SEPTEMBER, 1915

THE HARVARD
GRADUATES
MAGAZINE

VoL.24                   No. 93

PUBLISHED BY THE HARVARD GRADUATES
MAGAZINE ASSOCIATION
BOSTON MASS.

Entered at the Post Office, Boston, Mass., as second-class mail matter, October 19, 1892.
Copyright, 1915, by THE HARVARD GRADUATES' MAGAZINE ASSOCIATION.

 

War Notes.

Harvard Men in Hospital Work.

More especially the men connected with the activities of the American Ambulance Hospital, Paris.

Ever since the commencement of the great European war graduates of Harvard have been connected with the State Hospital, or War Departments of the various nations involved. More particularly, and in greater numbers, have they seen such service in France. My personal experience in Europe covers only the months of April, May, and June, 1915, but the stimulus received was perhaps sufficient to carry my interest and observations pretty well back over the entire course of the catastrophe. Once the game was on, the American Embassy in Paris became one of the busiest places in Europe, on it having devolved the care of those citizens of all the nations fighting against the French, still resident in, or traveling through, France. Many Harvard men were among those at once pressed into the corps of workers in the Embassy: Robert Bacon, '80, Robert W. Bliss, '00, 1st Sec, of the Embassy, and W. O'D. Iselin, '05, were active workers from the very beginning. Since those days there have been many changes. Major Morton Henry, '92, Edward Pickman, '08, and other Harvard men have at different times helped in the Embassy.

In the last days of August and early in September the American Ambulance was established as a military hospital for wounded soldiers, by members of the American Colony in Paris, and especially by those on the staff of, or interested in, the American Hospital, which had long been established in Paris, The Ambulance has been generously supported by Americans both in Paris and at home. It is directly under the control of the Service de Santé of the French War Department, and is independent of French, English, or American Red Cross Societies. The Lycée Pasteur, a very large school building, still under construction, at Neuilly, a suburb of Paris, was secured by the War Office, and after some alterations and finishing work, which was most admirably done in a very short space of time, was converted into an excellent hospital. All the administrative departments of a modern hospital were put into operation: kitchen, laundry, supply room, diet kitchen, apothecary, etc. The beds were divided into several services, in addition to which were established a Dental Department, Throat and Nose Department, Eye Department, and an X-ray Department. An excellent corps of trained nurses was brought into being, and a remarkable organization of volunteer or auxiliary nurses and orderlies fitted in to act as assistants. It is fair to say that without this efficient group of volunteer workers the cost of adequate maintenance of the hospital would have been very much increased.

Beginning with 170 beds the capacity was gradually increased, until, in June, 1915, it contained beds for over 570 patients. Of this number the University Service (Service D) had 190 beds, the rest being divided between the other three services, as follows: Service A, Dr. C. W. Dubouchet, surgeon-in-chief; Service B, Dr. Joseph A. Blake; Service C, Dr. Mignon. The University Service was composed of 18 wards, containing each 10 or 11 beds, with a special operating-room and laboratory provided on the fourth floor of one wing.

Simultaneously with the beginning of the medical work in the hospital, the Ambulance Service was started, and in this corps Harvard men were enrolled from the beginning. Intimately associated with the foundation and early days of the hospital were several Harvard men, especially Robert Bacon, '80, and Charles Carroll, '87. At the request of the Medical Board of the American Ambulance a surgical contingent was organized by the Harvard Medical School, and sent to France to take charge of the so-called University Service in that hospital from April 1 to July 1, 1915. This contingent, commonly known as the "Harvard Unit," was composed of 17 surgeons and nurses. The funds needed for their equipment and transportation were generously provided by William Lindsey, of Boston, who, though not n graduate himself, has a son, K. L. Lindsey, '10. The personnel of the unit was as follows: Dr. Harvey Cushing, m '95, Professor of Surgery, surgeon; Dr. Robert B. Greenough, '92, Assistant Professor of Surgery, surgeon and executive officer; Dr. Richard P. Strong, Professor of Tropical Medicine, bacteriologist; Dr. Robert B. Osgood, m '99, orthopedic surgeon; Dr. Beth Vincent, '98, assistant surgeon; Dr. Walter M. Boothby, '02, anæsthetist; Drs. Fred A. Coller, m '12, and Elliott C. Cutler, '09, resident surgeons; Drs. Philip D. Wilson, m '12, M. Smith-Petersen, m '14, and Lymon G. Barton, Jr., m '12, house officers; Dr. Orville F. Rogers, Jr., '08, medical assistant; Dr. George Benet, m '18, laboratory assistant; Misses Edith I. Cox, Geraldine Martin, Helen Parks, and Marion Wilson, operating-room nurses.

