We continue into the new year under the most severe lockdown arrangements and I think the majority of people realise we all must continue to show self-discipline and resilience to see these ‘strangest of times’ to a conclusion. With January now passed daylight is lengthening and we are moving towards springtime with a renewed optimism that better days are on the horizon.
This coming Friday 12th we welcome our old friend and long-time member Bill Mitchinson for his talk on the eleven battles of the Isonzo.
Next month’s talk, 12th March, will be given by Trevor’s wife Caroline. Her talk is about a lady whose grave Trevor and Caroline saw in Mikra, a suburb of Thessaloniki (aka Salonika), CWGC cemetery whilst visiting Greece. The lady in question is Gladys Murray Levack. See the full article currently on the North Wales website. https://www. nwwfa.org.uk Incidentally, Caroline recently had an email, out of the blue, from an American academic about her article.
There is a massive online interest in the Great War worldwide and all our WFA websites receive unbelievable visitor levels which is a credit to all concerned especially Trevor who does our website, http://www.landcwfa.org as well as North Wales Branch. If you have any articles or short stories of a family ancestor these will always be of interest to our readers and will be used online or in print space allowing.
I welcome you all with this first edition of ‘Up the Line’ for 2021. The WFA national website editor and development trustee have created many items of interest, see www. westernfrontassociation.com, to catch members’ attention and entertain. Great War reading and research time will probably be a useful distraction for all depending on your level of historical interest.
When meetings will return us to the Armoury is anybody’s guess but let’s keep fingers crossed.
You will have just received the January edition of “Stand To!” with twelve interesting articles arranged by the WFA’s new editor Matt Leonard. We wish him well in taking over the journal after the sad loss of Jon Cooksey. After thirteen years of working together on ST! I still find it hard to believe Jon is no longer with us.
The next edition of Bulletin (119) is my current distraction and I can promise you some interesting material when published, hopefully by mid/late March. Keep well and keep safe.
Best wishes for now.
Bill has published and lectured extensively on many aspects of the Great War for over 40 years. He has a particular interest in the work and performance of the Territorial Force.
He has recently retired as a member of the academic staff of King’s College, London, at the Joint Services Command and Staff College, Shrivenham. He has for many years led staff rides of senior British and international officers to the European battlefields of the First and Second World Wars.
Any study of the Italian Army on the Isonzo during the Great War reveals examples of incompetent leadership, the arrogance of a military supposedly subservient to a democratic government, appalling staff work, and treachery at home. Above all, however, it provides evidence of incredible bravery and endurance and, in the face of appalling adversity, remarkable group cohesion
The physical and climatic conditions in which the Italians and Austro-Hungarian forces fought were generally worse than those of the Western Front. The losses were unimaginable and the inability of certain Italian commanders to manage and learn from experience is bewildering. Despite the inhumanity with which they were treated - arbitrary executions, formal decimations, massacres of supposedly mutinous brigades by their own artillery - the fanti remained largely prepared repeatedly to hurl themselves against the Austrian defences.
There are tales of bizarre individuals such as the Italian poet-pilot who dropped his own poems instead of bombs on the Austrians; of how only hours after the capture of a mountain peak on which over 25,000 Italians had been killed and on which Austrian shells continued to fall, Arturo Toscanini conducted a band playing patriotic tunes; and of how, abandoned by his own comrades thoroughly irritated by his constant political exhortations, no more might ever have been heard of Benito Mussolini. There are instances of command relationships which were toxic to the point of treachery, and of inspired tactical leadership by individuals who rescued potentially disastrous situations.
Set amongst the incredible majesty of the Julian Alps, the verdant beauty of the Friuli Plain, and the sometimes torrential waters of expansive rivers, the first eleven Italian offensives were spread between June 1915 and September 1917. Characterised by their extreme brutality they were launched by hopelessly undertrained forces whose regimental soldiers could barely understand each other, against a polygot army whose almost sole unifying feature was its disparate soldiers’ hatred of the “treacherous” Italians.
With the intent of offering some insights to the conduct and character of the campaign as a whole, Bill Mitchinson will consider the eleven battles within their strategic and tactical contexts.
Topic: Zoom Meeting
Time: Feb 12, 2021 07:45 PM London
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The Royal Army Medical Corps and other healthcare professions The overlooked dispenser and the diary of one who served
Before the Great War, the medical provision available to the general population was centred around their local chemist. Here they could discuss their problem and obtain a wide range of products and medications. The chemist that provided this service was knowledgeable, local and accessible. What was sold over the counter would be largely unrecognisable to modern eyes.
