M nrniiiiiiiii 3 1822 01141 80 vsiCiAN \NCE II''' '■'■■i-'"»'f 1 !>>'' It III LIBRARY UNIVERSITY OF CAl'FORNIA SAN DICdO ■^ bmT 3 1822 01141 8076 ^ A PHYSICIAN IN FRANCE M \|i>K (il.M.K \l Sll; \\ll\K.l Ill-.KKIM.II \M. K.('.M.pi€ce FAllNl. I-AUK MEMORIAL TABLET AT DIXANT WHERE CIvrLIANS WERE SHOT - 30 FRONT OF OLR HOUSE AT HESDIN .... i7() VIEW IN OUR GARDEN AT HESDIN - - . . JgO THE EXCHANGE AT LILLE - - - , . IO4 CATHEDRAL liUILDINGS AT YTRES .... 22(; SCENE FROM PAGEANT AT ST. TROND - - - . 270 BATTLEFIELD ON MENIN ROAD ----- 281 YPKE8 BATTI.KITELD SHOWING MENIN ROAD - - - 284 vu " Gens eadcm, quao te, crudeli Daunia bcllo Insequitur; nos si pellant, nihil afore credunt Quin omnem Hespcriam pcnitus sua sub juga mittant, Et mare, quod supra, teneant, quodquo alluit infra." Virgil: Mneid, VIII. " Among the rest which in that space befell There came two springals of full tender yeares. Far thence from forrein land where they did dwell To seek for succour of her and her Peares With humble prayers and intreatfuU teares; Sent by their mother who, a widow, was Wrapt in great dolours and in deadly feares By a strong Tyrant, who invaded has Her land, and slain her children ruefully, alas ! " Her name was Belgfe; who in former age A lady of great worth and wealth had been And mother of a frutefull heritage." Spenser: Faerie Queene, V., 10. VUI A PHYSICIAN IN FRANCE CHAPTER I THE SURPRISE Now that the greatest war that was ever fought has come and gone, some of those who took part in it will wish to set down the thoughts that it aroused in them and the things that they have seen. AVe are still unable to grasp its enormous dimensions and the full consequences that will follow it, but we have time now to take breath and reflect. I suppose there was never a war which to future historians will appear more obvious in its oncoming. The past history of Prussia up to 1870, and the conduct of the German Empire from 1871 to 1914, will seem to all who read of them in the future to lead inevitably to this climax. They will never understand how men in England can have been so blind as to believe that it ( ould ultimately be avoided. They will wonder how we can have so misread the signs of our own times, and how we can have been so ignorant of the intentions which Germany in many ways expressed as not to prepare for the struggle or guard against the danger. They will hardly realize how true it is that men believe what they wish rather than what is plain before their pyeR, nor how easy it is to persuade a nation intent upon its domestic concerns that those who raise a cry of warning are enemies of the public. 1 2 A PHYSICIAN IN FRANCE Yet it remaius the truth, however strange it may appear to our posterity, that uo mxtion was ever more burprised by the outbreak of a capital war than we in August, 1914. In a conmionwealth hke ours the enormous majority of voters are totally ignorant of foreign nations, and can neither read what is written nor understand what is f^aid in a foreign tongue. They cannot comprehend the tendencies of international politics, nor the influences which govern them. It does not enter their heads that the order of things to which they have been accustomed, though it seems to them- selves a matter of course, may to other nations be a perpetual source of envy and of rage. Feeling that in their own country politics are more or less ruled by popular desire, which, save at moments of great excite- ment, is always for the preservation of peace, they do not realize for how little their own class counts in nations of another constitution, nor what power an autocratic Government can wield. If this was the temper of the common people, how, it will be asked by our descendants, w-as it possible that those who were better able to judge did not enlighten them ? Were there not poUticians who could read the times, or soldiers and sailors who could estimate the danger ? How was it that no eilort was made to awaken the public ? They will be met with the answer that the politicians were afraid and the soldiers were dis- believed. They will learn that the greatest soldier of the time, a nmn loved for his pure and simple life, respected for his unselfish devotion to the interest of hi.>5 country, and acknuwlcdged by all to be the highest authority that we possessed on militar}' subjects, had tried for fifteen years to rouse the people to a sense of danger, had told them that if peace was to be pre- THE SURPRISE 3 served defence must be strengthened, and had lU'ged them to prepare themselves by some slight training fur the trials that might come; that he had been treated at first with indilierence and then with obloquy ; that poli- ticians had so far forgotten themselves as to maintain that in warning his own country he was provoking others, and had not been ashamed to twist his words for their own pui'pose to a meaning that was not liis; and that not until a year or so before the war broke out did the temper of the people, though not that of the politicians, change towards the man who had devoted his last years, as all the rest of his life, to their interest and their safety. iVnd what of the politicians themselves ? Historians will acknowledge that the position of Parliament and the estimation in which it was held throughout the country had greatly fallen in the opening years of the twentieth centmy. There had been far stricter party discipline, and in consequence far less of the independence which with the English always carries the most respect. The party had become a machine, and the individual had lost his freedom. The payment of members, though necessary for the representation of labour, had produced its usual eitect in lowering the respect in which the repre- sentative was held. The electors had more and more governed their members, and the caucus had governed the electors. On the other hand, the Cabinet Jiad in- creased its power at the expense of Parliament, for it was the only force that could carry legislation through the immense mass of business which swamped the powers of the House; and yet the Cabinet was in turn governofi by the unknown and unrecognized managers of the party machinery. We had begun to nourish " bosses." The representatives had been either ignorant or afraid. Wishing for peace and recognizing the horror of war, they 4 A PHYSICIAN IN FRANCE had been so foolish as to think that what seemed good to a nation that ruled a fifth part of the globe would com- mend itself also to a nation that thirsted for more power and for more possessions. Ignorant of the might of Germany, more ignorant still of the envy and contempt with which she regarded us, ignorant, most of all, of the extreme danger in which a frerman victory would place England, they united to blind the country to the true state of the case. There were some in great positions who had had the means of judging and who claimed to have foreseen the event. The country rightly held theirs to be the greater blame. It was said that the public would not listen. But it is the business of Ministers to teach it and to make it hear. If leaders cannot lead, of what use are they 1 It was more true to say that they feared to precipitate the crisis they foresaw. For it had come to this, that as in a household all yield to the worst temper in the family, so in Europe we were fright- ened to provoke the most unfriendly nation. But the consequence for us was serious. No word of warning fell from any olHcial lips, no elt'ort was made to improve our condition. The Arsenal had been robbed of many of its best workmen; they were not replaced. The stock of guns, rifles, and ammunition was small, but no eftort was made to increase the sources of supply. In 1913 many leading Liberals joined in a memorial urging the diminution of the Navy, and were met with sympathy by the Chancellor of the Exchequer. They had a rude awakening. Luckily for the nation, Germany's first step in the war, the invasion of Belgium, whose independence she had herself guaranteed, not only called upon us in such a way that no party, hardly even an individual, could raise a hindering voice, but also opened the eyes of all to the unscrupulous character of THE RURPRTSE 5 Gennan policy, which, though often alleged, had been continually denied by those who were her friends. Her barbarous cruelty to the invaded country drove the lesson home. .Ajid, lest there should be any fear of our forgetting it, she continually, by such acts as the sinking of the Lusitania, the Sussex, and other passenger ships, by the Zeppelin raids upon open towns, by the brutal treatment of prisoners and the deportation and forced labour inflicted upon civilians, kept alive the anger of the nation, and hardened it into a resolution far more deter- mined than ever was aroused by the prolonged struggle against Napoleon. Among the loudest were some of the very men who had been the strongest believers in peace and the bitterest opponents of preparation. They were glad to show that their hearts were sound though their heads were not. Nor could any class in Germany escape the general condemnation. The teachers had been among the first to foster the idea of aggression. The clergy preached in the same vein, and uttered no word of reprobation against the barbarities inflicted by Germany upon Belgium, or the dreadful cruelty practised upon the Armenians by the Turks. When the Lusitania was sunk the school children celebrated the crime by a holiday. The commercial classes, again, had lent themselves to the extraordinary system of espionage which the German Government had elaborated not only in all European countries but in such distant centres as Hong Kong, in a way which forbade their ever again being treated as friends. The Germans at the present time complain of our attitude as unjust. Nothing is more extraordinary than their apparent belief that, the war once over, the world should immediately welcome them with open arms. 6 A PHYSTCTAN TN FEANCE That they were ignorant of other nations we knew. That thougli their professors were emdite and their spies most liiglily trained they were incapable of understanding other cultnres than their own we recognized . But it is n new and a surprising tiling to find them so unreflecting as to be forgetful of themselves. They pose now as a gentle and a trusting people misled by their rulers. All that was done wrong was done against their will. They had no love of war, no desire for conquest, no thought but to defend their homes against aggression. Have they forgotten the years of boasting, of insult, nnd of steady, unremitting preparation for attack ? AVhat voice was raised against the invasion of Belgium, the greatest public treachery within the memory of man; against the murderous warfare of the submarines on merchant shipping; against the wholesale robbery of Belgium and French property, or the deportation of men and girls in the invaded districts ? What were the terms that they imposed on Russia and Roumania ? AVhat, almost to the last, while they yet had hope of victory, those that they proposed to force on Belgium, France, and England ? Our statesmen, whatever their mistakes before, have through the war steadily maintained three principles — first, that the system of the Prussian military rule must be for ever broken; second, that at all costs we must liave security for the future; and third, that full reparation must be exacted for the past. Those things have been rendered necessary by the conduct of the German Govern- ment before and during the war. Tf to that it is added that the Germans have also lost all good'^'ill among the nations of Europe, they owe it to the fact that they, from the highest to the lowest, with hardly any exception, deliberately approved that conduct. CHAPTER II THE TWO IDEALS Thkre canhardlybc a greater contrast than that afforded by the political ideals oi ife was a good deal restricted, it is true; but the shorn lamb gets 10 A PHYSTCTAN TN FEANCE accustomed to the shearing, and we ourselves, who multiply each day restrictions on individual liberty, and have submitted for a century to the income tax, can understand that it is rather the novelty that causes irritation than any continued feeling of oppression or injustice. To the German at any rate the yoke seemed light, and he was best able to judge. That is the opposite pole of political thought to our own, but it was suited to the Germans, and it excit-ed their enthusiasm by reason of the noble idea of self- sacrifice for the public good on which it rests. For if it is true that man as a whole is governed by his material interests, it is no less true that it is not these but the refusal of these which rouses in him the deepest passion and the greatest efTort. The ideal of self-sacrifice is the paradox that has been at the bottom of all the groat religious and irreligious movements of the world. It had that effect in Germany; and while we despised the docility with which the Germans submitted to their exclusion from political power, they contrasted their unselfish devotion to the state with the continual claims for public assistance and refusal of public service which marked recent political life in England, and appeared to them the height of unpatriotic selfishness. The dangers of the German obedience have been shown often enough by the abominable crimes of which their Government was guilty during the war, but perhaps its greatest condemnation is afiordcd by the results of the system upon Germany itself. Ill success completely destroyed the trust of Germans in their own rulers, and when the ofiicial chiefs were deposed there was no one to take their place. The French defeat produced men like Gambetta and Thiers, who, whatever we may think of them, played a great part for their country. But THE TWO IDEALS 11 German autocracy had starved German thought. Not a single great man has emerged from the chaos of defeat. The spectacle that Germany offers is so pitiable that if that is the result of obedience I would almost liefer see England plunged in anarchy. When we turn to the views of the foreign relations of the state wliich we and the Germans held, the contrast is even more striking. Prussia had for the last two hundred years constantly sought to extend her influence in Europe, and war was the only means of doing it. The tradition of Frederic the Great had remained with her. and the principles upon which he acted were those which she still professed. The aggrandizement of Prussia had been the chief aim of her rulers from that time to this, and had justified in their eyes actions of which other nations took a different view. The wars on Denmark, x\ustria, and France made her the greatest military power in Europe. Still she was not content. For one thing, she lived in constant dread of the Powers she had provoked, and for another she had conceived tlie idea of becoming the greatest Power not only of Europe but of the world. England stood in her way, but for the last fifty years she had been convinced that our Empire was living on credit which we were too pusillanimous to defend, and that she had only to attack us under favourable circumstances to destoy our power and succeed to the heritage we were too weak to rule. In some respects she was not far wrong. The ])urden of armaments had created great discontent; there was a general failure to recognize danger, and in conse- quence a general unwillingness to prepare for it. It cannot be doubted that if the process had gone on niiich longer we should have reached a condition of weakness which would have prevented us from stennning the tide 12 A PHYSTCIAN IN FEANCE of rJenuan attack and fioin creating tlie army and the equipment necessary for victory. The war came just in time. England, on tlie other hand, had for the last two hundred years followed but one principle in European politics— to set herself against any attempt on the part of one Power to overawe and dominate the rest. Such enterprises seem to take place about once in every century. AVe fought Philip II. at the end of the six- teenth, Louis XIV. in the first years of the eighteenth century, Napoleon a hundred years later, and now, after just a century's interval, the Napoleon manque of Germany has again brought us into the field. But we can hardly say of ourselves that we have not made war during these two centuries for our own aggrandizement. "We had no chance of gaining territory in Europe, and we wisely refrained from the attempt. But we mad© up for it in other parts of the world; and if we now declaim against those who disturb the public peace, we must at any rate allow that, as we hold about a fifth part of the habitable globe, we have little to gain and much to lose by war, and are naturally prejudiced against it. It hardly becomes us to boast of a virtue that is of very recent gro\\i:h, and rests upon such solid grounds of self-interest. I can understand our driving other people mad with rage as we carry, in Bismarck's words, a Bible in one hand and a pipe of opium in the other. If he had lived to see the Liberals opposing India's wish to remove the excise on her own cotton, he would have sneered still more. The virtuous are always open to the taunt of hypocrisy, and when their sins are invariably profitable, it is difficult to distinguish between the two habits of mind. CHAPTER III THE TWO TEMPERS The temper of the two countries before the war was almost as dift'erent as their institutions. Patriotism is generally regarded as one of the highest virtues, though it occasionally conflicts with others. It varies in diilerent times and in different countries both in quantity and quality. In Germany it was both strong and ollensive. It was cultivated by every possible means in the school, in the university, and in the regi- ment. Mr. Owen Wister* gives an amusing instance of the division of America in a geography-book used in a Berlin girls' school into the black zone, the Indian reservations, and the land occupied by *' Teutons."' American girls at the school were questioned as to their race. They were not black, and as they were not Germans they must be Indians, for the school book said that between them they occupied the whole of the United States. To the amusement of the rest of the world, Shakespeare was claimed as an overseas German and Chartres Cathedral as a monument of German genius. In the university since the time of Treitschke the student had been taught that England was lazy, which was true, and cowardly, which was not true, and that the Germans had but to reach forth their hands and take the rich prizes of the British Empire. In the army the ofticers * " The Pentecost of Calamity." 13 14 A PHYSICIAN IN FRANCE carried this spirit to excess. Througliout Gerraany the day oi reckoning with England was a popidar toast. Germany had indeed much to be proud of. She has in a greater degree than any nation the power of continu- ous methodical labour. Her people are docile, and a highly centralized government has been able to produce an administration in some ways more benevolent and much more orderly than ours. She had the greatest army in Europe, and was justly proud of the self -sacrifice by which it was maintained. Her navy was great and growing. She reverenced learning, and her imiversities were the resort of students from all nations. In my own profession those who intended to follow the science of medicine went to Germany to learn method; those who wished to practise the art, especially the surgical branch of it, went there because they found more clinical material at their disposal than in their own country. A yomig smgeon who obtained the post of Assistant in a clinic could practically do as many operations as he chose, whereas in England or the Dominions the senior sui'geons themselves were held responsible and did not intrust their important operations to young men. But these opportu- nities were confined to the intellectual aristocracy. 1 do not think that any one questions that the rank and file of German medical students were much less etliciently taught than in England. Some points in the education, notably the system of lectures, were better than ours, but the clinical instruction in England was far superior. English medical education was always dominated by the idea of the public safety. Our teaching and our tests were directed rather to the practical efficiency of students than to their scientific training. The means to improve the latter is now the subject of great discussion in our THE TWO TEMPERS 15 schools. But the former, which we recoguize as essential, was of little account in Germany. In manufacture they could give us many a lesson. They were always on the watch for the teaching of science, and recognized its importance for industry. One of their greatest manufactm'es, the makmg of dyes, was founded on the discoveries of Professor Perkins, which English manufacturers had refused to take up. Germany was the great source of glass for scientific purposes and especially for lenses. There was a house in Paris whose work was good, but in England there was nothing to compete with German products. Even now 1 am told that our lenses do not equal those which the Germans made. But glass was at one time a great trade with us, and the Germans took it up because we failed to supply as good or as accurate glass work as was required. For similar reasons the making of drugs had become in large measure a German monopoly. In all such industries an immense number of chemists was employed, and the results of their experiments were daily tui'ned to the improvement and extension of production. With us a good deal of encouragement has been given to discoveries in the metal and textile trades, but not even there as nuich as in Germany. Chemistry has been so nnich neglected that chemists find hardly any posts open to them after taking a degree, and Government actually advertised for them at a salary of about £3 a week. German commerce is very speculative, but it has been very successful. They have somethmg of the American romance in business and love of large operations, which in England is almost conliiied to engineering. They have seized upon the principle of combination on a large scale both here and in manufacture, and they have been aided by their banks, whioii were founded directly for that pur- 16 A PHYSICIAN IN FRANCE pose rather than, like ours, for the deposit of savings. It was remarked to me by an American that the English would often invest large sums in opening up a new trade route, but that they refused money for the scientific discovery which is at the bottom of all manufacture. But with all this the main work of Germany in the world has been rather the application of discoveries than discovery itself. She has not done more than her share in the latter field; I doubt if she has done as much. In my own profession sanitary science was developed in England, Pasteur laid the foundation of all modern pathology, and on his teaching Lister remodelled surgery. The discovery of anaesthetics, which has enabled all the great advance in practical surgery to occur, was the work of Morton and Simpson. None of these, which are the great achievements of the last hundred years, have been of German origin. But Germany has done an immense amount of soujid and valuable work in all branches both of our science and of our art. A good illustration of her thorough and laborious method is given by the discovery of the drug that used to be called 606. Elirlich, who carried one line of Pasteur's teaching farther than any other man of his time, was impressed with the belief that arsenic was a specific for syphilis. It is, however, a very poisonous drug, and he set himself to discover some form of combination which would cause the greatest damage to the spirochaete which produces syphilis and the least to the man. A famous manu- factory supplied him with combination after combination of arsenic witli various other bodies until the six hundred and sixth attempt produced a body wliich fuhilled his requirements. There is no better example of that un- grudging labour and co-operation of many brains to the one end by which Germany excites our admiration. THE TWO TEMPERS 17 Germany was at one time supreme in music, and German pliilosopby has always lield a high position. Of late, however, it had taken a strange direction. In a destructive criticism of the Christian doctrine it had arrived at the conclusion that love and compassion were not of Divine inspiration, but were the defence put forward by human weakness to protect itself, and that the ideal was a life of ruthless force, oflering no apology and obeying no law. It had played directly into the hands of the highly practical and wholly unphilosophic soldiers of Prussia, who taught that warfare was not only a necessary but a salutary state; that the finest expression of the national spirit was the nation in arms; and that when war could be waged with success it was a religious duty to engage in it, since thus alone could power be placed in the hands fit to wield it and the obvious design of Providence be carried out. But although this phantasy is of interest to those who care to watch the varying tendencies of human thought, it is not of the importance which young Germany ascribed to it. It is logical enough, but it is logical because it gives up in despair the attempt to recognize and understand tlie full complexity of life. It is a hemianopic view, for it shuts oA" from the field of vision one-half of the impulses of humanity. It is too parhal to be called a great philosophy. The real glory of Ger- many lay not in this, nor in her commerce, her science, or her art. It was something greater and deeper than all these. It was her sincere reverence for learning and for labour, and her real comprehension of the dignity of both. It is in this that she can read us the greatest lesson of all. Wliile she worshipped work we worshipped play. \\'hile she fostered learning and discovery, thoule. Another method is the enumeration of the ENTERIC FEVER 113 defensive cells themselves. In pneumonia, for instance, a large increase in one class of these cells is thought to indicate that the patient is making good resistance to the toxin oi the pneumococci which have attacked hiiu. This i?, however, not a very certain piece of evidence. But two methods are of great value. One is the " deviation ol complement,'"' by which incomprehensible name is meant the power of the immune body to prevent certain processes which in its absence will take place when special albuminous fluids are mixed together in the laboratory. The other, which is called " agglutina- tion," is easier to imderstand. If you look through the microscope at a drop of fluid in which B. typhosus is growing, you see the field swarming with little short rods, which are scuttling about it in all directions like tiny fishes. If you now add to this scene a drop of the clear serum from the blood of a man who has had typhoid, it puts an entire stop to the festivitie.'i. The bacilli begin to move slowly, and to pack together in clumps. In a little while there is nothing left but little masses of lifeless and immovable organisms, clotted by some substance which we call " agglutinin " existing in the serum. This is the re- action kno\vn by the name of Widal, the physician of Paris who, though not the discoverer, first brought it into common use; and when the bacillus of typhoid cannot be grown either from the blood or from the excreta, this is the only means we have, besides the clinical symptoms, for diagnosing the disease. It is an instance of the umcliability of popuhir fame that among [)athologists the most revered name among living men is that of Bordet of Brussels, of whom few people outside my profession have ever heard. He 114 A PHYSICIAN IN FRANCE has been the great pioneer in all this work on the theory of immunity. It may be thought that physicians ought to diagnose typhoid without having to ask bacteriologists to do it for them, and in natural typhoid they can. Even under the conditions of inoculation, there were some cases in which the clinical diagnosis was clear and the laboratory diagnosis failed. But inoculation not only greatly lessened the death-rate, but so modified the disease, that this became in many cases a slight illness with nothing distinctive about it. Triple inoculation for typhoid and A and B paratyphoid — T.A.B. as it is called — altered it still more. Under these conditions the laboratory tests were of great importance. But in them, too, difficulties arose. When a man has had typhoid or has been inoculated for it, he shows the natural picture of agglutination. But if you suspect that an inoculated patient has, in spite of inoculation, caught typhoid, how are you to distinguish the effect of the one from that of the other ? That was the first puzzle. Later, when inoculation for the paratyphoids was added, and the men had the triple inoculation T.A.B. it was found that each of them modified the agglutination of the others, and the result was extremely confusing. Tlien Professor Dreyer of Oxford produced an elaborate method by which the test was carried out on all three kinds of bacilli, not once, but several times at stated intervals, and thus again gave the laboratories a test which has been widely accepted as reliable. 1 have illustrat<;d this method by enteric, but it is used for other diseases as well. This work and work like it was of the utmost service to the Army, and has been unknown in any previous war. This is the first time that bacteriologists and their laboratories have been brought into the field. ENTERIC FEVER 115 The first that came out was under Sidney Rowhmd, a pathologist from the Lister Institute, who had fitted up a motor touring caravan for the purpose. He was a man who had set before himself a life of science in the devoted and utterly unselfish spirit of an old monk — a man of an unclouded gaiety of disposition, and of a serious and liberal sympathy with human life, an inde- fatigable worker and a delightful companion. He died from cerebro-spinal fever after he had been working on it for fully two years, and his death was one of the greatest losses of the war in my profession. The first Mobile Field Laboratory so impressed the authorities with its value that others were quickly supplied. By October, 1915, there was one at No. 10 Clearing Station near Poperinghe, one at Bailleul, and one at Lillers, with two officers in each, and the Canadian Field Laboratory with three officers was at Merville. In October another was sent to Hazebrouck, where there were three Clearing Stations. It obtained distinction at a bound by reason of the orderly attached to it, who, in the space of a fortnight, drank two litres of absolute alcohol and one gallon of methylated spirit, which were part of the stock-in-trade of the laboratory. There were also two mobile laboratories for water analysis, whose ofiicers were attached to the First and Second Armies respectively, and were busily employed in examin- ing the various supplies of water all over the country. As other Armies were formed, similar bacteriological laboratories were attaclicd to them, and bacteriologists were also placed in one or two hospitals at the front. The first work done l)y No. 1 J^aboratory was the investigation of wounds and the discovery of the species of bacilli that were producing gas gangrene, which was the worst of the septic diseases. By the time that 1 116 A PHYSICIAN IN FRANCE came up to the front in 1914, the prevention of the spread of enteric had become the most pressing question, and after Christmas cerebro-spinal fever occupied the chief place. The next two mobile laboratories, Nos. 2 and 3, did not appear till the spring. From that time till the autumn they were chiefly occupied with enteric, paratyphoid, and the peculiar short fevers that were very frequent in the Army, one of which we nicknamed " trench fever.'' But the work of the bacteriologists was not confined to these subjects. They acted also as clinical patholo- gists for the hospitals within their zones, and w^ere constantly called in for purposes of diagnosis or to make vaccine for treatment. There was at times less medical than surgical work at the front, for the Army was extraordinarily healthy, but the investigation with the bacteriologists of cerebro- spinal and trench fever was most interesting and instruc- tive. I enjoyed nothing more than the hours spent in their laboratories. Apart, too, from the direct results they were able to obtain, their influence upon the work of the hospitals was great. Where there was a bacteriologist at hand the officers in charge of medical cases could investigate them as carefully as at home, and in consequence did so. Where there was not, they were perforce obliged to be content with a less exact diagnosis, and, as always then happens, were less interested in their cases and less careful in their work. Bacteriology is one of the strong points of the K.A.M.C., and we had friends at court. The Adviser in Pathology, an oihcer whose name is known all over the world, encouraged the scientific side of medicine by every means in his power, and on the staff of the D.G. was another, who, though compelled ENTEEIC FEVER 117 by seniority to serve tables for the most part, had boon Professor of Pathology at the R.A.M. College, and was always on the side of the angels. In 1918 the former Adviser went home and was replaced by the latter officer. The bacteriologists in charge of these stations were each given a motor, and used to divide their time between their laboratories and their visiting work. Each had his o\\ni area, and was summoned ])y an}' Field Ambulance or Clearing Station in which a case of enteric or other infectious fever appeared. At a later dat« an Assistant Adviser in Pathology was appointed for each Army, with the rank of Major, which was a great improvement in organization. There was a story against one of our bacteriologists. He was very short of guinea-pigs, and the mess declared that he had induced the neighbouring cures to pro- nounce from the pulpit that any child who possessed guinea-pigs would earn merit by taking any she could spare to the English hospital to help in curing the sick and wounded. He soon had as many as he wanted, but he denied the pulpits, and said it was the school- masters who had helped him. Both dysentery and enteric were a terrible scourge at Gallipoli, and we began to see dysentery in 1910, when troops which had been there came over to France. It broke out both at the Base, where the reinforcement camps were, and on the front also when we were fighting on the Somme. From that time we were never quite free from it, and in the warm weather it increased. It was not a very bad kind, and we had few deaths, but it was extremely dillicult to get the patients into such a 8tat€ that, besides being in good health themselves, they should not be a danger to others. It required great care and precautions. CHAPTER XII CEREBRO-SPINAL FEVER Ax epidemic of cerebro-spinal fever broke out among the troops in France in January, 1915, and lasted till August. This fever had never hitherto been rife in England, though small outbreaks had taken place in various parts of the country. We always have a few scattered cases among children in London, but we have never had an epidemic there. It is the most distressing ill- ness I have ever had to treat. The First Canadian contingent had a case before they left Canada, and one or two during the voyage. When they were on Salisbury Plain they had a number of them, and there seems no doubt that the English epidemic, which was very severe both among the troops and in the civil population, started from this contingent. Their first Division landed in France shortly before Christmas, and the first case among our troops there was found at Boulogne in the first week of January. Within a fortnight we had 7 or 8 cases at St. Omer. No. 10 Stationary was made the chief hospital for this disease, and we treated there 150 cases that spring, while 30 or 40 were treated at No. 14 Stationary, at Wimereux, beside those we sent down convalescent. The number of cases was not large, and its effect upon the strength of the Army was unimportant. Its spread was difficult to understand, for the first set of cases came from all parts of the Army, and could not 118 CEREBKO-SPTNAL FEVEE 119 be traced to any contact witli the Canadians. Throiioli- out the epidemic the same absence of direct contagion was noticeable, and very few units sent in more than one case, T believe that in England it was rare to get more than one case from a hut, though the huts were crowded. Evidently, then, the germ, though existing all over the Army, produced the fever in very few individuals. There must have been hundreds of men who were exposed to it, and probably carried it, for one who took the disease. It seemed to be a very widespread and, there- fore, a very numerous invasion, but weak in attack, and successfully resisted by most people. It is known to live in the mucous membrane of the back of the nose, and for some time the bacteriologists were busily employed in hunting for carriers. When- ever a case occurred all men who had been in close contact with it were examined. Twenty or thirty contacts was a common thing. But the germ is difficult to determine. It has first to be grown on a medium containing fresh serum at a temperature over 23° C. ; next it has to be put through certain tests with vsugara, lastly, it has to be agglutinated by an immune serum. The more of these tests that you omit, the greater the number of cases in which you think the germ to be present; the more conscientiously you carry out the tests, the fewer become the positive cases. Thus, in thirty contacts from which cultivations were taken, four cases grew, but only one gave the proper sugar reactions. There was some evidence that the microbe was just as frequently found among the general population in England as among the contacts. If so, the isolation of contacts would lose all value. 