A Surgeon in Belgium by Henry Sessions Souttar

A SURGEON IN BELGIUM by H. S. Souttar, F.R.C.S. Assistant Surgeon, West London Hospital Late Surgeon-in-Chief, Belgian Field Hospital Preface To write the true story of three months’ work in a hospital is a task before which the boldest man might quail. Let my very dear friends of the Belgian Field Hospital breathe again, for
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A SURGEON IN BELGIUM

by H. S. Souttar, F.R.C.S.
Assistant Surgeon, West London Hospital Late Surgeon-in-Chief, Belgian Field Hospital

Preface

To write the true story of three months’ work in a hospital is a task before which the boldest man might quail. Let my very dear friends of the Belgian Field Hospital breathe again, for I have attempted nothing of the sort. I would sooner throw aside my last claim to self-respect, and write my autobiography. It would at least be safer. But there were events which happened around us, there was an atmosphere in which we lived, so different from those of our lives at home that one felt compelled to try to picture them before they merged into the shadowy memories of the past. And this is all that I have attempted. To all who worked with me through those months I owe a deep debt of gratitude. That they would do everything in their power to make the hospital a success went without saying, but it was quite another matter that they should all have conspired to make the time for me one of the happiest upon which I shall ever look back. Where all have been so kind, it is almost invidious to mention names, and yet there are two which must stand by themselves. To the genius and the invincible resource of Madame Sindici the hospital owes an incalculable debt. Her friendship is one of my most delightful memories. The sterling powers of Dr. Beavis brought us safely many a time through deep water, and but for his enterprise the hospital would have come to an abrupt conclusion with Antwerp. There could have been no more delightful colleague, and without his aid much of this book would never have been written.

For the Belgian Field Hospital I can wish nothing better than that its star may continue to shine in the future as it has always done in the past, and that a sensible British public may generously support the most enterprising hospital in the war.

H. S. S.

Contents

To Antwerp
The Hospital
The Day’s Work
Antwerp
Termonde
The Chateau
Malines
Lierre
A Pause
The Siege
Contich
The Bombardment–Night
The Bombardment–Day
The Night Journey
Furnes
Poperinghe
Furnes Again
Work At Furnes
Furnes–The Town
A Journey
The Ambulance Corps
Pervyse–The Trenches
Ypres
Some Conclusions

A SURGEON IN BELGIUM

I. To Antwerp

When, one Saturday afternoon in September, we stepped on board the boat for Ostend, it was with a thrill of expectation. For weeks we had read and spoken of one thing only–the War–and now we were to see it for ourselves, we were even in some way to be a part of it. The curtain was rising for us upon the greatest drama in all the lurid history of strife. We should see the armies as they went out to fight, and we should care for the wounded when their work was done. We might hear the roar of the guns and the scream of the shells. To us, that was War.

And, indeed, we have seen more of war in these few weeks than has fallen to the lot of many an old campaigner. We have been through the siege of Antwerp, we have lived and worked always close to the firing-line, and I have seen a great cruiser roll over and sink, the victim of a submarine. But these are not the things which will live in our minds. These things are the mere framing of the grim picture. The cruiser has been blotted out by the weary faces of an endless stream of fugitives, and the scream of the shells has been drowned by the cry of a child. For, though the soldiers may fight, it is the people who suffer, and the toll of war is not the life which it takes, but the life which it destroys.

I suppose, and I hope, that there is not a man amongst us who has not in his heart wished to go to the front, and to do what he could. The thought may have been only transitory, and may soon have been blotted out by self-interest; and there is many a strong man who has thrust it from him because he knew that his duty lay at home. But to everyone the wish must have come, though only to a few can come the opportunity. We all want to do our share, but it is only human that we should at the same time long to be there in the great business of the hour, to see war as it really is, to feel the thrill of its supreme moments, perhaps in our heart of hearts to make quite certain that we are not cowards. And when we return, what do we bring with us? We all bring a few bits of shell, pictures of ruined churches, perhaps a German helmet–and our friends are full of envy. And some of us return with scenes burnt into our brain of horror and of pathos such as no human pen can describe. Yet it is only when we sit down in the quiet of our homes that we realize the deeper meaning of all that we have seen, that we grasp the secret of the strange aspects of humanity which have passed before us. What we have seen is a world in which the social conventions under which we live, and which form a great part or the whole of most of our lives, have been torn down. Men and women are no longer limited by the close barriers of convention. They must think and act for themselves, and for once it is the men and women that we see, and not the mere symbols which pass as coin in a world at peace. To the student of men and women, the field of war is the greatest opportunity in the world. It is a veritable dissecting-room, where all the queer machinery that goes to the making of us lies open to our view. On the whole, I am very glad that I am a mere surgeon, and that I can limit my dissections to men’s bodies. Human Anatomy is bad enough, but after the last three months the mere thought of an analysis of Human Motives fills me with terror.

Our boat was one of the older paddle steamers. We were so fortunate as to have a friend at Court, and the best cabins on the ship were placed at our disposal. I was very grateful to that friend, for it was very rough, and our paddle-boxes were often under water. We consoled ourselves by the thought that at least in a rough sea we were safe from submarines, but the consolation became somewhat threadbare as time went on. Gradually the tall white cliffs of Dover sank behind us, splendid symbols of the quiet power which guards them. But for those great white cliffs, and the waves which wash their base, how different the history of England would have been! They broke the power of Spain in her proudest days, Napoleon gazed at them in vain as at the walls of a fortress beyond his grasp, and against them Germany will fling herself to her own destruction. Germany has yet to learn the strength which lies concealed behind those cliffs, the energy and resource which have earned for England the command of the sea. It was a bad day for Germany when she ventured to question that command. She will receive a convincing answer to her question.

We reached Ostend, and put up for the night at the Hotel Terminus. Ostend was empty, and many of the hotels were closed. A few bombs had been dropped upon the town some days before, and caused considerable excitement–about all that most bombs ever succeed in doing, as we afterwards discovered. But it had been enough to cause an exodus. No one dreamt that in less than three weeks’ time the town would be packed with refugees, and that to get either a bed or a meal would be for many of them almost impossible. Everywhere we found an absolute confidence as to the course of the war, and the general opinion was that the Germans would be driven out of Belgium in less than six weeks.

Two of our friends in Antwerp had come down to meet us by motor, and we decided to go back with them by road, as trains, though still running, were slow and uncertain. It was a terrible day, pouring in torrents and blowing a hurricane. Our route lay through Bruges and Ghent, but the direct road to Bruges was in a bad condition, and we chose the indirect road through Blankenberghe. We left Ostend by the magnificent bridge, with its four tall columns, which opens the way towards the north-east, and as we crossed it I met the first symbol of war. A soldier stepped forward, and held his rifle across our path. My companion leaned forward and murmured, “Namur,” the soldier saluted, and we passed on. It was all very simple, and, but for the one word, silent; but it was the first time I had heard a password, and it made an immense impression on my mind. We had crossed the threshold of War. I very soon had other things to think about. The road from Ostend to Blankenberghe is about the one good motor road in Belgium, and my companion evidently intended to demonstrate the fact to me beyond all possibility of doubt. We were driving into the teeth of a squall, but there seemed to be no limits to the power of his engine. I watched the hand of his speedometer rise till it touched sixty miles per hour. On the splendid asphalt surface of the road there was no vibration, but a north-east wind across the sand-dunes is no trifle, and I was grateful when we turned south-eastwards at Blankenberghe, and I could breathe again.

As I said, that road by the dunes is unique. The roads of Belgium, for the most part, conform to one regular pattern. In the centre is a paved causeway, set with small stone blocks, whilst on each side is a couple of yards of loose sand, or in wet weather of deep mud. The causeway is usually only just wide enough for the passing of two motors, and on the smaller roads it is not sufficient even for this. As there is no speed limit, and everyone drives at the top power of his engine, the skill required to drive without mishap is considerable. After a little rain the stone is covered with a layer of greasy mud, and to keep a car upon it at a high speed is positively a gymnastic feat. In spite of every precaution, an occasional descent into the mud at the roadside is inevitable, and from that only a very powerful car can extricate itself with any ease. A small car will often have to slowly push its way out backwards. In dry weather the conditions are almost as bad, for often the roadside is merely loose sand, which gives no hold for a wheel. For a country so damp and low-lying as Belgium, there is probably nothing to equal a paved road, but it is a pity that the paving was not made a little wider. Every now and then we met one of the huge, unwieldy carts which seem to be relics of a prehistoric age–rough plank affairs of enormous strength and a design so primitive as to be a constant source of wonder. They could only be pulled along at a slow walk and with vast effort by a couple of huge horses, and the load the cart was carrying never seemed to bear any proportion to the mechanism of its transport. The roads are bad, but they will not account for those carts. The little front wheels are a stroke of mechanical ineptitude positively amounting to genius, and when they are replaced by a single wheel, and the whole affair resembles a huge tricycle, one instinctively looks round for a Dinosaur. Time after time we met them stuck in the mud or partially overturned, but the drivers seemed in no way disconcerted; it was evidently all part of the regular business of the day. When one thinks of the Brussels coachwork which adorns our most expensive motors, and of the great engineering works of Liege, those carts are a really wonderful example of persistence of type.

We passed through Bruges at a pace positively disrespectful to that fine old town. There is no town in Belgium so uniform in the magnificence of its antiquity, and it is good to think that–so far, at any rate–it has escaped destruction. As we crossed the square, the clock in the belfry struck the hour, and began to play its chimes. It is a wonderful old clock, and every quarter of an hour it plays a tune–a very attractive performance, unless you happen to live opposite. I remember once thinking very hard things about the maker of that clock, but perhaps it was not his fault that one of the bells was a quarter of a tone flat. At the gates our passports were examined, and we travelled on to Ghent by the Ecloo Road, one of the main thoroughfares of Belgium. Beyond an occasional sentry, there was nothing to indicate that we were passing through a country at war, except that we rarely saw a man of military age. All were women, old men, or children. Certainly the men of Belgium had risen to the occasion. The women were doing everything–working in the fields, tending the cattle, driving the market-carts and the milk-carts with their polished brass cans. After leaving Ghent, the men came into view, for at Lokeren and St. Nicholas were important military stations, whilst nearer to Antwerp very extensive entrenchments and wire entanglements were being constructed. The trenches were most elaborate, carefully constructed and covered in; and I believe that all the main approaches to the city were defended in the same way. Antwerp could never have been taken by assault, but with modern artillery it would have been quite easy to destroy it over the heads of its defenders. The Germans have probably by now rendered it impregnable, for though in modern war it is impossible to defend one’s own cities, the same does not apply to the enemy. In future, forts will presumably be placed at points of strategic importance only, and as far as possible from towns.

Passing through the western fortifications, we came upon the long bridge of boats which had been thrown across the Scheldt. The river is here more than a quarter of a mile wide, and the long row of sailing barges was most picturesque. The roadway was of wooden planks, and only just wide enough to allow one vehicle to pass at a time, the tall spars of the barges rising on each side. It is strange that a city of such wealth as Antwerp should not have bridged a river which, after all, is not wider than the Thames. We were told that a tunnel was in contemplation. The bridge of boats was only a tribute to the necessities of war. We did not dream that a fortnight later it would be our one hope of escape.

