Historic battlefields.

Welcome

Welcome to my weblog with which I hope to gather together information and thoughts (mine and of others) on the wars of the 20th century.

Arras April 1917- Continued operations

The results of 9 April 1917 were to be overshadowed by the attritional nature of the rest of the battle, as the offensive continued due to the demands of coalition warfare. As with most logistical or combat support elements, the work of the RAMC continued. Whether the “routine” casualties of trench holding or the peaks following attacks [or counter-attacks], the main burden continued to fall on the bearer companies. Whilst within a division it was sometimes possible to rotate brigades out of the line, with the bearer divisions of the three field ambulances effectively merged an equivalent relief was impossible. The process of evacuation was only able to continue as the structure of a field ambulance allowed an internal rotation of suitable men within units without any disruption of command and control.[1] 

 

As the fighting continued the various units of the BEF rotated in and out of the line. As their divisions heading to the rear areas, for many a period of rest beckoned, but a field ambulance had to continue providing medical support to its division. In the operation orders relating to moves out of the line, we see the field ambulances being temporarily affiliated back to brigades for administrative purposes, but also being ordered to set up Divisional Rest Stations. Through this facility, men could recover from minor wounds or illness, but stay within the division, desirable both for elements of esprit de corps but also for maintaining the strength of the division.[2]

 

The larger distances between the frontline and Arras gave more tactical freedom in the placement of medical posts, more of the general principles expressed in RAMC 1911 could be followed; posts appear in hollows, adjacent to roads, but the slow extension of the chain of evacuation required more collecting and relay posts, eventually supplemented with vehicle loading posts.[3]As the offensive stalled these posts took on an air of permanence, the location of many now being marked with Commonwealth War Graves Commission [CWGC] cemeteries.[4] In these the periods of occupancy can be clearly identified by the burials,[5] the association of cemeteries with medical facilities is an unfortunately obvious one,[6] but this is more commonly associated with dressing stations and CCSs.  At these forward posts staff applied a triage sieve preventing casualties unlikely to survive passing further down the chain. This was made easier as the various collecting and relay posts sat outside the regimental family and could make a less emotional, more realistic appreciation of the casualty’s chances.[7]

 

Whilst not always completed immediately an admission and discharge book [A&D book] was kept for each field ambulance, showing the nature [and numbers] of casualties passing though the unit.[8] The A&D book of the 51^st Field Ambulance still exists, it shows a surprising amount of men attending the ADS sick, with most being evacuated. Concern to keep the ADS clear dictated the swift evacuation of the sick, but was reliant on a vigorous filtration at unit level by the RMO. The A&D book covering 24-25 April 1917 has 90 admissions. Of these 12 were sick, all of whom are evacuated. A further two had suffered soft tissue injuries and were also evacuated, in this case to the Corps Rest Station.  Of the 76 injured most [61] were gunshot wounds, the majority [26] being to the limbs.[9]In this period there were four deaths in the ADS; two from abdominal injuries, a situation the field ambulance was not adequately equipped for; one a double traumatic amputation; the last being shrapnel wounds to the thigh. The field ambulance's pragmatic approach to triage and casualty assessment at forward posts coupled with the careful work to counter shock had resulted in a low mortality rate at medical facilities.

 

A record of operations carried out at No 19 CCS allows for an examination of the type of casualty making it through the whole chain of evacuation to surgery. On 11 April 1917 Captain Donaldson performed 18 operations, all gunshot wounds; 15 leg, 1 shoulder and 1 buttock injury.[10]All of these were evacuated before the end of the day. Faced with the high number of casualties of an offensive the finite resources of the AMS had to be directed towards those with most chance of success. This principle was applied from the first field ambulance post through to the CCS.

---

[1]For example, men of the 2/2 London Field Ambulance tent divisions were sent forward as reinforcements and replacements of the bearer company, TNA: WO 95/2944 entry for 14 April 1917

[2]In the post war Babtie Committee this was deemed to be one of the great successes of the field ambulance, TNA: WO 32/11395.

[3]Vehicle loading posts were originally staffed by a RAMC NCO purely responsible for the loading of the ambulance cars and accounting for the equipment. By 28 April 1917 both the 14^th and 56^th Divisions have more substantial posts.

[4]The Great War Digital product “Linesman” provides translation from contemporary trench maps to modern day IGN maps. Allowing for the inherent inaccuracy of mapping it is possible to identify the approximate position of wartime locations.

