Remember, if you will, that this man Burlingame is exceedingly long on common sense, quick thinking, and quick acting; short, if you please, on that abominable thing known as red tape. Sensing the situation with a keenness that, in the light of after events, was uncanny, he decided that, when the clash came, it would come midway between Soissons and Château-Thierry, a little to the east of the point where he had halted his car. And there it came. "It was bound to be a hard bump," said he, and so it was.
He at once got in touch with the American Red Cross warehouses at Beauvais and at Paris and ordered medical and surgical and hospital supplies in abundance forwarded to Chantilly—the point where he had so quickly decided he would locate the emergency evacuation hospital. He ordered eight surgeons, sixteen nurses, and twelve enlisted men, who were on duty at A. R. C. Hospital Number 104, at Beauvais, to proceed at once to Chantilly, where they were met by additional Red Cross personnel sent on direct from Paris. He made arrangements with the Ambulance St. Paul, which was then located at Chantilly, to establish the material and men and women being rushed from Paris and from Beauvais as an annex to its formation. Thus, in a mere twelve hours, was established an American hospital along the French lines of communication.
And none too quickly. On the following morning the big fighting set in to the north of Château-Thierry. And within a few hours the American wounded began pouring into the old French château town of Chantilly. In three weeks just 1,364 of our boys had been accommodated in our emergency Red Cross hospital there; after which there was a shifting of positions and of armies with a removal of the victorious Americans to other sectors, and only French were left in the neighborhood. Which, in turn, rendered it quite easy for our Red Cross to turn over the entire equipment to our French allies, who stood in great need of it.
Château-Thierrywas in fact the first really great test of the American Red Cross. It was its first opportunity to perform its chief and most vital service—the succoring of the wounded men of the United States Army. It met that test. As a single example of the many ways in which it met the test consider the request for three thousand blankets, in addition to several thousand pillows, pajamas, dressings, surgical instruments, and medicines that poured in upon the Bureau of Hospital Administration at Paris at four o'clock on the afternoon of the eighteenth of July. Osborne's department was a little short of motor cars at that particular moment; the continued emergency at Château-Thierry, with the multifold demands that it brought upon every function of the Red Cross, had fairly exhausted his garages. There might be cars in, in a few hours, said the transportation dispatchers. But Burlingame's men took no such chances. They poured down from out of the Regina headquarters and, taking their places in the middle of the Rue de Rivoli, halted and commandeered taxicabs as they hove in sight.
With a half dozen of the Parisian "one lungers" screeching their very souls out in the second speeds, they visited four of the Paris warehouses in quick succession. A truck was brought up out of the offing. By eight o'clock it was loaded, and by midnight it was at the firing line and being unloaded of its precious supplies.
On another night during the same battle, a veteran army surgeon major arrived in Paris at one o'clock in the morning. He found the medical offices of the Red Cross open—there were no hours in those strenuous days when one found them closed—and demanded supplies. The man was faint from lack of sleep. He was put in bed for 120 minutes—not one minute less, not one minute more. When he was awakened, his supplies were at the door. They had been gathered in a motor truck from three warehouses immediately roundabout.Later this army man returned to Paris and reported that the work of our Red Cross that night had made it possible for every man in his Division to have a chance for recovery. Had it not been for the supplies, he added, sixty per cent of them might have died.
But it was in the quick establishment of hospitals that I think that Burlingame's function of the Red Cross attained its most satisfactory as well as its most dramatic results. Take Number 110 at Coincy, also no great distance from Château-Thierry. It, too, sprang up as a direct result of that famous battle. A radical change of location of our troops in that territory and increasing activities in the neighborhood of Fère-en-Tardenois made an American evacuation hospital at or near that point an immediate necessity. Burlingame, in the same trusty motor which carried him so many miles over the battle-scarred and shell-holed and traffic-worn highroads of France, went out with Colonel Stark, of the Regular Army force, to find a site for it. They decided on a little town of Coincy, on the direct main line of evacuation from the American sector.
The only things that stood in favor of Coincy were its location and the fact that it had water. There was little else left there; not a château or a ruined church or even a barn in which to locate, temporarily at least, a hospital. Moreover, there was no time for picking or choosing in that country through which thebochein the beginnings of his final retreat had just passed. In the center of some partly demolished buildings, Stark and Burlingame found a pump, still in working order. This, they decided, would make a splendid site for their new hospital. The road which ran close by the ruins was the main road to the front—not far away, as the constant booming of artillery attested—and the fact that the railroad also was fairly near simplified the problem of evacuations. These two factors,together with that of the water, which was both pure and abundant—the French already had marked the pump, "Eau potable"—decided the question.
So the two men staked a claim to the ruin. Before they returned to the car Burlingame picked up a piece of board. He fished a bit of charred wood out of the débris. It served as chalk. With it he began slowly marking the board: "A. R. C. Hospital No. ——." He hesitated for just a moment. What the deuce was the number of that last hospital? Well, no matter. Number 110 would do. And Number 110 it became and so remained even after the hospital was ancient—whole weeks ancient—and finally had been moved to Villers-Daucourt.
