western front

Historic Environment Source Bank

• Frontline Soldiers' Diaries

• Frontline Soldiers' Letters

• National Newspapers

• Admission and Discharge Records from WW1 Hospitals

• Official War Office Statistics

• Local Newspapers

• Diaries of Medical Professionals

• Poems

• Soldiers' Memoirs

• Articles by Medical Professionals

• Photographs

• Military Maps

• Pathe Newsreels

What are Key Battles of the British Sector of the Western Front?

• The Battle of Arras (Apr 1917) - 160,000 British casualties

• The Battle of Cambrai (Nov 1917) - first time tanks were used in significant force and first blood bank

• 45,000 British casualties

• The Battle of the Somme (July-November 1916) - 1st July was the worst day in British Military History with 60,000 casualties and 420,000 British casualties by November

• Third Battle of Ypres (July-November 1917) - Infamous for quagmires which made evacuating casualties very difficult - 448,000 Allied casualties

The Trench System

• Surprisingly complex system with three main types of trench.

• Front line trench - 2.5m deep and 1m wide with soldiers spending approx 1 week in the front line. Soldiers were liable to being hit by enemy fire and sometimes their own artillery.

• Support trench - Provided a second line of defence in case the front line trench was taken by the enemy. They also had first aid stations and kitchens to ensure front line men had medical treatment and hot food. Positioned a few hundred metres behind the frontline and were therefore safer.

• Communication Trench - Used to move between the front and rear trenches. Also used to transport injured men to field hospitals.

Front Line Trenches

• Duckboards - wooden trench boards laid along the bottom of the trench to prevent ground becoming waterlogged.

• Sump - narrow drainage channel underneath duckboards.

• Firestep - Built in to enable men to see out of the trench and also climb up into no man's land

• Barbed Wire - Barbed wire was used extensively, being laid several rows deep to protect the front line trench.

• Dugout/Bolt Hole - Built into the sides of the trench to be used for protection, eating and sleeping.

• Sandbags - Used to protect from enemy rifle fire and sometimes placed along the bottom of a trench to soak up

The Third Battle of Ypres/Passchendae

• Jul- Nov 1917

• Allies advanced through four miles of mud later lost to the Germans

• 448,000 Allied casualties

• Battlefield was a quagmire of mud as a result of shellfire having destroyed the drainage systems and heavy rain made problem worse

Battle of Messines

• June 1917

• Most successful operation of the Western Front and precursor to Passchendaele - aim to recapture Messines Ridge.

• 18 months of prep to dig 8,000m of tunnel and lay 22 mine shafts

• Blew the crest off the Messines Ridge and killed 10,000 Germans in the explosion alone

• German counter attacks were unsuccessful and significantly boosted morale for the allies

Dangers facing tunnellers

• Carbon monoxide poisoning (oxygen starvation) where candles would be used to measure oxygen levels. If the candle went out, it was time to leave!

• Tunnel collapse (or explosion of mines already set leading to this).

• Meeting enemy tunnellers who would have to be fought in hand to hand combat, blow you up or bury you alive.

• Dangers led to development of the geophone - a pair of disc shaped microphones connected to earpieces so that enemy tunnellers could be spotted, before the British themselves were.

Underground hospital at Arras

• British WW1 field hospital abandoned in 1917

• Could take in 700 casualties

• Only in service or three days before a German shell hit the roof, collapsing it

Challenges of providing treatment underground

• Risk of enemy shelling

• Dark and dingy (difficulties in installing running water and electricity)

• Difficulties moving supplies in - horse drawn railway was used

• Difficult to achieve and maintain aseptic conditions

Top five causes of illness

• Pyrexia (fever of unknown origin)// high fever was often attributed to 'trench fever' which was spread by body lice: 97% of men infected

• Inflammation of connective tissue (ICT)

• Trench foot

• Influenza

• Scabies (infestation of mites in skin)

Top five causes of injury

• Shrapnel

• Gunshot

• Gas poisoning

• Fractured femur (broken leg)

• Wasp sting

• Percentage of total deaths amongst British Army was 17.6%

• Percentage of total injuries was 41.6%

Brodie Helmet and Thomas Splint

• Two medical innovations which helped to reduce effects of injury...