120 A PHYSICIAN IN FKANCE With us, at any rate, the carrier became a compara- tively unimportant item. We found a few, and kept them under treatment until the germ was no longer to be obtained from the nose. But we never traced a case of the fever to a carrier, and I do not remember to have seen any })atient who could be sup])osed to have caught his attack from another man who had it. Some cases were inexplicable. A Medical Officer who had been for six weeks at a hospital where there had been no case of the kind was suddenly seized with it, and died in three days. Soon after that a Brigadier who had been in action with a brigade of guns (aught it, and he also died very quickly. The two cases had no con- nection with each other, and no others occurred in the neighbourhood. It was a very variable disease. Some cases died in twenty-four hours; on the other hand, we had one in which the fever lasted for over three months. Some were so slight that we were in doubt whether they really had it, for it was not in every case that the germ could be discovered. Others were long unconscious or shriek- ing with pain. After months of practice we were almost as ill able to foretell the issue as at the beginning of the epidemic. A case that began mildly would often develop seriously, and relapses would occur when a patient appeared con- valescent. It was an illness in which the conditions of one day had no apparent connection with those of the next. 1 know no other disease of such extreme uncertainty. So far as the most careful observation could discover, the various methods of treatment then available were all equally ineflectual. The first batcli of cases was treated bv intrathecal injection of an antiserum supplied from home. Almost CEREBRO-SPINAL FEVEK 121 all of them died. Then wc began to vaccinate with the microbe taken from fresh cases in the hope that the tissues would produce antidotes which, after absorption into the blood, would reach the base of the brain, where the germs were chiefly congregated, and destroy them- At first we used dead and later living germs, but without effect. Then, as the reports ol the serum from the Pasteur Institute were good, I obtained a supply of it by the kindness of M. Roux, the Director, and we tried that in the precise way that was employed in Paris. Later we obtained Flexner serum, made by the New York Board of Health, and another serum made in America. At the last we did no more than draw of! the spinal fluid whenever the patient complained of headache. At various times our hopes were raised. For a few cases some one method appeared to give unusually good results. But a longer experience always reduced them to the same average as before. The patients were carefully fed and treated, and were placed as nearly as possible in the open air. The rooms were large and lofty, with very large and high French windows. These were kept constantly open. Our mortality was just about 50 per cent. We had to change the sisters not infrequently. A death-rate of half of all cases is too much for any nurse to stand. A doctor is not so much with the patients as a nurse, and has also the great interest of a study of the disease to relieve the gloom. Yet these wards afTected one's spirits very much. The sufTcring, the miserable appearance of the men, and, above all, our impotence, were depressing in the extreme. This was the story of the first year. But improve- ment has taken place since then, and the account is of great interest. The disease is due to a microbe called 122 A PHYSTCTAN IN FEANCE " meningococcus/* and it was known that there were different varieties of it, just as there are different breeds of pigs, wh it'll grew under tlie same conditions and fer- mented tlie same sugars, but differed in agglutination* A composite serum made by injecting all the varieties then known into horses agglutinated them all, and waa supplied for treatment. But when the outbreak of 1915 occurred it was found that this serum would not agglu- tinate the microbes grown from the cases then occurring. The inference was that they were fresh varieties which, since their specific agglutinin waa not in the serum, had not been injected into the horses. It was most unlikely, therefore, that the specific antidote of these fresh varieties would be contained in the serum either, and it was not, therefore, to be expected that it should have any curative effect. The first thing necessary was to separate and to grow the various strains now active. Two very distinct types were found, and two others less distinct. Serum was then prepared by injecting all of them at once, and also other serums by injecting separate strains into horses. The first might be expected to produce a mixture of antidotes to all the types, though of no great strength against any one; the others would be stronger, but would only be of use against the particular variety used in their production. At first this promised well, but then, for some unknown reason, the serum ceased to agglutinate, and the death- rate, which had fallen, began again to rise. We in France received orders to discontinue the use of the official serum sent out from the Lister Institute, and to draw upon the Pasteur Institute. But we found that neither serum could agglutinate our meningococci, nor did either show any great curative power. It may be imagined that this uncertainty completely CEREBRO-SPINAT. FEVEPv 123 puzzled the pathologists who were making the serum, and eventually the Medical Research Committee under which they were working decided to take the injec- tion of the horses into its own hands, in order, if possible, to discover the reason for it. It cannot be said that this is yet quite cleared up. But those who are working at it tell us that there is evidence of two facts: first, that the efficiency of the serum as a remedy depends upon its containing anti-endotoxin, and second, that the horses sometimes produce this, and sometimes do not, apparently according to some minute difference in the method or technique of the injection. Microbes may produce two kinds of poison. The first, which we call " exotoxin," they throw off into the blood while they are yet alive, much as we throw off excreta, urine, sweat or faeces from our bodies; but the second, which we call " endotoxin," resides in and is part of the body of the micrococcus, and is only given off when the micrococcus dies and is broken up. The latter is much the more difficult to test, and to use in experiment. More recently still it has been stated that it is possible to separate the endotoxin from the rest of the substance of the microbe, and that the latter, though it does not produce poisonous symptoms in the patient, stimulates him to create the antidote; and, since it can be safely injected in much larger quantities than the original, will create larger quantities of antidote than could be formerly obtained. Presumably it would be an antidote, not to the poison of the microbe, but to the microbe itself. Tt would act by preventing its growth rather than by neutralizing the symptoms it produced. But the interest lies not alone in the explanation of this particular problem, but in the wide possibilities which these ideas reveal. When the antitoxin of 124 A PHYSICIAN IN FK.^NCE diphtheria was discovered we confidently hoped that we had found a method wliich would be of wide application. It seemed as though we had only to find the microbe which caused any disease, to inject it into animals, produce the antidote, and then use this to cure the human patient. But of all those that have been tried up to now, two only have really established themselves — the antitoxin of diphtheria and that of tetanus. We have been unable to tell why other microbes should not produce antidotes; we have only known that we could not make the antitoxin. Now, it may turn out that the preparation of it in the living laboratory of the horse may be a much more delicate and varied matter than we thought; that some trivial change in the technique may enable us to make many more antidotes than we now can; and that many diseases which we cannot cure now we may cure hereafter by these means. Perhaps only doctors can feel the excitement of such a thought, but laymen can at least understand it. CHAPTER XIII TRENCH FEVER This campaign was full of surprises. Perhaps nothing would astonish the ordinary layman more than the almost complete absence of rheumatic fever. This disease is closely associated in the public mind with cold and damp. Yet in a country that was a quagmire, where it rained for days and weeks together, so that the men were always wet and seldom warm, I do not think 1 saw five cases of rheumatic fever in the first year. This was not so astonishing to us, for although we are not yet agreed that the microbe of rheumatic fever has been identified, we all of us accept the fact that it is due to infection of some kind. Yet even with this knowledge many of us have been of the opinion that wet and cold, by lowering the power of resistance, favoured the introduction of the germ of rheumatic fever, and disposed a man to catch it. On the other hand, the disease which, in spite of the veto of the College of Physicians, we still call muscular rheumatism, such as lumbago and stiffness of other groups of muscles, was extremely common. So, too, were various forms of neuritis, of which sciatica and brachial neuritis are the best-known examples. But there were beside these an enormous number of slight, and for the most part short, cases of fever, to name which honestly was impossible. 125 126 A PHYSICIAN IN FRANCE In former days we should have been content to say that the patient had caught a chill. But bacteriology has made us more exacting, and we are not satisfied now unless we can find a microbe to explain every fever. It was about May, 1915, that we began to recognize that there was a fever prevalent among the men which we had never seen before. It began like influenza, and the temperature fell to normal in three or four days; but, unlike influenza, a fresh attack began about the sixth or seventh day, and this process was sometimes repeated several times. It was, in fact, a relapsing fever with a cycle of about five days. We are familiar with the relapses of malaria, in which the recurrence of fever is explained by the periodic ripening of a microscopic parasite which bursts and scatters its spores into the blood, and we at once began to look for some such body in the blood of these patients. An enterprising bacteriologist proved that there was some infectious body present by injecting the blood of patients into a few men who volunteered for the pm'pose. This, however, was stopped, and we were reduced to micro- scopic examination, which we felt confident would yield results. This hope was disappointed, and though many pathologists found bodies that they thought were the cause of the fever, they were followed by others who showed that the suspected bodies occurred in healthy men. One such " find " caused great excitement at the time. Our bacteriologist at St. Pol discovered, in films of the blood of these patients, bodies which were un- doubtedly of the same order as the parasite of malaria. For a fortnight or more he worked night and day with his microscope, and showed beyond doubt that these bodies were frequently present. But he could not TRENCH FEVER 127 find them when he spread the blood extremely thin, and merely dried it on the slide. It was only when he took a thicker layer, stained it with dyes, and then washed the superfluous dye away with distilled water, that they appeared. He began, therefore, to have doubts. When he proceeded further to test the blood of healthy people he was astonished to find that with the same method of preparation the same bodies occurred. This led him to suppose that they must, after all, be due to some ingredient he was using, and it was ultimately found that they were an organism which bred in the distilled water with which the films were washed. By 1917 we knew the clinical features of the disease pretty well, but in spite of unremitting labour on the part of the pathologists, and in spite of the most varied treatment on the part of the Medical Officers, we were as far from finding the cause and as far from finding the cure as ever. As the disease was a great scourge, the Director General appointed a small committee to investigate it, and placed part of No. 12 Stationary Hospital, which was on the hill south of St. Pol, at our disposal. Just at that time it was conveyed to us that the American pathologists, who had by this time arrived in Paris, would be glad to co-operate with us. We at once, there- fore, invited them to join in the work, and as they could obtain volunteers which we were too short of men to afi'ord, we turned over to them the experimental part of the work, while we elaborated t he clinical obscrvat ions. They came up to St. Pol at the end of 1U17, had their laboratories and their experimental wards in the hospital compound, and lived with our officers. I should like to say a few words, if without imperti- ueuce I may, on the good feeling and the good fellowship 128 A PHYSICIAN IN FRANCE which existed between us and the Americans. Of the combatant branch 1 know only as much as I heard from chance conversation with officers who had been helping to train a few of their Divisions in our area. They spoke in the highest terms of their willingness to learn and their eagerness to work. The chief fault that they found was that they overworked themselves to the extent of somewhat impairing their powers. But of the medical branch 1 can speak with knowledge. There were several American hospitals in our Bases, all our Clearing Stations had one or two of their officers, and they were serving also in our Field Ambulances and with our regi- ments. They came to us to learn, for they, like us, were civilians, ignorant of the conditions of warfare, and we were glad enough by their help to supplement our de- pleted staffs. I think I can say that 1 never met a man who did not like them. One of them was a great authority on the surgery of the brain, another was a famous physiologist who helped us greatly both in Flanders and in England to solve the problem of shock after severe injuries, and a third was a surgeon to whom every fact in surgery seemed to open up fresh lines for thought and for discovery. Several of them were physicians of the first rank. Such men were most stimulating company, and while I do not think that the general level of knowledge in the ordinary officer was higher than our own, 1 think that their best men are equipped with a wider scientific training than men in the same position in England. 1 believe they had ex- pected to find us rather stift' and difficult. If so, I think they were disappointed. They were welcome everywhere, they shared our life and they shared our work, and while their special physicians and surgeons aided us greatly in advancing medicine and surgery, TRENCH FEVER 129 their younger officers made themselves no less liked by their modesty and hard work. It was the same with the troupe of pathologists who joined us at St. Pol. Their chief was a wise, Cjuiet man with a dry smile, well known for his pathological dis- coveries, whose one care, as he said himself, was to carry out his work in such a way that it would not have to be done again. His second in command gave us to understand that to take part in the elucidation of a new disease was a greater fortime than he had ever hoped, and that he would now die a happy man. The rest ot them were actuated by the same spirit. They brought with them about seventy volunteers drawn from their Medical Corps for purposes of experiment, and under- took to solve the question whether, as was suspected, the poison of the fever was conveyed by lice, which are known to spread typhus and swarm in every army. To carry this out it was necessary to have someone who knew how to breed and manage lice, and we were able to provide an officer (for there were all kinds of men in the Army) who was in civil life a lecturer on ento- mology, and had durmg his service in the ranks turned his training to account by making a special study of this insect. He brought over from England a stock ol lice which could be guaranteed never to have been in contact with trench fever, and they and their descen- dants were the means by which the experiments were carried out. But besides guaranteeing the lice, the experimental patients had also to be above suspicion. It would take too long to describe the minute precautioiiii that were taken first to prove that the volunteers had never had trench fever before, and second to insure that they did not become accidentally infected with it while they 9 130 A PHYS^TCIAN IN FRANCE were awaiting the experiment. They were strictly isolated, watched and examined for several days to make sure that they were free from fever or any other disease, and then bitten by lice which had previously been fed on the trench fever patients we were observing in the wards. A number of the insects which had been kept in cardboard pill-boxes and fed on a healthy man were placed on the arm of a fever patient, covered up, and retained there for a certain time. They were then returned to the box, and later placed in the same way on the arm of a healthy volunteer. The experiment was varied in a number of ways. It was found that the volunteers so bitten caught the fever, and that it could be conveyed from them to other healthy men, either by lice or by drawing some blood from a vein and inject- ing it into another man. But whereas the fever took but eight days to develop after injection of the blood, the incubation period after biting by lice was roughly about three weeks. The disease was thus carried on through three or four patients successively, and by March 9th we were able to report to the Director General that the disease was undoubtedly conveyed by lice. Meanwhile another committee in England, by excel- lent work, had found that the fever could be conveyed by the excreta of lice, if this material was inoculated into the arm in the same way as vaccine lymph. Later the Americans completed their work by proving, so far as the conditions permitted, that the mere bite of the louse without contamination by the excreta could convey the disease. And the English Committee completed theirs by subjecting the excreta to tests which showed that the poison was capable of resisting a temperature of 60° C. and over, and various other physical conditions. They also saw in England a series TEENCH FEVER 131 of protracted cases, and were able to contribute a study of the chronic form of the disease which we did not see in France. Meanwhile some excellent clinical observations on the obscurer symptoms of the disease, its definite distinction from enteric, its effect upon the blood and upon the heart, had been made by our own officers. So far, however, we still have been unable to dis- cover the microbe which causes the disease ; yet the method by which the disease spreads was dis- covered, and the campaign against lice, which had languished while they were thought to be merely a discomfort, received a fresh impetus when we could show them to be the cause of a large amount of sickness. But on March 21st the German attack broke off the work at St. Pol. The Americans returned to Paris to finish their experiments without the fear of interruption, and the hospital itself had to be cleared to receive wounded. For a time we could not attend to trench fever, and when we returned to it again we found it remarkably diminished. I cannot to this day feel certain from what causes this arose. It certainly coin- cided with a diminution of the pest of lice. The men were, on the whole, less lousy in the summer of 1918 than they had been. Partly this may have been, and probably was, due to increased measures of destmction. More facilities were given for disinfection by steam, a greater effort was made to bathe the troops more often, and to ensure that not only their underclothing, but their khaki clothes and all their equipment was disinfected at the same time. Where these methods could not be carried out, as in the front area, many underground pits were dug in which the clothing could be disinfected by a very liigli dry temperature. But 132 A PfiySTriAN IN FKANCE I think that the movement oi tlie troops, which was everywhere considerable, probably had a share in the change also, for they moved into fresh lines where dugouts in which the conditions were very favourable for infection had hardly time to be made. And, further, we were at the same time visited by a violent epidemic of influenza, in the midst of which it became mucJi more difficult to distinguish cases of trench fever, and a certain number of cases no doubt escaped notice. Yet, even allowing for this, there can be no doubt that the disease abated considerably, and I think that a share in the decrease must be given to both the two former causes. CHAPTEE XIV SHELL SHOCK It was not surprising that the sights and sounds of this war produced many cases of nervous aihnent. I can only judge by hearsay of the effect of prolonged and severe shell fire, but I cannot imagine that anything can be more terrible. I remember that a soldier, describing one of our own preliminary bombardments which only lasted five minutes, said it looked as if the earth was opening; and the son of some French friends who was a private in one of the four crack French corps and was at Douaumont in the Verdun battle told his parents that by the ninth day almost every soldier was crying. In addition to the awful and incessant noise and the ever- present danger, a shell might hurl you several yards, though without causing any severe wound; might bury you entirely under a mound of earth, with all the terror of suffocation; or might kill your comrade by your side, with the most ghastly accompaniments of shattering and mangling woimds. We became well accustomed to shell shock. Like any other illness, it was sometimes simulated by those who wished to get out of the line. These men were, however, detected without much difficulty, and in the Clearing Stations the majority of cases were both genuine and interesting. They were of various kinds. There were some who showed a univoisal ticmor, ceasing 133 134 A PHYSICIAN IN FRANCE during sleep and diminishing when the patient was alone or interested in something else, but increasing when his attention was recalled to his own case by the visit of the doctor. There were some who were tearful or dull and melancholy, and there were others who were in a state of terror and hid their heads beneath the bed- clothes. Others, again, showed loss of some physical power. Some were paralyzed in a limb, or over the whole of one side of the body; some lost their sense of touch, or perhaps some special sense, such as taste or sight or hearing. There were others who were unable to utter a word, or who had lost all memory for the event which had produced their condition, and perhaps for all that had happened for a considerable time before and after it. These cases were all of a class which we call " func- tional," by which we mean that the symptoms are not dependent on any gross damage to the brain, that they may disappear, and may even disappear suddenly. They are of the class which undergo miraculous cures and make the fortune, now of a shrine, now of one of those members of my profession who live upon the un- fathomable credulity of the world. Nearly all, also, of such patients betray when questioned evidence of a temperament which, either from an inborn predisposi- tion or from adverse circumstances, is unable to meet the ordinary trials of life with the firmness of an ordinary man. I remember well a case related to me by one of the Medical Officers. The patient was the younger son of a Scotch undertaker, who was not cruel to the children, but punished them by shutting them up in a dark cupboard. Their mother sought to impress the reality of the spiritual world upon their minds by appearing in their bedroom dressed in a white sheet and uttering SHELL SHOCK 135 groans, at which the children crawled under the bed for terror. The father retired from the business, and the elder brother, who succeeded, endeavoured to strengthen the mind of the cadet by taking him with him when he went to measure for a coffin and locking him into a room with the corpse. The boy was God-fearing and conscientious, and on the outbreak of war volunteered for service. He was unable to pass his firing tests owdng to the shaking of his hands, until a sergeant kindly assisted him. He was then sent out, and eventually came up to the front. On one occasion those who had not been through a course of bombing were told to step forward, and he, with others, was sent to a bombing school. He learnt the theoretical part of the work easily, for he was diligent and intelligent, but when the time came that he held a live bomb in his hand he hurled it wildly into the air and fainted. Luckily, no one was killed. He was sent to us as unfit for the line, and was relegated to a position in the rear where he would run less danger himself, and would be less of a danger to others. The majority of these patients were distressed at their condition, some were amused at it, most were genuinely anxious to get back to work and were rejoiced when their symptoms were relieved. In many of the slighter cases nothing more was needed than rest, good food, and encouragement. They were told that they would soon be all right again, and just as men recover from other frights they recovered from this. Some insisted that they had not been in the least afraid, but that (heir condition was due to some physical cause which they could not explain. Tlic only way to cure sucli men was to convince them by quiet reasoning that they really had been frightcjicd out of their wits, and then to point 136 A PHYSICIAN IN FRANCE out to tliem that everyone was hoiTibly afraid* but that brave men did not give way under the stress, and that now they realized the true state of the case they must resolve to control themselves and play their part with the others. Many went back with this determination. Some succeeded, and even won decora- tions for bravery, but probably the greater part even- tually broke down again. It was impossible in the field to follow individuals; it is possible that Records may ultimately be able to trace them for us. Cases with loss of speech could usually be cured by electricity or by an ansesthetic. If the latter was em- ployed, the patients were told that it would cure them; they were asked questions when they were slightly un- conscious, and they woke up talking. There were once two such patients in a ward. They were told what would happen, and one of them was taken away to be ansesthetized. He came back to the ward talking, whereupon the second man, who had been awaiting the issue, slapped him on the back, and, in the excitement of the moment, said, *' Ch-ch-cheer up !" and forthwith spoke himself. In other cases, and especially in cases with loss of memory, hypnotism was substituted for ansesthesia. Under hypnotism the man who while conscious had forgotten all about his accident would give a complete account of it. He was then told that when he woke up he would remember all about it, and everything else he had forgotten, and he did. In such cases, although we can hardly explain or even imagine the process, there is a complete gap in the conscious memory. One may almost think of it as broken like a bone. Whatever view we take of personality, it is indisputable that memory is essential to it. A man who could not SHELL SHOCK 137 remember any of his thoughts or actions would have no continuity of life. Oneself is the being that has lived in such places, has met such people, has done or said such things. Take away all memory even down to what was done an hour ago, and you deprive a man of all that he can call himself. We have most of us read of cases of ** dual personality," either in fiction, such as Steven- son's story of Jekyll and Hyde, or in medical treatises. Some of us have seen them. They are cases of a broken memory, of which the two halves, each becoming in some strange way continuous with itself, though discontinuous with the other half, produce two dift'erent personalities or selves. If they could be combined again, the man would be a single self once more. When some great shock thus breaks the memory the man runs a risk of becoming a double personality. The first object, therefore, which the Medical Officer who employs hypnotism has in his mind is to recall the memory of the shock, which is usually easy, and then to retain it for the patient's conscious state by telling him that when he wakes up he will remember it, which in fact he under those conditions does. Tliis, of course, provides him with some very frightening thoughts, and it may be tliought that the patient is none the better for having them. But here we meet with the second object of the hypnotist, the abolition of a painful or terrible memory buried in unconsciousness, or, as it Is commonly called, subconsciousness. The experience of those who have had large dealings with morl^id minds has led to the conclusion that in many cases the mental state is tluc to the repression of natural emotion. We recognize this in daily life. It is a common thing to say that a person strained by some great grief would be the better for a good cry, and we 138 A PHYSICIAN IN FRANCE all know the golfer who thiuks it is " better to smash your damned club than to lose your damned temper." These are instances of the good effect of giving expression to overcharged emotion. If I recollect my old studies aright, Aristotle thought that the benefit of tragedy was to provide an outlet for the emotions of the spectator. But these are conditions in which the emotion is of recent origin and, so to say, on the surface of life. Doctors have extended the rule to include past emotions long buried and forgotten. They have found that from cer- tain patients there can be recovered, under hypnotism, an account of some great shock or perhaps of some shameful action or habit which, though almost forgotten, has served to give a permanent twist to the mind. No doubt enthusiasts, by making too much of this, and also by laying far too much stress on the sexual emotions to the exclusion of others, have in many cases done more harm than good by their attempts. But there is a truth in it, and in such cases as these of sudden terror so great as to break the memory and be buried in subconsciousness it might fairly be supposed a salu- tary measure to recover the memory and enable the man to face it openly. Of course, such a patient, with the recovered memory, recovered in large part also his first terrors ; but however distressing at the first, we know that fear, grief, and all other emotions fade in time. It is only when they are " beneath the surface " that they retain their strength undisturbed by the innu- merable other emotions of daily life. Natural sorrow is conscious, and when a man has to catch a train his mind is for the moment set on that and forgets his sorrow. Repeat such little interests a million times a day, and he has so often forgotten it that it begins to return less vividly. But hidden emotions are " below SHELL SHOCK 139 consciousness," and the waves of time play over their heads without wearing them away. Hypnotism brings them to the surface and exposes them to the natural attrition of daily life. The most difficult cases were the deaf, for in order to cure them of their deafness the suggestion that they would recover had to be made through the eye by writing a statement to that effect. It is indeed curious to reflect how much we have substituted the eye for the ear. Nowadays everything must be seen to be believed. We read textbooks in preference to hearing lectures, and novels instead of listening to sermons, while every piece of scientific instruction is reduced to the form of diagrams or illustrated with pictures in order to impress it on the mind. This is true of all branches of thought that appeal especially to the intellect. But when we turn to the more emotional side of thought, everyone will acknowledge that the spoken word in the mouth of one who perfects its use is the most powerful of all stimulants, though not, per- haps, the most lasting, and in the deaf cases it was a great disadvantage to the Medical Officer that he had only the weak power of the pen wherewith to approach his patient. These cases were early placed under the care of special physicians, who developed great skill in dealing with them, and cured the majority in a comparatively short time. Some