"And so with a little burned wood, a piece of busted wall, and a cow yard, the most advanced American hospital in the battle of the Vesle started in," says Burlingame. "We took our burned-wood sign, fastened over the pump—and,voilà , there was Red Cross Hospital Number 110. And then we hustled to the first military telephone and began phoning Paris and other Red Cross headquarters to hustle the stuff out to it. 'Send it up the road from Fère-en-Tardenois,' I told them, 'until you come to the cow yard with the sign. Only look out you don't miss the sign.'... And all the time it was raining like hell."
One other of these Red Cross hospitals deserves especial mention in the pages of this book—the tented institution upon the race course at Auteuil just outside the fortifications of Paris. This institution, situated within the confines of the lovely Bois-de-Boulogne, also was established to meet the hospital necessities arising at the crux of the German drive of 1918. It was first planned to take cases far advanced toward recovery and so to relieve the badly overcrowded Red Cross hospitals at Neuilly and other points in the metropolitan district of Paris. And because of this type of cases, and the fact that summerwas close at hand, it was felt that tent structures properly builded and floored could be used, and so much time saved.
That at least was the plan in May when the race course was commandeered through the French authorities and work begun. In twenty-one days the hospital was completed with six hundred beds, while draughtsmen were preparing to increase its capacity to twenty-four hundred beds.
But as thebochecame closer and closer to Paris, that original plan was quickly swept aside, and even the Red Cross made quick plans to transfer its general headquarters to Tours or some other city well to the south of France. Auteuil became, not a convalescent resort, but a military emergency hospital of the first class—American Red Cross Hospital Number Five, if you please. It soon reached great proportions. In the five months that marked its career—from May 30 until the end of October, 1918—it received 8,315 patients who had a total of 183,733 days of hospital treatment and 2,101 operations. Nearly five per cent of all the surgical cases of our army in France passed through its portals. And when under the sudden and almost unexpected pressure that was placed upon it, it found itself seriously short of personnel—the men and women already working it fatigued almost to the point of exhaustion—nurses and other workers were drawn from the Children's Bureau, the Tuberculosis Bureau, and other functions of the American Red Cross. They were not registered nurses, to be sure, with neat little engraved diplomas in their trunks, but they were both willing and efficient. And that, at that time, was all that was necessary. I think that I have already referred to our Red Cross in France as a mobile institution.
When the Auteuil plan was first brought to the attention of the officers of the Medical Corps of our army they were inclined to scoff at it. To them it seemed vast, visionary, impracticable. And as Burlingame went steadily ahead with his plan—in those days, remember, itwas to be chiefly a rest camp—there were folk even in the ranks of the Red Cross who criticized it. Then it was that Burlingame answered criticism, not by drawing in on his plans, but by greatly extending them, by planning to build a full surgical evacuation hospital out there on the race course in the park. The criticisms grew, and finally Perkins, whom you already know as the head of the Red Cross organization in France, called the young doctor to him.
"They say that we already have two excellent Red Cross surgical hospitals here in Paris and that they are quite enough," suggested Perkins.
"We shall need more," insisted the hospital expert of his organization.
"The medical sharps in the army don't think that it is necessary," added the Commissioner.
"Then they are wrong," said Burlingame. "We are going to need Auteuil—and we are going to need it mighty badly."
"Then go to it, Major," said Perkins.
And Burlingame went to it, with the results that we have just seen, while those very army men who came to scoff at Auteuil remained to praise it—in unmeasured terms.
"It was a godsend," said Colonel Samuel Wadhams, medical officer on General Pershing's staff. "I don't know what we would have done without it."
Done without it? I sometimes wonder what the American Army really would have done without the hospitals of the American Red Cross. Although far fewer in number than its own, they performed a valorous service indeed. In the six great eventful months from the first of June to the first of December, 1918, these Red Cross hospitals together furnished an excess of 1,110,000 days of hospital care to our troops, which was approximately the same as giving to every battle casualty in the A. E. F. five days of care. It admitted to its hospitals a total of 89,539 sickand wounded men, and cared for them—not merely adequately, but with a real degree of comfort—at a total cost of 9.57 francs (a fraction less than two dollars) a day.
Back of, and closely allied to, these distinctive Red Cross hospitals were several groups of auxiliary institutions, which also had been financed and equipped and were under the care of our American Red Cross. The first of these groups was that of the military dispensaries, the value of whose work can be roughly estimated by the fact that Number Two, down at Brest, cared for 1,751 cases in the first month of its existence. The others of the so-called permanent dispensaries were at Bordeaux, Lorient, Nantes, Neuilly, Paris, and St. Nazaire, while temporary ones were operated from time to time and as the emergency demanded at Dijon, Senlis, Verberie, Compiègne, and La Rochelle.
