The New Zealand Medical Service in the Great War 1914-1918
Chapter XIII. Messines
Chapter XIII. Messines.
During the three days that preceded the assault of Messines there was a final revision of the divisional medical arrangements. These busy days were known as "W," "X" and "Y" days, the attack was to be made on "Z" day and at "Zero" hour. The 4th of June was a bright, fine day; and was announced as "W" day; the attack would be on the 7th unless the Second Army saw fit to pospone it by adding further "W" or "X" days to the calendar. Something yet remained to be done: the New Zealand Stationary Hospital was still busily engaged in erecting Nissen huts at Hazebrouck and No. 1 New Zealand Field Ambulance was putting up tents at Ravelsberg, making preparations to receive and hold 750 patients. The 4th New Zealand Field Ambulance, which had arrived on the 1st of June, had orders to send one section complete to the M.D.S. at Westhoff Farm; and one section to the C.M.D.S. at Pont D'Achelles with the tent subdivision detached to a corps detraining point for lightly wounded at Connaught Siding close to Pont D'Achelles. The advanced parties of No. 2 Field Ambulance were moved into Kandahar Farm A.D.S.
On the 5th, a bright, warm day—"X" day in the battle calendar—there was an appreciable augmentation in the already voluminous output of the Corps artillery and an increase in the enemy reply. There was a conference of ambulance commanders in Colonel McGavin's office at the Divisional Headquarters situated in Westhoff Farm buildings. The A.D.M.S. of the New Zealand Division was now responsible for clearing not only our own divisional front but also for evacuating the wounded of the 4th Australian Division which was to "leap frog" through the 25th and the New Zealand Division in the final stages of the battle. Lieut.-Col. Murray, D.S.O., was placed in charge of forward evacuations at Kandahar Farm, and Lieut.-Col. Hardie Neil with his 3rd Field Ambulance was to proceed immediately to Underhill Farm A.D.S. All the motor ambulance cars of the division were to concentrate at a parking station near Neuve Eglise. During the course of this conference a strange disaster befell at Ravelsberg where the 1st Field Ambulance had their page 295enlarged D.R.S.: an enemy aircraft landed a bomb on an ammunition dump at "York" Railway Siding quite close to the ambulance; an ammunition train caught fire and heavy and continuous explosions of shells followed for many hours wrecking part of No. 1 Field Ambulance and killing several civilians whose houses were adjoining. The horse lines of the field ambulance were only 50 yards away and were in considerable danger. Shells of every calibre were exploding in rapid succession—large jagged fragments were hurtling through the air in all directions—in the branches of a tree overlooking the horse lines hung the mangled body of a civilian, blown up there by the first explosion. But our A.S.C. men stood to their horses, and under the directions of the N.C.O.'s led them away to a place of safety; losing only some harness, which was burnt with one of the sheds. The ambulance was obliged to clear its personnel and patients, as debris and fragments of metal were flying or falling through their huts and tents. There were no casualties, except to civilians, whose houses adjoined the railway siding. It was a bad start for a shell shock hospital, and several of the nervous cases received an additional psychic trauma for which they had to be evacuated. The dump burned and exploded intermittently for about 36 hours. The transport N.C.O.'s had due recognition of their plucky work in saving the horses. During that night there was more trouble, this time at Kandahar A.D.S., and at Underhill Farm. Heavy gas and H.E. bombardments were causing casualties in the gun teams. At Underbill, the motor drivers of the 3rd Field Ambulance took their cars through the gas with respirators on, a particularly difficult feat; more especially as the road was, in places, ploughed up by shell holes. Only one N.Z.M.C. casualty resulted: one of the bearers fell into a shell hole and was gassed.
The 6th of June "Y" day, a dull morning with oppressive heat. Zero hour had now been fixed for 3.10 a.m. on "Z" day; the divisional orders for the attack were issued. The Second Army's medical arrangements were fully completed: the 4th C.C.S. at Baillieul and the 2nd Australian C.C.S. at Trois Arbres destined to serve the IInd Anzac Corps, had each been strengthened by 3 extra surgical teams, 3 additional M.O.'s and from 6 to 12 sisters, besides added bearer personnel up to 60; 16 ambulance trains or temporary ambulance trains were drawn up on the Second Army sidings. The D.M.S. had visited the New Zealand Stationary Hospital and found that it could now accommodate 1000 cases if required; there were 54 wounded and 133 sick in the unit at this date. Colonel Begg summoned a page 296meeting of his A.D.'s M.S.; matters of importance were discussed: the specially devised gas administration apparatus known as the "Novita" set was fully explained and demonstrated; some final instructions from the Second Army as to the surgical treatment of wounded were discussed and the new method of disposal of "shell shock" cases was defined. Cases of "shell shock" admitted to field ambulances were to be classified in two categories:— (1) Those with obvious shell shock who were to be evacuated to C.C.S. with the diagnosis N.Y.D. (not yet diagnosed) shell shock; (2) Doubtful cases including: exhaustion, nervousness, possible malingering; these were to be diagnosed as "Exhaustion" and sent to D.R.S.'s.
During the day, Lieut.-Col. Murray, D.S.O., with bearer officers and N.C.O.'s from Kandahar Farm visited the various posts and reconnoitred the communications, the trench tramways, and the overland routes, which were now flagged and marked by direction posts and illuminated signs for use at night. All the available bearers of No. 1 and No. 2 Field Ambulances were assembled at Kandahar Farm and the allotted N.Z.M.C personnel sent forward to the R.A.P.'s, the bearer relay posts, and the Divisional Collecting Post at Leeuwerck Farm.
The Corps Main Dressing station at Westhoff was fully manned, the total personnel under the command of Lieut.-Col. H. B. Kelly, R.A.M.C, of the 77th Field Ambulance, comprised: 15 medical officers, 260 O.R., made up of tent subdivisions from the 25th and the New Zealand divisional ambulances with added stretcher bearers supplied by the 4th New Zealand Brigade. The Westhoff station was organised in three departments: corps walking wounded collecting post; corps main dressing station; and the corps clerical bureau. There was a well equipped operating hut, a resuscitation room, a room fitted with "Novita" sets for the treatment of gas casualties and a small surgical ward with a few beds; in all, there was accommodation for 600 lying and 700 walking cases.
