Page:EB1911 - Volume 01.djvu/848

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802
AMBULANCE
  

organization of the German and French systems does not materially differ from that of the British service.

In the Japanese army a special feature is the sanitary corps, whose duty is the prevention of disease among the troops; it has been brought to a great pitch of perfection, with the result that in the Russo-Japanese War (1904–1905) the immunity of the troops from all forms of preventable disease surpassed all previous experience. Not only was Japanese system.the army accompanied by sanitary experts who advised on all questions of camping grounds, water supply, &c., but before the war began the Intelligence Department collected information as to the diseases of the country likely to be the scene of operations, unhealthy places to be avoided, and precautions to be taken.

Coming now to the ambulance system of the British army, in which are comprised the arrangements and organization of the medical department for the care and treatment of the sick and wounded from the time they are injured or taken ill, till they are able to return to duty or are invalided home, we will trace the progress of a wounded British army system.man from the field of battle to his home; remembering that, as British troops are usually engaged overseas, hospital ships as well as land transport are necessary.

When a soldier falls wounded in action he is attended by the regimental surgeon and stretcher-bearers, who apply some extemporized method of stopping bleeding and dress the wounds with the “first field dressing”—a packet of antiseptic material which every officer and man on active service carries stitched to some part of his clothing, First field dressing.and which contains everything necessary for dressing an ordinary gunshot wound. Recent wars have demonstrated that in all uncomplicated cases it is better to leave this dressing undisturbed, as the wounds made by modern projectiles heal up at once if left alone, if air and dirt have been thus excluded. From the field he is carried on a stretcher by bearers (formerly of the “Bearer Companies”) of the Royal Army Medical Corps to the collecting station, where he is placed on an ambulance wagon of the first line of assistance and taken to the dressing station. Here his wound will be Collecting station.examined if considered necessary, but as on the field the first medical officer who examined him has already attached a “specification tally” to the patient, giving particulars of the wound, it will probably not be disturbed unless complicated by bleeding, splintering of bone or some other condition requiring interference. Any operation, however, which is urgently called for will be here performed, nourishment, stimulants and opiates administered if required, and the patient moved to the field hospital in an ambulance wagon of the second line of assistance. From the field hospital he is transferred as soon as possible by the ambulance train to the general hospital at the advanced base of operations, and from there in due time in another train to the base of operations at the coast, from which he is ultimately either returned to duty or sent home in a hospital ship. The organization by which these requirements are fulfilled is the following:—Every regiment and fighting unit has posted to it, on proceeding on active service, a medical officer who looks after the health of the men and advises the commanding officer on sanitary matters.Regimental arrangements. When the regiment goes into action he takes command of the regimental stretcher-bearers who, to the number of two per company, have been in peace time instructed in first aid and in the carrying of the wounded on stretchers. These men leave their arms behind and wear the Red Cross armlets, to indicate their non-combatant functions, but in these days, when a battle is often fought at long ranges, it is not to be wondered at, or attributed to disregard of the red cross flag by the enemy, if medical officers and stretcher-bearers are hit. The bearer company into whose charge the wounded man next passes is composed of men of the Royal Army Medical Corps, with a detachment of the Army Service Corps for transport duties. In future, bearer sections of the Field Ambulances will perform the duties of the bearer company. Its function is to collect and succour the wounded on the battlefield and to hand them over to the field hospitals, with which these bearer companies are closely associated, though separately organized. In the Indian army the bearer company is provided from the personnel of the field hospital when there is a battle, and reverts to the hospital again after it is over. The war in South Africa of 1899–1902 clearly demonstrated the superiority of the Indian plan; for after the action the bearer company staff should be available to give the much-needed help in the field hospital, and some amalgamation of the two organizations, or something after the plan of the ambulance volante of the French, is necessary. The bearers afford the wounded any treatment required, supply water and sedatives, and then carry them back on stretchers to the collecting station in the rear, whence they are conveyed to the dressing station in the wagons or other form of transport.

At the dressing station, which ought to be out of range of the firing, and should have a good water supply, the patient is made as comfortable as possible, nourishment and stimulants are administered, and he is then taken to the field hospital. In times of great stress, when it is desirable to remove the wounded quickly from the field, and there are no roads or wheeled transport is not available, large numbers of bearers are employed to carry them on stretchers, &c. These men are engaged locally and are soon given the slight training necessary. This was done in Natal after the battles on the Tugela (1899), in which there were some thousands of wounded to be conveyed; also in Egypt, where the local troops not required for the fighting line were requisitioned; the Japanese in Mongolia employed hundreds of Chinese coolies for this purpose, the general use of sedan-chairs in China having accustomed the poorer class of natives to this kind of labour. In India, the rank and file of the Royal Army Medical Corps not being employed, the bearerIndian bearers. work is carried out by natives specially enlisted and organized into a corps. These men are bearers by caste—a reminiscence of the system which prevailed generally a hundred years ago, and is still met with in out-of-the-way places, of conveyance of travellers in dhoolies, which are closed wooden carriages fixed on long poles and carried on men’s shoulders. The bearers convey the wounded in dandies, similar to dhoolies, but made mostly of canvas, so that they are much lighter. The courage of these bearers on the battlefield has often been praised. The old bearer caste is, however, rapidly dying out owing to the general discontinuance of the use of dhoolies. Thus the ambulance organization in India is entirely different from that in other parts of the British empire. The rank and file of the Royal Army Medical Corps are not employed there, although the medical officers are. The warrant and non-commissioned ranks are replaced by a most useful body of men of Anglo-Indian or Eurasian (half caste) birth, called the Subordinate Medical Department, the members of which, now called assistant surgeons (formerly apothecaries), receive a three years’ training in medical work at the Indian medical schools and are competent to perform the compounding of medicines and to deal with all but the most serious cases of injury and illness. In the hospitals the men of the Royal Army Medical Corps are replaced by the Native Army Hospital Corps, subdivided into ward-servants, cooks, water-carriers, sweepers and washermen. The caste system necessitates this division of labour, and the men are not so efficient or trustworthy as the white soldiers whose places they take. The bearers of the wounded are a separate and distinct class, partly attached to regiments, &c., as part of the regimental transport, and partly organized into bearer companies, attached to field hospitals. The dandies in which they carry the wounded are much more comfortable than stretchers, being fitted with roofs and sides of canvas to keep off sun and rain, thus being collapsible so that the dandy is quite flat when not in use. Still they are heavy, clumsy, and cannot be folded up into a small compass for transport like a stretcher; they also take up a good deal of room in wagons and can scarcely be carried on the backs of animals owing to the length of the pole. Hence riding ponies and mules are much used in Indian warfare, especially in the mountains, for the carriage of less seriously wounded men. In India separate hospitals are necessary for white and native troops, and the latter have accommodation for the large numbers of non-combatant