From Our Partners: Bullitt Club Lectures at UNC

~Courtesy Dawne Lucas, Special Collections Librarian, Wilson Special Collections Library.

We hope you are ready for another exciting semester of Bullitt Club lectures! Information about February’s lecture is below. Please note that this lecture will be held in the Wilson Special Collections Library instead of the Health Sciences Library.

Tuesday, February 26, 2019 12:00 NOON Wilson Special Collections Library, Room 504

The Fabrica, the Epitome, and Issues of Accessibility in Early Modern Anatomy

Michael J. Clark, PhD Candidate, Department of English and Comparative Literature, UNC-Chapel Hill and 2018 McLendon-Thomas Award Winner

This talk will discuss how Andreas Vesalius increased access to human anatomy with the publication of De Humani Corporis Fabrica Libri Septem in 1543. By painstakingly designing his illustrations and the corresponding text to accurately represent what he had observed during actual dissections, Vesalius intended his magnum opus to serve as a textual supplement for live demonstrations in the anatomy theater, and simultaneously designed a shorter Epitome that served as a “footpath” to aid novice students of anatomy.

Michael J. Clark is a PhD candidate in Comparative Literature at UNC-Chapel Hill who specializes in Renaissance drama and the history of medicine. In his dissertation, Michael examines how trust and distrust between patients and physicians are depicted in Italian, English, and French Renaissance comedy. At UNC, Michael’s teaching experience has been cross-disciplinary and has included Italian language courses, first-year composition courses, and introductory literature courses. In addition to these teaching responsibilities, Michael has also served as a coach at the UNC Writing Center.

About the Bullitt History of Medicine Club

The Bullitt History of Medicine Club is a student organization within the University of North Carolina at Chapel Hill’s School of Medicine. The club promotes the understanding and appreciation of the historical foundations upon which current medical knowledge and practice is constructed, by encouraging social and intellectual exchanges between faculty members, medical students, and members of the community. The club’s annual McLendon-Thomas Award recognizes the best unpublished essay on a historical topic in the health sciences written by a UNC-Chapel Hill student. Please visit the Bullitt History of Medicine Club website for more information.

From Our Partners: “From Hysteria to Anorexia Nervosa: An Evolution of Medical Terminology”

– by Julia Jablonowski

Most people in our contemporary society are familiar with anorexia nervosa –more commonly known as just “anorexia.” Yet few know the development of medical thought and the advancement of medical etymologies in the Victorian era that led to the emergence of what we know today as anorexia nervosa.

Prior to the pathological conception of anorexia nervosa, its fundamental symptoms, which are grounded in self-inflicted food aversions, were not thought of as an independent disorder until the nineteenth century. A common diagnosis that was used in the days before anorexia nervosa was hysteria, a disease historically exclusive to the female gender.[1]

In the Victoria era, a woman was societally understood to be passive, feeble, emotional, and fragile.[2] These beliefs as espoused by Victorian culture created a space in which women were understood to be societally, and medically, more susceptible to illness. From mood swings to fevers, light-headedness to exhaustion, it seemed that almost any physical or mental affliction residing within the body and psyche of a woman could be met with the diagnosis of hysteria. Other symptoms included a vast array of nervous and erratic behavior projected by women in the form of fatigue, food refusal or self-starvation, depression, bodily pains, anxiety, and the general feeling of unwellness.[3]  Because of the broad symptoms of hysteria, it was applied to a large expanse of medical, mental, and emotional cases troubling the fragile Victorian female.

This identification of food refusal and self-starvation developed into an area of independent study in the nineteenth century, largely due to the high mortality rates of mental asylum patients in the United States and the United Kingdom.[4]  An English physician, Robley Dunglison, moved to America in 1825 to become a professor of anatomy and medicine. [5] [6] While in the United States, Dunglison was instrumental in the establishment of Pennsylvania’s first state asylum where proper provisions were made to treat the insane poor of Pennsylvania.[7]  Coincidentally or not, Dunglison’s position within the development of institutional asylums had a large impact on the evolution of the vocabulary we associate with self-inflicted food refusal.

In 1856, Dunglison published Medical Lexicon: A Dictionary of Medical Science. This medical dictionary defines a premature understanding of the word anorexia, then referred to as “anorex’ia,” which he defined as the “absence of appetite, without loathing.”[8] Dunglison’s dictionary elaborates on this new term, continuing the journey of the disorder’s etymological advancement, mentioning “anorexia exhausto’rum,” which is the “frigidity of the stomach.”

Anorexia began to be noted as an individual disorder rather than a symptom of a larger disease such as hysteria, due to the level of accountability asylums where held to in the public spheres of the U.S. and Britain. Anorexia began to be distinguishable as its own malady because of the level of transparency promoted by medical journals and newspapers that reported on mortality rates in such institutions.[9] In American asylums, the superintendents were held accountable through the spectacle of death by starvation, which was a frightening source of mortality to the public.[10] An asylum’s mortality statistics were published in professional medical journals, as well as abstracted in newspapers for society’s lay people.[11] A high mortality rate communicated immense failure on the part of the asylum. British asylum keepers were becoming increasingly aware of this transparency and the repercussions that followed when people began to catch on to the increasing numbers of premature patient deaths due to self-starvation in an institution meant to care for the ill, thus allowing for the disease to gain special attention. [12]

The attention drawn to this disease was largely addressed by two medical professionals: Parisian neuropsychiatrist, Ernest Charles Lasègue, and London physician, Sir William Withey Gull. Lasègue, a contemporary of Gull, was responsible for the term “l’anorexie hysterique” –hysterical anorexia.  Gull combated this name and proposed the name anorexia nervosa, which he publicly expressed in August 1868 in his address at Oxford University.[13] The significance of this terminological substitution of “nervosa” for “hysterique” was crucial to Gull because hysteria, as understood by Victorian medicine, was exclusively a woman’s plague. Although anorexia mostly affected the female population, Gull noted that it, too, plagued men, thus leading to the necessary use of the word nervosa, which focuses on anorexia’s association as a nervous, mental, and genderless disease.[14]

When defining the term anorexia nervosa in his address at Oxford, Gull explained:

“The want of appetite is, I believe, due to a morbid mental state. I have not observed in these cases any gastric disorder to which the want of appetite could be referred. (…) We might call the       state hysterical without committing ourselves to the etymological value of the word, or maintaining that the subjects of it have the common symptoms of hysteria. I prefer, however, the more general term ‘nervosa,’ since the disease occurs in males as well as females, and is probably rather central than peripheral.”[15]

This gender-inclusive research of Sir William Withey Gull, in addition to the growth of mortality rates –and public embarrassment—being suffered by asylums, shifted the understanding of self-starvation in medicine. This shift thus demanded intellectual and terminological changes to be made, resulting in the emergence of anorexia nervosa.

Notes:

[1] Cecilia Tasca, Mariangela Rapetti,, Mauro Giovanni Carta, and Bianca Fadda, “Women And Hysteria In The History Of Mental Health,” Clinical Practive & Epidemo=iology in Mental Health, 8, (2012): 110-111.

[2] “The Hysterical Female,” Restoring Perspective: Life and Treatment at the London Asylum,  https://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/hysteria.html.

[3] “The Hysterical Female,” Restoring Perspective: Life and Treatment at the London Asylum,  https://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/hysteria.html.

[4] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease.

[5] “Professor and Physician: Robley Dunglison, M. D.; The Dunglisons Reach the University of Virginia,” The University of Virginia, http://exhibits.hsl.virginia.edu/dunglison/at_uva/.

[6] “Professor and Physician: Robley Dunglison, M. D.; From Kewsick, England to Charlottesville, Virginia,” University of Virginia, http://exhibits.hsl.virginia.edu/dunglison/keswick/.

[7]  An Appeal to the People of Pennsylvania on the Subject of an Asylum for the Insane Poor of the Commonwealth, (Philadelphia, 1838).

[8] Robley Dunglison, M.D., LL.D., Medical Lexicon: A Dictionary of Medical Science, (Philadelphia, Blanchard and Lea., 1856), 80.

[9] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988), 101.

[10] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988), 101

[11] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease.

