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OBITUARY OF THE WAR. CHARLES KENNETH McKERROW, M.A., M.B., B.C. CAMB., CAPTAIN, ROYAL ARMY MEDICAL CORPS. NORMAN ERNEST JASPER HARDING, M.B., Captain C. K. McKerrow, who died of wounds received CH. B. EDIN., the same day, on Dec. 20th last, at the age of 33, was elder - MAJOR, ROYAL ARMY MEDICAL CORPS. son of the late Dr. George McKerrow, of Ayr. He was Major N. E. J. Harding, who died of cholera at Colaba educated at Cargilfield and Charterhouse Schools, gaining Military Hospital on August 10th last while in command from the latter the Science Scholarship of his year for of a stationary hospital at Bombay, was 41 years of Cambridge, and later an open scholarship at Clare College. age. He studied at Edinburgh and at University College, He took a first class in science, graduated iILB. and B.C. in Liverpool, graduating in 1908, obtaining in the medicine at Edinburgh same year the diploma University in 1900, and of the Conjoint Board. entering the Royal Army After holding resident Medical Corps a year posts at St. George’s later, after taking a Hospital and being extern diploma in Publicc to the 1st Frauenklinik Health. He obtained in Vienna, he joined his his captaincy in 1906, father in practice in Ayr and his majority in for some years. On 1914. He was seriously obtaining a commission i wounded in the Boer in the R. A. M. C. in June, War, and for his ser- 1915, he was appointed vices at that time was regimental medical decorated with thee officer to a battalion Queen’s medal with two of Northumberland clasps and the King’s Fusiliers, going with medal. He went to them to France, where- France with No. 12 he remained until his General Hospital on death. the outbreak of war, Captain McKerrow was and served there for 15 not one-sided in his months, before taking to India the unit which he was com- development. At school and later he had some reputation as a manding at the time of his death. Previously to the outbreak middle-weight boxer, and he also played Association football of war he had served in Burma and on the West Coast of for his college. His superior officer writes of him : "A few Africa. He contributed an article on the Value of Koch’s days before his death Captain McKerrow read an excellent Treatment of Malaria, to the Jo2irnal of the Royal Army paper on Trench Fever before our Divisional Medical Society, Medical Corps, and other articles of a historical and giving proof of his careful clinical work even in the trenches. professional character. I formed a very high opinion of him both as a gallant soldier In 1908 Major Harding married Dorothy, oldest daughter and a skilful surgeon. He was absolutely fearless in the of the late Ernest Wetton, of Maidstone, and of Kobe, performance of his duty." In McKerrow married Japan. - January, 1915, Captain Jean, only daughter of the late James Craik, and leaves a widow and ROGER FORREST HUGHES, B.A., M.B., CH,M. SYDNEY, one son. CAPTAIN, AUSTRALIAN ARMY MEDICAL CORPS. i. CLIFFORD CRAWSHAW .1l.R.C.S. Captain R. F. Hughes, who was killed on active service on PICKLES, ENG., D. P. H. LEEDS, Dec. llth last, was 26 years of age and the elder son of Sir Thomas Hughes, who was for many years Lord Mayor of LATE CAPTAIN, ROYAL ARMY MEDICAL CORPS (T.F.). Sydney. He was educated at St. Ignatius College, Sydney, Mr. C. C. Pickles, who died on Dec. 22nd last, after being entering the Sydney University, where he first graduated in invalided out of the Royal Army Medical Corps, was 30 years arts, and obtained his medical qualifications at the end of age, and the third son of Dr. J. J. Pickles, of Camp-road, ot ivio. tie tnen nlled Leeds, of whose six the position of resident sons five were members medical officer at of the medical pro- St. Vincent’s Hospital fession and one a until March, 1916, when student before the war. he enlisted in the Educated at the Leeds Australian Army Medical Grammar School, Corps. After serving Clifford Pickles entered for six months at a the School of Medicine base military hospital at the University of in Sydney he was Leeds, obtaining in detailed for service as 1909 the Conjoint Board regimental medical qualification, and two officer to an Australian years later the Public battalion in France, Health diploma of his arriving there early in University. After December. Ten days holding resident later while dressing a appointments at Leeds wounded man in his and acting as assistant advanced station he in general practice at was severely wounded Harrogate and Ossett and died the same e he was appointed day. Captain Hughes was well known in athletic medical inspector of school children under the North Riding circles in Sydney. He represented his school at cricket Education Committee and was stationed at Malton, where and football and his university at hockey. Just prior he was also in charge of the local company of the to leaving Australia he married Eileen, youngest daughter 5th Yorkshire Territorials. At the outbreak of hostilities of M. E. Maher, of Collaroy Station, Merriwa, N.S.W., he was medical officer at Gateforth Sanatorium, near Selby, with whom and his parents much sympathy will be and on mobilisation served with the 5th Yorkshire Regiment at felt for his untimely death at the outset of a promising home for some months, after which he was transferred to the career. medicalI service as a captain. He went out to France in 85

