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The New Zealand Medical Service in the Great War 1914-1918

Chapter XII. Preparations for Messines

page 270

Chapter XII. Preparations for Messines.

By the 1st March, 1917, the whole of the New Zealand Division had cleared the Sailly sector and had taken over from the 25th Division, a sector of defence in Belgium known as the Ploegsteert-Le Touquet sector. The right of the line extended as far south as the Lys, north of Armentières; the left touched St. Ives, the north-eastern corner of Ploegsteert Wood. The road running east from Ploegsteert to Warneton cut the position into two subsectors. In the right subsector the evacuation of wounded was superintended by the 1st Field Ambulance now in command of Lieut.-Col. M. Holmes* whose M.D.S. was at Pont de Nieppe in the Convent schools. There were two A.D.S.s: "Motor Car Corner," about half a mile north-east of Le Bizet, and the "Brewery Post" on the Armentières-Ploegsteert-Messines road about a mile due north of Le Bizet. Both A.D.S.'s were in Belgium, just across the frontier. At the Brewery there was fair protection, as much of the buildings remained, there were gas proof and shell-proof cellars and accommodation for one medical officer and 15 other ranks with one large ambulance car kept under cover of the stables. The wounded came down from the regimental aid post at Despierre Farm about a mile east by hand carriage, partly in the sap or by trench tramway when the weather gave concealment. A special truck marked with the red cross and capable of accommodating two stretcher cases was stationed near the R.A.P. at the bearer relay post. South of Despierre Farm in a dug-out magnificently named "Charing Cross Hospital" was the southern R.A.P. evacuating by the same means to Motor Car Corner about half a mile distant. At this last named post there was a gas-proof room in some ruined buildings and a protected shed for a small car; the staff consisted of one corporal and four privates N.Z.M.C. A good road from Le Bizet to Pont de Nieppe enabled both A.D.S.'s to be cleared by motor transport at any time by day or night. Continuing northwards along the road, past the Brewery, the village of Ploegsteert would have been reached and just north of it on the right hand side of the road on the western edge

* Replaced Lt.-Col. O'Neil, D.S.O., appointed to command the N.Z. Stationary Hospital.

page 271of the Ploegsteert Wood was the Charing Cross A.D.S. serving the left or northern subsector, manned by the 3rd Field Ambulance with a M.D.S. at Nieppe. Charing Cross A.D.S—whose name dated from 1914, given by London troops of the 11th, Hunter Weston's Brigade—was not far from "Hyde Park Corner," at the foot of Hill 63; it had three large concrete-protected gas-proofed Nissen bow huts; the personnel consisted of one medical officer, 15 O.R. A large car was kept at this station. Our front line was on the eastern fringe of the Ploegsteert Wood and just behind in the support line within shelter of the wood were the two R.A.P.'s: the northern at "Dead Horse Corner"; the southern at "Rifle House." From both posts trench tramways were available for stretcher cases to a point not more than 200 yards from the A.D.S. at Charing Cross. A good road through Romarin permitted easy evacuation to Nieppe. Both M.D.S.'s were on the Armentières-Bailleul pavé, and were cleared daily by M.A.C. to the 2nd Australian C.C.S. at Trois Arbres. The Divisional Rest Station in charge of the 2nd New Zealand Field Ambulance was in substantial buildings at Steenwerck where the headquarters of the Division had their offices.

There was a certain liveliness in the St. Ives sector—raids, trench bombardments, and the like, which entailed a moderate number of casualties—but the evacuation of the wounded presented little difficulty, as the existing facilities were excellent. About the middle of March the Division readjusted its position, moving northwards beyond St. Ives. The 1st New Zealand Brigade was relieved in the Le Touquet sector by a brigade of the 3rd Australian Division holding Armentières, and our position was extended northward from St. Ives to the Wulverghem-Messines road across the valley of the Douve where we relieved the 36th, Ulster Division. Medical arrangements were handed over and fresh disposition of medical personnel became necessary. The new sector taken over was a prolongation northwards of our original line and extended from St. Ives, the southern limit, to the Wulverghem road where our left subsector ended. In front was Messines, only a little over half a mile distant, its battered church still a prominent mark on the opposing sky line. South to St. Ives our trenches ran across the forward slopes of Hill 63 which confronted Messine to the south-west and flanked the Ploegsteert Wood. The combination of high ground and a dense wood made the position a strong one; it had been saved from the wreckage of the first battle of Messines by Hunter Weston's Brigade, of the 6th Division, in October 1914, and presented page 272a very solid obstacle to any further German advance in this area. In the depression between Messines and our hill and wood there ran the Douve stream, up the valley of which Wurtembergers had attempted to storm in 1914, and which subdivided our sector into two brigade fronts. Our line abutted on two roads leading into Messines: the southern from Armentières through Ploegsteert, the western, from Neuve Eglise through Wulverghem. At our back was Hill 63, and the wood to the south-east of it. On the rear slopes of 63 deep dug-outs had been prepared, approached by galleries driven into the hillside, and capable of housing a very large garrison.

The south side of the hill was well wooded; at the point where hill and wood adjoined was "Hyde Park Corner," a centre of considerable activity and evil fame as a shell trap for enemy artillery. The medical dispositions in this area were concentrated on the Charing Cross A.D.S., which we shared with the 3rd Australian Division; but in the northern sector an entirely different route of evacuation was established. The No. 1 New Zealand Field Ambulance moved to Ravelsberg just outside of Baillieul on the road that led through Neuve Eglise, via Wulverghem to Messines. The A.D.S. was at "Kandahar" Farm, on this road, about three to four miles east of Neuve Eglise, in farm buildings affording protection by splinter-proofs for about 100 lying cases. In front were two R.A.P.'s one at St. Quentin Cabaret, just a mile further east along the road, the other at a farm called La Plou Douve in the Douve Valley, both very much exposed to observation from Messines ridge which dominated the valley as far as the high ground about Neuve Eglise. Kandahar Farm was in telephonic communication with the M.D.S. at Ravelsberg, and was in touch with trench tramlines loading into the forward positions. It was distant from our front line about a mile and a half, at the nearest point, where the trenches crossed the Wulverghem-Messines road. Two large ambulance cars were kept at the A.D.S., and evacuation to Ravelsberg via Neuve Eglise, a distance of about 3½ miles, could be safely accomplished with motor transport, even by daylight.