About April 10 Dr. Strong was obliged to leave Paris for Serbia to take up the position of Director of the Red Cross Sanitary Commission; May 1, Dr. Cushing and Dr. Boothby left for home, and May 28 Miss Wilson left for England. The rest of the unit, however, remained working in the American Ambulance till our departure for home July 1.

Immediately on our arrival, April 1, we took over the University Service. As soon as possible stenographers were obtained and a system of filing and keeping records was established. A photographer was added to our retainers to aid in making our observations and records more complete. Histories were obtained on all patients, except the few discharged shortly after our arrival, and notes were dictated on cases almost daily. These, with duplicate X-ray prints, our own photographs, and various accessory studies, made our records fairly complete, and we brought back two complete sets which are to be filed away in the Library of the Medical School.

The supply of wounded to the American Ambulance was probably as constant as that to any of the French military hospitals, but, of course, varied with the activities at the front. Under ordinary circumstances a soldier wounded in the trenches has an immediate first aid dressing applied by himself or a friend; then he walks or is carried to the poste de secours, which is the emergency dressing-station, immediately on the field of battle, generally in some sort of a bomb-proof shelter; here he is observed, splints applied or an operation performed if necessity demands it, and then is at once evacuated to a first-line ambulance just beyond artillery fire; here he is again studied, his bandage changed and he may be operated on if necessary, but if his condition warrants it he is at once evacuated to the railway and shipped south on a "sanitary train." On such trains the wounded reach Paris and the great distributing centres, and are at once divided among the local hospitals. From the station they reach the hospitals by motor ambulances.

It seems complex, but we often got patients in the hospital in Paris within 12 to 14 hours after they have been hit, even when coming from Arras or the line farther north toward Ypres. On arrival in the hospital patients are at once seen by the receiving officer, who, in our service, was one of the residents, and by him sent either to the ward direct, to have a bath first, or to the operating-room, as each single case demanded. The largest number of admissions to the University Service in any 24 hour period was 33 cases. In the three months 295 new cases were allotted to us --- an average of over 3 cases a day. In all 441 cases were at one time or another under our observation and care. Of the 383 cases on which we have full records 318 received actual wounds by missiles --- as follows:

Rifle ball

128

Shrapnel ball

31

Shell fragment

133

Shell fragment and rifle ball

5

Shell fragment and shrapnel

1

Doubtful

5

Bomb fragments

9

Hand-grenade

3

Barbed wire

1

Mine explosion

1

Revolver ball

1

Total

318

Of the 65 cases in which no actual wounds were produced by missiles, a large number were due to falls, chiefly from horses or into trenches, and to men being thrown down by a mine or large shell or bomb explosion near by. Also there were a few simple surgical conditions, as appendicitis and hernia, demanding surgical treatment. Many of the cases presented more than one wound, there being 670 instances of medical or surgical conditions in 383 cases. A glance at the following table shows a rough estimate of the location of wounds, but, of course, it must be kept in mind that this is not a true measure of the proportion of wounds received in battle, for most of the head and abdominal injuries are fatal at the front, and never reach the great base hospitals:

Skull fractures

20

Spinal cord injuries

7

Superficial wounds, head and face

10

Fractures, upper and lower jaw

63

Diseases and injuries of the abdomen

13

Injuries of pelvis

4

Peripheral nerve lesions

39

Joint lesions without fracture

13

Fractures of extremities (13 required amputation)

140

          Upper arm 31
          Leg 36
          Thigh 21
Injuries of the chest (9 perforating wounds)

21

Lesion of soft parts alone

257

In several cases several missiles, commonly shell fragments, produced multiple wounds. In others one missile produced multiple wounds in the same individual; thus in one instance eight wounds were produced in one individual by a single rifle ball.