of them, as 1 have said, used hypnotism, but the greater number did not, and the immediate results were not very different. Probably in most cases the loss of memory was for so few events and for sucli a short time that, as often happens after a fall in the hunting field or other civil accident, the period could hv dropped out without inconvenience. But the general 140 A PHYSICIAN IN FRANCE opinion both here and in Germany, where they had very large numbers of such cases, was that much more depended upon the physician — that is, after all, upon the power to suggest — than upon any method of treat- ment that he happened to employ. On the other hand, if these patients could not be quickly cured, it was very didicult to cure them at all. Some of the obstinate cases may have had real injury to the brain, for we know that an extreme and sudden rise of atmospheric pressure such as occurs near an explosion may produce minute haemorrhage in the brain matter. But the most part were cases in which ideas of terror obtained such a hold upon the mind as to produce an obsession from which the patient could not shake himself free. Hundreds of such cases came back to England, and were treated in special hospitals. They need special skill and special care, which they cannot get in ordinary places. It is the worst policy to place them with ordinary patients, in the hope that the latter will cheer them up. There was great difficulty over the question of their title to compensation. At one time almost all cases sent in as shell shock were allowed to reckon the con- dition as a wound, and even to wear a wound stripe. But the number of slight cases became so great that the privilege was soon restricted to the severer forms. Then it was ordered that the circumstances should be guaranteed by the CO. of the battalion, but C.O.'s varied greatly in the care with which they certified their cases. Some certified every case, while others made real inquiry and certified few. At the best it neces- sarily gave an advantage to men who were of a weak spirit, while those who were of firmer minds endured the same trials without acknowledgment. SHELL SHOCK 141 Officers were less subject, I thinlc, to overwliolming fear than were the men. There were some cases of this kind among them; but, though I have no statistics, I should not say that the proportion was as 1 to 30, which is the proportion of officers to men in a Division. They were, however, murh more open to the eii'ects of worr}', such as sleeplessness, fatigue, and dyspepsia. The difiterence is probably to be explained, as a good authority has explained it, by the difference of training in early life, which gives an officer more self-restraint, and the difference in military duty, which gives him more responsibility. Tiie real wonder is not that so many men gave way to fear, but that the great majority held out. There is no doubt that the conditions of modern life have made us much more sensitive than our fathers, while the cir- cimastances of war are far more awful than they ever were before. I had always felt that modern warfare would be a terrible strain to modern men. But I had not appreciated that civilization, while increasing our sensibility to the emotions, was all the while also increas- ing our power to control them. Physiologists will under- stand what I mean when I say that the process of nervous evolution lies almost more in the development of inhibi- tion than in development of sensory or motor power, while laymen will realize that self-restraint is the mark of the civilized man. I have often reflected how much we owe to the prohibition of duelling. We no longer insult each other because for an insult there is no redress. It is significant that the greatest master of manners was the man who stamped out the custom of fatal duels, which in the preceding reigns was a serious danger to France. Modern French duelling is rather a skilful and regulated sport than serious war, and we nre unjust 142 A PHYSICIAN IN FRANCE in our judgment of it, because we do not recognize that view. At any rate, it is certain that there is no loss of bravery in modern life. The bravery shown in this war has exceeded all belief of what was possible to man. CHAPTER XV THE ADVANCE OF MEDICINE IN THE WAR The war, which might have been a great hindrance to scientific work in medicine, had the opposite effect. There arose a large number of problems to solve, and the need introduced a system of co-operation among our scientific men which had been lacking in England hitherto. The first effort was concerned with the making of drugs. Many had been entirely imported from Germany, and we found ourselves short of some that were much needed. Thereupon the Royal Society drew up a scheme for a series of investigations into the processes of their manufacture, which we did not know, and distributed it among the University laboratories. One took one part, one took another, until ultimately we not only discovered how to make the drugs, but also how to make them at less than the old import price. The same system was employed in the elaborate work on gas-poisoning, on surgical shock, and on the questions connected with flying. In gas-poisoning the Committee of ten persons ap- pointed by the Director General established the exact effects of phosgene on the different organs as they could be seen by the naked eye and through the microscope, together \vith the changes in the blood cells, the reaction of the blood, the affections of respiration and of cir- culation, and the meaning of certain persistent symp- 145 144 A PTTYSTC'TAN IN FRANCE toms, such as palpitation and nocturnal attacks ot dyspnoea. Alongside of this work they carried out experiments on the treatment of the various stages from the earliest to the latest, and Dr. Haldane per- fected the apparatus for giving oxygen which with us in France went by his name. It consists of a reducing valve which allows the gas to escape at a low pressure, and distributing valves which, when connected with flexible tubes and pneumatic rubber face-masks, enable the cylinder to supply four patients at once with oxygen, saving all waste of the gas, w^hile giving to each man the exact amount he needs. When nmstard gas (dichlorethyl sulphide) came into use, similar investigations were carried out, as well as others to ensure the safety of those employed in producing it. Surgical shock had already before the war been the subject of special study by American surgeons, and was taken up afresh when they came out to join us in 1917. In this case the Medical Research Committee took the lead, and invited ten experts to assist in its investigation. It was already known that the volume of the blood in the arteries was diminished in shock, and that trans- fusion — that is, the injection of fresh blood from a healthy man into the vein of the patient — could restore the circulation. Incidentally the wonderful fact had also been discovered that there are four kinds of human blood, though this division is not according to race or colour or any known classification, and that one man's blood may be another man's poison, so that transfusion requires care in the selection of a donor of blood. Now it was discovered that a solution of gum would also restore the circulation, though by common consent of surgeons in France its powej- was not quite so great. THE ADVANCE OF MEDICINE IN THE WAE U5 It had been noticed in France that the blood of these shock patients was not so alkaline as the natural, and the injection of alkali had been recommended to cui-e shock. This point was examined, and it was fomid that while the fact was correct, its significance was doubtful and the remedy of little effect to cure the condition. But it was found incidentally that it was sovereign for the distressing vomiting from which these cases often suffer, and also for the same symptom when it is caused by chloroform. Ultimately the conclusion was reached that shock might be produced by at least three causes — actual loss of blood from haemorrhage, virtual loss of blood by the withdrawal into the capillaries of a large body of blood which would usually be circulating — though the reason is yet unknown — and finally, as had been previously shown, by a poison derived from damaged muscle, such as existed in abundance in all wounds. In treatment the importance of rest and warmth, which had been our chief means till then, was not diminished, but the sm-geon was provided with one or two other means to be employed with them. The donation of blood by the healthy to the sick became common, and none the less that it entitled the donor to three weeks of leave. At first only fresh blood was used, but it was soon discovered that it could be preserved, and the hospitals could then take the donor's blood and send him down to the Base, while the blood was preserved till wanted. The method was pushed far to the front. Both blood and gum were taken up to the Main, and sometimes even to the Advanced Dressing Station. An interesting example occurred of a contradiction given by one set of experimenters to the results of another 10 146 A PHYSICIAN IN FRANCE party. This often happens between two experimenters who may be of different countries, or if of the same may be on indifferent terms. On such occasions the usual consequence is a wordy warfare which hists a long time and is seldom settled. But in this case the two parties met, talked it over, and found that the difference was explained by the use of a particular anaesthetic which had not till then appeared of any importance. We have hitherto known by the name of mountain sickness a group of symptoms which occur in climbers at great heights. These were found commonly in flying men also. They are known to depend on de- ficiency of oxygen owing to the rarefaction of the atmos- phere. The Medical Committee of the Air Force, to- gether with the Medical Research Committee, appointed nine men of science to work on the problem. Tests were invented to determine the capacity of the lungs, and on comparison of those fliers who suffered from the symp- toms and those who did not, the difference was clearly related to the breathing powers. In consequence a certain standard was adopted, which candidates for commissions were required to pass, and methods were invented to supply oxygen in aeroplanes. The scientific men tell amusing stories of the ignorance shown by the military element of physiological laws, and of their flat refusal to believe that the examination of the blood could throw any light on vomiting in the air. Beside the symptoms of oxygen want, flying men suffer also, especially after any mishap, from nervous breakdown, and accordingly regular periods of rest were recommended for those flying at the front, and tests were set up to eliminate the neurotic candidates. Fm'ther investigations which promise to be of great THE ADVANCE OF lAlEDICINE IN THE WAK U7 interest are now being made on the sense of stability and balance in the air. Side by side with these researches, which may be classed as in the main physiological, others more strictly pathological have been carried out. Dysentery has always been a scoui'ge of armies. There was a great deal of it in Mesopotamia and Gallipoli, and a certain amomit in France. It is of two kinds — the one caused by a low organism called " amoeba," the other due to various kinds of bacilli. The symptoms of the two are superficially the same in that both cause diarrhoea, but their course and results are different. It was first determined with immense difficulty what proportion of dysentery was amoebic, how long the parasite remained in the intestine, and what was the effect of treatment by emetin. Many ways of giving the drug were tried, a new chemical compound, emetui bismuth iodide, was invented, and various capsules and coverings of the drug were used to prevent the emetic effect. At length a standard method was adopted which is a great improve- ment on anything before known. The bacillary group was also investigated, and elaborate statistics made of the frequency of the various infective organisms. A report is now ready which will form the standard classification of this very difficult group of bacilli. Classification is the preliminary step to the making of antitoxin, and we in France found that specific antitoxin was of value in the treatment of these cases. The troops suffered from an acute form of kidney disease in sufficient numbers to be serious from the point of view of the individual, though to the Army the loss was very small. The Director General set up a Com- mittee which made some excellent cimical observations, 148 A PHYSICIAN IN FRANCE did some good biochemical work, and also made the most extensive and elaborate investigation that has ever taken place on the incidence of albuminuria in presum- ably healthy people. On the surgical side the French had made good progress in the detection and classification of the various or- ganisms which produced gas gangrene, and English officers have co-operated with them in this, and with Americans in the production of an antitoxin. I have already described the progress made in enteric fever, trench fever, and cerebro-spinal fever. It is impossible to close these paragraphs without a word on the Medical Research Committee. It was in the first instance formed and endowed by Mr. Lloyd George in connection with his Insurance Act to advance by research the health of the nation. When the war broke out it rightly decided that the health of the Army was an important part of the health of the nation, and opened its resources to problems which arose in the war. It paid a large number of scientific men for work on special subjects which I have already mentioned, and it furnished us abroad with many instruments of research which we should not have obtained from the Army authorities. It published a very large number of most opportune and instructive reports, and drew up statis- tics of special forms of injury to illustrate the effects of treatment. The whole enormous mass of medical and surgical records were turned over to it, and a large area in the newer part of the British Museum devoted to tlicir compilation and indexing. But, above all, it has made itself a centre of inspiration and guidance to pathology throughout the country. It has not been merely one more pathological institute rivalling others already existing, and content with its own work and THE ADVANCE OF MEDTCTNE IN THE WAE 149 interests. It has not followed one school of pathology, or one line of thought, nor assisted only those who used a certain shibboleth. It has not confined its attention to one group of diseases, or even to a few. It has been quick to recognize the problems which needed solution, and ready to help forward any one of them, whatever the nature of the task. It has collected for these purposes scientific men and women from all Universities and schools of pathology or physiology, and it has thereby set a fashion and a standard of combination in scientific effort which had not till then existed in England. It has played a great part and has conferred great benefits upon the country. The establishment of the Medical Research Committee was a momentous event, for it was the first official recognition that research and discovery were of national interest and importance. It has ])een followed by similar establishments in Agriculture and one or two other Departments, and it may be hoped that the system will be extended. It is worthy of note tliat neitlier of the two official parties moved a finger in this direction. What has been accomplished we owe to the insight of a single individual, Mr. Lloyd George. This brief account of medical scientific work during the war, though by no means exhaustive, is sufficient to show that England has done her fair share. It is quite safe to say that the German output does not com- pare with it for volume or for value. The enemy has learnt more from us than we from him. This will nol surprise any of us in England. English physiology has taken the lead for years, and English neuroh)gy has only been rivalled by tliat of the French. Our pathology, too, has in the last twenty years come into the front rank. We are deficient in the arts of publication and 150 A PHYSICIAN IN FRANCE of self-advertisement, and we have not had the endow- ments which have created the excellent professional laboratories and the abundant staff of Germany. We have been lacking too, in what may be called experi- mental medicine. When in the sixteenth century science arose afresh, medicine employed at first the method of observation, and anatomy, which is not an experimental science, led tlie way. But in the next century Harvey made his great discovery of the circu- lation of the blood by a long-continued series of experi- ments, and thus introduced the method which is the most essential for advance. In the eighteentli century Hunter used it in surgery, and it was tlius firmly estab- lished in England. But of late, though Lister had revolutionized surgery by its means, English physicians had, with few exceptions, confined themselves to clinical observation. They had been immersed in practice or in the routine teaching which was essential to obtain it, and had not kept in touch with the wider work of science or with scientific methods. They had been content, like the rest of England, to take results when they were estab- lished by others, and had neglected to invent and ex- periment themselves. It was not entirely their fault, for men cannot live by research, and there were no endowments to support those who were willing, and indeed anxious, to engage in it. It was supposed that because Darwin and others worked and discovered at their own expense, there was something wrong in the support of discovery by public funds. We recognize now that that is a mistaken policy. My profession has long been anxious for such work to be subsidized, but until Lord Haldane's report on the University of London appeared we might as well THE ADVANCE OF MEDICINE TX THE WAR 151 have asked for the moon. That report gave us our opportunity, and we are now asking the Treasury to lielp us to create positions for men who will work for the advance of medicine and not for their own fortune, and by their greater knowledge of science in general and of the medical sciences in particular will be able to bring the facts that they observe under wider laws, to establish connections and relations yet unseen, and even in common things — mdeed, perhaps especially in common things — to inspire into their pupils a deeper interest and a clearer sight. This is the task that we set before a Professor of Medicine, and now is the first time that the State has awakened to the fact, long recognized in every country but our own, that education is an investment that invariably pays, but that its expenses are far too great to be defrayed by the student alone. If once we learn that lesson I have no fear of the result. We have a greater power of invention than most other races have, and we have much more appreciation of the work of others. There will not be in our labora- tories the dictatorial organization wliich has been tho bane of Germany, and there will in consequence be greater freedom for, and greater encouragement of, the younger men. We can in my estimation make a finer thing of the professorial system than has been made by others, if — and it all depends upon this — if we are allowed the means. Out in France we tried to contribute to the improve- ment of our art by producing a little V(jlume on the nature and treatment of the diseases and injuries ot war. It was first issued in 191G, and revised and reissued in 1918. We who helped to write it are not perhaps 152 A PHYSICIAN IN FRANCE the best persons to criticize it, but I can at least express my admiration for much the greater part of it which was written by others. It struck me as equally excellent in its clear statement of the facts observed and ia its recommendation of the practice to be adopted. CHAPTER XVI THE TLAIN OF FLANDERS St. Omer, in which General Headquarters were until April, 1916, is an old-fashioned towTi lying on the northern edge of the chalk hills and on the southern borders of the great plain of Flanders. It is occupied by three classes, the noblesse, the garrison, and the bourgeoisie, and, as in our own cathedral towns, none of these consort with the others. The most exciting entertainment is a dinner to meet the Dean, and it is said to be the dullest garrison town in France. But a year or so before the war there was a little outbreak of scandals in high life which made the place quite lively for a time. A traveller going west to Calais or south to Amiens enters at once upon a rolling hill country, like our South Downs. Going north or east, he passes through an amphibious suburb, wliich consists of small houses built on the banks of canals or dykes, and ends in a tract of market-gardens of black earth intersected by water- ways. Each house has its punt at the foot of the steps, which carries the people to their work and comes back laden with magnificent vegelaljles. 1 saw, one day, a notice of 100,000 leeks to be sold by auction. Children play in the punts and fish from them in the weedy, dirty water. I suppose that they learn caution and that their mothers are accustomed to it. 163 154 A PHYSICIAN IN FKANCE This marsh spreads from St. Omer tlie whole way to the sea at Gravelines. It was originally a large estuary, and even in historic times the Norsemen sailed up and burnt St. Omer. But a very small river was big enough for them. One Sunday, looking for a lake that we had heard of, we walked tlirough an osier hedge and found ourselves face to face with a pretty lady. We were clearly trespassing, but she was very affable, introduced us to a hus})and, who was mending a motor-boat, and asked us to have tea. We could see no sign of a house, but a few yards through the osier patch brought us to a roof hardly above the ground. We went down some steps, and found ourselves in a pleasant little five-roomed house built of cement and sunk underground and below the water-level. It was a shoot- ing lodge, the owner of which was a manufacturer from Lille, and had built it thus to avoid scaring the duck. Probably his ancestors had fled into the same marsh to escape from Julius Csesar as he to escape the Kaiser. In the winter this plain is the dreariest piece of country I have ever seen. It is sopping wet. After rain the water stands in every furrow and hollow. There is no beauty in the muddy plough, and the sameness is most depressing. I shall not forget the extreme pleasure the first spring flowers gave me. When they began there was little reason to complain. The woods, with which the country is sprinkled, were carpeted with wood- anemones, and there were in a few places patches of primroses. Much more common was a large primrose- coloured polyanthus, or oxlip. Later came the marsh- marigolds, which in some meadows made a sheet of gold, and grew all through the ditches. Almost as showy were the dandelions. I never saw them grow so in England, and one day walked a couple of hundred THK PLAIN OF FLANDERS 155 yards off the road to see what the blaze of colour was. Then came the cuckoo-flower and the campions, and later the dirty dykes were full of white and yellow water- lilies. Near Aire and Merville there were many water- violets (Hottonia), and in July and August the meadow- sweet and the purple loose-strife were very fine. Willow- h<^rb was fairly common, but T did not see there a single plant of our beautiful rosebay. The most lovely sight of all was on the hills. One day, when riding, I came upon a patch of land which was carrying a very scanty crop of wheat, but a magni- ficent crop of red poppies, corn-flowers, nnd corn-cockle. For about a furlong it was a mass of blue and red, tinted with the purple of the corn-cockle. I have never seen, even on Swnss hills, such a blaze of colour. Birds are scarcer than with us; in winter there were few but crows, both black and grey, and magpies. The grey crows disappear in March. I did not see a single green plover. With the spring came the migrants. There were many nightingales in the little " jardin public," and every morning I heard from my room a woodpecker there. I saw several roe in the woods and there are also wild pig. Rabbits are very rare, and I missed them greatly. In the chalk hills are one or two pretty streams. I did not find them out till too late for good fishing, but it was a pleasant change on a Saturday afternoon to walk along them and throw a fly. We found a pretty little country inn, where we used to dine, and drive back in the dark. T did not know till then how far you could see a cat's eyes at night-time. The French are good fishers and keen shots. The local talent, even the boys, could catch trout better than I, and they throw a fly very well. They fish down 156 A PHYJ=;TrTAN IN FRANCE stream as a rule. The stream that I frequented was manned almost as closely as the trenches. I was not very successful, for it was my first introduction to the dry fly; but an hour or two by the side of a chalk stream is always delightful, whether you catch fish or not. The yellow mimulus grew in profusion l)y the riverside. From October to April is the close season for trout, and I was told that then even ducks and geese were forbidden to go on the streams, but apparently the law was not known to the birds themselves. Most of the fishing is preserved. The shootings are commonly let to syndicates. There was no shooting by Frenchmen in the first winter, for, as a member of a shoot said, no one wanted to shoot when his friends were away, and also it was forbidden by law. Some of our officers did a little poaching. T remember a Subaltern coming in one evening very wet, and not very cheerful. He had been shooting with his General. Someone asked how the General had managed the shoot. " Oh, very like a General !" was the reply. It did not sound like a compli- ment, but it may have been. One day a soldier came into hospital with a number of little wounds in his legs. It was thought he had been peppered by pebbles from the bursting of a shell, but he said no, and after some pressing told us the story. " You see, sir, it was this way. My mate see'd a pheasant, and he says, ' We'll have that bird.' So he takes out a cartridge, and cuts up the bullet into little bits, and puts them in on top of the rest of it. And then, sir, he hit me." There is nothing a soldier will not do. Two soldiers came in one day to a Field Amlnilance with a few wounds. As there was no fighting there, they were asked how they were wounded. It turned out that three of them had gone for a walk, and had THE PLAIN OF FLANDERS 157 amused themselves with picking up any " dud " shells they could find, and throwing them down again to see what would happen. At last something did happen. The shell exploded, blew one of them to bits, and wounded the other two. A French sportsman told me that when shooting begins the party always walk the first half of the day in line, but after that separate and shoot each for himself. He was very proud of his chiens d'arret, which were Gordon setters, trained {dresses) in England, and was eloquent on the way they worked. Roe they hunt with dogs, and shoot when at bay. Pig they drive, and shoot with ball. The woods are full of box-traps for vermin {betes puantes), weazel, stoat, and polecat. In the paths you come upon two lines of little stakes a few inches high, converging to each end of the trap, which is a double chamber with a floor that springs up like a mouse-trap when the bait is taken. Pheasants are plentiful in the woods, and partridges on the hills. There were many big coveys. The land is intersected by canals, most of which are made out of rivers. The barges are very large, and are hauled by two horses or by two or three persons, usually women. The men steer, and the freeboard at tlic locks is not more than six inches each side, if as nmch. At Arques there is an elevator lock with about forty feet of fall. A pair of enormous tanks, able to take a barge, arc hung in a cage of girders. As one goes elown the other rises. A little lower down they siphon a stream under the canal, bring it up in a siding, and then let it through sluices. In tliis way they can use it either to refill the canal when too empty, or to empty it when too full. 158 A PHi^SlGIAN IN FRANCE The flat plain is covered with villages, each of which is shaded by trees and surrounded by pastures with hedgerows. The chateau of the place is thickly enclosed with trees, for the French love shade, and need it much more than we. It usually stands a long way back from the road at the end of an avenue. There are large woods scattered over the country, but the remainder is a vast arable plain without hedge or tree, covered with wheat, oats, barley, beans, potatoes, and beetroot. The latter looks like mangold wurzel, and the same name, betterave, applies to both. There were hardly any swedes or tur- nips. The land is for the most part light, so that it can be easily ploughed with one horse; but the water-level, even in the summer, is very near the surface. The crops reach to the very edge of the little ditch that lies between them and the road, and on the land itself there is no interval between one crop and another. There is not a foot wasted throughout the great expanse. Our countryside has beauties of its own, but there is a grandeur about these unbroken miles of crops that we do not know. As in all alluvial plains, the land is extremely fertile and works easil}'. There l« hardly a stone to be seen m it. A French interpreter told me that good arable land in France is worth on a rough average about 6,000 francs the hectare (£100 an acre), grass land about 9,000 francs, and the market-gardens about St. Omer 15,000 francs. They manure more thickly than we, though the manure is not so good as ours, and in the sj^ring scatter artificial manure largely also. They hoe and weed till the crops are waist high, and use, besides ordinary hoes, a small share on a single wheel which is set just below the BUiface, and is worked by repeated shoves. It looks THE PLAIN OF FLANDERS 159 very hard work. For wide rowa, like beans, there are two or three shares. The holdings vary much in size. One farm 1 know is 750 acres ; another is 27 acres ; and others 1 saw being ploughed with a single mule or even a donkey, which must mean a very small holding. If you ask a peasant how big a farm is, he will say it has so many horses. One large farm liad sixteen or more. The land is com- monly owned by the farmer, but owners often hire other land in addition to their own. The homesteads are very large and the buildings picturesque; the barns have great tiled roofs and fine timber. The large 750 acre farm had a forge for shoeing and ironwork; a wheelwright's shop, where all the carts were made ; a motor engine for cutting the food ; and small tramways and trollies for carrying the fodder to the byres. The whole was lit by electricity. This farm employed sixty hands, but was sold because, at the present rate of wages, three francs a day, it was not profitable. In the summer the wages were nearly double that. On another I counted a row of forty people, chiefly women, hoeing day after day. The twenty-seven acre farm had a good horse, half a dozen cows, a waggon and a cart. The farmer's wife chui'ned her owd milk and kept pigs, poultry, and rabbits. Their two sons were prisoners, and she one day showed me photos of them taken in the prisoners' camp in Germany. The boys looked very well, and their imiform tidy. She told me they had been employed harvesting, had been well treated by the farm people and well fed, and had had beer to drink, which is their native tipple, and was no doubt a great consolation to them. The same day 1 was taken to aee an old weaver, eighty- lt>0 A PHYSICIAN IN FRANCE two years old and toothless, which, with the addition of a patois, made him ditticult to understand; but he was as merry as a grig, and worked away at his handloom all day. He had been in the Crimea. He also taught me how to make a weaver's knot. The churning is sometimes done by a wheel outside the house, worked by a dog, and the threshing is often done by a horse treadmill. The dog can stop when he likes, but the horse cannot, and it is, I believe, very hard work. They still use the flail here and there. An old fellow who was using one declared thaVit spoilt the straw much less than a machine. The larger farmers cut with machines, always American or Canadian, and there are a good many reapers and binders in use. But the smaller people cut with tools that we do not use. They hold in the right hand a short scythe {faucille) with which they chop the stalks and in the left a hook with which they gather them together into bundles, which the women bind. It is a long job, but they can cut closer with this, they say, than with a reaper. They roughed up the land directly after clearing the corn, and even between the lines of shocks while th( 7 were still on the ground. I believe the Government in the autumn of 1914 ordered as much corn as po.SHil)le to be sown. There was much less beetroot on the ground in 1915 than the winter before. The beet is a great crop here, and there are sugar and alcohol factories everywhere. The refuse runs into tanks, where it smells abominably; but tlic French nose is less dainty than the English, and wealthy manufac- turers live happy in the smell of their factories. The pulp is used for feeding cattle. It has very little nourish- ment left in it, but the farmers store it in what we call THE PLAIN OF FLANDERS ir.l pie8, heaps half aimk below the level and covered wit-h earth, or in ailos, until it solidifies and cuts like a cheese I saw silos which were troughs about six feet deep, lined with brick and drained at the bottom. The owner ■told me he had the pattern from Magdeburg. This stuff is mixed with the other fodder, mainly to increase the bulk, and cattle are fond of it. In the winter the cattle are in the byres, but they are turned out in the spring. Tlie milk sold in St. Omer was brought in glass litre bottles, and several milk carts advertised lail hi/gi Unique or la it tuherculim. One day in the spring, an English General went round to inspect some of his command v.ho were billeted in a big farm. He found one of his men in possession of a big stick, which he had taken from the farm labourer. The soldier showed the General a couple of young beasts which had been very brutally knocked about. Their heads were tied to a foreleg, and the farm hand had then deliberately set to work to beat them on the head. The farmer's wife, who was a pleasant little woman and well educated, said that it was customary to treat them so when sending them to the butcher, in order to prevent them from being dangerous. They are fatted under cover, and are taken out for the first time when they are goinor to be killed. It is an exception, for the people are kind to animals as a rule. Sheep are no part of the ordinary stock of a farm. They are a lean and nomad race, wandering over the country \vith their owner, browsing on fallows, com- mons, and roadsides. The shepherd wears a very large sheepskin coat and a wide-brimme*! hat. He carries a long staff, against which he usually leans. He has with him