PERHAPS no other man in France is so talked of so much as General Joffre. Certainly he is the idol of the French people. They look on him as their hero and savior, and his name is mentioned among them with a sort of half-worship. No other people have ever depended on their leaders as have the French. They believe with the right sort of leadership they can do anything. This is the impression you get in talking to them. They say that since the Franco-Prussian War they have looked forward to the time when they might have a general with Napoleon's genius and some other name—for even the name Napoleon now prevents a man from fighting for France, at least if he is of the royal line.
You may be certain that we all looked forward to meeting this great man. We did not meet him after all at close range, having to content ourselves with a view of the busiest man in France as he rode by in an automobile at top speed.
General Joffre, as we learned, has been at the head of the French Army for two years before the war. He first came into notice when, at the last grand maneuvers, he jarred military circles and greatly pleased the people by unceremoniously dismissing from their command five gold-laced generals whose methods did not meet with his approval.
But Joffre first showed what sort of stuff was in him when he met the Germans at the Marne. It will be recalled that the French, never suspecting that Germany would invade Belgium and having all their military plans laid for mobilizing on the German frontier, were more or less demoralized when they found an entirely new line of defense necessary. They had no railroads built to help reform their line, and the moving of a vast army is a perplexing task. Without a leader in whom the whole army had supreme confidence, and with the German host sweeping across Belgium and hurling back the English, it would have been a hopeless situation.
But while what the Kaiser called "Sir John French's contemptible little army" was holding back for a few days the German onrush at terrific cost, Joffre was busy realigning his forces between the invaders and his beloved Paris, which seemed doomed to all but him. He had studied the situation carefully and detected the fact that the long flank of Von Kluck's army left an opening. This opening was found by the Army of Paris, augmented in every possible way and finally reinforced by every available soldier, rushed from Paris in every kind of automobile to be found. The Germans were stopped at the Marne—twenty miles from Paris. Not only was the capital of France saved, but the invaders were steadily driven back until they were sixty miles away before they could make a successful stand.
[Illustration: Portrait in Tapestry—General Joffre.]
It was then that France found Joffre, so the people say. Up to that time they had heard little of him and nobody knew who he was or where he had come from. At once they began to inquire. Few of the soldiers had ever seen him, and there had been nothing much in the newspapers about the man who had managed all this.
After the Germans had been forced across the Aisne and there was time to breathe, the French decided to have a review of that part of the army that could be spared. It was here that everybody watched for Joffre. The French tell it in their own way and it is interesting to hear one of them explaining, with the usual gestures, just how the hero looked on the day of that review.
It was not much of a display of military style. The troops reviewed had been in the thick of the fight and there was an enormous amount of mud. There was no reviewing stand except a muddy elevation, on which the commander was to stand. Nobody seemed to know where he was or where he would come from, but it was passed around that he was to be there and the soldiers watched for him eagerly. Most of them thought that he was a little, fat man. They had unconsciously absorbed this idea from pictures of Napoleon, and, forgetting the terrible stress of the past weeks in the temporary flush of victory, they expected to see their general come to the stand with a blaze of glory. They looked for silken flags and gaudy uniforms and a regular French military parade. This was as little as they thought would do proper honor to the victorious commander of the Allied armies, and they were right, because General Joffre is at the head of the greatest force of men ever gathered together.
As you are told about this in France, the day came and at the spot selected for the review, an open field somewhat back of the lines, with plenty of freshly planted crosses in sight and evidence all around that the peace and quiet had not always been there, a few generals and officers gathered. Finally, a regimental band, playing the first martial music heard since before the battle of the Marne, swung out of the woods at the head of a body of troops.
Then a large man, tall and heavy and wearing an ordinary soldier's overcoat, but with the laurel band around his hat that showed him to be a general, came out of the woods behind the little knoll and walked rapidly toward the group of officers. Every hand went up in salute. Then they knew it was Joffre. He went to the muddy knoll, and stood there watching keenly while the soldiers marched past, the bugles blowing and the bands playing.
In spite of their muddy uniforms and the hard fight they had just gone through, the French say that these soldiers looked spic and span as they passed their general. Their rifles went up in salute as straight and accurately as if they had just come from quarters and were marching over a level parade ground, instead of over fields filled with shell holes and slippery with mud—or perhaps something worse.
Joffre is a silent man, they say. This does not interfere in the least with the adoration of the French, who are usually great talkers. They believe in him to the utmost, and they will follow him to the limit of endurance. So long as Joffre is at the head of the French army, the spirit of victory will remain.
Since Joffre has become famous, of course much is known about him. He was born in the Midi, as they call the southern part of France. Trained as a soldier, he saw service in the East, where he did that which he set out to do. There is no particular incident that points to the discovery of his genius, although he must have done unusual things to get to the top. He is known to have been a modest, quiet, home-loving sort of man, spending much time with his family at Auteil, and showing while there that he was very fond of fishing. Fishing is a good recreation for the man who wants to think, and the French believe that while Joffre was doing that he must have been evolving plans for settling with the hated Germans. He likes to fish yet, and when he can get away from the war zone, he hunts a small stream and spends his leisure hours along it.
During his brilliant career since the war began Joffre has developed some of the qualities notable in our own General Grant. There is not a particle of show or bluster about him. He dresses as plainly as possible, talks little and seems to prefer solitude. But his will is imperious and he does not hesitate when anything is to be done, whether it is pleasant or otherwise. For his men he has the greatest consideration, but they say in France that, like Lincoln, he has little regard for Generals. Some of the things told about him remind you of the story of Lincoln. In this story a Confederate raid had resulted in the capture of two generals and a number of privates. When the story was brought to Lincoln, he said it was too bad about the men. Someone suggested that it was a pity the generals had been taken, but Lincoln said that did not matter much, as he could make some more. Joffre has made it uncomfortable for the inefficient generals in France. Many of them have lost their commands and most of them live in fear of his quiet but inexorable discipline.
Joffre does not look kindly on visitors to the Front, and nobody gets there without his permission. He signed the passes on which the Commission traveled, but he did not seem overjoyed at our coming enough to look us up while we were there. Apparently he regarded us as people who could not help in his big job and who were likely in some way or other to become nuisances.
