On the Fringe of the Great Fight Part 12

1. _To D.D.M.S. J. Corps._

In accordance with your 1w/ER, 16 of 1/2/3, a rat is being sent from trench x.y.z. to No. 1 mobile laboratory at ----.

(Signed) A.D.M.S. K. Div.

2. _To O.C. No. 1 Mobile Laboratory._

Please let me know the result of your examination of this rat.

(Signed) D.M.S. Z Army.

3. _D.M.S. Z Army._

I have not received this rat.

(Signed) O.C. No. 1 Mobile Lab'y.

4. _To D.D.M.S. J. Corps._

With reference to attached, will you please say what has become of this rat.

(Signed) D.M.S. Z Army.

5. _To D.M.S. Z Army._

It has been sent to Canadian laboratory and report has been called for.

(Signed) D.D.M.S. J. Corps.

6. _To O.C. (Canadian) Mobile Laboratory._

Will you please let me know the result of your examination of this rat.

(Signed) D.M.S. Z Army.

7. _To D.M.S. Z Army._

This rat was quite normal and had evidently been killed by a blow. The report was forwarded to A.D.M.S. K. Div.

(Signed) O.C. No. 5 (Can.) Mobile Lab.

Even a partly decomposed rat was unable to escape the army system.

CHAPTER XI

LABORATORY WORK IN THE FIELD.

With the medical organization of the army in mind it may be seen that a small mobile laboratory might be of great practical service to the army in the field. Under the conditions which exist in the present war, the army itself is not very mobile, nor is it necessary for the laboratory to be, but it is of great importance to have a car which will permit of the area being covered quickly should a specimen, sample or investigation be required. The car is the really essential mobile part of the unit.

Our laboratory had charge of both the bacteriological and hygiene work of a given area; it was the only laboratory that did both types of work. When our apparatus had been unpacked and set up in the old ball room of the Hotel de Ville it made quite an imposing show, and after we saw what equipment the other laboratories had we were decidedly proud of ours.

Our first bit of work proved to be the examination of a number of soldiers who had been in contact with a case of cerebro-spinal meningitis, to detect "carriers" of the specific germ. Then material of all sorts began to come in for examination from the casualty clearing stations, field ambulances, sanitary and medical officers, rest stations and other places. Most of the routine bacteriological work proved to be of much the same nature as that done in a health laboratory at home, and consisted of examinations to detect some of the ordinary communicable diseases such as diphtheria, cerebro-spinal meningitis, typhoid fever, malaria, dysentery, tuberculosis, and venereal diseases.

Should a case of diphtheria, for example, be found in a soldier, all his immediate friends and companions with whom he had been in contact, would be swabbed to see whether they were infected. Those found to be infected would be removed from the army at once.

In a case of suspected typhoid fever the examination of serum, blood and excreta would be necessary to determine whether the case were really typhoid or not. If found to be typhoid the laboratory would be called upon to try to discover the source of the infection. The same general methods hold good in other epidemic diseases where the laboratory is capable of making the diagnosis, to see whether any danger lurks in "contacts" or "carriers" and to find the source of the infection where possible.

Very frequently material from wounds is sent in by the hospital surgeons to see whether wounds are infected. The soil of Flanders has been liberally manured for hundreds of years, and in every cubic yard of this manured soil are millions of the germs which cause gas gangrene and teta.n.u.s (lock-jaw) when introduced beneath the skin. If a wound is infected with gas gangrene or other dangerous organisms, the knowledge that they are present may materially modify the treatment used by the surgeon, and the laboratory is of value to him sometimes in determining that point.

The usual routine work of a hospital clinical laboratory was also carried on by us for the casualty clearing stations in the area, and all kinds of work from the making of a vaccine for the treatment of bronchitis in a British General to the inoculation of a civilian child with anti-meningitis serum came within our scope.

The hygiene work of the laboratory is also of a varied character: It consists of the examination of water supplies, milk and foods; the detection of poisons in water, and, occasionally, in human beings; the evolving of methods to purify effluents discharged into streams; work on poison gases and methods used to combat these, and many other things.

In each division there are some sixty water carts, each of which holds about 110 gallons. We attempted to get samples from all of these in turn, to see whether the water had been disinfected. As all the sources of water supply in Flanders, with few exceptions, contain large numbers of bacteria, and as a properly chlorinated water contains very few bacteria, it is easy to tell from a couple of simple tests whether or not the water in the carts has been chlorinated.

