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KernelPanic

Procedures for diagnosing and treating a non-combat related illness?

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KernelPanic

To whom would a soldier who was located behind the front line report in the event of illness? I'm particularly interested how this occurred in the Ypres area in 1915/early 1916.

 

I'm thinking of infections, GI problems, malaise, that sort of thing rather than problems directly related to combat injuries. Would he first report his problem to his superior? Where did he go from there?  A nearby CCS? Were there Divisional medical staff who 'did the rounds' in billets and rest areas? Just wondering what the standard procedure was.

 

They seem like simple questions, but I'm at a bit of a loss finding answers. 

 

Thanks.

Edited by KernelPanic

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MrSwan

The general policy was to keep the man as close to his unit as possible. Assuming a routine tour of the trenches, the procedure was that following the morning stand-to, when all ranks manned their posts, there would be the opportunity to report to the regimental medical officer in the regimental aid post. He had limited facilities for treatment, generally the tablets and ointments of the field medical pannier. In most cases the man would be sent to the nearest advanced dressing station of the RAMC field ambulance. In addition to the casualty clearing function for which they are better known, these units (depending on location) would often have a tented section for the treatment of minor illnesses and conditions which could be resolved within two to three days, with care provided by RAMC orderlies.

 

Quite often the advanced dressing station was too close to the front and in primitive conditions, in which case the man would be sent to the field ambulance's main dressing station, situated a few miles back. These were permitted to retain men for up to a week. Nursing care was provided by the men of the RAMC. 

 

With appropriate rest and treatment the man could be sent back to his unit, which might have completed its tour in the frontline but would be in the local area.

 

In the context of Ypres a man with a head cold might be sent to an ADS on the Canal Bank (notably Essex Farm) and perhaps back to the MDS located in Vlamertinghe Mill (just one example)..

 

Clearly more serious conditions, such appendicitis, for example, the man might have his appendix removed at the ADS but then be sent further back still to a CCS to recuperate.

 

This system applied also to units in the rear areas. It is not often appreciated that the RAMC field ambulances were on permanent duty, whether in the front line or not, and constantly received the "sick, lame and lazy" of the units in the division they served. 

 

If you are able to obtain the war diaries of a field ambulance you will see that they regularly report the numbers of sickness cases along with casualties.

 

 

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KernelPanic
10 hours ago, MrSwan said:

The general policy was to keep the man as close to his unit as possible. Assuming a routine tour of the trenches, the procedure was that following the morning stand-to, when all ranks manned their posts, there would be the opportunity to report to the regimental medical officer in the regimental aid post. He had limited facilities for treatment, generally the tablets and ointments of the field medical pannier. In most cases the man would be sent to the nearest advanced dressing station of the RAMC field ambulance. In addition to the casualty clearing function for which they are better known, these units (depending on location) would often have a tented section for the treatment of minor illnesses and conditions which could be resolved within two to three days, with care provided by RAMC orderlies.

 

Quite often the advanced dressing station was too close to the front and in primitive conditions, in which case the man would be sent to the field ambulance's main dressing station, situated a few miles back. These were permitted to retain men for up to a week. Nursing care was provided by the men of the RAMC. 

 

With appropriate rest and treatment the man could be sent back to his unit, which might have completed its tour in the frontline but would be in the local area.

 

In the context of Ypres a man with a head cold might be sent to an ADS on the Canal Bank (notably Essex Farm) and perhaps back to the MDS located in Vlamertinghe Mill (just one example)..

 

Clearly more serious conditions, such appendicitis, for example, the man might have his appendix removed at the ADS but then be sent further back still to a CCS to recuperate.

 

This system applied also to units in the rear areas. It is not often appreciated that the RAMC field ambulances were on permanent duty, whether in the front line or not, and constantly received the "sick, lame and lazy" of the units in the division they served. 

 

If you are able to obtain the war diaries of a field ambulance you will see that they regularly report the numbers of sickness cases along with casualties.

 

Many thanks for taking the time to give an extensive and interesting answer. Much appreciated.

 

My interest in getting an overview of these procedures is to try and figure out what might have been the evacuation route my great grandfather would have taken with a couple of medical issues. He was an ASC HT Driver in the 50th Division 1915/1916, probably spending most of his time in the Divisional Train (his service record is lost).

