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Remembered Today:

illness as opposed to combat casualties.


Muerrisch

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It is known anecdotally that illness was a substantial factor in draining trench strength, but it was not well reported in the war diaries that I have consulted. The more conventional Killed Wounded Missing are totted up virtually daily, but one rarely [in my limited experience] sees a total for "hospitalised sick" or "sick being held at the unit".

Given frost, trench foot, extreme fatigue, colds, trench mouth, trench fever and the catch-all PUO, one does not need to invoke influenza or shell shock to drain bayonet strength.

As an example, and from memory [away from my material] 2nd RWF had about a dozen men in hospital within days of arriving in France August 1914. Apart from kissing a few mademoiselles [or worse] they were hardly at the sharp end as there was no sharp end at that time.

So please does anyone have access to "typical" sickness statistics, particularly early in the war?

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Grumpy good day,

You need the Battalion or Coy Field States, But like the proverbial Rocking Horse Poop hard to find, I have some if you want statistical information.

post-7039-0-17098300-1389462440_thumb.jp

Coy daily field State.

These are returns to the AG Office I do not know if these are available.

post-7039-0-70186100-1389462783_thumb.jp

Regards Charles

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From Lumley's history of the 11th Hussars, on 17th September 1914, the regiment had lost 10 o.r. kia, 2 officers and 13 o.r. wounded, 2 officers and 83 o.r. missing and 3 officers and 18 o.r. sick since the start of the campaig. (4 o.r. were in detention at the time, too!)

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So please does anyone have access to "typical" sickness statistics, particularly early in the war?

France and Flanders, 1914 :

Battle casualties : 98,866

Non- battle casualties : 78,557

Of the non-battle casualties, 60,610 were sick, of whom 372 died ; 17,947 were injured, of whom 136 died.

Source :

Official History of the War, Medical Services, Casualties and Medical Statistics, Table 4, page 122.

Phil (PJA)

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Many thanks, the period important to my current quest is the 1914 star qualifying period, so the 1914 medical stats are very useful.

Any unit - specific stats for the same period would be most helpful, too.

At first blush we are looking at a staggering 8 sick/injured to 10 battle casualties during the period.

So much for pre-embarkation medical inspections, and having an RMO with every unit.

This aspect seems to me to be neglected in the literature.

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So please does anyone have access to "typical" sickness statistics, particularly early in the war?

My daughter read and made notes on the war diary for the 2nd Battalion of the Royal Berkshire Regiment from 1914 onwards as part of her dissertation. She tells me that the diary separated sickness from wounded for about the first six months but that thereinafter no differentiation appears. Is that perhaps common?

If it was useful I could probably prevail on her to dig her notes out and see if she could come up with some stats for August to December 1914.

David

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I would much appreciate data from daughter please!

My previous in-depth knowledge of War Diaries was 2nd RWF, who never [from memory] included sick returns with their entries.

I am now ploughing through 1st RWF for a major project.

From March 1915, there are often sick returns, before March, nothing!

This is unfortunate because their strength calculated from initial Establishment, battle casualties and reinforcements comes to almost 1000 by the end of 1914 which is unbelievable, so the missing link is highly likely to be sickness and injury.

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Will do. She's a cracking historian but seriously rubbish at maths so I will be checking before we send them through!

She was telling me that the 2nd Berkshires came to the Western Front straight from India and that the change of climate plus the tropical diseases they brought with them accounted for the high sickness levels that plagued the battalion throughout the period.

David

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Not France & Flanders but 2nd Loyal North Lancashires suffered appalingly high levels of sickness during and after their arrival in East Africa in November 1914.

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I have now crunched the 1st RWF diary from embarkation October 1914 to the datum point of actual returns of 9 March 1915.

Officers’ start point is known numbers embarking. Officers running total from diary accounting for gains and losses and detached 25, actual return 25. This even accounts for two in-house commissioning. Officers are named.

Other ranks start point is War Establishment. ORs running total from diary 1175, actual return 954.

The discrepancy may not be as exact as a simple subtraction, because we do not know how the unit accounted for detached other ranks, TMB, Bde etc., but at first blush some 221 men were sick or injured. This assumes that none of the drafts received were recycled wounded or sick, so the logic is fuzzy.

It was ever thus.

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At first blush we are looking at a staggering 8 sick/injured to 10 battle casualties during the period.

.

These non battle casualties produced relatively minimal fatalities, though. It looks like a ratio of more than forty- indeed, approaching fifty - battle deaths for every death from disease or injury.