[5]Within the area of this study, Happy Valley cemetery is approx 50 yards away from a relay post, identified casualties from the 12 Division can be found buried here from a period when 37^th Field Ambulance was running the post. The Rookery cemetery is about 40 yards from the position of a 18^th Division collecting post, Tigris Lane cemetery is approx. 25 yards from the site of a 56^th Division Vehicle loading post,

[6]A number of cemeteries are named after dressing stations. St Mary’s ADS near Loos is but one example, with cemetery registers often identify nearby medical facilities.

[7] An order is issued in October 1917 that “Moribund Cases are not to be moved from Field Ambulance.” The definition of these cases seems to have been left to the reader. Standing Orders of ADMS 56^th Division in TNA: WO 95/2038.

[8]Most of these have been destroyed, the following is taken from examination of part of a small sample kept within TNA: MH106.

[9]This incidence of injury to the limbs is slightly higher than the 40% suggested in Major T. Mitchell, Medical Services, Casualties and Medical Services of the Great War (London: Imperial War Museum, 1997) p. 279

[10]TNA: WO 95/414 No 19 CCS.

The first battle of the Scarpe 9 April 1917- New army division

On the opposite side of the Arras-Cambrai road the 12^th Division were to attack from the eastern edges of Arras toward a line between Feuchy and Monchy. This new army division had already experience much hard fighting since its arrival in early 1915 and all elements of the division had learnt from their time on the Somme.

 

In his instructions sent out to RMOs and his field ambulances, the ADMS noted:

“Medical Officers should consult with CO's as to the distribution of Regimental Stretcher Bearers, but judging from past experience it is advisable only to send over 8 bearers and 8 reserve with the Companies keeping the other 8 bearers and 8 reserve in reserve till the MO calls for them.”[1]  

In common with the other divisions, having reinforced and re-supplied the RAPs of the attacking battalions,[2] the OC Bearers established dumps of stretchers and similar stores on the likely routes of evacuation, before allocated the remaining men of the pooled bearers to clear the frontline. When the attack began the bearers at the RAP would take over the vacated aid posts and use them as bearer posts as the advance continued.[3] Sites for up to four ADSs had been prepared in the streets of Arras, the main two being located in a factory adjacent to the Arras-Cambrai road, the second in a nearby abattoir.[4]

 

Once the attack began the division advanced despite resistance from defensive works forward of Observation Ridge, only a few lying cases arriving at the ADSs in the morning. During this stage of the fighting two RMOs became casualties,[5] replacements quickly being found from officers of the field ambulances. The close relationship between RAP and field ambulance enabled swift replace of MO casualties with doctors experienced in the realities of trench warfare.[6] Maintaining touch with the advancing troops the bearers moved forward. As the advance ground to a halt near Feuchy chapel they set up an aid post in a recently abandoned German dressing station.[7] From here casualties were evacuated directly down the Arras-Cambrai road, with ambulances coming as far forward as Tilloy.[8]With the zone between frontline and Arras being covered by the one unit, ease of internal communications allowed flexibility of deployment for the medical posts. With RAPs in particular being sited as the situation dictated, returning bearers, via OC Bearers provided updates on locations and casualties, these being fed back to both field ambulance and Infantry Brigade headquarters.

 

As evening approached, the ADMS noted a build up of casualties around the ADSs. This is likely to have had a number of causes; one RAP [no 3] had received many more casualties than others,[9] causing an imbalance and congestion in the chain; as the front advanced the movement of casualties became easier within a, relatively, safe zone leading to a sudden influx; the extraction of casualties from the captured positions could only be done after some degree of defensive re-organisation again causing a rush of casualties. Movement had been inhibited by the explosion of an ammunition dump near to the railway bridge adjacent to No 1 ADS and the advance of cavalry units hindering the work of 15 Motor Ambulance Convoy.

 

To clear his ADSs the ADMS called for a concentrated effort from 15 Motor Ambulance Convoy, a 15-car convoy being sent to the division. Having cleared the ADSs, by midnight they were again full with 180 lying cases,[10] a further 14 car convoy being required, the ADSs eventually being clear of all casualties by 8 am on 10 April. With the largest advance of a single division in this study, the 12^th Division settled down to hold its gains,[11] its chain of evacuation forming around posts along the Arras-Cambrai road. This route provided good communications from the frontline to the rear, but with ambulance cars not able to proceed past Tilloy the hand carriage of casualties, necessarily slow, continued. By the early hours of 10 April 37 officers and 1009 men had been treated and evacuated,[12] on 11 April 8 officers and 383 men had been admitted but 20 men hadn't been evacuated immediately. The evacuation chain had begun to falter.