As we sometimes had eight divisions in our area at one time, this water control meant a good deal of work. The water carts were usually to be found at the headquarters of the unit to which they belonged, and we quickly discovered that the way to get the largest number of water samples in the shortest time was to travel by the map up and down the twisting narrow roads which intersected each other as though following the trails of the original inhabitants.

It must be remembered that four or five miles behind the front line every farm house and barn is in use most of the time for billeting soldiers, and that these farm houses are infinitely more numerous than they are in America. Little villages and towns are very frequent and many of them bear the same name as other towns and villages a few miles apart. Thus there are at least two Bailleuls, two Givenchys, two Neuve Eglises and so on. In our quest of these water carts we had to search the countryside diligently and we averaged a great many miles a day; we soon got to know every road and almost every farm house in our area.

When a cart was found it was necessary to get the man in charge of it--the water detail--in order to obtain information as to the source of supply, the amount of chlorine used, whether there had been complaints of taste and so forth. While the information was being obtained, officers of the unit would often come out to see what the trouble was and would ask questions; possibly some non-coms and men would also gather about, and the first thing we knew would be giving, to a very interested audience, a little lecture on the dangers of drinking untreated water; their interest would be greatly increased if a bottle filled with the water, to which a couple of drops of solution had been added, turned bright blue, thus showing the presence of the free chlorine. By such means a good deal of practical educational work was done, and the danger of men drinking raw water thereby reduced.

Reports of all samples were sent to the A.D.M.S. of the division concerned, who forwarded them to the medical officers of the units, with more or less caustic remarks should the samples be bad. The M.O.

in turn would get after the man in charge of the water cart, who usually had some more or less plausible excuse.

The water details of the first Canadian Division were the best trained lot of men we ever ran across. The very first day we took samples from their water carts they were all sterile, and there were no complaints about taste. It was an excellent example of what training could accomplish, for they had all been carefully trained in their duties in Canada and England.

As the water details of any division were constantly changing, the efficiency of the treatment depended to a great extent on the constant supervision of the problem by the A.D.M.S., medical and sanitary officers.

We have found divisions coming into our area for the first time with only 25 per cent. of their water carts chlorinated, whereas before they left they would have 90 per cent. or more chlorinated, and the division thoroughly educated as to the necessity for sterilizing their drinking water properly.

Wells, springs, creeks, and ponds used as sources of supply were also examined, and not infrequently samples from "springs," encountered while digging new trenches, were sent in to be tested. The tremendous number of bacteria found in some of these "spring" samples we on several occasions reported as indicating the presence of buried animal matter in the immediate vicinity of the springs, and resulted in finding this to be correct. In one case in which a badly polluted water was so reported upon, the burial place of some fifty Germans was found only a few feet away.

One suspected epidemic of dysentery was a typically water borne infection which did not prove to be the real thing. Half of one company was in a front line trench and half in support. Part of the one section took their drinking water from a shallow well near at hand without treating it, and practically every one who drank it, thirty-one in all, came down with typical symptoms of dysentery, while all the others who did not drink it raw escaped. The well water was found to be badly polluted. The sick were all quite well in four or five days, and able to return to the front line, but it proved to be an excellent lesson in hygiene to that Division.

A curious phenomenon in connection with the army water supply was noted that first spring in Flanders. The flat surface of the country in our area consisted of a very tenacious clay, and the farm wells were usually sunk ten to twelve feet in that clay. In the months of March and April, though the fields were water logged and the ditches br.i.m.m.i.n.g over, the wells which were being used by the troops were going dry. In other words the soil was almost impervious so that once a well had been emptied it would not fill up again for days.

For this and several other reasons we reported the necessity for large mobile water purification units, which could take the water from larger bodies of water such as ponds, creeks, ca.n.a.ls or rivers, purify it, and deliver it filtered and sterilized into the water carts or tanks. Such a system was subsequently adopted by the war office and is now in general use in the British Armies.

One hot morning in mid June we received a telegram from the Surgeon General to investigate a water supply complained of in the Festubert region. A premonition seized me that I was going to be killed, for the battery to be visited was in a very "unhealthy" spot. So I made a new will, and wrote a letter of farewell, to be posted in case of accident.