Fully 90 per cent of the wounds were badly infected, this in great part being due to the fact that pieces of clothing were frequently carried into the wounds, the sheet fibre of the stuff used in the French uniforms being particularly easily shot in, because of its texture. As frequently as possible cultures were made from wounds, either directly at entrance when the dressing was first changed, or on the operating-table. These bacteriological studies will later be reported by Drs. Rogers and Benet. As we gradually took in the nature of the infection and type of wounds we came more and more to subjecting each case to operation as soon as possible, in order to clean out the wounds, to remove whatever pieces of clothes, missile, or broken bone could be found, and to establish thorough drainage. This became the routine and our results seemed to justify the procedure, for the rapid recovery in cases thus treated was often striking.

Of all cases the compound fractures were the most serious and difficult to handle, and in the preparation of and advice as to what type of apparatus we had best put such patients into, Dr. Osgood was an invaluable asset. As a whole the cases did well, and we evacuated many cases in excellent condition, quite ready to return to the front. We had seven deaths in all, three from meningitis following head injuries, one from peritonitis due to a shell fragment perforating the bowel, one from a bad shell fragment tear of a lung, one from general gas bacillus infection following amputation of a broken, gas-gangrene arm, and one from gradual toxæmia following complete paralysis from the chest down, due to a spinal injury. The French soldiers, with whom we had almost entirely to deal, proved to be an exceptionally patient, cheerful, and brave type, and we found it hard to leave many of them.

But there were and are Harvard men scattered in hospital work not only elsewhere in France, but in England and even Serbia. With Prof. Strong in Serbia went Dr. George Shattuck, '01, Dr. F. B. Grinnell, '09, and Dr. Sellards, instructor in Tropical Medicine in the Harvard Medical School.

In a small hospital at Fort Mahon, France, were Dr. George Pierce, '94, and Dr. Charles S. Butler, '93; at the Château Passy Hospital, near Sens, were Dr. Percy Turnure, '94, and Dr. I. C. Walker, Assistant in Medicine, H.M.S. In the hospital at Juilly, an institution allied to the American Hospital, Paris, and supported by Mrs. H. P. Whitney, of New York, were at different times Dr. Jason Mixter, '06, and Dr. George E. Brewer, '85. Richard Norton, '92, headed the American Volunteer Corps working for the St. John's Ambulance Association (British), with headquarters near Amiens. At Paignton, England, Dr. Howard Beal, m '98, heads the Red Cross Unit, in which is also Dr. H. H. Howard, m '12.

And now only recently a second Harvard Unit has gone over to serve in the Royal Medical Corps (British), taking rank and pay as an integral part of the English Hospital forces. They are already France, close to the Channel coast. The personnel is as follows: Dr. E. H. Nichols, '86, Assoc. Professor of Surgery, chief surgeon; Drs. C. A. Porter, '88, M. E. Faulkner, '87, H. P. Mosher, '92, F. B. Lund, '88, A. Quackenboss, m '92, N. S. Hunting, '84, Roger I. Lee, '02, H. F. Hartwell, '95, R. H. Vose, m '96, D. B. Reardon, m '03, B. P. Stookey, m '13, F. A. Coller, m '12, R. P. Borden, m '13, Allen Greenwood, m '89, A. M. Frost, m '13, W. M. Lacey, m '12, P. A. Leavitt, '10, G. W. Bachmann, '08, H. M. Goodwin, m '13, II. R. Sattler, m '18, W. A. Lane, m '99, C. W. Bressler, medical special, Paul Withington, '10, W. E. Hunter, medical special, A. A. Barrows, m '02, G. L. Tobey, m '03, F. W. Snow, m '02, W. J. Dodd, m '01, V. H. Kazanjian, d '05, F. G. Brigham, m '09, F. H. Cushman, Dn. '15, H. S. Austin, m '11, and S. A. Hopkins, M.D. Col P. & S., N.Y., '80.