When you talk with people who know this man you are at once impressed with the fact that he appreciates his great responsibility and that there is nothing on his mind but how to win this war for France. They say he has a clipping bureau that saves for him all that is being printed about the war. He probably expects to read it somewhere after the war is over, but he will not likely be able to do this in the remainder of an ordinary lifetime.
Time only will decide whether Joffre is really a great military genius, or whether he is merely a good general, conscientiously doing his best and fortunate enough to become a popular hero. Modern war is so different from old time variety that no one can judge results up to this time. It is at least certain that Joffre has beaten the Germans back and back, slowly, but surely forcing them out of France. He says himself that he "has been nibbling at them."
There can be no doubt that at the time this is written he has reached the pinnacle of fame in France. He is the man in all France who is most talked about, most admired and most trusted. Were he to die now, as Kitchener died, his place in History would be secure. What will happen before the war is over is another matter. But, having heard the French talk about "Father Joffre" so much and so lovingly, and having been given the most useful thing in France, if you want to see the front—a pass by him in spite of the great cares resting on his shoulders, I hope that fate will be kind to him and that he will remain the idol of his people to the end.
As might be expected, France is full of the sayings of Joffre. Everyone you meet can tell you a new one. Some of the aphorisms credited to him that I can now recall are: "Go where the enemy is not expecting you"; "No soldier is expected to think of retreating"; "Now is the time to stand and die rather than yield". This last is said to have been his utterance before the beginning of the Battle of the Marne.
WHILE no estimate can be made of the cost of rebuilding the towns and cities destroyed in France until after the war is over and it is known what further damage has been done, this matter is already receiving earnest consideration. The French are confident of victory and are satisfied that they will soon be able to rebuild their cities and reorganize their industries. They are a frugal and thrifty people, and usually have more private means than the average American whose manner of living would indicate that he is wealthy. On this account it is my impression that France will recover very rapidly after the war and will soon be as well off in property as before it began.
The chief loss of the French is likely to be their young manhood. Houses can be rebuilt. Factories will spring up over night where there is capital and faith to invest it. Even the fine old cathedrals may be restored or replaced with something that will serve equally well in a practical sense. But the young men—the flower of the French nation—whose lives have been offered on the altar of national defense—these cannot be replaced. Generations must pass before the terrific price of national existence will be fully paid in this direction.
Most Frenchmen feel this way about the situation. From a material standpoint they expect to soon be as well off as ever. They do not seem to mind the loss in wealth destroyed by the great war. But they are bowed down with grief at the thought of the young men who have been slain and the years that will be required to replace them. Although they do not care to discuss this phase of the situation, the French have already begun nobly to meet the problem of the lame, halt and blind who are a part of the legacy of every war and an exceedingly prominent part of that left by this one.
It is surprising to learn that the Belgians, whose little country has been crushed under the heel of the invader so that its government retains only a narrow corner behind the British army, are even more optimistic than the French. They are determined that the Germans must be driven out and are already laying elaborate plans for reconstruction of their farms and villages and cities. Almost before the Commission had reached Paris we were asked by the Belgians to hold a meeting with their chamber of commerce in that city in order to discuss the problems of Belgium's rehabilitation.
[Illustration: Ruins at Nancy.]
When this meeting did finally take place, on October 16th, we were all impressed with the pathetic earnestness of the Belgians upon this subject. Some of the most prominent citizens of Belgium took part in the discussion. It was easy to see, even from the meagre translations we were able to get on the moment, that the Belgians realize that they have been martyrs and expect the world to render them substantial aid when the time comes to restore their national entity and rebuild their war torn country. In fact I was compelled to admit with reluctance that their enthusiasm was greater than their business acumen, for they seemed to have very little tangible information on which plans could be laid for helping them.
It was explained afterward that these Belgians have no means of securing the information they need, as the Germans have almost absolute possession of their country and are, as might be expected, not furnishing any information as to the amount of destruction, or the quantity of materials which can be used again, or in any other way. It is stated that the Germans have practically looted the whole country, carting off the machinery in most of the factories, and even forcing the Belgians to work on military defenses to be used against them and their allies. Under such conditions it was not to be expected that the Belgian chamber of commerce would be in possession of definite information. The impassioned belief of these gentlemen in the magnanimity and wealth of America was inspiring, and I sincerely hope that when the time comes to reconstruct this stricken land our people will have as large a part as the Belgians expect and one much more generous than they have had in the saving of the Belgians from starvation.
[Illustration: Trenches Occupied by French Soldiers]
At this meeting I heard many kind things said about the Americans who are working in Belgium and about how much this country has done to save the people there from suffering. Great praise was also given to the English, who have aided most nobly to prevent the absolute destruction of the Belgian nation.
TO the members of our Commission one of the most interesting things found in France was the organization of chambers of commerce, or bodies whose purpose is to promote the industrial and financial welfare of the communities where they exist. Unlike the situation in America, where chambers of commerce are purely local organizations, without power or even much prestige in the regulation of municipal affairs, the French have a system of such bodies that is probably the most important single force to be reckoned with in the republic.
We were entertained at almost every city where we made a stop by the chamber of commerce, and were given every opportunity to ascertain how these organizations work. We found their system admirable, and many features of it should be copied in this country. Before this can be done, however, we must have more liberal and sensible legislation on the question of co-operation among productive organizations.
The French chambers of commerce are officially recognized by the government and given certain powers which, to a large extent, place every community under their care, at least in so far as its business interests and development of its resources go. No chamber can be organized except by governmental decree, and this provision naturally prevents them from interfering with the legitimate prerogatives of the government, while giving them powers that enable them to be of real service to the community.