Nine American Red Cross infirmaries were operated at base ports and along the lines of communication for our doughboys. These served—and served efficiently—men taken ill on trains, or casuals passing through. During October, 1918, one of them treated 659 cases, while another in three weeks had 850 cases, while with the increase of deportation of our sick and wounded the work of our Red Cross infirmaries was greatly increased. In November, 567 cases passed through the one at Brest and in the following month 6,549 cases through the Bordeaux infirmary. In addition to these two most important base ports, infirmaries were also operated at Dijon, Bourges, Angers, Nantes, Tours, Limoges and St. Nazaire.
A still more interesting line of Red Cross work closely allied to its hospitals was in the convalescent homes which it established at various places in France, almost invariably at points which had especial charm of scenery or climate to recommend them. There were eleven of these; at St. Julien, at Biarritz, at Morgat, at St. Cloud, at Vetau, at Le Croisic, at Rochefort-en-Terre, at Villegenic-le-Buisson,at Hisseau-sur-Cosson, at Avignac, and at Antibes. In some cases these were established in resort hotels, temporarily commandeered for the purpose and in others in some of the loveliest of the châteaux of France. It so happened, however, that our convalescent home at Antibes, at the very point where the Alps come down to meet the sea, was in a hostelry—the Hôtel du Cap d'Antibes. Through the courtesy of a young Red Cross woman who was housed there for a time as a patient I am able to present a picture of the life there—a picture which seems to have been fairly typical of all those immensely valuable homes.
"It is a quiet place," she writes, "truly peace after war—and there the tired nurses and workers find the rest they need. Those who want to be really gay must go to Nice, Cannes, or Monte Carlo. In the morning nearly every one goes out on the rocks with a rug and a book for a sun bath. But if you had as fascinating a perch as my favorite one it would have to be an absorbing tale that could hold your attention. For, from the warm wave-worn rock that made a comfortable seat, I could look out across a broad sweep of blue water to a ragged range of dark-blue mountains against the paler blue sky. To the left is a little point of rocks where some one had built a villa in the shape of a Moslem mosque, which raised crescent-tipped domes and towers from among a grove of dark-green firs and gray-green cactus. To the right, where the mountain peninsula joins the mainland, the coast sweeps toward me in long, tawny curves. Villas make tiny dots among the green of the hills and along the shore, while at a distance, but I know that near by one finds in them a variety of shades of cream and buff, yellow and pink, and above the last bit of coast to the extreme right rise snow-capped Alps.
"If one is restless there are rocks to climb and fascinating paths to explore. One leads over the rocks, arounda wall, and up through a jungle-like tangle of neglected gardens and walks into the estate belonging to the King of the Belgians. The villa, begun before the war, is unfinished now, but a truly adventurous spirit will go on past it and be well rewarded. In what was once a formal garden, hyacinths and many colored anemones are blooming in the long grass; roses nod gayly from the walls, and almond blossoms lift their delicate pink flowers against that glorious sky. In a grove of olive trees near by, narcissus and daffodils are scattered in thick clumps here and there. There is a fragrance in the air that is like spring at home.
"Noon at Cap d'Antibes brings every one together for lunch and after that some go back to the rocks, others to their rooms, and still more take the afternoon bus to Cannes. You can shop there and get your films developed and your hair washed, but of course there are far greater attractions. From three until four an American band plays in the pavilion and all the world walks down the promenade to hear—'Smiles,' 'The Long, Long Trail,' and 'Over There.' Just such a band played just such tunes last summer at lunch time on the White House lot in Washington—only there the audience was composed of hundreds and hundreds of women and girls—war workers—with a few men in uniform, while at Cannes it is the other way about. The place simply swarms with American boys on leave or convalescence, officers and men, and besides their familiar khaki there is plenty of horizon blue and the mustard-colored coats of Moroccans, with red fezzes atop. There are French women, of course, and then a handful of Red Cross and 'Y' girls, nurses, and foreign sisters.
"There are a variety of places to go for tea—from the conventional, cosmopolitan rooms of the Carlton or Rumplemeyer's to the 'Y' canteen where one can get good hot chocolate and bread and jam for forty-five centimes. This 'Y,' by the way, is considered their star establishment. There are reading and billiard rooms, movies and dancing;and on Sundays, services are held where one used to play roulette.
"There is also a Y. M. C. A. club for officers, and here there is dancing to be had as well as tea. But at five o'clock the girls for the Cap must run, or they will miss the bus going back. No one wants to do that, and miss, too, the pleasant ride along the coast with the sunset glowing back of the Esperal Mountains and shimmering in a thousand colors across the ripples of the quiet sea; especially when the alternative to missing the bus is an hour's ride on a French 'tram.' So, singing as a rule, the busload swings along the smooth white road with twenty-five or thirty girls, as like as not, in the places where fifteen are supposed to be.
"That same big bus is used several times a week to take parties for the long ride along the Riviera, to Nice, Monte Carlo, and Menton—one of the supremely beautiful drives of the world. There is an hour's stop in Nice, another in Monte Carlo for lunch, and then, after a glimpse of the Italian border, the party turns back. The Hotel Cap d'Antibes, with its many lights, looks very pleasant after the long, cold ride—it is always cold on the Riviera after the sun goes down—and dinner, always good, tastes especially so to the hungry tourists.