Pharmacists of all grades and training were caught up in the enthusiasm to volunteer for service in August 1914. Commissions in the Royal Army Medical Corps (RAMC) were restricted to those individuals with a medical degree and to Quarter Masters, who were often elevated to the position through the ranks1. As an emerging medical profession, pharmacists were keen to establish a role for themselves within the existing Army Medical Service framework. The highly trained pharmacist was denied a RAMC commission and many opted not to join and served as an officer in other services, rather than as a non-combatant ranker.
To add to the integration dilemma, the RAMC was also a male only organisation; females even when qualified as doctors, were excluded initially from service. Pharmacy had encouraged women to become pharmacists and they would have qualified for enlistment in all ranks. These gender problems were not to be resolved in 1914 as other pressing issues prevailed. This article sets out to provide an overview of the chemist role within local healthcare pre-war and go on to highlight how the roles of one of those professions, dispensers, developed within the Army Medical Services. In doing so it will give perspective and appreciation to the war service of our subject James Alfred Griffiths, a pre-war Boots dispenser, as recalled in his diary. He enlisted on the 13th August 1914 and went to serve initially on the Hospital Ship Oxfordshire
The need for dispensers
At the outbreak of the Great War the RAMC placed an announcement in the Pharmaceutical Journal for volunteers to fill the vacancies which they had for dispensing chemists2. It read:
‘In reply to inquiries which are being received from pharmacists who are desirous of taking service as military dispensers during the war, we are enabled to state that the conditions of such service are laid down in a special Army Order issued this week, dealing with the ‘enlistment of civilians for temporary service during the war. Men enlisted under this Army Order must not be more than forty years old and enlistments will be for one year, or if the war lasts longer, for the duration. We are informed that the services of 150 dispensers will be required, and that not more than fifty of these will be expected to serve with any expeditionary force that may be sent out of the country’.
These men were quickly recruited and sent to Ash Vale, Aldershot, the future home of the RAMC, for their initial training. James was one of this initial batch of recruits. This period of training was to induct them into the military and specifically into the role of the RAMC. James’ diary for 1914 doesn’t exist so we do not know how he felt about his training. Although a trained professional in his own right, he would have been given training in first aid, stretcher drills, basic field-craft and hygiene, plus physical fitness. In essence, if his role had not been pre-determined he could have for filled any number of medical vacancies.
Dispensers were required to comply with changes in the law and professional accreditation from which the services were not exempt. The services had to comply with legal requirements for the dispensing of drugs, principally the 1868 Pharmacy Act. The increasing size of the armed services also necessitated that those involved with dispensing and ordering medications knew the products, procedures and special requirements such as safe storage of drugs; in the short term, it was advantageous to recruit qualified individuals rather than train in-house. The pre-war pharmaceutical industry bears little resemblance to our modern practice.
Chemist shops, or apothecaries, were numerous and family run. The larger chains such as Boots were beginning to establish themselves across the country. Types of medication fell into two general categories, the traditional and herbal remedies made in Britain and the modern pharmaceutical proprieties predominately made in Germany, by companies like Roche and Bayer. The types of product available to buy over the counter was extensive as people generally self-medicated. Epsom salts and castor oil were used as purgatives, milk of magnesia for indigestion and various remedies derived from iodine were prescribed for “internal disinfection”3. The chemist shop also sold and prepared all dressings for wounds, made poultices4, supplied bandages and splints.
The 1868 Pharmacy Act separated drugs into two schedules. The First Schedule included many poisons which the chemist had to record in a Poisons Book. Legislation, following several prominent murders, had removed arsenic5 from the shelves but it was still available and popular as a tonic and painkiller. Other poisons for sale included strychnine which was used as a circulatory stimulant, and potassium cyanide. All these remedies could only be sold if the purchaser was known to the seller or to an intermediary known to both. The Second Schedule included opium and all preparations of opium such as laudanum. Also available over the counter was cocaine6.
Following the 1868 Pharmacy Act, it became a requirement that only suitable individuals could produce and sell over-the-counter medication. The Pharmaceutical Society took over the responsibility of registering individuals who had undertaken either a major or minor examination. The RAMC only wanted men with the minor qualification to act as dispensers, who would be enlisted as privates. Holders of the minor certificate would have completed an apprenticeship attended college, and taken exams in chemistry, botany, dispensing and other subjects.
The six-week induction course at Ash Vale prepared the civilian for service in the RAMC. One recruit detailed the course as mainly drill and keep fit and getting use to field conditions. The dispensers he felt were given far more guard duty than those going on to be stretcher bearers7. The instructors may have appreciated that on the completion of the course and in accordance with their civilian qualifications and responsibilities, the dispensers would be quickly promoted to corporal.
