Volume 1

Minutes of evidence taken before the Royal Commission on the War in South Africa.

  • Great Britain. Royal Commission on the South African War, 1899-1900
Date:
1903
Catalogue details

Licence: Public Domain Mark

Credit: Minutes of evidence taken before the Royal Commission on the War in South Africa. Source: Wellcome Collection.

    522/558 (page 504)
    A D2. Fripp, O.B., C.V.0., M.S., M.B., . F.R.C.S 10 Dec. 1902. Enormous convalescent camps were established, because it was found that these men were quite capable of cooking.their own food:and making their own beds, and there was no need for them to be. attended to by the nursing sisters ; on the contrary, they were so well that they were difficult to handle. 11855. Who devised that system?—It was my own idea. It was not copied from any other scheme. I simply sat down and thought out the hospital according to my own ideas of what a military base hospital should be like. 11856. Was that as soon as you got out to South Africa?—No; it was all evolved over here before we started. It was most amusing. I was told that it would be a complete wreck. I was solemnly advised by one gentleman on the Headquarters Staff of the Director- General. His last piece of advice to me was: “ You are making an awful mistake about these nurses; they will all be tripping over each other’s skirts; there will be nothing for them to do. Take my advice, and lose them.” 11857. Was this a gentleman who had had some ex- perience in a previous war?—Yes; but not in a war with whites. It was a very good thing for the Royal Army Medical Corps that the Boer war came, because they were basing ail their ideas on wars with blacks, in which, of course, nurses cannot go anywhere near the fighting. In such black warfare they hamper the mili- tary movements because you cannot leave them behind as they could have been left behind at Dundee, for instance, or if Ladysmith had by any chance fallen ; but in this South African war we knew that no harm would come to our women nurses if captured by the enemy, and that should have made all the difference in our hospital arrangements. 11858. You mean that the Royal Army Medical Corps here and the Director-General never realised that as fully as you did P— Not for a single moment, I am quite sure. There was a complete want of realisation out there, and at home, as to how much use nursing sisters could be; also as to how big the need for accommoda- tion, and open-minded administration had become. 11859. You say that personally you have not had much experience of our military hospital orderlies P— No; I should not like to give an opinion upon them. 11860. What do you say of the equipment of the Army surgeons out there, their instruments and other ap- pliances that they had; what were they like as com- pared with yours ?—Generally speaking, I should say that they were quite adequate. 11861. We have heard that to a very great extent they were old-fashioned P—They were at first, because we had an old-fashioned Headquarter Staff of the Royal Army Medical Corps. 11862. You mean that they improved as they went on?—Yes; they could get pretty well anything they requisitioned for. Sometimes, of course, there were very long delays, but on the whole, taking it all round, I think the instruments were quite adequate, and the equipment. 11863. We have had evidence which went rather to show that the equipment was old-fashioned; that the instruments first of all had wooden handles, and that it was difficult to sterilise them?—If I may make a criticism on that, a wooden handle does not matter the slightest bit; you can sterilise it perfectly well. ‘The only thing is that it will not bear sterilisation so re- peatedly ; but many instruments are very seldom used. Lhe amount of surgery actually done, even at a big base hospital is not enormous. Surgery is a very secondary matter in the part that our medical profession ought to play in war nowadays. There is an enormous amount of lopping off and carpentry done in field hospitals just after, and during a battle, but such rough surgery does not require any elaborate instruments. And it is the same with antiseptics ; if you have anti- septics you have no water, and if you have water it is commonly so insufficient and so bad that it has been said the only thing to do with it is “ Boil it, then filter it, and then throw it away.” So that you cannot dignify that work by the name of surgery as understood nowa- days. The surgery proper is done at the base hospitals, but very little is done even there. Most of the cases could be sent home to England ; at any rate, most cases of difficult surgery really needing an expert operator. We touch there on the all-important point, which I want to be allowed to bring out in my evidence with rerard to the position of the Royal Army Medical Corps and of medicine in any future war. It is that our profession can be of enormous help to the combatant ranks if only they will realise how much we can do now to prevent disease ; that is the great point, and therein lies the . hope of our being able to help our country to win its next war. 11864. (Sir Frederick Darley.) Sanitation ?—Sanita- tion and hygiene, of which they do not understand the merest elements. Tommy does not understand it because he is not taught it, and he is not taught it because the officer looks askance at it and regards it as just a fad. With regard to that, our Advisory Board, through the Director-General, has recommended the Secretary of State that the combatant officers shall be educated in the elements of hygiene, and I think that is a most essential point. 1f only the combatant officer can be interested in just the elements of hygiene and sanita- tion, then he will see that his men obey the elementary laws of personal health as to boiling the water, and so on, when it can be done. It is, I fear, useless talking of boiling all the drinking water with mobile columns or out on picket duty; it never could be done. It can be done in any considerable garrison or standing camp or large hospital, and there it should be done ; but it was not, at least not during the first year of the war when I was in South Africa. That is a point where the medical profession can be of great use, and may strengthen the hands of the Commander-in-Chief, if only he will let us help to prevent disease. And then, what we cannot get him to see—I am not speaking personally of the Commander-in-Chief in the late war, but what we cannot get the authorities to see is the strategic importance of it, which comes out very promi- nently if the figures are examined. If you look at the number of patients sick in Bloemfontein, and then calculate how much it cost the nation to put each one of those men at the front, I believe it works out at about £100 a man, and they went sick by scores and hundreds, as you know, from a disease which was to a large extent preventible. Then again just consider how much sooner Lord Roberts’ hands would have been free to move from Bloemfontein, and dash after the Boers up towards Johannesburg if it had not been for that heavy epidemic ; and if he had been able to make that move forward earlier it would have saved the nation a considerable number of men, and a corresponding] v large amount of money. 11865. (Chairman.) What was there to prevent the Director-General of the Army Medical Corps from deal- ing with that problem years ago? It is not a fresh idea to you?—The quaking of the knees, I think. There is not the faintest doubt that that was a disease from which the responsible medical officers all suffered ; they were all afraid to go to their commanding officer and ask for an interview and make suggestions. I mean that they were afraid to go to the head people, they would only dare to go up through the channels which the Regulations gave them the right to apply through. 11866. You received every encouragement, did you not, from the Army authorities when you volunteered to go out in the first instance ?—Yes, every encourage- ment, 11867. And most of the eminent surgeons, from Sir William MacCormac downwards, all received encourage- ment f—Yes. 11868. But how about physicians? Do you know whether many physicians volunteered to go out?—I do not know whether they actually volunteered, but they would have been delighted to go if they had been asked. 11869. Were they encouraged to go?—Certainly not in the early days. I cannot speak of what happened after the time I left England. All I can say is that I was looked upon as a crank for taking a physician out with me. One comment that I remember was: “Take as many surgeons as you like, but, my dear fellow, the one thing that our officers do understand is the treat- ment of enteric.” Well, they do not; at least, they did not. They do now that they have had an enormous experience, but they did not understand how even to write its name down in the slightest cases, because they called it “simple continued fever,” unless it had very marked symptoms; and they allowed that man with simple continued fever to go about and infect other people, and the other people so infected may have the acutest enteric. ; 11870. And that was during the earliest stages of