[12] Joan Jacobs Brumberg, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988), 101.

[13] Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997): 498–502

[14] Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997): 498.

[15] Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997): 501.

Sources:

An Appeal to the People of Pennsylvania on the Subject of an Asylum for the Insane Poor of the Commonwealth, (Philadelphia, 1838).

Dunglison, Robley M.D., LL.D., Medical Lexicon: A Dictionary of Medical Science, (Philadelphia, Blanchard and Lea., 1856), 80

Gull, William Withey. “V.-Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica).” Obesity Research 5, no. 5 (September 1997).

Jacobs Brumberg, Joan, Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease, (Cambridge, Massachusetts, Harvard University Press, 1988).

“Professor and Physician: Robley Dunglison, M. D.; The Dunglisons Reach the University of Virginia.” The University of Virginia. http://exhibits.hsl.virginia.edu/dunglison/at_uva/.

“Professor and Physician: Robley Dunglison, M. D.; From Kewsick, England to Charlottesville, Virginia.” University of Virginia. http://exhibits.hsl.virginia.edu/dunglison/keswick/.

Tasca, Cecilia, Rapetti, Mariangela, Giovanni Carta Mauro, and Fadda, Bianca “Women and Hysteria In The History Of Mental Health,” Clinical Practive & Epidemo=iology in Mental         Health, 8, (2012).

“The Hysterical Female.” Restoring Perspective: Life and Treatment at the London Asylum.  https://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/hysteria.html.

Rubenstein Library Travel Grant Program

~Courtesy Rachel Ingold, Curator, History of Medicine Collections Rubenstein Rare Book & Manuscript Library

The History of Medicine Collections in the David M. Rubenstein Rare Book & Manuscript Library at Duke University is accepting applications for our travel grant program. 

https://library.duke.edu/rubenstein/history-of-medicine/grants

Research grants of up to $1,500 will be offered to researchers whose work would benefit from access to the historical medical collections at the Rubenstein Rare Book & Manuscript Library. Our holdings include over 20,000 print items and 4,500 unique manuscripts along with photographs, prints, and over 800 medical instruments and artifacts including a large collection of ivory anatomical manikins. Collection strengths include but are not limited to anatomical atlases, human sexuality, materia medica, pediatrics, psychiatry, and obstetrics & gynecology.

Any faculty member, graduate or undergraduate student, or independent scholar with a research project requiring the use of materials held by the History of Medicine Collections is eligible to apply. Writers, creative and performing artists, film makers and journalists are welcome to apply.  All applicants must reside outside of a 100-mile radius of Durham, NC.

Grant money may be used for: transportation expenses (including air, train or bus ticket charges; car rental; mileage using a personal vehicle; parking fees); accommodations; and meals. Expenses will be reimbursed once the grant recipient has completed his or her research visit(s) and has submitted original receipts.

Research topics should be strongly supported by the History of Medicine Collections.  We encourage applicants to contact the Curator of the History of Medicine Collections to discuss research projects and Rubenstein Library collections that might support it before submitting an application. 

The deadline for application is January 31, 2019 by 5:00 PM EST. Recipients will be announced in March 2019. Grants must be used between April 1, 2019 and June 30, 2020.

From Our Partners: Base Hospital No. 30, One-Hundred Years Later, Part Four: The People

~This post is courtesy Polina Ilieva, UCSF Archivist.

This is a guest post by Aaron J. Jackson, PhD student, UCSF Department of Anthropology, History and Social Medicine.

Figure 19 – San Francisco Chronicle, Monday, November 11, 1918

One hundred years ago, on the eleventh hour of the eleventh day of the eleventh month, the “war to end all wars” effectively came to an end as the Armistice went into effect. This momentous occasion would go on to be celebrated bas a national holiday in Britain, France, and the United States, where Armistice Day eventually expanded to honor the service of all veterans. With the centenary of the Armistice, it is worth reflecting on both the end of the First World War and on what it means to honor veterans’ service.

As a veteran myself, the phrase “thank you for your service” can at times feel like a platitude. It seems assumptive on many levels. Most often, those expressing that sentiment are strangers who have no knowledge of the details or motives of a given veteran’s service. And that can lead to difficult, guarded, or awkward conversation to follow. For the veteran’s part, it may be difficult to convey the multiple and complex layers of what our service means to us. A gulf can thus form between veterans and civilians, and that’s a shame.

As a historian, it is my sincere hope that the exploration of the past can provide useful insight in the present and future. By exploring veterans’ experiences in detail, we may be able to get past the platitudes and patriotic veneer and achieve a better understanding of what veterans’ service means. So it is my genuine privilege to present this brief account of the unit from the University of California School of Medicine during the First World War—the final part of a four-part series on the remarkable men and women who served with Base Hospital No. 30.

Figure 20 – “U.S. Army Base Hospital No. 30, World War I (University of California School of Medicine Unit),” from The Thirtieth, AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

Base Hospital Thirty resulted from the Army’s effort to provide the best medical care the United States had to offer to its fighting men in the Great War. When it became apparent that America was likely to enter the war that had been raging since the summer of 1914, the American Red Cross (ARC) began coordinating with the nation’s leading medical schools to help the Army prepare for the war by organizing hospital units. Shortly after the declaration of war against Germany in April 1917, the ARC approached the University of California School of Medicine to organize one such unit and was received with enthusiasm.

Figure 21 – “Liberty Loan Parade,” AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

Twenty-five medical officers, sixty-five nurses, and one-hundred-fifty enlisted men marched down Market Street as part of a highly successful Liberty Loan parade to raise money for the unit and to support the war effort. The Red Cross secured $100,000 to purchase supplies to outfit the hospital unit. Several of the nurses, enlisted personnel, and at least one officer were so eager to go to France that they quit their jobs and packed their belongings in anticipation of a quick deployment. But that initial enthusiasm soon bogged down in the realities of Army bureaucracy. It took more than seven months for the Army to formally organize the unit and another five months of drilling and training at Fort Mason in San Francisco before they received orders for France (for more information, see Part One).

Once in France, the men and women from California discovered that, before they could begin treating the Army’s wounded soldiers, they would have to figure out how to transform several dilapidated hotels in a French resort town into a modern hospital (for more information, see Part Two). They managed to pull it off and just in time as the Allied effort to blunt the German’s offensive and the subsequent Allied counteroffensive kept the hospital and its staff busy from June 1918 through January 1919 (for more information on “the work” of the hospital, see Part Three).

This post will address the human elements of Base Hospital Thirty—their entertainments, celebrations, and the communal bonds that shaped the military unit into something akin to family—and what those things contribute to the veteran experience. Entertainment and leisure activities were rare for units like Base Hospital Thirty, but when such opportunities presented themselves, the personnel and patients were quick to take advantage of the chances to let down their guard in an otherwise rigid and stressful environment and form communities that went well beyond their professional affiliation.

Figure 22 – “Orchestra” from The Record, AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

One of the first entertainments the personnel of Base Hospital Thirty developed was the orchestra and bands. Likely in response to the delay in the Army bureaucracy, the orchestra organized at Fort Mason in San Francisco and continued playing together until the unit’s disbandment in 1919. Under the direction of Captain C. M. Richards, the orchestra featured enlisted personnel right alongside the officers—indeed, four of the five “first” violin spots were held by enlisted personnel, including two Privates First Class, then the second-lowest military rank. More remarkable, Lieutenant Colonel E. S. Kilgore, the commanding officer of the entire unit for the majority of its existence during the Great War, played in the “second” violin and was apparently one of the lowest ranking members of the orchestra by measure of musical talent, demonstrating an interesting reversal of the traditional military hierarchy that formed the basis of the unit in all other cases. The orchestra was a meritocracy of talent, and it did not play favors to even the most senior officers.

While the unit drilled and trained during the days at Fort Mason in preparation for their deployment to France, the orchestra’s twenty-five members gathered and practiced diligently at night, eventually providing frequent concerts for the entertainment of the rest of the unit. They continued holding impromptu concerts aboard the S.S. Northern Pacific on its record-breaking journey from San Francisco to New York via the Panama Canal, and it was especially appreciated at Royat, where patients, hospital personnel, and nearby military units and French civilians alike had many occasions to hear their music.