 

The absence of MDSs made the field ambulance cars somewhat redundant,[13] by pooling them under the command of 15 Motor Ambulance Convoy they had been fully employed during the early part of the offensive and the large deployments needed to clear the dressing stations during the night 9/10 April had been possible. But as the units advanced, with new posts appearing, control of the cars became too remote. Feeling the moment had come, perhaps a few hours too late, DDMS Thompson released the ambulance cars back to their parent units, but the process wasn't completed smoothly.

 

This, the only significant breakdown in the evacuation chain, had not been caused by the field ambulances but by the removal of its assets. The idea of employing the otherwise idle ambulance cars elsewhere in the chain was sound, but didn't require their removal from their parent units, the field ambulance. If left under their own OC's control the inherent flexibility of the field ambulance would have enabled the cars to switch focus as required.

 

Across the front many critically injured men had received, basic, but sufficient treatment of their wounds. Their comfort had been given every possible priority,[14]partly to raise the individual’s morale but more clinically to ward off shock. Often rising their own lives, the men of the field ambulance had successfully ensured the rapid removal of the wounded, some reaching a CCS within two hours.

---

[1]TNA: WO 95/1834 ADMS war diary Medical Arrangements dated 3 April 1917

[2]Each RAP received 1 officer, 1 NCO and 18 men from the field ambulances in the 72 hours before the attack. The field ambulances supplied each RAP with 50 tins of water, candles, 60 stretchers, 80 blankets, 20 waterproof sheets [for protection of the blankets] dressings, rations [both for medics and casualties] and splints, possibly including three Thomas splints

[3]Strictly speaking this didn't occur until the RMO had left the aid post, it does however seem that most RMOs moved out into no mans land quite early

[4]For a short period in the afternoon all four ADS did open but the two above provided the bulk of the care. Their positions on a main road allowed easy access and a maximum distance RAP to ADS of 1.1 miles.

[5]Captain Prentice, RMO 5^th Royal Berkshires, was wounded and Captain Edey 6^th Buffs sprained his ankle.

[6] By October 1917 at the latest this practice had become formalised. In Standing orders the ADMS of 56^th Division requires all doctors to be trained ready to take over as RMO,   to do so they must have completed a month at the field ambulance including five days attachment to the sanitary section and ten days to a functioning RAP. TNA: WO 95/ 2938.

[7] This allowed the post to “open” rapidly. The combined artillery related  problems of the entrances facing the “wrong” way and the Germans knowing the exact location seemed to have been often accepted in return for the degree of shelter given.

[8]The aid post at Feuchy Chapel was quickly converted into a British ADS, this was a bound forward of 3.01 miles, measured in a straight line using Linesman.

[9]Someone had placed a red flag on the roof of this RAP, attracting casualties from across the division's front. some stray casualties from the nearby 15^th Division also made it to this aid post

[10]Many of these were German prisoners of war. As all casualties were to be treated equally this may be due to a clearance of the captured positions. TNA: WO 95/1834 “Report on Operations from 5.30 am 9^th April to 6 pm 11^th April 1917 by the ADMS dated 11 April

[11]The 37^th Division was expected to pass through and seize Monchy. Bearers of the 12^th Division's field ambulances would be required to remove 37^th Division's casualties, and those of 3^rd Cavalry Division from in front of Monchy.

[12]TNA: WO 95/1843 36^th & 37^th Field Ambulance

[13]Field Ambulance cars would normally be held at or around the MDS and be used to collect casualties from the ADS. If the situation allowed they might be used to clear posts further forward ie RAPs.

[14]RAMC units aimed to provide hot drinks to those passing through the chain, this extended to setting up at least one refreshment stall on the route of the walking wounded.

The first battle of the Scarpe 9 April 1917- Regular Division

Further north the 3^rd Division was in the line in the southeastern suburbs of Arras. The front for the attack was particularly narrow, the frontage slightly extending on the objective.