three sharp-nosed, prick-eared dogs, IL 162 A PHYSICIAN IN FRANCE like small wolves, but usually short-tailed, and a fourth on a chain. The dogs do not sit or lie, but run con- tinually, like curst spirits, up and down the edges of the fallow on which the sheep are, to keep them from the neighbouring crop. The sheep are so accustomed to pack that even when they are turned into a field they remain in a mass, each eating behind the other and, judging by appearances, eating very little. A shepherd to whom I talked told me his flock was 103 in number, that he usually took them home at night to a little farm he had, and that the pasturage was free. His wife and son worked the farm, and, as he did not bring the sheep out till eleven, he was able to do some work himself aleo. I fancy he thought the life of contemplation was the better part. Some of the rams come from England. We used to shun gicjot haricots, which was served about twice a week at our very inferior inn. Worse mutton I never tasted. " The hungry sheep look up and are not fed " was always in my mind when I saw a flock by the roadside. They have a good stamp of farm-horse hereabouts. He is the horse who appears in pictures of battles or processions in the fifteenth and sixteenth centuries. He has a good head, with a small muzzle and a large eye, and carries it well; high wathers, a short back, and rounded quarters. The legs are clean and longer than those of our cart-horses. He is spirited, but gentle. I have seen plenty of boys of six or seven driving or leading them. If you put a knight in armour on his back he would be the old war-horse of tlie days of chivalry. Writers often mention Flanders mares. But the mare was never ridden by a knight, and one part of the ceremony of degrading a knight who had disgraced his order was to mount him on a mare. These horses THE PLAIN OF FLANDERS 163 work very hard, and are well treated. The carts and waggona are primitive. They have no shafts, and the horse is a long way from his work. The carts are often three- wheeled. The carter holds a single rope rein, which is fastened to the middle of a bridle. He cannot, there- fore, guide the horse by pulling one rein or the other. But the horses are trained to signal. Several short jerks turn him to the off, a single pull turns him to the near side. This, at least, is what ought to happen. What actually happens is that when the driver begins to jab at his mouth, the horse throws up his head, and for a time will do nothing. If he is trotting he stops. It takes about five minutes to get a horse to his own side enough to let a car get by. The natural result is that not a horse in the country has a mouth. They will allow their necks to be bent double before fchey will obey the rein when reins are used. A two-wheel hooded cart is both for rich and poor the common driving vehicle. They are drawn by weedy little ponies, who look half-starved. Mules are common, and donkeys. Some of the donkeys are the smallest I ever saw. I have more than once seen an old woman ploughing with one donkey. The furrow was only three inches deep, but the ground is so rich and light that I suppose it was enough. Last of all draught boasts comes the dog. The bakers' barrows all have a dog underneath them. 1 did not see any with carta such as I remember drawn by dogs in Brussels many years ago; liut 1 often met an old man or woman seated in a little cart the size of a wheel- barrow, drawn by a dog or two. A dog is the most willing beast of burden there is. I remember long ago a witty old Frenchman declaiming against the unemploy' ment of dogs on the ground that it deprived the dogs 164 A PHYSICIAN IN FEANCE of a great pleasure. " Look at the deliglit of the dog," he said, " when you give him something to do, your stick or a basket to carry. Look at the pleasure which sheep-dogs and sporting dogs take in their work. Now the dog has become a melancholy animal, and melan- choly lays him open to still more serious nervous ail- ments. Croyez-7noi, cher Monsieur, le desoeuvrenierU tienl a la rage." But I would not be some of these dogs for a good deal. They are sometimes very badly treated. Every little rise has a group of houses or a village on it, eager to keep its feet dry, and there are one or two sharp little hills. Cassel Hill stands, I suppose, about three hundred feet from the plain, and rises steeply. The touii looks very well on it, and there is a fine church and one or two other buildings which stand out well. It is not, of course, to be compared with Jodhpur or Perugia, which are about the same size, though Perugia is much higher. But India and Italy have the most beautiful architecture in the world, and in this country we are thankful for small mercies. There is something very pleasant about the country towns. Though the streets are narrow, there are large market-places. In St. Omer, every Saturday both the Grande Place and the small Place Victor Hugo were crowded with comitry people and their wares. Volaille^, ceufs frais, and ceiifs conserves had their allotted place? in the latter, and the former was full of vegetables and stalls for cotton goods, with a corner under the Town Hall for flowers. There are fine old houses in the towns, with large and pretty rooms; but, as with our country towns, their g\ory is departed. There are some liandsome old brick churches, with Komanesque arcading on the towers and decorated THE PLAIN OF FLANDERS 165 Gothic elsewhere. At Bailleul, which has been burnt four several times, the cliurch has, in addition, a Palla- dian portico. The interiors are not as a rule interest- ing. There are not the old fonts, or fine capitals, or curious little relics of antiquity which give nearly every parish church in England an interest. They have a great deal of heavy wood-carving about the pulpit and organ- loft, and the chancel is, in the larger places, often rich with marble work of the seventeenth or eighteenth century. They are hung with pictures and banners. But the Cathedral at St. Omer is a fine building both inside and out, and has many beautiful things about it. There are some curious old pavements in the aide-chapels, of which I have not seen the like. The services were well attended, though chiefly by women, and at Vespers one evening they sang an Ora pro nobis of quite haimting beauty. I am not musician enough to know why I hate English hymns, but I do. There was a little Irish soldier in front of me who knew his way in the service, which I did not, and I wondered how he compared it vdih his little parish church in Connaught. In Bailleul there is a good museum. A certain " Greffier," or Town Clerk, who died in 1859, had a passion fur collecting, and when he died left his house and its contents to the town. His office brouglit him in contact with every inhabitant, and he bought wood- carving, furniture, delft, faience, stoneware, china, marqueterie, pictures, lace, coins, tapestry, playing- cards, fossils, and stuffed animals — ** a pretty coming-iu for one man." He bequeathed money also to found a drawing-school, aud Bailleul has had several Prix do Rome. Poor Bailleul ! It has been utterly destroyed since these words were written, it was a pretty little town . It 166 A PHYSICIAN FN FRANCE is said to iiave been the original home of the Balliol family; Bethune is probably connected with the Scotch family of that name, and I suppose I must have come from this part too, for there is one village called Heuring- hem, and another called Eringhem, in the neighbourhood. Chaucer's Sir Topas was a native of Poperinghe, and we had a great deal of intercourse with this country when it was under the Dukes of Burgundy. The old chateaux are pleasant white houses with slate roofs set among large trees, with a great farmyard and buildings attached to them. There is a beautiful one at Vandomme, near Fruges, of great size, built, I should think, 150 years ago. But the modern chateau of the wealthy paper manufacturer or distiller, of red brick, white stone, and encaustic tiles, is remarkably ugly. Windmills are a great feature of the country. They are dotted all over it. On the hill of Cassel there are seven. Most of them are of wood, but some are circular and built of stone. I went over one of the stone mills. Except the outer wall every bit of it, hood and machinery, was of wood. Its owner told me it was 300 years old, and I was shown a wooden mill which was said to date from the fourteenth century. The miller fetches the corn, grinds it, takes a tithe for his labour, and delivers the rest to the farmer. We found that some of them were used to signal to the enemy. The mining villages and the outskirts of the towns are squalid, mean places, full of slatterns and dirty children who are a great contrast to the people on the land. We complain of the number of public-houses in England. But here every other house is an " esta- minet." This is a word used in North France for a drink-shop, and was at once called " just a minute '* THE PLAIN OF FLANDERS 167 by our soldiers. I so seldom saw a drunken man that I began to think there was safety in numbers. But a French friend who knew England well told me that drinking was worse here than mth us, and the absence of drunkenness now was due to the absence of men. Anyone can set up a diink-shop, and, if he is not for- bidden by the authorities within three months, he obtains a permanent right. In the mining villages the estaminet-keeper is often a discharged and discontented miner, who gets the working-men into his debt, keeps them there, and foments strikes. The mining popula- tion contains men of every nation, and is very rough and lawless. The agricultural population is quite different. It is a land of plenty and of unremitting toil. The people work early and late. In harvest-time they begin about five and go on till it is dark, taking a meal out of doors in the forenoon and about five o'clock, but going home to feed themselves and the horses at mid-day. The women work as hard as the men and know as much about it. I saw many a woman ploughing with two horses, and they carried on the whole farming business while the husbands were away in the Army. The harvest was got in with astonishing speed and success, yet there was not a man on the land between the ages of eighteen and forty-five. The women did not often reap, but they bound, they shocked the corn, they loaded the carts, they helped on the stack, and they worked at the threshing. T wondered how many women in England would load a great waggon with twelve foot of corn on it, herself on the top, cord it, and then come down the cord like a boy, and drive the waggon into the farmyard. There is nothing to beat a Frenchwoman. If we had the system of small ownership that the 168 A PHYSICIAN' IN FRANCE Freucli have, 1 would pay the price that they pay, by Protection, for a country population such as this. These people could not live under Free Trade in corn, but they are a great strength to the State. Though the flat country is only just above the water- level, and the chalk hills should be good water-bearera, the supply of water is deficient. In summer the wells often give out, and in Boulogne during November the pressure was so low that the water did not rise to the second floor. The eflect upon the sanitary appliances can be imagined. The cool and rainy summer of 1915 was a godsend to the Army on account both of the water and of the flies. The flies would have been terrible in a drought. They were bad enough as it was. There is, I fancy, an impermeable stratum below the light alluvial upper soil. At one of the Field Ambu- lances they found, in digging a well, about six feet of light soil, then a very stiff clay, and then a comparatively loose layer holding a lot of water. We lived a year and a half at St. Omer, and w^e had many interesting visitors in our little sitting-room at the inn. Admiral Bacon came out with the first 15-inch howitzer built after his own design. He was disguised as a Colonel for the emergency. Colonel Fairholme, who knows all the countries of Europe, described to us one evening the Balkan nations and their armies. Colonel Lewis, of the Lewis gun, who, like most inventors of murderous instruments, is of unusually gentle de- meanour, told us of his work in Belgium and then in England. We had, too, Mr. Robert Bacon, who had been American Ambassador in Paris, and had stayed there throughout the German advance, giving every possible assistance in bringing in the wounded and taking up necessaries. He had begged to be allowed to do THE PLAIN OF FL.VNDERS 169 some work, however unimportant., in order to show an American's sympathy with our cause, and he was attached to our Red Cross. To him and to my other American friends the first two years of neutrality were a source of grief and indignation. His recent death enables me to say without otience that he was one of the greatest gentlemen I have ever met. You could not think meanly when he was in the room. Another American of whom we saw a good deal was Mr. Theodore Marburg, who had been Minister in Brussels and had a great esteem for the King and Queen of the Belgians. He came over to be with his son who lost a leg in our Flying Corps. He was keenly interested in the project for a League of Nations, which was then in its infancy. General Surtees, too, who had shot all over Gallipoli, and knew curious stories of the Turkish capital, visited us, and so did Colonel Swinton, who was then " the Eye- Witness," and was one of the inventors of the Tanks. Natural Science was represented by the Ento- mological Committee, who came out to devise means to prevent the increase of flies, which are dangerous to an army, since they carry infection everywhere with them; Literature by Mr. John Buchan; and Art by Mr. 8. J. Solomon, full of schemes for " camouflage,'* which afterwards took a very useful shape. These and many others gave us other things to think aljuut than wounds and disease. CHAPTER XVII OUR HOME AT HESDIN It is a mistake to suppose that all French inns are clean, and all French cooking good. At St. Omer we lived in one which, though the best that we could find, was alike in its table and its smells nothing less than abomin- able. When in the spring of 1916 G.H.Q. migrated to the south, we determined to better ourselves. The Second Echelon, to which we belonged, was to be located at Hesdin, and we drove down to prospect a little while before the move. The Mayor of Marconne, a little village just outside the town, gave us one or two addresses — 1 think of his political opponents — and we ultimately struck a bargain with Madame X., in whose house we lived for the next three years. It was a long white, two-storied house, fronting on the road from Hesdin to St. Pol. In front of it was a row of horse-chestnuts, and across the road a market-garden. Behind the house was its own large garden, or rather three gardens, of the old-fashioned kind, with box edging along the walks, backed by clumps of hardy flowers, behind which were a line of espalier or pyramid fruit-trees, and then the vegetables. The fruit-trees were extremely old and gnarled. St. Theresa says that her confessor, St. Juan de la Cruz, was like the roots of old trees. These fruit- trees of ours were like St. Juan de la Cruz. The garden contained two springs, two ponds, a wide water- 170 OUR HOME AT HESDIN 171 channel, a plantation of tall poplars at the farther end, and many pretty foliage trees and one or two large planes in other parts of it. Primroses and polyanthus were in full bloom when we arrived in April, and there was also a greenhouse which was Madame 's delight. We had two excellent bedrooms, but our chief delight was our sitting-room, which was a large library lined on three sides with books. Monsieur X., who was bedridden when we went there, and died that autumn, had been, like his father and grandfather, the chief la\v}'er of Hesdin. One member of a former generation had been an officer in the Grande ^Vrmee, and the shelves held an interesting collection of histories and memoirs of the Napoleonic period. It included Thiers' great work, which for style and composition is, I think, the best history I have ever read. It is really a great tragic trilogy of which the hero is Napoleon. In the " Revolution '' the scene is set, and in inexorable sequence the Gods destroy the Monarchy for its corruption, the Gironde for its weak- ness, and the Montagne for its crimes. Danton is the Ajax of the piece, and then, when the country is plunged in the utter ruin which its madness has deserved, the 18th Vendemiaire breaks and Napoleon initiates a new era. The Directoire is his period of Wander-jahre and apprenticeship. While the Directors are feebly govern- ing at home, he is making his first great success in Italy and his first great failure in Rgypt. Then he suddenly reappears for the 18th Brumaire, and begins as First Consul the noblest part of his life. After he has saved France from her own hands and from the hands of her enemies, he reforms her finances, develops her resources, settles her religious difliculties by the Concordat, gives 172 A PHYSICIAN IN FRANCE her li uew and woitliier peerage in the Legion d' Honneur, organizes her education, and codifies her law. Mean- while he has passed the Alps in winter, won Marengo, forced the Treaty of Luneville on Austria and that of Amiens on England, and the country hails him Consul for life. To this moment sympathy is strong for Napoleon. His wonderful genius and his still more wonderful labour have been devoted to his country, and we feel that in giving him the Consul's chair for life she has only rendered him his due. Yet even at this time the symp- toms of the great crime, vyS/ats, the Greek form of the unforgivable sin, when the hero, blinded by his own success, ceases to give the Gods the glory and ascribes it to himself, begin to appear in Napoleon, and almost immediately after the culmination of his triumph comes, first the angry rupture of the peace, and then, like an awful clap of thunder, the seizui'e of the Due d'Enghien, the gloom of the midnight trial, ruled in Thiers' account by the dark figure of Savary, though Savary himself denies it, and the morning's tragedy. The scene closes in the \nld uproar of the European Courts, while the reader recalls the innumerable murders and cruelties which they who condemn Napoleon have themselves committed, or complacently seen others commit, in the days gone by. Lastly comes the Gdtterddmmeriim/ of the P^mpire. Greater and more glorious grows the hero's fame, vaster and more splendid his victories, but all the while the seeds of ruin are being sown, the items of his guilt are being entered in the dread book; he is warned, but shuts his ears; he is threatened, but defies the Gods, until the retreat from Moscow and the long-drawn agony of the last war in Germany send him, a broken OLTR HOME AT HKSDTN 173 man, to the lonely rock where the vulture will gnaw hi3 liver. Thiers made his history centre on Napoleon's life, and he was right, for it was the truth. On that one man and on the strength and weakness of his character rested the history of the world. Each time Napoleon loses his temper you hold your breath to watch the result upon the farthest shores of Europe; each time he meets treachery by force and force by treachery you think of the harvest of hatred and distrust that he is heaping up. Each time he forges another link in the chain that is to strangle England's commerce you feel that he is creating an instrument so great and so ill welded that it must crush him in its fall. And yet, seeing this Titan, greatest of men, beset by the duplicity of some Courts, by the cowardice of others, and by the remorseless tyranny which lay at the bottom of all, you cannot help hoping to the last that he may conquer, may conquer both himself and them, and in a fresh spirit of humility set the world free, as he alone could. The Greek tragedians had no such hero as Napoleon. Perhaps we never in the history of the world have had such an one, or shall have such another. Mr. T lardy, in " The Dynasts," has given us a rendering of the story worthy of iEschylus; it is M. Thiers' great glory that he has succeeded by his wonderful prose in produc- ing an effect to the full as sublime. His chorus, the passages in which he comments on the action of the play, are of great dignity, and the final passage in which he sums up the verdict is of the noblest elevation. In truth Napoleon " etait par son genie fait pour la France comme la France 6tait fait pour lui," and no one can fully comprehend France or Frenchmen unless they 174 A PHYSICIAN IN FRANCE know the story of the greatest Frenchman, perhaps the greatest man, that ever lived. It is common to asiTibe to Napoleon a great knowledge of men. I think, on the contrary, that he was ignorant of almost all sides of human nature but the outside. He fell because he had not the least conception of politics, either internal or foreign, and he was deserted because he had no friends. But he was a great student and master of eilect. No man was ao beloved by an army as he, or ao much applauded by a crowd. He was a simpleton in social life, but a magnificent public figure. But there was much old history on our shelves of times before Napoleon, and many books of other kinds. The family were strong Catholics, and IVIonsieur X. had been a Legitimist all his life. There were therefore Bossuet and Fenelon and Chateaubriand and many minor prophets. Literature was not well represented, but the four finest books of France were there — La Fontaine, and " Gil Bias," and Montaigne, and the beautiful " Chanson de Roland." The books were in terrible disorder, and my first step was to arrange them on the shelves, my next to read as many as I could. We had bargained with ]\Iadame that we should be fed. She said Marie was rather '* frou-frou," but that she thought she could persuade her. She turned out to be an excellent creature — stout, red-haired, ungainly, and rather dirty, but as honest as the day and quite a fair cook. She was getting sixty francs a month, and we, of course, made ourselves acceptable by adding a little to her wages. I can always get on \vith a cook, because I am of a greedy disposition, and cooks like to be appreciated. Madame reminded me so much of my own mother that she went to my heart at once. She w\as a thin. OUR HOME AT HESDIN 175 grey-haired lady of seventy-eight with brisk habits and a humorous and incisive tongue. She loved trotting about her beautiful garden and pottering in the green- house, but she was very unhappy over the neglect which the want of labour had brought upon it. " Quelle misere V Marie had been with her seventeen years, and will certainly stay till one of them dies;* but, as often happens in such cases, they could neither do with each other nor without. When IMadame was irritable, which was not infrequent, the scenes in the kitchen were livelv, for Marie was rather " criarde " herself. Nor was the old lady very sympathetic with misfortune. Marie one day, gathering watercresses, fell into the pond and was nearly drowned. She had all the house-money in her pocket, and when she came in dripping wet she proceeded to dry the notes by putting them in the oven, which, it must be allowed, was a foolish proceed- ing. They were rescued, but the vials of Madame 's wTath were poured upon her red head for a considerable apace of time. Madame afterwards told me the whole story in the garden as she alone could tell it, and at the end she wound up, " Et 9a lui a gueri son nial aux dents, la sotte." Madame was very devout, and, in spite of having actually had eighteen children, very naive, and one of her daughters, who was neither, and I used, I am sorry to say, to tease her unmercifully. She was one of those people whom you cannot help teasing, and she not only enjoyed it, but was quite as ready with her tongue as the two of us put together. The Bible is not with the French the standard religious ])ook that it is with us, and they read it very little. I one day found Maduine reading the story of Ilerodias, and slie appealed to * I had forgotten love. Mario is about to murry. 176 A PHYSICIAN IN FRANCE me to explain the relationship of the family. T said: "Surely you have read it often before?" "No," she said, " I never have. A long time ago I began to read the Bible, but there were things in it which scandalized me, and my confessor told me that if I felt that I had better not read it." Lives of Saints, which are usually very poor productions, and sermons or meditations take its place. Madame never could remember my Christian name, and I was " Sir Kilian " for a fortnight after she had been reading that good man's life. She was very ill in the winter of 1918, and I feared she would die; but she recovered, and my attendance upon her in the end cemented our friendship, though it strained it a little at the time. She had been very naughty — there is no other word for it— during her illness, and I had lectured her so severely that I dared not present myself in her sitting-room when she came downstairs again. But she wrote me a charming note in her rather shaky hand, and, while maintaining that she had a perfect right if she liked to get out of bed in the middle of the night, sing hymns, and disturb the household, desired that we should resume our old terms. When I left I went in to say good-bye, and kissed her hand, as I always did on state occasions. She said: " Sans doute en Angleterre on ne s'embrasse pas." I stoutly denied the imputation, and we kissed aJlec- tionately, after which she added: " A notre age. General, il n'y a pas de danger, mais qa, fait plaisir tout de m§me." She was a difficult old lady, but a dear. We are still correspondents. There is a great deal of family pride in the provinces. Madame herself came of a very old name, and one of her great-unclea had been Governor of Artois under Louis XVI. She gave me a medal struck by him. The OUR HOME AT ilESDIN 177 Abbe Prevoat, the author of " Manon Leacaut " and of the " Doyen de Killerine," waa of her husband's family, but though the " Doyen de Killerine " was on the shelves, " Manon " was not, and I fancy the Abbe was not looked upon as a credit to the family, for Monsieur X. had been very rigid in his views. Near by waa living with her unmarried daughter an old lady whose married son had a house in the next village. Their ancestor had been King-at-Arms to the Duke of Bur- gundy, and the son, who was fond of history and had published a volume of his family records, showed me an account written by this ancestor of the " Joyeuso Entree " of Henry VI. into Paris. Their family had sufiered severely in the Revolution at Ai-ras under the cruelty of the renegade cure Lebon, and they still re- tained, as, indeed, do many people in the country, the feelings of horror and hatred which those years evoked. There is a great deal of prestige attaching to descent, and it counts for much in matrimonial all'airs. But it has its bad side. A lady, hearing a friend of her hus- band's complain of poverty, asked him why he did not obtain some position. He replied: " Si on s'appelle de M. on ne travaille pas." Such men do not even go into the Army. They live by picking up a rich wife. That ia not an uncommon industry in any country, but it is rifer in France than in most. On the other hand, many members of this class become professional soldiers, and some did very well in this war. The Due de Rohan, who before hia death won a name for romantic bravery, represented one of what were tli<3 three greatest families of France, and there were others like him. Yet the French wore bitter about the " embusquea," and undoubtedly ascribed their position of security to the influence of either birth or fortune. 12 178 A PHYSICIAN IN FRANCE Euglish people are always curious about marriage in France, where marriage for love is much less common and family arrangement much more common than with U3. Most observers allow that there is not much dif- ference in the results. There are plenty of unhappy marriages everywhere, and those that are happy depend much less on the love with which they start than on the good sense and good temper with which they are carried on. When a French girl comes back from the convent in which she has been educated she finds life at home so dull and so restrained that she marries quite as much to escape from it as for any other reason. A French- woman's life begins with her marriage, an English- woman's oft«n ends with it. Some marriages are very businesslike. The cure, knowing that one of his parishioners is ratlier bored at home, tells her that he knows of someone " qui fera votre affaire,'' or some family friend suggests that young So-and-so is eligible, or there is a distant cousin already provided. There is no question of coercion, as in the old days. In one case which I know a girl was told by her parents that three men had proposed for her, and the choice was left to her. She chose the wrong one — girls usually do — and her father felt so strongly about it that he made her sign a statement that she married against his wishes. But he did not prevent the marriage, though the result entirely justified his opinion. The position of married women's property is not quite the same as with us. There is no such thing, they tell me, as a marriage settlement under trustees for the benefit of the children. When I explained it, my French friends thought it an excellent plan. There is a possi- bility of the State acting as trustee, but it seems seldom usprl. and T could learn nothing about it. If no other OUR HOME AT HESDIN 179 steps are taken the husband has entire control of his wife's property. If he dies she can recover her " dot " from his estate if he leaves enough to cover it, but if he does not, she has no redress. But there is a simple safeguard which may be adopted. If a deed of '' separa- tion de corps et de biens " is executed, the husband cannot touch the wife's property, and it remains com- pletely under her control. This deed in no way inter- feres with married life, and many marriages are begun on those terms. It, however, leaves the \vife open to the influence of the husband, and does not protect the interests of the children so fully as our custom. After the husband's death the widow is entitled to half the income. There is a cei"tain restriction in the freedom of testament. As far as I could gather the property at the time of marriage was considered a family possession, and of this the father can only leave a small proportion according to his own wish. The rest is divided equally between the children. But as I under- stand it, if a cluld, by getting his debts paid, anticipates his share, he is debited with that amomit when the property is divided. If the father increases his fortune after marriage, he seems to have more testamentary freedom over the additional amount. The mother'^* fortune, I suppose if accruing to her after marriage, is smiilarly at her own disposal, and she can leave it to whom she will, or at any rate to whom she will of her children. j\ly informants were not lawyers, so that I do not profess to give a full legal account of the case. We hear of the patriarchal life of French families, and of several generations living together under the sway of the elders. 1 saw nothing of that kind, and though the family home was the natural refuge for the two daughters whu had lost their own, Madame held the opinion 180 A PHYSICIAN IN FRANCE strongly that a married daughter should have her ovvn establishment, and that the other was a bad plan. French provincial life was no doubt much restricted during the war, but it struck me as much duller than our own. There was little of our out-of-door life, and no games. Nor was there the same public activity as with us. My relations in P]ngland were every one of them hard at work all the time. Some of them had hospitals in their houses, others were managing allowances for dependants, and others, again, had volunteered — I am thinking of the women — for service on the land or in one of the women's corps. None of the people I knew in the country were doing anything of the kind except one of Madame's daughters, who went every other day to do some work in a hospital. Some of them read a good deal, and they did a good deal of needlework* but their chief occupation was conversation. Of that the French never tii'o. It is a natural gift with them, and it is improved and cultivated to the highest pitch. They expect not only that each member of the company should contribute ideas, but even more that they should be well expressed. In consequence their talk is far better turned and more pointed than ours. It is great nonsense to say that they chatter. On the contrary, though they talk continuously, they talk well. They may be ignorant or prejudiced, and in con- sequence may say things that are unreasonable, but they put their points clearly and forcibly nevertheless. My friends were together all day long, yet I never knew them at a loss for conversation. My room was over their parlour; as soon as they began to assemble talking began, and I never heard it cease. My friend in Paris, on the other hand, did a great deal of public work. She was on committees for refugees OUE HOME AT ITESDTX 181 which took a great deal of time, and her letters to me were generally written when she was on night duty in a hospital. But town life is everywhere different from country life. Though St. Omer was dull, the maiui- facturing towns, such as Lille, were very lively and sociable, and Paris is different from all other towns and from all the rest of France. The French are great connoisseurs in wine. Our officers used to suffer a good deal at hospitable tables from the number of different wines they had to driulc. I found in the library a book called " De I'Art de Boire les Vins,'' and the following is a section headed *' Strategie d'un Ctrand Diner." It begins : " Savoir boire le vin n'est donne qu'a un gourmet exerce ; savoir le faire boire a ses convives n'appartient qu'a un maitre de maison d'un tact exquis, et d'un gout eclaire. " L'oeil doit etre tout d'abord flattc par la mise en 3C(^ne de la table. L'eclat du linge blanc, de Targenterie, et des cristaux, doit etre agreal)lement releve par des fleura habilement choisies comme une combinaison d 'harmonic et de ton. " Devant chaque convive six ou sept verres doivent etre ranges en bataille. " Le grand verre ordinaire. " Le verre a madAre. " Le verre a bordeaux. " Le verre a bourgogne. " Le verre a grands vius. " Le verre a vin du Khin. " Le verre ou la coupe a Champafjne." Burgundy is to be at the temperature of the cellars, bordeaux at that of the dining-room, champagne frappe. 