The source I've cited contains another table which gives a breakdown for the causes of admission in well over fifty thousand cases :

Local and general injuries....10,612, a ratio of 55.85 per 1,000 of ration strength

Diseases of the digestive system....10,594 ; 55.76

Rheumatic fever...7,950 ; 41.84

Frost bite....6,447 ; 33.93

Diseases of the organs of locomotion...5,328 ; 28.04

Diseases of the respiratory system...4,551 ; 23.95

Diseases of the areolar tissue....3,422 ; 18.01

Venereal Diseases....3,291 ; 17.32

Diseases of the teeth and gums...2,495 ; 13.13

A yet more elaborate table gives details of 74,714 admissions of non battle casualties, with the significant revelation that 72,832 ( 97.48%) were returned to duty.

Phil (PJA)

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Grumpy - The biggest challenge here is that while data for the number of sick and injured is known and we also know how long (on average) they stayed in hospital, we don't know how long they spent out of hospital recuperating before being sent back to their units and we don't know what proportion were sent to support units rather than their original battalion. Over 90% of non-battle casualties returned to duty.

The official data for sick and injured compiled at the end of the war in the Official History of the Medical services tended to be consolidated data for 1914-18. There are however some shnapshots of the data for 1914. Among the mountain of data in the History of the Medical services: Casualties and Statistics is the sick rate for France and Flanders in 1914:

35.6% of average ration strength were admitted to hospital sick.

Clearly, most of these men recovered (see below) and most were probably recycled when recovered. While the data for 1914 is not provided, there is some useful data on the recovery rates from an analysis of 1,043,653 British casualties admitted to medical units 1916-1920 that might provide a reference point - see pages 274- 279 of the MedStats. Some examples are shown below

1. Infantry Non-battle Casualties (Disease or Injury) represented 43.9% of Total (all Ranks)

2. Of the men suffering from disease or Injury, 91.78% returned to duty and 8.58% were discharged as invalids.

2. Periods in hospital (% of total)

a. 1 week and under......21.52%

b. 1-2 weeks..................19.61%

c. 2-4 weeks..................11.16%

d. 1 month.....................10.71%

e. 2 months...................16.66%

f. 3 months.....................7.75%

g. 3-6 months.................6.38%

h. 6-9 months.................1.10%

i. 9-12 months.................0.34%

j. 12 months....................0.02%

k. Over 12 months..........0.13%

l. Incomplete...................4.32%

So, slightly more than 50% of men spent less than 1 month in hospital and slightly more than 75% spent less than 2 months in hospital. The data does not reveal how quickly they returned to duty, or indeed how many returned to the same unit (some many have been diverted to support units). Later returns in Feb 1915 show hundreds of invalids on the books of the reserve units, indicating a proportion of men who had been discharged from hospital but who had not returned to the front. Again we do not know if they are recovering wounded or recovering sick or injured which further complicates things. This data does not start to be recorded until early 1915.

I suspect it will prove to be extremely difficult to establish reliable figures as the war diaries and published histories were not particularly good at recording non-battle casualties in 1914. One of the reasons for this is that Form Z only had columns for Killed, Wounded and Missing. There is a possibility that the ADMS diaries or the Div HQ Admin diaries will have some data. The Gallpoli diaries certainly have this kind of data, but the BEF diaries in 1914 might be rather different as the mobile campaign in the early months might have made record keeping more difficult.

MG

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From the History of the South Wales Borderers The Great War 1914-1918 page 87:

"...Captain Fowler again represented the "pre-war Regulars" now getting terribly scarce in most battalions of the Line. Practically all the "pre-war" enlisted men, whether serving soldiers, Regular Reservists or Special Reservse, had been exhausted by this time [first half of Dec 1914], and the drafts were largely composed of men enlisted since the beginning of the war, whose training, more particularly their musketry, was naturally not up to the the level of the "pr-war" men; a substantial proportion however were re-enlisted old soldiers, men who had finished their Reserve engagement but had hastened to rejoin the colours. Many had the South African medals and there was very good stuff among the veterans, but they also included others whose military knowledge was decidedly rusty and whose physique was not equal to the strain of trench-warfare in the swamps of Flanders. For men of 45 and upwards to have to stand for hours in water-logged trenches was much too severe and if the sick-rate during that winter was high it was partly because these willing veterans were undertaking hardships beyond their powers of endurance."

A footnote mentions:

"On November the 30th the battalion had mustered 13 Officers and 815 men, by December 20th it had risen to 21 Officers and 967 men (First Corps A&Q diary)”

Later on page 92, the history records after the action at Givenchy:

"...on the 24th [Dec] ....it came out of the trenches with 10 Officers and 553 men, having had 1 Officer (2nd Lt Owen) and 114 men killed and missing, six Officers and 99 men wounded."

