at the call to arms, threw up their practices to undertake the arduous and oftentimes dangerous duties of the charge of Canadian sick and wounded Overseas.

Here, however, it may be pointed out that the work of an Army Medical Service is divided into two sections—the professional side, which comprises scientific medical work, and the military side, which provided the means whereby the professional side is able to carry out its duties to the best advantage.

382 Overseas Military Forces of Canada.

The two sections work hand in hand, but professional work is, of course, the raison d'etre of the Service, and how many and terrible are its problems can only properly be understood when it is realised that it had of itself a two-fold battle to fight. There was the long and bitter defensive and remedial action against horrors such as poison gas and the rest of the devilish devices of destruction—the inventions of that Kultur which was the offspring of a scientific spirit unmitigated by humanity. Again, there was the long and endless offensive against dirt which is the beginning of all that disease which ends in the destruction of armies. It was a combined offensive and defensive action which called forth not only devotion to duty but the highest qualities of mind and the utmost determination of spirit of which the physicians and surgeons were capable.

It was well for the Canadian Army Medical Services they had such splendid material to draw upon. The services of the most expert surgeons and physicians were, naturally, most urgently needed. The creation of a Consultant Staff, with officers of ripe professional experience to supervise the work at hospitals, sanitary formations, laboratories and so on, was one of the Canadian Army Medical Services' most pressing cares. It was organised on an effective and systematic basis, and its success has been largely due to the invaluable services which have been rendered by some of Canada's most brilliant medical men, in conjunction with those of England and of France. The advances in war medicine and surgery were kept pace with at every stride.

The Canadian consultants and specialists attended the different important Allied Medical Conferences and made tours of observation and instruction in the hospitals of various countries, and it was by these and other means that Canadian soldiers in hospital benefited by the latest medical and surgical discoveries in every land which was at war with the country responsible for the horrors which had to be faced. The knowledge so acquired was passed on to the eager and enthusiastic staffs of every Canadian Hospital. The different wonders accomplished by medicine and surgery during the war have long since been common knowledge.

–  –  –

As already indicated the resources of the medical profession were not called on merely to perform miracles of healing. The simple word sanitation covers a multitude of hygienic accomplishments.

First then, came sanitation and the prevention of sickness. Such a thing as a foetid odour is practically unknown in a military area. To drink from an unauthorised source is a crime. Wells were examined even while they were yet under fire, food is scrutinised before every meal, the men are bathed as methodically as they are fed, and a battalion of a thousand men can be inoculated against disease in 35 minutes. As a result of these and other precautions, the dreaded enteric has practically ceased to exist and epidemics are mostly confined to such childish maladies as measles, which still defy the ingenuity of medical science. The results in regard to enteric were the most remarkable of all. Of 100,000 Canadian patients only one man was found to have typhoid, and that was in the case of a man who for some reason had not been inoculated.

The professional side of the Canadian Army Medical Corps has, indeed, accomplished marvels, but due credit must be given to the military side of the same organisation, for its duties are many and complex, and organisation and administration have played a great part in the Service's fight for the lives of Canadian soldiers. The military side has to provide places of treatment, strategically located for the convenient and economical reception and evacuation of patients. It has to furnish the means of conveying the patients promptly and comfortably to places where their needs can be efficiently attended to without delay, and it has to devise and control the movements of railway trains, ships, and other transport for that purpose. It has to arrange for facilities in the matters of space, supplies, housing, feeding, clothing, proper records, and many other intricate details.

It will thus be seen that it is impossible to divorce the Medical Service from the rest of the military machine which it serves. It must be part and parcel of it and amenable to the same regulations and discipline, or its efforts to re-establish the sick and reconstitute the wounded will be for the most part vain.

The ordered system of the Director-General of Medical Services in London must be as complete, as comprehensive and as unfailing as the administration of the General Staff, 384 Overseas Military Forces of Canada.

the Adjutant-General's Branch, or the Branch of the QuartermasterGeneral. There must be machinery behind the men.

And this urgent requirement of a perfect organisation applies with equal force to the Front. Medical arrangements must be devised ahead of each action. They vary with the plan of battle, and must be modified as the battle proceeds.

Consider the difference, for instance, between the medical organisations with a division, or on the lines of communication, or again at the Base. It is impossible to enter into the intricacies of all these varying organisations, but the figures concerning the Medical Service attached to a division will alone serve to indicate what organisation and administration is entailed. In a division there are about 20 Regimental Medical Officers and three Field Ambulances, with nine Medical Officers each. The personnel is divided into bearer, tent and transport sections, about 750 men to the three ambulances. For transport, each ambulance has 50 horses and seven motor and three horsed ambulances, with General Service wagons and carts in addition. A compact little army in itself.

It is impossible to recapitulate the various achievements of the Canadian Army Medical Service, but here are a few of its activities in tabloid form which will serve to indicate the scope of its duties in scientific and organised healing.

A School of Massage and Swedish remedial drill was organised for training Nursing Sisters and soldiers for this service in hospitals.

The Medical Service for troops and civilians returning to Canada by transport was thoroughly re-organised and placed on an efficient basis.

A complete scheme was instituted for the hospitalisation of Canadian Officers and Nursing Sisters, and this pronouncedly reduced the period of non-effectiveness of casualties in these ranks.

