Medicine on the Western Front

Question 1

What was the trench system?

Answer 1

Trenches were first dug by the British and French Armies in Northern France in 1914. Their aim was to act as a barrier to stop the rapid advance of the German army. Trenches were different between places across the Western Front - not every soldier’s experience is the same. Roughly 475 miles long - English Channel to Swiss Alps.

Question 2

What is the: (cross-section of a trench)
- Firebay
-Duckboard
-Firestep
-Parapet
-Ammunition shelf
-Dugout

Answer 2

Firebay was where troops did shooting, they would be protected by sandbags.
Duckboards were to prevent soldiers from standing in water, preventing trench foot.
Firestep allows the soldiers to fire towards the other trench, trenches were 2.5m deep.
Parapet was a low protective wall.
Ammunition shelf was an area in which ammo was kept near the fireshelf.
Dugout was an area dug into the side of the trench where men could take protective cover.

Question 3

Trench system; The Frontline Trench

Answer 3

Frontline trench was where attacks were made from, the most dangerous area for a soldier to be. Only 15% of a soldier’s time was spent here.

Question 4

Trench system; The Support Trench

Answer 4

The Support Trench was located 80m behind the frontline trench, troops would retreat here if under attack. Only 10% of a soldier’s time was spent here.

Question 5

Trench system; The Reserve Trench

Answer 5

Reserve Trench located 100m behind the support trench, where troops would be mobilised to counter attack the enemy if they captured the front line. 30% of a soldiers time spent here.

Question 6

Trench System; The Communications Trench

Answer 6

The Communications Trenches ran between all other trenches, providing easy movement throughout the trench system.

Question 7

The Ypres Salient
(1914-1915)

Answer 7

1914: The First Battle of Ypres; In autumn, the Germans attacked the British positions around East and North East of Ypres. Britain kept Ypres but lost 50,000 troops.
Hill 60: Mines; The Germans held ‘Hill 60’ South-East of Ypres which gave them the height advantage over the British. In April 1915, British soldiers mined underneath the hill and literally blew up the German defences so the British were able to capture it.
1915: The Second Battle of Ypres; Between April to May 1915 the second battle began. It was the first time the Germans used Chlorine gas

Question 8

Where and what was the Regimental Aid Post? (RAP)

Answer 8

The regimental aid post was located in dug outs just behind the front line. Casualties would be given basic treatment before being sent further back for more thorough care. For the ‘Walking Wounded’. Towards the end of the war 67% were sent back to the front.

Question 9

Where and what was the Dressing Station?
(DS)

Answer 9

Between a 1/4 to 1 mile from the front line. Doctors would assess the severity of injuries and if necessary the soldiers would be sent off for further treatment. Could handle around 150 men but often in battles like Ypres (1917) they had 1,000 casualties per 2 days.

Question 10

Where and what was the Casualty Clearing Station? (CCS)

Answer 10

Located several miles from the front line, usually near railways or waterlines. Normally had minimum 50 beds, 150 stretchers and could care for 200. Later in the war they could hold between 500 and 1000 if need be. They were extremely well-equipped and in battles like Ypres treated over 200,000 casualties with only 4% dying. CCS treated the most critical injuries.

Question 11

Where and what was the Base Hospital?
(BH)

Answer 11

Situated near the ports of French/Belgian coast. Had operating theatres, x-ray machines, labs, even specialist centres for gas poisoning. Could treat up to 2,500 patients at once. Most patients were sent back to England with ‘Blighty Wounds’.

Question 12

The Somme
(1916)

Answer 12

The Somme was the largest British attack in WW1. There were huge casualties on both sides but majority for the British. Around 57,000 casualties and 20,000 dead on the first day alone. The Somme involved:
-First use of tanks - used but not effective
-Use of creeping barrage - artillery bombardment that moved towards the German trench as the British moved towards it.

Question 13

Arras
(1917)

Answer 13

The allies built over 2.5 miles of tunnels as shelter to prepare to attack. The tunnels could shelter around 25,000 men, containing accomodation, a railway, water and electrical supplies and a large hospital big enough for 700 beds. Initially the attack in April 1917 was successful as the British advanced 8 miles into enemy territory. However, by May the attack had virtually stopped with the allies suffering 160,000 casualties.