"Y" day was an oppressive day, but a thunderstorm cleared the air; the afternoon was cooler; the night fine with a full moon. At dusk, under the protection of our fighting aeroplanes, the three assaulting columns of the 25th, the New Zealand, and the 3rd Australian Division, moved into their assembly trenches. The first two divisions had no casualties during this manoeuvre, but at 9 p.m. a heavy gas bombardment caught the Australians; two of their battalions had serious losses from gassing. The gas proof arrangements at Underhill Farm acted well: the doors page 297constantly sprayed with anti-gas solution permitted the staff within the chambers to work without box respirators—an enormous advantage as prolonged work in a mask produces considerable fatigue and early exhaustion. At the A.D.S. at Kandahar Farm, many gassed men from the neighbouring batteries were admitted, and at midnight, an ammunition dump in close proximity to the farm exploded. Everywhere in the forward areas there was heavy shelling of roads and communications. Gas everywhere was plentiful. All the N.Z.M.C. bearers in the relay posts were obliged to work in box respirators; the gas, favoured by a "dangerous" wind, permeated the whole area, and, even at the Westhoff C.M.D.S., was definitely perceptible. At midnight there was a lull.
"Our R.A.P. was at a place called Fort Osborne"—writes Captain Johns of 1st Canterbury—"we were about 500 yards behind our front line. The 2nd Canterbury M.O., Captain Gordon, N.Z.M.C., shared this same dugout with me. The battalion got in without mishap although the enemy were putting a few gas shells over. It was about 11 p.m. when we arrived; we set our gear in order and waited about until the show started. There was just the normal artillery fire going on, and the Roches had not the faintest idea what was going to happen to them at 3.10 a.m., or that there were thousands of troops massed in the trenches where, usually, there were only a couple of battalions. We had been warned that our people were going to blow mines at zero hour, so at 3 a.m., we got out of the R.A.P. and lay down on the ground behind the trench. Precisely 10 minutes later the whole show was pandemonium, 19 mines along the front went up together, thousands of guns of all sizes and shapes went off as hard as they could lick, besides hundreds of machine guns. The ground rocked for about ten minutes like an earthquake, and in the Boche line there appeared to have been a volcanic eruption. At the same moment our men in the front line trenches jumped out and it seemed as if thousands of living men had suddenly grown out of the ground. They were across No Mans' Land before the Boche got his barrage to work. The casualties were very light and were chiefly due to the men being too eager and getting into our own barrage. We got busy about 4 a.m., the greater number of the wounded were walking cases. Owing to the gas shells we had to knock off once or twice as we could not work properly in the box respirators."
At "zero" the 3rd Brigade on the right and the 2nd Brigade on the left had crossed the parapet—the 1st Brigade at present in page 298reserve following up—the enemy's barrage fell on our old front line, ragged and thin; but all waves were across No Mans' Land before it opened. In 20 minutes the German front and support lines were captured and the New Zealanders were going on straight through Messines, headed by a wall of living fire fed by our guns. So rapid was the advance that the 12 tanks detailed to assist could not hope to keep up with the infantry.
There were three R.M.O.'s working at Fort Osborne at the time of this assault besides Captain Johns: Captain Gordon, 2nd Canterbury; Captain Connor, 1st Wellington and Captain Goldstein 2nd Wellington. The first cases to come down were walking cases who were directed to King Edward Sap and Medicine-Hat trail. The stretcher parties from the bearer relay posts arrived prior to 4 a.m. and at first found some difficulty in using the trench tramline for stretcher cases owing to damage to the ways by shell fire, and the passage of our tanks; but German prisoners were coming in, and, with their assistance, some of the earliest of the lying down cases reached Khandahar Farm just after 4 a.m. At 4.30 the first casualties from IInd Anzac Corps were already in C.C.S. The wounded, now, were being carried by hand by the overland route along the trench tramline to the bearer relay posts. Some of the R.M.O.'s were already moving forward to the newly gained trenches and, at 5 a.m., Captain Addison, N.Z.M.C., R.M.O. 2nd Auckland, had opened an R.A.P. at the Moulin de L'Ospice near Messines. This was the first R.A.P. to be established, and many wounded from all units were dealt with there. At 6.30 a.m. Messines village was clear of machinegun nests, the divisional objectives were being consolidated, and the Engineers were hurriedly repairing the road so that lorries and the Ford ambulance cars were now able to get up as far as Boyle's Farm. Up to this time 168 wounded had reached Kandahar Farm, of which 30 were lying down. The corps M.D.S. at Pont D'Achelles had received 500, of which 200 gassed from the 3rd Australian Division. Everywhere evacuations were proceeding with extraordinary rapidity. From 5.30 to 7.30 the enemy barrage had somewhat impeded work at Fort Osborne, sparse shells were falling in the communication trenches, three bearers were wounded, but after this, for some time, no trouble was experienced. No doubt the Bavarians were retiring their field guns. The attack so far had succeeded with machine-like precision; the medical arrangements resembled the military movements in time-table punctuality; the first ambulance train steamed out of Baillieul at 7.30 a.m. A steady flow of stretcher page 299cases was coming down mostly to Fort Osborne, some to Boyle's Farm where R.M.O. 1st Otago, Captain Prior, was working. Captain Connor, 1st Wellington, now pushed forward and established a new post 500 yards east of Boyle's Farm, about the time that his battalion was moving into the most advanced lines to be held by the New Zealand Division. By 8.30 the final objectives of the division were being consolidated by the 1st Brigade which had passed through the other two. The casualties reported so far were 1,200, including a few wounded Germans admitted to the corps M.D.S.'s; the light and broad gauge railways were working well; the walking wounded entraining like a holiday crowd.