Everywhere we went we found that the chamber of commerce was regarded as the guardian of the public interest, and we were told how these bodies took action frequently with much success in matters that in this country would be regarded as far beyond the scope of a chamber of commerce. They have power to represent the towns where they exist in all matters regarding industrial, agricultural and transportation problems. They are under the direct control of the department of industry, and the charter of each is signed by the minister of commerce then in office. Their members are elected much as we elect regular city officials, and the number cannot be less than nine or more than twenty-one, except in Paris, where there are forty at this time. The number is fixed for each chamber by government decree and depends on the population of the district. The members must be thirty years of age and citizens in good standing. Bankrupts are not allowed to serve. In every way these bodies are made thoroughly representative of the best citizenship, and it is regarded as quite an honor to be permitted to serve on them without pay.
These chambers usually meet twice each month and they keep in close touch with each other, working out plans that will be for the good of the whole country as well as for their special localities. Many of the largest undertakings in France have been begun and carried out largely by chambers of commerce. The new port at Marseilles, which will cost about two hundred million francs, is an example. For this work the chamber of commerce raised six million francs, the government provided a like amount, and with this the chamber was able to finance the improvement, depending on tolls and other revenues to pay the balance in due time.
The feature which appealed most strongly to me in these chambers of commerce was the manner in which they are dovetailed with the government in the performance of duties of a nature such as, in spite of their tremendous importance, we Americans generally regard as nobody's business in particular, and which are therefore usually left undone.
A national organization of chambers of commerce is maintained in Paris. Part of the expense of each chamber, as well as of this body, is paid by the government. The secretaries of the local chambers have also an organization, and all these seem to work in perfect harmony for the general good. The secretaries are usually professionals, and special courses of training may be had in France for this work.
We found that nearly every chamber had its own building and that all were handsomely housed, well financed and extremely effective. They have become a most important part of the government, handling with success many problems that are difficult for a government and which, at the same time, require a certain amount of governmental authority if they are to be disposed of in an efficient manner.
In my opinion this country could copy the French system of chambers of commerce with much profit. We are in advance of them in many things, especially in the matter of industrial operations, but they are a century in advance of us in the co-operation needed between the citizens and the government for the highest development of community life and progress.
SO much interest has been expressed in the new method of treating wounds discovered by Dr. Carrel and bearing his name, and the subject being of such great importance to the cause of humanity and the preservation of human life, I have thought it worth while to give here the following authoritative descriptions of this new and epochal discovery in the science of medicine. It is now generally known as the Carrel-Dakin treatment.
Reference has been made to meeting Dr. Sherman in London. On discovering that this physician had enjoyed considerable experience with the Carrel treatment and was thoroughly familiar with it, I invited him to deliver an address on this subject at my home town after his return from Europe. He readily agreed to do this, speaking to an interested audience under the auspices of the Mahoning County Medical Society on Dec. 19, 1916. A newspaper account of this address is appended. This will, in a measure, serve to show the importance of the Carrel treatment.
Out of the horror and carnage that is raging across the seas some inconceivable good must come. This is the opinion of all who have been close to the din of battle, who have visited hospitals and seen with their own eyes the human wrecks wrought by grape shot, shrapnel and bursting shells. Dr. William O'Neill Sherman's visit to this city Tuesday night, when he opened the eyes of the medical profession here to new and greater things, is the first inkling of one great good that is to come out of this war. To treat the millions of wounded and maimed, medical genius has been taxed to the limit. As in all great times, great minds have come to the rescue and found a way. The old saying that where there is a will there is a way, has been clearly proven.
Particularly is this true in the medical world. Dr. Sherman came here from Pittsburgh, the invited guest of the Mahoning County Medical Society, at the suggestion of J. G. Butler, Jr., who wanted him to tell the physicians of this city and county the many things he had learned by close application and association with conditions in European hospitals and trenches. Dr. Sherman was filled with an enthusiasm that he made every man who attended the annual banquet of the Mahoning Medical Society feel. Particularly was he anxious to bring the local medical fraternity to a realization of the methods and treatments developed by the horrible carnage raging now in the European countries. He drove home his point without gloves when he told physicians of Youngstown that medical men throughout this country were given too much to criticising new methods rather than investigating them.
The Carrel method, he explained at length. It is simply a newly discovered antiseptic solution, conceived by Dr. Alexis Carrel, which sterilizes wounds and arrests infection and inflammation before they have an opportunity to spread and result in blood poisoning and death.
[Illustration: Proclamation Posted in Reims Just Before the French Fell Back to the Marne. (See Chap. XXV.)]
TRANSLATIONREPUBLIC OF FRANCE, CITY OF REIMSTO THE INHABITANTSAt the moment when the German army is at our gates, and will probably enter the city, the municipal authorities request you to preserve all your presence of mind, and all calmness necessary to permit you to undergo this trial.There must not be any manifestations, any riotous gatherings, any outcries to trouble the tranquility of the streets. Public Service, Charity, Health, and street maintenance should continue to be safe. You must co-operate with us. You must remain in the city to help the unfortunate. We shall remain with you at our post to defend your interests.It does not devolve upon you, the population of an unfortified city, to alter events. It does devolve upon you not to aggravate the consequences. To this end it is necessary to keep silence, dignity and prudence.We rely upon you, you may rely upon us.Reims, September 3, 1914.DR. LANGLET, Mayor.Mr. Butler said to visit European capitals is to witness a revelation difficult to convey in mere words. Soldiers of every nationality are treated by the expert and world famed in medicine. Human wrecks, victims of shot and shell, are repaired and rebuilt. It matters little whether a man is friend or foe, as long as a spark of life is there, he is picked tenderly from the trench and everything known to medical science done to bring about his recovery.The mind is filled with horror and wonder of it all. New thoughts bombard the mind as one looks on. A man is brought in. His face is practically shot away. It seems that even should he recover he will be so disfigured that life will not be worth the living. The Carrel solution is applied. By plastic surgery and other means the disfigured mass is shaped. In a few short weeks the man again begins to resemble a human being and eventually is well, with little more than a few indistinct scars. Not infrequently he returns to