The division had been in position for some time before the attack and much of March had been spent labouring in improving its posts. The 3^rd Division medical facilities were centred on two ADSs, one in the buildings of a Girl's School, the other in Thompson's Cave. Most of the physical labour of preparing these, and other, posts fell to the men of the RAMC, particularly the bearers, with only specialist help on matters such as lighting.[1]

 

With the strong German position known as the Harp close to its narrow jumping off position, the 3^rd Division ADMS heavily reinforced the regimental medical elements, deployed the bearers of one field ambulance [7^th] into the RAPs and nearby trenches to advance with the attack. The tent sub divisions of this field ambulance formed the Cave and Girl's School ADSs. A second field ambulance [8^th] was in reserve packed ready to advance,[2] with all necessary equipment broken down into sandbags to allow “hand carriage”. This ability to project itself forward, without the reliance on external support, was essential to maintaining the connections of the chain of evacuation. The Division's third field ambulance [142^nd] was held further back at Hauteville packed with its wagons ready for the advance. The ADMS was obviously concerned by this apparent return to the affiliation of the field ambulances to Brigades as in his final draft of medical arrangements issued to RMOs he states:

 

“M.O's i/c of Battalion must remember that Field Ambulances do not belong to Brigades, but are Divisional troops....In action, and indeed at all times, the Field Ambulances of a Division work directly under the control of the A.D.M.S.”[3]

 

With the initial success of the attack, casualties were rapidly removed, the first arriving at the Girl's School ADS within 50 minutes of zero hour. As the day progressed the two ADSs alternated in receiving casualties, this simple expedient and the work of the Motor Ambulance Convoy, which initially experienced little traffic congestion, prevented any accumulation of casualties at any of the division’s medical posts.

 

At 2 pm the 8^th Field Ambulance received its order to move, heading towards Tilloy to open an ADS, this it achieved by 4.30 pm, with it's bearers moving forward to maintain touch with aid posts of the 8^th Brigade. This forward position did experience difficulties with traffic, casualties being evacuated by hand towards the original ADSs.  The common practice of using German prisoners of war as bearers helped clear the casualties, but by completing a single “one way” leg this caused minor difficulties in the necessary return of stretchers.[4] The bearers of the two field ambulances working the forward area successfully maintained touch with the RAPs, preventing these becoming overwhelmed and providing a rapid transit to the ADSs, always important but becoming critical as the climate deteriorated, with snow falling and a “piercing gale of wind”.[5]

 

As evening came on the Girl's school ADS was closed, having seen 160 casualties pass through since the beginning of the attack. By the early hours of 10 April 1917 the 3^rd Division's ADSs had treated a total of 291 cases.

---

[1]The efforts seem to have passed muster, as part of the continuous round of inspections and visits the DMS Third Army and DDMS VI Corps visited the ADSs on 30 March 1917, “The Surgeon General expressed his intense satisfaction with the preparations made at the Rue du Temple & the cave ADS (known as Thompson's Cave).” TNA: PRO W0 95/1396

[2]The 8^th field ambulance had two of its tent sub divisions detached to 19 CCS before the attack started

[3]TNA: PRO WO 95/1396 Medical Arrangements dated 6 April 1917 paragraph 6; the ADMS also urges RMOs to avoid “panicky” messages about numbers of casualties and reminds that there are only 300 field ambulance bearers in the whole division

[4]Some units retained German prisoners of war, almost as extra staff, see Rorie, A Medico's Luck in the War, pp 125-27. In his rather long anecdote Rorie confers the title “auxiliary loader” onto the prisoners who are kept in the ADS.

[5]TNA: WO 95/1396 ADMS 3^rd Division.

First Battle of the Scarpe 9 April 1917- Territorial Force

The German retreat to the Hindenburg line had the most effect in the southern region of the proposed attack. The 56^th (London) Division's attack was on a limited front, centred on the fortified village of Neuville Vitasse. The division's medical assets were orientated around its ADS at Achicourt, with a series of bearer posts [Agny then Beaurains] to the front line.[1] As with all attacking divisions, the field ambulances had reinforced the RAPs, placing 8 bearers forward to each attacking battalion. In keeping with most divisions on 9 April, the 56^th Division had pooled all its remaining bearers under the command of an officer of one field ambulance.[2] This role, that of Officer Commanding Bearers [OC Bearers] was an attempt to correct problems from the Somme;

“The previous medical arrangements..., where a shifting personnel and a divided jurisdiction of field ambulance commanders had been somewhat confusing, were now changed; and a forward evacuation officer was appointed, whose duty it was throughout the battle to contrive and supervise the evacuation of all wounded from the RAPs to the main dressing station and walking wounded collecting station,”[3]

The tented sub-divisions formed the aforementioned ADS, using the cellars of a row of shops in the village square. The central nature of this location [the square] meant it was shared with both an ammunition dump and a vehicle park and frequently became congested.

