This year marks the centenary of the outbreak of the First World War. The Library will be publishing four blog posts reflecting on the experiences of medical staff and patients during the conflict, not only at St George’s but within the wider medical community. The posts will be published at the beginning of each week during November starting from today. We hope you will find them interesting.
The outbreak of war in August 1914 was accompanied by a swell of patriotism in Britain and many appeared to accept the morale boosting suggestion that the War would not only be easily won, but that it would also be ‘over by Christmas’. Although confidence in the British Empire ran high, others were less sanguine and their outlook was epitomised by Viscount Grey’s famous comment of that same month:
‘The lamps are going out all over Europe, and we shall not see them lit again in our life-time’ (Spender, 1925, pp. 14-15).
At St George’s Hospital and Medical School however, both administration and staff appeared to share the enthusiasm of the nation for war. A writer in the St George’s Hospital Gazette described the:
‘patriotism of the younger and (many of the older men)’. He continued to note that within a few days of the declaration of war ‘practically the entire resident and non-resident staff volunteered their services to the Admiralty or War Office ‘(St George’s Hospital Gazette, Oct 1914, p. 99).
The dark side of this burgeoning patriotism also revealed itself. Forty nurses were reported to have attempted to have a housekeeper with a German name removed from her position; she only survived by revealing she had changed her nationality (Bloomfield, 1933, p. 92).
Title plate from The St George’s Hospital Gazette, October 1914.
The first effect of the war upon St George’s was the loss of medical personnel to the Territorial regiments or the Royal Naval reserve. They were soon joined by professional nursing staff; in October 2014 alone twenty two joined the British Red Cross Society (St Georges Hospital Gazette, Oct 1914, p. 106). At the same time there was naturally no respite in the workload of a busy London hospital. Visiting staff and Registrars stepped in to take resident posts, retired employees returned to work and despite placing a hundred beds at the disposal of the War Office, the hospital coped. This was partially ascribed to:
‘… Certain rearrangements evolved in the depths of the brain of the Superintendent, who , fortunately, is an ex-Wrangler…’ (St Georges Hospital Gazette, Oct 1914, p. 100).
The first major engagement, The Battle of Mons, took place in August 1914 and St George’s staff who had volunteered saw service soon after signing up. A St George’s medic wrote of treating casualties who had arrived after a lengthy train journey at an unnamed military hospital in France:
‘Of the wounds I need not say much, except that taken on the whole they were more severe than one sees in England’ he continued ‘The more severe injuries however, especially those caused by shrapnel were generally very foul, with a certain amount of gangrene and cellulitis’ (St George’s Hospital Gazette, Oct 1914, pp. 97 – 98).
Walking wounded 1916 (photograph courtesy of the Imperial War Museum).
Most of the younger doctors who volunteered from St George’s and elsewhere had no experience of military medicine. Some of the senior medical staff however had held military rank and worked in theatres of war, particularly during the Boer War. A letter published by the Lancet in September 1915 reflected this:
‘I have looked up my old notebooks relating to my experiences of the Boer war and Zululand rebellion of 1906 in the hope that [they] may be of use to others who have not had the advantage of previously treated cases of rifle wounds’ ( The Lancet, 1914, pp. 642–44).
In hindsight this might seem naïve, but during the early stages of the conflict few comprehended that advances in medical science such as blood transfusions would be matched by advances in weaponry. Medical establishments had historically evolved from military and religious organisations. This was reflected by the hierarchical disciplined systems adopted by institutions such as St George’s. The organisation of nursing on the wards had developed from Florence Nightingale’s theories, which were themselves condensed from her experiences in the Scutari Military Hospital during the Crimean War (Nightingale, 1859). In that, and subsequent conflicts, the majority of deaths were caused by infection and disease rather than injury, so the importance of medical care in contributing to military success was understood. Moreover advances in medicine including an awareness of sepsis and disinfection had improved recovery rates from injury. The late Victorian and Edwardian eras had also witnessed a growth in interest in public health including sanitation, infection control and hygiene. Therefore it is not surprising that there was initially a degree of confidence in modern medicine’s ability to deal with the war wounded.