Precautions against gas were at this time subject to very careful consideration. The Russian General Staff had reported an increased use of gas shells on their front; and prisoners we had taken had heard that a new form of lethal gas was to be used shortly. For these reasons a very thorough revision of gas defensive measures was initiated: the Divisional Gas Officer, Capt. G. Borrie, N.Z.M.C, was at special pains to revise the gas appliances of the Field Ambulances. Special drills and a very page 273stringent inspection of box respirators was ordered by the Division, and gas standing orders were promulgated, which were of a very complicated and comprehensive nature. The gas N.C.O.'s were supplied with special vacuum flasks for the purpose of obtaining specimens of any gasses that might be liberated.

Early in March, the D.D.M.S., Col. Begg, C.M.G., visited the D.M.S. Second Army, for the purpose of discussing the scheme for evacuation of wounded during the forthcoming operations. The military plans for the capture of Messines were now well in hand, and the troops destined to carry out the operation, the 25th, 3rd Australian, and the New Zealand Divisions, in the IInd Anzac Corps area, were already concentrated in their positions of assault. Ultimately, as the result of personal inspection, Colonel Begg selected two sites for the C.M.D.S.'s; the first draft of the plans allowed for the accommodation of 1,300 patients, in hospital Nissen huts and marquees at both stations.* "Westhoff Farm on the Baillieul-Neuve Eglise road, about a mile ahead of the Ravelsberg M.D.S. of the No. 1 New Zealand Field Ambulance was the site chosen for the left sector C.M.D.S. and Pont D'Achelles, at a point on the Baillieul-Armentières pavé where the road from Ploegsteert via Romarin joined it, about four miles from Baillieul, was selected to serve the southern, St. Ives sector. The plans for these stations were drafted by the Corps Engineers in collaboration with Colonel Begg, and made provision for 6 large and 22 small Nissen bow huts, together with the necessary kitchens, ablution places, latrines, incinerators, horse lines and roadways for each station. In addition to the erection of the buildings it was proposed to utilise 25 marquees at each station, and it was anticipated that both establishments would be completed by the middle of April. The work was put in hand forthwith, working parties being provided by the Ambulances. At Westhoff Farm a N.Z.M.C. officer and party took up permanent quarters; the Pont D'Achelles Station was erected by A.M.C. details from the 3rd Australian Division. Large quantities of roadmaking materials, broken bricks and other debris, were brought up at night by ambulance transport from the ruins of Armentières. By the end of March the completed medical arrangements made by Colonel Begg for the Corps front were drafted and circulated to the various divisions, but, as these plans were somewhat modified, by the postponement of the operations, we will consider them more in detail presently. The chief concern of the A.D.M.S. of the New Zealand Division,

* Hospital Nissen Bow Hut: Bow shaped; constructed of corrugated iron: lined with match boarding. Dimensions, 60 x 43 x 19ft. 10ins.

page 274Colonel McGavin, at this time was the supervision of these important medical arrangements for offensive operations.

Early in April the New Zealand troops, a brigade at a time, were relieved from duty in the trenches and sent out into the back areas where they underwent a period of intensive training on ground similar to that over which they were to attack. They had demonstrations on the subject with the aid of very large sized models of the terrain, in which every trench, sap, and strong point in the Messines position was reproduced.

An extraordinary amount of care was devoted to this special training and to the work of the Divisional Trench Warfare School near Ravelsberg, as it was realised by the Higher Command during the Somme operations that lack of skill in the intricacies of modern warfare and in the apt use of the newer weapons had resulted in casualties to British troops which could have been avoided by greater individual skill-at-arms. A certain detail of medical personnel accompanied each brigade during its period of training in the back areas.

Several important administrative adjustments in the N.Z.E.F. were made during this period, the chief of these, the formation of the 4th Brigade Group. In April, 1917, the strength of the N.Z.E.F. in England was over 15,000; it had grown in consequence of the lowered rate of wastage from the Division during the winter months; there were now some 10,000 "A" Class men available as reinforcements and the Division in France was over strength. It was hoped, at the time, that a new Anzac Division might be formed by two brigades of Australians in England, with the addition of the 4th New Zealand Brigade. The supply of the necessary reinforcements from Australia and New Zealand, however, presented insuperable difficulties to the fruition of the proposal, well favoured both by the War Office and the Anzac Commanders in France. New Zealand certainly disapproved of the continued existence of a 4th Brigade Group, but acquiesced in its temporary constitution and employment, with the proviso that it should not be reinforced and that it should ultimately be broken up to supply reinforcements for the Division. Early in April a special cadre of seasoned officers and N.C.O.'s was sent to England to join and train the new units required, and to organise the group, which was to be commanded by Brigadier-General Hart, D.S.O. At the end of April two N.Z.M.C. officers with picked N.CO.'s were ordered to England to mobilise No. 4 New Zealand Field Ambulance, which one of these officers, Lieut.-Col. McLean, N.Z.M.C. was to command.

page 275

The unexpected demand for officers and men to complete the new medical unit put a severe strain on the resources of the N.Z.M.C. personnel in the United Kingdom. The number of officers N.Z.M.C. with the N.Z.E.F. in England and France, at this time, totalled over 150. The services of the Anzac Corps, the Division, the Stationary Hospital, the Overseas Base in France including reinforcements, required 74 officers; and the front line units had a first call on reinforcements. The base units in England were below minimal establishments, and were working at a disadvantage owing to lack of sufficient staff. Some small accession of strength came from the enrolment of New Zealanders who joined the N.Z.M.C. on completion of their engagements with the British Forces; but the prevision made in 1916, of a shortage of medical officers for the N.Z.E.F. was now fully vindicated. To some it appeared that the resources of New Zealand in medical man-power hardly justified the maintenance in England of three general hospitals which, had they been fully staffed, would have absorbed as many officers as were required for the N.Z.E.F. in France. The policy of segregating New Zealand sick and wounded in our own hospitals had met with adverse criticism certainly, but it had the approval of the D.G.M.S., Sir Alfred Keogh, who agreed with the contention that under our own medical supervision, men of the N.Z.E.F. were returned to duty in a shorter time than when distributed in British Hospitals throughout the United Kingdom.