By 10 a.m. most of the R.M.O.'s had advanced their R.A.P.'s to dug-outs or trenches in and about Messines, and were in touch with the A.D.S. at Kandahar, stretcher parties had reached them and were clearing their wounded. The numbers of wounded passing through the A.D.S. had diminished somewhat. R.M.O. 1st Otago, Captain Prior, who was known to have advanced earlier, had not yet been located, and later it was reported at the A.D.S. that the first runner sent back by Captain Prior had been killed not far from the R.A.P. east of Messines. The second messenger, more fortunate, brought the map reference of the new R.A.P. safely to the A.D.S. Another R.M.O., Captain Nelson, of 1st Auckland, was not located, he had moved away early with his battalion and had established his R.A.P. well forward of his battalion headquarters, south-east of Messines, and about a mile from the old R.A.P. at Surrey Farm. Here in some German dug-outs, he was for a time overwhelmed with wounded; and quite out of touch with the N.Z.M.C. bearers.
At 12 noon the Division was well established: they had taken 300 prisoners, many machine-guns, and some field pieces. 2,200 wounded had passed through the corps stations in the proportion of one lying to three sitting; stretcher cases were coming in from forward R.A.P.'s which were mostly clear, with the exception of 1st Auckland. The ambulance parties were now taking over the old R.A.P.'s, Boyle's Farm and Fort Osborne, as advanced dressing stations under Captain J. G. Crawford, N.Z.M.C. of the No. 2 Field Ambulance. Up to midday 789 wounded had passed through Kandahar Farm, of which 300 walking, 188 lying, 243 sitting; 58 German wounded not included. The bearers of the 12th Australian Field Ambulance were moving up to the old R.A.P.'s to participate in the forward move of the 4th Australian Division to the final positions at 3 p.m. There was page 300a barrage falling about the advanced R.A.P.'s a few shells bursting on the Messines road which the motor ambulance cars were lucky to escape.
Captain Johns' narrative continues:—"About mid-day things were getting a bit slack and the ambulance came along to form an A.D.S., so Gordon and I thought we had better get off to Messines to pick up our battalions. The Germans were still dropping a few shells over the place at haphazard as they had lost all observation. We went up by leaps and bounds and I got up to my battalion safely. I found one company digging in. We discovered a line of German dug-outs and occupied them. I went forward to my headquarters which were a few hundred yards ahead. Here I learnt how things were going and, as I was sitting at the table, I was so dreadfully tired, I must have dropped asleep." Major Johns was known as "très calme," in his battalion; while he was sleeping a 5.9 shell hit the battalion headquarters: it was a solid structure and suffered no damage, but the place was attracting too much attention; consequently the party moved out. Captain Johns went back to his line of dug-outs, where he attended to his wounded, later had a meal and fixed up some sort of a bed for the night.
After 1 p.m. the Germans launched their counter attack, accompanying it by a very heavy barrage on Messines; shells of all calibres up to 8in. were falling in profusion behind our advanced positions. But the assaulting waves of the 1st Guards Division and the 24th Bavarian Division melted under our counter barrage, and we took some prisoners from both divisions who had come up by train from Tourcoing and Haubourdin. Shortly after the 4th Australian Division "leap-frogged" through us to the Oestaverne line, the final objective of the Anzac Corps. During their advance it was almost impossible for the N.Z.M.C. bearers to reach the new R.A.P.'s owing to the barrage which caused many casualties. A sleepered track made by the Engineers, early in the forenoon, led on past Spring Street R.A.P. and by 11 a.m. a Ford car had penetrated as far as this post. Later, a service of motor ambulance cars was established to Spring Street; but regularity could not be maintained as the track was subject to heavy shelling, more especially in the afternoon.
From 5 p.m. onwards there was desperate fighting on our front the 4th Australian Division and the tanks were meeting opposition in the capture of the final line. Cavalry patrols of the Otago M.R. went out to reconnoitre the position, but lost most of their horses. The "situation was obscure." A thick page 301curtain of fire was falling in the Steenbeck Valley west of Messines. Shortly after 5 p.m. the D.D.M.S. had visited both the A.D'sM.S. and the corps stations and was assured that every arrangement made was working smoothly. Colonel McGavin went out to the advanced dressing station at Kandahar Farm where by this time 648 wounded had passed through; and 375 walking wounded at the divisional collecting post. Extra stretchers and blankets had reached the new R.A.P.'s prior to this. There was some congestion of wounded at Westhoff M.D.S. caused by a block of the M.A.C.: over 80 stretcher cases, dressed and fed, awaited evacuation and there were about 300 German wounded still to be attended to, mostly walking cases. The block was at the C.C.S.'s in Bailieul where the spate of wounded so rapidly evacuated from the forward zone was held back by surgical necessities—the cars could not unload—the stream of wounded was now temporarily directed by Colonel Begg, to Pont D'Achelles Corps M.D.S.
At 7 p.m. it appeared that the 4th Australians were in their appointed positions, and as they were now in front of the New Zealand Division, Australian bearers replaced the N.Z.M.C. parties in Boyle's Farm and Spring Street. Here, the 4th Australian Field Ambulance relieved men of the New Zealand Field Ambulance whom they had not met since April, 1916, when they parted from a comradeship much cherished from Anzac days. Large N.Z.M.C. bearer parties under Captain Crawford, N.Z.M.C., now went out to clear the advanced R.A.P.'s—a difficult task, owing to the barrage on Messines and in the valley. As night fell, conditions of uncertainty and anxiety prevailed, heavy local counter attacks had to be met in the front line, the exact position of which was not determined at all points. The situation became more complicated by subordinate commanders, fearful of the safety of their own lines shortening their barrage, so causing casualties to the Australians in front, and ill luck had decided that both the enemy and ourselves were using identical star-shell signals for artillery support. It was impossible then for our observing officers to distinguish our own S.O.S. signals from those of the opposing infantry. The losses amongst the Australians from all these causes were very considerable.
About midnight the most forward R.A.P.'s were cleared by the ambulance bearers. There had been casualties: of the Australian bearers, 4 killed and 3 wounded; the N.Z.M.C, parties had, so far, 1 killed, 7 wounded, one R.M.O., Captain Prior, gassed. The wounded of the New Zealand Division, evacuated up to midnight page 302totalled: 60 officers, 1,884 O.R.; of these Kandahar Farm had tended 993, Underhill Farm, 600. Over 150 walking cases had passed through the divisional collecting post without calling at either of the A.D.S.'s. In the casualty clearing stations, at Baillieul, there was great congestion, so many of the wounded required operation; the surgical teams could not keep pace with the incoming casualties. In order to relieve the pressure, 100 stretcher cases, mostly gunshot injuries of the head, were despatched by M.A.C. to the New Zealand Stationary Hospital at Hazebrouck, where they arrived at 4 a.m. on the 8th. During the first day this unit had admitted 10 sick and 187 wounded.