Question 14

Cambrai
(1917)

Answer 14

First large attack by British tanks to attack the German front line. Over 450 tanks were used. No artillery bombardment was used, which surprised the Germans. The British attack succeeded at first, assisted by tanks. Yet, the Germans counter-attacked after the British attack stopped. All land was taken by the British was lost.

Question 15

What was Trench Foot?

Answer 15

Trench foot was an extreme problem caused by standing in waterlogged trenches with no change of boots or socks. In the first stage, the feet would begin to swell, go numb and the skin would turn red or blue. It would get majorly worse overtime and led to gangrene and the amputation of limbs.
In the winter of 1914-1915 cases of trench foot were serious, the 27th division the British experienced 12,000 cases of trench foot.

Question 16

What were attempted solutions of Trench Foot?

Answer 16

To prevent the impact of Trench Foot, medical officers ordered soldiers to carry 3 pairs of socks and change them twice a day. They were encouraged to rub whale oil on their feet.
Attempts were made to pump out the trench to reduce waterlogging and add duckboards, but constant bombings made this difficult.

Question 17

What was Trench Fever?

Answer 17

Flu-like symptoms with high temperature, headache and aching muscles which was spread by lice. Men could be ill for months. Estimated by half a million men on Western Front were affected by trench fever.

Question 18

What were attempted solutions of Trench Fever?

Answer 18

Delousing stations were set up on the front; clothes were disinfected, men were bathed and sprayed with chemicals to prevent lice.
As a result of this, there was a decline in the numbers experiencing the condition.

Question 19

What was Shell Shock?

Answer 19

Symptoms included tiredness, headaches, nightmares, loss of speech, uncontrollable shaking and complete mental breakdown. Estimated around 80,000 British troops experienced Shell Shock. Called NYD,N (Not Yet Diagnosed, Nervous) as a code by the army.

Question 20

What were attempted solutions of Shell Shock?

Answer 20

This condition was not yet understood, some soldiers who experienced shell shock were accused of cowardice and any were punished, some even shot. Craiglockhart Hospital in Edinburgh dealt with 2,000 sufferers.

Question 21

Gas Attacks:
Chlorine: Ypres 1915
Phosgene: 1915
Mustard gas: 1917

Answer 21

Gas caused a great panic as soldiers were unprepared for it. It wasn’t a major cause of death. Only 6,000 soldiers died in WW1.

Chlorine: caused death by suffocation, before gas masks, soldiers soak cotton pads with urine and ammonia and pressed them to their face.
Phosgene: used at Ypres, much faster acting than chlorine, killed an exposed person within 2 days.
Mustard: Odourless gas that worked within 12 hours. Caused internal and external blisters and could pass through clothing to burn skin.

Question 22

What was the solution of gas attacks?

Answer 22

British soldiers were given Gas masks from July 1915, which became more sophisticated over time. But gas gangrene could not be cured and could often kill in a day.

Question 23

What were advantages of X-Rays?
(1895- Wilhelm Roentgen)

Answer 23

As early as 1896 radiology departments were set up, like Birmingham General Hospitals where Dr John Hall-Edwards was one of the first doctors to use x-rays to locate a needle in a woman’s hand.
Could identify shrapnel and bullets in the body, able to transport around the battlefield.

Question 24

Problems with X-Rays?

Answer 24

• health risks from x-rays weren’t understood. Radiation levels were 1,500 times stronger than those today, so patients could lose hair or suffer burns.
• Roentgens X-Ray machine contained a glass tube which is fragile
• X-Rays took about 90 minutes to complete, a long time
• BIg X-Ray machines were being developed but immovable

Question 25

What were Blood Transfusions?

Answer 25

James Blundell completed first experiments and developed techniques. Karl Landsteiner discovered blood groups (1901) O was the universal blood group.

Question 26

Problems with Blood Transfusions?

Answer 26

Blood could not yet be stored so had to be used to straight away and the donor of the blood had to be connected directly to the recipient of the blood.

Question 27

What did Francis Rous and J.R Turner?
(1916)

Answer 27

After Lawrence Robertson developed the syringe method (1915). Rous and Turner introduced a citrus-glucose solution that permits storage of blood for several days after collection. Allowing blood to be stored in containers for later transfusions with the vein-to-vein method