“Our Field Ambulance arrived at the village of Achicourt near Arras, and set up its HQ as a MDS [sic] in a disused cafe, with cellars under, which joined up with those of the adjoining shops and buildings, adjacent to which was the narrow bridge over the stream by which all traffic had to enter the village and led to the square, only a short distance away.”[4]

This choke point was an obvious target for the German retaliatory shelling, an infantry platoon being wiped out in an adjacent building and the building containing the ADS itself was hit, the only casualties being the Sergeant's kit bags.[5]

At zero hour the assaulting units, whilst experiencing resistance, successfully entered the German trenches. As the attack progressed the RAMC pushed forward to maintain touch with the aid posts being established within the ruins of Neuville Vitasse. Casualties began arriving rapidly at the various posts, typically the lightly wounded first. The OC Bearers successfully managed his new responsibilities and maintained the critical junction between the regimental aid posts and the field ambulance throughout the day, all casualties moving rapidly down the evacuation chain.

Having survived the initial insult of injury, the cold, shocked casualty became a passive load in the gruelling journey “down the line”.

“...the bearers moved up from Agny. They passed through the shattered Beaurains, where a post had been established, and occupied a series of relays between that village and Neuville Vitasse, which had fallen in the morning's attack. By now the weather was very cold, sleet was falling at intervals, and the carrying across the scarred fields was made harder by the accumulating mud. Stretcher bearing went on intermittently through the night, but on the whole casualties were not heavy.”[6]

With the OC Bearers acting as one centralised, advanced, point of control the bearer division was able to react to movement and varying demands across their front. The pooled manpower also allowed for a reserve to be held, but under forward control, which in turn allowed for some relief of individual bearers. But if the opportunity for rest was more frequent the work was still hard and dangerous:

“They talk about a soldier going out + fetching a comrade in under shell fire-and he gets the MM or DCM, we are always under shell fire, I can't dump our stretcher + run for it to a soft spot, we have to plod on, up past the knees in mud- balancing on the edge of shell craters slipping + sliding, shells bursting above + in the earth quite all around us, its Gods mercy that we get thro but we have the patient to think of, + quickness probably means saving his life, so we go right thro it, not caring a damn + somehow when you get to the sap-head + safety, you laugh and joke at the capers.”[7] [underlining in original]

The existing records of the actual number of casualties passing through the 56^th Division's chain seem somewhat confused. The ADMS, in his war diary, records 11 officers and 211 other ranks till the early hours of 10 April. The war diary of the unit running the ADS at Achicourt states 329 total.[8]It is difficult to reconcile this difference as the ADS were under instruction to wire the ADMS every 12 hours with the number of casualties treated. The most likely explanation is the ADS number includes men from other units and possibly prisoners of war, as these would be passed down the same evacuation chain.

The successful advance of the division required the aid posts to move forward. In the traditional, caterpillar like movement, the bearers vacated the cellars for an ADP to be set up early during 10 April, this in turn was replaced by an ADS on 13 April. Having taken over the cellars of a small house, the capacity of the ADS was very limited, only able to hold four patients at a time, this seems to have been an acceptable compromise against the benefits of the location.[9] In the first hours following it's opening, 30 casualties passed through, testimony to the efficiency of the evacuation chain at this point.[10] Further, ultimately unsuccessful, attacks were carried out by the division during 14-15 April, approximately 200 casualties being treated in this cellar on each day.[11] The evacuation of these casualties was conducted by hand back over the newly won ground. To keep the ADS clear and to minimise the casualty's exposure to the harsh environment it was no longer possible to follow the doctrine of evacuation under the cover of darkness, so until communications trenches were established it was the demands of a carry over the top.

Due to the relatively confined area of operations, the influence of the centralised control of the bearer officer and comparatively light casualties the 56^th Division's chain of evacuation had held. The pooling of all bearers under one point of command and control had given a new flexibility to the RAMC's forward assets, allowing a rapid advance of medical facilities in support of the attack. Each unit in the chain had managed to maintain touch with the post to its front, ensuring re-supply of materials and a fluid passage through the extended chain of evacuation back to Achicourt.[12]

---

[1]On 5 April 1917 a last minute change of the allocation of personnel was forced by the absence of reinforcement by 100 [most likely non RAMC] bearers. Priority was given to the forward posts, but no post seems to have been shut.

[2] OC

[3]D. Rorie, A Medico's Luck in the War (Aberdeen: Milne & Hutchinson, 1929)

[4]A. Atkinson, 2/3^rd City of London Field Ambulance. London Soldiers-Unarmed Comrades (London,: Elsdale & Martin, 1969), p. 42

[5]The casualties from this shelling, mostly members of the 13th Battalion London Regiment, would have been received straight into the nearby ADS, demonstrating the flexibility of the chain. A similar direct access was often used for units to the rear of the front line such as artillery brigades.

