CHAPTER XXII on Their Return to Egypt the Australian Formations Were Sent to the Suez Canal Zone and Helped to Form There A

Home , 2nd Division (Australia), Force in Egypt, II Anzac Corps

CHAPTER XXII EGYPT : REORGANISATION OF THE A.I.F. ON their return to Egypt the Australian formations were sent to the Suez Canal zone and helped to form there a new defensive front for Egypt. Simultaneously with this service the force was reorganised : the infantry into five divisions, forming, with the New Zealand Division, two army corps destined for the Western Front ; the light horse into the Anzac Mounted Division and other mounted units which became part of a British force which fought for the rest of the war in Egypt, Sinai, and Palestine. The self-government of the force in all matters of internal administration was established, though not yet entirely recognised by all the authorities that dealt with it; in the medical service the new director, his powers being now confirmed by the Commonwealth Govern- ment but not fully admitted by the War Office, collected the new medical staff of the A.I.F., hastened clearance to Australia, finalised reforms in the dental and nursing services, and carried out in the A.A.M.C. units a reorganisation, which embodied several experiments of interest.

* * 8 The closing of the Gallipoli campaign opened for the A.I.F. a new phase in its history, with service in a much wider and more diversified sphere of action. The next Return to three months were occupied in a complete Eemt reconstruction and reorganisation of the force, carried out while the troops were taking their part in the dispositions for the new strategic situation. The mise-en-scine of the reorganisation was the neighbourhood of the Suez Canal. Hither the Gallipoli troops were transferred. The 8th Infantry Brigade, with the 2nd Casualty Clearing Station: was already established at I‘ Ferry Post ” near Ismailia, and, as they arrived from Lemnos, the units -of See #. 519.

472 Jan.-Mar., 19161 REORGANISATION OF THE A.I.F. 473 the two Australian infantry divisions were concentrated in the fine military camp recently constructed at Tel el Kebir for the outgoing Indian divisions now proceeding to India and Mesopotamia. Here, on the edge of the desert, within sight of the historic battlefield, roads had been formed, water laid on from sub-artesian wells, and a sanitary system installed. The New Zealand and Australian Division assembled at “ Moascar,” near Ismailia, and here, on January 4th, Anzac Corps Headquarters was also established under Lieutenant- General Godley. The light horse rejoined their remounts in their old camps at Maadi, Heliopolis, and Zeitoun, where, at the last named, in the Australian and New Zealand Training DBpSt, were now accumulated some 40,000 Aus- tralian unallotted reinforcements and recovered convalescents. The 1st Australian Division at Tel el Kebir was now rejoined by its transport from Mex camp,* and units were brought to strength from reinforcements and men who had recovered. With No. 2 Australian Casualty Clearing Station there had arrived in Egypt, as a line-of-communication unit for the 2nd Division, an Australian sanitary section (“ No. Sanitation of I ”). Authority was obtained by Colonel -Ps Howse as D.D.M.S., A. and N.Z. Corps, for another section (“ No. 2 to be at once formed in Egypt for the 1st Division, and, “in view of the proved value of such a unit on the Peninsula,” for both to be made divisional instead of army troops. The sanitation of the two camps was carried out under the direction of the A.D.M.S., Sanitary for Egypt, and the general supervision of the Medical Advisory Committee. There had been initiated a fly-proof pan system with incineration, carried out by native labourers. The prevalence of relapsing fever among the latter, and the endemicity of typhus in Egypt, made the delousing of the force a pressing concern. This process, however, could not, for the moment, be efficiently carried out, being quite beyond the capacity of

During its nine months at Alexandria 20 horse waggons of field ambulances of the 1st Division handled, under orders of the Embarkation Medical Officer, 13,000 sick and wounded, and in doing so travelled over 2,000 miles. ‘Following the British War Establishments laid down in “ Part VII., New Armies,” these consisted of one officer and 25 other ranks. 474 THE GALLIPOLI CAMPAIGN [Jan.-Mar., 1916 the sanitary sections working with I‘ Serbian barrels ” and one