"The Cap is too isolated to be gay in the evening; but, after all, most of the women there have come to rest and recuperate, so they are glad of a quiet game of bridge, a book before the open fire, or a short walk in the magic of southern moonlight. The energetic younger ones usually pull back the rugs and dance—a hen party, to be sure; fun just the same, if one judges by the faces of the girls. There is generally singing, too. One nurse while I was there had a very lovely voice (you kept thinking how much pleasure she must have been able to give the men in her ward) and after she had sung the verse of some popular song, every one joined the chorus. And it was at one of these singsongs, in the big white-paneled drawing-room,with the yellow light falling on many faces about the piano, that I had a glimpse of a gray hospital ward and one of those tragic commonplaces that make up the life of a nurse in times of war.
"The singer had been singing a favorite song of the British Tommies with a strong cockney accent:
"'Oi want go 'ome,Oi want to go 'ome,Now that Belgium is Belgium again,Now that France has got Alsace-Lorraine,Carry me over the sea,Where the Allymand cannot get me,Oh my, I'm too young to die,I want to go 'ome,'
when a girl near me, who had been rather silent, spoke for the first time:
"'That song reminds me of a boy I used to have in my ward. He had a broken back and it was just a question of time, but he didn't know that. He sang that song until I thought I couldn't stand it.'
"The singing was still to be heard as I slipped into my coat a few minutes later and went out of doors. Down on the rocks the water slipped against them softly, overhead were a million stars in the dark sky.
"And so, war—hideous and relentless—intrudes even on the peace of beautiful places, as it always will for most of us as long as we live. But even if the memories of what lay behind them came back to the nurses who had their leave at Cap d'Antibes, the days there were mostly happy ones. Nothing that the Red Cross has done has been more worth while than this place that they have had for the nurses who needed rest and recuperation. There were the creature comforts of hot water, good food, and soft beds; there was sunshine after an eternity of rain; peace after war."
At no time was it either the object or the ambition of the American Red Cross to build or equip or operate all the hospitals of the United States Army in France. For a more or less privately organized institution to have taken upon its shoulders, no matter how broad they might be, the entire hospitalization of an army of more than 2,000,000 men would have been suicidal. So our Red Cross in its wisdom did not even make the attempt; it was quite content to build and equip hospitals in the early days before the American Expeditionary Forces had completed their organization and so were themselves unable to work out their hospital problem as they were forced to do at a later time. The Red Cross did more; it conducted hospitals during the entire period of war—as you have just seen—and attempted to make these models, experiment stations, if you please, from which the medical experts of the army might derive inspiration and real assistance. But at no time did it seek to usurp any of the functions of the Surgeon-General's office of the army—on the contrary.
"When the army was ready to tackle the hospital problem in fine theory we should have gotten out," Colonel Burlingame told me; "but we did not. We were following out the first clause of our creed, which was to meet emergency whenever or wherever it arose and no matter at what cost. And at all times during the progress of the war the emergency compelled the Red Cross to at least maintain its hospitals. And so it did, with a total capacity up to the time of the signing of the armistice of some 14,000 beds. After that we dropped off pretty rapidly. Our pay-roll lists of personnel show that. On November11, 1918, these contained the names of 1,771 men and women; by the first of the following March this total had dropped to a mere 270."
So it was that upon the heels of the first established Red Cross hospitals in France there came the huge hospitals of the United States Army in great size and profusion. Sometimes these were gathered in groups—as at Savenay or Allerey or Dijon or around about Brest or Bordeaux—and at other times they stood alone and at comparatively isolated points. Even these last were sizable institutions, huge even according to the hospital standards of our largest metropolitan cities in America; while, when you came to a point like Savenay—halfway between Nantes and St. Nazaire—you beheld a group of seven individual hospitals which, shortly after Armistice Day, attained a total capacity of 11,000 beds and were planned, in fact, for some 9,000 more, with a further capacity of another 10,000 feasible and remotely planned. Into this great group of institutions there came between August, 1917, and May, 1919, some 85,000 wounded American boys. Its maximum staff consisted of 500 officers, 500 nurses, and a general staff of 4,000 enlisted men.
When I visited the place—at the end of April, 1919—it still had some 6,500 patients, the most of whom were well out of danger and were enjoying the warm sunshine of a rarely perfect day in France. I found the headquarters staff ensconced in a group of permanent stone buildings which, in the days before the war, were part of a normal school standing alongside the highroad to Nantes. This, itself, formed a hospital for general cases. Some of those that were grouped with it in the open fields around about specialized in serious bed surgical cases, in contagious diseases, in tuberculosis, in mental cases. This last had handled 7,500 cases in the progress of the war.
In each of these hospitals—as in each and every one of the United States Army hospitals in France and theoccupied areas of Germany—the Red Cross functioned. At Savenay it had not only erected recreation huts for the men of each of the individual hospitals, but a huge auditorium or amusement hall, permanently fabricated of brick and steel and glass, equipped with a complete theater stage, and capable of seating between 1,500 and 2,000 doughboys and their officers. This super-playhouse was in use every night of the week—for cinema, for drama, sung or spoken, for dances, and, from time to time, for meetings and for religious services.