 

He was hospitalized with scabies in late December 1915 in the 4th Stationary Hospital at Arques and then returned to his unit. But soon after in early January 1916 he was in hospital at Etaples with nephritis. He then was evacuated to England and very likely never returned to the 50th.

 

The 50th Division ADMS WD documents substantial numbers of scabies cases in the Division during December 1915, and presumably my great grandfather was one of these. This diary is one of the more interesting ones I’ve read, and provides a lot of information about how the RAMC tried--and often succeeded--to maintain soldiers’ health in very trying conditions. 

 

I also have the WD of the 1st Northumbrian Field Ambulance and as you say, it reports daily numbers for wounded and sick. From this I assumed that these units dealt with sickness, but I was curious how sick soldiers ended up being seen by RAMC personnel. From what you say, his route to Arques and later Etaples was likely through the nearest ADS, MDS, or CCS run by one of the 50th's Field Ambulances.

Edited by KernelPanic

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TEW

I'm not so sure that sick would be sent to or treated at a dressing station especially if the MO suspected something contagious.

Field Ambulances of the Division or possibly the Corps may have had a unit set up for intake of sick only. Once scabies had been confirmed then there would have been a designated CCS (or part of one) set up as an infectious unit.

If 50th division had numerous scabies cases then the CCS may had a scabies specific wing to deal with it.

TEW

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KernelPanic

It makes sense that you wouldn't want to mix infection cases with soldiers who had combat wounds. 

 

The 50th Division's outbreak of scabies occurred early Dec 1915 through to early Jan 1916. I took another look at the ADMS WD, and they record over 400 cases in the daily returns in mid-December. The outbreak seems to have died down by early January, 

 

Also didn't notice before that the WD mentions about soldiers reporting (or not reporting) their ailments at medical inspection parades. Also how the Division arranged with the 2nd Corps DDMS for the cases to go to Nos. 3 (Bailleul?) and then 50 (Hazebrouk?) CCSs. Maybe my Great Grandfather was moved along these routes on his way to Arques. He was recorded arriving there on December 23rd, so I presume he reported sick to his unit a few days earlier.

 

50th Divn, ADMS WD Dec 1915. Crown Copyright. 

ADMS 3.jpg

Edited by KernelPanic

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TEW

I can check the CCS and 2 Corps diary tomorrow and see what they say.

The "other rest stations" which had the scabies cases mentioned in 50 ADMS  diary should be identifiable in one of the Northumbrian field ambulance diaries.

It became common practise from spring of 1915 to have a sub-group of a FA set up specifically for sick and/or infectious cases of each division. When required a larger unit would be created possibly at corps level which could be termed disease specific EG Corps Scabies Station.

Interesting that their FAs went off to relieve those from 9 Division, perhaps 9 Div. FAs took over the 'other rest stations' with the scabies cases, potentially more diaries to check?

I would have thought that a scabies specific unit would have cured his scabies and returned him to duty. Perhaps something else going on to warrant a stay in  base hospital?

TEW

 

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TEW

I’ve checked the diaries for; 2 Corps DDMS, 5 Corps DDMS, 3 CCS & 50 CCS.

 

50th Division was with 2 Corps until 21/12/15 according to 2 Corps Diary. 5 Corps dairy says 50th Division arrived 18/12/15. 2 Corps has maps of dispositions for medical units for 1/12/15 and same for 1/1/16, positions almost identical but manned by different units. 1/12/15 shows three rest stations being run by 65, 77 Field Ambulances and a 50th Division Rest Station based at 3 CCS Bailleul. The Northumbrian field ambulances were running 5 different dressing stations presumably for wounded.

 

2 Corps also has tables for weekly sick admissions to FAs for each division, these are dated 4/12/15, 11/12/15 and 18/12/15. It seems they also had cases of frostbite and trench foot that show in the figures but as an example for 11/12/15 the table shows;

 

50th Division. 462 admitted, 60 evacuated to CCS

21st Division. 299 admitted, 103 evacuated to CCS.