II. The Hospital

Antwerp is one of the richest cities in Europe, and our hospital was placed in its wealthiest quarter. The Boulevard Leopold is a magnificent avenue, with a wide roadway in the centre flanked by broad paths planted with trees. Beyond these, again, on each side is a paved road with a tram-line, whilst a wide pavement runs along the houses. There are many such boulevards in Antwerp, and they give to the city an air of spaciousness and opulence in striking contrast to the more utilitarian plan of London or of most of our large towns. We talk a great deal about fresh air, but we are not always ready to pay for it.

Our hospital occupied one of the largest houses on the south-east side. A huge doorway led into an outer hall through which the garden was directly reached behind the house. On the right-hand side of this outer hall a wide flight of steps led to inner glass doors and the great central hall of the building. As a private house it must have been magnificent; as a hospital it was as spacious and airy as one could desire. The hall was paved with marble, and on either side opened lofty reception rooms, whilst in front wide marble staircases led to the first floor. This first floor and another above it were occupied entirely by wards, each containing from six to twelve beds. On the ground floor on the right-hand side were two large wards, really magnificent rooms, and one smaller, all these overlooking the Boulevard. On the left were the office, the common room, and the operating theatre. Behind the house was a large paved courtyard, flanked on the right by a garden border and on the left by a wide glass-roofed corridor. The house had previously been used as a school, and on the opposite side of the courtyard was the gymnasium, with dormitories above. The gymnasium furnished our dining-hall, whilst several of the staff slept in the rooms above.

It will be seen that the building was in many ways well adapted to the needs of a hospital and to the accommodation of the large staff required. We had in all 150 beds, and a staff of about 50. The latter included 8 doctors, 20 nurses, 5 dressers, lay assistants, and motor drivers. In addition to these there was a kitchen staff of Belgians, so that the management of the whole was quite a large undertaking, especially in a town where ordinary provisions were becoming more and more difficult to obtain. In the later days of the siege, when milk was not to be had and the only available water was salt, the lot of our housekeeper was anything but happy. Providing meals for over 200 people in a besieged town is no small matter. But it was managed somehow, and our cuisine was positively astonishing, to which I think we largely owe the fact that none of the staff was ever ill. Soldiers are not the only people who fight on their stomachs.

The management of the hospital centred in the office, and it was so typical of Belgium as to be really worth a few words of description. It was quite a small room, and it was always crowded. Four of us had seats round a table in the centre, and at another table in the window sat our Belgian secretary, Monsieur Herman, and his two clerks. But that was only the beginning of it. All day long there was a constant stream of men, women, and children pouring into that room, bringing letters, asking questions, always talking volubly to us and amongst themselves. At first we thought that this extraordinary turmoil was due to our want of space, but we soon found that it was one of the institutions of the country. In England an official’s room is the very home of silence, and is by no means easy of access. If he is a high official, a series of ante-rooms is interposed between his sacred person and an inquisitive world. But in Belgium everyone walks straight in without removing his cigar. The great man sits at his desk surrounded by a perfect Babel, but he is always polite, always ready to hear what you have to say and to do what he can to help. He appears to be able to deal with half a dozen different problems at the same time without ever being ruffled or confused. There is an immense amount of talking and shaking of hands, and at first the brain of a mere Englishman is apt to whirl; but the business is done rapidly and completely. Belgium is above all things democratic, and our office was a good introduction to it.

The common room was large and airy, overlooking the courtyard, and a few rugs and armchairs made it a very comfortable place when the work of the day was done. Anyone who has worked in a hospital will know what a difference such a room makes to the work–work that must be carried on at all hours of the day or night; nor will he need to be told of the constant supply of tea and coffee that will be found there. We go about telling our patients of the evils of excessive tea- drinking, and we set them an example they would find it hard to follow. We do not mention how often tea and a hot bath have been our substitute for a night’s sleep.’ A good common room and an unlimited supply of tea will do much to oil the wheels of hospital life.

But to myself the all-important room was the operating theatre, for upon its resources depended entirely our opportunities for surgical work. It was in every way admirable, and I know plenty of hospitals in London whose theatres would not bear comparison with ours. Three long windows faced the courtyard; there was a great bunch of electric lights in the ceiling, and there was a constant supply of boiling water. What more could the heart of surgeon desire? There were two operating tables and an equipment of instruments to vie with any in a London hospital. Somebody must have been very extravagant over those instruments, I thought as I looked at them; but he was right and I was wrong, for there were very few of those instruments for which I was not grateful before long. The surgery of war is a very different thing from the surgery of home.

The wards were full when we arrived, and I had a wonderful opportunity of studying the effects of rifle and shell fire. Most of the wounds were fortunately slight, but some of them were terrible, and, indeed, in some cases it seemed little short of miraculous that the men had survived. But on every side one saw nothing but cheerful faces, and one would never have dreamt what some of those men had gone through. They were all smoking cigarettes, laughing, and chatting, as cheery a set of fellows as one could meet. You would never have suspected that a few days before those same men had been carried into the hospital in most cases at their last gasp from loss of blood and exposure, for none but serious cases were admitted. The cheeriest man in the place was called Rasquinet, a wounded officer who had been christened “Ragtime” for short, and for affection. A week before he had been struck by a shell in the left side, and a large piece of the shell had gone clean through, wounding the kidney behind and the bowel in front. That man crawled across several fields, a distance of nearly a mile, on his hands and knees, dragging with him to a place of safety a wounded companion. When from loss of blood he could drag him along no longer, he left him under a hedge, and dragged himself another half-mile till he could get help. When he was brought into the hospital, he was so exhausted from pain and loss of blood that no one thought that he could live for more than a few hours, but by sheer pluck he had pulled through. Even now he was desperately ill with as horrible a wound as a man could have, but nothing was going to depress him. I am glad to say that what is known in surgery as a short circuit was an immediate success, and when we left him three weeks later in Ghent he was to all intents perfectly well.

There were plenty of other serious cases, some of them with ghastly injuries, and many of them must have suffered agonizing pain; but they were all doing their best to make light of their troubles, whilst their gratitude for what was done for them was extraordinary. The Belgians are by nature a cheerful race, but these were brave men, and we felt glad that we had come out to do what we could for them.

But if we give them credit for their courage and cheerfulness, we must not forget how largely they owed it to the devoted attention–yes, and to the courage and cheerfulness–of the nurses. I wonder how many of us realize what Britain owes to her nurses. We take them as a matter of course, we regard nursing as a very suitable profession for a woman to take up–if she can find nothing better to do; perhaps we may have been ill, and we were grateful for a nurse’s kindness. But how many of us realize all the long years of drudgery that have given the skill we appreciated, the devotion to her work that has made the British nurse what she is? And how many of us realize that we English-speaking nations alone in the world have such nurses? Except in small groups, they are unknown in France, Belgium, Germany, Russia, or any other country in the world. In no other land will women leave homes of ease and often of luxury to do work that no servant would touch, for wages that no servant would take–work for which there will be very little reward but the unmeasured gratitude of the very few. They stand to-day as an unanswerable proof that as nations we have risen higher in the level of civilization than any of our neighbours. To their influence on medicine and surgery I shall refer again. Here I only wish to acknowledge our debt. As a mere patient I would rather have a good nurse than a good physician, if I were so unfortunate as to have to make the choice. A surgeon is a dangerous fellow, and must be treated with respect. But as a rule the physician gives his blessing, the surgeon does his operation, but it is the nurse who does the work.

III. The Day’s Work

In any hospital at home or abroad there is a large amount of routine work, which must be carried on in an orderly and systematic manner, and upon the thoroughness with which this is done will largely depend the effectiveness of the hospital. Patients must be fed and washed, beds must be made and the wards swept and tidied, wounds must be dressed and splints adjusted. In an English hospital everything is arranged to facilitate this routine work. Close to every ward is a sink- room with an adequate supply of hot and cold water, dinner arrives in hot tins from the kitchens as if by magic, whilst each ward has its own arrangements for preparing the smaller meals. The beds are of a convenient height, and there is an ample supply of sheets and pillow- cases, and of dressing materials of all kinds arranged on tables which run noiselessly up and down the wards. At home all these things are a matter of course; abroad they simply did not exist. Four or five gas- rings represented our hot-water supply and our ward-kitchens for our 150 patients, and the dinners had to be carried up from the large kitchens in the basement. The beds were so low as to break one’s back, and had iron sides which were always in the way; and when we came to the end of our sheets–well, we came to the end of them, and that was all. In every way the work was heavier and more difficult than at home, for all our patients were heavy men, and every wound was septic, and had, in many cases, to be dressed several times a day. Everyone had to work hard, sometimes very hard; but as a rule we got through the drudgery in the morning, and in the afternoon everything was in order, and we should, I think, have compared very favourably in appearance with most hospitals at home.

But we had to meet one set of conditions which would, I think, baffle many hospitals at home. Every now and then, without any warning, from 50 to 100, even in one case 150, wounded would be brought to our door. There was no use in putting up a notice “House Full”; the men were wounded and they must be attended to. In such a case our arrangement was a simple one: all who could walk went straight upstairs, the gravest cases went straight to the theatre or waited their turn in the great hall, the others were accommodated on the ground floor. We had a number of folding beds for emergency, and we had no rules as to overcrowding. In the morning the authorities would clear out as many patients as we wished. Sometimes we were hard put to it to find room for them all, but we always managed somehow, and we never refused admission to a single patient on the score of want of room. The authorities soon discovered the capacity of the hospital for dealing with really serious cases, and as a result our beds were crowded with injuries of the gravest kind. What appealed to us far more was the appreciation of the men themselves. We felt that we had not worked in vain when we heard that the soldiers in the trenches begged to be taken “a l’Hopital Anglais.”

The condition of the men when they reached us was often pitiable in the extreme. Most of them had been living in the trenches for weeks exposed to all kinds of weather, their clothes were often sodden and caked with dirt, and the men themselves showed clear traces of exposure and insecure sleep. In most cases they had lain in the trenches for hours after being wounded, for as a rule it is impossible to remove the wounded at once with any degree of safety. Indeed, when the fighting is at all severe they must lie till dark before it is safe for the stretcher-bearers to go for them. This was so at Furnes, but at Antwerp we were usually able to get them in within a few hours. Even a few hours’ delay with a bad wound may be a serious matter, and in every serious case our attention was first directed to the condition of the patient himself and not to his wound. Probably he had lost blood, his injury had produced more or less shock, he had certainly been lying for hours in pain. He had to be got warm, his circulation had to be restored, he had to be saved from pain and protected from further shock. Hot bottles, blankets, brandy, and morphia worked wonders in a very short time, and one could then proceed to deal with wounds. Our patients were young and vigorous, and their rate of recovery was extraordinary.