In order to provide the necessary O.K., N.Z.M.C, each Base Hospital was called upon to contribute its quota of men. The draft from No. 1 N.Z.G.H. was relatively the largest: 6 N.C.O.'s and 55 privates; but the other general hospitals each supplied a quota of trained N.C.O.'s and orderlies whose place was taken by V.A.D.'s and "C" class men. Increased reinforcements, both of N.Z.M.C. officers and men were demanded from New Zealand, more especially as the sinking of Hospital Ships during the unrestricted submarine offensive compelled the replacing of N.Z.A.N.S. by N.Z.M.C. details in the two New Zealand Hospital Ships. No. 4 New Zealand Field Ambulance was mobilised at Sling Camp on the 28th of April. The personnel consisted of a draft from the New Zealand General Hospitals of 145 N.Z.M.C. N.C.O.'s and privates made up to strength from the 22nd Medical Reinforcements and by the neeessary A.S.C. and M.T.A.S.C. details. The first step taken in the training of the unit was to send all the N.C.O.'s and junior officers to a special "bull ring" class organised by the infantry instructors. A short, brisk course page 276of physical training, squad drill, platoon and company drill was completed, which was of the greatest possible advantage, more especially to the N.C.O.'s. It was unfortunate that the full course of infantry training of the unit could not be carried out at Sling Camp, where the character of the work, the discipline, and morale were of the best; but for some reason it was found necessary to move the unit to the R.A.M.C. Depot at Blackpool. The training at Blackpool was a disappointment. A field ambulance as a complete unit had not previously been mobilised there. The staff of the Depot were most anxious to help in every way, but there was a shortage both of instructors and equipment. Later it was found that equipment could be drawn in the Southern Command, so that our ambulance was obliged to move to Codford for final equipment. So many days were wasted by these moves that there was not sufficient time in which to instruct the men in the use of the field equipment. In spite of these disadvantages and thanks, mainly, to the hard work of the N.C.O.'s brought from France, whose experience in field work had been gained in Gallipoli, Egypt, and on the Western Front the ambulance was ready to take the field after less than three weeks training. The formation of the new ambulance demonstrated the importance of infantry training as a basis for field medical work and the necessity of obtaining men of good physique and high endurance, at least for the bearer personnel. Full and meticulous training in gas defensive measures was deemed to be equally important as all other considerations, as our bearers were at times obliged to work for long periods in gas laden zones, and were liable, to serious casualties thereby.

The reorganisation of Sanitary Sections had been made the subject of a special meeting of the Second Army Medical Society held during the month of April, 1917. The questions at issue were thoroughly discussed by officers interested, D.A.D.M.S.'s, Sanitary Section commanders, and officers in charge of Mobile Laboratories. The concensus of opinion expressed was: that all Sanitary Sections should be guided by a central policy dictated by approved scientific thought and that uniformity of detail in execution was most essential; and further, that in order to attain continuity of local effort, Sanitary Sections should remain in allotted areas and should not move with divisions. The outcome was a new organisation and distribution of Sanitary Sections which became Army units, detached from their respective divisions. So, the New Zealand Sanitary Section in command of Captain Sinclair, N.Z.M.C., D.P.H., passed under Army control on the 15th page 277of April, 1917, and was allotted an area which coincided with the existing distribution of the New Zealand Division.

Another important medical unit, the New Zealand Stationary Hospital at Amiens, was about to move up into the Second Army area. During the six months, July to December, 1916, some 11,870 British troops had passed through the unit, of which 10,865 sick and 1005 wounded during the active operations at the Somme. The mortality amongst the wounded was about 10 per cent. and of the sick about 28 per cent. In October, 1916, Majors Acland and T. D. M. Stout, N.Z.M.C., were detached for surgical duties to the 2/2 London and the 36th C.C.S. respectively, and with them went six ladies of the N.Z.A.N.S. for similar duties in the Casualty Clearing Stations. The commanding officer, Lieut.-Col. McGavin, on promotion to the appointment of A.D.M.S. to the New Zealand Division was temporarily relieved by Major Acland until Lieut.-Col. O'Neil, D.S.O., late commanding the No. 1 New Zealand Field Ambulance took command of the hospital in November. At the end of October, Major Acland was appointed Consulting Surgeon to the N.Z.E.F. and was posted to No. 1 N.Z.G.H. with the rank of Lieut.-Col.; relieving Lieut.-Col. Barnett, N.Z.M.C., as consulting surgeon and head of the surgical division at Brockenhurst. Early in the spring of 1917, the stationary hospital, which had an average bed state of about 350, increased the accommodation to over 400 by opening an annexe as an officers' auxilliary and sick sisters' hospital. This necessitated some increase in personnel which was met from N.Z.M.C. reinforcements and a few P.B. men. The establishment of the unit was at this time defined in N.Z.E.F. Orders as:—17 officers, 34 sisters N.Z.A.N.S., and 141 O.R.—total 192. In March, 1917, the actual strength was 18 officers; 161 O.R., and 35 Sisters. In this month as the result of the forward move of the Fourth Army, who were now keeping step with the German strategic retirement to the Hindenberg line, there was a considerable falling off in the local admissions; and in April, Amiens came under the L.O.C. control when the Stationary Hospital ceased to act as a C.C.S. and passed to the command of the D.M.S. L.O.C. This, of course, is the normal disposition of a stationary hospital, but the New Zealand unit had always desired a more forward position, in fact, wanted to be a C.C.S.; it was the first expressed wish of the commanding officer on disembarkation in Egypt, in 1915. Circumstances, not as yet clearly defined, prevented a very desirable change of designation and organisation, and although it was the wish of the N.Z.E.F. that the New Zealand Stationary Hospital should be brought up page 278into the vicinity of the Division, no steps were taken to convert it to a C.C.S. In May, welcome orders came from the Q.M.G. to hand over to the 59th General Hospital at Amiens and to report to the Second Army. On arrival, at Hazebrouck Lieut-Col. O'Neil relieved the 12th C.C.S., taking over 118 patients and exchanging certain portions of the equipment. The buildings handed over formed part of the College St. François—a girls' boarding school —and were three storied. On the ground floor there was a large ward of 50 beds with an operating room for two tables. On the first floor were two wards for 40 and 80 beds, respectively; and on the second floor a ward for 88 beds, with a recreation room and dining room. The capacity of the building, after certain modifications had been made, was 304 beds, and 50 extra stretchers if required.