• Brodie Helmet was introduced as standard kit in 1915 and reduced head injuries by 75%

• Thomas Split significantly reduced the death rate from a broken femur because it stabilised injury and controlled infection - following its introduction in 1916, the chance of death from this injury declined from 80%-20%. Was invented by Hugh Owen Thomas.

RAMC (Royal Army Medical Corps)

• The 'official' Army Medical Unit formed in 1898

• Fought against centuries old culture of warfare where medical affairs were deprioritised

• August 1914: 9,000 Warrant Officers and men of the RAMC compared to 113,000 by 1918

• Initially provided inadequate care, but ability to cope improved as war went on.

• Created RAMC Sanitary Sections which checked the sanitation of all barrack areas, cookhouses, billets etc.

• Increasing realisation that speed was crucial and so Chain of Evacuation was set up.

FANY (First Aid Nursing Yeomanry)

• Voluntary Organisation who were a British all female registered charity formed in 1907

• Leaders were Grace McDougall and Lillian Franklin

• British Army wanted nothing to do with them and so funded their own ambulances and equipment.

• Acted as a first aid link between the field hospitals and front line

• Would rescue the wounded and administer first aid similar to a modern combat medic

• Also set up their own hospitals and field stations, such as the Lamarck hospital opposite the Notre Dame

Challenges of Medical Treatment

• Unprecedented Demand - as a result of machine gun fire and death on a scale never seen before

• Limited resources - War disrupted supply chains + inadequate numbers of medics

• The Working Environment - Stationary hospitals were hastily converted from schools and hotels. CCS were in muddy fields.

• Challenging Attitudes - Medical care deprioritised and British Army did not allow female medics

• Psychological Trauma - Constant exposure to blood and horrific injuries. Shell shock not just confined to soldiers.

• Lack of Knowledge - No antibiotics for infection and lack of NHS meant fewer skilled professionals.

Specific Challenges: Gunshot Wounds

• Trenches protected soldiers' bodies, but left their heads vulnerable to enemy fire

• Machine gunners could fire 600 rounds a minute, which wreaked havoc in the body, twisting tissue and splintering bone

Specific Challenges: Shrapnel

• Biggest killer on the battlefield and cause of many facial injuries

• Twisted metal shards produced from shrapnel blasts could rip a face off

• Shrapnel's shape would often drag dirt into the wound

• Was extremely difficult to locate and remove all pieces of shrapnel and control infection

Specific Challenge: Wound infection

• Fighting on farmland fertilised by manure meant wounds became infected quickly

• Gangrene was rife and antibiotics not yet available

• Sanitary section of the RAMC helped to combat this and carbolic lotion was used to wash wounds, which were then soaked in gauze

• Another solution was debridement where tissue around the wound was cut away and the wound sealed

Specific Challenge: Gas Attacks

• Soldiers were terrified of gas attacks, even if only 9% of casualties in war were caused by gas... 3% as fatalities.

• Chlorine - destroyed the victim's respiratory organs, bringing on choking attacks.

• Mustard Gas - kill by blistering the lungs and throat if inhaled in large quantities and produced blisters all over the body.

• Soldiers combated this by using cotton pads dipped in solution of bicarbonate of soda and held over the face.

• Also used urine drenched cloths to put over their faces in an emergency.

• Better prepared by 1918 when filter respirators (using charcoal as an antidote) became normal.

Specific Challenge - Psychological Effects

• Shell Shock (also known as war neurosis) is understood today as PTSD.

• Symptoms include hysteria and anxiety, paralysis, limping and muscle contractions, blindness and deafness, nightmares etc.

• By 1916, over 40% of casualties in fighting zones were victims of the condition and 80,000 cases passed through the British Army medical facilities during war.

• Little sympathy at the time and it was thought to be a sign of emotional weakness and cowardice

• Treatment was harsh and often included solitary confinement, electric shocks, physical reeducation or emotional deprivation.

• Lucky ones received massage/rest/dietary treatments/sent home.

Specific Challenge: Self Inflicted Wounds

• Also known as 'blighty ones'.

• Highly serious wartime military offence.

• Often would be rifle shots to the hand or foot in the aim of being sent home.

• Military authorities tried to trace injury back to wound which caused injury. If found guilty, men were sent to prison for lengthy periods.