When a rush came we all had to work our hardest, and the scenes in any part of the hospital required steady nerves; but perhaps the centre of interest was the theatre. Here all the worst cases were brought–men with ghastly injuries from which the most hardened might well turn away in horror; men almost dead from loss of blood, or, worst of all, with a tiny puncture in the wall of the abdomen which looks so innocent, but which, in this war at least, means, apart from a difficult and dangerous operation, a terrible death. With all these we had to deal as rapidly and completely as possible, reducing each case to a form which it would be practicable to nurse, where the patient would be free from unnecessary pain, and where he would have the greatest possible chance of ultimate recovery. Of course, all this was done under anaesthesia. What a field hospital must have been before the days of anaesthesia is too horrible to contemplate. Even in civil hospitals the surgeons must have reached a degree of “Kultur” beside which its present exponents are mere children. It is not so many years since a famous surgeon, who was fond of walking back from his work at the London Hospital along the Whitechapel Road, used to be pointed to with horror by the Aldgate butchers, whose opinion on such a subject was probably worth consideration. But now all that is changed. The surgeon can be a human being again, and indeed, except when he goes round his wards, his patients may never know, of his existence. They go to sleep in a quiet anteroom, and they waken up in the ward. Of the operation and all its difficulties they know no more than their friends at home. Perhaps even more wonderful is the newer method of spinal anaesthesia, which we used largely for the difficult abdominal cases. With the injection of a minute quantity of fluid into the spine all sensation disappears up to the level of the arms, and, provided he cannot see what is going on, any operation below that level can be carried out without the patient knowing anything about it at all. It is rather uncanny at first to see a patient lying smoking a cigarette and reading the paper whilst on the other side of a screen a big operation is in progress. But for many cases this method is unsuitable, and without chloroform we should indeed have been at a loss. The Belgians are an abstemious race, and they took it beautifully. I am afraid they were a striking contrast to their brothers on this side of the water. Chloroform does not mix well with alcohol in the human body, and the British working man is rather fond of demonstrating the fact.

With surgery on rather bold lines it was extraordinary how much could be done, especially in the way of saving limbs. During the whole of our stay in Antwerp we never once had to resort to an amputation. We were dealing with healthy and vigorous men, and once they had got over the shock of injury they had wonderful powers of recovery. We very soon found that we were dealing with cases to which the ordinary rules of surgery did not apply. The fundamental principles of the art must always be the same, but here the conditions of their application were essentially different from those of civil practice. Two of these conditions were of general interest: the great destruction of the tissues in most wounds, and the infection of the wounds, which was almost universal.

Where a wound has been produced by a large fragment of shell, one expects to see considerable damage; in fact, a whole limb may be torn off, or death may be instant from some terrible injury to the body. But where the object of the enemy is the injury of individuals, and not the destruction of buildings, they often use shrapnel, and the resulting wounds resemble those from the old smooth-bore guns of our ancestors. Shrapnel consists of a large number of bullets about half an inch in diameter packed together in a case, which carries also a charge of explosive timed to burst at the moment when it reaches its object. The balls are small and round, and if they go straight through soft tissues they do not do much damage. If, however, they strike a bone, they are so soft that their shape becomes irregular, and the injury they can produce in their further course is almost without limit. On the whole, they do not as a rule produce great damage, for in many cases they are nearly spent when they reach their mark. Pieces of the case will, of course, have much the same effect as an ordinary shell.

The effects of rifle-fire, particularly at short ranges, have led to a great deal of discussion, and each side has accused the other of using dum-dum bullets. The ordinary bullet consists of a lead core with a casing of nickel, since the soft lead would soon choke rifling. Such a bullet under ordinary circumstances makes a clean perforation, piercing the soft tissues, and sometimes the bones, with very little damage. In a dum-dum bullet the casing at the tip is cut or removed, with the result that, on striking, the casing spreads out and forms a rough, irregular missile, which does terrific damage. Such bullets were forbidden by the Geneva Convention. But the German bullet is much more subtle than this. It is short and pointed, and when it strikes it turns completely over and goes through backwards. The base of the bullet has no cover, and consequently spreads in a manner precisely similar to that in a dum-dum, with equally deadly results. There could be no greater contrast than that between the wounds with which we had to deal in South Africa, produced by ordinary bullets, and those which our soldiers are now receiving from German rifles. The former were often so slight that it was quite a common occurrence for a soldier to discover accidentally that he had been wounded some time previously. In the present war rifle wounds have been amongst the most deadly with which we have had to deal.

It will thus be seen that in most cases the wounds were anything but clean-cut; with very few exceptions, they were never surgically clean. By surgically clean we mean that no bacteria are present which can interfere with the healing of the tissues, and only those who are familiar with surgical work can realize the importance of this condition. Its maintenance is implied in the term “aseptic surgery,” and upon this depends the whole distinction between the surgery of the present and the surgery of the past. Without it the great advances of modern surgery would be entirely impossible. When we say, then, that every wound with which we had to deal was infected with bacteria, it will be realized how different were the problems which we had to face compared with those of work at home. But the difference was even more striking, for the bacteria which had infected the wounds were not those commonly met with in England. These wounds were for the most part received in the open country, and they were soiled by earth, manure, fragments of cloth covered with mud. They were therefore infected by the organisms which flourish on such soil, and not by the far more deadly denizens of our great cities. It is true that in soil one may meet with tetanus and other virulent bacteria, but in our experience these were rare. Now, there is one way in which all such infections may be defeated–by plenty of fresh air, or, better still, by oxygen. We had some very striking proofs of this, for in several cases the wounds were so horribly foul that it was impossible to tolerate their presence in the wards; and in these cases we made it a practice to put the patient in the open air, of course suitably protected, and to leave the wound exposed to the winds of heaven, with only a thin piece of gauze to protect it. The results were almost magical, for in two or three days the wounds lost their odour and began to look clean, whilst the patients lost all signs of the poisoning which had been so marked before. It may be partly to this that we owe the fact that we never had a case of tetanus. In all cases we treated our wounds with solutions of oxygen, and we avoided covering them up with heavy dressings; and we found that this plan was successful as well as economical.

Though any detailed description of surgical treatment would be out of place, there was one which in these surroundings was novel, and which was perhaps of general interest. Amongst all the cases which came to us, certainly the most awkward were the fractured thighs. It was not a question of a broken leg in the ordinary sense of the term. In every case there was a large infected wound to deal with, and as a rule several inches of the bone had been blown clean away. At first we regarded these cases with horror, for anything more hopeless than a thigh with 6 inches missing it is difficult to imagine. Splints presented almost insuperable difficulties, for the wounds had to be dressed two or three times, and however skilfully the splint was arranged, the least movement meant for the patient unendurable agony. After some hesitation we attempted the method of fixation by means of steel plates, which was introduced with such success by Sir Arbuthnot Lane in the case of simple fractures. The missing portion of the bone is replaced by a long steel plate, screwed by means of small steel screws to the portions which remain, “demonstrating,” as a colleague put it, “the triumph of mind over the absence of matter.” The result was a brilliant success, for not only could the limb now be handled as if there were no fracture at all, to the infinite comfort of the patient, but the wounds themselves cleared up with great rapidity. We were told that the plates would break loose, that the screws would come out, that the patient would come to a bad end through the violent sepsis induced by the presence of a “foreign body” in the shape of the steel plate. But none of these disasters happened, the cases did extremely well, and one of our most indignant critics returned to his own hospital after seeing them with his pockets full of plates. The only difficulty with some of them was to induce them to stop in bed, and it is a fact that on the night of our bombardment I met one of them walking downstairs, leaning on a dresser’s arm, ten days after the operation.

And this brings me to a subject on which I feel very strongly, the folly of removing bullets. If a bullet is doing any harm, pressing on some nerve, interfering with a joint, or in any way causing pain or inconvenience, by all means let it be removed, though even then it should in most cases never be touched until the wound is completely healed. But the mere presence of a bullet inside the body will of itself do no harm at all. The old idea that it will cause infection died long ago. It may have brought infection with it; but the removal of the bullet will not remove the infection, but rather in most cases make it fire up. We now know that, provided they are clean, we can introduce steel plates, silver wires, silver nets, into the body without causing any trouble at all, and a bullet is no worse than any of these. It is a matter in which the public are very largely to blame, for they consider that unless the bullet has been removed the surgeon has not done his job. Unless he has some specific reason for it, I know that the surgeon who removes a bullet does not know his work. It may be the mark of a Scotch ancestry, but if I ever get a bullet in my own anatomy, I shall keep it.

IV. Antwerp

There is no port in Europe which holds such a dominant position as Antwerp, and there is none whose history has involved such amazing changes of fortune. In the middle of the sixteenth century she was the foremost city in Europe, at its close she was ruined. For two hundred years she lay prostrate under the blighting influence of Spain and Austria, and throttled by the commercial jealousy of England and Holland. A few weeks ago she was the foremost port on the Continent, the third in the world; now her wharves stand idle, and she herself is a prisoner in the hands of the enemy. Who can tell what the next turn of the wheel will bring?

Placed centrally between north and south, on a deep and wide river, Antwerp is the natural outlet of Central Europe towards the West, and it is no wonder that four hundred years ago she gathered to herself the commerce of the Netherlands, in which Ypres, Bruges, and Ghent had been her forerunners. For fifty years she was the Queen of the North, and the centre of a vast ocean trade with England, France, Spain, Portugal, and Italy, till the religious bigotry of Philip II of Spain and the awful scenes of the Spanish Fury reduced her to ruin. For two hundred years the Scheldt was blocked by Holland, and the ocean trade of Antwerp obliterated. Her population disappeared, her wharves rotted, and her canals were choked with mud. It is hard to apportion the share of wickedness between a monarch who destroys men and women to satisfy his own religious lust, and a nation which drains the life-blood of another to satisfy its lust for gold. One wonders in what category the instigator of the present war should appear.

At the very beginning of last century Napoleon visited Antwerp, and asserted that it was “little better than a heap of ruins.” He recognized its incomparable position as a port and as a fortress, and he determined to raise it to its former prosperity, and to make it the strongest fortress in Europe. He spent large sums of money upon it, and his refusal to part with Antwerp is said to have broken off the negotiations of Chatillon, and to have been the chief cause of his exile to St. Helena. Alas his enemies did not profit by his genius. We are the allies of his armies now, but we have lost Antwerp. Germany will be utterly and completely crushed before she parts with that incomparable prize. A mere glance at the map of Europe is sufficient to convince anyone that in a war between England and Germany it is a point of the first strategical importance. That our access to it should be hampered by the control of Holland over the Scheldt is one of the eccentricities of diplomacy which are unintelligible to the plain man. The blame for its loss must rest equally between Britain and Belgium, for Belgium, the richest country in Europe for her size, attempted to defend her greatest stronghold with obsolete guns; whilst we, who claim the mastery of the seas, sacrificed the greatest seaport in Europe to the arrangements of an obsolete diplomacy. If we are to retain our great position on the seas, Antwerp must be regained. She is the European outpost of Britain, and, as has so often been pointed out, the mouth of the Scheldt is opposite to the mouth of the Thames.