The early months of 1917, in Flanders, were bitterly cold and spring was late in coming; frosts and occasional snow with intervals of wet weather continued throughout April, but by the middle of May, fine, warm weather and, at times, a somewhat oppressive heat finally banished the winter. The New Zealand Division with an average strength of 20,250, had reached a very considerable degree of general fitness. During the month of May, the sickness wastage rate had fallen as low as 3.9 per 1000; the lowest rate for any month the division had spent in France. During April and early May the infantry brigades had, each in turn, enjoyed a spell of hard training away from the trenches which improved their health considerably. Yet the Division was in the throes of a mumps epidemic which had reached its acme at the end of March, and was still lingering on. The epidemic began in December, 1916, and was assumed to have spread to us from the 3rd Australian Division, then on our left, and in which the disease had become epidemic since its arrival in France. Measles and mumps were both responsible for a very considerable temporary wastage in the British Armies in France: in the year 1916, no less than 4,333 cases were reported, and of these, 3,629 were Australians. The incidence was chiefly in men who came from sparsely inhabited countries—the Highlands, the Scottish Islands, Australia, New Zealand and the frontiers of India—whose levies had not as yet acquired the immunities normally present in other British troops recruited from more densely populated countries. In spite of early precautions, such as segregation of contacts and disinfection, the disorder spread rapidly and simultaneously through all units, so that isolation of contacts became impossible without dislocating the work of the page 279division. The maximum incidence was reached on March the 24th, when 142 cases were evacuated during the week; a total of 769 cases was recorded up to the end of April. There was a simultaneous outbreak of measles, though not on a large scale: 128 cases in all. While the 3rd Australian and New Zealand Divisions suffered heavily the 57th and the 34th, who at the time formed part of the IInd Anzac Corps, were not affected. Apart from metastatic orchitis—which was frequently observed— the long period of incubation and the quarantine of 24 days caused serious wastage and made the disease somewhat formidable in susceptible troops. In April Col. Begg decided to mass all the mumps cases in the Corps in No. 1 New Zealand Field Ambulance who opened a mumps hospital for the purpose. The percentage of testicular metastasis was high in the Dominion troops, and in some instances the orchitis appeared to be the only symptom complained of, the swelling in the paratoid gland being very slight or inconspicuous. In the month of May, 144 cases were admitted to No. 1 Field Ambulance, when complication by orchitis was still more frequently observed: of 404 cases admitted 131 had metastatic orchitis, a percentage of 32. Lieut.-Col. Holmes, N.Z.M.C., made an interesting observation that in cases of double orchitis much relief was afforded by a free incision of the tunica vaginalis with improved prospects of continued function. With the warm weather in May, there was a marked falling off in the numbers admitted and had it not been for this epidemic, the general health of the division would have been excellent.

The curious immunity to trench nephritis in New Zealanders and Australians was commented on by Colonel Soltau, consulting physician to the Second Army, at a meeting of the Medical Society, held at the 2nd Canadian C.C.S., at Remy Siding, on the 11th of May. Colonel Soltau said that there had been 718 cases observed in the Second Army during the past three months, of which the New Zealand Division had 10 cases only, and the 3rd Australian, 6; both of these Divisions of the IInd Anzac Corps, had much the lowest incidence in the Second Army; the 25th Division was evacuating 20 cases per month.

Owing to the increase in enemy submarine activity, a rigorous policy of economy in food stuffs was now being enforced in the B.E.F. The New Zealand Division, apparently without any difficulty, excelled in securing economy—more especially in fats—the average quantity of first class dripping saved by the New Zealand Division was over twice as many pounds as any other page 280division in the corps, and probably the Army. The total amount of fat forwarded by our Division to the base since the inception of the scheme was 43,302 lbs., averaging 6000 lbs. per week, of which two thirds at least, first class dripping. The cheese ration, a more palatable form of fat ration, was underdrawn by 10 per cent. and preserved meat to a lesser extent. Whatever the reasons adduced for this economy, it is clear that dripping and cheese were not popular foods with the New Zealanders. Even in New Zealand the peace training ration of 1912, which provided 133 grammes of fat, part, of it in good butter, resulted in a waste of fats. It was not likely then that our troops could utilise the full fat content of the standard war ration namely, 150 grammes per diem, at least in the forms provided by the ration. It would perhaps be rash to attribute high sickness wastage to low fat consumption, but it does appear that there was a measure of association between the sickness wastage rate of units and their fat consumption as estimated by their dripping returns. Such a calculation has been made for 12 New Zealand Battalions for a period covering 40 weeks in 1917, and it emerges that the battalions which used least fat had the highest sickness wastage, the degree of association being 643, which amounts to very good grounds for belief. Our men, at this time were unquestionably fit, but as compared with British troops, they appeared to be lean and a trifle too "fine" in condition. There was plenty of hard work doing at the time in preparation for the coming onslaught.

Active operations on a large scale on the Somme front had ceased by the end of November, 1916, owing to unfavourable weather conditions, but to the north of the Ancre some heavy fighting continued, during which Thiepval and Beaumont Hamel were taken. The plan of campaign for 1917, as projected by Joffre and Haig, contemplated a joint offensive on the Somme front in February or April. But a change in national and political views abhorring the war of attrition, the "blood bath" of the Somme, led in France to the demission of Joffre and Foch; and a new plan of operation, by whirlwind battles on the Aisne heights, devised by Nivelle was universally hailed by England and France as the new short cut to victory. At a conference of Premiers at Calais in February, Sir Douglas Haig was subordinated to the French Generalissimo, and was instructed to support the Aisne campaign to the fullest extent. Part of the Joffre-Haig scheme included an attack on the northern hinge of the Siegfried line in front of Arras; it was agreed that this page 281stroke should precede the larger French operations; meanwhile the Germans retired slowly to their Hindenberg fortresses, and the Russian Revolution temporarily paralysed the Eastern Front.

The British "push" at Arras early in April, although limited in extent, was extraordinarily successful. Vimy Ridge and Bullecourt were taken with about six miles of the Siegfried line, and as compared with the Somme offensive of 1916, our gains were greater and our losses much less. Nivelle's armies attacked in great force in the Champagne, but were brought to a stand some seven miles short of their objective, the Laon Plain; a local tactical success, but of no strategic importance, bringing no compensations for the heavy casualties, disappointment, and loss of morale which the failure of the ambitious scheme carried in its train. The fighting about Arras had to be maintained for a much longer period than was anticipated so postponing the Flanders Campaign—in order to give support to the long drawn out French operations. The schemes of the Allies had failed, at least in bringing an end to the war, a consummation seriously envisaged by the more sanguine: Nivelle was replaced by Pétain, who was to nurse the French Armies back to a more optimistic mood, and Sir Douglas Haig was left free to prosecute his Flanders Campaign, also a part of the old Joffre-Haig plans for 1917. To this course the British Cabinet was agreed in May.