‘I thresh disinfector ” for each division.‘ The only other element of importance in the health state at this time was an increased incidence of cerebro-spinal fever, of which twenty-five cases occurred in the two camps during the month. Pending the arrival of the line-of -communication units from Lemnos, cases of serious sickness and of venereal disease were sent to Cairo by “ No. 4” taskHeavy dental ambulance train, which had been handed over by the Egyptian authorities to serve the Australian requirements and manned by an Australian medical staff. During the next two months twenty-one dental sections set to work on the Augean task of cleaning up the accumulations of dental decay. Branches of the Australian Base DQp6t of Medical Stores were established at Tel el Kebir and Ismailia, where the Australian Red Cross Society, now possessing its own staff and transport, also formed centres. On January 29th No. 2 Stationary Hospital arrived from Lemnos and opened at Tel el Kebir with 400 beds. With the evacuation of Gallipoli 250,000 Turks had been set free for an attack on Egypt, the defence of which became at once a matter of urgent concern. The Defence of the Canal M.E.F. was transferred to Egypt, and Sir Archibald Murray (who had replaced General Sir Charles Monro) was placed in command of the “Canal Defences,” his jurisdiction extending five miles west of the Suez Canal. A defensive line was being formed east of that waterway. During the last week in January the 1st and 2nd Divisions entrained to the Canal, and, crossing at Ferry Post and Serapeum respectively, “ route marched” to the line of low sand-hills nine miles from the Canal in the Sinai Desert and occupied the ‘I Central Sector” of the new defensive front for Egypt. Already from Serapeum and Ferry Post light railways and roads, built by Egyptian labour, were bridging the shifting sands of the lines of communication; and the “ pipe-line ” brought daily nearer from the sweet-water canal

‘At Moascar the New Zealand engineers constructed fine baths and a “ delousing ” Cstablishment with laundry.

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/. I. Jan.-Mar., 19161 REORGANISATION OF THE A.I.F. 475 the water of the Nile, treated by sand filtration and chlorina- tion to purify it from the varied pollutions of Egypt. Here, in ptrfect weather, and under health conditions unsurpassed in the history of the A.I.F., the 1st and 2nd Divisions re- created the trenches of Gallipoli, reaching in the process a very high standard of fitness. On March Ist, for example, only one patient was evacuated from the 1st Division and six from the 2nd. Pending the arrival of the road and railway, the tent divisions behind the lines ex- ploited for the first time the camel " cacolet " and the sand-cart, clearing to casualty clearing stations at Ferry Post and Serapeum, where on January 29th the 1st A.C.C.S. had opened on the banks of the Canal. From those points serious cases went to Ismailia by ambulance-waggon and hospital-barge respectively. Here on February 1st No. I Stationary Hospital formed in a French nunnery a fine hospital of 400 beds, clearing to Cairo by the " Australian " ambplance train. The four weeksbccupied in these movements in the field formations were a period of great administrative activity and were marked by momentous decisions in Ih " AurtraliPa which the Australian medical service was Imperial intimately concerned. The reorganisation of Fame " the force under General Birdwood (who on his return resumed his position with the temporary title of " G.O.C., Australian and New Zealand Forces ") was associated with the deliberate facing of the question of the status of the A.I.F. in matters not only of administration for maintenance, but also of command for active service, within the military forces of Great Britain. The Gallipoli campaign had caused a break in the internal development of the A.I.F., but a break which greatly influenced the nature and

32 47'6 THE GALLIPOLI CAMPAIGN [Jan.-Mar., 1916 direction of its subsequent progress to self -government. For better or for worse the spirit of nationalism had entered the Australian people and directed the reorganisation of their force in all its branches and services. There could now be no question of the piecemeal absorption of any part of the A.I.F. into the British Army. Though, in respect of the higher command and administration officered almost entirely by British regular soldiers, and dependent to a great extent on Great Britain for arms and even for services other than combatant and front-line units, the force that was organised in the headquarters at Ismailia and Cairo and assembled and trained in the camp at Tel el Kebir and in the Sinai Desert, was a purely Australian one, already with marked character- istics of its own. It is not possible, nor is it -necessary, to follow the course of the negotiations6 that led to the separation of the Australian force from that of New Zkaland an the evolution of the administrative system whereby coalete internal self-government was associated with full subordina- tion to British command for service$;lThis evolution, which extends beyond the period under review, was achieved by the identification of a fighting command with administrative direction, embodied in General Birdwood, with a two-fold staff-(^) fighting headquarters of the I Anzac Corps, and (2) administrative headquarters of the Australian Imperial Force in the field and at the base. The Australian Inter- mediate Base DBpBt became " A.I.F. Headquarters " overseas, its commandant being now made responsible, under the G.O.C., A.I.F., for the training of all reinforcements and details and for the administration of all details and units other than field formations. A.I.F. administration was represented in the field by the A.A.G., A.I.F., at corps headquarters and his small staff' The New Zealanders became similarly differentiated under General Godley." Before proceeding to an account of the reorganisation of the force, it is necessary to describe briefly the formation and early activities of the new A.I.F. medical headquarters. The new-provisional-Director of Medical Services for the 'See Oficial History of Australia in the War, Vol. III. chai~s.i. ii, and Vi #During the preoccupation of General Birdwood and his chief-of-staff in the reorganisation of the A.I.F.. General Galley retained the command of the Anzac Corps and signed A.I.F. orders. Dec., IgIS-Jan., 19161 REORGANISATION OF THE A.I.F. 477

