1914-18: Western Front

• First Battle of Ypres, Oct-Nov 1914:      
  • The British managed to hold on to Ypres.
  • It was vital in maintaining access and control of the English Channel ports.
  • But the Germans had gained ground.

• Battle on Hill 60, April 1915
  • The British tunnelled into and under the hill.
  • They exploded five mine from the tunnels.
  • This enabled them to take the hill.

• Second Battle of Ypres, April-May 1915:
  • The Germans made very slight gains towards Ypres.
  • The battle was the first time chlorine gas was used
  • The chlorine gas was used by the Germans.

• Third Battle of Ypres, July-Nov 1917:
• • The Brits used a creeping barrage to make small gains to break out of the Ypres Salient.
  • The awful weather left the ground waterlogged and many drowned.

• The Somme, July-Nov 1916:
  • Extremely high casulties on both sides.
  • Two new stratergies by the British: "The creeping barrage" & "The first use of tanks".
  • These stratergies had little impact.

• Arras, April-May 1917:
  • 1916, British expanded the underground tunnels and caves for shelter.
  • The tunnels were used to launch the battle, there were high levels off casualties for both.
  • It was initially successful but ended with little progress.

• Cambrai, Nov-Dec 1917:
  • This was the first large scale use of tanks.
  • They were successful but were not backed up.
  • The British were forced back.

Trench System:

• All three rows of trenches were linked by communication trenches.
• The reserved trench was where troops could be stationed for counter-attack.
• The frontline trench where attacks were launched.
• The support trench was where troops would retreat to from the frontline.
• Dugouts were holes in the side of the trench for troops to take over.
• Trenches formed a zig-zag pattern.

Trench construction:

• The first was hurriedly dug by troops.
• They were often used existing ditches/banks to make it easier.
• The trenches were constantly improved, e.g. steps were added.

Terrain and Transport:

• Terrain varied in different places and according to weather conditions.
• It was very difficult to get aroud when they was deep mud and holes from explosions.
• The trenches were very muddy and overcrowded.

• Gas Attacks:
  • They caused temporary blindess, coughing and burns.
  • Soldiers would protect themselves with pads soaked with urine.
  • 1915, gas masks were given to the British soldiers.

• Head Injuries:
  • These were mainly caused by shrapnel.
  • Late 1915, soldier's soft caps were replaced by Brodie helmets.
  • This reduced head wounds.

• Bullets:
  • These came from rifles and machine guns.
  • They cold penetrate organs and fracture bones.

• High Explosive Shells & Shrapnel:
  • This was responsible for most deaths and injuries. 
  • It removed limbs and caused major internsl injuries.

• Trench Fever: 
  • This was caused by lice, it had flu-like symptoms which lasted for months and reoccur.
  • 1918, troops were deloused which reduced cases.

• Trench Foot:
  • This was caused by by standing in waterlogged trenches.
  • It could lead to gangreen which had to be amputated.
  • To protect soldiers feet there were spare socks, whale oil, pumps to drain the trenches and duckbords to keep the feet above water.

• Shell Shock:
  • It caused a wide range of symptoms including total metal breakdown.
  • Some sufferers were accused of cowardise.
  • Many were treated close to the Front.
  • Some were evacuated to British hospsitals.

• Wound Infection:
  • Soil on Western front contained tetanusand gas gangrene bacteria.
  • These would infect wounds during attack or when victimes layed on the ground.
  • Late 1914, tetanus injections were given, but no preventing gas gangrene.

• RAMC=Royal Army Medical Core
• FANY= First Aid Nursing Yeomanry

• Medical Workers:
  • Was initially from RAMC but later volunteers were allowed from FANY.
  • Volunteers mainly drove ambulences and cooked and cleaned.

• UndergroundHhospital at Arras:
  • Thompson's cave was very close to the frontline in the tunnels underneath the town.
  • There was space for 700 beds, an operating theatre and mortuary.
  • It was supplied with running water and electricity.

• Transport problems:
  • Difficult terrainso, some places only stretcher-bearers & horse-waggons could be used.
  • Many roads and railway lines had been destroyed.
  • Constant shelling and artillery fire made recovery of the injury very difficult.
  • No motor abulances were sent and there were not enough horses.
  • A  public appeal in Britain raised money for 512 motor abulances.

• Regimental Aid Posts:
  • Closest medical help to the frontline
  • one medical and stretcher bearers
  • gave basic first aid and pain relief
• Field Ambulance:
  • About a mile back from the front line
  • Included dressing stations to treat troops
  • staffed by medical officers and nurses
• Casualty Clearing Stations:
  • First place to see a doctor and there was significant medical equipment
  • several miles from the frontline
  • Carried out treatment, including operations
• Base Hospitals:
  • Far from the frontline near to coastal ports
  • many medical staff and aseptic conditions
  • patients could stay for some time
  • It became a where doctors gained special knowledge of certain wounds/treatments

• X-rays-1895, Wilhelm Roentgen:
  • Used to see damaged to bones and to locate metal objects in the body
  • Hurt men had to stay still for a clear picture
  • Machines were large and heavy and expensive to build
  • It could not be used on the battlefield
• Blood Transfusions-1818, Jamess Blundell:
  • Blood transfusions could be used to treat blood loss and shock from wounds/surgery
  • Problems with inability to store blood to get it where it was needed
• Aseptic Surgery-1900's, Joseph Lister:
  • Very useful in preventing infections 
  • Keeping and maintaining aseptic conditions was very difficult near the battlefield

• Wound Infection:
  • Use of chemicals on wounds to kill bacteria
  • Sterilised salt solution to clean the wound
  • Improvements in surgery, damaged/infected tissue was removed
• Blood Loss:
  • Blood could not be stored as it clots 
  • Before 1917, transfusions had to be directly from person to person
  • This limited how many people got treated
  • 1917, various chemicals and refrigerating found to prevent bloodclotting
• Broken Legs:
  • 1915, the Thomas Splint was used keep legs rigid which reduced blood loss
  • Mobile X-rays were used to located bullets/shrapnel, so surgeons can remove it.
• Bullts/Shrapnel:
  • Mobile & static X-ray machines were used to precisely locate smaller remnants in the body, so that surgeons could remove it.
  • Improvements in brain surgery and plastic surgery meant that items were successfully removed from the head and reconstructed.