All through the night of the 7th and early hours of the morning of the 8th ambulance bearer parties, New Zealand and Australian, were carrying from the forward R.A.P.'s to Boyle's Farm or to Spring Street both points now used by the A.M.C. as A.D.S.'s. There was intense work going on behind the captured positions: parties with pack-mules carrying water, food, ammunition, and all manner of trench stores were hurrying up and down with ant-like industry between the dumps and the newly acquired positions. The N.Z.E. were laying down sleepered tracks, building temporary culverts, supervising the construction of a sap through. No Mans' Land, improving the old enemy communications. By daylight they had completed a mule track as far as the Moulin de L'Ospice on the western fringe of Messines, in which neighbourhood at least four R.M.O.'s were working. Not many casualties were reported in this group of R.A.P.'s during the night. Captain Johns tells us, that, having made his bed he slept in it only to be awakened by a large shell, "which had burst at the corner of the dugout and made a hole big enough to bury a bullock in, but the old dugout stood it well. The Huns like the Egyptians, built their 'pill boxes' to last for eternity." At dawn he was awake, he tells us, had a wash, shaved, attended a few wounded, breakfasted and admired the view, notably the work of the Maori Pioneers, heroic wielders of the shovel, who had driven a sap almost up to his dugout.
By sun up on the 8th, all R.A.P.'s were reported clear of wounded; over 2000 had passed through Kandahar Farm, of which 670 were stretcher cases. Spring Street R.A.P. was now connected with Messines by a road repaired during the night, and the motor ambulance cars were able to load stretcher cases here, as the sleepered track from Kandahar Farm was quite satisfactory except at the times when it was barraged. The A.M.C. bearer parties despatched from Spring Street followed the page 303mended road which led past "Stinking Farm" and "Gooseberry Farm" to our old front line, thence across country to the eastward group of R.A.P.'s. Had they followed the road it would have led them up Messines Hill to the site of a cabaret, "Au Bon Fremier," where the mended road joined the Ploegsteert road and ended in the Grande Place at the Institute Royale in Messines. It was quite close to the cabaret site that Captain Johns and Captain Gordon had established their R.A.P.; away some 200 yards to the left of them was the Moulin de L'Ospice, used by the Germans as a strong point and adjacent to the Wulverghem road as it entered Messines at its northern extremity. To their south, down in the Douve valley, and eastward of them in an old German support line, known on our trench maps as "Ulcer" support line, was Captain Nelson's R.A.P. in a concrete dugout. The Australian R.A.P.'s were considerably to the east of Messines in the German second line trenches, over a mile and a half from Spring Street. In closely searching the ground for outlying wounded near these exposed posts considerable risk had to be run by our bearer parties, well led by Captain Aitken of the 1st New Zealand Field Ambulance; repeatedly his squads passed through the barrage; carrying out over the badly broken ground large numbers of stretcher cases, mainly from the 4th Australian Division and some from Captain Nelson's R.A.P. Many of the wounded had injuries of a severe type, caused by the large calibre shells used during the German counter attacks. The German wounded, now brought in, were very serious cases and some, who had been lying out since the previous dawn, had commencing gas baccillus infection. In dealing with the enemy wounded at the A.D.S. the interpreter was a great help. Amongst the miscellaneous information obtained by him was the fact that the main German aid post which was situated just behind the Institute Royale in the Grande Place and sheltered two German medical officers, had been completely demolished by one of our heavy shells which killed both the officers and their orderlies. This accounted for the fact that no German medical officers were found by us in the village.
During the forenoon, Sir Anthony Bowlby visited the corps M.D.S.'s and expressed great satisfaction with the conditions of the wounded tended there. The Thomas hip splint was largely used and unquestionably saved many lives. The weather, too, being very warm and dry was most favourable to the seriously wounded. At the New Zealand Stationary Hospital "head" cases had been coming in since the night of the 7th. Relays of page 304operating teams were working day and night. Dr. Harvey Cushing, one of the vanguard of the U.S. Medical Corps, was for a time assisting in the work. Both operating theatres were required and were used by three teams, each working in eight hour shifts. The majority of the cases had compound fractures of the skull without peneration of the dura. X-rays were used, where possible, in all cases. The operative methods adopted consisted in: excision of the scalp wound, enlargement of the opening in the skull, removal of depressed fragments of bone and foreign bodies where accessible; arrest of haemorrhage, the application of B.I.P., and closure of the wound without drainage. The great majority of the wounded required operation. The immediate mortality of the "head" cases was 24 per cent; of the abdominal wounds subjected to operation, 75 per cent.
By 12 noon a readjustment in the New Zealand divisional front became necessary in order to avoid a serious congestion of troops. The 3rd Brigade was to be withdrawn to Hill 63 and placed in reserve; the 1st Brigade would hold the New Zealand line with the 2nd Brigade in support. In front, to the east of Messines, the 4th and the 3rd Australian Divisions were now linked up in a fairly solid position. Throughout the afternoon there was no change on the New Zealand front, but the enemy fire was slowly increasing in intensity, and after nightfall became very violent; a counter attack was said to be in progress. Again the 4th Australian Division had heavy casualties, in some instances from our own protective barrages. Up to midnight there were alarms and excursions, and in the midst of this hubbub parties of bearers led by Captain J. G. Crawford, N.Z.M.C. set out to clear the forward R.A.P.'s. All through the troubled night they worked, bringing in some 34 stretcher cases at no little risk, and with much difficulty. The brutal distortion of the crater area over which they worked may be imagined when we read that, in our preparatory bombardments, no less than five and a half tons of high explosives had been thrown by our guns into every yard of frontage of the German defences. By night the difficulties of the bearers stumbling through with heavily laden stretchers were increased tenfold by alternate flashes of brilliant lightning from bursting shells succeeded by moments of blinding darkness. The German guns fired heavy salvos behind our front line all through that night, but towards dawn the barrage abated, by which time all wounded were safely brought in to Spring Street and had been loaded on cars for Kandahar Farm.page 305
By 6 a.m. on the 9th, 1121 walking, 799 sitting, and 1029 lying, wounded had passed through Kandahar Farm; a heavy proportion of stretcher cases. The New Zealand wounded amounted to 80 officers, 2460 O.R. A bright warm day, wind rather strong—the military situation fully cleared up by aeroplane reconnaisance. At midday, the 1st New Zealand Brigade had orders to come out of the line and retire to rest billets. All R.A.P.'s were clear in the afternoon, when Lieut.-Col. Murray handed over Kandahar Farm to the 4th Australian Division; his tally of wounded passed through now reached 3126. The bearer personnel of No. 1 and No. 2 Field Ambulances were relieved by A.M.C. and marched to Ravelsberg for a period of rest, having worked almost continuously for three days and nights. No. 3 New Zealand Field Ambulance passed under control of the A.D.M.S. of the 4th Australian Division, now responsible for forward evacuations. Owing to the direction taken by the trench tramways, and the general use of the Wulverghem road, most of the New Zealand casualties had passed through the northern sector, but at Underhill, some assistance was given to the 3rd Australian Division whose A.D.S. was near by at Charing Cross and was occasionally overcrowded.