Not only did the orchestra provide entertainment to the audience—a crucial element in a stressful hospital environment—it provided opportunities for the unit to bond. It is remarkable, given how busy the personnel of Base Hospital Thirty were, that the orchestra as a whole was able to so often practice and play together, given that their musical pursuits would necessarily be secondary to their medical and official duties.

The hospital even boasted its own in-house jazz orchestra, whose members dedicated much of their downtime to entertaining the troops, French civilians, and neighboring units. Led by the musically-talented Private First Class Harold Turner—who played trombone and clarinet with the symphony orchestra, piano with the jazz orchestra, and served as the official bugler for the unit when he was not working in the clinic—the jazz quartet was always featured in the hospital’s entertainment programs.

Figure 23 – “The Base Thirty Vaudeville Aggregation at Les Sables d’Olonne” Program Announcement from The Record, AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

But the orchestra was not the only entertainment. Grace Haviland, an American newspaper correspondent, happened to be in Royat during the Fourth of July celebrations. Lacking fireworks, hospital personnel and patients—most of whom were Marines fresh from the fighting at Belleau Woods—made up for it in a day and night full of “patriotism, entente cordials, fun and feasting.”

Most of the patients were convalescing and restricted to bed rest, recuperating from serious wounds including exposure to mustard gas in the ferocious fighting on the Western Front. But the local French civilians decided to do something for the Americans in the hospital as French schoolchildren brought bouquets of red, white, and blue flowers and a local chocolatier donated large amounts of their sweet desert to the troops free of charge. And to further raise spirits, the personnel of Base Hospital Thirty put together a three-hour long amateur vaudeville show featuring sketches of San Francisco, Egypt, and “Somewhere in France.”

A highlight of the program was the play “In My Harem,” put together by the pharmacist, Sergeant First Class Henry Creger—a man known to all in the unit to have a ready cure for anything from a “hold over” (hangover) to a corn. The play provided a rare opportunity in military entertainment in the form of the comic skit. Haviland described the scene:

The Hero was a cross between Otis Skinner’s Hadj, in his make-up, and the modern idea of a Pirate, and the sinuous dancing by the “not much dressed Egyptian mural decoration” effect of the Lady Turk was—words fail me—we must leave it with the costume to the imagination.

The well-known pharmacist sergeant played the hero, and the equally well-known private in charge of the commissary store, Tom Hill, dressed as a member of the hero’s harem—the Lady Turk—and danced for the crowd to great comedic effect. Their skit left an impression not only on Grace Haviland, but on the entire unit, as the Fourth of July show was well-covered in the unit’s memory book The Record. Dressing in drag for skits for the sake of laughs is, to modern observers, a long-standing tradition in military units, but it was something I was not expecting to find among the troops in the First World War. Unfortunately, no pictures of the event survived, so as Grace Haviland says, we must leave the scene to our imagination.

Figure 24 – “Base Hospital No. 30 rugby team” in Base Hospital #30 Collection, Calisphere.org

Members of the unit also engaged in sports, when time allowed, which was not often. They organized a football team to play rugby against a team of local French citizens and managed to play two exhibition games. The team was made up of former high school and university stars like Lieutenant Colonel Alanson Weeks—a former fullback for the undefeated 1898 Michigan Wolverines—in addition to “earnest beginners.” Down six points to none at the end of the first half, the men from California managed to rally in the second and pull off the victory by a score of eight to six, giving the hospital unit a measure of bragging rights for their time in France. But the most popular sport was baseball.

Members of the unit started playing baseball together beginning at Fort Mason, and in France they played many games against teams from neighboring units. They played, and usually won, many games against teams from the aviation and ordnance units stationed near Clermont, France, and even managed to secure a friendly game against Base Hospital No. 20, the unit from the University of Pennsylvania.

Base Thirty had the edge all the way through, and leading by a score of 3 to 2 in the ninth with two out, the umpire (a Base Twenty man and their coach) deeded the game to them by favoring his team with a couple of not-even-close decisions. Thus (as often the case in a prize fight), the best side won, but Twenty was given the decision.

Their crowning achievement was an exhibition game against the Vichy Hospital Center. With a one-score lead in the ninth, the men of Base Thirty ended the game on a double-play with the last out being made on an attempt to tie the score. The Vichy player slid into home plate, intentionally running into Bill King, Base Thirty’s catcher, in an attempt to get him to drop the ball. Bill held the ball firmly, ending the game, though he had to be admitted to the wards of Base Hospital No. 30 on account of having suffered a broken leg in the collision. Private King might have simply been remembered as a member of the Quartermaster Corps but for his heroics on the ballfield that day.

Figure 25 – “Verdun Battlefield” courtesy of Chemins de Mémoire, www.cheminsdememoire.gouv.fr/en/revue/verdun-1916-2016

The announcement of the Armistice on November 11th was well received by all, but the patient load at the hospital at the time prevented any organized celebrations. Lieutenant Colonel Eugene S. Kilgore, the hospital commander, had received orders to a new duty station and had been busy showing Major Alanson Weeks around to make the necessary introductions to ease Weeks’s transition into command. Kilgore caught a train to Paris on the night of the 11th and found the city celebrating the peace in full measure on the 12th.

Everywhere there were informal processions—boys or soldiers with a drum or a bugle and some flags would march hither and thither, and crowds would fall in behind them. Then they would meet a group of soldiers, and the little procession would break up and join hands and dance around the group. Those in the center would throw up their hands and cry “Kamarad” or else would rush at the dancers and kiss the women. As I stared down the Av. Mont-Martre a crowd of girls seized both my arms and my coat-tails and dragged me into the stream. The girl on my left had an American buck private on the other arm and we were all mixed up with Poilus, Australians, Italians, etc. An American soldier kissed an American colonel on both cheeks with the remark, “You’re a colonel and I’m a buck private, but I don’t give a damn!”

The Armistice changed the Army’s plans almost overnight. The Army rescinded Kilgore’s orders and left him in limbo for a time, which he used to take in some sightseeing, including the now-quiet front. He recorded an adventure to Verdun—the site of one of the bloodiest battles of the war—in early December 1918 in his diary:

I soon found a small truck going to Verdun…. We passed thru Verdun and across the Meuse, then… into “Death Valley” and past Dead Man’s Hill. These little villages were good example of large numbers over the battle fields of France that are completely destroyed—just piles of rubbish without anything to indicate where the houses stood…. [We left the truck and] here we began to explore trenches and dugouts not yet entered by the Clean Up Companies. Even the dead were not all buried. I saw one dead German, and others saw a number of corpses a little farther over in the wood. There were, oof course, all sorts of sourvenirs; and in a short time the chauffer and I, who were together, had picked up a couple of helmets, four German rifles, a lot of bayonettes, etc…. In gathering our trinkets we used due care to avoid touching wires or stumbling into any of the numerous traps [and] unexploded grenades and “potato-mashers” lying about.

Dr. Kilgore and his chauffer wandered much further into the battlefield than they had planned and soon found they could not find their way back to the car, so they continued until they found a poor road to follow through a series of shelled-out villages until they stumbled into a dugout still occupied by Allied troops. The Armistice ended the fighting, but the scars of the war were certainly still quite fresh, as Dr. Kilgore’s overnight venture through the Verdun battlefield demonstrated.

Likewise, work at the hospital in Royat continued just as it had before the armistice, though with an expectancy of going home again soon. Allowances were made to prepare for Thanksgiving and Christmas in a proper manner. This was made possible in large part thanks to a $5,000 donation (about $90,000 today) from banker William H. Crocker—a major financial backer of the UC School of Medicine—which was used to secure food, new musical instruments, and decorations for the holidays.

Figure 26 – Nurses’ Masquerade at Hotel Richlieu, Royat from The Record, AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

By Christmas, the patient load was beginning to fall off as the Army focused on stabilizing patients for transfer to hospitals in the United States. The Red Cross, hospital personnel, and local officials and businesses worked together to create a full week’s program of festivities between December 24, 1918, and January 1, 1919, complete with a very attractive program published specifically for the occasion. They stuffed hundreds of stockings for the patients and personnel, exchanged gifts throughout the wards on Christmas Eve, held plays and concerts, presented movies at the Red Cross theater, and capped it all off with a New Year’s Eve Reception and Dance for the officers and nurses.