182 A PHYSICIAN IN FRANCE The order is from the more (eniperes to the more fvmeux or more fmrfumes. With tlie soup madeira or dry slierrv, with tlie oysters, or Iiors (Vanivres, tlie ])est white wines of (Jraves. Barsac, Sauternes, Chablis, Meursaiilt, or ^lontrachet. " All premier service les grands ordinaires et bour- geois du Medoc pleins de moelleux et de corps a la robe purpurine au bouquet parfume. Au roti les vins corses et capiteux de St. Emilion ou de la Bourgogue. Puis enfin les grands crus de Bordeaux, de Bourgogne, et des cotes du Rhone. Aux entremets les grands vins blancs de France et le vin du Rhin. A la fin du repas champagne frappe des meilleures marques, les vins de liqueurs. " Le maitre d'hotel charge de verser les vins aura soin de prononcer distinctement le nom de chaque cru propose au convive." CHAPTER XVTTT EDUCATION IN FRANCE AND THE RELIGIOUS QUESTION T DO not know how else to head this chapter, but I should explain that it is nothing but a set of notes taken from what I heard in conversation with French friends. It has no claim whatever to be an authoritative account, and it may contain many mistakes. It is, however, what I was told. Among the Catholics the boys are usually educated at Jesuit colleges, some of which are specially for younger boys, while others take them at all ages up to eighteen. One little boy of fourteen told me of his daily lifo at school in Paris. They got up at 5.30 a.m. winter ami summer, worked from 6.30 to 8 o'clock, and at 8 had soup, their first food. They worked again from 9 till 12, when they had dinner, consisting ot soup, meat, vegetables, and 100 grammes (3J ounces) of bread. They worked again from 2 till 4.30, when they again had 100 grammef^ of dry bread. They worked again from 5 till 7, and at 7.30 had supper of soup and 100 grammes of bread. This boy had some meat or fish at supper, for which his relations paid extra. They had no milk, butter, cheese, pudding, tea, coffee, or chocolate, and the boy looked much underfed. It must be remem- bered, however, that this was during the war. I wrot-e to a great friend of mine in Paris, the wife of a professor, in high indignation. She repudiated the atory, but 183 184 A PHYSICIAN IN FRANCE Madame and all tlie family assured me that it was true, 'riic boy was a grandson, and was staying with her for the holidays. Tlie education of a boy at a Jesuit college in the North of France costs, or cost before the war, £70 or £80 a year for board, residence, and education. There is nothing wliatever of the freedom and very little of the open-air life and exercise which is the regular custom in English schools. I do not think the boys enjoy their school life. One young fellow said that he had rather serve six months more in the trenches than go back to school for three. At the age of eighteen the boys go up for their hacca- lavreat, which is a school-leaving certificate examination held by the Universities. Lately the Government have refused to allow Ijoys to present themselves for it from the Jesuit colleges, and have permitted only those educated at State lycees to go up. This rule is to a slight extent evaded, but it is a severe penalty on the colleges, as tlie haccalaureat opens the doors not only of the University, but of other careers. For instance, a boy with the haccalaureat gets into an Army school for ofllicers on much easier terms than one without it. There is nothing in France like the University life of Oxford and Cambridge, or even like the life of our newer Universities. No one goes to a University except to enter one of the learned professions, and the life is one of strenuous application, unrelieved by our open- air recreations. The only thing that in any way supplies the place of this side of the life of a young Englishman is the military service of a Frenchman. That is a very dilTerent life, and a very hard one. But it has its good points both for the boy and for the country. My friend in PtTris, who belongs of course, to the University circles, EDUCATION IN FKANCE 185 spoke to me before the war of the hardship that service was to young men who intended to follow learned careers. It stopped their work, it stupefied their minds, and it returned them to civil life less intelligent than when they left it. But during the war I wTote to her about our Compulsorj^ Service Act, and her reply is so interesting that I quote it. " Ce que vous me disiez de TAngleterre nous a vive- ment interesse mon mari et moi. A I'heure actuelle tant de liens nous unissent qu'il est curieux de con- stater que nous nous connaissons, que nous nous com- prenons si pen. Je crois qu'^ la base il y a une difference totale, radicale, d'education et de principes, mais je suis contente pour votre pays que vous fassiez I'ex- perience du service obligatoire avec tout ce que cela comporte. Ici en France les esprits avances en ont dit beaucoup de mal. II n fallu cette guerre pour que nous comprenions qu'a la caserne beaucoup plus qu'a I'ecole s'etait faite cette profonde imion nationale que nous surprend nous-memes. C'est la que les classes sociales se sont unies, connues, penetrees, brassees. Je ne crois pas que les individus y aient perdu. En tout cas la collectivite y a beaucoup gagne. " Je crois bien que tout cela repugne a Tesprit anglais, mais il me semble que votre peuple, vos basses classes, sans aucun contact d'aucune sorte avec les classes cultivees ont moins de chance de s'elever. La caserne fait le rapprochement force, et vraiment nous en voyons en ce moment les excel lents resultats. C'est une sorte de fierte chez beaucoup de nos enfants que de rester simple soldat, et il a fallu dix-neuf mois de campagne, et un changement d'armes qu'ils avaient sollicite, pour qu'un do mos fils 8oit nommc caporal. Encore s'excuse- t-il presque." 186 A PHYSICIAN IN FEANCE In other letters she told me of the excellent effect that the campaign had had upon the health of both her sons. One of them was afterwards recalled to work at the mathematical proljlems of some novel form of gnn, and was kept in Paris, to his great annoyance, till the ^ork was finished, when he hurried back to the front. The younger of the two, who had been in England for a year, declares that no book is fit for the trenches but Shakespeare. Certainly the war made a great many people read poetry. After all, it is the aristocracy of literature. The mixture of classes in the French Army leads to greater freedom of intercourse between the ranks than there is with us. One of Madame 's grandsons was a bombardier. He did not think it strange that he should occasionally dine at his officers' mess. He happened to be quartered in a village where was a certain General who was his next-door neighbour at home. The General told him that if he wanted a little quiet he might come into his office and smoke a cigar. He was sitting there one day when an officer came in on business. He, of course, left the room, but the officer, somewhat surprised, asked the General who he was. When he heard he was a personal friend he said: " Well, I gave him twopence yesterday for holding my horse, and told him to get a drink {aUer hoire une cJiope)." We asked the young man what he did uath the twopence. He said : ** I had my drink, and was very glad to get it." This freedom, however, leads to some consequences which are not altogether to the advantage of the French Army, as most soldiers who have been next them will tell you. In all armies there was a great loss of officers, and I suppose in all the difficulty of getting good officers was EDUCATION IN FINANCE 187 very great. We had a wounded German who told us that his company commander was a hairdresser. Another, a Prussian, explaining the surrender of his battalion, said: " They ])ut us under Bavarian officers, Bavarian Reserve officers, and of course we would not stand that/* In the French ranks there was a good deal of feeling against incompetent officers, but the stories I heard were, I daresay, exceptional, and in any case are better not repeated. Before the war a Frenchman got his commission either by going through an Army school at the beginning of his career, or by going through the ranks, getting his stripes, and then gaining entry to an Army school by passing an examination. I had been under the impression that this was a common path. But a French interpreter who had been a sergeant, told me that the examination was so hard that few except well-educated men could pass it. He himself had failed thrice, and then gave it up and became a fencing-master. French girls of Catholic families are educated in convents, and like both the convent life and the sisters. But though the latter are devoted and kindly, the girls recognize that they have no knowledge of the world, and are poor guides for conduct. The education is again much in the hands of the Jesuits, and they interfere in details that we should think to be outside their pro- vince. A lady whom I knew was asked in confession, when a girl at school, by her 'ph'e Jesuite liow she waslied herself, and was forbidden to wash in the ordinary way any part, of her body except her face, neck, and hands, lest it should lead her thoughts astray. I believe the rest of the body might be washed under some kind of bathing-robe if desired. It is difficult to believe that a 188 A PHYSICIAN IN FRANCE man could be so stupid and so prurient as to give such orders. In " my " family the girls as they came home from school were by their father's orders at once put through a full course of house management and cooking, under the chef whom they then kept. Each girl in turn went into the kitchen. She had to get up in time to prepare her parents' breakfast at 8 o'clock, and she had to help to cook the midday and evening meals. The chef was given a day or two of holiday in order to test the girl's progress, and she was not released imtil she could single- handed send in a complete dinner to the approval of her father, who, it may be added, w^as particular about his food, as every self-respecting Frenchman is. At the same time she was expected to do the house market- ing. Her father used to give her a regular sum for the month, and she bought all that was needed in the market or at the shops. What she could save she could keep for herself. He used to tell them: " My dear, if you marry a rich man you will not need to do this work, and it will be a pleasure; if you marry a poor one, you will have to do it, and you will not feel it a burden." He was a man much out of the common in many ways, and this training is not the general rule in France. But it strikes me as an admirable course, and more practical, though more restricted, than the Home Science that we teach in England. There are Ecoles inenagkres in France also, but my ladies said that they were not nearly so useful as home training, and deplored the factory life just as we do, for that it took the girls away from home, so that when they came to marry they did not know liow to keep their houses. In discussing girls of their own class, *' Elle ne sait rien," which was a frequent EDUCATION IN FRANCE 180 criticism, meant that a girl had not been trained in the management of a household. I expect that the work that women have done in France during the war will greatly alter their lives after it. In Paris girls who never went into the street without their mother or a maid have been going oi? alone to hos- pitals, laboratories, and charitable work of all kinds. They who were so strictly kept have been witnessing the crudest facts of human misery. They will never, I feel sure, return to their former state, and their mothers think so too. I knew a few ladies sufficiently well to ask them frank questions. I had an impression that the young Frenchman of education was more graceful and more understanding in his ways with women than the young of the English. But my friends said no. They declared that our boys were more attentive " avaient beaucoup plus d'egards pour nous " than their own, were less selfish, and more to be trusted. One mother said she could let her daughters associate more freely with Englishmen than she would dare with Frenchmen. That is no doubt partly because the girl, being at home, would be more the mistress of the situa- tion with a stranger. But I remember many years ago a Frenchman asking me about the girls whom he saw in the streets of l^ondon. I explained to him that with us young girls walked about alone and with safety. His comment was: " Alors vos jeuncs gens seraient tres peu entreprenant-s." But even with us this freedom is of recent growth. 1 remember when a woman could hardly be seen in a hansom alone, and even now she is not always safe from rudeness in the street. In France this kinil of bad manners is less reprobated by public opinion, and in consequence more frequent. The marriage customs have themselves, in a curious way, 190 A PHYSICIAN IN FRANCE an ellect in this direction. Frenchmen may not, or at least do not, niariy in the irresponsible and independent way of England. It is a matter of family arrangement and consent. If a young girl of good family is seduced, the man is not considered bound to marry her. His conduct is disapproved., but he is not ostracized, as under similar cii-cumstances he would be in England. He is mider the control of his family, and they naturally dislike such an alliance. There is the same division in elementary education as in secondary. There are the State schools, supported by public fmids, which teach morality, but not religion, and, according to my Catholic informants, with unsatis- factory results, and there are ecoles lihres supported by the voluntary contributions of Catholics. The cures themselves depend upon the contributions of their parishioners. They get no other salary, and in poor parishes they are extremely poor. Parish life seems much the same as in England. There is the same small set of women who every morning go to early Mass, the same devoted lady who plays the harmonium and puts flowers on the altar, and the same Lndilierenco of the men. There are the same little processions and societies for the children and the girls, though, instead of being Bands of Hope or G.F.S., their duties are to accompany funerals in a white wreath or veils ; and there is the same criticism of the cme by his parishioners, and of the parishioners by the cure. There was not wanting the tongue of scandal which 1 have heard [requeiitly in country parishes at home. On certain festivals, and especially on Corpus Christi, there were processions in all the villages. The village streets were strewn with grass, or in ambitious places with branches, and most houses had flags and flowers. There were at EDUCATION IN FRANCE 191 odd spots canopies with sacred groups, aud a general air of sweetmeats, and crowds of little girls in white carrying by poles on their shoulders emblematic figures made of unknown substances, sometimes woolly, some- times plastery, but always clearly adorable. The natural taste of religious people is now abominable, and it ollends them to try to make it otherwise. Woolly lambs and plaster Madonnas and cows with the tooth- ache inspire more devotion than beautiful design. Tinsel is the right thing if you want to make people really virtuous. But the striking thing in France is the bitterness between the Crovernment and that part of the popula- tion which is Catholic and religiously inclined. It has no parallel with us. Even a schoolmaster dares not frequent the church or his chance of promotion would be destroyed. This religious difficulty, or, not to put too fine a point upon it, the persecution of religion in France, has alienated the Catholics and is a source of weakness to the State. It has its origin, no doubt, in past times, when, if there were Archbishops like Fenelon, there were Cardinals like Dubois, when the gloomy orthodoxy of a King resulted in the oppression and banishment of thousands of his subjects, and the clergy claimed to be free of taxes, while the poor died of star- vation. But it has its reasons still. The policy of the Church has always been reactionary, and with a few exceptions, such as the Abbo Lemire at Hazebrouck, who has shown that a good priest can be a good re- publican, has been hostile to the present form of govern- ment. Seeing how difficult and dangerous has been the path of the Kepublic, it is no wonder that it should have been hard when its safety was involved. But it has been very hard, and not only fur that reabou. There 192 A PHYSICIAN IN FRANCE is in France a spirit of fierceness in these matters which we profess not to uncierstand. Were safety tlie only rule of conduct, 1 should expect the Republic, now that she is secure, to be more lenient; were patriotism the criterion, 1 should expect her to be more charitable in the future, for the Catholics have fought as hard as any Frenchmen, and the great figure of Foch stands at their head. Yet 1 see little prospect of any such change and the Catholics do not expect it. But before we criticize let us at least remember. Our Revolution was a hundred years before the French, but it is less than a century since we gave Catholics a vot«, and less than fifty years since we admitted them freely to the older Universities. 1 am not aware that since the Terror the French have denied them either privilege. We think it strange that men should feel bitterly upon religious questions, yet our great-grandfathers cherished towards the Roman Church as fierce a hatred as French Liberals cherish now. These memories may make us chary of boasting that religious intolerance is a vice from which the English race is free. And next let us realize that there is very good reason for these feehngs. Religion is in private life exacting, and to those who hold different opinions often exas- perating. Her attitude to questions concerning mar- riage drives men to fury in England as well as in France. In public life, although in early days she championed the cause of the poor, she extorted a heavy tribute from them then, and, where she can, extorts it now. But, above all, she has been steadily opposed to liberty, and especially to that principle of liberty of thought which once swayed our ancestors and now sways France. There it is held now, as it was in England then, with the same conviction, there it excites the same passion EDUCATION IN FRANCE 193 as the most incomprehensible mystery of any faith. Men persecute for its sake because it is their religion, and religion in power has always persecuted. The Roman Church stoned the reformers and burnt the discoverers when she could. Now her foes are foUowinsr the example that she set. 13 CJIAPTER XIX LE PAS DE CALAIS The country round Hesdin is pretty. The little town lies at the junction of the Ternoise with the Canche, which runs past Montreuil and into the sea at Etaples. The two streams enclose an oval hill over which the road goes east to St. Pol. There is in the town a large market-place, on the west side of which is the old Town Hall, with a fine portico built between 1564 and 1629, when the place was part of the Spanish Netherlands. Just behind the Town Hall was the Chateau of the Queen of Hungary, sister of Charles V. The town was founded in 1554, soon after Vieil Hesdin, once a favourite seat of the Dukes of Burgundy, had been destroyed. It was strongly fortified, but it was taken by the French in 1639, and remained ever after in their hands. The weather in June that year seems to have been much the same as now. We had to light our fire in the evenings up to June 22nd, 1916, and from June 23rd to 26th, 1639, " le vent estoit furieux, la pluie estoit meslee de gresle et de neige." It was the fashion then as now for distinguished ecclesiastics and civilians to visit the trenches. Shells were used in the attack which were 15 inches in diameter and 18 inches high. Piccolomini sent a letter to the Governor to say that he was coming to his relief, but the French captured the messenger and forged a letter in the opposite sense, 194 LE PAS DE CALAIS 195 so the Governor surrendered and the Spaniards marched out. La Meilleraie, the French commander, was made a Marshal on the field, Louis XIIL giving him his cane for a baton. Our sporting friend at Faucquembergues had told us that the auctions for fish at Calais and Boulogne differed in that at the latter the bids are made upward in the usual way, but at the former the auctioneer begins at a top price and comes down till some one cries " ]\Iincq.''* 1 could not imagine what " Mincq " meant until I came upon a decree of the Governor of Hesdin in 1767 which grants — " 1° Qu'un mincq sera etabli a Hesdin pour la vente des poissons de mer non sales. " 2° Qu'outre les mincqueurs il sera cree douze minc. quants ou mincquantes pouvant acheter sur Fassise (les prix faite par le mincqueur en criant mincq." The long hill that runs east and west on the north side of the valley is covered with a fine beech forest, and there are scattered woods everywhere. The hills are nearly all under plough and the valleys chieflv pasture, which in winter is very wet. The hills are chalk with a coat of clay, and the ground is poor. Crops are not nearly so fine as in Flanders. The farms do not run so large as they do there, and the buildings are not so good. Many houses and almost all outhouses and farm buildings are made of laths filled with mud hardly two inches thick, which quickly breaks and falls out. They were woefully out of repair during the war, and many were nothing but an open framework of laths. The cultivation is much the same, l)ut they do not need to ridge thoir ploughs for drainage as in the plain, and therefore use a plough with two shares, turned 196 A PHYSICIAN IN FRANCE opposite ways, wliich they reverse at the end of the furrow and so deliver the swath always in the same direction. The crops are much the same, but they grow some long-stalked cabbages, 2 feet 6 inches or 3 feet high, wliich I had not seen before, and there are occasional patches of Ratubaga. This, too, is the principal area for growing French tobacco, which [ like very mucli. The seed is given bo applicants by the Government, is sown in frames, and pricked out in April, About seven leaves are allowed for each plant — at St. Sepolcro in Italy it used to be five — and in July the Government inspector visits the crops. In the autumn the leaves are pulled and brought to the depot, where, after allowing a little to be retained as a perquisite, the rest is bought according to its quality and the price given to the farmer, less one-tenth surrendered as the Government's share. The horses here are the Boulonnais, an excellent breed for labour. The face is longer and the muzzle bigger than in the Flanders horse, the head is carried lower, the back is longer, and the legs more hairy. The colour is commonly white. This rolling chalk hill-country stretches from St. Omer in the north into Normandy, and from the Channel eastwards to the line of Lille, Lens, Douai, and Cam- brai. It was a great pleasure after the dreary flats of Flanders. The population is much better of! than our country labourers. Each family owns its own cottage and a piece of land for cultivation. By paying a small sum they have the right to pasture on the pres communanx where these exist. In our village, which had common pasture, they all kept livestock, a cow or a goat or two. They work very hard and there are no reading-rooms LE PAS DE CALAIS 197 or similar amusements such as we provide. But they read newspapers even more than we, and the week's work is diversified by the weekly market, which ;i.ll attend. We do not realize what we lose by not having frequent markets. In France it is the club of the countryside. The poorest have something to sell, if only half a dozen eggs, and also something to buy, if it is only a sixpenny broom. They see not only thoir neighbours, but the townspeople; they gossip and hear the news, and it is a meeting-place of various classes, for the richer housewives come to buy. It is, moreover, a natural relaxation, and not an exotic like the club- rooms, concerts, and lectures which the benevolent think that our poor appreciate. When people talk about the needs of other classes than their own, they commonly seem to me very ignorant. They do not realize how different are the ways of life and the ways of thought. The thing that is easiest to catch is their farcical humour. You can generally put things in that queer extravagant way that they use. But that is a small part of their life, after all. For most people, the best attitude is one of respect but aloofness, while at the same time you " stand by " to employ, on certain occasions, powers or opportunities, which they lack, in their aid, though with considerable risk of ill success. One of my friends at the war had to do ^nth the Irish Fisheries, and told me many stories of the failure to get the West Irishmen to take advantage of them. He told mo of the fishing-boats which they were given, and how the crews could never be got together because one of them always wanted to dig potatoes; of the oysters that were laid down, and promptly all scraped up again; of the little starving mussels that they refus(»(l 198 A PHYSICIAN IN FRANCE to transplant to good beds even for excellent wages; and of their losing the trade in mackerel, because they would not grade them. There was a complete want of sympathy between the Board and the people, which led to a waste of money and a waste of effort. In the Hesdin woods are roe and wild boar as usual, and buzzards breed there. I once had four of them — I suppose the old birds and the young of the year — wheeling and settling in a tree over my head, and making their curious scream. I saw one of them flying over the valley attacked by a kestrel, who swooped at him three times. The buzzard paid him not the least attention. One day in a lovely corner of the Authie Valley 1 heard a bird whose note was quite new to me. I just managed to see it in the top of the trees, and later I saw more of them, but I never had the luck to get near enough to see the plumage. It was the golden oriole, a very rare bird in England now, though Gerald, Arch- deacon and historian, knew it in Wales in the reign of Henry II. I once saw a flock of green plover high up, the only time I ever saw them in France, and two or three times I heard, and once saw, curlew. Swallows were fairly punctual to the 16th of April. I was one day given an uncommon little beast, a garden dormouse, which the men had killed for a rat. It has a black patch under the ear enclosing the eye and running down the side of the nose, and another on the shoulder. The tail has a tuft, which is ])lack above and white at the edge and underneath. It walks like a dormouse, and not like a rat. The flowers here were more varied than up north. Beside the flowers I saw there I found wood-sorrel, several orchids (including the butterfly, the fly, and helleborine), aconite, larkspur, Venus' looking-glass, LE PAS DR CALAIS 199 a fine large purple groundsel, and many others. As railway embankments sometimes atone for their ugliness by preserving rare species, so tlie parapets of old trenches became in that area beautiful gardens of wild-flowers. Out of the eater came forth meat. It is a popular belief that the roads of France are straight. It is true of the main roads, which are all that most travellers see, but the country roads are as irregular as any in England, though they run broader than our lanes. Through villages they are hardly ever straight. Most villages are built on a Z plan, with two right-angled turns, and sometimes it is a double Z with four turns. This is so common that I think it must have been intentional for purposes of defence. The main roads are wider than ours, and the stretch of grass on eacli side and the line of trees which borders it are very pleasant. The Germans, when retreating in 1916, cut down a great many of these avenues as well as many fi'uit-trees. The latter they sometimes ringed, which could have had no purpose whatever but wanton destruction. The French prune the tall trees ver}'' close to the stem by means of a crescent-shaped knife like a turf -cutter, at the end of a long pole, the butt of which they hammer with a mallet. The tree-stems are often very bare and ugly, yet there is a picturesque grace al)()ut these long sticks with a tuft of foliage at the top wliich makes our short, bunchy little oaks look like cabbages. The Honterrains, or underground habitations, are a curious fctatun; of this part. I went through those at Naours and Etaples, and saw the entrance of that at Bouzincourt, near Albert. It is supposed that they wore made as refuges to escape from the contiiui.d invasions which from the davs of Cajsar have devastated thi.^ 200 A PHYSICIAN IN FRANCE unfortunate land. The best account is that of M. Salomon* of the souterrains, or " muches/* of Herniies, which M. Rocli^re, a learned antiquary of ISIontreuil, lent me to read. This particular underground, like that of Bouzincourt., started in the floor of the chm'ch tower, where a large flagstone concealed a winding stair which led to a corridor about one hundred and fifty metres long. At the end of this, and connected with it by branch passages, were found two or three series of chambers, about twelve feet square, a hundred and thirty two in all. The corridor was partly walled with dressed chalk, and was six feet high. In this underground village there were fifteen chimneys for smoke, for thro^\'ing food in, and for climbing in and out. Up some of them were footholds. There were two wells, one of which contained under the debris a deposit of cinders in which were bones of the domestic animals and man, and some pottery of the second and thir^I centuries of our era. There were five entrances from the open, which were probably concealed. The Naours underground contained chapels. They seem not to have been used after the sixteenth or seventeenth century, and had been completely forgotten. They have been rediscovered by accident. This country is full of history, and there is hardly a village that is not mentioned by Froissart. Isbergues, between Aire and St. Venant, is named after a daughter of Pepin, who, probably for good reasons, vowed herself to celibacy. This saved her from a German suitor, but it was not enough to baffle an English prince. She accordingly prayed to Heaven, which bestowed upon her " les ecrouelles," scrofulous glands in the neck, and * A. Salomon. " Lea Muches d'Hermies," BuU. Soc. frehist. Franc., 1913. LE PAS DE CALAIS 201 thus protected her against the Prince of Wales of the period. Later, however, she seems to have been much disappointed that she was not allowed to many Didier, a Lombard prince, and retired to a convent which she founded and managed at Isbergues.* With an Abbess of that history I feel sorry for the nuns. Didier was afterwards defeated and captured by Charlemagne, and is supposed to have been imprisoned at ]\Iontdidier. Our home at Hesdin lay midway between Crccy and Agincourt. At Aire Bayard gave his first tournament. At Peronne Quentin Durward saw Louis XL put his head into the lion's mouth. The Spaniards inheriting Burgundy froperly behaved person never feels insulted because he never need. This attitude is obligatory in the Services as well as among civilians, and if our ofhcers deviated into German ways I suppose we should take them out and drown them in the deep blue sea. They are both officers and gentlemen. So we learn to treat delicate situations with humour, and I remember one distin- guished officer saying to me that when the weather became a little stormy he invariably developed a disgraceful ignorance of the French language. Filtra- tion through an interpreter cleared the atmosphere at once. CHAPTER XXI WET. COLD, AND POISON GAS The weather lias been extremely bad during the winters in Flanders and Northern France. In November, 1914, there was a very hard frost which produced a certain numl^er of cases of true frost-bite. The first three months of 1915 were so wet that the coimtry was hall under water and the trenches were flooded. We were then entirely in the low country north of Bethune, and the whole front sufi'ered, for everywhere along the line the men were standing in water. A CO. of a cavalry regiment told me that he had just brought his men out after standing for forty-eight hours in water above their waists. He had not lost a single man, but when tliev came out they were exhausted to the last degree, and in other regiments some men died of exposure, and som<* were even drowned in the trenches. Exposure to cold combined with wet, and inability to keep the circulation active by walking about — for movement was not only almost impossible iii the deep water, but also dangerous from the enemy's fire — produced a condition that we called " trench foot." It did not give the typical picture of frost-l)ite as il occurs in the dry cold of Arctic countries, but was more like a wide extension and severe degree of chilblain. We all caught chilblains in France. I never liad thorn 80 badly since 1 was a cliihl. And it is interesting 215 216 A PHYSICIAN IN FRANCE to find that Larrey, Napoleon's great military surgeon, states tliat the men's feet were attacked much more when tho snow melted than at the height of the cold. In natural conditions the warmth of the limbs is maintained by the continual circulation of the blood from the central parts to the limbs and back again, and this is greatly assisted by muscular movement. In the present case the legs were not only continuously chilled by the cold water and the circulation reduced by inaction, but they were undoubtedly affected also by prolonged soaking. The feet first became painful and tender, then swollen, cold, and numb, and then red and hot. They often blistered, and in bad cases lost the toes or even a larger part of the foot from mortification. Combatant officers were at first inclined to make light of it, but they soon found it was a very serious question. One Division which had been rather care- lessly handled lost two thousand men in a week. The medical branch knew better, and from the first tried not only to instil the need of care into the minds of Com- manders, but also to devise means of prevention. The trenches had been constructed under great pressure of time, and in circumstances of great difficulty. It was not possible to drain them, for they represented the water-level of the country. The water could be pumped out for a time to a certain extent, but it rose again through the floor and walls. It was impossible at that time to use the various methods by which, when we had more experience, more time, and better weather, the trenches were afterwards improved. Some of them were abandoned and the troops moved a little backward into better lines. But in most parts the whole country was a mass of liquid mud, and no change of this kind was of any advantage. We urged WET, COLD, AND POISON (JAS 217 that the period of duty should be shortened, and this was of use where it could be adopted. But in many places the Germans overlooked our lines, and relievinp was so dangerous tliat it could not be carried out at short intervals, for the loss of life would have been too great. There is also a drawback in very short periods of duty, for the men will not work at the repair of trenches which they are going to leave next day. To avoid any pressure on the bloodvessels, and so to maintain the circulation as free as possible, the men were ordered to wear their puttees loose, and not to lace their boots tightly, and to lessen the effect of cold they were supplied \nth two pairs of socks and a larger size of boot. But this measure, excellent for dry cold, was of little use when the legs were wet. Great attention was paid to the feet. Before going up they were washed, dried, and greased. Every twenty-four hours the pro- cess was repeated, and after the feet had been rubbed warm dry socks were put on. Leg-drill was ordered in the trenches to increase the circulation. Again, various suggestions were made for waterproof boots. Sir Arthur Lee (Lord Lee of Fareham) had seen in Japan waterproof stockings of paper, and some such were tested, but they wore out in a day or two. Canadian lumber boots, high boots like the Norwegian field-boot, but with felt leg-pieces, were described to us, and requested. 