Early in the war Sir John French had foreseen that the continued occupation of the Belgian ports by Germany would prove a very real danger to England. The unrestricted submarine campaign, which, according to Von Tirpitz was to strangle England in a few months, and the frequent bombing raids on London, had their respective bases of operations in the neighbourhood of Ostende and Zeebrugge. An advance to Bruges through the Ypres salient would cut off these bases, but, before troops could debouche from the Ypres salient or concentrate within it, it must be enlarged by capturing all the high ground which superior forces of men and guns had enabled the Germans to seize in 1914. The first step was to make good the heights about Messines and Wytschœte, so gaining observation and providing a pivot for further manoeuvre. For the reasons explained, the Messines attack was delayed by six weeks, the first plans were completed by April the 15th, the original anticipated date for the opening of the Flanders Campaign; the delay was to have serious consequences. The British Army was now to assault the enemy alone, the French Armies for the time remaining inactive Something was still hoped for from the Russians, but better page 282still the United States had now definitely joined the Allies and by May some assistance in medical troops was coming from across the Atlantic.

The second battle of the Messines-Wytschœte Ridge may be taken as the perfected type of the battle of limited objectives. Preparations had been under weigh ever since the late autumn of 1916, which included the laying down of broad gauge and narrow gauge railways leading right into the heart of our positions, the formation of many new roads, mining operations of an unheard of magnitude, and at an unusual depth, and the accumulation of vast stores of ammunition and engineering material. Not the least important of the preparations was the training of the troops. Each division destined to assault the position knew its sector as it had trained in the back areas, over exact models of the positions to be taken. The topography of the trenched country had been studied in all its intricacies by aerial photographs, and the front line had been systematically explored by reconnaisance patrols. "The final preparations were carried out," says Sir Douglas Haig, "with a thoroughness of organisation and an attention to detail which are beyond all praise."

The medical arrangements made by the Second Army, the Corps and the New Zealand Division were no less thorough. Early in March Surgeon General Porter had summoned the D.D.M.S.'s of the various corps to discuss the medical plans. The allocation of duties to the various commands were clearly outlined. The A.D.'sM.S. of divisions were to be responsible for evacuation of the wounded from the fighting line to the Corps Main Dressing Stations. The D.D.'s M.S. of corps would supervise the evacuation from the corps dressing stations, and the transport of both lying and walking wounded to the Casualty Clearing Stations to which end a Motor Ambulance Convey was placed at the disposal of each D.D.M.S. Three Corps were to be engaged at the assault on the Messines-Wytschœte Ridge; from north to south: the Xth and the IXth and the IInd Anzac, each Corps having four divisions. The medical arrangements made by each Corps were somewhat similar to those adopted by Colonel Begg for the Anzac Corps, and which we propose to consider more in detail. The Army arrangements included the allotment of the C.C.S.'s of which, No. 53 British, in the Asylum Buildings at Baillieul, and the 2nd Australian C.C.S. at Trois Arbres, not very far from Pont d'Achelles Corps Main Dressing Station, were the chief. Special C.C.S.'s were detailed for particular page 283classes of casualties: No. 11, at Baillieul East was to be used for lightly wounded from our Corps; one C.C.S. was reserved for officers, sick and wounded. All gun-shot injuries of the head, fit to travel the distance prior to operation, were to go to the New Zealand Stationary Hospital at Hazebrouck, about eight miles by road from Baillieul. The New Zealand Hospital was also to take the overflow from C.C.S.'s and to hold cases for a longer period than the more forward units. The nearest C.C.S. to the firing line was No. 2 Australian, at a distance of about 5½ miles, in a direct line from Messines Village, and within the zone of long range enemy artillery fire. At Baillieul the C.C.S.'s were, say, eight miles from the front, but still subject to very long range artillery fire; even Hazebrouck, at a later period, came under fire from naval guns at extreme ranges of from 20 to 21 miles. Considerable use was to be made of the network of railways both broad and narrow gauge, to clear lightly wounded to the Army units, and for bringing up the Ambulance Trains to the sidings near the Casualty Clearing Stations. In order to avoid overcrowding at the C.C.S.'s, each corps was to set apart at least one Divisional Rest Station, to which men, not seriously ill, could be sent pending final disposal; as few as possible were to be evacuated during active operations. The C.C.S.'s were so staffed as to be able to deal with 150 lying cases in one batch; three surgical teams* and three extra medical officers with six sisters were detailed to each, and a certain number of extra stretcher bearers drawn from category men. At the New Zealand Stationary Hospital, an adjustment of accommodation and an increase of beds was made necessary by the special duties imposed. An additional operating theatre was fitted up with the X-ray room adjoining; a small plant used for lighting the college supplied the necessary power for the X-ray apparatus. Certain extra buildings were taken over from the 50th C.C.S. and the "Sous Prefecture" and the "Clinique," municipal buildings, were also requisitioned; at the "Clinique" there was an operating theatre. Already by the 24th of May head injuries were coming into the New Zealand Stationary Hospital and were subjected to operation under favourable conditions.

Very explicit instructions as to the surgical treatment of the wounded were issued by the Second Army, the more important being these:—Eusol was recommended as the standard lotion; picric acid 2 per cent. solution was to be used for skin sterilization in place of iodine; operations forward of the C.C.S. were to be restricted to the arrest of haemorrhage and the removal of

* A.C.C.S. surgical team consisted of: 1 surgeon. an anasthetist, a sister, and an orderly.

page 284hopelessly shattered limbs; morphia was to be used sparingly. In all cases of fracture of the femur or wounds of the knee joint, the Thomas splint was to be applied; wounds of the thorax were to be made air tight by immediate suture. Wounded in a condition of shock were to be retained for rescuscitation at the dressing stations, and were to receive hypertonic saline infusions* with the administration of camphor in olive oil; morphia was to be withheld or at least given in very small doses. The use of morphia and anaesthetics generally, in the forward dressing stations had been found to increase post operative mortality in the C.C.S. Unquestionably the dosage of morphia in the early years of the war had been excessive: some of the wounded dosed themselves from private stores, and half a grain by the mouth was not infrequently given at the R.A.P.; if hypodermic injection of a further dose was administered at the A.D.S. or M.D.S. the patient was dangerously drugged by the time of his arrival at C.C.S. In all cases the time of administration and the dose of morphia given was to be noted on the tally or field medical card. In the early treatment of gassed cases, bleeding and emetics were recommended, with continuous administration of oxygen, to which purpose the Corps Main Dressing Stations were equipped with oxygen inhalation sets. All these recommendations—Army Orders we may say—were to a great extent devised by the consulting surgeons and physicians of whom Sir Anthony Bowlby, Consulting Surgeon in Chief, was foremost. Colonel Gordon Watson and Colonel Soltau were the Second Army Consultants.
The IInd Anzac Corps objectives were limited to the southern portion of the battle field, including Messines village; four divisions were to be employed on a front of about 6,000 yards. A rough estimate of the casualties to be anticipated would be 15,000, allowing for 25 per cent total casualties, of which 1 in 4 killed, leaving about 11,000 wounded; of these over 5000 would be lying cases. Owing to the presence of Hill 63 in the centre of the corps front, and in order to conform to the elaborate traffic control arrangements, Colonel Begg found it necessary to establish the two corps M.D.S.'s already referred to: one for the northern routes at Westhoff Farm; one for the southern routes at Pont D'Achelles. His line of evacuation in the northern sector was to the C.C.S.'s at Baillieul, in the southern to the 2nd Australian C.C.S. at Trois Arbres. No less than four Casualty Clearing Stations were available for his purposes: the 11th at the railway siding at Baillieul was to take the overflow from the