It was a happy time for most as they knew they were going home, but it was also a farewell for most. The hospital received orders to finish processing its remaining patients—it had about six-hundred in the wards on January 1, 1919, in a hospital with an operating capacity of twenty-four-hundred beds—and many of the personnel were being reassigned. By January 20, 1919, the hospital at Royat closed shop and the majority of the unit set out for the trip home.

Figure 27 – “Grunnagle, Parmelee, and Barshinger” (left) and “Creger Leaves Merritt” (right), from The Record, AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

A review of the “Enlisted Personnel” section of The Record, written by First Sergeant Alexander Rattray, the “top” or ranking enlisted man in the unit, provides a few sentences of insight into the family that formed at the hospital. First Sergeant Rattray wrote a paragraph for 159 enlisted men, excluding himself, who served with the hospital at some point—demonstrating a senior non-commissioned officer’s unique respect for his men. Not all of the paragraphs were flattering, and some of these paragraphs are longer than others, but they provide insight into the family that developed in Base Hospital Thirty. A few examples from Rattray’s notes are worthy of mention.

Sergeant First Class Henry P. Hauser, “Red” for short by his friends (meaning everybody in Royat). “Red” could tickle a typewriter (meaning, of course, a machine) with the best of them. He could also show a few tricks on the football field and could take his place on the stage when the occasion arose. As an all around man “Red” was there. Was last heard of leading a band of athletes around France. Their headquarters were probably Paris.

Red Hauser was a beloved rabble rouser in Base Hospital Thirty, pushing paper by day, he took part in every opportunity for entertainment. He apparently had a reputation for seeking passes to Paris to take in the sights and serves as an example of the adventurous type of veteran who took full advantage of the opportunities provided by his deployment.

Sergeant First Class Elmer McKnew, “Choate,” had charge of the laundry at Royat and had his hands full. He played shortstop on the ball team, that was, one game. Mac was always sure to produce a smile when you mentioned home, as he was waiting for the first sight of a young son.

Many soldiers, like Elmer McKnew left pregnant wives behind in San Francisco when they deployed to France. Soldiers like McKnew were a constant and poignant reminder of home and what the members of the hospital were missing out on in order to serve their nation. It was also a reminder that those serving in France were not the only ones affected by the war.

Figure 28 – “’Veteran’ Army Nurses Return from Europe” clipping of The San Francisco Chronicle, Tuesday, March 25, 1919, in AR 207-16, UCSF Archives and Special Collections, Parnassus Library, UCSF, San Francisco, California

Back home, in San Francisco, the officers’ wives formed the Women’s Auxiliary for Base Hospital No. 30 to support the unit and each other during the deployment of their loved ones. They raised money for the purchase of instruments used by the orchestra, for athletic equipment used by the baseball and football teams, and to augment the purchase of food and gifts for the holiday celebrations.  Their story is relatively limited in The Record, covering only three paragraphs, but it details the account of their effort to welcome the nurses back to San Francisco in March 1919, and to hold a special dance and reception for the main part of the unit at the Palace Hotel on May 15, 1919.

Readers of the San Francisco Chronicle on March 25, 1919 may have seen the article “‘Veteran’ Army Nurses Return from Europe” covering the reception the nurses received at the Oakland Ferry Canteen, provided that they read through to page ten. Perhaps many of those readers would have viewed it as a colorful little article about the pluck of local nurses, or as an addendum to the patriotic trappings hung on the veterans of the war. But the whole story, as this blog series has hopefully shown, goes much deeper than that.

On Veterans Day we celebrate our nation’s veterans with pomp and circumstance very similar to that displayed in the pages of the San Francisco Chronicle. We wave flags, hold parades, and decorate in themes of red, white, and blue. But for many veterans, the day has deeper meaning. It is a reminder of the men and women with whom we had the pleasure (or displeasure) and the privilege to serve and of the communities for which we served—both the ones we left behind and the ones we formed in the military.

Within a year of returning from France, the men and women of Base Hospital Thirty put together and published a memory book they called The Record. In it, they told their story to each other and to anyone interested in flipping through its pages. They also listed the addresses of anyone interested in staying in touch—an indication that they wanted to continue to keep tabs on the members of their military family.

Attached to the copy of The Record stored in UCSF’s Archives and Special Collections is a letter from Dr. Eugene S. Kilgore to Dr. Howard Fleming, dated September 16, 1919. In it, Dr. Kilgore expresses how many of the unit had written him expressing interest in getting everyone together again for another evening of entertainment and reflection, “possibly on Armistice Day Nov. 11.”

So, on this centennial anniversary of the armistice, let us reflect upon and remember the remarkable men and women of Base Hospital Thirty and the surrogate family they formed. Their service and stories are, in many ways, precursors to our own stories, making us extended members of their family. Their story provides examples of service to others, of overcoming difficulties, and of working together towards the best possible outcome. It is a story that is rooted in the traditions of the hospital and healing professions as it is in the military. It is a story of selfless service. And that’s appropriate, for isn’t that what Veteran’s Day is really all about?

Acknowledgements

I want to offer my sincerest appreciation to the staff at the UCSF Archives and Special Collections—first for not only allowing but encouraging me to explore their collected materials on Base Hospital No. 30, but also for being so incredibly helpful and foundational to this project. Archivists Polina Ilieva, Kelsi Evans, and David Krah all deserve recognition for their contributions and I am extremely grateful for their guidance, assistance, and suggestions throughout the process. I would also be remiss if I did not express my appreciation to the Medical Heritage Library for agreeing to expose these posts to their audience as well.

If you are interested in learning more about Base Hospital No. 30, I highly encourage you to visit the UCSF Archives and Special Collections and ask to see the Base Hospital Thirty collection (AR 2017-16), the Homer Woolsey Papers (MSS 70-5), the Howard Naffziger papers (MSS 97-04), and anything else that the helpful archivists suggest based upon your interests.

From Our Partners: Base Hospital No. 30, One Hundred Years Later – Part Three: The Work of the Hospital

~This post is courtesy Polina Ilieva, UCSF Archivist.

This is a guest post by Aaron J. Jackson, PhD student, UCSF Department of Anthropology, History and Social Medicine.

One-hundred years ago, the First World War raged into its fourth year. Millions perished in the conflict as the armies of the “civilized” nations applied industrial efficiency to the brutality of warfare. The first weeks of conflict in 1914 shattered traditional conceptions of war. While battlefield success once depended on the ability to field more and better-trained men, the machines of the modern age leveled numerical and soldiery advantages. These new weapons wreaked death and destruction on unprecedented scales and forced the survivors to dig defensive trenchworks that quickly stretched from the Alps to the English Channel along Germany’s Western Front. A deadly stalemate ensued as opposing armies attempted to cross the no man’s land between the trenchworks, often suffering enormous losses in futile assaults. The war became one of attrition and soon caught civilians in its machinations as the richest economies in Europe quickly drained their resources into supplying the war machine.

The entry of the United States into the war in 1917 promised a glimmer of hope for the Allies that they would finally be able to overwhelm the Germans, but it would take time for the enormous resources of the unscathed Americans to be brought to bear. Meanwhile, the Russian collapse in March 1918 presented the German High Command with an opportunity to break the stalemate and deliver a knockout blow before the Americans could fully mobilize by shifting more than fifty divisions of troops from the Russian frontier to the Western Front. The Kaiserschacht, or Spring Offensive, would be the largest German assault of the entire war, with more than three million soldiers poised to break through the Allies’ lines and force a peace on German terms.

Figure 11 – Group photo, nurses and soldiers, World War I.

Meanwhile, the men and women of U.S. Army Base Hospital No. 30—the University of California School of Medicine Unit—arrived in France with the expectation of providing expert medical care to the soldiers wounded on the front lines. The hospital unit ostensibly formed before Congress officially declared war on April 6, 1917, and they spent more than a year gathering supplies and personnel, raising funds, navigating the Army bureaucracy, training in the latest medical techniques and military drills, and traveling to France where they expected to set up a hospital and get to “the work” of caring for the wounded. What they found in France, however, was the Herculean task of converting an ancient resort town in the Auvergne Mountains into a modern hospital.