A.I.F., Surgeon-General Howse, arrived from Lemnos on December 28th. He found himself in a very anomalous position-chiefly through the fact that the Instalment Of new D.M.S., A.I.F. was not as yet organised as an adminis- A.I.F. trative entity. He was still D.D.M.S., Anzac Corps: his A.I.F. position had as yet the authority only of a notification of his appointment by the D.G.M.S. for Australia. Further, he had been gazetted by the War Office (on December 7th, to date from November 22nd) temporary Surgeon-General, and appointed to the staff of the P.D.M.S., Surgeon-General Babtie, " to assist him in administering the Australian service." After arrival in Egypt, therefore, he reported to that officer. The position that he found awaiting him was, however, of such a nature that, in his opinion, his acceptance of the appointment would lead inevitably to the administrative absorption of the Australian service in the British. He therefore demurred at taking up the duties, pending confirmation of the appointment by the Commonwealth Government ; and in the meantime with the concurrence of the G.O.C., A.I.F. (at this time Major-General Godley who held the position in virtue of his temporary command of the Anzac Corps), he took up duty in the medical section of the Australian Intermediate Base DBpGt, with a somewhat undefined status but an authority that was recognised by the Australian administration in Egypt. From this office, under the D.M.S. for the Force in Egypt, with the provisional staff appointed by the acting D.G.M.S., Australia, he gradually assumed control of the Australian base units in Egypt. In addition, as D.D.M.S. of the Anzac Corps, under the D.M.S., M.E.F., he directed the medical arrangements of the Australian formations on the Canal. The large headquarters staff authorised by the acting D.G.M.S., Australia, was reduced to three assistant-directors and a matron-in-chief, with a staff of six Medical clerks. Into this headquarters the " Staff headquartam- for A.I.F. Officer, A.I.F.," was absorbed, and continued to perform the same duties, the position of " S.M.O., A.I.F.," lapsing automatically. A consulting physician and a consulting surgeon formed a permanent 478 THE GALLIPOLI CAMPAIGN [Dec., 1915-Jan., 1916 invaliding board.? The essential feature of the new regime was that, in place of the vague and ineffective direction by an unsupported, isolated, and somewhat inactive officer which had resulted in chaos, the A.I.F. acquired a well-organised administrative department, directed by a vigorous and re- sourceful personality towards clear and definite ends, backed by military command which had been chastened by unhappy experience to a lively appreciation of the importance of an efficient medical service, and possessing to an unwonted degree the confidence of the combatant side, a confidence begotten of a joint experience in facing unusual problems under unusual circumstances. The duties of the new D.M.S. were not defined by any order. Those laid down for Surgeon-General Williams had by assuming a scope of responsibility proper to an expeditionary force, hindered rather than helped the solution of the problem. Practically, the scope of the department was gradually evolved by a process of " peaceful penetration,"8 which took the form of a tentative assumption of responsi- bilities hitherto assumed by the two British directors in Egypt. The War Office persistently clung to ~~~~~e""the theory that there were two Australian administrative medical officers (deputy- directors) of equal status in Egypt and England respectively, the latter being under the Director-General at the War Office, and the former under his representative in the East, Surgeon-General Babtie. Whatever may have been the case afterwards, it cannot be questioned that at the present juncture such an arrangement would have resulted in an impasse. It was adroitly escaped by the Australian director, who took the earliest opportunity of making clear to the High 'The officers appointed to the several posts were- A.D.M.S. I: Lt.-Col. R. J. Millard. A.D.M.S. a: Major T. E. V. Hurley. A.D.M.S. 3: Captain D. S. Mackenzie. Matron-in-Chief. Miss E. A. Conyers. Consulting Physician: Colonel H C. Maudsley. Consulting Surgeon: Colonel C. S. Ryan. The confirmation of these appointment. and that of Col. Howse as D.M.S., A.I.F., was given by the Commonwealth Defence department at the end of January and they were gazetted to date from Dec. I except that of the Matron-h-Chief. which was dated Jan. Ia. Confirmation by the War Ofice of the appointment of a D.M S.. A I.F., was. however, delayed. This matter receives further consideratton in Vol. II. Described by Colonel Howse as " alternate bullying and cajolery." Jan.-Mar., 19161 REORGANISATION OF THE A.I.F. 479 Commissioner in England, and to the Australian D.D.M.S. there (General Williams), that there was now one director of the internal affairs of the A.A.M.C., A.I.F. The grounds on which the appointment of a new D.M.S., A.I.F., had been urged included the effective direction of the medical service at the base, and the tightening-up of the disposal of Australian convalescents in the Vigorow action by interest both of the field force and of D.M.S. Commonwealth finance. In pursuing these purposes the D.M.S. relied on the application of a new driving power to existing machinery. The occasional interventions of the D.M.S. for the Force in Egypt, and the somewhat vague ‘I assistance ” of the P.M.O., Cairo, were replaced by a firm, if at first somewhat inexperienced, direction. The special establishments drawn up by the acting D.G.M.S., Australia, for the auxiliaries and convalescent dBp8ts were confirmed, and the activities of each closely supervised. The infectious disease hospital at Abbassia (No. 4 Auxiliary) was expanded from special staff. A special unit from Australia took over the venereal detention barracks. Mena House was closed, and the concentration camp at Suez was replaced by No. 2 Auxiliary as a dBp8t for invalids awaiting return to Australia. With these steps was associated a general speeding-up of the system of embarkation; for which machinery already existed in the fine organisation built up during 1915.~ A survey by the “flying board” for Australian convalescents in Egypt was already in progress, and, of 4,000 passed under review, 1,392 were selected by invalids Of the D.M.S., A.I.F., for immediate return to Australia. Their clearance was expedited by the arrival of the two Australian hospital ships, and of the transports proceeding to Australia for the 3rd Division. Under order of the Egyptian Command-based on the advice of the Medical Advisory Committee-358 convalescent enterics were sent to Australia, but upon evidence adduced by the chief bacteriologist, A.I.F., this ______-. DThuson Tanuary ZI three vessels were notified by the Australian naval transport officer as available. on the 25th the Sufolk was selected, and on the 29th she sailed with 3 rg invalids. The Australian embarkation medical officer inspected and prepared the selected transports at Port Said. and thus saved demurrage and delay at Suez; invalids proceeded directed from Cairo to their berths in the transport (p. 410). 480 THE GALLIPOLI CAMPAIGN [ Jan.-Apr., 1916 unnecessary provision was thereafter relaxed and the enteric d6pGt at Port Said closed. The disposal of the troublesome 'I B " class of temporarily or partly unfit was now clearly laid down. Such classification could henceforth be made only by a medical board and approved by the D.M.S., A.I.F. Approved " permanent ' B ' Class " men might be employed at the base and also transferred to the medical service in view of its deficiency in personnel.1° To none of the various branches of the Australian Army Medical Corps did unified control bring greater benefit than to the nursing service. It may almost be said and Nursing that the nursing service of the A.I.F. was Services created by the appointment of a responsible head, the matron-in-chief (Miss Conyers) on the staff of the Australian D.M.S. The dental service found in the new D.M.S. a chief who shared their belief in the potentialities of this speciality as a branch of reparative surgery and preventive medicine. New dental units were formed and equipped as rapidly as men and material could be found. Whereas at the end of 1915 there were only twelve dental officers, by April, 1916, thirty-six dental units were at work, of which twenty-five had been equipped locally from the dental section of the Australian Base D6pGt of Medical Stores, now in charge of a dental quarterniaster.l' The Base DBp8t of Medical Stores received ?tFaDE:d ,, an " establishment " and was constituted on a permanent basis. During this time there was proceeding a reconstruction which doubled the formations constituting the field force, and to this attention must now be directed. Near Reorganisation the end of 1915, under circumstances to be of A.I.F. related,12 Australia had decided to form three new divisions. On January zIst Sir Archibald Murray, on the advice of the G.O.C., A.I.F., reported to the War Office concerning Australian reinforcements in Egypt that " for reasons of training and discipline " it was " essential that these