During the night of the 9/10th, the Division was relieved. The day was quiet, Divisional Headquarters moved into Baillieul. The 4th New Zealand Brigade which had not yet been engaged in the fighting line passed to the control of the 4th Australian Division, taking over a sector of the line just north of the Lys, the Ploegsteert-Le Touquet sector already described. The 4th Field Ambulance established a M.D.S. at Pont de Nieppe, using the routes of evacuation from Motor Car Corner and the A.D.S. at the Brewery.
The second battle of Messines terminated on the 9th of June, what further operations ensued, in advancing our out-post line belong to a period of exploitation of the initial success. With these operations we will deal later, but the moment seems opportune to review the medical work during the assault and capture of the village by the New Zealand Division.
All contemporary accounts written by medical officers agree in stating that the medical arrangements worked satisfactorily. There were some minor imperfections however. First, as to the R.M.O.'s: the position of the regimental medical detachment in the course of an assault is to a great extent a matter for the battalion commander to decide, although divisional routine orders issued at the Somme governed the dispositions somewhat; but, page 306in the assault of Messines the 1st Brigade, as it passed through the 3rd and 2nd Brigades to the east of the village, carried the regimental medical officers forward with, or shortly after, the infantry waves. The N.Z.R.B. kept their regimental aid posts for some time in our old front line, and this, as we have seen, applied also to the 2nd Brigade; their objectives were not so far off as those of the 1st Brigade. The advance of one of the regimental detachments of the 1st Brigade, then, can be reviewed as an illustration of similar movements in other battalions.
Captain Nelson, N.Z.M.C., R.M.O. to the 1st Auckland, was in the assembly trenches in front of Spring Street, at zero hour. He advanced with the final waves of his battalion, having with him 4 regimental stretcher bearers, his corporal medical orderly, 1 regimental water duty man of the N.Z.M.C., 1 N.Z.M.C. runner, taken from the old R.A.P., and the battalion chiropodist. He kept close touch with his battalion headquarters detachment. He reached the enemy trench known as "Ulcer" support without casualties, but did not at first occupy the trench. He dug in his R.A.P. in a shell hole—his party carried spades, and were able to improve the position somewhat. Here he attended to such wounded as were in his vicinity and at 5 a.m. despatched his runner to Spring Street, There was no shell fire for about two hours in this locality and at 6 a.m. one squad of N.Z.M.C. bearers cleared his post of stretcher cases which only numbered two. Just before midday he went forward about 200 yards and found a strong concrete "pill box" in "Ulcer" Sap. The dug-out was full of dead and wounded Germans; the dead were removed, the wounded attended to. During the day no bearer parties had penetrated to this post, now over a mile from Spring Street, on the extreme right of the New Zealand Division and the most advanced R.A.P. Some time after the assault of the 4th Australian Division returning German prisoners were commandeered to carry back the accumulated stretcher cases, but it was not until 9 p.m. that Captain Nelson's post was finally in touch with Australian bearers going forward to their own still more advanced posts. After this there was no further trouble, the N.Z.M.C. officers were now fully informed as to the position. In the morning, water supply was a difficult problem, but some water was obtained from a disabled tank and later a pipe supply from Messines was discovered near the pill box. During the 8th and 9th many Australian wounded were brought down to Nelson's Post and Captain Crawford, in person, brought up bearer squads on the morning of the 9th. The regimental stretcher bearers had page 307very heavy casualties as there was much enemy artillery fire and most of the time a heavy barrage between the post and Spring Street. Captain Prior, R.M.O. 1st Otago Battalion was for a short time not located but he was in touch at a much earlier hour than 1st Auckland. Generally, touch was maintained with much greater ease than at the Somme, and, with the exception of Nelson's Post, all R.A.P.'s were kept clear at all times. Only the wounded who were lying in shell holes were difficult to locate, and late in coming in. At some R.A.P.'s there was much less work than at others. Captain Johns and Captain Gordon at the Cabaret corner had few casualties, mainly because they were too near to Messines, which was subjected to a withering bombardment from the Le Quesnoy group of heavy field guns, whereas 200 yards north of them, Captain Addison, N.Z.M.C, at the Moulin de L'Ospiee attended a great number of wounded from all units. The fortified R.A.P.'s in our old front line positions were a tower of strength in the evacuation scheme, but it was thought by some of the R.M.O.'s that bearer relay posts should have been advanced beyond these points. The A.M.C. parties did push forward their B.R.P.'s after the 7th, as they had a longer carry to negotiate.