[6]Anon, The Second-Seconds in France (London: Spottiswoode, 1920),  p 41

[7]IWM 7997 98/28/1 A E Douglas

[8]TNA: WO 95/2944 2/3 London Field Ambulance. War diary summary by compliers of official medical history. TNA: WO 95/814 DDMS VI Corps gives a total of 13 officers and 277 other ranks till 6 pm 9 April 1917, a further 13 officers and 295 men by 6 am 10 April 1917.The official history gives the total figure of casualties into field ambulances between 9am 9 April to 9 am 10 April as 26 officers and 522 men for the 56^th Division. The “extra” casualties must have found their way into the facilities of nearby divisions, a relatively common occurrence.

[9]The position chosen was/is on a junction of the few roads at the north side of Neuville Vitasse. As such it had good access and egress, is relatively sheltered from view [and hostile fire], would have been easy for men of the division to locate and fairly central on the axis of the division's advance.

[10]The ADS was open at midday, these casualties passed through by 6 pm. There is no way to tell of the chronological distribution within this period.

[11]TNA: PRO WO 95/2944 2/3 London Field Ambulance.  14^th “about 200 wounded” 15^th 234. In both cases this represents the holding capacity of the ADS x 50

[12]The initial distance from the front RAMC posts to the ADS at Achicourt had been 2.57 miles, by last light on the 10 April it was at least 3.7 miles. These measurements are taken “as the crow flies” but via the appropriate posts in the chain of evacuation.

The RAMC deployment at Arras prior to 9 April 1917

Recent debate has looked at the effective levels of command and control of the various assets of the BEF.[1]From the medical point of view, with a chain of evacuation stretching back to the United Kingdom, the RAMC needed representation at all levels of command, but on the western front the RAMC functioned due to Corps and Divisional level command. The former allocated resources and controlled rearward assets, such as CCS and Motor Ambulance Convoys [MAC], whilst the latter planned and directed the physical deployment of the forward units.

 

The war diary of the Director Medical Services at GHQ shows the diverse range of issues of concern to the office; censorship/publication of medical articles, procurement of medical equipment and the allocation of resources amongst the Armies.[2]The latter was a constant struggle in prioritisation difficult to appreciate to minds now conditioned to think in terms of individual set piece battles.

 

A concern from the battle of Loos, starkly highlighted by the recent Somme fighting was the issue of ambulance trains. On 31 March 1917 an estimate was made of possible casualties of the forthcoming offensives and the required number of trains.

24 hour periods	Number of casualties (expected)	Number of trains required
1st	8000	18
2nd	8000	18
3rd	8000	18
4th	8000	18
5th	5000	11
6th	4000	9
7th	3000	7

 

This allocation was made on the assumption that 50% of casualties during the first three periods would be transported by road.[3] Across the BEF the routine daily ambulance train capacity at this period was 9000 [3000 to Boulogne and Rouen, 2000 to Havre and 1000 to Calais].[4] To meet the perceived extra needs, the Third Army Directorate of railway transport garaged eight ambulance trains and three temporary ambulance trains near the CCSs before the attack.

 

Third Army’s Director Medical Services [Surgeon General J.M. Irwin] was responsible for the placement of the CCSs as army level assets. Due to the closeness of much of the frontline to the town of Arras, Main Dressings Stations [MDS] were left out of the chain of evacuation.[5] Casualties would be transported, by Motor Ambulance Convoy - a Corps level asset, direct from an ADS to a CCS. Irwin placed these in three main groups; three at Warlincourt Halte in the VII Corps area,[6] three at Agnez-les-Duisans in the VI Corps area and four at Aubigny for XVII Corps.[7] The group at Warlincourt Halte were approximately 18 miles from the British front line, but any suitable closer sites were within range of the German guns. After the German withdraw to the Hindenburg Line this threat was removed but there was insufficient time to relocate this group of CCSs. The CCS stayed in position throughout the battle but an advanced operating centre was deployed forward into Arras during the latter part of April.

 

The Agnez-les-Duisans group was about 11,000 yards from the VI Corps front line placing them within shell range but despite the surrounding areas being hit the group of CCS remained untouched, the risk was accepted due to the favourable position of the site on a broad gauge railway line. The largest group at Aubigny, out of shell range was again near a railway line. Additional CCS were allocated for dealing with Third Army’s sick, slightly wounded and local [behind the lines] casualties. On 5 April 1917 the CCSs received reinforcement by surgical teams from Fifth Army and Second Army.[8] Determined to avoid the previous year’s problems at CCSs, the DMS of Third Army further reinforced his CCS by ordering his ADsMS to provide each CCS with 3 officers 3 NCO and 24 other ranks from their field ambulances. Initially given a variety of roles, from burial parties to unloading ambulances, many of these men were replaced by non-medical reinforcements,[9] most eventually being employed on clerical or proper medical duties.