Another footnote explains that

"The discrepancy between these figures and the total decrease in the battalion's strength and the total decrease in the battalion's strength since December 20th is to be accounted for by the very large number of men reporting 'sick' mostly with rheumatism or "trench-feet" after long exposure in water-logged trenches"

To save you the calculation:

.............................Officers......ORs

20th Dec:.................20.........967

24th Dec................10.........553

difference...............10........414

Of these, 7 Officers (1 KIA + 6 WIA) and 213 ORs (114 KIA/MIA + 99 WIA) were battle casualties, implying that in these four days alone, 3 Officers and 201 ORs went sick. - equivalent to 20.7% of the battalions strength on 20th Dec. Roughly speaking for every 2 battle casualties, the battalion lost a man as a non-battle casualty in this period.

A small snapshot that I suspect was fairly typical of the experiences of a Line Infantry battalion in Dec 1914. What is interesting is that as the attrition continued in late 1914, the gaps were being filled with men of either lower physical standard or lower levels of training compared to the men who landed in August 1914; there was in effect a gradual erosion of the standard of reinforcement.

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The history of the Gloucestershire Regiment, page 92

"On 23rd [Dec] the battalion set to work to etend and improve their trenches as far as possible. But on such ground the water and mud could not be overcome. To put a spade into the earth meant drawing water. The cold was intense which combined with wet weather resulted in appalling sickness from frost-bite and rheumatism. The stretcher bearers were continually at work, casualties occurring faster than they could be carried away. During the last week in december there must have been nearly two hundred cases."

Later (page 93) :

"Thus ended the operations of 1914. .....Their losses had been very heavy, in fact by the end of the year the battalion had been practically re-formed"

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The Somerset Light Infantry 1914-1919 - page 58

"The Diary of the 11th Inf Bde HQ for December 1914 contains some very interesting figures of approximate casualties incurred by all units of the Brigade from the time they landed in France in August to the end of the year. The figures concerning the 1st Somerset Light Infantry are illuminating. No less than 36 Officers and 1,153 other ranks ahd become casualties, whilst of the original Battalion which landed on 22nd August, only 4 Officers and 266 other ranks remained...... Of the 1,153 other ranks casualties, 131 had been killed, 434 wounded, 58 wounded and missing, 80 missing and 450 sick in hospital"

My underlining. To save you the calculation, 39% of recorded casualties were sick in hospital - roughly the same as the number of wounded.

Officer casualties were:

Killed:...............................8

Wounded:..................... 12

Wounded and Missing:....6

Hospital..........................10

I will try and dig up the 11th Inf Bde War Diary to get the data for the other three battalions. MG

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From page 35 of The West Yorkshire Regiment in the War 1914-1918 vol I: The passage relates to the beginning of January 1915

"In the 8th Division sickness was rife - the flooded nature of the ground and the constant rain creating ravages amongst the troops. The 2nd West Yorkshires had many men evacuated to hospital. Amongst the rank and file of the 23rd Infantry Brigade the casualties suffered from sickness since the 8th Division landed in France - only 2 months previously - were more than double the numbers sustained in actual warfare. The Brigade had evacuated fourteen Officers and 1,359 other ranks to hospital from sickness (of which five Officers and 338 other ranks were from the 2nd West Yorkshire R) : casualties in actual warfare were nine officers and thirteen wounded and 553 other ranks killed, wounded and missing."

2nd West Yorks landed on 5th Nov 1914. Roughly the equivalent of 37% of Other Ranks' war establishment were hospitalised within 2 months.
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The Worcestershire Regiment in the Great War records on page 53:

"Before the middle of December [1914] the [1st] Battalion had lost half its strength - over a hundred killed and wounded and more than four hundred disabled by severe frostbite"

A footnote records:

"The actual figures were as follows: - from 15th November to 13th December [1914]

Killed, 4 Officers [named], 35 other ranks.

Wounded, 1 officer [named] and 73 other ranks

Evacuated with severe frostbite, 4 Officers [named] and 436 other ranks.

Total 9 Officers and 544 other ranks....."

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Martin,

Martin G.

very illuminating quotations thank you.

By those examples, 1st RWF with my calculated sickness/ injury toll got away lightly, in contrast to their battle casualties. Worth reiterating perhaps that the scrap/log book of 3rd RWF is clear that it sent no war-enlisted men to the front until May 1915 [this has nothing to do with New Army men] and therefore the drafts sent after the reserve and the SR had been used up were the men under training or under-age as war broke out. We do know that there was a spike in the regiment's recruiting in the couple of years before the war: just as well.

But the figures shine a light in a dark corner, not very well explored in the past. One wonders what the sick rate per 1000 among adult males NOT in the military was in the same period ...... certainly not zero as any visit to a surgery would confirm!