1 do not think we ever secured any of the proper pattern, but twenty thousand pairs came out which, when unpacked, were found to be the rubber and felt shoes reaching to the ankle that are sometimes worn over thin boots when there is snow on the ground. At last some long waterproof thigh-boots began to come out, and on December 6th, 1915, an A.D.^LS. told me that there were enough for eveiy man in the trenches 218 A PHYSICIAN IN FRANCE to have a pair, with about a hundred pairs extra per battalion. At the same time arrnnfjenients were made to f^upply hot food to the men in the trenches. All these measures were excellent so far as they went, but owing to the conditions they could not po all the way. In the Division just mentioned the boots were enough to go round the men in the trenches. But as the reliefs had to march a long way up, partly through wet com- munication trenches, they arrived wet through, there was no possibility of drying in the trench, and the boots they received from the outgoing men were wet throuch too. Every now and then the water would be over the tops even of long thigh-boots. Then, again, some trenches were very much isolated and could not be relieved often, or even supplied with food except by night. In another set of trenches the nearest place where it was possible to change and dry the feet was in the bank of a canal a mile or more in the rear. All the dug-outs had fallen in, the firing-step was under water, and the sentries were standing on half wine-vats to keep them out of tlie water. AVhere conditions permitted the orders to be carried out great benefit was afforded, and subsequently, as we had opportunity, we improved the trenches very much. We never had so many bad feet after 1915. The affection does not occur only in the trenches. J have seen a mild case of it in a dispenser who stood all day on a cement 6oor, and I have seen it, or something very like it, appear in a hospital patient. I believe the flying men never got it, though no doubt exposed to intense cold. Even when at rest in the rear life was not luxury for WET, COLD, AND POISON GAS 219 a soldier. One evenins a nephew who hal enlisted and happened to Le in ramp near-liv eame to our room. He was so drippingr ^-ifli water and mnd tliat he refused to advance bevond the threshold for fear of spoilins: the carpet. He was, however, quite cheerful over it. He said they were livine in a sea of liquid mud, that he had not washed or had his clothes off for two days, and that, speaking generally, it was a novelty. However, his tent was water-tight; there were eight of thein in it, so it was not cold, and the little trench dug round it kept the water from running over the floor. Tt was a sort of Ararat, the only dry spot around. T lent him my gum-boots, which added to his cheerfulness, and he went off with them under his arm. His surroundings were typical of the faculty that the men had for making the Ijest of things. I found him living by the side of a very deep and wide ditch. In the bank they had scooped out two garden seats, had planted a bed of flowers, and had run a winding cinder path round it. The British soldier is always making these little oases. If he sits down anvwhere for a week, you may be sure he will either make a garden, or some sort of a shanty decorated with twirligigs made out of old tins, and usually with some romantic name like " Celiacs Arbour " painted up on it. T once found the hut of a Salvage Corps Officer labelled ** The House of Auto- lycus " (the " picker-up of unconsidered tri6es "). The soldier's cooking places are very clever also. The A.S.C-. lorries line the side of the road in some places, and you find all kinds of kitchens built. Some are simply old petrol-tins with holes in them, which make excellent grates on which to put the kettles. Others are built of bricks, and some are elaborate little furnaces made of stones or bricks and neatly plastered with mud, 220 A PHYSICIAN IN FRANCE witli a bit of old iron pipe for a chimney at one end, and an opening on which to boil the kettle or grill the meat in the middle. Sometimes, if they are very particular, they wlutewash the whole. I am not speaking of com- pany kitchens or anything official. These are for the three or four orderlies of a single lorry, and are quite privat-e ventures. These were what the children loved, and no doubt they got pickings in plenty. The cold was extreme in January and February, 1917. On several nights the thermometer fell to zero in exposed places, and, to make it worse, there were no huts in the Fourth Army about Albert, and so little fuel that the troops had hardly enough to cook wath and none left over for warming themselves. Those who were in health did not sufTer from this hard frost, but patients with bronchitis and broncho-pneumonia suffered severely. Everything was as dry as tinder, and three fires broke out in the tented hospitals of that Army, though fortu- nately no lives were lost. The tents burnt wnth great rapidity. I saw one fire break out and it took but three minutes to burn a line of three marquees. There w^as no time to get the extinguishers to work. It was an evacuation ward, so that the men were not bedridden, but were able to help themselves and get out of danger. At that time, owing to the freezing of the Seine and the difficulty of railway traffic, Paris became very short of coal, and very long convoys of motor-lorries plied between the mines about Bethune and the capital. The result of the frost and the heavy traffic together was the destruction of the roads. The metal crust of French roads is always thin, and in the region where we were it lies upon the chalk, which naturally holds a great deal of water. The frost went through the crust into the WET, COLD, A:srD POBO.V GAS 221 chalk, and, turning all the water it contained into ice, crushed the chalk into powder by the force with which the water expanded on freezing. So long as the frost held the only sign of damage was the wearing into ruts of the upper surface under the stream of traffic, but when the thaw began the chalk became a kind of por- ridge, and the crust, no longer supported on a solid foundation, broke and sank into it, while the chalky pulp below burst through, forming a morass through which it was difficult — indeed, in places impossible — to pass. For the Army, which depended for its supplies at the front upon motor or horse traffic, the result was very serious. All unnecessary driving was suspended, and great sections of the roads were dug up and relaid from the foundation, but it was months before they were fully repaired. Nor was it the roads alone that were affected. Under the rime of freezing fog or the occa- sional snowfalls miles of wires came down in every direction, and commimication was often seriously dis- turbed. It was at this time that a weekly journal severely criticized our Generals for not harassing the enemy, in order to turn his retirement into a rout. Probably the editor had read when at school that great Generals always followed up a retreating foe, and dealt him severe blows with great success. Ho was no doubt unaware that the mud was up to the men's waists, that fog eiloctually concealed the enemy's movements, and that a voluntary retirement to a prepared position is, as wo ourselves more than once showed, one of the safest operations in war. Of all the qualities of a soldier, endurance is the highest. Bravery is common to all nations and to the majority of individuals. It is seen in a fight when the blood is 222 A PHYSICIAN IN FRANCE up, and many are working tugeiiier; it is seen in moments of peril when a man is alone, and his life depends upon the shot, it is magnificent, and many as have been the decorations of this war, they are wholly incommensurate with the extraordinary valour that has been shown. Some of our Divisions were known for their extreme daring, and at one time certain French regiments developed it to a degree that was a calamity- If tiiey were ordered to attack they went straight on regardless of orders, giving no quarter and asking none imtil the last man was killed. Others of our Divisions were famous for their steadiness in the fight and for their unconquerable tenacity in defence. Such qualities are as much beyond the impertinence of praise as they are beyond the power of imagination. But wonderful as such conduct is it is still a harder thing to bear without complaining the long-continued misery of trench life. The ceaseless danger, the never- ending din, the miserable discomfort of the dirt and wet, the peril of the night working party, the fatigue of bringing up supplies, the exhaustion of the march that will not and that cannot halt— that men can bear these things is a more amazing fact than acts of even the greatest valour. There is no reward given for it. it was the soldiers' duty, nothing more, and they carried it out unflinchingly, consoling themselves by grumbling with that cynical humour which is an English characteristic. Our humour is a little different from the American variety, and is deeper and more sombre in Its quality, but we each appreciate the other. i have not seen anytliing in English which approaches " Le Eeu " in real description of the soldier's life or as a record of the facts of war. We must have had writers in our trenches like Barbusse in the French, but they WET, COLD, AND POISON GAS 223 have not given us any account, that can be compared \N'it}i his. An unpretentious little volume of letters called " A Temporary Gentleman in France " is the best I know. It is faithiuUy and simply written, but of small compass. " Le Feu " is partial, for it is tinged through- out by the sombre melancholy of its author, and gives none of the lighter moments which break the monotony of a S(jldier"s life. But he has that accuracy of repre- bbntation which is the aim of all French art, and is neglected by modern English writers. What he de- scribes, he describes in such detail and with so vivid an expression that the scene is almost reproduced in the reader's mind. The language of the book is the language of the French soldier, and needs an interpreter. Parts of it are so horrible that English readers, who as a rule like pretty and sentimental writing, would hardly wish to read it. But it is true, and with the Frenchman, as with men of science, that, so far as the matter of the book is concerned, is the thing desii-ed. They desire equally that the manner in which it is written shall be fine also. But provided that it aJi'ords a sincere record of the fact, they permit and approve even the most hitleous details. That is a logical position, and those who criticize English standards hold up to us the French liberty as an example, it is ujidoubtcdly the fact that the ollicial censure, which exists in France as with us, permits the publication of writing that would not be allowed here, and it is no answer to say that such works do not appear on the tables of your friends. They are oilicially allowed and that is enough. But the French are in theii* way just as illogical as we, for they are far stricter in the rules they lay down for their daughters' reading. T ]i;ive been asked to recom- 224 A PHYSICIAN IN FRANCE mend English novels, and it was a condition that there should be nothing in them but what a young girl should read according to French ideas. 1 knew what that meant, and my writers did not accordingly get much farther than Miss Yonge. But, at least, it may soothe our consciences to retiect that if the French publicly permit a greater freedom in writing, they privately allow much less in reading than we. They admit all works to the gallery, but they exclude half the public. In " Le Feu " there are some scenes which are written with a power that is frightening, and that with which the book closes can only be compared with the most terrible passages of the *' Inferno." Indeed, it is the same spirit of remorseless logic which actuates them both. To think of the world as a system in which the cause is followed by the consequence is altogether beyond the compass of most men ; they have no conception of the awful majesty of law. Many, on the other hand, to whom science has given this vision lessen the poign- ancy of its appeal by refusing to recognize the disturb- ing element of will. They minimize responsibility and they ridicule forgiveness. In human life those who are weak in hope see only the inflexible rigour of the rule; those who cannot grasp that fearful inflexibility think pardon easy. Their God is either too cruel or too kind. It was the strength of mediaeval theology that, while believing in the Mercy, it recognized the Justice, and by faith acquiesced in the mystery of their union. Dante in the nine grandest and most awful lines that poet ever wrote, the opening of the third canto of tlie " Inferno," was not afraid to state that the highest wisdom and the primal love were implied in the terror of Divine justice; for to him, as to Michelangelo in the Sistine Chapel, the great fact of this life was the reign WET, COLD, AND POISON GxVS 225 of law. It appears to me that this overpowering thought is in Barbusse also. War poetry has seemed to mo poor. The l)est I have seen were some lines sent me from home which were said to have been found on the body of an Australian at Gallipoli. There was a fierceness about them that was genuine and direct. The French have a delicious vein of religious humour and there are two very tender and delightful pieces of that kind — " La Passion de notre Fr6re le Poilu " in Angevin patois, and " Le Retour," by Lucien Boyer. The spring of 1915 was a time of depression. No one but Lord Kitchener seems to have realized the magnitude of the war, and we had expected to attack when the summer began. But few troops came out and, worse still, very little ammunition. Batteries were in some cases, I was told, reduced to forty rounds a week. Even what ammunition there was was not wholly reliable. A battery of 4*7 inch guns had to be moved up to 3,000 yards because the shells were bursting short and killing our own men. It was at once heavily shelled, the CO. wounded, and hardly enough men left to take the battery out. Under those circum- stances the efTect of Mr. Asquith's Newcastle speech was to produce a great sense of bitterness against the Government. It was on April 22nd of that year that the Germans first used drift gas. We were at Baillcul in the morning, and hearing that there had been some disaster to the north, drove up to Poperinghe, where we learned that French troops had come through tlie town in a panic, and thence to Vlamertinghe, where in a Canadian Field Ambulance I found three Algerian soldiers. They said that the Germans had pumped some liquid or other on 15 226 A PHYSICIAN IN FRANCE to the ground and liad tlien set light to it, creating a heavy white smoke wliioli Iiad drifted down on to them. Later and better observation sliowed that the gas formed a greenish cloud and was not ignited. There was at any rate no doubt about the result. The Algerian troops had bolted en masse, and if it had not been for the Canadians, who had at once turned out and marched to meet the enemy, Ypres would have been in their hands. The Canadians met them about Pilkem and stopped the rush, but that and the next few days were very bad for us. The Canadians and the Northumbrian Division suffered most. There seems no doubt that the Germans were not prepared for such a success. If they had had any large body of troops behind the gas they could have walked over the ten-mile gap between Ypres and the Belgian inundations. We sulTered very heavily as it was, but almost entirely from the guns, which the enemy were able to push forward behind the salient we held in front of Ypres. I did not see any asphyxiated cases among our troops that day, but on April 24th there were hundreds of them in the hospitals, and still greater numbers of men who were not so badly affected were sent down to the Base. There is no need to dwell on the horrors of that day; none who saw that scene can ever forget it. The attacks were repeated up to May 23rd, when the wind became unfavourable for the enemy. The Germans took elaborate precautions with their gas. They had in every trench a meteorologisfc, whose business it was to study the wind and the air currents in that particular trench. On some days they had to report every half -hour to H.Q., where the head meteo- rologist was, and he had the entire direction of the gas attacks. The engineer oflicers who handled the ap- y.i I WET, COLD, AND POTSON GAS 227 paratus were required to consult the local meteorologist on every occasion. It was imperative to protect the men against such attacks in future. The first step was to find out the nature of the gas used. We followed various clues which failed. But there were many in the Army, both officers and men, who had a knowledge of chemistry, and some of these had been in the way of the gas. They were clear that the green colour and the irritating pro- perties were those of chlorine. This is a heavy gas much used in manufactures, and for that purpose it can be condensed into liquid and stored in strong metal cylinders such as are used for oxygen, in which it is under considerable pressure. On turning the tap the liquid issues in a white vapour which quickly expands into the green-coloured gas. With the help of the wind this gas drifted along the ground, expanding as it came, until it formed a wall which by some was said to be forty and by others twelve feet high. The height probably depended upon the distance of the trenches, for the gas would tend to diffuse as it came. Local conditions of the atmosphere or ob- stacles would probably af!ect it also. When the gas, which came to be called drift gas to distinguish it from the gases sent over in shells, reached a hollow like a trench, it rolled into it and, being heavier than air, stayed in the bottom. But the main body of the gas passed on, borne by the wind. Many victims said that the gas, when inhaled, pro- duced a feeling of listlessness and a desire to lie down. This was highly dangerous, since the gas lay in the floor of the trench. It was equally dangerous to run, for in addition to shrapnel, which was poured upon them, those who ran, ran witli t.lie'^gas, and were the longer 228 A PHYSICIAN IN FRANCE exposed to it. To stay still and to stand upright was the safest course, and those who did so frequently had their reward. For the Germans, after an interval, followed the gas, expecting to find our trenches empty, and those battalions who stayed beat them back with great slaughter. At once the means of prevention were sought. The easiest form of protection was by respirators, and thousands of these were improvised. They were at first of the simplest kind, mere pieces of flannel or cloth wetted and held over the mouth and nose. These, being of no use, were as fast as possible replaced by pads of cotton waste impregnated with a chemical antidote and folded in muslin netting. These, again, were supplanted by a helmet of cloth, with gelatine windows for the eyes and loose ends to be tucked into the collar. The whole hel- met was treated with the necessary chemical. These took much longer to make, and we had not sufficient to equip every man in the battalions even so late as the end of July. The military effect of the gas was at that time serious. It was the means of our losing a considerable tract of ground, and it created panic both among the African Corps of the French and among our own men later. But it exasperated the soldiers. They fought more fiercely and more mercilessly afterwards. English soldiers are good-natured, and though they do not mind fighting, they bear little ill-will to their enemy. But treachery, as in the abuse of white flags or the Red Cross, both of which were practised by the Germans, cruelty to the wounded, of which they had good evidence when in the counter we returned to trenches we had lost, and methods which they think unfair, such as this, fill them with a fury which bodes ill for those with whom WET, COLD, AND POISON GAS 229 they fight. There was little complaint after this time that the men were too familiar with the enemy opposed to them. A chemical laboratory was set up at G.H.Q. under Lieutenant-Colonel Watson, an Assistant Professor in the Imperial College at South Kensington, which became the centre of all analytical work in France on offensive gases used by the enemy and for testing our own pro- tectors. Another able chemist was extracted from the trenches to assist him. Watson died in 1919, and his death was a great loss to science. He was a brilliantly clever man. When the Germans next attacked, which was in December, 1915, they used carbonyl chloride, or phos- gene, which is of the same nature as chlorine, but more poisonous. But our protection was by this time fairly efficient, and though the casualties might run to three or four hundred at a time, they never again ran into thousands until the " mustard gas " was used in July, 1917. The Germans defended the use of gas on the ground that it was no worse than shells, and that all ollensive measures are justifiable in war. Other nations did not think so, and it is another instance of the wide diflerencc between the standards of Germany and those of the rest of the world. Froissart says that (Jernian knights were less generous and more cruel and mercenary than those of other nations, and their descendants maintain this character to the present day. After I came home in 1919 I heard that the chemist of some northern lirni of manufacturers, while travelling in Germany in 1909j was aware of a curious smell in the air, and on walking in the direction from which it camo saw a number of German soldiers on a piece of rising ground apparently 230 A PHYSICIAN IN FRANCE doiug something to a number of sheep, several of which hiy dead upon the ground. He and his companion were at once warned oil. This was probably an experiment in the use of gas for oilensive purposes. The cloth helmet was replaced in 1916 by a much more efficient apparatus, the box respirator. It had a mask with eye-pieces fitting closely from the forehead to the chin, and a flexible breathing-tube which drew in the air through a layer of various chemical substances enclosed in a light box which was slung round the neck. When the men had it they were safe from phosgene, and, as far as their eyes and lungs were concerned, from " mus- tard gas " also. But there was always room for acci- dents. The Germans took to sending the gas over in shells, which when used by themselves could be dis- tinguished by their way of bursting, but were usually mixed in with high explosives so that detection was almost impossible. At other times a bombardment began when the men were asleep, and they did not wake up until the gas was on them. I first heard of shell gas in December, 1915, but I first saw its effects in July, 1916, when during the Somme battle a party of K.R.R.'s were brought in very badly poisoned with phosgene. Their sergeant told me that during the afternoon they had noticed that many of the German shells did not explode as usual, and had remarked what bad stuji they were using. They were then lying in the open, but a little later he moved the party into a covered shelter, and almost at once found that they were poisoned. The gas had collected there. At a later date the gas shells were used by thousands at a time, and once at least in 1918 we suffered severely owing to the bloAving-up of a large dump of gas shells which the retreating Germans had left behind them. WET, COLD, AND POISON GAS 231 When, however, they got fairly on the run they had no leisure to arrange gas attacks, and I saw very few cases. In July, 1917, the Germans developed a new form of gas offensive by means of what we called " mustard gas." It was first used on the night of July 13th-14th, and led to about three thousand casualties. The next attack was on July 21st, and produced about four thousand. The first was north of Ypres, the second in the Nieuport area. The poison, which is dichlor-ethyl- sulphide, is a brown liquid with a slight but rather pungent smell, which by the explosion of the shell containing it was scattered in the form of a minutely subdivided cloud. It inflamed the eyes, entirely pre- venting their being opened, and it scorched the skin and the air-tubes, eventually setting up septic inflam- mation of the lungs. The worst of it was its penetrating quality. It went through cloth and flaimel directly, and through gaiters and the upper leather of boots. It was very stable and hung about the ground for a long time. Unless there was ^v•ind or rain to decompose it, it could render a position untenable for a fortnight. Orderlies tending those affected were liable to suiler, and were given india-rubber gloves in consequence, and, where they could be got, waterproof overalls. It caused the eyes to water and the lids to swell so that men were forced to go back because they could not see. In hospital they had to be led about for the first three days. Long strings of them might be seen all holding hands and led by a pati(mt who could see. Cases of permanent dani;;gc to the eyes were, however, very rare. Horses suJlcred far more, and many lost their sight from it. It was used in increasing amount up to the time that the final German retreat set in. 232 A PHYSICIAN IN FRANCE We Lad phosgene ourselves in 1916, and were the first to use it in projectors, by which we coukl throw a large amount on a given spot in the enemy's lines. We had in October ample evidence of the severe effect which it produced. We were a long time in discovering how to make mustard gas in large quantities. But on August 7th, 1918, I saw an order of Ludendorff giving directions about our mustard gas, which showed that it had not only come into use, but was doing great damage to the enemy. Besides the respirators against the gas, the soldiers were also given steel helmets to protect their heads. They were a great success and saved many lives. Pro- tective armour was suggested for the trmik, but the weight was a fatal objection. The soldier carries 68 pounds, besides the clothes and boots he wears, which weigh at least 12 pomids more. If his things are wet the weight rims up to 100 pounds, and that is more than anyone should be asked to carry. It was impossible to increase the load. CHAPTP]R XXII MANY INVENTIONS Of the various methods of attack, I have been told that bombing was the most terrifying. As it was the only attack to which we in the rear were exposed, I have no means myself of comparing it. But Clearing Stations, Divisional Headquarters, and troops all disliked it, and Confessed that they disliked it, worse than shelling. If you have ever seen partridges under a kite, it fairly represents the feelings of human beings under a " dove.'' However, they are as well known in England as they were in France, and there is no need to describe them. We were bombed several times at St. Omer, and one Taube dropped thirteen bombs, of which one fell close to our hotel. Several persons, including women and children, were killed or maimed, but I believe that only one soldier was ever injured there; and though a few private houses were wrecked, no damage of military importance was done. That was not the case elsewhere. On three occasions there was great destruction from this cause, and on several occasions there was consider, able damage and loss of life. In 1917 and 1918 bombing by night became the fashion, and was a serious danger. A good many hospitals were hit, but, except in one in- stance, I do not think the bombs were meant for thorn. In the first two years of the war railway facilities were obtained with great dlfTiculty, and wc wore in con- 23a 234 A PHYSICIAN IN FRANCE sequence obliged to put hospitals, stores, and reinforce- ment camps together wherever railway accommodation could ])e had. In bombing the two labt<3r the Germans occasionally hit the hospitals. Etaples was very badly bombed, and one of the Canadian hospitals lost a large number of its personnel, including some nurses. That it was not meant for them was no consolation. There was great consternation among the fisher-folk, and both they and the hospital stalls took to sleeping out in the sand-dunes and woods away from the hospitals, while the latter were emptied as far as possible of patients. No one was in greater panic than one or two wounded German aviators whom we had somehow received there. They knew that another attack was timed for a day or two lat^r, and were extremely anxious to be shifted. But while these and other hospitals were prob- ably bombed by mistake, no such explanation can be given for the attack on No. 3 Canadian Stationary at Doullens. It was in the old citadel, which was no longer used for military purposes, but in civil life was a reformatory, and had been a hospital for eighteen months. It was marked with red crosses on the roof which were easily visible by aeroplanes and showed clearly in aerial photographs, and it had been there so long that it was well known to the German Air Force. On the night of May 29th, 1918, it was half destroyed, with much loss of life, by a German air- man, who first illuminated it by flares, so that he nmst have seen the red cross, and then flew over it and back again, dropping several bombs. The citadel lay outside the town, and a long way from either the railway or the stores. This was a calculated and deliberate attack upon a hospital, and an inexcusable piece of brutality. In order to avoid the fragments of bursting bombs > MANY INVENTIONS 235 the hospitals in most places built earthworks about 3 feet high or parapets of sandbags round their huts and tents, and dug caves for the sisters to take refuge in. \Vhere they were on a dry and suitable soil they some- times excavated the wards to a depth of 2i or 3 feet, so that the patients lay below the level of the surface and were quite out of the reach of splinters. As a large new railway junction was made at Hesdin just outside our garden, we were always expecting bombs. The aeroplanes often came over and dropped bombs about the country, but only once near enough to break our windows. On that occasion the least perturbed person in the house was Madame, who flatly refused to leave her bed. I was writing in the library, and promptly placed myself upon the floor flat on my stomach. It is the sensible thing to do, but you do not feel heroic when, after waiting in vain for something more to happen, you get up again. In the summer of 1918 we developed at the front an admirable combination of searchlights and high night patrols which was very fatal to Gothas. I was told we had brought down twenty-eight of them in twenty - one nights. There was an alternation about the air fighting. At one time we would be a good deal the best, then the Germans would invent a new and better machine, and then we would beat them again. We were better in machines at the end, and though the Germans had some very good performers, our men wore, on the whole, superior in flying and a good deal more daring. For long spells — indeed, almost all the time after early in 1916 — the Germans were so far infc^rior that they hardly came across our lines by day. In the Somme Battle that year, letters found on German oflicers and unm 236 A PHYSICIAN IN FRANCE were full of coniphiiiits that, while our men gave our artillery every possible help in ranging and shooting, with terrible eilect, their own service did not even attempt it. They must have had very little information from the air during the last two years. There were three ways of locating enemy artillery. The first was by direct aerial observation and photo- graphy. It is often diflicult to see guns, for they can bo easily hidden by screens, but it is much harder to conceal the tracks leading to them. It is they that usually show the position. Partly to avoid this, and partly for protection, the batteries were often approached by covered ways. A second method was by observing the flash at night along a series of points. When the angles are taken, the distance is easily determined. A third and more elaborate method was by sound. In this case the observing points contained microphones which registered the waves produced by the guns and trans- mitted them automatically to a central receiving station, where they appeared on a recording drum at slightly diilerent intervals according to the distance of the micro- phone from the gun. The calculation was made from the difference. The different kinds of gun could be easily distinguished, as they produce different waves. I was told that this system had been originally invented by one of our own R.E. officers, and rejected by the War Office at that time, but taken up again when wo found the French using it during the war. Our greatest invention was no doubt the Tanks. They were first tried in small numbers during the battle on the Somme, and there were several derelicts on the ground about Puisieux. They were again tried in the Passchendaelo area, but the ground there was so un- favourable that they greatly lost credit, and were only MANY INVENTIONS 237 rehabilitated at Cambrai, when for the first time they showed what thoy could do. They were brought up with great secrecy, and were largely responsible for the success of the attack. Tank officers have told me that they were saved from condemnation by the Cambrai operation. They were of three kinds — male, female, and whip- pets. The first carried two 6-pounders and two machine guns, the second and third four machine guns. The third was a light and fast machine. The make of their machine guns and also their engines was altered and improved as time went on, and since the armistice the improvements have been even greater than before. The larger tj'^es carried crews of seven men and an officer. There was very little room, it was very hot, and there was a good deal of petrol fumes, exhaust fumes, and carbon monoxide from the guns, which occasionally caused casualties. In hot weather each Tank was a small hell upon earth. They could flatten barbed wire as nothing else could, they could deal with trench resistance and machine guns effectually, and they were terrifying. It was enough to frighten any- one to see one of these immense tortoises waddle up to an apparently impassable sunk road or excavation, quietly tip itself over the edge head foremost, disap])ear into the hollow, claw itself up the opposite bank, how- ever st«ep, and reappear imperturbably on the top. The Germans tried to stop them with great rifles like duck-guns carrying a large armour-piercing bullet; but these were seldom used, perhaps owing to the damage they did to the men who flrod them, and only once with success. There was a picture in the Royal Academy this year which gave a faithful rendering of a part, of a trench, a Tank, and a German with an anii-Tank riflo. 