The newly recruited dispenser quickly found themselves in a crucial position within the medical logistic chain. With a keen understanding of the drugs, equipment and clinical need their expertise was quickly recognised and promotion came quickly. The role of dispensing sergeant was established. It was not uncommon for further promotion to the rank of Quarter Master Sergeant Major (RQMS) the second most senior non-commissioned rank to be held by former dispensing chemists. In between the political strategic decision making and the tactical resupply of soldiers on the fighting lines lies the operational or theatre level of the logistics of war. It was into these medically strategic bases that the dispensers were deployed. Base hospitals, home and abroad, ports, casualty clearing stations, railheads and anywhere there was a concentration of medical services. In the early stages of the war, they were also pivotal to the classification and distribution of medical supplies recovered from the retreating Germans8.
The dispenser became an integral role, initially in the sphere of their own civilian capabilities and experience but quickly learning and adjusting to the needs of the service. The specific competency would be in terms of medication supply and production. It should be remembered that many medications had to be made by the dispenser, hence the James crib notes in the front and back of his diary.
Alongside the date October 3rd (1915) is the chemical equation for Arsenic Trioxide. Arsenic compounds were, and are still, used therapeutically. In this instance it probably refers to Salvarsan, the drug then used in the treatment of syphilis.
Amanzimtoti is not a drug but a town near Durban, South Africa where he had a family friend and James was to visit her when his war took him to East Africa.
On the left-hand page: The formulae on the right are for external use, probably as muscular pain relievers or similar and makes two quantities, one to be used after the other (on dates given). The symbols used denote the old Greek apothecary system used before, Imperial and metric9.
The dispenser’s specific role was determined where in the logistical chain they were located. James Griffiths was posted to the Hospital Ship Oxfordshire, the first ship to be converted for the role in the Great War. James doesn’t record mundane everyday details. He reserves any comments for what he considers noticeable events. Occasionally, as on a trip to Dublin, he would state that he was “ashore in the quest for supplies”10 or he would comment on meeting old Boots’ employees (performing a similar role) when ashore looking for stores. The second crib sheet again gives a comprehensive over-view of his responsibilities, see Fig 3. On the left-hand side are James’ ward list detailing the number of patients and their location aboard ship. A very precise man in his recordings as befits a pharmacist, the ship initially must have been for 400 and X+Y were added at some point bringing the total to 604. James, as part of the quartermasters team, would require to know how many patients they would potentially be treating, the duration of each voyage and when they can re-stock. He also in his jottings gives contact details as to where he can obtain medical stores for instance “The Chief Ordinance Officer, Orion Sheds, Cherbourg”.
The formula on the right-hand page (Fig 3, above) is to do with making a special solution as to test for sugar in urine in diabetes mellitus, before the advent of our modern dip-stick test12. James Griffiths dispensing role was specific to his hospital ship and would require a high degree of personal initiative.
Cox (2017) details several letters “from the front” which give a different insight into the wider dispenser’s role:
The maintaining of stock levels and all the correspondence involved was a large task for the dispensary. The chief dispenser wrote that they used vast quantities of tinct of iod . BP (tincture of iodine), hydrogen peroxide, acetosalicylic acid13, gauze, and absorbent wool. In addition, there were prescriptions from the twenty medical officers, and they also had to make and fit splints14.
This goes on to give a more detailed account of the Dispensing Sergeant’s role later in the war when established in a hospital setting as related by a Medical Officer:
It was suggested that all supplies had to go through the dispenser and if you wanted an appliance or instrument, you must get it from the dispenser on loan. If however the dispenser was inclined to be unpleasant, he could disinter Army Orders, which forbade anyone from ordering anything but a purgative pill or any instrument except their own. The writer commented that the dispenser probably spent more of his time with the commanding officer, than anyone else did in the place. Also, that the commanding officer was held financially responsible for drugs or instruments which were not accounted for. The dispenser therefore had many opportunities to lodge complaints against the prescribers.
The dispenser needed to be familiar with the procedures of indenting for all surgical instruments and know the intricacies of every army form. Finally, he described a typical working day:
It was busy in the morning, and evenings were generally quiet. The army dispenser was ‘fairly free of his own domain’. There was the occasional parade, or kit inspection. Everybody – the medical officers, the matron, the sister and the nurses – were on friendly terms with the dispenser as ‘he could always do any of them a service.
The role of the dispenser within the RAMC undoubtably expanded as the war progressed and became embedded within the logistical process. To ensure the efficiency of the system as the number of trained dispensers increased they came to populate all RAMC units all the way down to the smallest, the Field Ambulance. Initially the men were recruited for their civilian experience as to comply with legislation. Very quickly the scale of the war increased and medical logistics became imperative to enable the services to deliver one of the moral components of war, that of providing care for the injured. The dispenser became an integral part of the Quarter Masters team because he controlled the drugs, the surgical instruments and appliances. That responsibility was a heavy burden as at times, supply, maintenance of stocks, repair and sterilisation of instruments could not always be guaranteed. New medical/ surgical treatments also required the dispensers to keep their knowledge up-dated and have an active dialogue with Senior Medical Officers, their Commanding Officer and colleagues working at different levels within the army’s hierarchy. An effective dispenser was an asset; an inept one would create a considerable logistical headache.