To this entertainment phase of the American Red Cross in the hospitals we shall presently return. For the moment I shall ask you to consider the part it played in the essential job of supplying hospital supplies. It was not, of course, either practicable or possible for our Red Cross to supply all of these—or even any tremendously large part of them. But it could—and did—supply goodly quantities of all of them when they were most needed, and so worth ten times their value and quantity at any other time.
Time and time again it furnished materials, both for their regular and for their emergency necessities. Sometimes the army itself did not function properly—there were instances of red tape disgraceful and some, too, of red tape inevitable. And yet there were other times when all the tape cutters in the world could not have saved the situation, but the American Red Cross, with its emergency warehouses and its well-organized transportation system all the way across the face of France, did save it. A truckload, two, three; perhaps even four or five truckloads of beds or bedding—perhaps even a small camionette filled to the brim with dressings and drugs or surgical instruments could, and did, save precious lives—by the dozens and by the hundreds. Do you remember, in the preceding chapter, the several instances where our Red Cross played its part—and no small part at that—in the winning ofthe big fight at Château-Thierry? Those were not unusual instances; they were fairly typical.
There came one day when the commanding officers of the U. S. A. hospital center at Allerey—one of the largest in all France—sent for Captain James C. Ramage, the American Red Cross representative in the district. He told the Red Cross man that a tremendous convoy of wounded soldiers from the Soissons-Rheims district was expected within a few days and asked his help in securing a real bulk of medical supplies. Those were the days when the Surgeon General's department of the army was not always able to furnish even drugs and dressings when they were most needed.
Ramage lost no time in discussing the thing. He said that he would do his best and caught the first train into Paris; spent several days there in getting together the necessary supplies, personally supervised the loading of them into a freight car, and then performed the unheard-of feat of inducing the French railway authorities to attach the freight car to a fast passenger train bound down to Dijon. Camions were rushed from Allerey to Dijon, and two days later the necessary supplies were all at the hospital center—and well in advance of the coming of the wounded soldiers. On another night in that same summer of 1918, some 2,250 wounded Americans poured into that selfsame army hospital center of Allerey. The hospital warehouses were exhausted. The Red Cross's were not; do you remember what we said at the beginning—that the fullness of its job lay in its being forever ready to meet any emergency which might arise?
It was being ready that made it able that hot August night to turn into the crowded hospital in a space of time to be measured in minutes rather than in hours, 10,000 blankets, 10,000 sheets, 8,000 towels, 8,000 pairs of pajamas, 2,000 yards of Dakin tubing, 1,000 operating gowns, 1,000 helmets, and two whole carloads of surgical dressings.
Emergency work! How it always does count!
The securingof these supplies in the beginning was, of itself, a master problem. It involved not alone purchase but manufacturing—manufacturing upon a really enormous scale. We saw at the beginnings of the Red Cross work in France the various workrooms in Paris which devoted themselves to the making of dressings—of one sort or another and in tremendous quantities. Yet the actual beginnings of this work antedated even the establishment of the Paris workrooms; immediately on the outbreak of the European War, a special department was established at the National Headquarters of the American Red Cross in Washington for giving advice concerning hospital garments and supplies for European relief and furnishing patterns and samples for the same. A New York City committee, organized for the same purpose by Mrs. Mary Hatch Willard, began the sending of old linens to French hospitals. This work grew into a unit known as the Surgical Dressings Committee of the United States, for the making of dressings by volunteers in this country, and finally led to the establishment of the first of the Paris workrooms. By the time that Pershing had first arrived in France this work in America had grown to a point where it employed more than two thousand committees and subcommittees. Its output increased so rapidly that in the week ending August 27, 1917, ninety-two hospitals were supplied and 155,261 dressings were made in the Paris workroom alone. And that, of course, was long before there were any American wounded. In the summer of 1917 the National Surgical Dressings Committee entered into coöperation with the American Red Cross and from that date its efficient distribution service in France became the Surgical Dressings Service Department of the American Red Cross.
Then came the imminent necessity of standardizing these surgical dressings—which was accomplished by a special board which Pershing appointed at the end of August, 1917. Its standards were followed, but its energies onlydimmed at the time when it was actually seen that they were quite exceeding the necessities of the situation. And the volume of those selfsame energies is perhaps the better understood when it is realized that from October, 1917, to January 22, 1919, 147,230,777 cases of surgical dressings alone, both donated and manufactured, were received at the Red Cross warehouses in Paris.
Splints, of which an immense number were necessary even for the very short period in which we were actually engaged in the conduct of the war, formed a real Red Cross specialty. Our army hospitals were entirely dependent upon the American Red Cross for these necessities—the total orders for which in July and August of 1918, totaled some 15,000 to 20,000 weekly. For that entire year the output was 94,583 splints, the factories often working from eighteen to twenty hours a day to keep pace with the requisitions upon them. Our Red Cross also supplied all the nitrous oxide used in American hospitals of every type in France. The use of this ultra-modern anæsthetic, to the increasing exclusion of ether and of chloroform, forms one of the fascinating chapters of the medical conduct of the war. Although it had been employed as an anæsthetic in the United States for a number of years before the beginning of the war, its first use in Europe was when Colonel George W. Crile—the distinguished surgeon from Cleveland, Ohio—introduced it into operations in the then American Ambulance Hospital at Neuilly—afterward the American Red Cross Military Hospital Number One. That was in 1915. Nitrous oxide as an anæsthetic immediately attracted the attention of a number of eminent British surgeons.