–  –  –

A system for the thorough and efficient training of Canadian Army Medical Corps officers and men was organised at the Canadian Army Medical Corps Depot, and a finishing course in the hospital.

Refresher courses were provided for reinforcements drafted for Overseas Service.

The Canadian Army Medical Corps Laboratory Service has been definitely organised on an economical and efficient basis. Four grades of laboratories have been adopted with standard equipment and established personnel for each ; and each of the two laboratory Units and 22 Hospital Laboratories have been organised. The XRay Laboratory Service had been similarly organised and systematised.

A Central Medical Stores was organised through which all Medical Supplies and Technical Equipment were received and distributed, and the Medical Stores and Technical Equipment of all Units and Medical Inspection Rooms were standardised and redistributed on an economic basis. Further, there was established a complete and effective system of supply and accounting for stores and equipment which made at once for efficiency and economy.

The Sanitary Service was also completely re-organised, and measures for the prevention and control of infectious diseases placed on an effective basis, and one that embraced all the recent advances made in this particular branch of Medical Science.

Machinery was organised for the immediate segregation and control of infectious cases and contacts arriving from Canada, similar machinery being established to deal with cases or contacts developing in any part of the Forces while in England. The movement of infectious cases and contacts between Formations was also strictly guarded against. The despatch of cases of carriers to France was similarly dealt with.

Definite arrangements were drawn up for all Medical Units and Division Units organised or re-organised in accordance with the authorised scheme. In this way the combined experience of military experts produced the organisation of similar Units on uniform lines, which increased the uniformity of the Service as a whole and resulted. in great economy of personnel.

–  –  –

In addition an establishment was provided for the Nursing Section of the Canadian Army Medical Service, placing this most valuable part of the Service on a definite basis for the first time.

The re-organisation of the Medical Board Services and the classification of troops according to medical fitness was alone a great undertaking. During the later stages of the war there was an average of over 6,000 Medical Boards per month, while upwards of 14,000 troops were reviewed per month for classification.

The Canadian Army Medical Service did not exempt itself from this review. On the contrary, its personnel was thoroughly sifted for the release of Category A men fit for General Service. As a result, 1,883 men nearly the strength of two Battalions were released to the combatant forces.

Boarding and classification was decentralised into Areas to do away with congestion and delay, and at the same time a Central Control was organised with a systematic inspection and supervision, which ensured proper and uniform standard throughout the Service. In addition, the Board Service was coordinated with the work of the Pensions Authorities and with the Hospital Service, the Adjutant-General's Branch, and to the general internal economy of the various Formations of the Forces. The Board Establishment also took over the examination of reinforcements drafted from Overseas, and this work was coordinated with the inspection work at the Base in France.

Truly this is an administrative record of which the Canadian Army Medical Corps may well be proud. But it must be

–  –  –

remembered that just as there is " the man behind the gun," so there is the doctor and the man behind the lancet, and the nursing sister and the true Canadian woman behind the grim paraphernalia of her office. And great have been the souls and stout the hearts and deft the hands, not merely of the doctors and the nursing sisters, but all those " other ranks " who give the great machine of healing its life and its humanity. Unflinching in danger, resolute in duty, unremitting even in the drudgery of their voluntary crusade against disease and death-to these devoted men and women go out the thanks of scores of thousands of Canadian soldiers, and the heartfelt gratitude of hundreds of thousands who loved the men maimed in the defence of Canada upon the Fields of Flanders and of France.


Air Raid on Hospitals at Etaples.—It was not to be expected that the Canadian Army Medical Service would escape its share of outrage from the enemy, and three events will forever be remembered for the murder most foul of Canadian sick and wounded-the bombing of the Canadian Hospitals at Etaples and Doullens, both in May, 1918, and the sinking of the Canadian Hospital Ship "Llandovery Castle " in June of the same year.

It is beyond all question that the Germans made any mistake in regard to the bombing of the Hospitals at Etaples. Since the autumn of 1914 Etaples was perfectly well-known to the Germans as a great Hospital Area, Canadian General Hospitals No. 1, No. 7 and No. 9 being merely three Units in the colony of British Hospitals which housed thousands upon thousands of beds. Like enough it was the assemblage of so many stricken soldiers which presented the enemy with a temptation which he could not resist.

No. 1 Canadian General Hospital had been established there since the spring of 1915 ; No. 7 (Queen's University) had taken over another site at Etaples when it had returned from the East ; and No. 9 had been transferred from St. Omer because of the danger from shell fire at what had formerly been British Headquarters. The whole Area indeed must have been well marked on the enemy's map.

(642) CC2 388 Overseas Military Forces of Canada.

It was perhaps, too, typical of his mentality that he should choose the night of Whitsunday (May 19) for his first raid on the helpless in this district. On that night there were upwards of 1,000 patients in No. 1 Canadian General Hospital, 300 of whom were femur cases. The nature of the treatment for these cases demands that the patients shall have the leg fixed by bandages in an extended position to a firm, immovable framework. It is easy, therefore, to conceive the plight of these patients who could not be moved as the bombs began to fall ; and with obviously deliberate purpose the first bombs which the enemy dropped were incendiary bombs, so that the flames from the burning buildings gave him plenty of light for his work.

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