THE BIOMEDICAL SCIENCE SCIENCE THE BIOMEDICAL 28 SCIENTIST The big story The big story SCIENTIST 29 IN THE TRENCHES To mark 100 years since the First World War came to a close, we look at the conditions in the trenches and hear from the diaries and letters of those who endured the horrific conflict.

he First World War is The biggest risk estimated to have claimed Ceri Gage, Curator of Collections at the 20 million lives and to have Army Medical Services Museum in left 21 million wounded. Aldershot, says that infection posed one The total number of deaths of the greatest medical risks. included 9.7 million military “A simple cut to a finger from cleaning personnel and about 10 your gun or digging a trench could quite million civilians. Of these quickly become infected and develop into deaths, an estimated 5.7m were soldiers ,” she says. Tfighting for the Allies. “The men were knee-deep in mud nine Many died in combat, through out of 12 months of the year, surrounded accidents, or perished as prisoners of war. by bacteria from the bodies of men and But the majority of loss of life can be animals in no-man’s-land. attributed to famine and disease – horrific “Their bodies were weaker anyway conditions meant , parasites and from a lack of sleep, wet and dirty clothes infections were rife on the frontline and and a restricted diet in which a piece ripped through the troops in the trenches. of fruit or vegetable was a treat.” Among the and that Field ambulance records show how were most prevalent were influenza, the pattern of offensives and attacks 1 typhoid, and trench . dominated work for the doctors at times. THE BIOMEDICAL SCIENCE SCIENCE THE BIOMEDICAL 30 SCIENTIST The big story The big story SCIENTIST 31

3 Fig. 1. An officer of the 10th Battalion, Cameronians (Scottish Rifles) leads the way out of a sap Fig. 2. A 'bag' of rats from the French trenches Fig. 3. bacterium