"It is good," said Colonel Crile, tersely.
And so it is—good. It is so good that Colonel Alexander Lambert, at that time chief surgeon of our American Red Cross, immediately made it the standard anæsthetic of its medical service. For, like so many other American surgeons, he quickly concurred in the opinion that nitrousacid, used in combination with oxygen, three parts to one, is the least dangerous as well as the best adapted for use when operating upon cases of chest surgery, abdomen wounds, or of shock. Under this anæsthetic the percentage of recovery is seventy-two per cent, as compared with fifty per cent for either chloroform or ether. Moreover, it has none of the disagreeable after effects which come almost invariably with the use of chloroform or ether. To quote Colonel Lambert:
"The use of nitrous-oxide anæsthetic to the exclusion of ether or chloroform in case of at least the seriously wounded seems to me not only advisable but beyond the advisability of discussion."
Its official use, therefore, was predicated. It was first supplied to the casualty-clearing stations; American and British coöperating for the sake of an exchange of ideas as to its best use. Our Red Cross supplied an apparatus of special design that had gradually been evolved from those already devised. This allowed the separate administration of the nitrous oxide, of oxygen, or of ether—which at times was used in small quantities—or of the three in various combinations. And all our American nurses were trained as anæsthetists in its use.
The making of the nitrous-oxide gas itself was one of many similar tasks assigned to the Manufacturing Department of our Red Cross, of which Major Arthur W. Kelly was department chief. He ordered a huge gas-making plant from America which, after some considerable delay, finally was set up at Montreau, fifty miles distant from Paris. In the meantime the Red Cross had discovered a man in the French Army who had had some experience in the making of nitrous oxide. He was released from active army service and at once started to work making an emergency supply, the limited quantities carried to France by Colonel Crile having become completely exhausted. This small plant had a daily capacityof about 4,000 gallons. But when the bigger machinery from America had finally been set up—in the midsummer of 1918—this output was increased to 75,000 gallons a day. This could easily have been doubled, had it not been for a single limiting factor—the extreme difficulty of securing 3,280 gallon cans in which the gas was transported. Finally the Red Cross secured some hydrogen tanks that had been captured from the Germans in their first July defeats. It was then and not until then that the nitrous-oxide plant began running at anything like its real capacity. And with the definite result that from September, 1917, to October 23, 1918, our Red Cross was able to supply our army with 699,420 gallons of this precious anæsthetic, its own hospitals with 405,620 gallons, and some miscellaneous institutions with an additional 251,110 gallons, while it saw Great Britain formally acknowledge nitrous oxide as an anæstheticpar excellenceand even conservative France making the first steps toward its adoption.
A few of the medical and surgical requisitions of a typical American Army Division—the Second—upon our Red Cross are before me as I write. They are indicative of the overwhelming demands that were made upon it, not only from every corner of the front, but from every corner of France that was occupied by our fighting men—and what corner was not?
It was at the request of the chief surgeon of this Division that one of its field hospitals—originally supplied direct from the army's own sources of supply—was amplified by the American Red Cross, by the use of Bessoneau tents and other equipment so as to become practically a mobile unit, capable of handling far heavier cases. The supplying of the equipment shown by these requisitions began while the division was still in the vicinity of Montdidier and continued until after it had moved to Meaux and was in active preparation for its great rôle at Château-Thierry.In addition to the Bessoneau tents, the following were the requisitions which were delivered to this single formation while it was under heavy pressure:
June 1: 1 tortoise tent and 100 collapsible cots.June 3: 12 antitoxin syringes for anti-tetanus serum, 200 packages of absorbent cotton, 30 feet of glass tubing, and 25 operating gowns and caps.June 4: 250 single blankets, 100 litters, 5,000 anti-tetanus serum, 2 autoclaves, 4 thermometers for autoclaves, 50 wash cloths, 1,000 pairs of socks, 50 towels, and 200 comfort kits.June 6: 50 clinical thermometers, 2,000 temperature charts, 1 gallon of green soap, 36 bottles of ammonia, 5,000 Greeley units, 20 syringes, 15 liters of Lysol, 20 chart holders, 100 rubber sheets, 2 small instrument sterilizers, 500 nightshirts, 500 blankets, 1,000 sheets, 500 forks and spoons, 100 bedside tables, 100 folding chairs, 50 hot-water bottles, 36 maps, 50 hand basins, 20 bolts of gauze, 10 bolts of muslin, 100 beds, and 100 mattresses.June 7: 200 litters, 250 blankets, 100 rolls of cotton, 200 rolls of gauze, 144 rubber gloves, 100 operating gowns and caps, 96 tubes of catgut, 500 Carrel pads, 100 gowns for nurses, 20 sterile water containers, 5,000 folded gauze compresses, and 5,000 small sponges.