This entry, the third of four planned posts, will cover “the work” of Base Hospital No. 30. After the arrival of the first patient train in June 1918, hospital personnel worked around the clock caring for thousands of sick and wounded soldiers—many of them surgical cases—right through the Armistice of November 11, 1918. These stories are derived primarily from materials kept at the UCSF Archives & Special Collections at the Parnassus Library in San Francisco, and it is with great appreciation to the archival staff there that I write about the experiences of the men and women of the University of California School of Medicine in the Great War. If you have not read them yet, please take a moment to read Part One: Organization, Mobilization, and Travel and Part Two: France for the context they provide.

Figure 12 – Fighting in Belleau Wood.

The German army began the Kaiserschlacht in March 1918 with a massive artillery barrage, dropping more than one million heavy shells on the Allies’ trenches followed closely by lightning-fast stormtrooper assaults to break through opposing lines and create gaps that could be exploited and held by masses of infantry. This strategy allowed the Germans to break the stalemate that had dominated the Western Front since late 1914 and gain ground. They repeated their process in five separate assaults between March and July, gaining enough ground to put Paris under threat.

By June, as the offensive approached the Marne River, American troops including elements of the U.S. Marine Corps rushed to form defensive lines to hold back the Kaiser’s troops at Belleau Wood near Chateau-Thierry. As the Marines dug hasty defensive positions, retreating French troops warned them of the coming Germans and encouraged the Marines to fall back to better ground.

“Retreat? Hell! We just got here!” replied Captain Lloyd W. Williams of the 2nd Battalion, 5th Marines. Fighting from hastily-dug, shallow fighting positions, the Marines took advantage of an 800-yard long wheat field and their training as expert riflemen to halt the German advance and force the Kaiser’s forward elements to dig their own defensive positions in Belleau Wood and the nearby town of Bouresches. Having stalled the Germans, the Americans knew that they had to counterattack before the Germans could dig in too far.

On the morning of June 6, 1918, the Marines charged across the knee-high wheat fields separating them from the entrenched Germans. As they ran, German machineguns opened up, cutting down the charging Americans like the wheat through which they ran. German artillery rained down on the Marines with the high explosive shells shaking the ground and shattering bodies. Despite heavy losses, the Marines managed to reach the edge of the woods and the outskirts of Bouresches before their assault finally stalled, but they paid a heavy price. It was the costliest single day of fighting in the history of the Marine Corps to that date as 228 men gave up their lives and another 859 suffered wounds. And the fighting was far from over.

Over the subsequent twenty days, the Marines fought so fiercely to dislodge the Germans from Belleau Wood that they earned the nickname Teufel Hunden or “Devil Dogs” from their German opponents. The fighting was often hand-to-hand with artillery splintering the trees and filling the air with deadly wooden splinters in addition to shrapnel. Desperate to halt the American advance, the Germans deployed mustard gas, a chemical weapon that painfully blisters the skin, burns the eyes resulting in blindness, and inflames the lungs making breathing impossible if inhaled. As many as 2,000 Marines fell victim to the gas. By June 26, when the Marines finally secured Belleau Wood, they had suffered 1,811 killed and 7,966 wounded.

Figure 13 – Evacuating the Wounded.

The wounded began a journey through a tiered system of medical care established by the Army. The first stage consisted of regimental aid stations located just behind the front lines. Those who were able to do so walked to these stations while stretcher bearers carried the rest. Medical corpsmen and the occasional doctor would dress their wounds, send superficial cases back to the front lines, and coordinate the evacuation of the seriously wounded by motorized ambulance to the clearing stations and field hospitals located further behind the lines.

The field hospitals and clearing stations, while out of range of small arms fire, were often still within range of enemy artillery and aircraft. Despite these hazards, teams of nurses, doctors, and surgeons worked to stabilize their patients, clean their wounds, and prepare them for evacuation to the base hospitals located well out of danger. It was at these facilities that nurses would flush the eyes of gas attack victims with saline solution and surgeons would perform emergency surgeries under extreme conditions, often lacking proper supplies. The wounded who could be stabilized enough for the trip would then be loaded onto hospital trains for the journey to base hospitals like Base Hospital Thirty at Royat, five-hundred kilometers away from the front at Chateau-Thierry.

Figure 14 – The Hospital Trains.

When the first hospital train arrived at Base Hospital No. 30 on June 12, 1918, the hospital was not yet operational as the main kitchen installation was incomplete. Thankfully, the 360 patients aboard that first train were primarily convalescents who were able to help complete the preparations in time for the second train’s arrival on June 17. This second train held 461 seriously wounded patients from the fighting near Belleau Wood. Captain Earnest H. Falconer, Medical Corps (MC), described the scene for posterity in the pages of The Record:

On June 17 a train arrived in two sections, containing many gas cases…. These cases had been gassed on June 14. Many of them had severe skin burns, some comprising as much as one-eighth to one-half the total skin surface. In the more superficial burns the skin was a dusky purplish to reddish purple hue. The deeper burns were pale, translucent, edematous, with many blisters. In most cases serum was drained from blisters. The serum from these blisters was very irritating to the skin of the hands of the dressers, causing in some cases a mild dermatitis to be set up…. Nearly all these cases had burns on the scrotum and penis, which were painful and very slow healing. Also nearly all the cases had burns of the lids and conjunctiva, with occasional burns of the face and scalp. Many cases of bronchopneumonia were already present when the patients were admitted, and a number of these cases developed shortly after admission. These cases were nearly all fatal…. The cases with superficial burns healed for the most part very slowly. New skin formation progressed slowly, and the crusts that formed invariably contained pus beneath them.

Base Hospital Thirty consisted of 25 officers (all physicians), 65 nurses, and about 150 enlisted corpsmen. By June 18, they were treating 821 wounded soldiers, many requiring extra attention due to the nature of their injuries. The staff worked continually performing surgery, cleaning wounds, and feeding the patients, all the while continuing their efforts to improve the hospital’s infrastructure. Thankfully, the surgical cases in the first two trains were less taxing because their wounds had been debrided of foreign objects and dead and damaged tissue at the clearing stations and field hospitals. Amputations were dressed but kept open, allowing hospital staff to manage the healing process and maintain an aseptic wound environment. This was achieved through the Carrel-Dakin method, which involved applying diluted chlorine and bleach solution to wounds and dressings to prevent infections. It must have been an excruciating experience for the patients, but it worked to prevent deadly infections in the era before antibiotics.

Unfortunately, not all patients arrived in similarly good conditions. A train on August 21 contained men who had been kept in the clearing stations as medical professionals attempted to stabilize them enough for travel. They arrived with infected wounds requiring extensive debridement, additional surgery, and the occasional re-amputation of a limb to establish aseptic wound environments.

After the arrival of the first trains in June, hospital staff worked around the clock for months on end. Patient trains would arrive, usually and preferably with some notice, and the wounded would be carried by stretcher into the hospital and sorted. Surgical teams worked continuously, often without the aid of the x-ray machines for a want of electric power. The laboratory was similarly handicapped, making diagnosis and treatment that much harder for physicians. Nurses worked tirelessly to clean wounds, dole out medications, fill out charts, and keep a clean and ventilated environment. Corpsmen carried patients up several flights of stairs to their rooms, hauled water in buckets for want of proper plumbing, cooked meals in the kitchens and delivered them to non-ambulatory patients’ rooms, removed waste from the rooms, made new batches of Carrel-Dakin solution, worked to improve the plumbing and heating in the old hotels, loaded and unloaded hospital and supply trains, and somehow found a way to help keep the streets of Royat clean and the hotel cesspools from overflowing. There was so much work that ambulatory patients were conscripted to assist. And just when the hospital appeared to find its rhythm, events found a way to throw it off.

Figure 15 – The Influenza Pandemic of 1918.

