With the possible exception of Germany, which seems to have anticipated everything, no one of the nations engaged appears to have expected the fearful carnage of this war. The destructive effect of the modern, high-explosive shell has been well known, but it is the trench form of warfare which, by keeping troops in stationary positions, under grilling artillery fire, has given such shells their opportunity. Shrapnel has not been so deadly to the men in the trenches.
The result of the vast casualty lists has been some hundreds of isolated hospitals scattered through France, not affiliated with any of the Red Cross societies, unorganised, poverty-stricken, frequently having only the services of a surgeon who can come but once a week. They have no dressings, no nurses save peasants, no bedding, no coal to cook even the scanty food that the villagers can spare.
No coal, for France is facing a coal famine to-day. Her coal mines are in the territory held by the Germans. Even if she had the mines, where would she get men to labour in them, or trains to transport the coal?
There are more than three hundred such hospitals scattered through isolated French villages, hospitals where everything is needed. For whatever else held fast during the first year of the war, the nursing system of France absolutely failed. Some six hundred miles of hospital wards there are to-day in France, with cots so close together that one can hardly step between. It is true that with the passing of time, the first chaos is giving way to order. But France, unlike England, has the enemy within her boundaries, on her soil. Her every resource is taxed. And the need is still great.
The story of the town of D----, in Brittany, is very typical of what the war has brought into many isolated communities.
D---- is a little town of two thousand inhabitants, with a thirteenth-century church, with mediaeval houses with quaint stone porticoes and outside staircases. There is one street, shaped like a sickle, with a handle that is the station road.
War was declared and the men of D---- went away. The women and children brought in the harvest, and waited for news. What little came was discouraging.
One day in August one of the rare trains stopped at the station, and an inspector got off and walked up the sickle-handle to the schoolhouse. He looked about and made the comment that it would hold eighty beds. Whereupon he went away, and D---- waited for news and gathered the harvest.
On the fifth of September, 1914, the terrific battle of the Marne commenced. The French strategic retreat was at an end, and with her allies France resumed the offensive. What happened in the little village of D----?
And remember that D---- is only one of hundreds of tiny interior towns. D---- has never heard of the Red Cross, but D---- venerated, in its thirteenth-century church, the Cross of Christ.
This is what happened:
One day in the first week of September a train drew up at the box-like station, a heterogeneous train--coaches, luggage vans, cattle and horse cars. The doors opened, and the work of emptying the cars began. The women and children, aghast and bewildered, ran down the sickle-handle road and watched. Four hundred wounded men were taken out of the cars, laid prone on the station platform, and the train went on.
There were no surgeons in D----, but there was a chemist who knew something of medicine and who, for one reason or another, had not been called to the ranks. There were no horses to draw carts. There was nothing.
The chemist was a man of action. Very soon the sickle and the old church saw a curious sight. They saw women and children, a procession, pushing wounded men to the school in the hand carts that country people use for milk cans and produce. They saw brawny peasant women carrying chairs in which sat injured men with lolling heads and sunken eyes.
Bales of straw were brought into the school. Tender, if unaccustomed, hands washed fearful wounds, but there were no dressings, no bandages.
Any one who knows the French peasant and his poverty will realise the plight of the little town. The peasant has no reserves of supplies. Life is reduced to its simplest elements. There is nothing that is not in use.
D---- solved part of its problem by giving up its own wooden beds to the soldiers. It tore up its small stock of linen, its towels, its dusters; but the problem of food remained.
There was a tiny stove, on which the three or four teachers of the school had been accustomed to cook their midday meal. There was no coal, only wood, and green wood at that. All day, and all day now, D---- cooks the pot-a-feu for the wounded on that tiny stove. Pot-a-feu is good diet for convalescents, but the "light diets" must have eggs, broth, whatever can be found.
So the peasant woman of D---- comes to the hospital, bringing a few eggs, the midday meal of her family, who will do without.
I have spoken mainly in the past tense, but conditions in D---- are not greatly changed to-day. An old marquise, impoverished by the war, darns the pathetic socks of the wounded men and mends their uniforms. At the last report I received, the corridors and schoolrooms were still filled--every inch of space--with a motley collection of beds, on which men lay in their uniforms, for lack of other clothing. They were covered with old patchwork quilts, with anything that can be used. There were, of course, no sheets. All the sheets were used long ago for dressings. A friend of mine there recently saw a soldier with one leg, in the kitchen, rolling wretched scraps and dusters for bandages. There was no way to sterilise them, of course. Once a week a surgeon comes. When he goes away he takes his instruments with him.
This is not an isolated case, nor an exaggerated one. There are things I do not care to publish. Three hundred and more such hospitals are known. The French Government pays, or will pay, twenty-five cents a day to keep these men. Black bread and pot-a-feu is all that can be managed on that amount.