To sail shortly to join this same unit are Dr. C. C. Simmons, '99, and Dr. Edward P. Richardson, '02. The undertaking is very large, and the preparations involved a great amount of work and energy. But that Boston should send such a large contingent of our ablest surgeons, and that they are all Harvard graduates, or have been at some time connected with the University, is a source of much satisfaction. We, who have just returned, with them the best of luck!

HARVARD-DRIVEN AMBULANCES IN ALSACE.

AMBULANCE DRIVERS AT BEAUVAIS.

Left to right D.D.L. McGrew. '03, E. V. Salisbury, '08, H, A Webster, Yale, '91.

AMBULANCE DRIVERS

Left to right: E.J Crowley, Jr, 04: R. Lawrence '02, Section Director; Lovering Hill, '10, Squad Director: Durant Rice, '11: D.B. Douglas; D.D. L. McGrew, '03, Squad Director. Below: Powel Fenton.

AMBULANCES IN THE COURTYARD OF THE AMERICAN AMBULANCE HOSPITAL, AT NEUILLY.

HARVARD WORK IN THE WAR ZONE

Thus it is seen that really great numbers of Harvard men are actually in Europe, and closely associated with the relief of the suffering and destruction that is the inevitable price of war. Besides such as I have named there must be others, for it is indeed hard in such times to locate individuals definitely. Beyond those in hospital work there are, of course, the Harvard men in the Ambulance services, those actually engaged in the war, and those in the diplomatic services. The number is creditable and the work such as we know it, has, we hope, been of some aid and support along the best lines of endeavor. The effort is certainly praiseworthy. But before closing let me say that there is much yet to be done, that the opportunity for helping is limitless, and that, to those who have gone over, the reward has been found immeasurable.

F. C. Cutler, '09.

 

Personal Notes.

E. M. Pickman, '08, J. D. Paul, '08, N. Roosevelt, '14, Day Kimball, '15, and H. G. Carey, '13, are all assisting in the tremendous work of the American Embassy in Paris.

Richard Norton, '92, has been awarded the French military cross, the Croix de Guerre, for bravery in his work among the wounded on the battlefield. He was told by the Government that the decoration was awarded especially for his heroic work in rescuing the wounded during the evacuation of a village within 500 metres of the enemy's lines.

Victor C. Chapman, '13, who is a member of the French army, has been promoted for conspicuous bravery. He is in the famous Foreign Legion, which has always been renowned for its bravery and daring.

J. R. Childs, A.M. '15, and A. R. Jennings, Sp.L.A., have gone to France to serve with the American Red Cross.

H. B. Willis, ['12], who has been working with the American Ambulance Corps from Pont-à-Mousson, was mentioned for bravery for his excellent work in carrying wounded from a farmhouse which was under shell and rifle fire. He has written articles about the war for the Boston Globe.

C. F. Hawkins, p '13, who entered Oxford last autumn as a Rhodes Scholar from Massachusetts, spent a good part of the winter assisting the American Relief Commission in Belgium. His work was especially in the Province of Luxembourg.

W. P. Draper, '13, is a 2d lieutenant in the Royal Field Artillery, in command of an ammunition column in the 33d Brigade of the Eighth Division of the British Expeditionary Force. He has seen continuous active service since he was sent to the front some months ago.

Dr. Richard P. Strong, Professor of Tropical Diseases in the Medical School, has been doing a marvelous work in Serbia in the disinfecting of the towns and in the eradication of typhus. Medical men say that Dr. Strong's position is really more dangerous than that of soldiers in the trenches. It is the most important possible life-saving work. Some of the hardships and successes of the work are described, in diary form, by Dr. Strong, in the August number of the American Red Cross Magazine, and this simple, unpretentious article gives, better than any more formal report could do, an idea of the difficulties to be surmounted, and of the scope of what must be accomplished. That very much has ...