In Antwerp, as we saw her, it was almost impossible to realize the vicissitudes through which she had passed, or to remember that her present prosperity was of little more than fifty years’ growth. On all sides we were surrounded by wide boulevards, lined by magnificent houses and public buildings. There are few streets in Europe to eclipse the great Avenue des Arts, which, with its continuations, extends the whole length of the city from north to south. The theatres, the Central Station, the banks, would adorn any city, and the shops everywhere spoke of a wealth not restricted to the few. The wide streets, the trees, the roomy white houses, many of them great palaces, made a deep impression upon us after the darkness and dirt of London. Even in the poorer quarters there was plenty of light and air, and on no occasion did we find the slums which surround the wealthiest streets all over London. In the older parts of the city the streets were, of course, narrower; but even here one had the compensation of wonderful bits of architecture at unexpected corners, splendid relics of an illustrious past. They are only remnants, but they speak of a time when men worked for love rather than for wages, and when an artisan took a pride in the labour of his hands. If it had not been for the hand of the destroyer, what a marvellous city Antwerp would have been! One likes to think that the great creations of the past are not all lost, and that in the land to which the souls of the Masters have passed we may find still living the mighty thoughts to which their love gave birth. Are our cathedrals only stones and mortar, and are our paintings only dust and oil?

The inhabitants of Antwerp were as delightful as their city. On all sides we were welcomed with a kindness and a consideration not always accorded to those who are so bold as to wish to help their fellow-men. Everywhere we met with a courtesy and a generosity by which, in the tragedy of their country, we were deeply touched. They all seemed genuinely delighted to see us, from the Queen herself to the children in the streets. Our medical confreres treated us royally, and the mere thought of professional jealousy with such men is simply ludicrous. They constantly visited our hospital, and they always showed the keenest interest in our work and in any novelties in treatment we were able to show them; and when we went to see them, we were shown all the best that they had, and we brought away many an ingenious idea which it was worth while going far to obtain. Wherever we moved amongst the Belgians, we always found the same simplicity of purpose, the same generosity of impulse. Everywhere we met the same gratitude for what England was doing for Belgium; no one ever referred to the sacrifices which Belgium has made for England.

The one thing which so impressed us in the character of the Belgians whom we met was its simplicity, and the men who had risen to high rank did not seem to have lost it in their climb to fame. But it was just this, the most delightful of their characteristics, which must have made war for them supremely difficult. For strict discipline and simplicity are almost incompatible. None of us tower so far above our fellows that we can command instant obedience for our own sakes. We have to cover ourselves with gold lace, to entrench ourselves in rank, and to provide ourselves with all sorts of artificial aids before we can rely on being obeyed. These things are foreign to the Belgian mind, and as a result one noticed in their soldiers a certain lack of the stern discipline which war demands. Individually they are brave men and magnificent fighters. They only lacked the organization which has made the little British Army the envy of the world. The fact is that they are in no sense a warlike nation, in spite of their turbulent history of the past, and, indeed, few things could be more incompatible than turbulence and modern warfare. It demands on the part of the masses of combatants an obedience and a disregard of life which are repellent to human nature, and the Belgians are above all things human. Germany is governed by soldiers, and France by officials. Unlike the frogs in the fable, the Belgians are content to govern themselves.

It was our great regret that we had so little time in which to see the work of the Antwerp hospitals, but we made use of what opportunities we had. There are many of them, and those we saw were magnificent buildings, equipped in a way which filled us with envy. The great city hospital, the Stuivenberg, was a model of what a modern hospital ought to be. The wards were large and airy and spotlessly clean, and the nurses seemed to be extremely competent. The kitchens were equipped with all the latest appliances, steam boilers, and gas and electric cookers. But the show part of the hospital was the suite of operating theatres. I have always felt the pardonable pride of a son in the theatres of the London Hospital, but they were certainly eclipsed here. Each theatre was equipped with its own anaesthetizing room, its own surgeon’s room, and its own sterilizing rooms and stores, all furnished with a lavishness beyond the financial capacity of any hospital in London. Perhaps some of the equipment was unnecessary, but it was abundantly evident that the State appreciated the value of first-class surgery, and that it was prepared to pay for it. I have never heard the same accusation levelled at Great Britain.

At St. Camille we had the good fortune to see M. Xambotte at work. His reputation as a surgeon is worldwide, and it was pleasant to find that his dexterity as an operator was equal to his reputation. It is not always the case. He is an expert mechanic, and himself makes most of the very ingenious instruments which he uses. He was fixing a fractured femur with silver wires, and one could see the skilled workman in all that he did. There is no training-ground for one’s hands like a carpenter’s bench, and the embryo surgeon might do much worse with his time than spend six months of it in a workshop. When medical training emerges from its medieval traditions, manual training will certainly form a part, and no one will be allowed to attempt to mend a bone till he has shown his capacity to mend a chair-leg. Here, again, the surgeon was surrounded by all the appliances, and even the luxuries, that he could desire. The lot of the great surgeon abroad is indeed a happy one.

But there is one thing in which we in England are far better off–in our nursing staffs. In most of the hospitals we visited the nursing was carried on by Sisterhoods, and though some of them were evidently good nurses, most of them had no idea whatever of nursing as it is practised in our country. Fresh air, for example, is to them full of dangers. One would almost think that it savoured of the powers of evil. We went into one huge hospital of the most modern type, and equipped lavishly, and such wag the atmosphere that in ten minutes I had to make a rush for the door. One large ward was full of wounded soldiers, many of them with terrible wounds, gangrenous and horrible, and every window was tightly shut. How they could live in such an atmosphere is beyond my comprehension, but the Sisters did not seem to notice it at all.

Some of the surgeons have their specially trained nurses, but nursing as a profession for the classes who are alone competent to undertake it is a conception which has yet to dawn upon the Continent, for only a woman of education and refinement can really be a nurse.

The absence on the Continent of a nursing profession such as ours is not without its influence on medicine and surgery abroad. The individual patient meets with far less consideration than would be the case in this country, and is apt to be regarded as so much raw material. In Belgium this tendency is counteracted by the natural kindliness of the Belgian, but in other countries patients are often treated with a callousness which is amazing. There is in many of the great clinics a disregard of the patient’s feelings, of his sufferings, and even of his life, which would be impossible in an English hospital. The contact of a surgeon with his hospital patients as individuals is largely through the nursing staff, and his point of view will be largely influenced by them. There is no one in our profession, from the youngest dresser to the oldest physician, who does not owe a great part of his education to Sister.

V. Termonde

Anyone who has worked in hospitals will realize how important it is for the health of the staff, nurses and doctors, that they should get out into the fresh air for at least some part of every day. It is still more necessary in a war hospital, for not only is the work more exacting, but the cases themselves involve certain risks which can only be safely taken in perfect health. Practically every one is septic, and to anyone in the least run down the danger of infection is considerable; and infection with some of the organisms with which one meets in war is a very serious thing indeed. We had four large motors in Antwerp belonging to the members of our hospital, and always at its service, and every afternoon parties were made up to drive out into the country. As a rule calls were made at various Croix Rouge posts on the way, and in that way we kept in contact with the medical service of the army in the field, and gave them what help we could. We were always provided with the password, and the whole country was open to us–a privilege we very greatly appreciated; for after a hard morning’s work in the wards there are few things more delightful than a motor drive. And it gave us an opportunity of seeing war as very few but staff officers ever can see it. We learnt more about the condition of the country and of the results of German methods in one afternoon than all the literature in the world could ever teach. If only it were possible to bring home to the people of Britain one-hundredth part of what we saw with our own eyes, stringent laws would have to be passed to stop men and women from enlisting. No man who deserved the name of man, and no woman who deserved to be the mother of a child, would rest day or night till the earth had been freed from the fiends who have ravaged Belgium and made the name of German vile.

One afternoon towards the end of September we visited Termonde. We heard that the Germans, having burnt the town, had retired, leaving it in the hands of the Belgian troops. It was a rare opportunity to see the handiwork of the enemy at close quarters, and we did not wish to miss it. Termonde is about twenty-two miles from Antwerp, and a powerful car made short work of the distance. Starting directly southwards through Boom, we reached Willebroeck and the road which runs east and west from Malines through Termonde to Ghent, and along it we turned to the right. We were now running parallel to the German lines, which at some points were only a couple of miles away on the other side of the Termonde-Malines railway. We passed numerous Belgian outposts along the road, and for a few miles between Lippeloo and Baesrode they begged us to travel as fast as possible, as at this point we came within a mile of the railway. We did travel, and it would have taken a smart marksman to hit us at fifty miles an hour; but we felt much happier when we passed under the railway bridge of a loop line at Briel and placed it between ourselves and the enemy. The entrance to Termonde was blocked by a rough barricade of bricks and branches guarded by a squad of soldiers. They told us that no one was allowed to pass, and we were about to return disappointed, when one of us happened to mention the password. As without it we could not possibly have got so far, it had never occurred to us that they might think we had not got it; and as we had no possible business in the town, we had no arguments to oppose to their refusal to let us in. However, all was now open to us, and the cheery fellows ran forward to remove the barrier they had put up.

Termonde is, or rather was, a well-to-do town of 10,000 inhabitants lying on the Scheldt at the point where the Dendre, coming up from the south, runs into it. A river in Belgium means a route for traffic, and the town must have derived some advantage from its position as a trade junction. But it possesses an even greater one in the bridge which here crosses the Scheldt, the first road bridge above the mouth of the river, for there is none at Antwerp. At least six main roads converge upon this bridge, and they must have brought a great deal of traffic through the town. When we mention that a corresponding number of railways meet at the same spot, it will be seen Termonde was an important centre, and that it must have been a wealthy town. The Dendre runs right through the centre of the town to the point where it joins the Scheldt, and on each side runs a long stone quay planted with trees, with old-fashioned houses facing the river. With the little wooden bridges and the barges on the river it must have been a very pretty picture. Now it was little better than a heap of ruins.

The destruction of the town was extraordinarily complete, and evidently carefully organized. The whole thing had been arranged beforehand at headquarters, and these particular troops supplied with special incendiary apparatus. There is strong evidence to show that the destruction of Louvain, Termonde, and of several smaller towns, was all part of a definite plan of “frightfulness,” the real object being to terrorize Holland and Denmark, and to prevent any possibility of their joining with the Allies. It is strictly scientific warfare, it produces a strictly scientific hell upon this world, and I think that one may have every reasonable hope that it leads to a strictly scientific hell in the next. After a town has been shelled, its occupants driven out, and its buildings to a large extent broken down, the soldiers enter, each provided with a number of incendiary bombs, filled with a very inflammable compound. They set light to these and throw them into the houses, and in a very few minutes each house is blazing. In half an hour the town is a roaring furnace, and by the next day nothing is left but the bare walls. And that is almost all that there was left of Termonde. We walked along the quay beside a row of charred and blackened ruins, a twisted iron bedstead or a battered lamp being all there was to tell of the homes which these had been. A few houses were still standing untouched, and on the door of each of these was scrawled in chalk the inscription:

“GUTE LEUTE,
NICHT ANZUNDEN,
BREITFUSS, Lt.”

One wondered at what cost the approval of Lieutenant Breitfuss had been obtained. His request to the soldiers not to set fire to the houses of these “good people” had been respected, but I think that if the Belgians ever return to Termonde those houses are likely to be empty. There are things worse than having your house burnt down, and one would be to win the approval of Lieutenant Breitfuss.