June 1: 1 tortoise tent and 100 collapsible cots.June 3: 12 antitoxin syringes for anti-tetanus serum, 200 packages of absorbent cotton, 30 feet of glass tubing, and 25 operating gowns and caps.June 4: 250 single blankets, 100 litters, 5,000 anti-tetanus serum, 2 autoclaves, 4 thermometers for autoclaves, 50 wash cloths, 1,000 pairs of socks, 50 towels, and 200 comfort kits.June 6: 50 clinical thermometers, 2,000 temperature charts, 1 gallon of green soap, 36 bottles of ammonia, 5,000 Greeley units, 20 syringes, 15 liters of Lysol, 20 chart holders, 100 rubber sheets, 2 small instrument sterilizers, 500 nightshirts, 500 blankets, 1,000 sheets, 500 forks and spoons, 100 bedside tables, 100 folding chairs, 50 hot-water bottles, 36 maps, 50 hand basins, 20 bolts of gauze, 10 bolts of muslin, 100 beds, and 100 mattresses.June 7: 200 litters, 250 blankets, 100 rolls of cotton, 200 rolls of gauze, 144 rubber gloves, 100 operating gowns and caps, 96 tubes of catgut, 500 Carrel pads, 100 gowns for nurses, 20 sterile water containers, 5,000 folded gauze compresses, and 5,000 small sponges.
June 1: 1 tortoise tent and 100 collapsible cots.
June 3: 12 antitoxin syringes for anti-tetanus serum, 200 packages of absorbent cotton, 30 feet of glass tubing, and 25 operating gowns and caps.
June 4: 250 single blankets, 100 litters, 5,000 anti-tetanus serum, 2 autoclaves, 4 thermometers for autoclaves, 50 wash cloths, 1,000 pairs of socks, 50 towels, and 200 comfort kits.
June 6: 50 clinical thermometers, 2,000 temperature charts, 1 gallon of green soap, 36 bottles of ammonia, 5,000 Greeley units, 20 syringes, 15 liters of Lysol, 20 chart holders, 100 rubber sheets, 2 small instrument sterilizers, 500 nightshirts, 500 blankets, 1,000 sheets, 500 forks and spoons, 100 bedside tables, 100 folding chairs, 50 hot-water bottles, 36 maps, 50 hand basins, 20 bolts of gauze, 10 bolts of muslin, 100 beds, and 100 mattresses.
June 7: 200 litters, 250 blankets, 100 rolls of cotton, 200 rolls of gauze, 144 rubber gloves, 100 operating gowns and caps, 96 tubes of catgut, 500 Carrel pads, 100 gowns for nurses, 20 sterile water containers, 5,000 folded gauze compresses, and 5,000 small sponges.
I rather feel that this record of a single week of the demands of one Division upon our Red Cross will show quite enough the burden which it was forced to bear; and bore most joyously as a part of the opportunity for service which was given unto it in France. In a single day and night during that same great offensive of 1918, 128 different requisitions—each comprising from one to fifty items—were started out on the road from Paris; while on the twentieth of August of that same summer—the day which marked the beginning of the St. Mihiel drive—120,000 front-line emergency parcels and more than fifteen carloads of surgical dressings were shipped to the scene of activity. From the Paris headquarters of the Red Cross alone, supplies were shipped that summer to sixty-six base hospitals, two naval-base hospitals, fifty-four camphospitals, twenty-one convalescent hospitals, twenty army divisions, seven evacuation hospitals, nine field hospitals, eight hospital centers, nine mobile hospitals, six medical supply depots, and the central medical department laboratory—all of the United States Army in France. This great record does not, of course, include the supplies sent to the Red Cross's own hospitals or those sent to the A. E. F. hospitals from the nine zone headquarters of the American Red Cross; nor even emergency supplies sent to eighteen detached American Army units, far away from their bases of supplies. In a single month and from one warehouse, our Red Cross made the following shipments to formations operated entirely by our army: 77,101 surgical instruments, 2,820 beds and cots, 24,733,126 surgical dressings, and 15,300 pounds of drugs.
It also supplied specialties, and all for the comfort of our wounded boys over there. Take ice—that simple product of our modern civilization—so indispensable to the American. It is second nature with us to-day and yet little used by the French. Ice is as much an essential to our up-to-date hospitals as drugs or nurses or the beds themselves. Properly packed, it cools the fever and so greatly eases the sufferings of wounded men as they toss upon their cots. Its beverage use is too universal to even need comment here.
"My, that's good!" more than one sick boy murmured, as the nurse held a spoonful of it to his hot lips. "It's just like home."