On September 22, 1918, when the hospital was near full capacity, a train full of French patients arrived in the middle of the night without prior notice. Due to the hour, the hospital staff decided that the best course of action was to distribute the new patients throughout the hospital wherever a spare bed could be found. Unfortunately, they discovered that practically all the new patients were suffering from acute respiratory infection. Distributing them through the hospital into crowded rooms exposed other patients as well as the staff to infection.

By the end of September, as many as 40 of the 150 enlisted men assigned to Base Hospital No. 30 had to be hospitalized themselves, and many officers and nurses were also afflicted to a milder degree. Five corpsmen and one officer died from their infections, and as the epidemic spread among neighboring units, the hospital’s local admissions amounted to between 30 and 70 new patients a day. Making matters more difficult, the hospital’s laboratory officer and his assistants fell ill, necessitating a suspension of investigative work on the mysterious disease. Autopsies of the first victims indicated the cause of death to be pneumonia developed as a complication following a likely infection of influenza. The hospital staff could do little to combat the contagious disease other than to reorganize the patients to attempt to hinder its spread.

While Base Hospital Thirty dealt with its share of the Influenza Pandemic of 1918, they received orders to expand the hospital to accommodate anticipated casualties from the ongoing Allied counteroffensive. The Germans’ kaiserschlacht floundered in July and the Allies, their numbers and supplies flush with fresh American troops and materiel, had been pushing the Germans back ever since. Base Hospital No. 30 officers examined potential sites for expansion in Royat and completed leases for new buildings in September. They established another surgical unit and moved their administrative offices into the Royat Palace Hotel on September 26. The new buildings allowed them to finally abandon the old “dungeon” kitchen in the Continental hotel and create a new kitchen in the Grand Hotel, which did not have the Continental’s cesspool problems. The new space also allowed for the creation of a dedicated ward for respiratory and enteric cases, freeing up space in the already-established portions of the hospital for surgical and bed-ridden patients.

Figure 16 – Patient wards at Base Hospital No. 30 in Royat, France, 1918-1919.

The hospital also expanded beyond adding new wards. Corpsmen built warehouses near the rail head to ease the burdens of transferring supplies and coal bunkers to provide a consistent fuel supply for heating the hospital as the days and nights grew colder. The Army assigned more corpsmen to the hospital staff, and the officers organized a small local labor force to help keep up with waste, garbage, and maintenance concerns. Perhaps the most welcome addition to the hospital’s roster was a section of Army engineers to finally improve the hospital’s water, sewer, and electrical supplies. Corpsmen would no longer have to haul buckets of water up stairs or worry about overflowing cesspools, allowing them to do the work for which they trained, and there was plenty of that to go around. By the end of September 1918, Base Hospital No. 30 had roughly 30 physicians, 60 nurses, and 250 corpsmen to take care of a 2,400-bed facility, and the combination of the war and pandemic ensured that the hospital continued to operate near capacity. Beyond the work in Royat, the UC Medical School unit also contributed surgical teams to support the effort of stabilizing the wounded near the front lines. Two such teams, each consisting of two surgeons, two nurses, and three corpsmen, set out for the front lines to work in field hospitals to provide surgical intervention to wounded men, often within only a few hours of their injuries.

Figure 17 – Members of Surgical Team 50: Weeks, Woolsey, Dunn & Ireland.

Surgical Team No. 50 was commanded by Lieutenant Colonel Alanson Weeks, who once played fullback for the undefeated 1898 Michigan Wolverines before moving to San Francisco to become a surgeon. Alongside Captain John Homer Woolsey, Nurses Agnes Dunn and Alta Ireland, and three enlisted men, Weeks set out for the front lines on June 6, 1918. The team arrived at the American Red Cross Hospital at Juilly (today on the northeast outskirts of Paris) at 3 p.m. on the 7th and his team was immediately assigned to an operating room and remained in surgery until 8 o’clock the following morning.  Dr. Weeks recalled the experiences of the team’s time at Juilly in The Record:

The wounds were very severe in type, many fractures and a high percentage were infected with “gas” bacilli. There were also 300 “gassed” cases who were first treated at this hospital. The sight of these gassed men, lying on stretchers and filling the entire courtyard—blinded, hacking, begging for water, for protection from the sunlight for their sensitive eyes, and for something to relieve their pain—gave all of us a craving desire to meet the Hun and kill. June 16 saw the end of this tremendous rush of wounded…. The Team operated for the most part at night and during its watch cared for all neurological cases and approximately a total of 240 wounded.

Surgical Team Fifty specialized in neurological cases, of which there were many. Due to the nature of trench warfare, headwounds were frighteningly common as the soldier’s head was usually the only part of his body exposed to enemy fire. But like all surgical teams, No. 50 dealt with all types of cases as they came in, often without much notice. Victims of gunshots, artillery shrapnel, high explosive shock, chemical weapons, and even bayonet wounds were common sights, and the work kept coming. The seventeen-hour shift the team worked on its first day at Juilly would become routine until the team returned to Base Hospital Thirty in late October.

Before Surgical Team No. 50 could return, Base Hospital No. 30 sent out another surgical team, No. 51, under the command of Major Herbert S. Thomson on September 10 to support the evacuation hospital at Toul, near Nancy to support the St. Mihiel offensive. Accompanying Dr. Thomson was Captain Homer C. Seaver, who had graduated from the University of California Medical School only weeks before deploying to France, along with nurses Adelaide Brown and Kathleen Fores and three corpsmen.

Shortly after arriving at Toul, Surgical Team Fifty-One was put to work and faced similar working conditions to their predecessors, working seventeen out of the first twenty-four hours. They only saw the most serious cases and had no opportunity to follow up on their patients. As soon as they finished working to stabilize one patient, orderlies would take him off the table and another patient would take his place. The pace of work and long days coincided with the military offensives as the team worked sixteen- or seventeen-hour shifts for a week during the St. Mihiel offensive. During the space between assaults, the teams often found themselves traveling to a new front to support a new offensive.

Imagine graduating medical school and within a matter of weeks finding yourself working 16-hour days, seven days a week, doing nothing but intensive surgery on the most severe trauma cases imaginable and not being able to follow up on the results of your work because there are so many patients waiting—and literally dying in the process—for you to save their life. Such was the medical residency of Dr. Homer C. Seaver.

Figure 18 – The Meuse-Argonne Offensive, September 26 – November 11, 1918.

In October, Surgical Team No. 51 received orders to support the offensive into the Argonne Forest. The fighting there resembled Belleau Wood. The Germans had been beating a slow retreat since June, but now that their homeland was imperiled for the first time of the war, they turned and fought hard. In his account of the event for The Record, Major Thomson described the work in the Argonne:

We were ordered from Toul to the Argonne Forest on October 8 and received transportation by ambulances to Evacuation Hospital No. 14, situated in the Argonne Forest near the village of Les Islettes. This hospital was situated in the heart of the Argonne Forest near the line of American advance and in a country that had been completely destroyed by the Germans in their former campaign. The hospital was entirely under canvas except for a small chateau which housed the nurses and senior officers. This country was very wet; it rained nearly every day and there was mud everywhere. The operating tent was pitched on the ground and for the first few days there was considerable mud on the operating room floor. In order to go from the operating room to the wards, one had to wade through about six or eight inches of mud. While at Les Islettes, the Team was busy all the time, working on the twelve-hour shift. There never was a time when anyone had a breathing spell as the triage was always filled with patients and there was frequently a line of ambulances waiting in the road. At this hospital, only the seriously wounded were treated and there was a very large number of gas infections. Many times, patients were brought in from two or three days after being wounded and a patient was rarely operated on within 15 hours of being wounded. At this hospital, we were near the German lines and were treated to the spectacle of anti-aircraft guns shooting at the German planes and could always see the observation balloons over the forest to the north. It was difficult to get supplies in this region and the hospital was rather poorly equipped. On the 25th of October the Team was ordered to return to Base Hospital Thirty.

Thus, the work of Base Hospital No. 30 continued throughout the long months from June to November 1918. Their commemorative book The Record demonstrates just how busy “the work of the hospital” really was by its absences more than its inclusions. The pages of The Record are filled with pictures from the hospital unit’s early days of organization, its travels to France, and its struggles to transform a resort town into a modern hospital. But it only includes a few pictures of “the work.” Perhaps this absence is due to the fact that everyone was too busy caring for their charges to be able to take pictures or jot down notes for posterity. Or perhaps the absence marks a time in the history of Base Hospital No. 30 that needed no commemoration in something like The Record because those who were there remember it well. Perhaps both possibilities are true.