loThis deficiency bad been brought about by the policy of '' special reinforcements " (now locked u in the auxiliaries) and by the small percentage of regular reinforcements !or the medical service. llA shortage of plaster of Paris was met by organising local manufacture from deposits of gypsum in Egypt. I' p. 515. Feb., 19161 REORGANISATION OF THE A.I.F. 481 be formed into definite units.” On February 2nd the Australian Government agreed that two divisions should be formed in Egypt and one (the 3rd) in Australia. There would then be two army corps, I and II Anzac. This duplication of the Anzac Corps was accomplished by a process akin to that whereby a hive of bees forms new colonies. The first “migration” was that of the New Zealand Infantry Brigade, which, with a “rifle” brigade from New Zealand and another infantry brigade created locally from reinforcements, formed a New Zealand division. Somewhat later the light horse brigades, with the New Zealand mounted rifles, formed an Anzac mounted division. In order to form the two new Australian infantry divisions with the greatest possible speed and the least delay in training, the expedient was adopted of dividing each unit of the 1st Division and of the 4th Brigade into two parts, of which one remained as the original unit, being brought to strength by absorption of reinforcements and of recovered casualties accumulated in Egypt or sent in drafts from England.1s The remaining halves became four skeleton brigades, which, reinforced from the training battalions, and combined with the reorganised 4th and the new 8th Brigades, formed two “ provisional formations,” each containing the elements of a division, with the officer commanding No. 2 Australian Stationary Hospital, Lieutenant-Colonel Barber-a keen sanitarian-as “ S.M.O.” These formed the nuclei of the two new divisions. The actual reconstruction began with the formation on February I Ith of a second “ Anzac ” Corps.14 The units of the new formation, marching in from the Canal defences, assembled at Tel el Kebir and were there joined by their reinforcements. Training commenced with vigour, and the camp became another ‘‘ Mena,” though less strenuous and far more healthy.