238 A PHYSICIAN IN FRANCE Field guns which came up far enough and stayed long enough would stop them, but it meant the capture of the guns; and minefields, when sown, were declined with thanks by the General of Tanks, but wore so diffi- cult to lay that they were rare. On one occasion in 1916, when we first used Tanks, the Germans pounded them with some field guns which they brought into the trenches. In order to discover their position the Canadians built a dummy Tank, which they moved with a system of ropes. It successfully drew the German guns, which were marked, and promptly smashed by our own. The dummy was after- wards preserved at H.Q. Fourth Army. In our advance of 1918 the Tanlcs played a new and most important part. It had been our custom to pre- pare an attack by a long previous bombardment in order to destroy the enemy's wire and to lower his moral. Tliis gave him a long warning both of the situation and of the strength of the coming attack. In 1918 all this was altered, and a complete change in tactics introduced. About August 1st, Tanks in various parts received orders to entrain for an unknown destination, and at the moment the train started the Commanding Officer was given a sealed packet of instructions. While it was still dark he detrained, and proceeded to a wood indicated, where he liid his Tanks and his men. Night by night he moved forward, slowly in order to prevent noise and over hard ground to avoid leaving tracks which aeroplanes might notice, until on the night of August 7th he arrived close behind our o\vn lines. Up to this time no bombardment had taken place, but at zero, which was about five in the morning, the guns crashed out in an awful storm of shells, and simul- taneously six hundred Tanks passed the lines and made MANY INVENTIONS 239 for the enemy. In sections of throe, a leader and two supports, they crossed the German wire one beliind the other, leaving two tracks sufficiently crushed down for the Infantry to follow in single file. Turning left-handed on the near side of the first enemy trench, they travelled doAvn it, clearing it by their offside guns until they reached the first communication trench. Crossing the fire-trench, they worked up the communication to the second fire-trench, where they turned right-handed again, clearing it to a point opposite their original posi- tion, and then pushed forward, repeating the same movements. Thus each section advanced by right- angled turns across a given strip of ground, clearing tlie way for the Infantry. The guns lifted gradually as the troops advanced, and so complete was the surprise that, while some Tanks ran into a German Corps Headquarters breakfast lying ready laid but still uneaten, and others captured a supply train and locomotive with steam up, the general line advanced that day to the Divisional Headquarters of the enemy, and the Cavalry farther still. The extent of the advance so far prevented com- munication and led us into country so little known that one battalion of Tanks was led on August 10th and after- wards by a Commanding Officer on horseback. The first had three horses shot under him and lost an arm; his successor was also killed in about a fortnight, and the third not long afterwards. In retreating the Germans left not only delayed mines, one of which did not go ofi for a whole month, but also laid traps such as a box of cigars, a revolver lying in the road, and similar things, which when touched produced an electrical contact that fired a hidden mine. Latrines also were used for that purpose, ])ut the most horrible was a corpse left in the o]i(«ralinp-tlieatre of a hos])ital 240 A PHYSICIAN IN FRANCE which exploded when our orderlies tried to take it away for burial. A\'e had a regular ])asiness in " camouflage " or con- ceahnont of various kinds. Mr. B. J . Solomon, the artist, came out when we were still at St. Omer, full of schemes for the purpose, and though I did not see him again, I believe he was at the head of this industry throughout. Everything used at the front was painted in various colours to prevent a distinct outline, and many natural objects were counterfeited to provide hiding-places for observation. Our gun-shooting seems to have improved greatly during the war. I foimd one day the Commanding Royal Engineer of an Army in hospital, and when we began to talk we discovered that we were old school- fellows who had gone up Winchester together neck and neck. He had been looking at the German gun positions after the Arras fighting in 1917, and told me that in one battery every single concrete emplacement had been smashed, and the covered way for bringing up ammu- nition had been destroyed also. The improvement in our gunnery since the Somme fight struck him as remark- able. Thore was a great deal of mining in this war. It is an old art, for the Black Prince had a mining company who blew up the walls of Limoges; but in this war it was far more extensively employed than ever before and the explosives were no longer gun-powder, but compounds of ammonium nitrate. It was dangerous and anxious work. Each side mined, and sought continually to destroy the mines of the enemy and to defend its own. Many months before the Messines battle of 1917 we had driven over eight thousand yards of gallery and had laid many huge mines, wliich ;i.ll needed watching and MANY INVENTIONS 2il guarding until the time came for the attack. There were various devices for detecting the enemy's operations. I once foimd an Australian olhcer who was a Professor of Geology and an intrepid Antarctic explorer devising in the Central Laboratory an ingenious little instrument for the purpose. Shortly before I met him the Austra- lians had let him drop down an 80-foot well; but though he was a man of about my age and was much hurt, he made his observations at the bottom and while he was being hauled up again. The best instrument, however, was a modification of the stethoscope. It needed skill and experience, for diilerent soils, like different con- ditions of the limg, alter the conduction of sound. Chalk, like pneumonic lung, conducts well, loose strata badly. The scale had therefore to be found for each gallery by experiment. But the results were surprisingly accurate. An officer told me that in spite of the automatic pick which the Germans kept at work to confuse oui* observa- tion, he had traced the driving of an enemy's mine which at first ran parallel to and then turned and passed under his own, had estimated its distances, had even mapped out its sidings and dug-outs, and had been able by actual survey after its capture to prove the almost exact truth of the plan he had drawn of it. Explosions produce carbon monoxide, which when inlialed is highly poisonous, and other gases which when mixed are liable to ignite. They were formed from our own charges and percolated through the soil from those of the enemy. To meet these dangers mine-rescue schools were formed in which the men were trained by repeated drill, first to wear the safety apparatus; then, while wearing it, to carry out sucli work as clearing a gallery, or recovering bodies from a mass of fallen rubbish, which is needed when an accident occurs; next, to por- 10 242 A PHYSICIAN IN FRANCE form artificial respiration and administer oxygen; and lastly, to transport the patients, who were often un- conscious, on various forms of stretcher to the shaft. It was even sometimes necessary to continue mining in a gallery filled with gas. Shifts of the rescue men wearing safety apparatus were then employed in hewing. We exploded two enormous mines in the southern area, one at Pozi^res, the other, still larger, at Beau- mont Hamel. I could throw a stone about halfway across the crater of the latter, which was 70 feet deep. It was like a large quarry. In the attack on Wytschaete and Messines in 1917 we exploded nineteen very large ones. A Bavarian officer wounded and captured that day took a very gloomy view of German prospects, but derived some consolation from the fact that " Thank God" we had " blown up a thousand of those damned Prussians." In that attack we also ran miderground galleries to bring up reinforcements without exposing them to shell fire. Our miners were, according to mining officers, a good deal faster than the Germans, and our arrangements more skilful. This war has been remarkable also for the use of the spade. Digging has always been a branch of the military art, and the descriptions given by Caesar are surprising not only from the amount of work that was done, but from their resemblance to the lines of the present day. When he hivested Alesia, a town on a hill close by the railway from Paris to Dijon, he formed lines which were eleven miles long. First came a ditch 20 feet wide with vertical sides. Four hundred feet to the rear he dug two more, 15 feet wide and 15 feet deep, which he filled with water. Behind them was a parapet 12 feet high, which was reveted, and strengthened with chevaux de fri^c and with towers which stand for our MANY INVENTIONS 243 " fortins," or strong points. In addition, in front of these works, I suppose between the moats and the parapet, there was an entanglement made, not of barbed wire, but of five rows of sharpened stakes wound in and out \vith branches. In front of this were eight lines of pits 3 feet deep sloping to the bottom, in which a sharp stake hardened in the fire stuck 4 inches out of the gromid. The holes were arranged in echelon 3 feet apart, and were concealed by brushwood. I saw exactly similar pits dug by the French near Wattem. The Romans called them " lilies '' because of their shape; the French name is " trous de loup." Lastly, in front of these the ground was thickly strewn with a kind of calthrop made of an iron bar embedded in the ground with hooks sticking up. These the soldiers called " stimuli,'' or, as we might say, " pick-me-ups." I do not think we have used calthrops in this war, but they have been used in modern da}'s. It must be remembered that the Gauls were either barefoot or very lightly shod. This, however, was not all. Cassar, fearing that the enemy would try to relieve the town, constructed exactly similar works in the rear of his camp, but these lines, being outer lines, were as much as fourteen miles long. He had perhaps sixty thousand men unth him, and as the town only held out for about thirty days, the whole must have been completed in less than that time. I have been sometimes tempted to think Ciesar a liar, but I suppose that is heretical. It is to bo noted that the Italians are still the navvies of fche Continent . The French lines against Marlborough were strong and extensive, but I doubt if any digging since Roman times could compare Nvith that of the present war. It has been enormous in extent and most elaborate in 244 A PHYSICIAN IN FRANCE character. The trenches themselves must have been many thousand miles in extent. Out of them the Germans first, and we when we had favourable ground, sunk steep shafts 20 feet or more in depth, at which level large subterranean chambers were constructed for the troops. The German shafts were lined with planed and well-fitted wood, and staircases were made in them. The air in the vaults became very foul, and a system of ventilation was erected to freshen them. They were death-traps if the trenches were taken, for there was no other exit, and the entrances had to be protected by hangings soaked with chemicals against gas, which other- wise flowed down into them. They also, I believe, tended to sap the spirit of troops which were kept much imderground. But they were at any rate dry and of a fairly even temperature, neither hot in summer nor cold in winter. I saw one at Beaumont Hamel which was of a diii'erent character. Into the reverse side of the hill which was pro- tected from us ran a gallery 6 feet high and 200 yards long. On either side opened side-galleries in wliich were tiers of bunks. At the end was a small ante-room and a room so large that it was called a ballroom, \vith an exit by a staircase to the surface. It looked to me like a head- quarters. It was lit by electricity and was perfectly fresh and sweet. We too made great dug-outs in the hill country. I was told that on Mont Kenmiel there was cover for three thousand men. But I had no lamp when I was there, and did not explore it. CHAPTER XXIII ODDS AND ENDS When I was a patient in hospital my next-bed neigh- bour was a battalion commander whose conversation combined amusement — for he was of the family of Flurry Knox — with instruction. Since it greatly in- terested me, I think it may interest others who, like myself, are not sokliers. Every Commanding Officer is first and foremost a teacher. Some years ago I met a distinguished General with whom I had played in my College eleven. We compared notes, and I told him that I had been a teacher all my life. I was a little surprised when he replied, " So have I." In tliis war not only was teaching continually begimiing afresh for all new drafts on ordmary Infantry duties, but there were a number of special duties, bombing, sniping, machine-gunning, and so forth, which needed separate training of an elaborate kind. Teaching, thereforo, was both never-ending and laborious. It was chiefly carried out when the Division was at rest. Active work brought with it other cares. Aft^r a march the men's feet had to be inspected, washed and powdered, and fresh socks put on, before any otlicers could attend to their own wants. When they came into trenches it took fully twenty-four hours to settle down, and no one got any sleep the first night. Aiii'.v that he was very firm in his opinion that the sound lil5 246 A PHYSICIAN IN FEANCE principle was to make yourselves comfortable and beliave as much as possible as if you wore at home. He insisted upon daily shaving, and was particular that the men's food should be as varied as it could be, and as well cooked. He himself expected to get fish once or twice in the week, and insisted that such things were a mere matter of a little arrangement. I remembered jMontaigne's remark, " Je prends plaisir de veoir un general d'armee au pied d'une breche qu'il veult tantost attaquer, se prestant tout entier et delivre a son diner au devis entre ses amis," and the opinion quoted from a fine regimental officer who was killed at Gallipoli that the art of trench warfare was the practice of the domestic virtues. Rations were always good, and were plentiful until the last advance began. In 1917 our chief sanitary officers attended a conference on military dietary in Paris at which both French and Italians considered our scale of rations to be in excess of requirements. Our regular ration when the war began was IJ pounds of meat (including bone and fat), IJ pounds of bread, 4 ounces of bacon, vegetables, tea, sugar, jam, salt and pepper. A great deal was wasted or given away or sold, and accordingly rations were reduced to 1 pound of meat and 1 pound of bread, and butter was added. In 1918 the ration was reduced to J pound of frozen with 3 ounces of preserved meat, 13 omices of bread \vith 2 5 ounces of biscuit, and 3 ounces of bacon. The calorie value was 4,643 at first and 4,200 in 1918, less about 10 per cent. The calorie value of the French ration was 4,481, of the American 4,700, and of the German about 4,050. The German ration contained about h pound of meat. The French ration included a wine issue. The Italians, ODDS AND ENDS 247 who, I believe, had the shortest issue of the three, took a great deal of care with their cooking. If anyone reads ** Lo Feu " or " Gaspard," by Benjamin, he will see that the French cooking left a great deal to bo desired. So did ours, but we instituted schools of cookery which were very good, very popular, and of great service in improving the art. At the time of the last advance rations seemed to be rather sliort, and were certainly extremely difficult to get up to the front, owing to the distance from railhead. A high authority told me that many a day he knew the men had had no breakfast, and feared he could not continue the advance, but that the temper of the men was so fine and their eagerness to push on so great that he never stopped them. The lorries had to go fifty miles back and fifty miles up again to bring supplies, and they were every day diminishing in numbers. Even at the Base there was a certain shortage, both of supplies and of some kinds of equipment. Civil rations in France were very short in sugar and restricted in bread. There was no butter in Paris hotels in January, 1918, though you could buy it in the shops, and at liesdin we could always got it, though it cost as much as nine or ten francs the pound at that time. Bread was eighty centimes the kilo (2 pounds) in 1915, and one franc ten centimes in 1918. Eggs were five francs for twenty-six — it is always the baker's dozen for eggs — in 1915 and thirteen francs in thu winter of 1918. In 1918 u fowl cost fifteen francs. These were prices paid by French people themselves in the urea of our Army. They were no doubt aiVected by our demand. In June, 1919, in the Gironde new-laid eggs were still sixty centimes apiece, but butter was only six francs and a half and meat six francs a poiuui. There was 248 A PHYSICIAN IN FEANCE abundance of meafc both in Paris and the country, though it ^vns doai-. Coiilincntal nations eat liorse-flesh to some extent and like it. In to^vns of any size there is usually a shop where it is sold. The taste had its disadvantages, for the Belgians killed and ate my nephew's pony. To return to my neighbour's stories. When the bat- talion attacked he used to explain to each company commander every minute detail, almost yard by yard, of the ground he would have to cross. Little ditches, a bush, a shell-hole, were ol)jects that had each to be shown and noted. After the first line of the enemy is reached, knowledge of the ground is entirely taken from photographs, and as a bombardment has taken place in the meantime the surface is very diflerent when the attack reaches it. No one but a soldier can realize what holes made by shells mean to an advancing line. We think of them as of a hole in the road that we avoid by passing to one side. But when you have seen a battlefield you realize that you cannot go to one side. The whole ground is a network of holes. Or we imagine that, after all, it is lilvo stepping across a ditch, which if it is too wide to step can be jumped. We do not realize that shell-holes are about ten feet wide and almost as deep, and generally full of water. With a greasy surface and your riiie and equipment on, you could as easily jump over the moon. It is horrible ground to move over. The only advantage shell-holes give is to aftord cover. Most advanced posts are in shell-holes, the men lying inside on the slope of loose earth, often with their legs in water up to tlie knees, to keep their heads out of sight below the edge and sometimes deeper still. Various ways of going forward were tried and at a later period of the war, though the first line attacked ODDS AND ENDS 249 in extended order, the ensuing waves went up in Indian file, the leader threading his way ilirougli tlie hibyriiilh and the others following. Military writers give the impression that an attack on an entrenched position is a rapid movement carried out at the double. It may have been so in former times, but it is not so now. In " Le Feu " Barbusse gives the only exact description that I have read of a modern attack. The chief part of it was a slow walk over very bad ground under a devastating fire of shells. Only in the last fifty yards did the pace quicken to a trot. Our regulation pace was eighty yards a minute, to keep just behind the creeping barrage, and when this was lengthened the pace remained the same. It was difficult in rehearsals to keep it slow enough. It is about the pace of a funeral march. An Artillery officer described to me an attack he had watched in Mesopotamia from the wooden erection he used for an observation-post. He said it was most impressive, but not from its speed. He could see a long line of black dots advancing steadily by sections through tlie deep sand. Some of the dots fell, many fell, but the line went steadily on like an inexorable machine, until when they came within fifty yards of the trenches the Turks broke and ran, and the attack quickened in pursuit. I once asked a well-known war correspondent what an attack looked like. He replied: " It looks like a geolo- gizing party.'* There is none of the excitement of quick movement, none of the passion of the strupffile. It is a doliberuto and determined slow walk forward, slipping in the mud and stumbling over things that you cannot see in the dim light, while the enemy rains death upon you from rifles and machine guns in the trenches, and fr«»ni every 250 A PHYSICIAN IN FRANCE sort of gun in the rear. Men welcome an attack as the end of the discomfort and danger of their trench duty, but no one that 1 ever spoke to said that he liked " going over." The effort is almost beyond belief, and it is worse for the officers, since they have to set an example themselves and also to keep the men steady to their hard task. It is no wonder that over and over again the officers were almost completely wipefl out. Everyone knows that one young officer dribbled a foot- ball in front of his men. It recalls Napier's story of Cloudesley Shovel getting off his horse to tighten his girths in front of a regiment which was being subjected to a very severe fire. The Duke cursed him for a young fool, but he excused himself by saying, " I thought, sir, the men were getting a little unsteady." Mr. Macpherson stat-ed in the House of Commons that up to November 10th, 1918, the total killed was officers 37,876, other ranks 620,828 — that is, one officer to every sixteen men. In a Division there are 589 officers and 18,522 other ranks, which is in the proportion of 1 : 31-4. Officers are therefore returned as killed at almost double the rate of other ranks, or in other words they run double the risk. Communication is one of the great difficulties in a fight. Telephones are laid, but are often cut by the enemy's fire. When, as at Messines, the attacking force is under the brow of a hill, direct signals can be used. Usually the chief reliance is upon aeroplanes. They tell the H.Q. where the battalions are, and receive messages to be given to them. Sometimes the message is that the battalion is to disclose its position. Then the aeroplane blows its horn, the battalion sends up flares, the observer draws a line on his map, and tlies back and drops it on H.Q. Signalling to ODDS AND ENDS 251 the aeroplane is done by white panels laid on the ground. There was a system of communication by carrier pigeons, and I was instructed in the trade by a corporal who at home was a commercial traveller and a pigeon fancier. Just then his pigeons were tired out, for they had been having sometimes two flights a day during the German offensive of 1918. Some had been shot, and he declared that cert*iin gallant troops killed and ate the pigeons sent them as messengers. The message is a piece of flimsy paper of the size of small note-paper, which is put into an aluminium cylinder about an inr-h long and fastened to the pigeon's leg by clips. He had begun to mate his birds in January, but breeding had been interrupted by the fighting. Pie fed them on maize, peas, and tick beans, and thought maple peas the best to fly on. The rest of my instruction came from the officers of a Flying Corps squadron. They had an amusing mess. Two of them knew all about racing pigeons. I think they had been " jocks," or whatever takes the place of a '* jock " to a pigeon. Anyway, they knew all the tricks of the trade. It seems that blood is just as important in pigeons as in horses, and that a winner of races is in great demand for the stud. There is a regular studbook, and though you don't enter your pigeon for the studbook while ho is in the egg, as you enter your boy for Eton, you have to send in his birth certificate and get him entered directly ho is hatched, as the ring which the Club gives you as a certi- ficate of entry, without which he cannot race, has to be slipped on over the foot, and you cannot bend the hind-claw back to pass the ring on to the leg after the bird is nine days old. Their wireless expert was a man with a passion for wars, and had been in every war that 252 A PHYSICIAN IN FRANCE had been going since he was a lad. He Lad come from Plonohilu to join up with this war. Their interpreter was a descendant of tlic Didcc of Berwick, and tlierefore of the blood of Sir Francis Drake, as well as of the ChurchUls. Both parties admitted that it was a very nefarious sport, but the corporal added: " What sport isn't '( Look at whippets ! I've seen a dog doped while he was being weighed. I don't know how it was done, but after six rabbits he began to run round in rings." There were a number of dog messengers in the later years, and a regular establishment at Etaples for training tliem, but I never heard any details about their work. Spies are a means of information in every campaign, and can always be had for money. At St. Omer I noticed one day two nice-looking girls dining at one of the tables. Two days later there was a hue and cry (" Huee et Cry " of old French law) after them, for the French had discovered they were spies. I once witnessed the capture of a spy. I was coming home down a little hill. At the bottom was a tiny house, and down the opposite hill a two- wheel country cart was coming with the usual farmer and his wife. When they reached the little house, two men suddenly stepped out, one in plain clothes, the other in gendarme's uniform, and held up the cart. The man tried to push past, but in a second they had taken the reins off the bit and covered him with revolvers. They bundled him out of the cart and put handcuffs on him, and then they moved the cart on a few steps to let us get by, and thus put the woman out of their observation. I saw her face when she thought no one was looking. Great terror is an ugly thing to see. It was in the man's face also, but is more dreadful in a woman. ODDS AND ENDS 253 Her face was very pale, but the eyes were filling with tears, and the lips and nose were flushing as the tears came. The pallor of the rest was a great contrast. The lips were open, the eyes staring. 1 suppose thou- sands of women have looked like that up and down Belgium and France during these years. There were many stories current of spies in our lines. Once I heard that an officer in P]nglish uniform had been limching with several messes and making himself generally agreeable. At another time I was told of an officer, apparently of French artillery, on a black horse who was greatly interested hi oiu* gunnery. Twice he was received cordially, but as each of his visits was followed by the heavy and accurate shelling of his hosts, preparations were made for his next reception, which he frustrated by not returning. Another story related how one of our own guimer officers, going to report to H.Q., was inquiring the way, when he was given in charge by an Army Chaplain who suspected him of being a spy. He was taken off to the A.P.M. who was at the H.Q. to which he wished to report, and had just been discharged, when the Chaplain met him again, and again got him arrested. When the matter had been a second time put straight, the sergeant respect- fully suggested to the officer in charge that he was not quite sure about the Chaplain. On one occasion wo winged a German flying man, and as there was always good feeling between these services, one of our Flying Corps called next day at the hospital and offered to drop a note on his aerodrome to tell his friends that he was alive. The German thanked him, but' said it was not worth the risk. If, however, he would be so good as to let anyone in Lapanne know, his aerodrome would get the news in two or throe hours. liapanno was tho 254 A PHYSICIAN IN FRANCE Belgian H.Q. and the residence of the King and Queen. Our own intelligence was very complete, and we once captured an order of Ludendorflt enjoining the strictest secrecy, because our information was so good. CHAPTER XXIV RED TAPE When we were in Hesdin we had a soldier servant. He was a skilled clerk who had volunteered immediately on the outbreak of war, had served a year with the Royal Fusiliers at the front, and had then been sent to hospital, for chronic disease of the frontal sinus, and classed as " Permanent Base " on account of it. When an outcry was raised about the number of men who were taken off the strength in order to provide servants for officers, 1 asked him what happened in his battalion. He said that only two men in the battalion were excused on that score from trench duty, and that no one wanted to be an officer's servant, because, though it increased the pay, it increased the duty also. An officer is so much engaged in taking care of other people that he requires someone to take part care of him. He cannot do both himself. As this man was on the one hand permanently unfit and needed special treatment, and on the other was much too valuable a man to be merely a servant, 1 suggested that he should be recalled for work in his own branch at home. This was done, but between nuiddling at home and nmddling in France it took about three months to get his papers through. He had been trained in a big business house, and had also been em- ployed in military oflices in France before he came to us. He told mo that from what he had seen of Army tiling 250 A PHYSICIAN IN FRANCE methods he was astonished, not that they lost some papers, but that they ever found any. A\'e constantly declaim against the dilatory character of Government work, and are apt to ascribe it to the slackness or stupidity of Government officials. That 1 believe to be wholly unjust. The fault is not with the persons, but is inherent in the conditions under which they work. In the first place, the Army is by far the greatest business firm in the country. It employed in this war something like five million men, and it not only pays them their wages as other firms do, but in addition clothes them, feeds them, houses them, trans- ports them long distances by land and sea, treats them medically and spiritually, pensions them, compensates them and their dependents, and, if need be, buries them. It manufactures or buys every conceivable thing in enormous quantities. It builds and repairs houses, huts, roads, bridges, railways, every kind of vehicle, and oven barges. It owns thousands of horses and mules, and many hundreds of camels, dogs, and pigeons. It is a world in itself, and it is difficult to understand how business can be carried on at all on such a vast scale, and difficult to realize how good the organi- zation must be in order to accomplish it. It is quit-e true that any business should avoid mistakes, but no business ever docs, and the enormous midtiplicity of military business necessarily increases the number of mistakes. The wonder to my mind is rather that they are so few. That is one side of the question. But in addition the Army is a business minutely responsible to the public, and the strict account which is exacted of it obliges it to maintain the most elaborate system of justification which it can devise. Any Member of Parliament can KED TAPE 257 question the Minister in the House, and any member of the public can attack him in the Press on the smallest personal grievance or the most trivial detail of adminis- tration. The Minister has to show that each subject raised was fairly considered and discussed in all its bearings by persons in such a position of authority as will satisfy his questioners. The result is that an immense number of forms are required, and an immense number of reports have to be made, for mere purposes of record, which even to Regu- lars are a burden, but to civilians would be infuriatins:. In my own branch, for example, when a man is brought in to a Field Ambulance he has his number, name, rank and regiment noted, and the nature of the injury or disease for which he is admitted. His religion also has to be recorded, because if he is dangerously ill a minister of his own creed should visit him. When, either there or at a Clearing Station, he is given the comfortable hospital uniform, his kit has to be taken and labelled, and his valuables are handed in and entered in a book under the supervision of an officer. The date of his admission and that of his discharge must both be entered. It is obvious that not one of these necessary items can be omitted at any one of the hospitals he passes through. Every morning, again, and, durmg a fight, several times a day, a return has to be made showing the number of patients in hospital, how many are fit to travel, and whether these can sit up or nuist be carried lying down. This is necessary to arrange for transport. Again, the patients have to be fed, and, in (conse- quence, every morning Supply must be notified how much meat, broad, and so forth, is needed. This neces- sitates the keeping of two sets of forms in tlic hospital 17 258 A PHYSICIAN IN FRANCE because the diet-sheet is not a half-pound of meat, a half-pound of bread, and so on, for each patient, but Diet 1, Diet 2, Diet 3, and such extras as the officer orders. Then the equipment of the hospital itself- stretchers, Vilankets, hospital uniforms, instruments, dressings, bowls, basins, every sort of thing, has to be maintained, and if it is worn out or broken a return has to be made before it can be replaced. Lastly, the hospital accounts have to be kept, the pay of the personnel and the local bills all noted, and money drawn from the Field Cashier to settle claims. I do not know what the clerical work of a battalion amounts to, but I remember a Colonel once telling me tliat the most necessary part of an officer's education was the knowledge of how to keep accounts. Some of these innumerable records are needed for the satisfaction of the patients' friends, some for the ad- ministration of the hospital, and others to ensure against waste. Every one of them is justifiable, and there is hardly one that could be omitted. In addition to all these, other returns are continually required to show the prevalence of infectious disease, and whenever some special illness excites interest, such as nephritis or trench fever, returns are demanded of that, and must be demanded if the disease is to be understood and ultimately prevented. Then again, in order to justify expenditure the most elaborate authorization is required. If the hospital requires new thermometers the CO. has to certify that those he had were broken in use or captured by the enemy. He is not allowed to lose any himself. But if anything is required that is not in the schedule of its regular equipment the difficulty in obtainingit is extreme. RED TAPE 259 The course of such a request was sketched out for me in conversation by an officer who, though inclined to be critical, certainly knew the details of administration. He instanced an indent drawn by an enthusiastic CO. of a Field Ambulance for some article which he thought would be of great service to the work of his unit, Ijut was not in the regular equipment. It goes to the A.D.M.S., who endorses it and sends it to the G.O.C.> who passes it to the Corps, which hands it to the D.D.M.S., who endorses it and sends it to the Corps Commander, who passes it to the Army, which hands it to the D.M.S., who endorses it and sends it to the Army Commander, who passes it to G.H.Q., who forwards it to the D.G.M.S., who endorses it and sends it to the C.