James Alfred Griffiths
James was born in Wellington, Shropshire in 1880. In 1901, twenty-year-old James moved to Streatham and was employed as a chemist’s assistant. By 1906 James had moved to Exeter where he was married. He lived above another chemist’s shop run by John Tighe. At some point James started working for Boots the Chemists, fulfilling a relief role and so he regularly moved around the south of England, resulting in him having three daughters all born in different towns. James enlisted in the Royal Army Medical Corps as No. 9060 in August 1914 and after training started his war service on hospital ships from October 1914. His family returned to Barnstaple where they stayed for the duration. James kept a daily diary throughout the war until he completed his service in the spring of 1919. It is at this point that the diary stops. James returned to his family in Worcester in 1921.
James Griffiths sat cross legged 5th from the left. A picture taken at Ash Vale presumably of the 50 dispenser recruits plus trainers. Note that many do not have a RAMC badge on their cap, including James Griffiths
1 The commissioning of Pharmacist was a contentious issue and the profession lobbied Parliament to set up an Army Pharmaceutical Corps but to no avail. See Anderson, S.C. ‘Pharmacy and the Great War: The ‘Anti-microbe Corps’, Gas Masks and ‘Forced March’ Tablets’, Medical Historian, (2017) 27: 3-19).
2 Anon, ‘Pharmacists as Military Dispensers’, Pharmaceutical Journal 93, (8 August 1914), 218.
3 G. Heath and W.A. Colburn (2000) “An evolution in drug development and clinical pharmacology during the twentieth century” Journal of Clinical Pharmacology: 40: 918 -29.
4 Poultices. Prior to antibiotics, boils and swellings of the skin had poultices applied externally. They consisted of a mixture of bread, bran or kaolin mixed with boiling water, spread on gauze and then applied to the infected area.
5 The Arsenic Act 1851. All Arsenic solutions for human treatments had to be coloured by soot or indigo as to be more readily identified.
6 Anderson, S.C. (2011) ‘Drugs and War: ‘Useful presents for friends at the front,’ The Pharmaceutical Journal, 287, 7685, 742-7
7 Cox, N. (2017) “Frontline Pharmacy: letters from the First World War 1914 – 1918 Pharmaceutical Historian Volume 47, Number 3, September 2017 pp 66-69(4)
8 Medical stocks were left under the Geneva Convention which both sides adhered to. German pharmaceuticals were prized and made-up deficiencies in British stocks. For example see W.G. Macpherson et al (1923) Medical Services: diseases of the War Vol ll 10,000 doses of German made Salvarsan (the treatment for venereal disease) was liberated and shared out, there was no Allied alternative product at that time p. 148
9 Top formula Strong solution of ammonia 45 minims 2.5 fl.oz Sodium carbonate 0.5 drachms 1.5 oz. Borax 20 grains 1 oz Water to 3fl.oz. 1.5 gallons. Dissolve and add Spiritus Vini Rectificatu 3 fl.oz 1.5 gallons (alcohol) Citronella oil (fragrance)
10 minims 6 drachms. Bottom Formula Pilocarpine nitrate 4 grains Solution of Epispasticus 35 minims Balsam of Peru 25 minims SVR (alcohol)0. 5 fl.oz Olive oil to 1 fl.oz. Epispasticus is also known as ‘blistering liquid’, works like chilli paste, hot! 10 Griffiths Diary. Ashore in Dublin 25th June 1915 after embarking 694 patients.
11 McGreal. S. (2008) “The War on Hospital Ships 1914 – 1918” Pen and Sword, Barnsley approximates HS Oxfordshire to have 560 beds. James Griffiths records in his diary returning from Le Havre 3rd July 1916 with 1397 patients on board.
12 Fehling’s test comprises 2 solutions, No.1 was a copper sulphate solution, no.2 was potassium sodium tartrate. The two were mixed then boiled in a test tube with the urine sample. The copper sulphate (bright blue) turned brownish in the presence of sugar. The test was named after a German chemist, Hermann von Fehling.
13 The new wonder drug aspirin.
14 Cox, N. (2017) “Frontline Pharmacy: letters from the First World War 1914 – 1918 Pharmaceutical Historian Volume 47, Number 3, September 2017 pp 66(4) 69(4).
PoWs and the Queen Victoria Jubilee Fund Association
For an article on this curiously named organisation and its work in Switzerland tracing British PoWs, see Terry's article on this link - click here