* Sodium Chloride, 180 grs.; Potassium Chloride. 4.5 grs.: Calcium Chloride, 4.5 grs.; Boiled water, 1 pint.

page 2852nd Australian at Trois Arbres, Which could accommodate 1000 cases. The medical personnel at his disposal consisted of 13 field ambulances including the 4th New Zealand Field Ambulance which arrived at Baillieul on June 1st, and a proportion of category men placed at his disposal. The services of each of the two C.M.D.S.'s required six complete tent subdivisions provided by the divisional ambulances which also furnished the necessary staff for a corps walking wounded collecting post, and for three corps rest stations situated at L'Estrade, Steenwerck and Ravelsberg to be used for the reception of slightly wounded and less seriously sick. At Ravelsberg all cases of functional disorder, shell shock and the like were to be temporarily housed and treated. The transport available was: 1 M.A.C. for lying wounded; the various train services for lightly wounded; and a special service of motor omnibuses. Two circuits for the buses with a five minutes service and regular stopping places were arranged: in the northern sector, from Baillieul to Westhoff, on a circular route with stopping places at the C.M.D.S., Ravelsberg, and certain C.C.S.'s in Baillieul; in the southern sector the buses ran as far as the Corps Rest Station at L'Estrade and Steenwerck with a stopping place at Trois Arbres for the Australian C.C.S. Each bus held from 20 to 25 sitters and had instructions to unload only at a given point, so as not to interrupt the timing of the circuit. Each bus load, therefore, had to be made up of patients bound for a common destination. The Corps arrangements included the due recording of all casualties; the rendering of the necessary casualty reports; and the administration of antitetanic serum. Colonel Begg's original arrangements were completed in April, but in consequence of the postponement of the operations, were somewhat elaborated during the interval. The 3rd Australian Division was instructed to take over the D.R.S. at Steenwerck and Lieut.-Col. Holmes had orders to clear his mumps hospital at Ravelsberg and to increase his tentage, so as to receive slightly wounded and "nervous" cases. The 25th Division and the 3rd Australian were to take 600 cases each in the corps rest stations and were to clear all their present patients by the 30th of May.

The divisional medical arrangements, which concern us moat may now be examined. The front held by the New Zealand Division and from which we were to assault, lay between the Wulverghem and Ploegsteert roads as they converged from west and south to enter Messines about a mile away along these roads from either flank. The centre of our front line was just half a mile from Messines Church, and touched the Steenbeck, page 286a muddy creek at the foot of the hill. A formidable position lay in front: there were no less than three organised lines west of the village, and others behind it, partly on the reverse slopes of the hill; there was a "switch" running east to a very strong; 4th line traced from north to south, the chord of the salient about three-quarters of a mile to a mile in rear of the village. Severe fighting was to be anticipated as the enemy were prepared and in strength both of guns and men. From these considerations it was prudent for the A.D.M.S., Colonel McGavin, to anticipate many casualties in the Division. The medical arrangements for the evacuation of wounded in the divisional area centred about the advanced dressing stations: in the northern sector, Kandahar Farm; in the southern, Underhill Farm. In rear of the front line, three quasi-permanent regimental aid posts had been specially constructed and protected. From north to south they were:— Boyle's Farm, dug-outs in a communication trench about 200 yards from the front line, and close to the Wulverghem-Messines road, affording accommodation for one R.M.O. on the left of the divisional front; Fort Osborne, R.A.P., 600 yards south of Boyle's Farm accommodated two regimental medical officers and eight bearers N.Z.M.C.; and, furthest south, Spring Street R.A.P. with a similar capacity. Each of these stations had been enlarged and specially protected and made splinter-proof by the N.Z.E. The sites had been selected by the A.D.M.S. in consultation with the General Staff of the Division. The routes of evacuation from each varied: from Boyle's Farm the route lay through a C.T. known as Boyle's Cut, and an avenue "Medicine Hat Trail," to the Wulverghem road. In the vicinity of Boyle's Farm, as it lay on a forward slope towards Messines, the road was inoperable but 1000 yards further back it fell again into dead ground near St. Quentin Cabaret, where the sap opened out on the road. From Fort Osborne wounded could come down by King Edward's trench to Medicine Hat Trail, so joining the road, or by night— when not observed—by trench tramline above ground. From Spring Street the southernmost R.A.P. by Currie Avenue or by trench tramway. Special trucks to take four lying cases were available on the trench tramways but their use was limited by enemy observation, conditions of barrage and so forth. Two bearer relay posts were provided for the service of the R.A.P.'s. One known as "McBrides' Mansions" was three-quarters of a mile from Boyle's Farm and situated near St. Quentin Cabaret, where the saps opened out on the road. The other at Ration Farm about half a mile west of Spring Street R.A.P. Both bearer page 287relay posts were in sandbagged dug-outs and held some reserves of medical equipment; their function was to take over the wounded from the bearer parties coming down from the R.A.P.'s. All stretcher cases were carried to the A.D.S. at Kandahar Farm from the northern sector. The farm had previously been used as an A.D.S. by other divisions, the chief advantage of the site lay in the fact that it was in dead ground. The distance from Kandahar to Boyle's Farm by road was about a mile and a half and somewhat more to Spring Street across country.