-in-C, who passes it to the Q.M.G., who writes to the D.G.M.S. asking why, if this Field Ambulance is allowed the article, all Field Ambulances should not have it. Is it necessary that they all should ? If not, why not ? Cannot this one discontented unit get along without it ? Whereupon the documents, which by this time number about a dozen, are labelled P.A. (put away), and the sea grows calm again. That is perhaps a slight carica- ture, but it is not far from the real course of events. It was here that the Ked Cross came in, and I do not know what wo should have done without it. At the beginning of the war it provided practically everything for which it was asked. I know it provided a motor- car for a Consulting Surgeon; I know it provided a wedding-dress for an unlucky bride who lost hers on the way to Switzerland, whither she was going to be married to a prisoner invalided out of Germany; and I know it provided every single article of use or comfort for which request was made by responsible persons. At a later date it was by rule restricted to such things as Ordnance 260 A PHYSICIAN IN FRANCE did not stock. But a certain discretion was left to its officers, and many a time when the need was urgent the Red Cross supplied at once articles that Ordnance would have taken two months or more to furnish. It never stinted, it nearly always had the things in stock, and it could obtain what it had not got in hand with ease and speedily. The patients and the Medical Ser- vice owe it a debt which can never be sufficiently ac- knowledged, and the public, if it likes, can learn a lesson from it, for it can here contrast the working of a Govern- ment Department and a private business covering much the same ground. Government management is necessary for all matters, such as sanitation, which, while advantageous to the public, produce insufficient profit to attract private capital, and is useful for keeping up the standard of certain civilian work, such as education, in which the temptation is to save the rates at the expense of the country. The Post Office has been well managed, though it has been much criticized both for its negligences and for its ignorances, and appears now to be run at a diminishing profit. The Telephone is usually said to be the worst in the world, and is the laughing-stock of Americans and Canadians; it certainly is exceedingly bad. The Navy^ and Army are the best examples of Government management, but the methods of the Army at any rate are wholly unsuitable to ordinary business. Further, the system of promotion in a Government Department is necessarily based on seniority, since once in an office a man stays there for the rest of his life, and it would be unjust to deprive him of the natural reward of long service, except for some considerable fault. The general level of work is very even, and selection for merit almost impossible. It was attempted RED TAPE 261 during the war in the R.A.M.C, where it should be comparatively easy, and created universal discontent. The selections were severely criticized by every officer to whom I spoke, and gave rise to widespread suspicion of favouritism, which no doubt was unfounded. Some of the decisions were such flagrant mistakes that they had to be corrected afterwards. The chief reason why a soldier welcomes war is that it upsets routine, and may give him the chance to show what is in him. For the same reason he volunteers with readiness for the most dangerous and unpleasant duties. A civil servant hardly ever gets these chances, and his whole life is spent in an atmosphere of routine and subordination, which deprives him of the versatility and energy, and, above all, of enterprise, on which success in business depends. Seven hundred masters will ruin any pro- perty, and public control inevitably causes parsimony where an intelligent owner would spend freely on experi- ment, and delay where quick decision is vitally needed. It has been claimed of late, as though it were some- thing remarkable, that those employed in public offices feel a devotion to their task. Rather would it be remarkable if they did not, for almost any occupation produces that feeling in an honest man. It is not, however, possible to use it as an illustration of disin- terested labour when compared with private employ, for the great majority of mankind work for regular wages, whether for private or public masters, and neither look upon the latter as more noble than the former? nor claim a lesser reward for it. They leave it if they see better prospects in private employment, and they rightly consider good work as honourable and as useful to the world in the one as in the other. In my own profession, which has as high a moral standard as is 282 A PHYSICIAN IN FRANCE usual among learned professions, there has been a great deal written and said during the last year or two upon what is called a Stat^e Medical Service, but the arguments urged in its behalf have been chiefly drawn from the supposed advantages which it will offer, not to the patient, but to the doctor. This question of a State Medical Service is confused by the diilerent senses in which the phrase is used. Some mean by it that the State, besides co-ordinating the medical services at present performed by various public Departments, should also expand the Insurance Act by providing, in addition to the ordinary treatment of the poor, consultation with experts, increased hos- pital accommodation with payment of the doctors, and greater facilities for the scientific assistance that can be obtained at laboratories. All these things have long been desired by medical men, and now that the public is at last beginning to understand what we have been dinning into its ears for half a century — first that public health is public wealth, and next that the en- couragement of pathology is necessary for the improve- ment of treatment — these changes seem to me the natural corollary of the policy already begun. Others mean an elaborate system of the military type, according to which the whole population would be divided among a body of general practitioners, who would be Government officials at a regular salary, con- trolled and supervised by a Headquarters Staff of Buperior rank. That would, I think, break down on two points — the public preference for doctors of their own choice, and the impossibility of any satisfactory inspection of private practice. A man would be judged by the returns he sent in rather than from his care or skill in treatment; for while the former are easy to RED TAPE 263 criticize, there is no way of judging the hUter. In- spectors have forgotten practice too mucli to act as critics. While I am actually writing these won Is I have received the current issue of the St. Bartholomew's Hospital JouDwl, from which I extract the following specimen of the kind of official criticism on which a man's reputation will depend. A STATE MEDICAL SERVICE. REPORTS AND RETURNS. By a Caitain in the R.A.M.G. 1'hc following is an example of what much of the work con- sists of in a State Medical Service : Reports and Belarus. 2626/2a( d.m.s.5). Armv Headquarters, India, Medical Branch, Simla, October lOth, 1918. From The Director, Medical Services in India. To The Medical Officer in Charge of Prisoners OF War Camp, Hospital, . Memorandum. With reference to the montiily return of sick for Turkish Prisoners of War for September, U)1.S, it is pointed out that the causes of deaths shown marginally is not considered suffi- ciently explanatory for statistical purposes. Attention is invited to this Office letter Xo. 17243-15 (d.m.s.5) dated the 26th February, 191H. {Signed) . Liout.- Colonel, R.A.M.C\ For Director of Medical ScTvices in India. Rppbj. No. , Civilian, -. Drowning (accidental). Kindly note that this death should be returned as No. 1030 (a), Suffocation from suhm'Tsion. Kindly correct your offico copy accordingly. 264 A PHYSICIAN IN FRANCE There will be, on the other hand, great discontent among ourselves, for the pay cannot be large, and pro- motion w-ill be slow. And, moreover, a system of routine subordination will certainly destroy the initia- tive and readiness to accept changes and improvements without which Medicine cannot advance. An atmos- phere of obedience suffocates science. CHAPTER XXV THE TURN OF THE TIDE On August 4tli, 1918, the anniversary of the declaration of war, we attended the first Army Church Parade. It took place in a large park between two banks of great elms, on a hne day, and was very impressive. The Bishop preached, and then the Army Commander made an address. The latter won easily. He said, among other things, that August 4th had every year hitherto seen the initiative with us, and it would be so now. On July 18th Foch had made the stroke described to me by one of our Army Commanders as the greatest feat of generalship in the war, in which, leaving the point of the salient to look after itself, he Hung his attack on the enemy's flank, and so learnt at once that the Germans had used up their reserve. The Germans have given various dates as the turning-point. Some told us that their inability to defeat the Third Army on March 28th showed that they had failed. LudendorlT himself said that our attack on August 8th proved to him that Germany could not win. But though March 28t]i stopped all hope of German advance in the Amiens salient, and though the battle of August 8th was an extraordinary surprise and success, yet July 18th was the day for which we had all been breathlessly waiting. In the autumn of 1017 wo know that the monaco was 2<»r> 266 A PHYSICIAN IN FRANCE terrible, and that, if the Germans brought all their strength against our front we should have an awful struggle, but we believed that we should just hold out. I remember writing home that if I were the Germans I would not attack our front, but would turn south, over- run the Balkans, open a new base for submarines in the Mediterranean, and cut our communications. Strategy is not ray strongest point, though I daresay I was quite as wise as some of the critics. But we none of us knew how near Germany was to breaking, nor how vital to her was the earliest possible decision. Then came the blow, greater even than we expected, and the Army, without reinforcements from home, holding everywhere too long a line, holding just there a line of forty-five miles, which there had been too little time to prepare, with fifteen Divisions reduced to nine battalions each instead of the regular twelve, was beaten back foot by foot, fighting all the way. H.Q. Fifth Army had to issue constant orders to come back, now to this Division, now to that, though the men asked only to stand and fight it out and grew savage and half- mutinous under the immense fatigue and repeated disappointment. But H.Q. dared not risk it. They had, above all, to keep the line continuous and to prevent the Germans breaking through. The line did not remain continuous with all their efforts, for a gap occurred north of the Somme, which the Germans found, yet luckily could not turn to full advantage. But we did enough, just enough, and after five days an Australian Division heralded the reinforcements, and instantly what was left of those fifteen Divisions stopped where they stood. H.Q. Fifth Army drew breath, got a little rest for the first time since the battle started, and began to congratu- late themselves on their success. And then they woke THE TURN OF THE TIDE 267 up to the fact that the world thought they had failed, and failed badly. The French, who had done little to help, abused them; the Government, who had not sent reinforcements, and who now made unfortunate and misleading statements about the strength of the Army, recalled the General, and the public for the time joined in the outcry. Everyone knows better now. There may have been mistakes; there always are. But nothing can ever enable men to hold such a position as that was against forces so overwhelming as those were, and no historian will forget that the stubborn play of the Command and the fierce resistance of the troops held back even that furious onslaught, kept the line unbroken, parried the stroke on which all the hope of Germany depended, and saved the issue of the Great War. Our advance began on August 8th with the clever and extraordinarily successful attack of the Foui'th Army, which had replaced the Fifth in front of Amiens. On August 21st the Third Army on their left joined in, and on their left, again, the First advanced on August 26th. For a long time these three did all the fighting, and carried on the advance, which never stopped. The greatest decision after August 8th was the attack on September 27th, when the Third Army and part of the First stormed the tremendous Hindenburg line, and turned the enemy out of their last great prepared position. The Fourth Army completed the operation next day, and at the same time the Second Army and the Belgians went forward in the ncjrth. That was the first time the Belgians had had a chance. In the first battle of Ypres they held the Yser to the left of the French and us, and a war correspondent who was with them told me that their original army practically 268 A PHYSICIAN IN FRANCE died ill its lines, so tliat they had to train a new one from the beginning. A high authority in the Second Army told me tliat in this attack, though the Staf! work was faulty from inexperience, the Divisions did very well and the men fought like tigers. The Armistice revealed in a curious way the strain, unsuspected until then, that the war had been upon the mind. As each morning when sleep ceases and before consciousness has returned a great sorrow is dimly felt with a sense of pain, so was there now an unexplained comfort when one's eyes unclosed. At first one lay still, and then gradually the thought grew clear, " I shall never see a womided man agam." The feeling lasted many weeks. The hospitals of the Third Ai'iiiy lay chiefly between Cambrai and Le Cateau when the advance stopped. But at the end of February, 1919, we started on a tour of inspection to see the hospitals in Belgium and as far as the Rhine. We drove by Cambrai, Le Cateau, Landrecies, and Charleroi to Namur on the first day. Beyond Landrecies it is a pretty, enclosed country, chiefly pasture, and little damaged. Charleroi is a big coal town, stretching out in ugly suburbs for miles. Namur is a pleasant place, built on the point where the Sambro from the west runs into the Meuse coming from the south. The joint river turns at right angles to the Upper Meuse and conthiues the course of the Sambre to the east. In the narrow triangle between the two is a steep hill on which is the citadel. Upon the top of it there is a large modern pavilion, inscribed " Ludus pro patria," overlooking a level piece of ground suitable for athletic sports. Its rear front is a stage like an ancient theatre. After seeing the Clearing Station, which was in groat THE TURN OF THE TIDE 269 straits owing to the continual demobilization of its orderlies, we drove down the lovely valley oi the Meuse to Huy. Our road led through Dinant, where we saw the ruined quarter, and tablets on the walls to mark the places where the Germans had shot batches of the inhabitants to terrorize the rest. The same happened at Xamur also. At Dinant all the factories were robbed of their machinery. In Huy is buried Peter the Hermit, native of Amiens, " Gentilhomme, pretre et solitaire, d'une petite taille et d'une figure hideuse," within the walls of a monastery that he founded; and a local saint is St. j\Iengold, who was the son of a King of England called Etbald (Ethelbald) by the daughter of Arnoulf, Emperor of Germany and illegitimate son of Carloman. There is in the square a beautiful metal-work fountain 'wath figures in fifteenth -century costumes, and a fine copper basin. The Clearing Station at Huy was in the school, and there was another at the Chateau d'Ardenne in the high country south of the river, a beautiful place, but lonely and far away. We seized at Namur an immense flotilla of German barges laden with produce, which varied from ammuni- tion to children's toys, and was evidence that the Germans had determined to stop there for the winter. We were disposing of it as well as we could, but for lack of suffi- cient guards, which could not be supplied, the barges were heavily pillaged. Robbery reached surprising lengths in Belgium. Numbers of motor-cars were stolen, and supply trains were robbed by men in uniform, who got into the waggons at night and threw out the contents to their confederates while tlie train was moving. At last we put a guard in every waggon, and sent two orderlies with each car. We took tlie opportunity to see Waterloo again, aft 1916, five days after we had taken it. We lay on the south-western side of a little marshy dip, and towards the north and east the ground rises gently to a road THE MEN AND THE BATTT.EFIELDS 28?. cut into the slope and sheltered by six or eight feet of cutting. Behind this the men sheltered in the first rush, but it ia hard to imagine getting up and going on. It is hard to think of climbing that bank and standing up on the bare slope of perhaps a hundred yards that led to the German trenches. There was not a thistle to cover you or stop the fire; the men must have gone forward in the face of a hurricane of bullets. On that slope lay little heaps of knapsacks, bayonets, caps, belts, rifles, every yard or two. Their owniers were in their graves, but the equipment had not been removed, and marked where they had fallen. In front of the trenches were widths of barbed wire, cut to pieces in places by our fire, but in others still intact, and two great craters in the chalk where the Germans had blown up mines under the advancing troops. The parapets had been damaged, but the trenches were still deep and defensible enough. Under the parapet opened the wooden doorways of the stairs, which led steeply down for 20 feet to the dug-outs beneath. One of them in a trench a little way to the rear had been the quarters of a Medical Officer. He had a bedstead, a washstand, an armchair, a table, and a what-not, all no doubt taken from the village houses whose inhabitants had fled. Here and there in the German trenches still lay a few dead bodies, swollen and putrefying, which the burial parties had not yet reached. Thiepval is another terrible place. The Ancre runs there from north to south through a marshy valley about a quarter of a mile wide. West of it the hill rises steeply, and on the east there is more high grouiul which sends down to the south a big rounded spur a mile long. Thiepval lies on the root of the spur, and looks straight down n])on Albert, nearly four miles away, while from 2^ A PHYSTCTAN IN FRANCE Thiepval the ground rises very slightly for about half a mile to the great (Jerman position formed by the Stuss, 8ehwal)en, and Regina redoubts, which have an open field of fire of that distance in front of them. On each side of the Thiepval spur there is a little shelter, the Ancre valley on the west, and another small dip on the east, but the spur itself, up which the troops in the centre had to advance, is bare in front of Thiepval, while behind it to the great main line of trenches which we took on October 20th, 191G, there is no cover anywhere, and it must have been like walking into the mouth of Death. The Butte of Warlencourt, which was another famous place, is a large chalk mound looking like an old burial tumulus which lies just to the south of the road from Albert to Bapaume. It is about twenty feet high, and standing on it you can see a long distance over a rolling country on which nothing stands above the level but the bare skeletons of a few trees here and there, marking where villages once were. Le Sars and Warlencourt, which are on the main road, have completely disappeared; in Ligny, a little way off, there are a few walls. North of the road you look across a shallow valley whose far slope was a sheet of red poppies, looking like a field of blood. Everywhere, as far as the eye could see, was a desolate, ruined country covered \vith thistles, burdock, and other weeds as high as the knee, which hid the innumerable shell-holes that pitted it. The mound had been filled \\'ith machine guns, which were so protected by the chalk above them that they could not be shelled out, and their effect over the open slopes was devastat- ing. On the top of the mound stand three crosses in memory of the 6th, 8th, and 9th Durhams, who, after dreadful losses, captured it. But the most awful battlefield of all was the scene of I ■>*■ .■ •* liATTI r.l ll'.l IP -IN Ml-.MN RciAIi. N IKI> ii\ I 1 1 I I 111 I' >ii<>\\ 1N<. Ml \i\ U'>\lt. THE MEN AND THE BATTLEFIELDS 285 the operations east of Ypres. Ypres itself must have been a lovely place. It is an old fortified town, and the great ramparts which still remain on its eastern side are hardly damaged, though continually pounded by heavy guns. Coming through the ramparts from the east, you enter a large square, on the north side of which stood the great Cloth Hall, and across a street north of the Hall, the Cathedral. The architecture was of the best Gothic, and even in ruin it is lovely. It used to be a holiday resort from the neighbouring large towns, and there was an excellent restaurant on the east side of the square. The battlefield east of it is a line of very low slopes about a mile and a half across, which before the war formed a pretty piece of wooded country with a few villages. To the north of the road was the Polygon racecourse, where the Belgian officers used, I believe, to train the horses that earned prizes in our military tournaments. The whole is now an utterly desolate bog. You cannot walk five yards in a straight line on account of the shell-holes, which are full of water and deep in mud. They have completely blocked the natural surface drainage, and I cannot see how it can be put right, for each single hole is a lake in itself, without any outlet. A wounded man falling into one of them cannot get out. The sides are very steep, the hold is soft, and he sinks in the deep mud like a bogged horse. Even an unwounded man is in danger. An officer \vhom I know sent his servant back to his H.Q. late one evening with a message. Next morning he found the man had not come in, and discovered him in a shell-hole with the \\ ater up to his chin. Kopes were passed under his arms, and with great difficulty he was hauled out, but he died of the exposure. Nothhig is left of the villages here but a few bricks; nubhing of the woods but tho soared slumps 286 A PHYSICIAN IN FRANCE of trees. Nothing stands above the surface of the ghastly ground but these, and the remains of our Tanks and of the German cement-built fortresses that we called pill-boxes. I have seen three sad things in France. I have seen the refugees flying before the enemy's advance with all the property that they could save, and on the top of it the mother and the younger children piled upon the cart. The elder children and the father walked beside it, and when the hill was steep took out the old horse, joined with their neighbours to form a team, and so one by one dragged the heavy loads to the top. They had lost their homes, and they went they knew not whither. I have seen the villages that they had left. Some had almost disappeared, and others had been so completely shattered that it seemed a cheaper and an easier plan to build a new village elsewhere than to attempt the restoration of the old. But I think that the dreadful sight which the land itself presented was worse than either of these two things. What had once been a richly cultivated country and in summer a wide sea of waving corn was now like nothing but a blasted and a barren moor. Brown, lifeless tracts of bents they were that filled it, flecked with white patches of chalk thrown out of old trenches and lit by countless pools of stagnant water, while down the middle of the dead and wasted valley the puffing engine of a light railway made solitude more solitary still. Such desolation is more pitiable than unhappy fugitives, more terrible than ruined villages, and gives a more awful impression of the effect of war. CHArXER XXVII THE END THEREOF The first object of the Allies was to free Europe from German tyranny. That has been accomplished, and I hope for a time so long that when Germany regains the power she will not have the desire to attack others. She will quickly begin again to produce, and it is to every- one's advantage that she should, for the immense loss of wealth can only be made good by work, and every hand is needed if we are to recover the abundance of commodities in which alone prosperity consists. There is DO fear of crushing her. An industrial nation whose machinery is uninjured cannot be prevented from regaining prosperity, even if anyone was so foolish as to wish it. 8 lie will pay, and pay easily, any fine likely to be imposed upon her, will soon again be a thriving nation, and will not, in my opinion, remain republican. Her upper classes, who are both patriotic and capable, will be so much needed that they will reg.iin influence, and will probably set up a constitutional monarcliy. llepublicanism is not in the German blood, and Germany as a whole will prefer the historical forms to which she is accustomed. But though this will be to some extent a danger, her larger classes will have nmch more power than before, and will be able to enforce the desire for peace inherent in all largo industrial masses. The French would not have gone lu war except lur Ihcii own prc- 287 288 A PHYSICIAN IN FRANCE servation, and we are consistently pacific in policy. At present Germans are outwardly uni'epentant, but when they settle down and think matters quietly over they will see, if not with our eyes, at any rate with a vision very different from the present, the real proportion of events. Moreover, since Austria will not again be a united Empire and Turkey will be cut of! from her, Germany will be in a very different position from that which she held before the war. America early put forward proposals for a League of Nations designed to prevent future wars, which was the second great object of the Allies. This plan, which is admirable in spirit, will have considerable effect. But its usefulness in the future depends upon the possession by its members of an intelligence which they have not shown in the past. The danger was clear enough then, but we neither appreciated it nor prepared for it. There will be the same inertia as before, and if the time for action ever unhappily comes there will be divided counsels. We cannot afford to build our hopes uj^on it alone, though it will nourish a spirit which will greatly assist other influences. It is hoped by some that the community of inter- national interests will be sufficiently appreciated greatly to diminish the risk. But each nation is a large business concern, and must to some extent be in rivalry with its neighbours. It is to the world's advantage that this should be so, for it increases production and makes the things that everyone needs more plentiful. Class dis- putes may eventually cut across this feeling, but at present the national interest has a stronger influence with a man than the interests of the world at largo, and if his country were in danger would certainly over- come the latter claim. THE END THEREOF 289 The best hope of future peace lies iii the spread of democracy, chiefly because the wish of the majority of any nation and of any class, except such a chiss as ruled Prussia, is always to avoid war, but also because a democratic government can command neither the efficiency nor the secrecy deliberately to prepare for it. Democracy is the best safeguard against oppression that has yet been invented, but its weakness is that it is permeated by a distrust which makes its operation both dilatory and wasteful. Its virtue will be to acquire the habit of trusting its leaders, perhaps even to bread leaders who can be trusted, while retaining its safeguards against the abuse of power. At present such a faith is strikingly deficient from the top to the bottom of the scale, and until political discovery — for all advance in politics is of the nature of discovery — has provided the means for obtaining it, democracy will never be able to show what she can accomplish. The union of the different parts of the British Empire, which is another great influence for the preservation of the world's peace, has undoubtedly been strengthened by the war. Many years ago the Colonies, as they were then called, chafed under our rule, and the general opinion was that they would separate from England. Later still, English statesmen themselves favoured separation in the supposed interests of the Mother Country. The Boer War and Mr. Chaml^erlain's in- fluence bound them strongly to us, and the present war has bound them closer still. Tliore is nothing more wondorfiil than the attachment whirh thoy have shown to the political ideals for which we have stood, and to the sentiment of union with the other Dominions and with England. Political philosophers have devised schemes by which the Dominions may in a formal manner take ID 290 A PHYSICIAN IN FRANCE a greater share in the management of the Empire; but it is probable that no great scheme will ever be adopted ready made l)y any English race. If we want to con- sult Dominion Ministers we ask them over, and if they are willing to consult with us they come. One year we confine the discussion to certain very limited subjects^ the next it is much wider. The custom will gradually grow as it is found convenient, and one fine day we shall discover that we have laid the foundations of an Imperial Constitution, which we shall then proclaim to have existed ever since we first began to colonize the world. It will be a tarther gain to civilization if the misunder- standings that used to poison our relations with the United States can be diminished . These difficulties have not been of our seeking, and we have done all we could to overcome them. Those Americans whom I know myself respect us first for our unwillingness to go to war, which our want of preparation proved ; next for our defence of Belgium in fulfilment of our public pledge; and thirdly for the staunchness with which we have conducted the great struggle and the sacrifices we have made. I hope that this feeling may exist in a certain degree among the general population of the States. They have the same sense of chivalry as we, the same hatred of oppression, and the same fundamental ideals. It is not too much to hope that they will use their great power in common with ourselves to spread the liberty and justice we alike revere. In England before the war the struggle between employers and employed had in some quarters reached a dangerous stage owing to the distrust with which each party regarded the other. It has always been evident that the war would produce as groat changes in THE END THEREOF 291 the relation of classes withia our own country as in the relation of our State to others. I.abour has not had an open market of late, and its price has been so much altered by this and by the increased money value of goods, that no one knows what it rightly is at present, still less wliat it will be when prices fall. The men are making great demands now, for they know that with the return of soldiers to civil life, with the diminution of the vast military demands, and with the lowering of prices, the natural tendency will be for wages to fall. But they are taking a greater st«p than this. They are urging that all means of communication and transport shall remain permanently in the hands of the State, and they are impeaching the whole system of private ownership. They have selected for attack the coal industry, where for many years they have believed that the owners were cheating them out of their just share of the profits, but their leaders have indicated their intention to extend Stat-e ownership to other industries as well. Class feeling is the strongest that there is, but it is not omnipotent, and if the claims of one class are opposed to what the nation feels to Ije the general interest, they are not likely to succeed. But in any case it is a mistake to suppose that by State ownership or any other system disputes will be avoided. The interest of one man or one class is never the same as that of another, and wliere interests conflict there will always be dilTeronces. Whether the immediate antagonist is a company, or the Government, or the nation, either as private consumers or as other industries, there will always be something to oppose unlimited concessions, and in consequence dis- putes Nnll always occur. It would be a mistake to adopt a plan othervs-ise disadvantageous in the belief that they would be prevented. 292 A PHYSICIAN IN FRANCE Tliere is a great deal of fairness and good sense in Englislimen. Tliey usually allow that there are two sides to a question, and are willing to discuss it with good temper. It nearly always turns out that each party has some reason on its side, and that each has overstated its case in some particulars. The result is a compro- mise. Over large sections of industry masters and men meet one another with mutual respect. Neither side objects to hard bargaining, for they bargain hard them- selves. If in a particular industry this feeling does not exist, the public feels that there must he a grave fault somewhere, and is not likely to show much mercy to those whose fault it is. But if the public has to come in to settle the difference it will take such steps as seem good to itself, and will expect both parties to abide by the award. Whatever system is adopted, one thing is sorely needed. "We have lost the desire for work and the pride in working well. We are no longer the industrious nation that we have been. We do not realize that prosperity depends, not upon wages, but upon goods, and that a nation cannot buy if it does not produce enough to sell. Men work as little as they can, and the restriction of work is actually thought to benefit the workman. It is said that men read much on economic questions, but on this they show an ignorance which is appalling. They are faced with severe competition, for the Germans worship work as we worship play. German engineering is better than ours, and we have lost more than one industry to her. She was before the war increasing her trade at our expense, and she will at once begin to compete with us again. If she succeeds it will be the reward of her industry, and if we fail we shall deserve it. There is no place for a nation that will not work. THE END THEREOF 293 But the war has taught us many thmgs, and it has perhaps taught us this. The puljlic seems to have learnt that money invested in Education and in llealtli will inevitably bring profit to the nation. There seems a new spirit abroad among employers, more enterprise, a greater appreciation of discovery, a greater readiness to consider new methods. And as tor tlie men, they are the same men that 1 have seen in France. I know how they bore their sufferings, and I have heard but one story from Commanding Officers of how they did their work. Just at present labour has lost its head, but I do not believe that the men who have saved Europe are about to ruin England. Ml LIMO AND MKH, I TD., pmilTKIlH, oUILDrnRn, KNaUkKD.