 

Within the Corps the respective DDsMS began to co-ordinate the actions of their units. Despite having lost men in the reinforcement of the CCSs, the personnel for all medical and sanitation posts being established were to be found from the division’s field ambulances. The DDMS of VI Corps, Colonel Thompson, was to have the biggest effect on the medical arrangements at Arras, and to a degree the future workings of field ambulances. Thompson realised that as his sector was directly in front of Arras all movement would be limited to, at best, a couple of roads. As traffic associated with the attack would take priority over medical evacuation he planned for his units to “hold” their casualties for up to 36 hours.[10] Thompson achieved much of this by effectively turning his ADSs into MDSs, his main site being set up in a cave 800 yards from the front line.[11]Whilst still primarily designed to treat and evacuate, the ADS, especially Thompson’s Cave, developed a capacity for emergency cases including surgery. Thompson’s most striking innovation was to reduce the paperwork required in the forward units. He used the men detached from his field ambulances to CCSs as clerical staff and gave the order that no Admission and Discharge books were to be completed in the field ambulances during the offensive. Simple casualty cards were completed on each man as he moved down the chain,[12] systems being developed to note basic treatment given and advice for the next station in the chain. The systems were simple but also flexible, in the case of a soldier receiving anti-tetanus serum:

 

“In addition to entering this on the Field Medical Card, a “T” in blue indelible pencil should be inscribed on the back of the left wrist. If the left wrist is wanting, then on the right wrist.”[13]

 

All relevant entries were later transcribed by the attached clerks at the CCS into the respective field ambulance Admission and Discharge books at leisure. Only a small sample of these still exist but these and some surgical logs from the CCSs give some indication of the type of injuries making it this far down the chain.[14]

 

To aid the rapid transit of the critical injured each Corps' also set up it’s own Walking Wounded Collecting Post [WWCP] to remove the lesser cases to a parallel chain of evacuation, with a clearly signposted route for the wounded to follow. VII Corps' at Agny was under the control of the OC 43^rd Field Ambulance of the 14^th Division, VI Corps' at the Bastion in the Western suburbs of Arras was fairly typical. It was equipped to receive, record, feed and dress up to 450 casualties at a time.

 

Across the battle area the men of the various field ambulances manned bearer relay posts, collecting posts, advanced dressing posts, advanced dressing stations, main dressing stations, walking wounded collecting posts and reinforced both RAPs and the CCSs. Having laboured to move themselves, medical supplies and stores into position they waited,[15] all was ready for the attack.

---

[1]For example, Andy Simpson, Directing Operations: British Corps Command on the Western Front 1914-18.

[2]TNA: WO 95/46-50 GHQ DMS includes frequent cases of clearance for articles being sought, outsourcing of refilling of oxygen cylinders, which had previously been returned to the UK, discussion on “opium mixture” for Indian troops and a running tally of cases evacuated due to Venereal Disease and Trench foot, 900 & 200 cases per week respectively.

[3]Therefore the estimate of casualties for the first 24 hours was 16,000. The actual number was 11,520.

[4]TNA: WO 95/46-50

[5]This attempt to minimise the number of stages in the evacuation chain was in keeping with RAMC 1911. The VII Corps was the exception to this rule. Due to the Corps’ extended chain of evacuation the 2/2 London Field Ambulance of the 56^th (London) Division operated a CMDS with accommodation for 2000 patients in Gouy-en-Artois. TNA: WO 95/814 Summary of War Diaries April-May 1917

[6]No.s 20, 43 + 32

[7]Agnez-les-Duisans No.s 19, 41 + 8; Aubigny No.s 30, 42,

[8]Six teams arrived from Second Army, four from Second Army.

[9]TNA: WO 95/414 NO 19 CCS. On 14 April received men of the Middlesex Regiment and the Somerset Light Infantry to act as stretcher bearers. On 15 April men of the Devons and 12th Black Watch were released from grave digging.

[10]TNA: WO 95/790 DDMS VI Corps War Diary, this priority of forward movement over rearwards was as per 1911 manual, but is also found in other ADMS war diaries, see 51^st Div

[11]This facility was to become known as “Thompson Cave”, it was in a cave system originally excavated in the 16^th century. Equipped for standard and surgical care, accommodation for up to 700 casualties was planned. It was staffed by two tent sub-division of the 7^th Field Ambulance of the 3^rd Division. The site is near to the recently opened Wellington Cave system and is under a busy road junction and housing estate.