the trenches. Some of the things that shock the mind are metal jaws, screened behind false beards, artificial noses, ears, cheeks, eyes and limbs. Sometimes when a man is facially disfigured beyond repair, that is, when nature can never replace the countenance, a copper mask is fitted. These sculptors in flesh-and-blood do their work with such precision and accuracy that it is startling and cannot be believed unless it is seen.The war has seen the springing up of many hospitals of special character. There are groups of institutions where only faces are treated, eyes, ears and nose, maimed limbs, etc. Medical attention in most cases begins in the trenches and the patient is carefully watched while being transported to the hospital. By sterilizing wounds shortly after they occur, infection and pus are robbed of their chance to hinder nature and the patient recovers in a few weeks from a frightful wound that if infected would take that many months. There are many things of today that help in the preservation of human life. The highly developed X-ray has played an important part in this great war. Electricity, new antiseptics and anaesthetics have been at the finger's end of the skilled medical profession, to work what can honestly be called miracles and wonders.One of the strange things of this great war is the fact that new, unheard of diseases are developed. It has tended to make common rare diseases and greatly increased those that are usual. Thousands die, having no mark upon their body. Post-mortems held have disclosed in nearly every case that such deaths were caused by shell shock. Bombs from the huge guns dropping near a company of men will often so disarrange organs that death follows quickly. Many who survive lose mind, sight, hearing, speech, and so on. This has become one of the common things of this great war. As a result the warring countries will find themselves confronted with a new and difficult problem when peace comes and normal times are again established. There will be hundreds of thousands to pension and no doubt insane institutions will have to be enlarged. Rest is often a saviour. Men taken away from the fronts, minds blank, in the quiet of home often regain their reason. There is the large percentage that God in his goodness does not see fit to restore that will form an elephantine problem. There will have to be vast pension lists, for these men often have large families.The way men may be pieced and patched together is one of the finds of the new medical era. It has been discovered that bones in legs and arms practically shot in two can be brought together by means of silver and vanadium steel plates fitted with screws and that the bones will knit and after a period the afflicted can walk almost as satisfactorily as if nothing had happened. Dr. Sherman while in this city this week displayed a steel plate that he worked out and used with marked success in the hospitals of France. These plates are applied in what would seem to be a very simple manner. A man may have a leg or an arm practically shot off. By placing the broken bones together, after a treatment with the Carrel solution to keep down infection, a plate is fitted on either side of the fracture and screws are applied. This holds the two members solidly together and in a few short weeks the bones knit. In time this place is practically the strongest part of the limb. What this means can best be told by explaining that before the discovery, an arm or a leg so badly shattered was simply amputated because this was the only safe and logical way to save the life of the individual. In the olden days gangrene would invariably set in and the patient die within a short time unless amputation was performed promptly following the accident.Dr. Carrel has gone a long way to eliminate this danger.
TRANSLATION
REPUBLIC OF FRANCE, CITY OF REIMS
TO THE INHABITANTS
At the moment when the German army is at our gates, and will probably enter the city, the municipal authorities request you to preserve all your presence of mind, and all calmness necessary to permit you to undergo this trial.
There must not be any manifestations, any riotous gatherings, any outcries to trouble the tranquility of the streets. Public Service, Charity, Health, and street maintenance should continue to be safe. You must co-operate with us. You must remain in the city to help the unfortunate. We shall remain with you at our post to defend your interests.
It does not devolve upon you, the population of an unfortified city, to alter events. It does devolve upon you not to aggravate the consequences. To this end it is necessary to keep silence, dignity and prudence.
We rely upon you, you may rely upon us.
Reims, September 3, 1914.
DR. LANGLET, Mayor.
Mr. Butler said to visit European capitals is to witness a revelation difficult to convey in mere words. Soldiers of every nationality are treated by the expert and world famed in medicine. Human wrecks, victims of shot and shell, are repaired and rebuilt. It matters little whether a man is friend or foe, as long as a spark of life is there, he is picked tenderly from the trench and everything known to medical science done to bring about his recovery.
The mind is filled with horror and wonder of it all. New thoughts bombard the mind as one looks on. A man is brought in. His face is practically shot away. It seems that even should he recover he will be so disfigured that life will not be worth the living. The Carrel solution is applied. By plastic surgery and other means the disfigured mass is shaped. In a few short weeks the man again begins to resemble a human being and eventually is well, with little more than a few indistinct scars. Not infrequently he returns to the trenches. Some of the things that shock the mind are metal jaws, screened behind false beards, artificial noses, ears, cheeks, eyes and limbs. Sometimes when a man is facially disfigured beyond repair, that is, when nature can never replace the countenance, a copper mask is fitted. These sculptors in flesh-and-blood do their work with such precision and accuracy that it is startling and cannot be believed unless it is seen.
The war has seen the springing up of many hospitals of special character. There are groups of institutions where only faces are treated, eyes, ears and nose, maimed limbs, etc. Medical attention in most cases begins in the trenches and the patient is carefully watched while being transported to the hospital. By sterilizing wounds shortly after they occur, infection and pus are robbed of their chance to hinder nature and the patient recovers in a few weeks from a frightful wound that if infected would take that many months. There are many things of today that help in the preservation of human life. The highly developed X-ray has played an important part in this great war. Electricity, new antiseptics and anaesthetics have been at the finger's end of the skilled medical profession, to work what can honestly be called miracles and wonders.
One of the strange things of this great war is the fact that new, unheard of diseases are developed. It has tended to make common rare diseases and greatly increased those that are usual. Thousands die, having no mark upon their body. Post-mortems held have disclosed in nearly every case that such deaths were caused by shell shock. Bombs from the huge guns dropping near a company of men will often so disarrange organs that death follows quickly. Many who survive lose mind, sight, hearing, speech, and so on. This has become one of the common things of this great war. As a result the warring countries will find themselves confronted with a new and difficult problem when peace comes and normal times are again established. There will be hundreds of thousands to pension and no doubt insane institutions will have to be enlarged. Rest is often a saviour. Men taken away from the fronts, minds blank, in the quiet of home often regain their reason. There is the large percentage that God in his goodness does not see fit to restore that will form an elephantine problem. There will have to be vast pension lists, for these men often have large families.