Lieut.-Col. Murray's contemporary report on the work at Kandahar Farm has some interesting passages. He says—"Throughout the whole of the operations evacuations proceeded satisfactorily, the wounded coming in very quickly. There was little holding up of wounded forward of the A.D.S., and very few cases that had not been brought in within 24 hours. Later on in the operations a few wounded were located in shell holes where it was very difficult to find them, or, in some instances, to approach to their assistance owing to severe shell fire. The trench tramways were of much assistance in evacuating from Spring Street and Port Osborne. Each trolley had been adapted by special gates to carry four stretcher cases; only three bearers were required to handle the load. The specially constructed protected aid posts, roomy and well equipped with all necessary medical stores, staffed by N.Z.M.C. nursing orderlies, were of the greatest assistance to the R.M.O.'s who were enabled to work expeditiously and safely, and later advance to their forward aid posts with the battalion medical equipment intact and unopened. The field ambulance runners were well used to maintain touch with the advanced dressing station by accelerating the despatch ef bearer parties to an already known point. Occasionally, owing to heavy hostile artillery fire it was not possible, within the bounds of reasonable safety, for bearers and wounded, to clear page 308some of the forward posts, and a pause in the work was necessitated until fire ceased or slackened. Thomas' hip splints were largely used and unquestionably enabled the transportation of men with fractured thighs to be carried out with the minimum of shock. Hot restorative drinks and food were given to all cases at the A.D.S. prior to dressing and evacuation. Along the walking wounded tracks, refreshment points were provided by the New Zealand Y.M.C.A. or the field ambulance personnel; here hot drinks and biscuits were available."
A small detraining point for lightly wounded coming down by the 60 c.m. railway was established by one tent subdivision of the 4th New Zealand Field Ambulance. It was near Connaught siding on a track leading to the C.M.D.S. at Pont D'Achelles. During the Messines operations some 900 walking wounded detraining at this station were fed at a long counter in the open, their wounds redressed and their progress assisted to the Pont D'Achelles station. During the afternoon of the 7th a 12in. gun of ours drew up near the siding and engaged with a similar monster in the Lille defences in a very noisy and alarming duel the effect of which was, if anything conducive to accelerated: evacuations.
The A.D.M.S. of the New Zealand Division, Colonel McGavin, was responsible for clearing both the New Zealand and the 4th Australian Division from zero hour up to the 9th of June. He had under his command the whole of the bearer personnel of the Australian Ambulances from 3 p.m. on the 7th until relieved by the Australian A.D.M.S., Colonel Barber, A.M.C. Colonel McGavin makes the following comments in his report written shortly after the engagement. "The total number passed through the advanced dressing stations in the period defined was as follows:—walking wounded, 980; sitting wounded, 1620; lying wounded. 1230; total 3830 (including P.O.W.). The protected A.D.S.'s and R.A.P.'s were very efficiently fortified; several direct hits by 5.9 or 4.2 shells were noted, but in no case did the shells penetrate the dug-outs. The gas-proofing proved very effective at Underhill Farm, the neighbourhood of which A.D.S. was subjected to heavy bombardments by gas. Dayfield body shields were furnished for all medical personnel, but were mostly used by those who were working about the A.D.S.'s and the R.A.P.'s and by the drivers of the ambulance cars, that is to say: by those who, not having to move about a great deal, were not unduly hampered by the extra weight. Five men were hit on the body shields, in four of these cases there can be no doubt that the wearers were saved page 309from dangerous abdominal or chest wounds. The A.D.S. of the right subsector, Underhill Farm, was prepared to deal with many more cases than, as a matter of fact, passed through it. This was anticipated, but it was considered advisable to provide ample accommodation here in case the enemy fire should prevent access to or evacuations from Kandahar Farm; in which case, the greater part of the evacuations would have been conducted through the alternative route in the right subsector. Telephone lines to each A.D.S. proved invaluable. The wire to Underhill Farm was several times broken by shell fire, but was speedily repaired. Despatch riders (motor cyclists) did excellent work in maintaining communications and supplementing the telephones. The motor ambulance cars of both divisions with the exception of a few stationed at A.D.S,'s were parked near Westoff in charge of a N.Z.M.C. officer [Captain Mitchell, Q.M. of No. 2 New Zealand Field Ambulance]. A continuous circulation of cars from the A.D.S.'s to the C.M.D.S. was maintained; the numbers of cars required at any one time being controlled by telephone or despatch messages from the A.D.S.'s so that varying requirements were rapidly met. Valuable services were rendered by the New Zealand Y.M.C.A. under Mr. J. L. Hay, who established refreshment stalls at certain points along the routes of evacuation, even as far forward as Boyle's Farm and Gooseberry Farm." The A.D.M.S. reports the casualties of the New Zealand Division admitted to the corps M.D.S's from midnight on the 6/7th June to midnight on the 9/10th as 22 officers, 2840 O.R. and the casualties in the N.Z.M.C. as killed, 1 O.R.; wounded, 22.
At the corps M.D.S. at Westhoff the work had been shared by three departments: walking wounded under N.Z.M.C. officers; stretcher cases tended by British and New Zealand details; and the clerical section—corps casualty bureau—by a mixed detachment of clerks. In the stretcher case department three large hospital huts with four tables each were manned by shifts of six medical officers, one to every two tables. Smaller huts on the opposite side of a plank walk provided an operating theatre, a gas treatment room and a resuscitation room. A large hut controlled by a senior N.C.O. was in use as an evacuation room for stretcher cases. The three large hospital huts used for lying down cases gave on the admission road and received the stretchers in turn or simultaneously as desired. A heavy curtain of blankets separated the receiving from the dressing subdivision of the hut and in each hut the chaplains and orderlies saw to the immediate comfort of the wounded as soon as they were admitted. Four page 310trestles were loaded at a time, each had a nursing orderly in charge, whose duty it was to prepare the wounded for the surgeon's inspection. Two bearers assisted in removing or cutting out clothing, boots, or in other necessary rough work. A clerk entered the particulars of each case on a buff slip and prepared the field medical card for the medical officer's notes. Next a special orderly in charge of the serum, administered the antitetanic injection, and lastly the case was examined by the surgeon. Where there was free haemorrhage or considerable shock, the case was immediately transferred to the operating room, but in the general run of cases the surgeon once satisfied as to the nature of the injury, gave necessary instructions to the nursing orderly and dictated to the clerk the description of the injury to be entered on the field card. If the wound required splinting or was at all extensive, the surgeon applied the apparatus and dressing himself, but in very many cases this was not necessary as the nursing orderlies were expert dressers, so that by the time he had examined one case his other table was occupied and ready for his attention. In this way and by strict adherence to a well rehearsed drill, and carefully ordered dressing and sterilizing tables, a maximum of work could be put through in an incredibly short time. Gloves were used by some of the staff, not all; masks were not used; all were clothed in sterilized gowns. In many instances the wounds had been very well dressed and the case carefully splinted at the A.D.S., nothing was required here except the anti-tetanic serum and the necessary clerical work. Cases coming down in this condition from the A.D.S. had their bandages marked in indelible pencil with the sign "O" meaning "O.K. C.C.S." and were not disturbed but passed straight through to the evacuation room. The first field dressing, if not removed at A.D.S. was always taken down at M.D.S. so that a full description of the wound could be recorded; a very necessary precaution, as wounds of a trivial nature are not easily distinguishable from more serious penetrating injuries, especially where small fragments of high explosive shell are concerned.