Figure 19 – Armistice Declared, November 11, 1918.

Regardless, when the Armistice went into effect on the eleventh hour of the eleventh day of the eleventh month, and while the world breathed a sigh of relief at the end of the fighting, “the work of the hospital” at Base Hospital No. 30 and other hospitals throughout Europe and the United States continued at a frantic pace. For weeks, wounded men would continue to pour in to Royat.

This concludes Part Three: The Work of the Hospital. One part yet remains in the tale of the remarkable men and women of Base Hospital Thirty. In the final part of this series, we will take a closer look at some of the remarkable people who carried out that work, how they came home again, and what happened to them after the war.

In the meantime, I want to take the opportunity to encourage you to take a moment and visit the collection at the University of California San Francisco’s Parnassus Library in the Archives and Special Collections to read more about the incredible men and women who made up the University of California Medical School Unit in the First World War.

Figures:

11 – “Group photo, nurses and soldiers, World War I,” circa 1917, Mount Zion Photo Collection: Historical Life, UC San Francisco, Library, UCSF Medical Center at Mount Zion Archives, Calisphere, https://calisphere.org/item/ark:/13030/c8028ttx/, accessed July 29, 2018.

12 – Georges Scott, “American Marines in Belleau Wood,” circa 1918, Illustrations, Wikimedia Commons, https://commons.wikimedia.org/wiki/File:Scott_Belleau_Wood.jpg, accessed July 29, 2018; and George Matthews Harding, “Rounding Up German Prisoners,” July 1, 1918, War Department AF.25747, Smithsonian National Museum of American History, http://americanhistory.si.edu/collections/search/object/nmah_448013, accessed July 29, 2018.

13 – Wallace Morgan, “U.S. Medical Officers,” circa 1918, War Department AF.25791, Smithsonian, http://americanhistory.si.edu/collections/search/object/nmah_448030, accessed July 29, 2018; George Matthews Harding, “First Aid Station with American Wounded,” circa 1918, War Department AF.25742, Smithsonian Museum of American History, http://americanhistory.si.edu/collections/search/object/nmah_448015, accessed July 29, 2018; and Wallace Morgan, “Dressing Station in Ruined Farm,” July 19, 1918, War Department AF.25767, Smithsonian Museum of American History, http://americanhistory.si.edu/collections/search/object/nmah_448052, accessed July 29, 2018.

14 – “Loading and unloading patients during World War I,” circa 1917-1919, Base Hospital #30 Collection, UC San Francisco, Library, University Archives, Calisphere, https://calisphere.org/item/d3c4b7a0-ec00-4a29-99bf-b3157799718a/, accessed July 29, 2018.

15 – “The influenza ward at Walter Reed Hospital during the Spanish flu pandemic of 1918,” and “St. Louis Red Cross Motor Corps personnel wear masks as they hold stretchers next to ambulances in preparation for victims of the influenza epidemic in October 1918,” Library of Congress.

16 – “Surgical ward, an average size room, Hotel Metropole,” circa 1918, Base Hospital #30 Collection, UC San Francisco Library, University Archives, Calisphere, https://calisphere.org/item/ad3fa9c8-8d7e-4068-917f-47c7e4217154, accessed July 29, 2018; and “Surgical ward, German war prisoners, Royat Palace,” circa 1918, Base Hospital #30 Collection, UC San Francisco Library, University Archives, Calisphere, https://calisphere.org/item/69deaae8-23af-4dd4-8092-19237319153d, accessed July 29, 2018.

17 – “Alanson Weeks in uniform,” circa 1917-1919, Woolsey (John Homer) Papers, UC San Francisco Library, Special Collections, https://calisphere.org/item/5d2ca217-a521-4573-b693-0610c6019ac3, accessed July 30, 2018; “John Homer Woolsey in uniform,” circa 1917-1919, Woolsey (John Homer) Papers, UC San Francisco Library, Special Collections, https://calisphere.org/item/ceae074e-bff0-42a2-890b-b819e0480062, accessed July 30, 2018; and “Misses Dunn and Ireland leaving Clermont-Ferrand,” 1918, Woolsey (John Homer) Papers, UC San Francisco Library, Special Collections, https://calisphere.org/item/f187f041-1911-4aa9-aa26-be3a96d813aa, accessed July 30, 2018.

18 – “Soldiers of Headquarters Company, 23rd Infantry Regiment, 2nd Infantry Division, firing a 37mm gun during the Meuse-Argonne offensive,” 1918, U.S. Army Photo; Lester G. Hornby, “Argonne-Meuse 1918,” 1918, US Army Art Collection.

From Our Partners: ““FACTS AND INFERENCES”—DIGITIZING SHADOWS FROM THE WALLS OF DEATH PART 1”

NLM has digitized and made publicly available for the first time, one of four known copies of Shadows from the Walls of Death: Facts and Inferences Prefacing a Book of Specimens of Arsenical Wall Papers, 1874. In this three-part series learn more about the origins of this rare book, the digitization effort, and the arsenic pigments of the 19th century.

By Krista Stracka ~ Krista Stracka is a Rare Book Cataloger for the Rare Books and Early Manuscripts Section in the History of Medicine Division at the National Library of Medicine.

In a digitization workflow, the assessment of the physical condition of each book is a critical step to determine whether its fragile pages can withstand the rigors of scanning without damage. However, for one book in the NLM collection, these considerations also had to be flipped. Aside from a random paper cut, what if the book itself could potentially harm the person scanning each page? Contained inside the binding of the rare but increasingly popular Shadows from the Walls of Death: Facts and Inferences Prefacing a Book of Specimens of Arsenical Wall Papers are 84 samples of wallpaper sheets colored with arsenical pigments. In appreciation of North American Occupational Safety and Health (NAOSH) Week, this three-part series will provide a behind-the-scenes look at actions that were taken by NLM staff to safely scan this curious book (now available online) and the hazardous pigments contained inside.

Faded printing on green paper gives the title of the book, author and additional information.
Detail of the original cover of Shadows from the Walls of Death: Facts and Inferences Prefacing a Book of Specimens of Arsenical Wall Papers, 1874
National Library of Medicine #0234555

The inclusion of these pigments was intentional, as you may have guessed by the dramatic title. Published in 1874, Shadows from the Walls of Death was written and compiled by Dr. Robert C. Kedzie to raise awareness about the beautiful yet toxic pigments used by many wallpaper manufacturers. Shadows from the Walls of Death is composed of a letter of introduction issued by the Michigan State Board of Health and an eight-page preface by Dr. Kedzie, the Chairman of Committee on Poisons, followed by over 80 arsenical wallpaper samples. Dr. Kedzie purchased these samples from leading dealers in Lansing, Detroit, and Jackson to compile 100 copies that were then distributed to public libraries in the state of Michigan. Out of concern for patron health, most copies have been discarded or destroyed and only four are known to exist today. The National Library of Medicine’s copy was sent in 1874 to John Shaw Billings, who was then serving as director of the Library of the Surgeon General’s Office. The other three surviving copies are located at the University of Michigan, Michigan State University, and Harvard University.

A striped pattern with grey flowers and green stripes.

Although arsenic has been used as poison and as medicine since antiquity, the nineteenth century witnessed a surge in its use in industry to manufacture consumer goods, earning the nickname “the arsenic century” from historian James Whorton. Coloring agents containing arsenic were both cheap to produce and capable of yielding vivid hues. In particular, the vibrant shades of Sheele’s and Paris green pigments became especially fashionable, leading to a demand for a variety of goods in these colors, including clothing, furniture, playing cards, toys, food…and wallpaper. Of these products, wallpaper raised much concern from the medical profession and the public as reports of illness increased with exposure to the poisonous substance in the home and on the job. Nausea, headaches, diarrhea, joint pain, skin diseases, and other symptoms of arsenical poisoning were reported to disappear once time was spent away from the offending pigments.

A vining pattern of green leaves and flowers.