I’ On I January, 1916, some 23,500 Australian recovered and recovering casualties were in hospitals or dip6ts4n England 11.000, in Emt 10,066 (including over 3.000 at the Australian Overseas Base, Gherireh), in Malta 2,273, at Mudros 135, at Gibraltar 15. ‘To this formation Colonel Reuter Roth, A.A.M.C.. was ap ointed D.D.M.S. By the wish of General Birdwood, Colonel C. C. Manifold, I.M.8.. was appointed to a similar position in the I Anzac Corps. 482 THE GALLIPOLI CAMPAIGN [Feb., 1916 In the reorganisation of the medical service regimental establishments were divided along with their units. For the field ambulances, however, at the request of Of the D.M.S., A.I.F., and with the approval the new medical -ta of the D.G.M.S., Australia, it was arranged that the infantry units, like those of the light horse, should consist of two instead of three sections, with the addition of thirty-six bearers and three officers. This policy was put into effect by separating the “C” sections from the eight existing units. From these sections four new units were constructed, making, with the “ A ” and “ B ” sections of the 4th and 8th, the six required?& Sanitary sections (4th and 5th) were formed for each “ provisional formation.” For the many new appointments,l’ postings, and promotions the D.M.S., A.I.F., obtained authority for the policy (promised by General Bridges but interrupted by Gallipoli) that the medical corps should form the “ unit ” for promotion and posting in the medical service of the A.I.F., and that, in all appointments to field formations, officers who had served at Gallipoli should be given prefer- ence. On February 25th the provisional formations became the 4th and 5th Divisions.17 On February 29th General Birdwood received warning that the Australian force “would be required to begin to move to France within two weeks.” The FranceThe move to events leading to this notice must be briefly related. On February 16th was fought