The way men may be pieced and patched together is one of the finds of the new medical era. It has been discovered that bones in legs and arms practically shot in two can be brought together by means of silver and vanadium steel plates fitted with screws and that the bones will knit and after a period the afflicted can walk almost as satisfactorily as if nothing had happened. Dr. Sherman while in this city this week displayed a steel plate that he worked out and used with marked success in the hospitals of France. These plates are applied in what would seem to be a very simple manner. A man may have a leg or an arm practically shot off. By placing the broken bones together, after a treatment with the Carrel solution to keep down infection, a plate is fitted on either side of the fracture and screws are applied. This holds the two members solidly together and in a few short weeks the bones knit. In time this place is practically the strongest part of the limb. What this means can best be told by explaining that before the discovery, an arm or a leg so badly shattered was simply amputated because this was the only safe and logical way to save the life of the individual. In the olden days gangrene would invariably set in and the patient die within a short time unless amputation was performed promptly following the accident.
Dr. Carrel has gone a long way to eliminate this danger.
Having seen with my own eyes the wonderful results of this treatment during my visits to the American Ambulance and other hospitals in France, I requested Mr. Laurence V. Benet, superintendent of the American Ambulance, to furnish me with an authoritative description of the treatment. The chief purpose of this is to enable medical authorities in this country, particularly those connected with hospitals maintained by iron and steel plants, to gain a reliable outline of the treatment. Dr. Benet, in spite of the fact that he is one of the busiest men in France, kindly agreed to furnish this information. In doing so he accompanied the description with the following letter:
1 Avenue De CamoensParis, October 26, 1916.
Mr. Joseph G. Butler, Jr., Youngstown, O.
My dear Mr. Butler:—
In compliance with my request, Dr. Joseph Lawrence, of the American Ambulance, has kindly prepared a short note on the Carrel treatment of wounds, and this I am now enclosing. I trust that you will find it sufficiently explicit for your purposes, and that it will be of use and interest to you.
Now that you are again home I hope that your wonderful trip in France will be less than a mere memory and that the labors of the Industrial Commission will prove, as they should, most valuable to the manufacturers and exporters of the United States. Believe me that it was to me a great privilege as well as a great pleasure to have met you and your distinguished colleagues, and that my only regret is that I was unable to be of greater use to the Commission.
I am, with very kind regards,
Sincerely yours,
LAURENCE V. BENET
1 encl.
The Carrel Treatment of Wounds.The Carrel treatment consists in thorough irrigation guided by the bacteriological observation of the wound.For the irrigation of the wound, Carrel has chosen a certain size of rubber tube about 4 mm. in diameter into which he punches small holes at intervals. The one end of this tube is shut, the other end is allowed to protrude from the dressing.On the surface wound, the tube is laid over the wound in the direction of the greatest diameter of the wound with the open end towards the most elevated part.In perforating wounds, the tube or several tubes, when the wound is large, are passed through from both sides, or pushed into cavities or pockets that may exist.If the wound is not a perforating wound, but a deep wound, the tubes are planted deep into the cavity that may be formed. These tubes are always of sufficient number to thoroughly irrigate the broken surface.Over the uninjured skin, about the wound, is placed thin strips of gauze which have been steeped in vaseline, the skin having been thoroughly washed before with soap and water.To keep these tubes in place, a bandage wet with Dakin's solution is placed over them. The wound is flushed every two hours with Dakin's solution. The amount of solution used per wound, varies in proportion to the size of the wound from 500 c.c. per day up. Wounds are dressed daily.The bacteriological observation is made by taking a smear from the most vicious part of the wound at intervals of two or three days. The number of bacteria on these smears is noted and counted per oil immersion field. A count of more than 75 bacteria per field is considered infinity. When there are less than 10 bacilli to the field, and not less than 5 to the field, three fields are counted. When less than 5, and not less than 7, five fields are counted. When less than one, from five to twenty fields will be counted.A wound that retains a count of one bacillus to two fields or less for three observations, is considered bacteriologically clean, and suitable for operation. If the wound is a compound fracture, it is advisable to close the wound, converting it into a simple fracture.If this can be done without exerting too great tension on the sutures.If the wound is a flesh wound, and can be drawn together without too great tension, its closure is indicated.[Illustration]The important parts of the treatment consist in thorough irrigation, and careful bacteriological observation. The bacteriological observations are charted on charts similar to temperature charts.Dakin's Solution.(Sodium Hypochlorite at 0.50%)1—To prepare 10 litres of solution, weight exactly:Chloride of Lime (Bleaching Powder)200 grms.Carbonate of Soda (dried)100 grms.or if used in crystals200 grms.Bi-carbonate of Soda200 grms.2—Put the Chloride of Lime into a large mouthed bottle of about 12 litres capacity. Add 5 litres of water (half the quantity) and shake well two or three times. Let this stand all night.3—Dissolve in another 5 litres of water of two Soda salts.4—this latter solution directly into the bottle containing the maceration of lime. Stir well and let the solution stand in order to allow the precipitate of Carbonate of Lime to settle.5—At the end of half an hour, siphon the clear liquid and filter by means of a paper, in order to have a perfectly clear solution. This should be kept away from the light.6—No heat should be employed in the manufacture of Dakin's andordinary Tapwater should be used.Preparation of Dakin Solution.Technique of Dr. Daufresne.The solution of sodium hypochlorite for surgical use must be free of caustic alkali; it must only contain 0.45% to 0.50 of hypochlorite. Under 0.45% it is not active enough and above 0.50 it is irritant. With chloride of lime (bleaching powder) having 25% of active chlorine, the quantities of necessary substances to prepare ten litres of solution are the following:—Chloride of Lime (bleaching powder) 25% CI act.200 gr.Sodium Carbonate, dry (Soda of Solway)100 gr.Sodium Bi-carbonate80 gr.Pour into 12 litre flask the two hundred grammes of chloride of lime and five litres of ordinary water, shake vigorously for a few minutes and leave in contact for six to twelve hours, one night for example. (Shake until dissolved) at least the big pieces are dissolved, large pieces float—notice only floating pieces. At the same time, dissolve in five litres of cold ordinary water the carbonate and bi-carbonate of soda.After leaving from six to twelve