Mud, snipers and rats: rescuing the injured from the trenches

“The spade will be as indispensable to a soldier as his rifle” predicted Ivan Bloch in 1899. This proved to be an accurate prediction for the static and trench bound nature of World War I.

With machine gun fire faster and more long-ranging than previous wars, the need for cover was crucial for front line soldiers. Realising this, the Germans began digging in September 1914 and the over-exposed Allied Forces were forced to follow suit. The Western Front began zig-zagging a route eventually stretching from the North Sea coast of Belgium down through France to the Swiss border, occupying some 25,000 miles.

World War I: the Royal Army Medical Corps on Active Service, by Haydn Reynolds, 1918. Wellcome Images reference no. L0068379.

Rescuing the injured from this treacherous battleground was no easy task: littered with muddy shell holes, twisted barbed wire, snipers and already lifeless bodies, the Royal Army Medical Corps (RAMC) officers risked life and limb themselves in their heroic and often nightly evacuation duties. In a letter to his brother,  Captain Thomas H. Gibbon gives a hair-raising account: with his horse shot dead, he was forced to walk 4 miles with a gunshot wound to his leg to reach the dressing station, while he continued to treat other injured men on his tortuous journey.

The difficult terrain meant roads were non-existent so stretcher bearers and their ‘horse-ambulances’ had to use improvised paths with names like ‘sunken road’ to approach the front line – the treacherous conditions meant it was impossible to get closer than 4-5000 yards from the front. Woodland areas (like Trones Wood) proved particularly difficult according to Captain Neil Cantlie’s war diary. Reserve stretcher-bearers were called upon to sacrifice their own rest to help those in difficulty attempting to navigate the non-existant tracks. Delays were inevitable, and potentially fatal in some cases.

Wounded awaiting evacuation trains to the Casualty Clearing Station in 1916. Wellcome Library reference: RAMC/730.

The walking wounded were a common sight – those able enough would have to ‘lie out’ or at least wait outside the medical ‘tents’ for the hospital train that would take them back to the main Casualty Clearing Station. Severely wounded men were treated or operated on in theatres under canvas.

Operating theatre at 1/1 West Lancashire Casualty Clearing Hospital, RAMC Territorial Force, on the Western Front. Wellcome Library reference: RAMC/730.

It was paramount that wounds were treated as quickly as possible before infection and disease, which could be hastened by cold and wet conditions, took hold . By the autumn of 1916, the majority of wounds being treated were performed under anaesthetic and commonly consisted of excision of damaged or dead tissue, drainage of wounds, arrest of haemorrhage, treatment of bad fractures and many amputations. ‘Gas gangrene’, became more prevalent as trench warfare dragged on – this was a fatal  bacteria-induced gassy tissue build-up in an already gangrenous wound.

It is commonly known that rats were prevalent in or near the trenches, but the true horror of their presence comes home on reading the RAMC archive. They were not only attracted by the men’s food rations but also their living flesh! On one occasion a man’s finger was bitten in the night, when he and his ambulance crew were stationed in a barn that was ‘infested’ with them.

The other frequent but unwelcome visitors were lice: clothing was “often a grey moving mass” that perpetually disturbed troops – so much so that ‘Trayer’ of the 35th Field Ambulance Division started using the Serbian barrel technique – first used by Serbian medics at the start of the war – to disinfect clothes through a drying process in barrels.

These are just some of the first hand accounts by medical personnel from World War I that you can discover in the digitised RAMC archives.

Author: Julia Nurse is Content and Metadata Officer at the Wellcome Library.