During the month of May, a great deal of protective work was made at the farm by working parties from No. 1 New Zealand Field Ambulance. The outer walls of the barn were reinforced by a sand-bag breast work 9 feet high and 10 feet wide at the bottom. The ceiling of the ground floor was timbered with six inch props.; above the ceiling which was of brickwork, an "air space" of three feet was made by means of sand-bag buttresses supporting iron rails which were crowned by concrete "bursters." Some parts of the A.D.S. were further protected by curved iron dug-outs constructed inside the buildings. Two large cylindrical water tanks were embedded in the sand-bag walls on the western side away from the enemy fire. A sandbagged shelter in the lea of the farm buildings provided a garage for two motor ambulance cars always stationed at the A.D.S. A good road constructed from the pavé into the yard gave access to the many doorways of the fortified barn and returned in a broad sweep to the road by a separate exit. The material for the roadways was collected by night from ruined brick buildings in the neighbourhood and was carted by the ambulance transport. No casualties luckily resulted in men or horses engaged in this work, but part of the buildings was destroyed by shell fire on the 29th of May, the thatched roof of the farmhouse was set alight and considerable damage resulted; one medical officer, Captain Kidd, N.Z.M.C. was severely wounded. The elephant dug-outs inside the farmhouse remained intact: the barn was not damaged. It was a large building and provided four chambers, of which two measured 24 feet by 20 feet. One used as a dressing station could accommodate four operating tables and had a gas proof exit on to the car roadway; the other a large receiving chamber of the same size as the dressing room, provided shelter for stretcher cases, 28 of which could be accommodated in two tiers on wall racks leaving ample room for bearers. The large receiving room had also a gas-proof doorway for admitting stretcher cases. One smaller room 20 feet by 13 feet gave off page 288the receiving room and supplied racks for eight stretcher cases in pairs disposed around the walls. A small central receiving room 20 feet by 11 feet with gas-proof doorway opened on to the dressing room on the left, and the receiving room on the right. Two smaller dressing stations also protected and provided with elephant dugouts could take 40 loaded stretchers so that in all there was ample room for over 70 lying cases. The wounded on stretchers coming down from the bearer relay posts, either by hand or by trucks on the trench tramway which ran into the farmyard, were taken through the sandbagged doorway into the small receiving room from there passing either to the dressing room on the left, of the receiving room on the right, and could be evacuated to the cars on the roadway by three doors at once if necessary. Evacuations from the A.D.S. were by motor ambulance or horse transport to Neuve Eglise, thence to the corps M.D.S. at Westhoff, a journey of about two and a half miles.

The personnel to be provided for the A.D.S. was:—2 tent subdivisions and 1 bearer subdivision. The equipment included: 600 blankets; 100 stretchers; 5,000 shell dressings; 20 trestles for stretchers; 4 medical comfort panniers; 400 assorted splints; 100 pyjama suits; 2 F.M. panniers; 2 field surgical panniers; 30 hot water bottles; 2 field fracture boxes; 4 Sawyer stoves; 6 primus stoves; 25 camp kettles; 50 petrol tins containing water; 100 gas helmets and 6 acetylene lamps.

The divisional collecting station for walking wounded was at Leeuwerck Farm, situated on a road which ran east and west through the sector, and had access to the Neuve Eglise-Wulverghem road. The route from the trenches was flagged and marked by white-washed posts to maintain direction at night, so that walking wounded could find their way easily. A dressing station had been built at the farm, but owing to heavy shelling it had to be abandoned at the end of May. Another collecting station was prepared close at hand, but at the end of the month, Leeuwerck Farm was repaired; it was supplied with dressings and comforts and a coffee stall for refreshments. A car post for a Ford car was close at hand and could be used in emergency for the evacuation of a lying down case from any of the battery positions in the vicinity. In the northern sector, then, there were three R.A.P.'s from which evacuation of stretcher cases could be effectuated either by communication trenches, by trench tramways or by hand across country to the bearer relay posts, which were adjacent to roads where wheeled stretchers could be used as far as the A.D.S., whence by motor ambulance to the page 289C.M.D.S. at Westhoff. Walking wounded were to be directed by orderlies stationed at critical points along flagged and well marked tracks to the divisional collecting point at Leeuwerck Farm, and thence after refreshment and dressing, if required, to broad gauge railway entraining points, or by car to A.D.S., or on foot to the corps M.D.S.; returning lorries would be utilised as far as possible to take down walking wounded.

In the southern sector, south of Hill 63, somewhat similar conditions were provided. An A.D.S. at Underhill Farm, near Red Lodge had been prepared by the N.Z.E. assisted by the 3rd Field Ambulance. It lay close in under Hill 63, thus obtaining protection from observation, but as very many gun and howitzer positions required the same advantages the area was subject to very heavy bombardment at times, for which reason the structures required to be heavily protected by sand bags and overhead cover. Some of the wounded from the extreme right of our line would, it was anticipated, find their way across the western slopes of the hill to Underhill Farm, but as it was to the south of our line of assault it was not considered to be so important as the northern A.D.S. A very detailed plan of this elaborately fortified A.D.S. is to be found in Lieut.-Col Hardie Neil's little book, "Field Ambulance Organisation," which sets out with a wealth of detail the routine work of an ambulance in the warfare of fixed positions such as existed in 1917. As the chief danger at Underhill Farm was gas, because it was in the heart of the artillery positions, very special gas proofing was provided for the reception chambers; and as events proved, the precaution was very necessary. As evidence of the solidity of this A.D.S. it may be cited that several direct hits by shells of large calibre were registered upon it without material damage resulting. The route of evacuation was by motor ambulance to Pont D'Achelles C.M.D.S. about four miles away, the roadway being fair, but at times impassable owing to shell fire or gas.