1b Field ambulances were finally distributed as follows.- 1st Division-Ist, znd, and 3rd. and Division-5th, 6th, and 7th. 3rd Division-gth, Ioth, and 11th. 4th Division-4th, Izth, and 13th. 5th Division--8th, 14th. and 15th. These numbers corresponded with those of the infantry brigades. le A.D’sM.S. were appointed as follows.- 1st Division-Col. A. H. Sturdee. and Division-Col. A. Sutton. 3rd Division-Col. A. T. White. 4th Division-Col. G. W. Barber. 5th Division-Col. C. H. W. Hardy. Anzac Mtd. Div.-Col. R. M. Downes. “From February I all medical reinforcements from overseas went, by an A.I.F. order, to the details camp at Zeitoun instead of being attached to the general hospitals pending allotment. Some 50 ’I B ” class combatanto were transferred to complete the number required. Feb., 1916j REORGANISATION OF THE A.I.F. 483 the Battle of Erzerum, where Russia, by defeating the Turks, again gave her allies a badly-needed respite and set free the “strategic reserve’’ in Egypt to meet the crisis developing in Europe. Thus again it was to a certain extent the action of Russia that determined the destination of the A.1.F.-this time westward. On February 2Ist the Germans attacked Verdun, and six British Divisions, including two Australian, were ordered at once to France. All activities were now directed to preparation for the move of the I Anzac Corps (then the 1st and 2nd Australian Divisions and the New Zealand Division), command of which was now resumed by General Birdwood. The 4th and 5th Divisions were to follow later as the II Anzac Corps under General Godley. Question was made by the D.M.S., A.I.F., as to the raising of casualty clearing stations for these new divisions. After consultation with the War Office the G.O.C., A.I.F., decided that, since the force would operate in a seat of war of which the lines of communication were fully organised, these units were not required. Nos. I and 2 General Hospitals were, however, to go to France with the formations. The consent of the Australian Government and, after some demur, of the G.O.C., M.E.F., was obtained by General Birdwood to yet another innovation in the medical estab- hperimentm in medical lishment accompanying the divisions, this mganiaation being the attachment to each field ambulance of a dental section, perhaps the most useful contribution made by Australia to medical organisation. Equipment was completed at high pressure by the Australian Base DBp8t of Medical Stores, twenty pairs of medical panniers being constructed locally in twenty-one days. The new British establishments provided that half the transport of the ambulances should be motor, but, since the Australian motor-ambulance transport section was still required in Egypt, the matter was left for adjustment in France. The 2nd and 1st Australian Divisions were in succession relieved respectively by two brigades of light horse, route-marched to the Canal, and entrained for the huge concentration camps at Moascar and Serapeum, there to undergo some final preparation to fit them for a place in the new force and among a European population. 484 THE GALLIPOLI CAMPAIGN [Feb.-Mar., 1916 Notice to proceed to France was accompanied by instructions in which can be seen the influence of the sinister reputation which, in a medical respect, the France for Gallipoli campaign, and particularly the Australian force, had acquired in Europe. Affecting the medical service .there came from Geneial Headquarters in France, through the P.D.M.S., orders that, with a view to the elimination of infection, a “complete inspection” of the troops should be carried out, and special directions were given (with what purpose, it is difficult to say) that a “ venereal inspection ” was to precede embarkation in Egypt and disembarkation at Marseilles-the port from which the Australian formations would proceed to their place on the Western Front. Except for the detection of skin disease, however, a “ medical inspection” as the means of eliminating potential sources of contagion from a large force-especially one that had come into contact with so varied a pathological fauna and flora as had the Australian-must have proved a futile procedure. Freedom from in fectiveness can be secured only by an effectively organised and controlled routine system of preventive measures calculated to minimise the incidence of incubating cases and carriers. Such a system, fortunately, was now in operation in the camps in Egypt, whither-save for the moiety sent to Macedonia-the galaxy of talent assembled for Gallipoli had transferred their attention. At no time in its history was the A.I.F. more closely supervised in this respect. Measures of prevention New,, Banitation era in ,, both direct and indirect were effectively organised and strictly controlled.ls Space will not permit of an account of the new develop- ments, initiating for the A.I.F. a new era, in camp sanitation. The explanation of the healthinessle of the Australian troops at this time, which offers a remarkable contrast, except in the one respect of venereal disease, to the condition of the “In addition to actual inspection and report to the D.M.S. for Egypt or M.E.F., or the formations concerned, the Medical Advisory Committee and Entomological Commission exercised a high educational influence. The demonstration of sanitary methods and exhibit of models near Ismailia, by officers of fhe I.M.S., were visited by a large proportion of Australian medical officers and sanitary personnel. lsUnfortunately it is impossible, except in a few S ecific instances, to give figures for this period, because of the destruction of AustraEan statistical records for 1916 and onwards. Jan.-Mar., 19161 REORGANISATION OF THE A.I.F. 485 first force during the corresponding season of the previous year, is not to be found in any single factor but in the sys- tematic supervision now exercised over all measures €or controlling transmissible disease. The camps were spaced out, the troops well fed, and not overcrowded; fly infection was minimised, cleanliness of person promoted. It is, however, probable that, while these direct measures played their part, the most important factor was the provision made for stamping out foci of infection by prompt evacuation of all cases, control of contacts, and search for carriers. A bacteriological laboratory, arranged in a railway carriage by the D.M.S., M.E.F., was the forerunner of even more mobile methods of ensuring prompt diagnosis, a task in which the Australian medical service became very directly concerned.Po From January onwards routine bacteriological work for the A.I.F. was carried out under the direction of the senior bacteriologist, A.I.F.21 As regards inspiratory infections, the place taken in 1914-15 by pneumonia was now largely occupied by cerebro- spinal fever, carriers of infection being €or Changesin the most part brought by transports from dieeaee picture camps in Australia. Mumps took the place of measles. Gastro-intestinal infections were not conspicuous, though enteric was much more prevalent than in the preceding year. The menace from the endemic insect- borne diseases of Egypt was the subject of strict appropriate procedures and the results were satisfactory. Stringent orders were issued regarding bilharziaeZ and relapsing fever. The force was effectively protected against small-pox. Ophthalmia did not become prevalent. Of all diseases occurring in camps, with the possible exception of mumps, venereal infections were again the most Venereal difficult to prevent, the most troublesome to disease treat, and the most productive of absence