We crossed the Dendre and wandered up the town towards the Square. For a few moments I stood alone in a long curving street with not a soul in sight, and the utter desolation of the whole thing made me shiver. Houses, shops, banks, churches, all gutted by the flames and destroyed. The smell of burning from the smouldering ruins was sickening. Every now and then the silence was broken by the fall of bricks or plaster. Except a very few houses with that ominous inscription on their doors, there was nothing left; everything was destroyed. A little farther on I went into the remains of a large factory equipped with elaborate machinery, but so complete was the destruction that I could not discover what had been made there. There was a large gas engine and extensive shafting, all hanging in dismal chaos, and I recognized the remains of machines for making tin boxes, in which the products of the factory had, I suppose, been packed. A large pile of glass stoppers in one corner was fused up into a solid mass, and I chipped a bit off as a memento.

In the Square in front of the church of Notre Dame the German soldiers had evidently celebrated their achievement by a revel. In the centre were the remains of a bonfire, and all around were broken bottles and packs of cheap cards in confusion. Think of the scene. A blazing town around them, and every now and then the crash of falling buildings; behind them Notre Dame in flames towering up to heaven; the ancient Town Hall and the Guard House burning across the Square; and in the centre a crowd of drunken soldiers round a bonfire, playing cards. And miles away across the fields ten thousand homeless wanderers watching the destruction of all for which they had spent their lives in toil.

Of the ancient church of Notre Dame only the walls remained. The roof had fallen, all the woodwork had perished in the flames, and the stonework was calcined by the heat. Above the arch of a door was a little row of angels’ heads carved in stone, but when we touched them they fell to powder. The heat inside must have been terrific, for all the features of the church had disappeared, and we were surrounded by merely a mass of debris. In the apse a few fragments of old gold brocade buried beneath masses of brick and mortar were all that remained to show where the altar had been.

The Town Hall was once a beautiful gabled building with a tall square tower ending in four little turrets. I have a drawing of it, and it must have formed quite a pleasing picture, the entrance reached by the double flight of steps of which Belgium is so fond, and from which public proclamations were read. It had been only recently restored, and it was now to all intents and purposes a heap of smoking bricks. The upper part of the tower had fallen into the roof, and the whole place was burnt out.

But no words can ever convey any idea of the utter destruction of the whole town, or of the awful loneliness by which one was surrounded. One felt that one was in the presence of wickedness such as the world has rarely seen, that the powers of darkness were very near, and that behind those blackened walls there lurked evil forms. Twilight was coming on as we turned back to our car, and a cold mist was slowly rising from the river. I am not superstitious, and in broad daylight I will scoff at ghosts with anyone, but I should not care to spend a night alone in Termonde. One could almost hear the Devil laughing at the handiwork of his children.

VI. The Chateau

One of the most astounding features of the war is the way in which the Germans, from the highest to the lowest, have given themselves up to loot. In all previous wars between civilized countries anything in the nature of loot has been checked with a stern hand, and there are cases on record when a soldier has been shot for stealing a pair of boots. But now the Crown Prince of the German Empire sends back to his palaces all the loot that he can collect, on innumerable transport waggons, amid the applause of his proud father’s subjects. He is of course carrying out the new gospel of the Fatherland that everyone has a perfect right to whatever he is strong enough to take. But some day that doctrine may spread from the exalted and sacred circle in which it is now the guiding star to the “cannon fodder.” Some day the common people will have learnt the lesson which is being so sedulously taught to them both by example and by precept, and then the day of reckoning will have come.

Loot and destruction have always gone hand in hand. The private soldier cannot carry loot, and it is one of the most primitive instincts of animal nature to destroy rather than to leave that by which others may profit. Even the pavement artist will destroy his work rather than allow some poor wretch to sit beside his pictures and collect an alms. And there is great joy in destroying that which men are too coarse to appreciate, in feeling that they have in their power that which, something tells them, belongs to a refinement they cannot attain. That was the keynote of the excesses of the French Revolution, for nothing arouses the fury of the unclean so much as cleanliness, and a man has been killed before now for daring to wash his hands. And it is this elemental love of destroying that has raged through Belgium in the last few months, for though destruction has been the policy of their commanders, the German soldier has done it for love. No order could ever comprehend the ingenious detail of much that we saw, for it bore at every turn the marks of individuality. It is interesting to ponder on a future Germany of which these men, or rather these wild beasts, will be the sons. Germany has destroyed more than the cities of Belgium; she has destroyed her own soul.

It is not in the ruined towns or the battered cathedrals of Belgium that one sees most clearly the wholehearted way in which the German soldiers have carried out the commands of their lord and made his desires their own. Louvain, Termonde, Dinant, and a hundred other towns have been uprooted by order. If you wish to see what the German soldier can do for love, you have to visit the chateaux which are dotted so thickly all over the Belgian countryside. Here he has had a free hand, and the destruction he1 wrought had no political object and served no mere utilitarian purpose. It was the work of pure affection, and it showed Germany at her best. One would like to have brought one of those chateaux over to England, to be kept for all time as an example of German culture, that our children might turn from it in horror, and that our country might be saved from the hypocrisy and the selfishness of which this is the fruit.

Among our many good friends in Antwerp there were few whom we valued more than the Baron d’O. He was always ready to undertake any service for us, from the most difficult to the most trivial. A man of birth and of fortune, he stood high in the service of the Belgian Government, and he was often able to do much to facilitate our arrangements with them. So when he asked us to take him out in one of our cars to see the chateau of one of his greatest friends, we were glad to be in a position to repay him in a small way for his kindness. The chateau had been occupied by the Germans, who had now retired–though only temporarily, alas!–and he was anxious to see what damage had been done and to make arrangements for putting it in order again if it should be possible.

A perfect autumn afternoon found us tearing southwards on the road to Boom in Mrs. W.’s powerful Minerva. We were going to a point rather close to the German lines, and our safety might depend on a fast car and a cool hand on the wheel. We had both, for though the hand was a lady’s, its owner had earned the reputation of being the most dangerous and the safest driver in Antwerp, and that is no mean achievement. We called, as was our custom, at the Croix Rouge stations we passed, and at one of them we were told that there were some wounded in Termonde, and that, as the Germans were attacking it, they were in great danger. So we turned off to the right, and jolted for the next twenty minutes over a deplorable paved road.

The roar of artillery fire gradually grew louder and louder, and we were soon watching an interesting little duel between the forts of Termonde, under whose shelter we were creeping along, on the one side, and the Germans on the other. The latter were endeavouring to destroy one of the bridges which span the Scheldt at this point, one for the railway and one for the road; but so far they had not succeeded in hitting either. It was a week since our last visit to Termonde, and it seemed even more desolate and forsaken than before. The Germans had shelled it again, and most of the remaining walls had been knocked down, so that the streets were blocked at many points and the whole town was little more than a heap of bricks and mortar. There was not a living creature to be seen, and even the birds had gone. The only sound that broke the utter silence was the shriek of the shells and the crash of their explosion. We were constantly checked by piles of fallen debris, and from one street we had to back the car out and go round by another way. At the end of a long street of ruined houses, many bearing the inscription of some braggart, “I did this,” we found our wounded men. They were in a monastery near the bridge at which the Germans were directing their shells, several of which had already fallen into the building. There had been four wounded men there, but two of them, badly hurt, were so terrified at the bombardment that they had crawled away in the night. The priest thought that they were probably dead. Think of the poor wounded wretches, unable to stand, crawling away in the darkness to find some spot where they could die in peace. Two remained, and these we took with us on the car. The priest and the two nuns, the sole occupants of the monastery, absolutely refused to leave. They wished to protect the monastery from sacrilege, and in that cause they held their lives of small account. I have often thought of those gentle nuns and the fearless priest standing in the doorway as our car moved away. I hope that it went well with them, and that they did not stay at their post in vain.

By the bridge stood a company of Belgian soldiers, on guard in case, under cover of the fire of their artillery, the Germans might attempt to capture it. There was very little shelter for them, and it was positively raining shells; but they had been told to hold the bridge, and they did so until there was no longer a bridge to hold. It was as fine a piece of quiet heroism as I shall ever see, and it was typical of the Belgian soldier wherever we saw him. They never made any fuss about it, they were always quiet and self-contained, and always cheerful. But if they were given a position to hold, they held it. And that is the secret of the wonderful losing battle they have fought across Belgium. Some day they will advance and not retreat, and then I think that the Belgian Army will astonish their opponents, and perhaps their friends too.

We were soon out of Termonde and on the open road again, to our very great relief, and at the nearest dressing-station we handed over our patients, who were not badly wounded, to the surgeon, who was hard at work in a little cottage about a mile back along the road. We drove on due east, and forty minutes later found ourselves at the entrance of the lodge of our friend’s house. It lay on the very edge of the Belgian front, and would have been unapproachable had there been any activity in this section of the line. Fortunately for us, the Germans were concentrating their energies around Termonde, and the mitrailleuse standing on the path amongst the trees at the end of the garden seemed to have gone asleep. We turned the car in the drive, and, in case things should happen, pointed its nose homewards. That is always a wise precaution, for turning a car under fire in a narrow road is one of the most trying experiences imaginable. The coolest hand may fumble with the gears at such a moment, and it is surprising how difficult it is to work them neatly when every second may be a matter of life or death, when a stopped engine may settle the fate of everyone in the car. It is foolish to take unnecessary risks, and we left the car pointing the right way, with its engine running, ready to start on the instant, while we went to have a look at the house.

It was a large country-house standing in well-timbered grounds, evidently the home of a man of wealth and taste. The front-door stood wide open, as if inviting us to enter, and as we passed into the large hall I could not help glancing at our friend’s face to see what he was thinking as the obvious destruction met us on the very threshold. So thorough was it that it was impossible to believe that it had not been carried out under definite orders. Chairs, sofas, settees lay scattered about in every conceivable attitude, and in every case as far as I can recollect minus legs and backs. In a small room at the end of the hall a table had been overturned, and on the floor and around lay broken glass, crockery, knives and forks, mixed up in utter confusion, while the wall was freely splashed with ink. One fact was very striking and very suggestive: none of the pictures had been defaced, and there were many fine oil-paintings and engravings hanging on the walls of the reception-rooms. After the destruction of the treasures of Louvain, it is absurd to imagine that the controlling motive could have been any reverence for works of art. The explanation was obvious enough. The pictures were of value, and were the loot of some superior officer. A large cabinet had evidently been smashed with the butt-end of a musket, but the beautiful china it contained was intact. The grand piano stood uninjured, presumably because it afforded entertainment. The floor was thick with playing cards.

But it was upstairs that real chaos reigned. Every wardrobe and receptacle had been burst open and the contents dragged out. Piles of dresses and clothing of every kind lay heaped upon the floor, many of them torn, as though the harsh note produced by the mere act of tearing appealed to the passion for destruction which seemed to animate these fighting men. In the housekeeper’s room a sewing- machine stood on the table, its needle threaded, and a strip of cloth in position, waiting for the stitch it was destined never to receive. There were many other things to which one cannot refer, but it would have been better to have had one’s house occupied by a crowd of wild beasts than by these apostles of culture.