In the operating department tourniquets if present were removed. Ether by the open method, was administered and haemorrhage was arrested by ligation in situ or by amputation in the case of badly shattered limbs. Chest wounds were closed by suture without an anaesthetic. Abdominal cases were not handled but were sent on urgently—frequently from A.D.S.—by direct car to C.C.S. The operating team of three medical officers page 311assisted by skilled nursing orderlies, also attended to resuscitation by warmth, stimulating drinks and intravenous injection of hypertonic saline solution with added calcium chloride; camphor and small doses of morphia were administered, all shocked cases were detained until they had rallied. Moribund casualties were admitted to a small comfortable hut, named euphemistically the "surgical" ward, where the chaplains ministered to them to the end. The splinting of compound fractures or of extensive flesh wounds of the upper or lower limbs was occasionally much facilitated by light ether narcosis, the dose of morphia already administered permitting good relaxation under the anaesthetic In spite of the general interdiction of anaesthetics at M.D.S. the advantage to the patient of having good extension and immobilisation in a well adapted splint appealed strongly to the forward surgeons as a preventive measure against pain and shock in transport and handling prior to operation at C.C.S., which for a variety of reasons, might not be for many hours after the first adequate dressing had been applied. If it were not for the danger of early gas infection many of these cases, put up handsomely at M.D.S., might have embarked in ambulance trains direct for general hospital without risk in transit; but it had been noted on the 8th and the 9th, more especially in German wounded who had been lying out undiscovered for many hours, that gas gangrene developed in from 18 to 36 hours after receipt of injury.
In the dressing of minor wounds iodine was not used; sterilized gauze with eusol was the universal dressing. Picric acid in two per cent. solution with methylated spirit was applied to the scalp, after shaving, where there was a penetrating injury of the skull. The moat interesting advance in first line surgery was the extensive use of Thomas' hip splint as far forward as the original R.A.P. The difference in condition between wounded who were thus splinted and those otherwise dressed, was very striking. All medical officers commented on the vast improvement effected by the use of this apparatus in handling a condition heretofore fraught with extreme danger to the injured. Some of the R.M.O.'s were of the opinion that a supply of these splints should have been brought up to the forward R.A.P.'s by the ambulance bearer parties; in this contention they were right; the idea was developed later.
Cases of gas poisoning were numerous on the morning of the 7th: they were treated in the open by means of the "Novita" sets which were extremely satisfactory on account of their light weight and portability. The apparatus was fitted with a two-way page 312face piece and inhalation bag, the regulation of the flow of oxygen was so easily controlled that one orderly could attend to several patients simultaneously.
The walking wounded department was manned by N.Z.M.C. personnel. Here, the steady stream of casualties passed at once to the refreshment counters, where food, drink, chocolate, and cigarettes were dispensed, mainly from the stores of the New Zealand Y.M.C.A. Benches were provided where many a grim story was told and the whole battle, as seen or imagined by the narrators, fought all over again with all its hair-breadth escapes. Very loquacious, the walking wounded are in a fine state of exaltation which, duly fortified by good food and minor comfortable attentions, makes them an easily managed and very patient crowd. Passing in turn before the clerks who filled in the necessary entries on the field medical card, and the buff slip, the cheerful queue reached the inoculation tables where A.T.S. was administered—the fact duly noted in the documents; ultimately they reached the dressing room where the whole staff of six medical officers and their nursing orderlies worked simultaneously during rush hours at 12 chairs. The medical officers completed the diagnostic entries on the cards and indicated the nature of a disposal either to C.C.S. or to D.R.S. in the case of the more trivial injuries. From time to time a few of the wounded would be transferred to the M.D.S. if the severity of the case demanded more elaborate surgical treatment and evacuation by stretcher. It is very remarkable how soldiers with severe wounds such as compound fractures of the upper extremity or, rarely, penetrating wounds of the head or abdomen, manage to mingle with the stream of walking wounded and, through battle inebriation, will walk considerable distances, apparently unconcernedly, until exhaustion compels them to become stretcher cases. From the dressing-room the flow of casualties was directed to the evacuation yard where three-ton lorries fitted with seats, and motor omnibuses carried them away at the rate of 180 an hour during the main rush of the 7th.
From 3 a.m. on the 7th June to 12 noon on the 9th, the Westhoff station handled 187 officers, 4822 O.R.; of these: sitting and lying cases, 1767; walking cases, 2879; over 5000 in all, including German wounded prisoners. The lorry service for walking wounded was well maintained, there was no delay, but on about three occasions the stretcher cases awaiting removal accumulated to about 80. From 5 p.m. on the 7th and onwards page 313the evacuation by M.A.C. was continuous. During the first sixteen hours the wounded were evacuated at the rate of four per minute.