~~ ~ ~- 'Osee p. 631. Lieut -Col. A. H. Tebbutt, and later LieutXol. C. . Martin. Hitherto the great bulk of the work was carried out in the Cairo dntral Laboratory under Dr. C. Todd, to whom the Australian medical service was greatly indebted. The Australian Dermatological Hospital (see f. 519) was self-contained in respect of leboratory investigation Though bathing. in the Nile .waters was prohibited, a number of cases tbst remained infective in Australia till the advyt in 1919 of treapent by antimony tartratr were contracted from the infested sweet-water canal at Tel el Kebir. rhieflv when the troops were watering horses. 486 THE GALLIPOLI CAMPAIGN [Jan.-Apr., 1916 fiom The number of cases constantly under treatment in the Abbassia Detention Barracks rose from 183 in October to 607 in January, 1,187 in February, and 1,493 in March. The average period spent in hospital being thirty- five days, these figures represent approximately the number admitted monthly. By far the greater proportion of them were from the training dkpijt. In these diseases, contagion king from without, isolation of cases and carriers could not affect their incidence. Of the means taken to abate the violence of attraction toward sources of infection- such as moral suasion, counter-attractions, fear, and stoppage of pay-the only one fully effective was distance from the sphere of influence.*‘ In the middle of March the D.M.S., A.I.F., found himself compelled to inform the corps commander that drastic steps must be taken to deal with the situation, “ over 2,000 cases ” being then under treatment. Leave from the Canal to Cairo was stopped, and the training d6pijt was moved to Tel el Kebir. These steps resulted in the number dropping in April to 914. At the end of January the improvised unit which had in October replaced the scratch staff that at first supervised the self-treatment of these cases was itself replaced by a fully- equipped and well-staff ed scientific technical unit. The “ Australian Dermatological Hospital ” took up duty at the end of January, the two senior officers being sent on to Europe to study the methods in vogue. Hereafter venereal disease was treated with the same scientific accuracy as any other, and, except for the “moral” stigma, and military stoppage of pay as punishment for wilfully contracted disease, was on the same plane as scabies or scarlatina. The most important medical procedure in preparation for the move to France was a complete compulsory inoculation ‘JDuring the year which ended in February, 1916, beginning with the concentration of 311 Australian cases in the isolation hospital at the old Detention Barracks, Abbassia, 8,858 cases were treated there, of whom 5,924 were Australian, 1,979 British, and 955 New Zealand, the average stay in hospital (taking all types of case) being 35 days. Of these 1.344 were returned to Australia. The incidence per 1,000 of troops can be seen in graph No. 6, at 8. 466. I‘ The Australian Y.M.C.A. and the Australian branch of the B.R.C.S. co-operated in running soldiers’ clubs, etc., in Cairo, Alexandria, and elsewhere. Meanwhile an organiscd system of personal prophylaxis was developed by the medical service for the careless or uncontrollable. Mar., 19161 REORGANISATION OF THE A.I.F. 487 of the whole force with T.A.B. vaccine,aa of which the advance supplies from England were made T.A.B. inoculation available for the Australian force. Except in cerebro-spinal fever and enteric, a search for bacillary carriers was not a practicable procedure. In those diseases, however, in which hospitality to the infective agents of disease was shared by the troops with camp followers in the form of insect pests, the problem became amenable to a campaign. For so large a force whole- sale methods were needed, and fortunately were available through the experience of the Medical Advisory Committee in Serbia. A “delousing train” was fitted up under the direction of its originator (Colonel W. Hunter, R.A.M.C.T.), and by means of this the divisions were practically freed from vermin with no delay to their onward movement.2e Units of the I Anzac Corps began to embark on March 14th, and, with the 2nd Division in advance, the whole corps had by the 30th left Egypt. A “divisional infantryDeparture Of base dBp8t ” accompanied each division, taking ten per cent infantry reinforcements and seven per cent “ extra medical personnel per field ambulance.” Drafts from England were now stopped. The 1st and 2nd Casualty Clearing Stations followed the field formations ; corps headquarters and the department of the A.A.G., A.I.F., left on March 30th. Before leaving for France, General Birdwood authorised General Godley to exercise in Egypt the “powers of the G.O.C., A.I.F.,” conferred on him by the Commonwealth Government. Coincident with these moves, certain initial steps were taken to close up the Australian base hospital system in Egypt-cxcept so far as it should be required for the light horse-and in general to disentangle the mounted and unmounted parts of the Australian Imperial Force and at the same time provide for continuity of policy and a unified command. The closing of the AUetralian ho@als in base hospitals was greatly helped by the Egypt closed opening of No. 3 General Hospital in the