hours, pour the salt solution in the flask containing the macerated chloride of lime, shake vigorously for a few minutes and leave to allow the calcium carbonate to be precipitated. In about half an hour, siphon the liquid and filter with a double paper to obtain a good, clear liquid, which should always be kept in a dark place.Tritration of Chloride of Lime (Bleaching Powder).Because of the variation of the products now obtained in the market, it is necessary to determine the quantity of active chlorine contained in the chloride of lime which is to be used. This, in order to employ an exact calculated quantity according to its concentration. The test is made in the following manner:—Take from different parts of the bar a small quantity of beaching powder to have a medium sample, weigh 20 grammes of it, mix as well as possible in a litre of tap water and leave in contact for a few hours. Measure 10 c.c. of the clear liquid and add 20 c.c. of a 10% solution of potassium iodide, 2 c.c. of acetic acid or hydrochloric acid, then put drop by drop into the mixture a decinormal solution of sodium hyposulfite (2.48%) until decoloration. The number "N" of cubic centimeters of hyposulfite employed multiplied by 1,775 will give the weight "N" of active chloride contained in 100 grammes of chloride of lime.The test must be made every time a new product is received. When the result obtained will differ more or less than 25%, it will be necessary to reduce or enlarge the proportion of the three products contained in the preparation. This can be easily obtained by multiplying each of the three numbers—200, 100, 60 by the factor N/25 in which N represents the weight of the active chlorine per cent of chloride of lime.Measure 10 c.c. of the solution, add 20 c.c. of potassium iodide 1/10, 2 c.c. of acetic acid and drop by drop a decinormal solution of sodium hyposulfite until decoloration. The number of cubic centimeters used multiplied by 0.03725 will give the weight of the hypochlorite of soda contained in 100 c.c. of the solution.Never heat the solution and if in case of urgency one is obliged to resort to trituration of chloride of lime in a mortar, only employ water, never salt solution.Test of Thetalkalinity of Dakin Solution:—To easily differentiate the solution obtained by this process from the commercial hypochlorites, pour into a glass about 20 c.c. of the solution and drop on the surface of the liquid a few centigrammes of phenol-phthaleine in powder. The correct solution does not give any coloration while Lebarraque's solution and Rau de Javel will give an intense red color which shows in the last two solutions existence of free caustic alkali.TECHNIQUE—Dakin Solution.The procedure is very simple. The solution, however, must be between 45 to 50% hypochlorite. Anything above this strength will burn and anything below is too weak. The edges of the wound should be covered with gauze which has been well soaked in vaseline, the solution should then be introduced into the wounds from an irrigator every two hours. A stopcock should be put on the tube and only sufficient solution should be allowed to enter the wound to completely saturate all parts of the wound. In other words, the wounds should be bathed with the solution every two hours—do not mistake this and irrigate continuously. You can easily tell how much solution it takes to keep the wound wet.Rubber tubes are used. The end of the tube is tied off and six to eight small perforations are made so that the solution can run into all parts of the wound. If the wounds are superficial, the same kind of a tube can be used to which a cuff of turkish towel is wrapped around the end of the tube.If you feel that the wounds are sure to be infected, it would be well to lay them open freely and immediately start this treatment, be sure to have the skin well protected with the vaseline and gauze and see that the solution does not run out of the wound on the bed. Just keep the wound bathed every two hours.I have been informed that a movement is on foot to inaugurate the use of this remarkable discovery in the United States military hospitals, and that the Rockefeller Foundation has in view the erection at New York of a large hospital where the treatment may be studied and still further perfected for the benefit of this country.[Illustration: Proclamation by the Mayor of Reims Issued on the Day the Germans Entered that City, Sept. 4, 1914.]TRANSLATIONAPPEALTO THE POPULATION OF REIMS.Dear Citizens:To-day and in the days following, many from among you, both prominent citizens and workmen, will be kept as hostages to guarantee to the German authorities the quiet and good order which your representatives have promised in your name.It is to your security and to the safety of the City and to your proper interests that you do nothing which may break this agreement and compromise the future.Have realization of your responsibility and facilitate our task.Men, women, children, remain as far as possible in your homes, avoid all discussion.We depend upon you to be equal to this occasion.All riotous gathering is absolutely forbidden and will be immediately dispersed.J. B. LANGLET, Mayor.L. ROUSSEAU, DR. JACQUIN,E. CHARBONNEAUX, J. De BRUIGNAC.Assistants.
The Carrel Treatment of Wounds.
The Carrel treatment consists in thorough irrigation guided by the bacteriological observation of the wound.
For the irrigation of the wound, Carrel has chosen a certain size of rubber tube about 4 mm. in diameter into which he punches small holes at intervals. The one end of this tube is shut, the other end is allowed to protrude from the dressing.
On the surface wound, the tube is laid over the wound in the direction of the greatest diameter of the wound with the open end towards the most elevated part.
In perforating wounds, the tube or several tubes, when the wound is large, are passed through from both sides, or pushed into cavities or pockets that may exist.
If the wound is not a perforating wound, but a deep wound, the tubes are planted deep into the cavity that may be formed. These tubes are always of sufficient number to thoroughly irrigate the broken surface.
Over the uninjured skin, about the wound, is placed thin strips of gauze which have been steeped in vaseline, the skin having been thoroughly washed before with soap and water.
To keep these tubes in place, a bandage wet with Dakin's solution is placed over them. The wound is flushed every two hours with Dakin's solution. The amount of solution used per wound, varies in proportion to the size of the wound from 500 c.c. per day up. Wounds are dressed daily.
The bacteriological observation is made by taking a smear from the most vicious part of the wound at intervals of two or three days. The number of bacteria on these smears is noted and counted per oil immersion field. A count of more than 75 bacteria per field is considered infinity. When there are less than 10 bacilli to the field, and not less than 5 to the field, three fields are counted. When less than 5, and not less than 7, five fields are counted. When less than one, from five to twenty fields will be counted.
A wound that retains a count of one bacillus to two fields or less for three observations, is considered bacteriologically clean, and suitable for operation. If the wound is a compound fracture, it is advisable to close the wound, converting it into a simple fracture.
If this can be done without exerting too great tension on the sutures.