April, 1915, in charge of a clearing station, came home The original idea in the minds of the organisers of the three months later with severe shell shock, and was invalided ambulance unit, Dr. Brock tells us, was to provide as an out of the service in October, 1915. In spite of his poor adjunct to it a small evacuation hospital of 25 beds with health he then took over the practice at Earby of his brother, 25 stretchers for cases requiring to remain in the hospital for the late Surgeon P. D. Pickles, who died of gas poisoning a few hours only. The accommodation, however, has been after going down with H.M.S. Russell in.the Mediterranean gradually so greatly extended that 97 patients can now be last year. Unfortunately, his health did not improve, and provided with beds, and there is room in an emergency for an attack of broncho-pneumonia following influenza proved more. -The unit’s funds do not at present allow of filling fatal. more than about 65 of these, and this may be con- Captain C. C. Pickles’s service to his country was under- sidered for the moment the normal number. The ground taken with no thought of himself. His transference from floor of the villa was appropriated, as far as possible, for combatant to medical service was made at a time when hospital purposes. The outbreak of Asiatic cholera made it doctors were urgently required for the Army, and the strain necessary to prepare an isolation ward. A part of the of his work contributed to the illness from which he never granary was partitioned off into two rooms, one for suspected quite recovered. His record and that of his family are a cases and the other for cases such as typhus or cholera. notable achievement. Captain Pickles married in June of After the great battle in the first week of November, 1915, a last year Dorothy B. E. Wilkinson, only daughter of Charles great rush of wounded came from the Gorizia section. All Wilkinson, of Boston Spa and Leeds. the beds (5t) in the villa were quickly filled and the remainder of the patients were put on mattresses or on straw in the granary in four long lines. As many as 150 THE FIRST BRITISH RED CROSS UNIT IN ITALY. patients were at one time in the hospital. The remaining of the has since been off and divided We have received from Dr. G. S. chief medical part granary partitioned Brock, into two, so as to form two large wards. officer to the unit, a of the first work report year’s hospital An out-patient department has also become a necessity. drawn for the Joint War Committee, from which we take up Many soldiers sent from the front into reserve are the :- encamped following in this neighbourhood, often unaccompanied by a medical Villa Trento, the headquarters of the ambulance unit, is officer. In case of illness they usually come for advice on the high road beyond the bridge over the river Natisone to this hospital. The number of these soon necessitated at Manzanol, and within a dozen miles of the fighting on the an out-patient department. A waiting-room and consulting- Isonzo front, on Monte Sabotino, at Oslavia, and on Monte room have been partitioned off in the granary, and this work Podgora. The villa is a large building of seventeenth is undertaken by an Italian colleague, Lieutenant De Lisi, century design, belonging to the Conte di Trento, with a who has been attached to the unit from the first and has central portion of three storeys and wings of two storeys, rendered invaluable assistance. flanked on either side by tall pine trees. Behind the latter, The pharmacy of the hospital is under the care of Lieu- on one hand, is a line of offices occupied by a detachment of tenant Balotta, another Italian officer detailed by the Carabinieri, while on the other is a long building of which Direzione di Sanita to assist the unit. A certain amount the upper storey, ordinarily used as a granary, now forms an of the drugs used has come from England, but the greater important part of the hospital. There is plenty of garden part of the pharmacy supplies is obtained from the space where convalescents can take air and exercise "Magazzino Avanzato" of Udine, These are used not enjoyably. only for the hospital, but also for the out-patients. A Dr. Brock tells us that at the time of the unit’s arrival certain equipment (hospital supplies other than drugs) was (Sept. 5th, 1915) the villa was occupied as an Italian hos- brought out from England and more followed later by sea. pital and the first ambulance work consisted in transporting But a great many things had to be obtained locally, as, for some 50 patients to the neighbouring Abbazia Hospital. instance, the furniture of the operating-room. Fortunately Much had then to be done both in improving the very bad a large number of bales containing such stores, collected by sanitary conditions and in adapting the villa to its purpose. the Ladies’ Committee in England and Scotland, were sent This work, performed almost entirely by members of the with members of the unit coming out in time for the great unit, was speedily carried out. On Sept. 12th was received rush of wounded. Since then the hospital has received the first batch of 8 patients, and by the end of the month many generous contributions of money and supplies from the number accommodated was 55. After dealing with friends in Britain and from British residents in Italy. Large defective sanitation the unit turned its attention to getting consignments have been received from various war hospital a satisfactory water-supply. Water from a deep well was supply depots, including those of Kensington, Belgravia, found by Captain Franchini, of the VI. Army Corps, to be Norwich, and Rome, and a very large one has now-arrived quite free from pathogenic organisms. A second source from the Scottish Red Cross. from an open stream, in spite of