Interior of a military hospital ward in Cambridge (photograph courtesy of the Imperial War Museum).
As the war continued, the adoption of trench warfare meant the combination of wound and infection would become a major and recurrent challenge. The first shipment of wounded back to St George’s arrived on the King’s and Hope Wards in mid-October 1914. (St George’s Hospital Gazette, Oct 1914, p.100). John Lavery’s painting: The First Wounded, London Hospital, August 1914 although somewhat idealised suggests how the wards at St George’s might have looked. In the painting the wounds are probably not depicted in their full severity but the injuries and conditions prevalent amongst those admitted would have been similar to those treated at St George’s later that year. The most common problem was frostbite which continued to be the case throughout the war (Atenstaadt, 2006). Infections were also rife as was rheumatism, most probably caused by trench fever. Of the trauma cases upper limb injuries were more numerous (Park and Park, 2011). Although hospitals like St George’s were at this point staffed by professional medics and nurses used to treating infection and trauma, the scale and violence of the injuries must have profoundly affected the staff working with the first tranches of war casualties.
John Lavery. The First Wounded, London Hospital, August 14 (courtesy of Dundee Art Gallery).
This seems to have concentrated the minds of some medics, as a less grim consequence of the outbreak of war at St George’s was a rush to marry sweethearts, with the Gazette recording four such marriages (St Georges Hospital Gazette, Oct 1914, p. 108).
The effects of the War and the speed of its escalation in terms of manpower and effort can be detected within issues of the St George’s Hospital Gazette which appeared during its early months. As the war continued the numbers of St George’s staff involved increased and some were taken prisoner, injured, or killed in action. One of the first casualties was Septimus Hibbet, a House Physician at St George’s who was lost with the H.M.S Formidable in January 1915, one of the first battleships to be sunk during the war (St George’s Hospital Gazette, Oct 1914, p.102). In a surreal footnote a survivor of this sinking was reputed to have been resuscitated by a sheepdog called ‘Lassie’ who may have provided the inspiration for the famous Hollywood films (Clarke, 2008).
HMS Formidable (photograph courtesy of the Imperial War Museum)
Atenstaadt, R. L. (2006) ‘Trench foot: the medical response in the First World War 1914 – 1918’, Wilderness and Environmental Medicine, 17(4), pp: 282 -289.
Blomfield , J. (1933) St George’s 1733 – 1933. London: The Medici Society.
Clarke, N. (2008) Shipwreck Guide to Dorset and South Devon. Charmouth: Nigel J. Clarke Publications
Ministry of Information First World War. (2014) Ward of the 1st Eastern General Hospital which stands on the grounds of Kings and Clare Cricket Fields, Cambridge. Available at: http://media.iwm.org.uk/iwm/mediaLib//290/media-290607/large.jpg (Accessed: 29 October 2014).
Lavery, J. (1915) The First Wounded, London Hospital, August 1914 [Oil on canvas]. Dundee Art Gallery, Dundee.
Nightingale, F. (1859) Notes on Nursing: What it is and What it is Not. London: Blackie & Son.
Park, M. P. and Park, R. H. R. (2011) ‘Art in wartime: The First Wounded, London Hospital, August 1914’, Medical Humanities, 17(1), pp: 23-26.
Spender, J. A. (1927) Life, Journalism and Politics. London: Cassell and Company Ltd.
(1913-1914) St Georges Hospital Gazette.
(1914-1919) St Georges Hospital Gazette (1914 – 1919), 22.
The Royal Navy 1914 – 1918. HMS Formidable. Available at: http://www.iwm.org.uk/collections/item/object/205319700 (Accessed: 29 October 2014).