If the wound is a flesh wound, and can be drawn together without too great tension, its closure is indicated.
[Illustration]
The important parts of the treatment consist in thorough irrigation, and careful bacteriological observation. The bacteriological observations are charted on charts similar to temperature charts.
Dakin's Solution.(Sodium Hypochlorite at 0.50%)
Preparation of Dakin Solution.
Technique of Dr. Daufresne.
The solution of sodium hypochlorite for surgical use must be free of caustic alkali; it must only contain 0.45% to 0.50 of hypochlorite. Under 0.45% it is not active enough and above 0.50 it is irritant. With chloride of lime (bleaching powder) having 25% of active chlorine, the quantities of necessary substances to prepare ten litres of solution are the following:—
Pour into 12 litre flask the two hundred grammes of chloride of lime and five litres of ordinary water, shake vigorously for a few minutes and leave in contact for six to twelve hours, one night for example. (Shake until dissolved) at least the big pieces are dissolved, large pieces float—notice only floating pieces. At the same time, dissolve in five litres of cold ordinary water the carbonate and bi-carbonate of soda.
After leaving from six to twelve hours, pour the salt solution in the flask containing the macerated chloride of lime, shake vigorously for a few minutes and leave to allow the calcium carbonate to be precipitated. In about half an hour, siphon the liquid and filter with a double paper to obtain a good, clear liquid, which should always be kept in a dark place.
Tritration of Chloride of Lime (Bleaching Powder).
Because of the variation of the products now obtained in the market, it is necessary to determine the quantity of active chlorine contained in the chloride of lime which is to be used. This, in order to employ an exact calculated quantity according to its concentration. The test is made in the following manner:—
Take from different parts of the bar a small quantity of beaching powder to have a medium sample, weigh 20 grammes of it, mix as well as possible in a litre of tap water and leave in contact for a few hours. Measure 10 c.c. of the clear liquid and add 20 c.c. of a 10% solution of potassium iodide, 2 c.c. of acetic acid or hydrochloric acid, then put drop by drop into the mixture a decinormal solution of sodium hyposulfite (2.48%) until decoloration. The number "N" of cubic centimeters of hyposulfite employed multiplied by 1,775 will give the weight "N" of active chloride contained in 100 grammes of chloride of lime.
The test must be made every time a new product is received. When the result obtained will differ more or less than 25%, it will be necessary to reduce or enlarge the proportion of the three products contained in the preparation. This can be easily obtained by multiplying each of the three numbers—200, 100, 60 by the factor N/25 in which N represents the weight of the active chlorine per cent of chloride of lime.
Measure 10 c.c. of the solution, add 20 c.c. of potassium iodide 1/10, 2 c.c. of acetic acid and drop by drop a decinormal solution of sodium hyposulfite until decoloration. The number of cubic centimeters used multiplied by 0.03725 will give the weight of the hypochlorite of soda contained in 100 c.c. of the solution.
Never heat the solution and if in case of urgency one is obliged to resort to trituration of chloride of lime in a mortar, only employ water, never salt solution.
Test of Thetalkalinity of Dakin Solution:—
To easily differentiate the solution obtained by this process from the commercial hypochlorites, pour into a glass about 20 c.c. of the solution and drop on the surface of the liquid a few centigrammes of phenol-phthaleine in powder. The correct solution does not give any coloration while Lebarraque's solution and Rau de Javel will give an intense red color which shows in the last two solutions existence of free caustic alkali.
TECHNIQUE—Dakin Solution.
The procedure is very simple. The solution, however, must be between 45 to 50% hypochlorite. Anything above this strength will burn and anything below is too weak. The edges of the wound should be covered with gauze which has been well soaked in vaseline, the solution should then be introduced into the wounds from an irrigator every two hours. A stopcock should be put on the tube and only sufficient solution should be allowed to enter the wound to completely saturate all parts of the wound. In other words, the wounds should be bathed with the solution every two hours—do not mistake this and irrigate continuously. You can easily tell how much solution it takes to keep the wound wet.
Rubber tubes are used. The end of the tube is tied off and six to eight small perforations are made so that the solution can run into all parts of the wound. If the wounds are superficial, the same kind of a tube can be used to which a cuff of turkish towel is wrapped around the end of the tube.
If you feel that the wounds are sure to be infected, it would be well to lay them open freely and immediately start this treatment, be sure to have the skin well protected with the vaseline and gauze and see that the solution does not run out of the wound on the bed. Just keep the wound bathed every two hours.
I have been informed that a movement is on foot to inaugurate the use of this remarkable discovery in the United States military hospitals, and that the Rockefeller Foundation has in view the erection at New York of a large hospital where the treatment may be studied and still further perfected for the benefit of this country.
[Illustration: Proclamation by the Mayor of Reims Issued on the Day the Germans Entered that City, Sept. 4, 1914.]
TRANSLATION
APPEALTO THE POPULATION OF REIMS.
Dear Citizens:
To-day and in the days following, many from among you, both prominent citizens and workmen, will be kept as hostages to guarantee to the German authorities the quiet and good order which your representatives have promised in your name.
It is to your security and to the safety of the City and to your proper interests that you do nothing which may break this agreement and compromise the future.
Have realization of your responsibility and facilitate our task.
Men, women, children, remain as far as possible in your homes, avoid all discussion.
We depend upon you to be equal to this occasion.
All riotous gathering is absolutely forbidden and will be immediately dispersed.
J. B. LANGLET, Mayor.L. ROUSSEAU, DR. JACQUIN,E. CHARBONNEAUX, J. De BRUIGNAC.Assistants.
FEW who read this book have ever been in contact with actual war. In order that they may have an idea of what happens to a city which finds itself in the path of an irresistible enemy, some account will be given here of what happened to Reims, a city about the size of Youngstown, having a population of one hundred and twenty-five thousand and being situated on the north bank of the river Aisne, in north-eastern France.
When the Germans attacked France they hurled their great armies by three routes. Not only did they violate the neutrality of Belgium and Luxembourg, but they also sent an army across the frontier between Verdun and Belfort, this being the force stopped by the chasseurs at Gerbeviller, as has been told elsewhere. France had trusted too much and was in a desperate plight because her troops had been mobilized on the wrong front.