On a single day, up to 300 men could be Rats kept a diary, admitted with gas poisoning and on days The trenches were home to millions published where there was no fighting, medics were of rats, which could produce up to 900 TOP 20 MEDICAL decades after able to treat non-urgent cases, such as young a year, meaning attempts to kill CONDITIONS TREATED his death when his tooth decay. and curb the rat population proved futile. granddaughter found Pyrexia of unknown origin (8.7%) But despite the threat of fighting, Private Harold Saunders enlisted in it hidden in the attic. Inflammation of connective documents show that the top five the 14th London (London Scottish) in In it he wrote of “the same tissue (7.9%) conditions treated by 51st Field Ambulance November 1915, and went to France with tragic story” repeating itself. Trench foot (6.8%) were pyrexia (a catch-all term for fevers) the 2nd Battalion in June 1916. “Men march up singing and return (8.7%), inflammation of connective tissue When the 6oth Division left France Influenza (6.6%) wounded as fast as lorries can carry them. 2 (7.9%), trench foot (6.8%), influenza (6.6%) for Salonika, he was left behind with Scabies (6.1%) They return huddled together like and scabies (6.1%). Shrapnel comes in sixth a septic heel. He was then transferred Shrapnel (4.9%) carcasses of meat.” He went on to pay place, causing 4.9% of conditions treated. At the time, the causative agent was To minimize the chances of contacting to the 1st Battalion and was finally Gun shot (4.7%) tribute to the to the “heroism” and The figures come from the Western Front identified and grouped with the Rickettsia trench foot, men were ordered to change discharged April 1918. “courage” of the nurses on the front lines. Mustard and chlorine gas and were compiled from the records of and named Rickettsia Quintana. After the into dry socks as often as possible. And In an account of his experiences, poisoning (3.98%) He wrote: “There’s another class of 30,000 men treated in field hospitals (see war, R. quintana would subsequently join the around 1916, John Logie Baird started published in the 1930 anthology Everyman women whose heroism and courage is Diarrhoea (3.0%) box, opposite, for the top 20 conditions genus . to sell socks prepared with borax to help at War, he wrote: “One got used to many deserving of the highest praise but they Rheumatism (2.6%) treated by the 51st Field Ambulance). alleviate the problems of wet feet. things, but I never overcame my horror of too appear to be forgotten – the nurses Trench foot the rats. They abounded in some parts, Shell shock (2.3%) in the front areas where romance and Trench fever Another common and serious issue was First-hand accounts great loathsome beasts gorged with flesh. Gonorrhoea (2.2%) sentiment cease to exist, where life hangs Trench fever, often classed as “pyrexia”, trench foot, especially during the winter Soldiers were not allowed to keep diaries I shall never forget a dug-out at the back Lung infection (2.1%) but by a thread, where the work which is a condition that was first reported from of 1914-15, when over 20,000 of the – in case they fell into enemy hands and of the line near Anzin. It was at the foot (2.0%) they are called upon to do is even worse troops in Flanders in 1915, when individuals Allied are thought to have been affected. included details that could be useful and of rising ground, at the top of which was Fractured femur (1.9%) than the shells and aircraft bombs which suffered from a febrile illness that relapsed By the end of the war, a total of 74,000 exploited. But we are able to hear a French war cemetery. number them among their victims. Urinary tract infection in five-day cycles. At the time, the cause of Allied troops are believed to have suffered first-hand about the dreadful conditions “About the same time every night the There is no holding patients’ hands (1.8%) the disease was unknown. from the condition. that were the catalyst to the spread of dug-out was invaded by swarms of rats. in flower bedecked rooms amid Lice (1.8%) It is estimated to have affected 380,000 The issue was prominent in trenches disease and infection through secret They gnawed holes in our haversacks and romantic surroundings where to 520,000 members of the British army that were dug in land that was at, or diaries kept hidden and letters sent home. devoured our iron rations. We hung Other STDs (1.6%) the gallant Dragoon staggers and had a debilitating effect, leaving a near, sea level, where the water table “Bent double, like old beggars under haversacks and rations to the roof, but (1.3%) in with gold braid and a large numbers of men incapacitated. was just beneath the surface. sacks. Knock-kneed, coughing like hags,” they went just the same. Once we Wasp stings (1%) bloodstained bandage around A lot of research was carried out by the The soldiers would hit water after a is how poet Wilfred Owen described his drenched the place with creosote. It almost his head. British and US to identify the cause and couple of feet and the trenches would fellow soldiers. The words come from suffocated us, but did not keep the rats “No! The work is fast and mechanism of transmission. flood. After long periods standing in opening stanza of Dulce et Decorum Est, one away. They pattered down the steps at the furious, filthy and bloody, Due to its similarity to Malaria, many soaking wet socks and boots, trench of the most famous poems to be penned usual time, paused a moment and sneezed, something to do with it as well abdominal cases are bad at any time thought that lice were the cause, but foot would start to set in. The men’s feet in the trenches. and then got to work on our belongings. as the heat and the still unburied but when the casualty has been snatched attempts to find a treatment were not would swell and go numb and then After three years of service, he was A battalion of Jerrys would have terrified dead bodies about. from a muddy, gory swamp, hardly successful, and efforts to prevention were the skin would start to turn red killed in action on 4 November 1918 while me less than the rats did sometimes.” “There are millions and millions of flies recognisable from the wind which is mainly focussed in using insecticides or blue. Untreated feet often became crossing the Sambre-Oise Canal, exactly one here and they are all over everything. Put everywhere, as lousy as a cuckoo, and to delouse clothing. gangrenous and the condition could week before the signing of the Armistice Flies a cup of tea down without a cover and it is with no control over the lower organs, the lead to nerve damage, tissue loss and brought the bloody conflict to a conclusion. Harold William Cronin, Lieutenant in immediately covered with dead ones, they smell and the groans, it is a miracle that ultimately the need for amputation. In his poems, the most famous of which 5th Bedfordshire Regiment, described are all round your mouth and directly you these women don’t lose their reason.” were published posthumously, he lays out the conditions in which diseases thrived open it to speak or to eat in they pop. It is He also noted down in his diary: the horrors of trench and gas warfare. We in a letter home. a game. We have all got nets of course, we “There is a good deal of talk in the hear of men marching who had lost their “In the trenches it was fairly bad, should have been worried, no medicine by papers about venereal disease and to “Every night the dug-out was boots “but limped on, blood-shod” “lame”, they are so narrow and smelly and one is now if we hadn’t.” judge by some articles one would think “blind” and “drunk with fatigue”. being potted at and shelled all the time.” that the war was being fought in some invaded by swarms of rats. They While he is the most famous chronicler He continued: “Although it is so Frontline nurses prostitutes’ parlour. gnawed holes in our haversacks of the conditions of the war, many gloriously sunny something is wrong Sergeant Horace Reginald Stanley served “Well after three years in the front lesser-known voices also recorded the with the place and it really isn’t as the 1st Cambridgeshire Regiment on the areas, I’ve seen very little opportunity

and devoured our iron rations” situations they endured. IMAGES: ISTOCK/ALAMY healthy as it looks. I think the flies have front line at Ypres and the Somme and of contracting this grievous disease.”