Typhoid 500 millions. paratyphoid “ A ” and “ B ” 375 milliona each of killed bacilli. sa Colonel Hunter records: I‘ In three months two double-van disinfectors carried out the disinfection of I 70,000 kits, I 7o.ooo overcoats, J.IO,OOO blankets, and a great mass of ordnance clothing. 60,000 troops and native Labour Corps had their clothing disinfected monthly.” 488 THE GALLIPOLI CAMPAIGN [Mar.-June, 1916 Egyptian Army Barracks, Abbassia, a huge building selected by the acting D.G.M.S., Australia, while in Egypt.*‘ Fitted up with the aid of the Australian Red Cross this formed one of the best Australian general hospitals organised during the war. In succession Nos. 2 and I General Hospitals were closed, and left for France. With No. I went the A.D.M.S. 2 of the medical headquarters, Lieutenant- Colonel T. E. V. Hurley, who arrived in France on March 31st under instructions “ to furnish the British authorities with information concerning the A.I.F. medical units and organisation.” No. z Auxiliary and the Australian Con- valescent DQpGt, Helouan, were closed at the beginning of April, the staff being absorbed in the A.A.M.C. details. These events practically synchronised with an important change in the system of command in Egypt. On March 19th dual control of the British forces in that ” E.E.F.” formed region ended by the formation of the “ Egyptian Expeditionary Force ” under command of Sir Archibald Murray. The Levant Base having ceased to function, the P.D.M.S. returned to the United Kingdom, as also did Sir John Maxwell, commander of the Force in Egypt, and his D.M.S., Surgeon-General Ford. With the departure of I Anzac Corps the full significance of the transfer to France became evident. At two important conf erencesas with the “ Imperial ” authorities The new medical in London the decision had been reached that dispositions the administrative headquarters of the A.I.F. and the medical base for the troops in France should be in England. A cable from Australia instructed that the new D.M.S., A.I.F., should proceed to England at once in order “ to personally arrange regarding hospital accommoda- tion.” He embarked on April Igth, leaving an “ hD.M.S., A.I.F.,” in Egypt to represent him. A.I.F. headquarters left for England on May loth, leaving under the “ G.O.C., A.I.F., in Egypt” a cadre to which the A.D.M.S. was attached. The II Anzac Corps (4th and 5th Divisions), after eight weeks on the “ Canal Defences,” followed I Anzac to France, commencing its move- on June 1st and undergoing a like The hotels were found to make bad hospitals. mThis matter will be referred to in Yo/. II. June-July, 19161 REORGANISATION OF THE A.I.F. 41s9 clearance and weeding-out of unfits.28 On General Godley’s departure Major-General H. G. Chauvel, commanding the Anzac Mounted Division, was appointed G.O.C., A.I.F., in Egypt. With the departure of the corps the “ A.D.M.S., A.I.F.,” in Egypt found his position difficult. The D.M.S. had left for England holding the view that Australian medical affairs in Egypt would be under his direction. Neither the British authorities, however, nor the new G.O.C., A.I.F., in Egypt, were prepared to accept the situation ; which indeed presented considerable difficulties. The A.D.M.S. found his chief business-and a considerable one-in the gradual clearance of the hospital population left in Egypt. Of 4,709 sick in hospitals in Egypt on June Ist, 1,5@ had been boarded for return to Australia. Of these, from 300 to 400 had been boarded for “diseases The light horse takes contracted prior to enlistment.” The com- over plaints from the A.I.F. and retorts from Australia on this matter deepened at this time almost to the degree of recrimination. That there were two sides to the question is visible in the nature of the disabilities and in the divergence of views even within the A.I.F. it~elf.3~ The training dBp8t and “ medical details ” followed the A.I.F. headquarters to England, together with an additional sanitary section (No. 6) organised for duty at the base. On July 29th the Base DBpBt of Medical Stores embarked for England. Early in July Nos. I and 3 Auxiliaries were closed and the personnel transferred to England, leaving the Australian Dermatological Hospital to follow. No. 3 Australian Genera; Hospital at Abbassia, and Nos. I and 2 Stationary Hospitals on the Canal, served in the first instance the requirements of the light horse, to whom from this time onwards belongs the history of the Australian Imperial Force in Egypt.

19 For reasons that belong elsewhere the field ambulances went with three sections. They were, however, accompanied by dental sections. ‘OAfter the departure of the I Anzac Corps dwisional medical boards reported 548 men unfit for service. Upon these cases bein5 reviewed by the D.D.M S.. only 346 of ,,the prrvious decisions were confirmed. The opinions of the Divisyul Boards the D.A. & Q hi&, II Anzac, reported to the corps commander, are npparekly at variance with that of the D D.M.S.”