Our friend had said very little while we walked through the deserted rooms in this splendid country-house in which he had so often stayed. Inside the house he could not speak, and it was not until we got out into the sunshine that he could relieve his overwrought feelings. Deep and bitter were the curses which he poured upon those vandals; but I stood beside him, and I did not hear half that he said, for my eyes were fixed on the mitrailleuse standing on the garden path under the trees. My fingers itched to pull the lever and to scatter withering death among them. It slowly came into my mind how good it would be to kill these defilers. I suppose that somewhere deep down in us there remains an elemental lust for blood, and though in the protected lives we live it rarely sees the light, when the bonds of civilization are broken it rises up and dominates. And who shall say that it is not right? There are things in Belgium for which blood alone can atone. Woe to us if when our interests are satisfied we sheath the sword, and forget the ruined homes, the murdered children of Belgium, the desecrated altars of the God in whose name we fight! He has placed the sword in our hands for vengeance, and not for peace.

I no longer wonder at the dogged courage of the Belgian soldiers, at their steady disregard of their lives, when I think of the many such pictures of wanton outrage which are burned into their memories, and which can never be effaced so long as a single German remains in their beloved land. I no longer wonder, but I do not cease to admire. Let anyone who from the depths of an armchair at home thinks that I have spoken too strongly, stimulate his imagination to the pitch of visualizing the town in which he lives destroyed, his own house a smoking heap, his wife profaned, his children murdered, and himself ruined, for these are the things of which we know. Then, and then only, will he be able to judge the bravery of the nation which, preferring death to dishonour, has in all likelihood saved both France and ourselves from sharing its terrible but glorious fate.

VII. Malines

We were frequently requested by the Belgian doctors to assist them in the various Red Cross dressing-stations around Antwerp, and it was our custom to visit several of these stations each day to give what assistance we could. One of the most important of the stations was at Malines, and one of our cars called there every day. I went out there myself on an afternoon late in September. It was a glorious day, and after a heavy morning in the wards the fresh breeze and the brilliant sunshine were delightful. Our road led almost straight south through Vieux Dieu and Contich, crossing the little River Nethe at Waelhem. The Nethe encircles Antwerp on the south and south-east, and it was here that the Belgians, and in the end the British, made their chief stand against the Germans. We crossed the bridge, and passed on to Malines under the guns of Fort Waelhem, with the great fortress of Wavre St. Catharine standing away to the left, impregnable to anything but the huge guns of to-day.

Malines is a large town of 60,000 inhabitants, and is the cathedral city of the Archbishop of Belgium, the brave Cardinal Mercier. To-day it is important as a railway centre, and for its extensive railway workshops, but the interest of the town lies in the past. It was of importance as early as the eighth century, and since then it has changed hands on an amazing number of occasions. Yet it is said that few of the cities of Europe contain so many fine old houses in such good preservation. The cathedral church of St. Rombold dates back to the thirteenth century, and in the fifteenth century was begun the huge tower which can be seen for many miles around. It was intended that it should be 550 feet high–the highest in the world–and though it has reached little more than half that height, it is a very conspicuous landmark. The Germans evidently found it a very tempting mark, for they began shelling it at an early stage. When we were there the tower had not been damaged, but a large hole in the roof of the church showed where a shell had entered. Inside everything was in chaos. Every window was broken, and of the fine stained glass hardly a fragment was left. A large portion of the roof was destroyed, and the floor was a confusion of chairs and debris. The wonderful carved wooden pulpit, with its almost life-size figures, was damaged. When the shell entered, the preacher’s notes from the previous Sunday lay on the desk, and they were perforated by a fragment.

The Croix Rouge was established in a large school on the south side of the town. We drove into the large courtyard, and went in to see if there was anything for us to do. The doctor in charge, a distinguished oculist, was an old friend and was very cordial, but he said there was no fighting near, and that no cases had come in. We stood talking for a few minutes, and were just going, when one of our other cars came in with a man very badly wounded. He was a cyclist scout, and had been shot while crossing a field a few miles away. He had been picked up at considerable risk by our people:–for the Germans rarely respected a Red Cross–and brought in on the ambulance. He was wounded in the abdomen, and his right arm was shattered. He was in a desperate state, but the doctor begged me to do what I could for him, and, indeed, the power of recovery of these fellows was so remarkable that it was always worth a trial. As rapidly as possible we got ready stimulants and hot saline solution to inject into his veins. We had not come prepared for actual operating, and the local equipment was meagre, but we succeeded in improvising a transfusion apparatus out of various odds and ends. It did not take long to get it to work, and in a few minutes he began to respond to the hot salt and water running into his vessels. Alas it was only for a moment. He was bleeding internally, and nothing could be done. I went over to the priest, who had just come, and said: “C’est a vous, monsieur.” He bowed, and came forward holding in his hands the holy oil. A few murmured words were spoken, the priest’s finger traced the sign of the Cross, a few moments of silence, and all was over. Death is always impressive, but I shall never forget that scene. The large schoolroom, with its improvised equipment, ourselves, a crowd of nurses and doctors standing round, in the centre the sandalled priest bending downwards in his brown mantle, and the dying man, his lips moving to frame the last words he would speak on earth. It was in silence that we stole out into the sunlight of the courtyard.

We went on to Sempst, a small village at the extreme limit of the Belgian lines. A little stream ran under the road beside a farm, and a rough breastwork had been thrown across the road to defend the bridge. German soldiers could be seen a mile down the road moving behind the trees. It was only a small Belgian outpost, but it was a good enough position to hold, so long as the enemy did not bring up artillery. A machine gun was hidden beside the bridge, and would have made short work of anyone advancing up the road. My friends were talking to the men, whom we knew quite well; and for a moment I was standing alone, when one of the soldiers came up and asked about the man whom we had just left, and who had come from near by. I told him what had happened, and for a moment he did not speak. At last he looked up at me with tears in his eyes, and said simply: “He was my brother, and this morning we were laughing together.” I held his hand for a moment, and then he turned away and went back to his post.

Our way home led past a villa where an encounter had taken place three days before between the Belgians and an advanced detachment of German troops, and we stopped to see the scene of the fighting. It was a large country-house standing back in its own grounds, and during the night a party of Germans had succeeded in concealing themselves inside. In the morning, by a ruse, they induced a Belgian detachment to come up the drive towards the house, never suspecting that it was not empty. Suddenly the Germans opened fire, and I believe that scarcely a single Belgian escaped. Next day, however, having surrounded the villa, the Belgians opened fire upon it with their 3-inch guns. The Germans made a bolt for it, and the whole of them were killed. As we walked up the drive we saw on the left-hand side a little row of graves with fresh flowers laid on them. They were the graves of the Belgian soldiers who had been entrapped. An officer was standing by them with bared head, and, seeing us, he came over and walked on with us to the house, which he was then occupying with his soldiers. It was a fine house, with polished parquet floors and wide staircases. The dining-room was ornamented with delicate frescoes in gilt frames. In the drawing-room stood a new grand pianoforte, and light gilt chairs and sofas, looking strangely out of place on the field of war. By the front-door, sticking in the wall, was a shell which had failed to burst. I wonder if it is still there, or if anyone has ventured to shift it. It was half inside and half outside, and if it had exploded there would not have been much of the entrance of the house left. Upstairs the rooms were in glorious confusion. Apparently the Germans had opened all the drawers, and flung their contents on the floor, with the idea, I suppose, of taking anything they wanted. One room was plainly the nursery, for the floor was covered with children’s toys of all descriptions, all broken. It may be very unreasonable, but that room made me more angry than all the rest of the house. There is something so utterly wanton in trampling on a child’s toys. They may be of no value, but I have a small opinion of a man who does not treat them with respect. They are the symbols of an innocence that once was ours, the tokens of a contact with the unseen world for which we in our blindness grope longingly in vain.

VIII. Lierre

When, years hence, some historian looks back upon the present war, and from the confusion of its battles tries to frame before his mind a picture of the whole, one grim conclusion will be forced upon his mind. He will note, perhaps, vast alterations in the map of Europe; he will lament a loss of life such as only the hand of Heaven has dealt before; he will point to the folly of the wealth destroyed. But beneath all these he will hear one insistent note from which he cannot escape, the deep keynote of the whole, the note on which the war was based, the secret of its ghastly chords, and the foundation of its dark conclusion. And he will write that in the year 1914 one of the great nations of civilized Europe relapsed into barbarism.

In the large sense a nation becomes civilized as its members recognize the advantages of sinking their personal desires and gain in the general good of the State. The fact that an individual can read and write and play the piano has nothing at all to do with the degree of his civilization, an elementary axiom of which some of our rulers seem strangely ignorant. To be of use to the State, and to train others to be of use to the State (and not only of use to themselves), should be, and indeed is, the aim of every truly civilized man. Unless it be so, his civilization is a mere veneer, ready to wear off at the first rub, and he himself a parasite upon the civilized world.

As time has gone on, the State has laid down certain rules by means of which the men who formed it could serve it better, and these are our laws which we obey not for our own good directly, but for the good of the State. From the point of view of the plain man in the street, it is all utterly illogical, for it would be logical to go and take from your neighbour whatever you wished, so long as you were strong enough to hold it. But, let us thank Heaven, no sane man is logical, and only a Professor would dare to make the claim. It is one of the prerogatives of his office, and should be treated with tolerance.

And as our views of life are small and limited by our surroundings, when States grew large they took from the shoulders of the individual his responsibilities in the great State which the world has now become; and the States of which the world was composed agreed together on certain rules which should control their relations to one another, not for the good of each, but for the good of the greater State of which they were members. They are not so accurately laid down as the laws of our separate States, but they are broad, general principles for the use of statesmen and not of legalists. They are the Charter of Civilization among the nations of the world, and the nation which disregards them does so at her peril, and has handed in the abnegation of her position as a civilized State. Like the laws of each State, they are utterly illogical–at least, to those who have made up their minds that they are strong enough to hold what they can take from their neighbours.

I am often told, in half-defence of what they have done, that the Germans are conducting the war in a strictly logical manner. At first, I must admit, I was rather taken with the idea, and, indeed, one felt almost sorry for a noble nation sacrificing its feelings on the uncompromising altar of Logic. For the object of war is obviously to defeat your enemy, and it may be argued that anything which will accelerate that result is not only justifiable, but almost humane, for it will shorten the unavoidable horrors of war. I should like to mention a few of the features of logical warfare, all of which have at one time or another been adopted by our opponents, and I shall then describe as far as I can an example which I myself saw.

When an army wishes to pass through a country, the civil population is in the way. To get rid of them, the best plan, and the quickest, is to annihilate the first town of a suitable size to which the army comes. If the town is wiped out, and men, women, and children slaughtered indiscriminately, it will make such an impression in the rest of the country that the whole population will clear out and there will be no further trouble. The country will then be free for the passage of troops, and there will be no troublesome civil population to feed or govern. The conduct of the war will be greatly facilitated. Of course, it will be necessary at intervals to repeat the process, but this presents the further advantage that it advertises to other nations what they may expect if war enters their borders. This, one of the most elementary rules of logical warfare, has been strictly observed by Germany. The sack of Louvain and the slaughter of its inhabitants met with an immediate success. Wherever the German army arrived, they entered with few exceptions empty towns. Termonde, Malines, Antwerp, had everything swept and garnished for their reception. It would, of course, be absurdly illogical to confine one’s attack to persons capable of defence. To kill a hundred women and children makes far more impression than to kill a thousand men, and it is far safer, unless, of course, it is preferred to use them as a screen to protect your own advancing troops from the enemy’s fire.