 

Not sure why 21st Division were evacuating a higher percentage of cases to CCS but this is consistent throughout December 1915.

 

For December the diary also has a 2 corps scabies chart which shows a peak of 108 cases for 50th Division 12/12/15. NB this shows the scabies to be prevalent in 50th Division (in blue)

 

scabies.jpg.22a0565d6a7d69d394b5cb8163df1231.jpg

Image sourced from National Archives WO95/658/3

 

5 Corps diary mentions the need for a Thresher Disinfector for 50th Division on 16/12/15. These are normally used for de-lousing clothes or for removing gas deposits.

 

Same diary shows 2/2 Northumbrian FA running a Divisional Rest Station, 1 NFA a Dressing station in Vlamertinghe and 3 NFA running an ADS at Maple Cross and another post in Railway Dugouts.

24/12/15, the diary mentions a Scabies Hospital in Hazebrouck which I’m certain is run by 50 CCS.

 

Diary for 3 CCS suggests it ran the 50th Div. Rest Station from 5/12/15. It may sound odd but they were evacuating sick to either 3 CCS or 50 CCS. 50 CCS set up in Hazebrouck around June 1915 and had a variety of buildings and grounds for different purposes. They had units for; infectious, venereal, scarlet fever, mumps and skin disorders. They only give daily totals for admissions or discharges and no evacuation details given. 3 CCS mentions 86 scabies cases being evacuated to 50 CCS 23/12/15, this is probably when it closed as 50th DRS. Otherwise there are admissions, discharges (to duty or to CCS) throughout December.

 

The ‘normal’ part of 3 CCS seems to have been evacuating mainly to Arques throughout December.

 

So, either he was admitted to the 50th DRS then discharged to 3 CCS (perhaps just to be evacuated to Arques). Or admitted to 50th DRS then discharged to 50 CCS who then moved him to Arques.

 

Given that 50th DRS had daily discharges to 3 CCS who had almost daily evacuations to Arques I think that may be the most likely route. Although 50 CCS is noted as a Scabies Hospital 50th DRS only evacuated on three days of the month as opposed to almost everyday for 3 CCS.

TEW

 

Edited by TEW
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KernelPanic

That’s a lot of interesting information!

Thanks for checking the Corps DMS and the CCSs diaries. I hadn’t thought of looking at those. I should do that for more info and particularly for the maps.

 

I took a look at the 1stNorthumberland FA, and it gives some info for late November/December about the scabies hospital in Hazebrouk being full and the cases being kept by the FA at Caestre. Sounds like the RAMC was a bit overwhelmed at this time by all these cases. Also some interesting descriptions in the ADMS WD of how soldiers were reluctant to report scabies, and how the Division was receiving new recruits already infected. 

 

Your suggested evacuation route for my GGF makes sense. I suppose if he arrived at Arques on the 23rd, (via the ‘Sick Convoy’ according to his MH 106 transcript) he must have first reported the scabies 2-3 days earlier. 

 

On 20/10/2019 at 15:50, TEW said:

I would have thought that a scabies specific unit would have cured his scabies and returned him to duty. Perhaps something else going on to warrant a stay in  base hospital?

 

This same transcript said he returned to duty on Jan 2nd. But he was then admitted to base hospital at Etaples just over a week later on Jan 10th with nephritis. So yes, the short gap between the two hospital visits suggests his nephritis was already evident along with the scabies. Maybe they first diagnosed it in Arques?

 

I find exploring all of this non-combat related medical treatment is fascinating. It shows how hard the RAMC worked to try and maintain soldiers health. 

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TEW

I find the non-ancestry medical diaries EG Army, Corps, CCS, MAC, Ambulance Train, Bases, Hospitals & Ships full of an incredible amount of info. They can sometimes all link up with the Division and FA diaries to show an evacuation process in a lot of detail.

TEW

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KernelPanic

Looks like I've got some interesting digging and reading to do.

 

Quick question: EG (?) Army.

 

Thanks again for all the useful pointers and info.

 

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TEW

At army level (1st, 2nd, 3rd, 4th, reserve & 5th) there are DMS diaries, Director Medical Services. At corps level DDMS, Deputy Director Medical Services.

TEW

 

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