filtering, was impure, but When the hospital was opened in September, 1915, the no doubt often found its way into the unit’s food and drink. unit expected to act only as a cleating station. Later, Fortunately another source became available from the according to instructions received from Colonel Moreno in Acquedotto Poiano by the kind help of Colonel Moreno, of regard to the stay of wounded in the hospital, the unit the "Genio" of the Army Corps, to which the unit is was to work only as a field hospital. It was soon realised, attached. This water is of excellent quality and practically however, that when little fighting was in progress the work unvarying quantity, is moderately soft, and under high done might be that of a small base hospital, but when a rush of pressure. The effect of this new water-supply on the wounded is anticipated all the sick and wounded who can be health of the unit was immediate, there being no longer safely transported are evacuated in order once more to take cases of diarrhoea. The absence of heating arrange- on the role of a field hospital. ’ ments did not lead to serious inconvenience during the The medical staff consists of the chief medical officer, summer, but on the approach of cold weather something who is also its " direttore," and two surgeons. -The present had to be done. The Genio provided stoves for all chief medical officer has been with the unit since its work the wards and also for some of the rooms. By means began. The two surgeons, Dr. W. E. Thompson, and Dr. W. A. of these and a number of petroleum stoves the villa Propert, joined later-in October, 1915-when Dr. W. R. has been fairly well heated. The villa is lighted by Dakin and Professor Henry Tonks, F.R.C.S., the well- its own electric installation of gas-engine accumulators. known artist, who had come out with the unit, were The laundry arrangements were totally inadequate. Appli- obliged to leave by other engagements. Mr. R. Creasy, cation was made to General Cavicchia, of the Direzione di of Windlesham, Surrey, took duty for -a month at the Sanita of the 2nd Army, laying before him a scheme for the beginning of 1916 in the absence of one of the surgeons. erection of a disinfecting-room, washhouse, ironing-room, Dr. Propeit rejoined some time ago. As to nursing, the unit and drying room, which he very kindly had carried out by at first went on as best it could with the help of men the Genio, and also provided a steam disinfector and a com- belonging to the unit and of some Italian soldier orderlies. plete set of apparatus, consisting of two large galvanised- Nineteen of the members, seven of them medical students, iron boilers, a soaking tank, and a rinsing machine. Regard- took duty as nurses and dressers. Eventually the autho- ing the disposal of refuse, all combustible materials are rities consented to female nurses being employed. The advent burnt by two incinerators’-one of brick built by the unit, of female nurses made a vast difference for the better, many the other of iron supplied by the Direzione di Sanity. Non- of them speaking Italian. Of our male nurses and dressers combustible materials are buried in a neighbouring field. only five remain on the hospital side. 86

Up to the end of March, 1916, the numbers of patients on, in one a piece of. shrapnel being literally picked off the treated were as follows :- I back of the heart. Practically every surgical case .required drainage in some form, and some for a length of time. For gas gangrene nothing was found better than peroxide of hydrogen and e.u.sol, followed by 5 per cent.- saline. The best absorbent dressing for these cases was the sphagnum moss bags presented by Mr. C. W. Cathcart, of Edinburgh, and others. These were a great saving in dressings as well as an ideal dressing. Two the to the The - death-rate was low the supplementary reports bring figures up thus very considering many end of June and and deal. with severe cases. The death medical cases was in a August respectively, only among the second of work. the three months case of double The 398 sick were year During pneumonia. discharged to June the total admitted increased ,from all cured or convalescent. the few April patients nearly Among exceptions 1022 to 1492-792 sick, 700 wounded. on were cases of cholera removed to cholera on Unfortunately eight hospitals June, 7th the unit lost Dr. services his enforced four Oases of frozen feet with Propert’s by diagnosis, terminating fatally. return to England. For the month of August the admissions the skin uninjured have been counted as medical, apparently to hospital reached a high figure, especially in the early part but those with the skin blistered or broken as surgical. during the great Italian offensive which resulted in the The nature of the medical cases met with will be seen chiefly of Gorizia, when there was a of 160 from the to 450 sick admitted capture daily average following table, relating up to beds. As be strain on the end of 1916. occupied may easily imagined,,the March, , , organisation and personnel was very severe, since not only were the numbers sometimes double that for which the unit is normally equipped, but it had to play the r61e of a clear. ing hospital as well. Fortunately a great many wounds were light, many patients in a day or two being fit to return to their regiments. Great although the strain was, everything went on with wonderful smoothness and efficiency, calling forth praise both from the Italian military and sanitary authorities and from the Chief Commissioner of the British Red Cross for,the Mediterranean, Sir Courtauld Thompson, who happened to be here during the most strenuous part of it. ____