It is a mistake to burden your transport with the enemy’s wounded, or, indeed–low be it spoken–with your own. The former should always be killed, and the latter so far as the degree of culture of your country will allow. It is one of the regrettable points, logically, of Germany’s warfare that she appears to pay some attention to her wounded, but our information on this point is deficient, and it is possible that she limits it to those who may again be useful.

To kill the Medical Staff of the enemy is obviously most desirable. Without them a large number of the wounded would die. If, therefore, it is possible to kill both the doctors and the wounded together, it is a great advantage, and of all possible objectives for artillery a hospital is the most valuable. So complete was our confidence in the German observance of this rule that when we heard that they were likely to bombard Antwerp, we were strongly advised to remove our Red Cross from the sight of prying aeroplanes, and we took the advice. Several other hospitals were hit, but we escaped.

There are many other rules of logical warfare, such as ignoring treaties, engagements, and, indeed, the truth in any form. But these are those with which I myself came in contact, and which therefore interested me the most. There is only one unfortunate objection to logical warfare, and that is that it is the duty of the whole civilized world, as it values its eternal salvation, to blot out from the face of the earth they have defiled the nation which practises it.

I do not wish to be unfair to those with whom we are fighting, or to arouse against them an unjust resentment. I am merely attempting to express succinctly the doctrines which have been proclaimed throughout Germany for years, of which this war is the logical outcome, and in the light of which alone its incidents can be understood. She is the home of logic, the temple where material progress is worshipped as a god. For her there is no meaning in those dim yearnings of the human mind, in which logic has no part, since their foundations are hidden in depths beneath our ken, but which alone separate us from the beasts that perish. And, above all things, I would not be thought to include in such a sweeping statement all those who call themselves German. There are many in Germany who are not of this Germany, and in the end it may be for them as much as for ourselves that we shall have fought this war.

It is only when viewed in this setting that a scene such as that we saw at Lierre can be understood. By itself it would stand naked, meaningless, and merely horrible. Clothed in these thoughts, it is pregnant with meaning, and forms a real epitome of the whole German conception of war; for horror is their dearest ally, and that scene has left on my mind a feeling of horror which I do not think that time will ever eradicate.

Lierre is an old-world town on the River Nethe, nine miles south of Antwerp, prosperous, and thoroughly Flemish. Its 20,000 inhabitants weave silk and brew beer, as they did when London was a village. Without the physical advantages of Antwerp, and without the turbulence of Ghent, Lierre has escaped their strange vicissitudes, and for hundreds of years has enjoyed the prosperity of a quiet and industrious town. Its church of St. Gommarius is renowned for its magnificent proportions, its superb window tracery, and its wonderful rood-loft–features in which it has eclipsed in glory even the great cathedrals of Belgium, and which place it alone as a unique achievement of the art of the fifteenth century. It is in no sense a military town, and has no defences, though there is a fort of the same name at no great distance from it.

Into this town, without warning of any kind, the Germans one morning dropped two of their largest shells. One fell near the church, but fortunately did no harm. One fell in the Hospital of St. Elizabeth. We heard in Antwerp that several people had been wounded, and in the afternoon two of us went out in one of our cars to see if we could be of any service. We found the town in the greatest excitement, and the streets crowded with families preparing to leave, for they rightly regarded these shells as the prelude of others. In the square was drawn up a large body of recruits just called up–rather late in the day, it seemed to us. We slowly made our way through the crowds, and, turning to the right along the Malines road, we drew up in front of the hospital on our right-hand side. The shell had fallen almost vertically on to a large wing, and as we walked across the garden we could see that all the windows had been broken, and that most of the roof had been blown off. The nuns met us, and took us down into the cellars to see the patients. It was an infirmary, and crowded together in those cellars lay a strange medley of people. There were bedridden old women huddled up on mattresses, almost dead with terror. Wounded soldiers lay propped up against the walls; and women and little children, wounded in the fighting around, lay on straw and sacking. Apparently it is not enough to wound women and children; it is even necessary to destroy the harbour of refuge into which they have crept. The nuns were doing for them everything that was possible, under conditions of indescribable difficulty. They may not be trained nurses, but in the records of this war the names of the nuns of Belgium ought to be written in gold. Utterly careless of their own lives, absolutely without fear, they have cared for the sick, the wounded, and the dying, and they have faced any hardship and any danger rather than abandon those who turned to them for help.

The nuns led us upstairs to the wards where the shell had burst. The dead had been removed, but the scene that morning must have been horrible beyond description. In the upper ward six wounded soldiers had been killed, and in the lower two old women. As we stood in the upper ward, it was difficult to believe that so much damage could have been caused by a single shell. It had struck almost vertically on the tiled roof, and, exploding in the attic, had blown in the ceiling into the upper ward. I had not realized before the explosion of a large shell is not absolutely instantaneous, but, in consequence of the speed of the shell, is spread over a certain distance. Here the shell had continued to explode as it passed down through the building, blowing the floor of the upper ward down into the ward below. A great oak beam, a foot square, was cut clean in two, the walls of both wards were pitted and pierced by fragments, and the tiled floor of the lower ward was broken up. The beds lay as they were when the dead were taken from them, the mattresses riddled with fragments and soaked with blood. Obviously no living thing could have survived in that awful hail. When the shell came the soldiers were eating walnuts, and on the bed of one lay a walnut half opened and the little penknife he was using, and both were stained. We turned away sickened at the sight, and retraced the passage with the nuns. As we walked along, they pointed out to us marks we had not noticed before–red finger-marks and splashes of blood on the pale blue distemper of the wall. All down the passage and the staircase we could trace them, and even in the hall below. Four men had been standing in the doorway of the upper ward. Two were killed; the others, bleeding and blinded by the explosion, had groped their way along that wall and down the stair. I have seen many terrible sights, but for utter and concentrated horror I have never seen anything to equal those finger-marks, the very sign- manual of Death. When I think of them, I see, in the dim light of the early autumn morning, the four men talking; I hear the wild shriek of the shell and the deafening crash of its explosion; and then silence, and two bleeding men groping in darkness and terror for the air.

IX. A Pause

The life of a hospital at the front is a curious mixture of excitement and dullness. One week cases will be pouring in, the operating theatre will be working day and night, and everyone will have to do their utmost to keep abreast of the rush; next week there will be nothing to do, and everyone will mope about the building, and wonder why they were ever so foolish as to embark on such a futile undertaking. For it is all emergency work, and there is none of the dull routine of the ordinary hospital waiting list, which we are always trying to clear off, but which is in reality the backbone of the hospital’s work.

When we first started in Antwerp, the rush of cases was so great as to be positively overwhelming. For more than twenty-four hours the surgeons in the theatre were doing double work, two tables being kept going at the same time. During that time a hundred and fifty wounded were admitted, all of them serious cases, and the hospital was full to overflowing. For the next ten days we were kept busy, but then our patients began to recover, and many of them had to go away to military convalescent hospitals. The wards began to look deserted, and yet no more patients arrived. We began to think that it was all a mistake that we had come, that there would be no more fighting round Antwerp, and that we were not wanted. Indeed, we canvassed the possibilities of work in other directions, and in the meantime we drew up elaborate arrangements to occupy our time. There were to be courses of lectures and demonstrations in the wards, and supplies of books and papers were to be obtained. Alas for the vanity of human schemes, the wounded began to pour in again, and not a lecture was given.

During that slack week we took the opportunity to see a certain amount of Antwerp, and to call on many officials and the many friends who did so much to make our work there a success and our stay a pleasure. To one lady we can never be sufficiently grateful. She placed at our disposal her magnificent house, a perfect palace in the finest quarter of the city. Several of our nurses lived there, we had a standing invitation to dinner, and, what we valued still more, there were five bathrooms ready for our use at any hour of the day. Their drawing-room had been converted into a ward for wounded officers, and held about twenty beds. One of the daughters had trained as a nurse, and under her charge it was being run in thoroughly up-to-date style. The superb tapestries with which the walls were decorated had been covered with linen, and but for the gilded panelling it might have been a ward in a particularly finished hospital. I often wonder what has happened to that house. The family had to fly to England, and unless it was destroyed by the shells, it is occupied by the Germans.

Calling in Antwerp on our professional brethren was very delightful for one’s mind, but not a little trying for one’s body. Their ideas of entertainment were so lavish, and it was so difficult to refuse their generosity, that it was a decided mistake to attempt two calls in the same afternoon. To be greeted at one house with claret of a rare vintage, and at the next with sweet champagne, especially when it is plain that your host will be deeply pained if a drop is left, is rather trying to a tea-drinking Briton. They were very good to us, and we owed a great deal to their help. Most of all we owed to Dr. Morlet, for he had taken radiographs of all our fractures, and of many others of our cases. We went to see him one Sunday afternoon at his beautiful house in the Avenue Plantin. He also had partly converted his house into a hospital for the wounded, and we saw twenty or thirty of them in a large drawing-room. The rest of the house was given up to the most magnificent electro-therapeutical equipment I have ever seen or heard of. We wandered through room after room filled with superb apparatus for X-ray examinations, X-ray treatment, diathermy, and electrical treatment of every known kind. It was not merely that apparatus for all these methods was there. Whole rooms full of apparatus were given up to each subject. It was the home of a genius and an enthusiast, who thought no sum too great if it were to advance his science. Little did we think that ten days later we should pick its owner up upon the road from Antwerp, a homeless wanderer, struggling along with his wife and his family, leaving behind everything he possessed in the world, in the hope that he might save them from the Germans. We heard from him not long ago that they had carried off to Germany all the wonderful machinery on which he had spent his life.

The very next morning, while we were still at breakfast, the wounded began to arrive, and we never had another day in Antwerp that was not crowded with incident. The wounded almost always came in large batches, and the reason of this was the method of distribution adopted by the authorities. All the injured out at the front were collected as far as possible to one centre, where a train was waiting to receive them. There they remained until the train was sufficiently filled, when it brought them into the Central Station of Antwerp. At this point was established the distributing station, with a staff of medical officers, who arranged the destination of each man. Antwerp has a very complete system of electric trams, scarcely a street being without one, and of these full use was made for the transport of the wounded. Those who could sit went in ordinary cars, but for the stretcher cases there were cars specially fitted to take ordinary stretchers. A car was filled up with cases for one hospital, and in most cases it could deposit them at the door. It was an admirable method of dealing with them, simple and expeditious, and it involved far less pain and injury to the men than a long journey on an ambulance. In fact, we were only allowed in exceptional circumstances to bring in wounded on our cars, and it is obvious that it was a wise plan, for endless confusion would have been the result if anyone could have picked up the wounded and carried them off where they liked. Our cars were limited for the most part to carrying the injured to the various dressing- stations and to the train, and for these purposes they were always welcomed. They were soon well known at the trenches, and wherever the fighting was heaviest you might be sure to find one of them. Many were the hairbreadth escapes of which they had to tell, for if there were wounded they brought them out of danger, shells or no shells. And it says as much for the coolness of the drivers as for their good luck that no one was ever injured; for danger is halved by cool judgment, and a bold driver will come safely through where timidity would fail.

