The experience of Japan had not passed unnoticed by other nations. In Britain, however, there is little room, for doubt that the process of improvement had not been carried far enough. She went into the Great War of 1914 with a medical service which lacked nothing so far as personnel was concerned but which lacked many things in respect of the demands which were soon to be made upon its equipment. To some extent this was inevitable, So long a time had elapsed since the last great European War that the conditions of war in a temperate climate and upon a highly cultivated soil were not fully appreciated. Moreover in the interval between 1870 and 1914 surgery and preventive medicine had become new sciences.
It was scarcely possible to foresee exactly what the relationship between war and medicine would be or what new demands the new conditions might make. No one, for example, foresaw the important role which the soil of Europe was to play in the infection of wounds: the need for the rapid evacuation of immense numbers of wounded men which arose early in the campaign was not fully provided for: nor was it thought probable that every branch of medicine from massage to dentist try would-be requisitioned before the war had lasted eight months. There was a tendency—no doubt the result of experience in South Africa—to regard war surgery as a straightforward business concerned chiefly with the dressing of wounds.
Sherwood Ranken R.A.M.C., a fellow student of my own. His leg was shattered whilst attending to wounded on the battlefield—he arrested the bleeding, bandaged his wounds and then continued to dress the wounds of his men, sacrificing his chances of salvation to their needs—he died shortly after he finally allowed himself to be carried to the rear.
The first impressions of the effects of modern shell fire obtained in these battles astonished the medical world and speedily convinced the authorities that drastic change: were necessary in transport and hospital accommodation. The soil of France introduced new and terrible complications into war surgery—wounds arriving in England practically untreated since the first battlefield dressing were found to be infected with organisms from the soil amongst which lockjaw or tetanus and gas gangrene were too frequent. It became abundantly clear that a long railway journey in circumstances which precluded proper surgical attention was fatal to the recovery of the soldiers and that urgent measures were necessary to guard against the peril of tetanus. A change for the better was very soon seen—dressing stations were established on the railways—these were established by the British Red Cross Society which thus as early as September 1914 came prominently into public notice, a prominence which it has rightly retained ever since.
Text read from the printed page and cleaned; old type leaves the occasional error.