The first Germans crossed the frontier of little Luxembourg on the morning of August 2, 1914. They were met by the Grand Duchess, who disputed their passage and pleaded with them to turn back. Her little army of four hundred and thirty men could do nothing, and when she turned her car across the road the German soldiers gathered around and, on the order of their commander, pushed it to one side and passed on.
The Germans entered Belgian territory at Gemmenich on August 3, 1914. The next day they attempted to take by assault the city of Liege, Belgium's greatest industrial center, and failed. This city, with its ring of nine forts, blocked the passage of their troops and held the main roads into Germany. After a most bloody and unsuccessful assault, the Germans brought up their big guns and blew the forts to pieces. But they had been delayed five days. Then their hosts swept across Belgium and soon came in touch with the French and English. The English army of one hundred and twenty-five thousand men met them at Mons. The French met them between Mons and Verdun.
At this time the Allied lines swung like a huge gate from Verdun west toward the sea, barring the Kaiser's passage. The Germans then had a million of men, with hordes of the famous lancers, and clouds of these horsemen hung on the right flank of the English, swinging out and around them so as to force Sir John French to fall back or suffer the turning of his flank. Von Kluck was in command of this turning movement, which was made possible by the fall of Namur, Lille and Charleroi. Things then looked desperately bad for the Allies.
[Illustration: First Order From the Invaders.]
TRANSLATIONORDERHaving taken possession of the City and the fortress of Reims I command the following:Railroads, routes of communications, both telegraph and telephone, not only of the City of Reims, but also throughout the immediately outlying districts, must be protected against all possibility of destruction; it is absolutely necessary to protect by a minute surveillance the public buildings along the lines of communication. The City will be held responsible for disobedience to this order: the guilty ones will be pursued and shot; the City will be levied for considerable contributions.I add also that it will be to the interest of the population to conform to the foregoing commands, at the same time going about their ordinary occupations; thus the inhabitants will avoid having new and serious losses.THE GERMAN GENERALCommander in Chief.This notice on a white card, 45 by 56 centimeters, was posted on the walls of the City of Reims by German authority during the occupation of September 4th to 12th, 1914.
TRANSLATION
ORDER
Having taken possession of the City and the fortress of Reims I command the following:
Railroads, routes of communications, both telegraph and telephone, not only of the City of Reims, but also throughout the immediately outlying districts, must be protected against all possibility of destruction; it is absolutely necessary to protect by a minute surveillance the public buildings along the lines of communication. The City will be held responsible for disobedience to this order: the guilty ones will be pursued and shot; the City will be levied for considerable contributions.
I add also that it will be to the interest of the population to conform to the foregoing commands, at the same time going about their ordinary occupations; thus the inhabitants will avoid having new and serious losses.
THE GERMAN GENERALCommander in Chief.
This notice on a white card, 45 by 56 centimeters, was posted on the walls of the City of Reims by German authority during the occupation of September 4th to 12th, 1914.
As they were forced back toward Paris, not so much by actual fighting as by the necessity to keep their lines clear and avoid the turning movement of the swift German division under Von Kluck, the Allied armies swung, like a gate with its hinges at Verdun and the outer edge at Mons, back until they stretched between Verdun and Paris. This movement uncovered the beautiful city of Reims, with its countless art treasures, its magnificent cathedral and its thriving population of more than a hundred thousand people, all of which, as the swinging movement continued, were left to the mercy of the German army. The French evacuated Reims with nothing more than some rear-guard fighting and fell back southward to take their places in the great battle line which Joffre had planned somewhere north of Paris—on the Marne, as it was later evident.
As the Allied forces swung backward to this then unknown position, they were hard pressed by the advancing German hosts. Their retreat will stand as one of the most masterly in history, for during ten days these vast armies retired more than two hundred miles on their left flank without disorder and without excessive loss of men or material.
The English army occupied the side toward the sea in these grand maneuvers for position. Sir John French moved swiftly backward, fighting as he went and constantly swinging outward to prevent Von Kluck from encircling his flank. On the morning of September 3rd, he reached a point between Paris and the sea, actually a little north of that city. Suddenly in response to orders from Joffre, he marched his tired troops through Paris to Lagny, twenty miles east of the capital, where he took up a position on the Marne front.
Von Kluck was almost in sight of Paris in hot pursuit of the English when he found how he had been tricked. He could not attack the defenses, and it was urgently necessary for him to join the main army on the Marne front. To do this he had to circle to the north, around the outer fortifications of Paris a much longer march than that of the English.
The French government had packed its belongings and left for Bordeaux on the morning of the day the English passed through Paris, and the people thought the Germans were about to besiege the city. All buildings in the line of fire had been destroyed, the civilian population sent south, and every preparation made for defense. Joffre only knew the real plan.
The Parisians were amazed when the Germans scarcely stopped in front of their city. They could not understand why Von Kluck should suddenly withdraw to the east, because they did not know how badly he was needed on the Marne front. But Von Kluck must have suspected, for it is said that he told an aide that, "We have met with a great misfortune."
Von Kluck was right, for the masterly strategy of Joffre had won the battle of the Marne before a shot had been fired in that historic struggle.
These facts were gleaned from military men whom we met in France. They show how little the civilian population of a military zone, or even the soldiers themselves, know of the movements in which they are engaged. Evidently Joffre had not confided his plans even to the government authorities at Paris, preferring to have the seat of government move and the population flee rather than take chances of these plans being learned by the enemy. So also at Reims.
The French who had been stubbornly defending the city they love best next to Paris from German "Kultur," were forced to move through Reims and to the south to take their place in the great battle line on the Marne. They went reluctantly and the Germans followed them into the city.
This explains the situation shown in the poster on page 245. The Germans were just outside of Reims on September 3rd, and the Mayor knew that the French army was moving south and leaving the city at their mercy. He counselled his people concerning their conduct, warning them to interfere in no rear-guard action such as was likely to occur. This proclamation was dated September 3, 1914.
[Illustration: Second German Proclamation.]