Special huts were provided for the corps bureau in which 22 clerks worked continuously in shifts. The reports, returns, and states to be furnished were:—
|(1)||Four hourly signal message to D.D.M.S., giving the numbers of admissions and evacuations of wounded, sick and prisoners of war;|
|(2)||A. and D. books, kept separately for each of the British, Australian and New Zealand Divisions, and other units engaged;|
|(3)||A.F.W., 3185, a daily state, showing sick and wounded admissions and disposals for the use of each of the divisions or other formations.|
|(4)||A.36, as provided for in F.S. Regs.: the nominal roll of casualties admitted showing full designation, unit, corps; the nature of the injury; dates of admission and discharge; and disposal. In other words, an extract from the A. and D. books.|
|(5)||Telegraphic notification of death of officers, to D.M.S.|
The correct compilation of the A. and D. book, the basis of all these returns and states, needed special care and some clear-cut method of recording. The method adopted was this:—The buff slip already described and the field medical card were made out for each wounded man admitted; the slip when completed in the dressing room, was placed in the waterproof envelope which contains the field card, and was collected at the time of evacuation by an orderly specially posted by the loading stage. In the case of the walking wounded the buff slip was their ticket of admission to the lorry, without which they could not pass. From the buff slips brought to the office, the A. and D. books were compiled at leisure. The method was almost identical with that adopted at the Somme in 1916; each A.D.M.S. division had his returns sent to him daily whilst the A. and D. books passed to the field ambulance concerned. But the corps bureau system had its imperfections. One of the troubles at Messines was that the bureau was in the same buildings as the corps M.D.S. The extraordinarily busy environment of such a station is not the most suitable for the work of a highly technical clerical staff. Nor is the much harassed commander of such a station in a position to devote his whole energies to organising and supervising the accountancy. The constant inquiries of divisions, units, individuals even, as to the disposal of certain wounded is pre-page 314judicial to the smooth working of the mechanism. A corps casualty recording centre, remote from the scene of ambulance activity, was a conception which evolved itself during these days, and was, later, put into operation.
At the corps D.R.S. at Ravelsberg, commanded by Lieut.-Col. Matthew Holmes, there were in all three officers and two tent subdivisions, all of the N.Z.M.C. As the station had been opened for several days, all was in running order by the 7th. Cases came in very rapidly from the night of the 6th, the majority slightly wounded. They were classified on arrival; where it seemed unlikely that the soldier would be fit for duty in three or four days, he was evacuated to C.C.S. A large number were returned to unit after a good meal and a night's sleep; they were collected daily at 9 a.m. under arrangements made by the A.P.M. who took them to the straggler post by motor lorry. It was found that wounds of the lower extremity, however slight, were not suitable for treatment at D.R.S.; as a number of them were infected owing to the presence of small foreign bodies and were not likely to recover under 14 days. "Shell shock" cases were, at first, admitted under the diagnosis "N.Y.D., shell shock." Such of these, as appeared to be true "shell shock" were evacuated to C.C.S., the doubtful were retained for observation. Lieut.-Col. Holmes noted that, considering the arduous nature of the work at the corps M.D.S. the type of case sent down had been well selected. Evacuations to C.C.S. were effectuated by means of horsed ambulance waggons. During the week following the battle the total admissions amounted to 1463, of these: 836 went to C.C.S. while 40 per cent. of the cases were fit for duty in less than seven days.
Colonel Begg, who had so carefully prepared and supervised the corps medical schemes, had every reason to be gratified by the results obtained. "At all points," he says, "the plans worked smoothly and rapidly." He makes special comment on the fact that the original dressing and immobilisation of fractures at the permanent R.A.P.'s was well done and that the surgical and operative work of the C.M.D.S.'s was of a high standard. The train arrangements for removing the lightly wounded had worked admirably: the narrow gauge railways carried 1000 the first day: and his fleet of motor lorries and omnibuses had maintained uninterruptedly their five minute services. He anticipated that the divisional rest stations would be able to restore some 1,500 to 2000 men to duty within a week. Several minor considerations required improving, in his opinion. As both the CM.D.S. and page 315the C.C.S.'s had on one or two occasions become overcrowded increased accommodation at these points were requirements for future consideration. "Though the delay was not serious," be says, "yet, in a rush, it is essential that the stretcher cases be immediately unloaded from the cars of the field ambulances and the M.A.C.'s. The added accommodation could easily be provided at C.M.D.S. by covering large areas with tarpaulins." The return of wounded made by the D.D.M.S. as from noon on the 7th to noon on the 10th shows that the Corps had dealt with a total of 9,735 wounded in all and that the New Zealand Division with 96 officers and 2,798 wounded had the highest casualties.
A correct estimate of the casualties of the New Zealand Division during the capture of Messines is difficult to assess. The number of wounded admitted from the Division, including the 4th Brigade from midnight of the 6/7th to midnight on the 11/12th was: officers, 101; O.R., 2895, a total of 2996 wounded. By adding the killed and missing—most of the later subsequently accounted for—we get a total of 3903. The figures on which this estimate is based are drawn in part from the return of casualties furnished by units to the A.A. and Q.M.G. daily. As the Division was relieved on the night of the 9/10th and battalions were not able to state their casualties in full until the 10th 11th and 12th, during which days they were in rest, it is fair to assume that the casualties reported on these dates represent losses in the Messines operation. If the total of killed, wounded and missing, is accepted to be: 473 killed, 2726 wounded, and 434 missing, as shown in the reports mentioned, the total casualties amount to 3633, equivalent to 15 per cent. of the New Zealand troops engaged. The losses may be said to have been light. The difference between the number of wounded reported by units to A.A. and Q.M.G. and the total given by the A.D.M.N. is 270 wounded. Many, no doubt, reported as missing by their battalions were later accounted for as wounded or killed. The number of killed approximates 700.
Surgeon General Porter, in commenting on the operations of the Second Army, states that the total number of wounded was less than anticipated and that the IInd Anzac casualties were much the heaviest: "The wounds on the whole, were severe," he notes, "mainly caused by H.E.; machine-gun bullet wounds were infrequent, forming only from five per cent to ten per cent. of the whole. Penetrating wounds of the head and thorax were numerous but compound fracture of the femur was in lower proportions than usual. This is accounted for by the neutralis-page 316ation of hostile machine-gun fire by our artillery. The number of cases requiring operation was high." The D.M.S. forwarded to the Corps a very flattering message directed to the medical service by the Army Commander in which he expressed his great appreciation of the most efficient way in which the medical service carried out their arduous work. He was greatly impressed by the rapidity with which the wounded were evacuated, and by. the excellent administrative arrangements made and which reflected the greatest credit on all concerned. General Godley, also, expressed his appreciation and thanks for the excellent work that had been done during the recent operations.