Convalescents sit up in bed and painfully unravel their tattered socks for wool. They tie the bits together, often two or three inches in length, and knit new feet in old socks, or--when they secure enough--new socks. For the Germans hold the wool cities of France. Ordinarily worsted costs eighteen and nineteen francs in Dinard and Saint Malo, or from three dollars and sixty cents to three dollars and eighty cents a pound. Much of the government reserves of woollen underwear for the soldiers was in the captured towns, and German prisoners have been found wearing woollens with the French Government stamp.
Every sort of building is being used for these isolated hospitals--garages, town halls, private dwellings, schools. At first they had no chloroform, no instruments. There are cases on record where automobile tools were used in emergency, kitchen knives, saws, anything. In one case, last spring, two hundred convalescents, leaving one of these hospitals on a cold day in March, were called back, on the arrival of a hundred freshly wounded men, that every superfluous bandage on their wounds might be removed, to be used again.
Naturally, depending entirely on the unskilled nursing of the village women, much that we regard as fundamental in hospital practice is ignored. Wounded men, typhoid and scarlet fever cases are found in the same wards. In one isolated town a single clinical thermometer is obliged to serve for sixty typhoid and scarlet fever patients.[F]
[Footnote F: Written in June, 1915.]
Sometimes the men in these isolated and ill-equipped refuges realise the horror and hopelessness of their situation. The nights are particularly bad. Any one who knows hospitals well, knows the night terrors of the wards; knows, too, the contagion of excitement that proceeds from a hysterical or delirious patient.
In some of these lonely hospitals hell breaks loose at night. The peasant women must sleep. Even the tireless nuns cannot labour forever without rest. The men have come from battlefields of infinite horror. A frenzied dream, a delirious soldier calling them to the charge, and panic rages.
To offset these horrors of the night the peasants have, here and there, resorted to music. It is naive, pathetic. Where there is a piano it is moved into the school, or garage, or whatever the building may be, and at twilight a nun or a volunteer musician plays quietly, to soothe the men to sleep. In one or two towns a village band, or perhaps a lone cornetist, plays in the street outside.
So the days go on, and the nights. Supplies are begged for and do not always come. Dressings are washed, to be used again and again.
An attempt is now being made to better these conditions. A Frenchwoman helping in one of these hospitals, and driven almost to madness by the outcries of men and boys undergoing operations without anaesthetics, found her appeals for help unanswered. She decided to go to England to ask her friends there for chloroform, and to take it back on the next boat. She was successful. She carried back with her, on numerous journeys, dressings, chloroform, cotton, even a few instruments. She is still doing this work. Others interested in isolated hospitals, hearing of her success, appealed to her; and now regular, if small, shipments of chloroform and dressings are going across the Channel.
Americans willing to take their own cars, and willing to work, will find plenty to do in distributing such supplies over there. A request has come to me to find such Americans. Surgeons who can spare a scalpel, an artery clip or two, ligatures--catgut or silk--and forceps, may be certain of having them used at once. Bandages rolled by kindly American hands will not lie unclaimed on the quay at Havre or Calais.
So many things about these little hospitals of France are touching, without having any particular connection. There was a surgeon in one of these isolated villages, with an X-ray machine but no gloves or lead screen to protect himself. He worked on, using the deadly rays to locate pieces of shell, bullets and shrapnel, and knowing all the time what would happen. He has lost both hands.
Since my return to America the problems of those who care for the sick and wounded have been further complicated, among the Allies, by the inhuman use of asphyxiating gases.
Sir John French says of these gases:
"The effect of this poison is not merely disabling, or even painlessly fatal, as suggested in the German press. Those of its victims who do not succumb on the field and who can be brought into hospitals suffer acutely and, in a large proportion of cases, die a painful and lingering death. Those who survive are in little better case, as the injury to their lungs appears to be of a permanent character and reduces them to a condition that points to their being invalids for life."
I have received from the front one of the respirators given out to the troops to be used when the gas clouds appear.
"It is prepared with hypophosphite of soda," wrote the surgeon who sent it, "and all they have to do before putting it on is to dip it in the water in the trenches. They are all supplied in addition with goggles, which are worn on their caps,"
This is from the same letter:
"That night a German soldier was brought in wounded, and jolly glad he was to be taken. He told us he had been turned down three times for phthisis--tuberculosis--and then in the end was called up and put into the trenches after eight weeks' training. All of which is very significant. Another wounded German told the men at the ambulance that they must move on as soon as they could, as very soon the Germans would be in Calais.
"All the German soldiers write home now on the official cards, which have Calais printed on the top of them!"
Not all. I have before me a card from a German officer in the trenches in France. It is a good-natured bit of raillery, with something of grimness underneath.
"'I nibble them'--Joffre. See your article in the Saturday Evening Post of May 29th, 1915. Really, Joffre has had time! It is September now, and we are not nibbled yet. Still we stand deep in France. Au revoir a Paris, Madame."
He signs it "Yours truly," and then his name.
Not Calais, then, but Paris!
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