[12]These cards, AFW xxxx already existed, but the sole reliance on them to document casualty care was the innovation.

[13]TNA: WO 95/790 DDMS VI Corps Medical Appreciation on Proposed Operation dated 1 March 1917, repeated in WO 95/1396 ADMS 3^rd Division RAMC Operation Order 41 paragraph 15; further examples common to the units of the attack were; an “O” = no need to redress the injury before the CCS; “M” on forehead= a dose of morphia had been administered.

[14]The Admission and Discharge book for the 51^st Field Ambulance, part of the 17^th Division is contained in TNA: MH106, TNA WO 95/342 the war diary of 8 CCS contains at log of surgery carried out during the month of April. As well as giving detail on injury and treatment it is also possible to calculate the number of operations carried out by individual surgeons thereby giving an indication of the high workload experienced.

[15]The situation of infantry troops being tired by fatigues and working parties is familiar, but much time and effort seems to have been expended by RAMC personnel in establishing their posts. As a possibly low priority for RE assistance men were frequently tasked to work on making and/or improving positions. Vast amounts of stores were required, a RAP typically receiving [from the field ambulances] an extra 50 stretchers, 50 blankets and 50 water tins in addition to true medical supplies such as dressings.

The Storm of War by Andrew Roberts

Just starting on this one [as per my tweets], full title: The Storm of War: A New history of the Second World War.

Do we need a new history? Well Andrew has already tried to answer that himself here.

 

A chateau General?

Today marks the anniversary of the death of Major-General Frederick Drummond Vincent Wing CB. With the common portrayal of WW1 Generals being out of touch with the experiences of their men, Wing's death, as one of three Generals to die in September/October 1915, hopefully provides a contrast.

A career soldier, he had taken over command of the newly formed 12 [Eastern] Division in March 1915. In his relatively short tenure he had taken the Kitchener division to war, frequently visiting the frontline and been slightly wounded in September 1915.

In early October the division was engaged in the Battle of Loos in Northern France. German shelling was described in the divisonal history as "incessant", the division's artillery units being particulary effected. It was whilst on his way to one of these units that Major General Wing and his ADC Lt Tower DSO [Essex Yeomanry] were killed by shellfire.

They were buried on the 4th October and now lie in Noeux-les-Mines communal cemetery near Bethune. In Bulford garrison on Salisbury Plain there is a Wing barracks in honour of this man.

Welcome changes at the National Archives

As a long term user of parts of the National Archive's Documents Online service, I'm surprised to report that I welcome the recent changes to its war diary service.

With changes to "improve service" such as barriers in the car park in mind, it was with a sinking feeling that I recently tried the system, but the experience was mostly good. Gone is the laborious [and expensive] break down of digitised diaries into monthly downloads, replaced with Brigade level groupings. This extra information may be unnecessary for those researching an individual's war service- but if your interest spreads to units and engagements it is superb. This repackaging does result in large files to download, but amazingly not large prices! Previously a download, likely to cover a month, cost £ 3.50, but a whole Brigade's [commonly 3 or 4 units] whole diary can often be purchased for the same price.

Signs of a credit crunch busting National Archives? Or the ground work for more fundamental changes?

The German Army at Cambrai- first thoughts

A full review will follow shortly, but from the first page I was enthralled with Jack Sheldon's latest book. The shorter timespan than his early works has allowed his narrative to both focus and broaden, focus on individual units and men, broaden into a valuable discussion of the German staff system. More too follow.

International Red Cross Records

As a small experiment, and to continue some personal research, I've applied to the IRC for a search to be completed in their records of POWs from the First World War. 

It seems strange to think of the belligerent nations communicating about the fate of individuals, but a constant stream of information on soldiers' death, capture or injury has left a wealth of information for modern day researchers. These records were consulted during recent research associated with the exhumation of soldiers' remains at Fromelles, but are also accessible for individuals conducting research.

For example, William George Hollington, wounded and captured in August 1917 whilst serving with 13 Royal Irish Rifles. By chance William has a record at the National Archives in Kew, London. He is part of the 1% kept in PIN 26, a sample of true pension records, not those of WO 363 often described as such.

This stroke of luck has fleshed out the story, but it will be interesting to see:

 1. what the IRC records can add;

2. The speed of response, some members of the Great War Forum quote a wide range, 6 months being common.