X. The Siege

It is difficult to say exactly when the Siege of Antwerp began. For weeks we heard the distant boom of the guns steadily drawing nearer day by day, and all night the sky was lit up by distant flashes. But so peculiar was the position of Antwerp that it was not till the last ten days that our life was seriously affected, and not till the very end that communication with our friends and the getting of supplies became difficult. Our first real domestic tragedy was the destruction of the waterworks on the 30th of September. They lay just behind Waelhem, some six miles south of Antwerp, and into them the Germans poured from the other side of Malines a stream of 28-centimetre shells, with the result that the great reservoir burst. Until one has had to do without a water-supply in a large city it is impossible to realize to what a degree we are dependent upon it. In Antwerp, fortunately, a water- supply has been regarded as somewhat of an innovation, and almost every house, in the better class quarters at least, has its own wells and pumps. It was, however, the end of the summer, and the wells were low; our own pumps would give us barely enough water for drinking purposes. The authorities did all they could, and pumped up water from the Scheldt for a few hours each day, enabling us, with considerable difficulty, to keep the drainage system clear. But this water was tidal and brackish, whilst as to the number of bacteria it contained it was better not to inquire. We boiled and drank it when we could get nothing else, but of all the nauseous draughts I have ever consumed, not excluding certain hospital mixtures of high repute, tea made with really salt water is the worst. Coffee was a little better, though not much, and upon that we chiefly relied. But I really think that that was one of the most unpleasant of our experiences. A more serious matter from the point of view of our work was the absence of water in the operating theatre. We stored it as well as we could in jugs, but in a rush that was inadequate, and we began to realize what the difficulties were with which surgeons had to contend in South Africa.

We were really driven out of Antwerp at a very fortunate moment, and I have often wondered what we should have done if we had stopped there for another week. Such a very large proportion of the inhabitants of Antwerp had already disappeared that there was never any great shortage of supplies. Milk and butter were the first things to go, and fresh vegetables followed soon after. It was always a mystery to me that with the country in such a condition they went on for as long as they did. The peasants must have worked their farms until they were absolutely driven out, and indeed in our expeditions into the country we often saw fields being ploughed and cattle being fed when shells were falling only a few fields away. However, margarine and condensed milk are not bad substitutes for the real articles, and the supply of bread held out to the very end. A greater difficulty was with our kitchen staff of Belgian women, for a good many of them took fright and left us, and it was not at all easy to get their places filled. As the week went on the pressure of the enemy became steadily greater. On Tuesday, the 29th of September, the great fortress of Wavre St. Catherine fell, blown up, it is believed, by the accidental explosion of a shell inside the galleries. It had been seriously battered by the big German howitzers, and it could not in any case have held out for another day. But the results of the explosion were terrible. Many of the wounded came to us, and they were the worst cases we had so far seen.

On Thursday Fort Waelhem succumbed after a magnificent resistance. The garrison held it until it was a mere heap of ruins, and, indeed, they had the greatest difficulty in making their way out. I think that there is very little doubt that the Germans were using against these forts their largest guns, the great 42-centimetre howitzers. It is known that two of these were brought northwards past Brussels after the fall of Maubeuge, and a fragment which was given to us was almost conclusive. It was brought to us one morning as an offering by a grateful patient, and it came from the neighbourhood of Fort Waelhem. It was a mass of polished steel two feet long, a foot wide, and three inches thick, and it weighed about fifty pounds. It was very irregular in shape, with edges sharp as razors, without a particle of rust upon it. It had been picked up where it fell still hot, and it was by far the finest fragment of shell I have ever seen. Alas we had to leave it behind, and it lies buried in a back-garden beside our hospital. Some day it will be dug up, and will be exhibited as conclusive evidence that the Germans did use their big guns in shelling the town.

The destruction produced by such a shell is almost past belief. I have seen a large house struck by a single shell of a much smaller size than this, and it simply crumpled up like a pack of cards. As a house it disappeared, and all that was left was a heap of bricks and mortar. When one considers that these guns have a range of some ten miles, giving Mont Blanc considerable clearance on the way, and that one of them out at Harrow could drop shells neatly into Charing Cross, some idea of their power can be obtained.

Every day we had visits from the enemy’s aeroplanes, dropping bombs or literature, or merely giving the range of hospitals and other suitable objectives to the German gunners. From the roof of the hospital one could get a magnificent view of their evolutions, and a few kindred spirits always made a rush for a door on to the roof, the secret of which was carefully preserved, as the accommodation was limited. It was a very pretty sight to watch the Taube soaring overhead, followed by the puffs of smoke from the explosion of shells fired from the forts. The puffs would come nearer and nearer as the gunners found the range, until one felt that the next must bring the Taube down. Then suddenly the airman would turn his machine off in another direction, and the shells would fall wider than ever. One’s feelings were torn between admiration for the airman’s daring and an unholy desire to see him fall.

It was evident that Antwerp could not withstand much longer the pressure of the enemy’s guns, and we were not surprised when on Friday we received an official notice from the British Consul-General, Sir Cecil Herstlet, that the Government were about to leave for Ostend, and advising all British subjects to leave by a boat which had been provided for them on Saturday. On Saturday morning came an order from the Belgian Army Medical Service instructing us to place on tramcars all our wounded, and to send them to the railway station. It appeared evident that Antwerp was to be evacuated, and we took the order to clear out our wounded as an intimation that our services would be no longer required. We got all our men ready for transport, and proceeded to pack up the hospital. The tramcars arrived, and we bade good-bye to our patients, and saw them off, some in ordinary trams and some in specially equipped stretcher-cars. It was a dismal scene.

The hall of the hospital was still covered with stretchers on which lay patients waiting their turn for the cars to take them, and the whole hospital was in process of being dismantled, when tramcars began to arrive back from the station with the patients we had just packed off. They told us that the whole of Antwerp was covered with tramloads of wounded soldiers, that there were five thousand in the square in front of the railway station, and that two trains had been provided to take them away! It was evident that some extraordinary blunder had been made; and while we were in doubt as to what to do, a second order came to us cancelling entirely the evacuation order which we and all the other hospitals in Antwerp had received a few hours before. It was all so perplexing that we felt that the only satisfactory plan was to go round to the British Consul and find out what it all meant. We came back with the great news that British Marines were coming to hold Antwerp. That was good enough for us. In less than an hour the hospital was in working order again, and the patients were back in their beds, and a more jubilant set of patients I have never seen. It was the most joyful day in the history of the hospital, and if we had had a case of champagne, it should have been opened. As it was, we had to be content with salt coffee.

But there was one dreadful tragedy. Some of our patients had not returned. In the confusion at the station one tramcar loaded with our patients had been sent off to another hospital by mistake. And the worst of it was that some of these were our favourite patients. There was nothing for it but to start next morning and make a tour of the hospitals in search of them. We were not long in finding them, for most of them were in a large hospital close by. I do not think we shall ever forget the reception we got when we found them. They had left us on stretchers, but they tried to get out of bed to come away with us, and one of them was a septic factured thigh with a hole in his leg into which you could put your fist, and another had recently had a serious abdominal operation.

They seized our hands and would scarcely let us go until we had promised that as soon as we had arranged with the authorities they should come back to our hospital. It was managed after a little diplomacy, and they all came back next day, and we were again a united family.

XI. Contich

Sunday, the 4th of October, dawned with an extraordinary feeling of relief and expectancy in the air. The invincible British had arrived, huge guns were on their way, a vast body of French and British troops was advancing by forced marches, and would attack our besiegers in the rear, and beyond all possibility of doubt crush them utterly. But perhaps the most convincing proof of all was the round head of the First Lord of the Admiralty calmly having his lunch in the Hotel St. Antoine. Surely nothing can inspire such confidence as the sight of an Englishman eating. It is one of the most substantial phenomena in nature, and certainly on this occasion I found the sight more convincing than a political speech. Obviously we were saved, and one felt a momentary pang of pity for the misguided Germans who had taken on such an impossible task. The sight of British troops in the streets and of three armoured cars carrying machine guns settled the question, and we went home to spread the good news and to follow the noble example of the First Lord.

In the afternoon three of us went off in one of the motors for a short run, partly to see if we could be of any use at the front with the wounded, and partly to see, if possible, the British troops. We took a stretcher with us, in case there should be any wounded to bring in from outlying posts. Everywhere we found signs of the confidence which the British had brought. It was visible in the face of every Belgian soldier, and even the children cheered our khaki uniforms as we passed. Everywhere there were signs of a new activity and of a new hope. The trenches and wire entanglements around the town, already very extensive, were being perfected, and to our eyes they looked impregnable. We did not then realize how useless it is to attempt to defend a town, and, unfortunately, our ignorance was not limited to civilians. It is a curious freak of modern war that a ploughed field should be stronger than any citadel. But, as I say, these things were hidden from us, and our allies gave the finishing touches to their trenches, to the high entertainment of the Angels, as Stevenson would have told us. If only those miles of trench and acres of barbed wire had been placed ten miles away, and backed by British guns, the story of Antwerp might have been a very different one.

The road to Boom is like all the main roads of Belgium. The central causeway was becoming worn by the constant passage of heavy motor lorries tearing backwards and forwards at racing speed. The sides were deep in dust, for there had been little rain. On each side rose poplars in ordered succession, and the long, straight stretches of the road were framed in the endless vista of their tall trunks. And in that frame moved a picture too utterly piteous for any words to describe–a whole country fleeing before the Huns. The huge unwieldy carts of the Belgian farmer crept slowly along, drawn by great Flemish horses. In front walked the men, plodding along beside the splendid animals, with whose help they had ploughed their fields –fields they would never see again. In the carts was piled up all that they possessed in the world, all that they could carry of their homes wrecked and blasted by the Vandals, a tawdry ornament or a child’s toy looking out pitifully from the heap of clothes and bedding. And seated on the top of the heap were the woman and the children.

But these were the well-to-do. There were other little groups who had no cart and no horse. The father and a son would walk in front carrying all that a man could lift on their strong backs; then came the children, boys and girls, each with a little white bundle over their shoulder done up in a towel or a pillowslip, tiny mites of four or five doing all they could to save the home; and last came the mother with a baby at her breast, trudging wearily through the dust. They came in an endless stream, over and over again, for mile after mile, always in the same pathetic little groups, going away, only going away.

At last, with a sigh of relief, we reached Boom, and the end of the lines of refugees, for the Germans themselves were not far beyond. At the Croix Rouge we asked for instructions as to where we were likely to be useful. Boom had been shelled in the morning, but it was now quiet, and there was no fighting in the neighbourhood. We could hear the roar of guns in the distance on the east, and we were told that severe fighting was in progress in that direction. The British had reinforced the Belgian troops in the trenches at Duffel, and the Germans were attacking the position in force. Taking the road to the left, we passed the great brick-fields which provide one of the chief industries of Boom, and we drove through the poorer portion of the town which lies amongst them. It was utterly deserted. It was in this

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