Yet, while our government planned ice-making machinery for each of its hospitals, large or small, they were not always ready as quickly as the rest of the plant. There again our Red Cross stepped into the breach, supplying small portable ice-making plants not only to the field hospitals for which they were originally designed, but even for larger installations. Each of these portable plants consisted of a gasoline engine of fifteen horse power, water-cooled and attached to a compressor, which in turnwas connected to the water piping in the brine tanks. The capacity of each of these was about two tons and a half each twenty-four hours. And each was accompanied by two Ford camionettes—builded with special ice boxes—to carry its product to the wards roundabout.
Second only to ice in importance as a hospital auxiliary was light. In the early years of the war, the surgeons of the allied nations worked under great difficulties at night and undoubtedly many lives were sacrificed because of the lack of proper lighting facilities. I have heard of the doctors ripping off a wounded man's clothing by the light of one star shell and waiting for the next to give them enough brilliancy to examine his injuries.
For at least ten or a dozen years past our larger American circuses have used portable electric-lighting plants on their various itinerant trips across the land—with a fair degree of success. Those circuses gave our Red Cross in France an inspiration. Lieutenant Harry C. Hand, a director in its Central Department of Requirements, in studying the markets for the proper sort of equipment, used them as models and so evolved, as a plant most practical for Red Cross needs, a three-and-a-half kilowatt outfit consisting of a gasoline engine, an electric generator, and a switchboard. This outfit, mounted upon a stout camion, would light 135 incandescent lamps of twenty-five watts each. On its travels it carried in its lockers the lamps, extension cords, sockets, and the like to make them available for almost instant service. And the Red Cross in the heart of the war emergency had five of these outfits at its service in France.
One other allied factor in this hospital supply service deserves attention before we finally turn away from it. I have referred from time to time to the vast quantities of drugs which our Red Cross distributed to both its own and other hospital centers. It was obvious that this distribution had to be centralized, and because of the delicateand extremely valuable nature of this particular form of supplies be kept quite separate and distinct from the others. So "The Red Cross Pharmacy," as it was generally called, came into existence, at a former apartment building at No. 10 Rue de Tilsitt, Paris, and quickly came to such importance that it was made the headquarters of the Section of Hospital Supplies, which in turn was a division of the larger Bureau of Hospital Administration.
Throughout all of the hard months of the war this section boasted that each night found the requisitions for that day filled. There were no left-overs; not even when a single day's work meant fifty-six huge orders entirely completed, and little rest for a staff which averaged forty-one men and women.
The pharmacy was well systematized. In its basement were the receiving, the packing, and the shipping departments, while upon its broad main floor the drugs and antiseptics were actually stored, the second floor being given to dental supplies, surgical instruments, rubber goods, sutures, serums, laboratory equipment, and the like. Each of these various departments was in charge of a specialist, a man of many years' experience in the line which he headed.
By June, 1918, the pharmacy in the Rue de Tilsitt had become of such importance that it was re-created into a Section of Supplies, with Major George L. Burroughs, of the Massachusetts College of Pharmacy in Boston, as its sectional chief. Within a month he had found the demands upon his department so much increased that he was forced in turn to increase its facilities—by the addition of two warehouses. In another six weeks a new burden was placed upon his shoulders—the distribution of all alcohol, ether, oxygen, and nitrous acid issued by our Red Cross, which meant, of course, more space needed—so the unused powder magazine at Fort D'Ivry and the riding academy at No. 12 Rue Duphot—both loaned by the FrenchGovernment authorities—were added to the quarters of the pharmacy.
Some idea of the amount of work undertaken and accomplished by this Red Cross pharmacy may be gained when it is understood that in the six months ending January, 1919, 75,016 pounds of drugs were issued from it. There were in that time 3,954,178 tablets, 21,566 phials of serum, 271 surgical units, 15,108 pairs of rubber gloves, and 22,059 feet of adhesive plaster, in addition to many hundreds of packets of other drug supplies.
Seemingly we have drifted away from our American boys, sick or wounded and in hospitals. In reality, of course, we have not. Every one of these provisions, large or small, was aimed directly at their comfort, while each deserved to be rated as a necessity rather than comfort—comfort, at least, as the average luxury-loving American knows it. It was comfort rather than luxury that I found our boys enjoying there at Savenay—long, comfortable huts, builded hurriedly but furnished with great care, great taste, and great attractiveness. Savenay, itself, was a good deal of a mud-hole, a fearfully wretched place underfoot. The Red Cross huts shone brilliantly in contrast. Here, as in the canteens all over France, the boys might congregate—practically at all hours—and amuse themselves as their fancies dictated; or, if fancy grew a bit bored, it was part of the job of the directress—one of whose essential qualifications was resourcefulness and another versatility—to find some new form of amusement. It was not enough to hand out the cigarettes—one or two packs a week—or the pipes and the playing cards and the tobacco, pretty much as requested—there had to be shows. The American passion for play-acting is something to be reckoned with.
Perhaps you do not quickly understand how versatile those very shows might readily become. Let me quote fromToot Sweet—the little fortnightly newspaper which ourAmerican Red Cross printed for the boys convalescing there at Savenay. That is, the Red Cross furnished the printing press, the type, and the rest of the paraphernalia for the making of the publication; the boys, themselves, supplied the brains that made it so very readable at all times.