I see peeping round the corner of the 1st battalion war diary that, later in the war, they attach as appendices men "to hospital" and "from". I shall report as and when.

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But the figures shine a light in a dark corner, not very well explored in the past. One wonders what the sick rate per 1000 among adult males NOT in the military was in the same period ...... certainly not zero as any visit to a surgery would confirm!

Since such a significant proportion of men were serving, the 'civilian' number is hugely distorted. The MedStats provides a sick ratio per 1,000 for the Regular Army in 1913 which was 437.7 which struck me as being was surprisingly high. the problem is that the data does not provide a breakdown of the types of sickness.

Tangentially related to this - There has been some remarkable work by demographers on mortality of the population and some rather interesting estimates of the effect of the War using historical data from Prudential Life. The are two methodologies which assume the civilian mortality rate in 1913 remained static (estimate A) or, alternatively assume the rate of pre-war decline in mortality continued through the war years (estimate B ). The actual numbers are then compared and the differences calculated as a percent. The table doe this calculation for every male age from 16 year-olds to 60 year-olds.

For 20 year-olds, mortality was 712% higher* using Estimate A assumptions and 751% higher using Estimate B assumptions. 20 year-olds were the age most impacted. I guess it is another way of saying they had the highest mortality in the Great War. Nearly every age-group from 17 year-olds upwards is impacted. One has to get to the 37 year-olds before we find an age-group where mortality rates are not impacted by the war. As you would expect there is a sharp rise from 16 year-olds to 20 year-olds and then a long decay in the excess mortality data from 21 year-olds to 37 year-olds.

Of the 20 year-olds, mortality was 712% higher. i.e. 7 times more men died that peacetime projections would have indicated.

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Reading further on this subject in the Regimental histories it is very clear that there is an extremely high correlation between the onset of cold, damp weather and sickness from November onwards. Most histories allude to this (although less than half give numbers). The Medstats indicate that rheumatism and related illnesses were some of the most dominant ailments (see post #12 above) and a few histories refer to what was later called 'trench foot'. Frostbite also gets mentioned more than a few times.

My sense is that the sick list rose exponentially from mid November onwards and continued to be a problem through Decemeber, January and February.

MG

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Hi,

Could I suggest that you have a look at the Admission and discharge books for No 3 CCS in MH106.

I think you will find them very useful.

The second book covers from 27/11/14 to 20/12/14. There are 32 lines of names to a page and in this volume only one out of the first four pages is a

GSW.

For example the first two casualties are

28/11/14 ASC 1st CAV DIV 464 Pte Halstead H Scabies to duty 1/12/14

28/11/14 1/L N Lancs 6533 Pte Fowden T indigestion to duty 29/11

These volumes will give you a lot of info but there are 103 books covering from 11/14 to 23/1/19

Only five cover 1914.With around 1200 men mentioned in each book.

regards

John

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Hi,

Could I suggest that you have a look at the Admission and discharge books for No 3 CCS in MH106.

I think you will find them very useful.

The second book covers from 27/11/14 to 20/12/14. There are 32 lines of names to a page and in this volume only one out of the first four pages is a

GSW.

For example the first two casualties are

28/11/14 ASC 1st CAV DIV 464 Pte Halstead H Scabies to duty 1/12/14

28/11/14 1/L N Lancs 6533 Pte Fowden T indigestion to duty 29/11

These volumes will give you a lot of info but there are 103 books covering from 11/14 to 23/1/19

Only five cover 1914.With around 1200 men mentioned in each book.

regards

John

John

I assume these are at The National Archives...any idea what the refs no.s are?

MG

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Hi,

They are MH106 281 through to MH106 384. Below is the number of men and regiment admitted in Book MH106 282.

Regt Grand Total A CYCLIST CORPS 5 A S C 56 A V C 1 B WATCH 48 BEDFORDS 1 CAM HDRS 30 COLDM GDS 44 FRENCH ARMY 1 GLOSTER 22 GLOSTERS 31 GREN GDS 5 HERTS 2 HUSSARS 8 IRISH GDS 3 K R R C 50 L N LANCS 87 LEICESTER YEO 2 LIFE GDS 7 LONDON SCOTT 43 M F P 1 NORTHANTS 107 O&BLI 1 QUEENS 1 R DGNS 1 R DRAGOONS 1 R ENG 32 R F A 213 R FA 3 R G A 20 R H A 9 R M FUS 29 R SUSSEX 150 R W SURREY 20 RAMC 34 RGA 1 S I RISH HORSE 1 S IRISH HORSE 10 S STAFFS 1 S W BORDERERS 60 SCOTS GDS 32 W RIDING REGT 1 WELSH 24 WORCESTER 1 WORCESTERS 1

1200

When posted that was a good spread sheet.

Regards

John

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