It would be tedious to enumerate the many minute directions and instructions issued as to personnel, equipment, and detail of evacuation. One or two points, however, may be mentioned as showing the extreme care and foresight exercised by the A.D.M.S. in making his arrangements as complete and harmonious as possible. Telephonic communication was made with the A.D.S.; to supplement this means of contact motor cyclists were also used as heretofore. Alternative sites for both A.D.S.'s were chosen before hand in case either became untenable. Special patrols of N.Z.M.C. orderlies each carrying stretchers and medical page 290supplies, were detailed to the walking tracks so as to pick up any of the wounded who should fall by the wayside. All workers at the A.D.S. were instructed to make themselves familiar with the tracks and communications leading to the R.A.P.'s. Each motor ambulance was supplied with two drivers in case of casualty. The directions given to the R.M.O.'s were specially explicit: body armour, the "Dayfield" body shield, was to be worn by medical officers advancing behind the assaulting waves of their battalions. A steel chain vizier hanging from the rim of the helmet for the protection of the eyes had been experimented with, but found too inconvenient to wear as it added considerably to the weight of the helmet and interfered with vision. The special construction of the R.A.P.'s was designed to give protection to the medical personnel just prior to the final assault and later to serve as a retreat for wounded and ambulance personnel where they could shelter during the enemy counter barrage falling on our front line. The regimental medical officer on leaving the main R.A.P. at such a time as, barrage permitting, it seemed advisable to advance to his battalion headquarters, by now presumably established in or near the enemy lines, was to take with him three N.Z.M.C. bearers leaving one, a nursing orderly, behind in the old R.A.P. The ambulance bearers advancing with the R.M.O. were to act as runners: returning to the original R.A.P.—if necessary with an urgent stretcher case—they could act as guides to the newly established battalion aid post for the advancing bearers of the ambulances. By these means provision was made for continuous touch with the regimental medical detachment. The duties of the regimental stretcher bearers whose numbers were now increased to 48 per battalion (12 per coy. instead of 4), were to locate the wounded, place them in some position affording the best shelter available and ultimately to collect them at or near the R.A.P. As the enemy position was heavily trenched and had many concrete dugouts, some suitable positions were invariably to be found where protection or concealment were available. The instructions for intercommunication were that the R.M.O. should at the earliest moment after the establishment of the new R.A.P., generally adjacent to battalion headquarters, send back a written message to the A.D.S. at Kandahar Farm stating his location and the approximate number of stretcher cases requiring evacuation. In the case of the slightly wounded, when a dressing had been applied, a cross in blue pencil was to be marked on the bandage indicating that the wound was of such a nature as not to require redressing at A.D.S. In all cases where page 291morphia had been administered by the R.M.O. the time of administration and the dosage was to be written in indelible pencil on the patient's forehead. If a tourniquet had been applied the word "tourniquet" in black letters was to be inscribed on the tally so as to give these cases a priority in despatch and treatment at A.D.S. Tallies when used, were to be signed by the R.M.O. and as far as possible all cases were to be tallied. This was not possible, of course in many instances as congregation of wounded and bearers about an exposed R.A.P. was not a safe proceeding: the unusual movement and assembly of groups of men was certain to attract artillery fire. For these reasons certain battalion commanders did not approve of the R.A.P. being moved forward during the early stages of a limited advance; they considered it preferable to leave the regimental medical establishment behind in the old R.A.P. at least during the first hours of the consolidation. As regards medical supplies, the following is a list of equipment furnished to each of the original R.A.P.'s:—1 medical companion; 10 stretchers; 300 shell dressings; 100 triangular bandages; 100 four-inch roller bandages; 12 petrol tins of water (chlorinated); 50 blankets; 2 bottles of brandy; 4 pounds of cocoa; 30 pounds of beef tea essence; 20 arm splints; 20 leg splints; 20 Thomas and Liston splints; 20 pounds of biscuits; 4 candles and 2 primus stoves. Ample reserves of medical supplies were kept at the A.D.S. to supplement their equipment, if necessary, and to replace expenditure: It was intended to use the permanent R.A.P.'s as advanced posts of the ambulance personnel under a forward evacuating officer as soon as the R.M.O.'s had taken up fresh quarters in the new positions.

Under the Corps Bureau system all the casualty returns were to be compiled at the M.D.S.'s the only documents to be forwarded by the A.D.S. parties were: four-hourly progress reports showing the numbers passing through and a nominal roll of enemy wounded dying in the A.D.S. For the purposes of facilitating the disposal of enemy wounded an interpreter was posted at each A.D.S.

The IInd Anzac Officers' Rest House at La Motte au Bois, under the command of Major Izard, N.Z.M.C, had by this date become an Army unit, and was now known as the Second Army Officers' Rest House. In anticipation of further demands for accommodation and for the reception of convalescent officers from the C.C.S. during operations, the bed state was increased to 75, the necessary quarters being taken over under army directions.

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Sanitary considerations had not been neglected in preparing the medical arrangements of the Flanders Campaign of 1917. A highly efficient reticulated water supply system had been provided for the Ploegsteert sector under army arrangements. There were many water points in the corps area supplied by this water system which covered a wide area of distribution and had its source in the Lys river. As the Lys water was normally heavily polluted, requiring 14 scoops for chlorination—which of course means quite unfit for drinking purposes—and yielding over 1000 total organisms per c.c. with B. Coli present in minimal quantities of the water, a system of purification and chlorination on a large scale was required. At the Jesus Farm across the river from Fort Rompu there were two large water filtration barges. Of these, No. 1—the Ransome-Ver Mehr Barge—was fitted with a streaming sand filter, and was designed for removing metallic poisons from water. Its output was 6000 gallons per hour and its powerful pumps were capable of distributing the flow to a wide area. On board was a chemical and bacteriological laboratory in charge of an R.A.M.C. officer. The No. 2 Barge—Bell System—was similar, although the treatment varied in detail and it had about the same capacity. Both barges were frequently visited by N.Z.M.C. officers attending the corps medical school at Estaires, during the winter. It is of melancholy interest to recall the fact that the gallant barges went down at their moorings, blown up by their crews rather than fall into enemy hands when the Germans crossed the Lys at Sailly in 1918. Other elaborate means of water supply were in use; the Water Tank Companies with motor clarifiers and carriers had been in the field since 1916. and were much in evidence before Messines in May, 1917, the "white dolphins" flashing past carrying 150 to 500 gallons of purified water to remote areas not supplied by the reticulation. Their presence indicated the possibility of a rapid advance into Belgium which in the area to be invaded was known to be very short of water during the late summer months. One section of a Water Tank Company comprising 41 motor tanks and clarifiers, yielding 4,350 gallons per trip was allotted to the New Zealand Division. Apart from the chlorination of all water supplies issued to the Division, special provision had been made by the Second Army to maintain a constant reserve of 30,000 sodium bisulphate tablets with each division. All medical officers were required to instruct the men under their medical charge in the method of using the water purification tablets whenever page 293the supply of chlorinated water failed. About this time, cases for testing water for metallic poisons were issued to all regimental medical officers. The "Cases, Chemical, Water Testing," had already been authorised as a supply to Sanitary Sections and Field Ambulances by orders issued in December, 1915, but owing to persistent rumours that the enemy had used arsenic to poison water supplies in Flanders it was considered necesary that advancing troops should be supplied with this apparatus.

The new allotment of Sanitary Sections under Army control temporarily delegated to D.D.'sM.S. corps, had in view the adjustment of sanitary areas in re-occupied Belgium and immediate provision for adequate public health services in the case of a rapid advance until such time as the Belgian authorities were in a position to resume their functions. No more eloquent testimonial to the praiseworthy thoroughness of the medical arrangements can be cited than these sanitary provisions.