THE PANEL COMMITTEE FOR THE COUNTY OF LONDON AND THE MOBILISATION OF THE MEDICAL PROFESSION. The following resolutions were passed by the Panel It is remarkable that no case of occurred in cholera Committee of the County of London at their meeting on members of the were, unit, many of whom constantly Tuesday last, Jan. 9th :— coming in contact with cholera this was patients ; (a) That the Panel Committee are of opinion that, in respect to the no doubt the result of the precautions taken, including proposal to mobilise the medical profession, it is essential, in order to anti-cholera vaccinations of nearly all - the members secure the eflicient working of any, scheme adopted, that extended after arrival with vaccine the powers be conferred upon tne Central Medical War Committee in con- shortly supplied by nexion therewith, and that the personnel of the Committee be Lister Institute of London. It is also striking to find strengthened by the addition of at least six practitioners actively true typhoid absent, as well as the comparatively large engaged in panel practice, one of whom should be a woman. Panel are number of, cases. In the Italian (b) That the Committee of opinion that, in 60 far as the (17) paratyphoid Army recommendations of the Central Medical War Committee shall have antityphoid vaccination has been practised, but not anti- reference to the services rendered by the medical profession to the civil pa’atyphoid vaccination. A combined vaccine is, however, population, if accepted, these should be carried into effect by a small now used 800 million and executive committee appointed from the members of the Central being largely containing typhoid Medical War Committee, with lay members appointed by the Direotor 500 million paratyphoid B bacilli per cubic centimetre, in of National Sfiv ce. three doses at intervals of a week. the last two doses of 1 c. c. (c) That the Pacel Committee are of opinion that the difficulties of these in this connexion would and a beiug double the first. The paratyphoid was on the whole of Committees be greatly lessened considerably .increased number of medical men set free for active a benign type and unaccompanied by grave complications. service abroad without serious interference with the medical needs of A great difference of opinion prevails as to the causation of the civilian population if .much greater:,use were in future made of the " Dr. Brock is convinced that part-time services of civilian doctors for the treatment of sick and p4edi congelati " (frozen feet). wounded soldiers whilst in hospitals and for other military duties in the puttee is the chief offender. this country. There have been a great many visitors, both Italian and (d) That copies of the foregoing resolutions be forwarded to the The of has three visits, at the Central Medical War Committee, the Director of National Service, and English. King Italy paid to the other Government Departments concerned. last one decorating the commandant, Mr.,G. M. Trevelyan, We comment on these resolutions elsewhere. with the silver medal for valour. Another royal visitor on three occasions was the Duchess of Aosta. :A follows on the cases in the report surgical hospital IN offer Mr. W. E. Oh.B..Edin. The CONVALESCENT HOME CALCUTTA.-An by Thompson, M...B., numbers has been made and from Calcutta to entertain of cases, he tells us, varied. At the com- accepted surgical greatly ii 100 men and or more officers invalided from mencement wards had been and an 10 Mesopotamia. ,prepared operating I Mr. Galstaun ha-< the use of his house in Circnlar-roa(i" theatre reconstructed. Instruments in large variety, tables I given while Raja Kristo Das Law has lent No. 23 Theatre-road as and cupboards of good sterilisable material were, procured I a re,idential club for convalescent officers. The . Calcutta. and a good supply of dressings was put ready to hand. It nursing division of the St. John Ambulance Brigade are was soon found that more apparatus was needed; especially out these two fine residences for. the purposes they a and an X ray installation. Both fitting bacteriological laboratory are to serve. The cost of the -and of these have since been sent, the the of estimated furnishing microscope gift for months has at lakhs Miss of Rome. The other the X installz- upkeep five been put 11/2 of rppees, Gray, gift, ray and this to.be tion, is largely owing to the generosity of Dr. Barbour, amount,is likely forthcoming. of Edinburgh, and Mr. Saunders, of Croydon. A great variety of surgical cases has been dealt with from cuts and METROPOLITAN ASYLUMS BOARD : THREATENED bruises to severe chest, and abdominal to OF _ head, injuries. Up SHORTAGE AMBULANCES.—The lack of motor and driver March 31st, 1916, there were 84 operations,-34 of these being mechanics is.reducing the ambulance service of the Asylums major. Taking into account the severity of so many cases Board to. a dangerous extent. The Ambulance Committee states that 37 cent. of ambulances are where the only object attainable was relief of suffering, the per the awaiting and that within a few months the ambu- death-rate of cases over 10 per cent.- and repair, probably operation was just lance service will be unable to remove fever patients from the total of all cases about 1’5 cent. mortality surgical per their homes. The committee urges on the Board the neces- There were 31 amputations of the leg and arm-12 being of sity for the return of mechanics who have been taken for the leg. Four cases of traumatic empyema were operated Army or munitions. service.