Concerns about the toxic effects of arsenical wallpaper were raised as early as 1839 when German chemist Leopold Gmelin submitted a letter to a newspaper about his own findings. Although demand in the United States decreased temporarily, warnings were brushed aside by consumers as manufacturers and members of the medical profession questioned the hazards. Symptoms of arsenic poisoning were easily mistaken for those of cholera or dysentery. Susceptibility varied widely among individuals exposed to the wallpaper—even within the same household—leading many to doubt its harmfulness. Aside from physical effects, employment was another driving factor. The use of these pigments was quite lucrative, providing work for many who accepted the conditions as part of the job. With these conflicting messages, arsenical greens became highly fashionable again in the 1860s.

A shield type pattern with green pendants and white flowers on a grey background.

In response to this resurgence, education campaigns increased in the next decade to eliminate the use of arsenical pigments. As Dr. Frank Draper stated in the 1872 Annual Report of the State Board of Health of Massachusetts, “the demand ceasing, the supply will cease; and a correct taste in color will find its gratification in agents which possess no poisonous character.” Two years later, the Shadows from the Walls of Death campaign was created in Michigan. By sending the book to the leading libraries in Michigan, Dr. Kedzie went a step further than other campaigns to make the information accessible to the public. Through these efforts, demand increased for safer products which ultimately led manufacturers to produce arsenic-free wallpaper. The benefits reached both the consumers and the workforce.

By digitizing this copy, The National Library of Medicine went one step further to be the first library to make Shadows from the Walls of Death freely accessible to the everyone online. Before sending the book through to the scanning stage of the digitization workflow, NLM staff were careful to consider employee exposure and contacted the NIH Department of Occupational Health and Safety (DOHS) for guidance on the recommended protection to use while scanning arsenical wallpaper and for future handling of similar materials, because Dr. Kedzie was not the last to include samples of arsenical wallpaper in a publication!

On Wednesday—National Occupational Health and Safety Professional Day—learn more about the safety analysis and sampling performed in cooperation with DOHS in Part 2 of this series!

Like a good mystery? Discover Shadows from the Walls of Death as seen on Mysteries at the Museum “Jack the Ripper, Wooden Money, Deadly Décor which premiered Thursday, July 12 at 10 p.m. ET/PT on Travel Channel.

From Our Partners: “Finding the Flu: Crisis and Documentation”

~From the College of Physicians of Philadelphia blog, Fugitive Leaves and Beth Lander, College Librarian.

On September 7, 1918, 300 sailors arrived in Philadelphia from Boston, where, two weeks earlier, soldiers and sailors began to be hospitalized with a disease characterized as pneumonia, meningitis, or influenza. The sailors were stationed at the Philadelphia Naval Yard.

On September 11, 19 sailors reported to sickbay with symptoms of “influenza.” By September 15, more than 600 servicemen required hospitalization.

Physicians and other public health workers in Philadelphia first met on September 18 with city officials to discuss what they perceived as a growing threat. Public health officials demanded that the city be quarantined – all public spaces, including schools, churches, parks, any place people could congregate, should be closed. City officials did not want to create panic. They were more concerned that local support for President Wilson’s efforts in World War I should not be disturbed. Anything that would damage morale – or the city’s ability to raise the millions in Liberty Loans required by federal quota – was unacceptable.

The Board of Health declared influenza a reportable disease on September 21, which required physicians to report any cases they treated to health officials. The Board advised residents to stay warm and keep their feet dry and their bowels open. The Board also suggested that people avoid crowds.

Against the calls for quarantine, the city hosted a Liberty Loan parade on September 28. The two-mile route south on Broad Street was complete with marching bands, Boy Scouts, women’s auxiliary groups, soldiers, sailors, flags, and patriotic fervor. It is estimated that more 200,000 people attended the parade.

 

Liberty Loan Parade, September 28, 1918.

 

Within 72 hours of the parade, every bed in Philadelphia’s 31 hospitals was full.

We are saturated with information today. We not only consume it, but we create it through social media posts, YouTube videos, blogs, and so on. A May 2018 article in Forbes magazine notes a terrifying thought (at least for a librarian): “Over the last two years alone 90 percent of the data in the world was generated.” Few public events today escape immediate documentation.

Researchers who are examining the 1918 influenza pandemic expect to find rich sets of primary sources at the Historical Medical Library. Unfortunately, their expectations are met with disappointment.

A simple search on the term “influenza” in the Library’s OPAC (online public access catalog) shows 688 hits across both Library and Mütter Museum collections regardless of publication or creation date. Library collections, while greater in number, are mostly secondary sources, with only a small number (19) published in the years between 1918 and 1925.

The most significant primary source in the collection of the Historical Medical Library is a scrapbook of newspaper clippings contemporary to the pandemic in Philadelphia. The majority of the clippings are not dated. A small number have enough of the masthead visible to safely assume that some, if not all, of the clippings were taken from the Philadelphia Evening Bulletin. The clippings are pasted edge to edge, roughly clipped, and assumed to be in date order. There is no provenance available to determine who created the scrapbook – it was acquired by the Library on October 19, 1919, through the Medical Library Association’s Exchange program, which encouraged medical libraries throughout the United States to swap items outside of their own collecting scope.

 

[Scrapbook of newspaper clippings (September 14, 1918 to March 1, 1919) concerning the influenza epidemic in Philadelphia, 1918-1919]. Historical Medical Library, Z10 d7

Why, then, are there so few extant primary sources about the influenza pandemic in the collections of The College of Physicians of Philadelphia?

The Historical Medical Library was founded in 1788, one year after the founding of The College of Physicians, which is the oldest medical fellowship in the United States. The Library was developed mostly through donations of books, manuscripts, and archival collections, but also through small acquisition funds and, in the late 19th and early 20th centuries, the aforementioned Exchange program. The collection reflects the interests of the Fellows of the College at any particular time in the history of the College. The evolution of medical specialization is particularly evident in the subject of books acquired; the development of the manuscript collections reflects the interests and work of those Fellows most closely affiliated with the College.

The College offered Fellows the opportunity to publish works in the Transactions & Studies of The College of Physicians of Philadelphia, which was issued between 1793 and 2002. Again, the Transactions reflect contemporary medical practice and concerns, as well as the research and teaching of Fellows.

The College was prominent in public health in Philadelphia since its founding. In November 1787, a month after the founding of the College, Benjamin Rush composed what was called a “memorial” to the Pennsylvania State Assembly promoting temperance as a measure of public health. In 1848, the College acted to mitigate urban overcrowding, intemperance, tainted food and water, poor sanitary conditions, and the solitary confinement of prisoners in city jails. After the Civil War, the College addressed issues related to industrialization, street cleaning, and the creation of public sewers and indoor plumbing. In 1883, a report was submitted to the state legislature stating “Philadelphia is now recognized as the worst-paved and worst-cleaned city in the civilized world.”

In 1912, the College created the Committee on Public Health and Preventive Medicine, one of a number of official committees that had promoted public health issues over the years. This Committee addressed long working hours for women and children, the use of night soil as a fertilizer, keeping hogs within the city borders, compulsory vaccination against smallpox – and clean streets.

One would assume that an institution committed to an active public health role within one of the country’s largest cities would have a prominent response to the 1918 influenza pandemic. Instead, between 1917 and 1925 the words flu, influenza and epidemic appear only infrequently in any College records and College publications. (Transactions published in fall 1918 and early 1919 mention a symposium that occurred at the College on complications of influenza in the “current epidemic” and lament the nursing shortages that plagued hospitals during the epidemic). It is almost as though the pandemic never happened.

There is no pat answer as to why the pandemic did not merit much official attention of the College. Perhaps it was because of World War I –three-quarters of Philadelphia’s medical staff, physicians and nurses, were already serving in hospitals in France and England by the fall of 1918.

 

Officers of Mobile Hospital No. 8, Deux-Noeuds, Oct. 27, 1918. George W. Outerbridge papers (MSS 2/138), 1916-1919. Historical Medical Library of The College of Physicians of Philadelphia.

 

Perhaps this lack of primary sources that we would typically find around an event – the letters, images, and diaries that would document individual or even corporate response to something like the pandemic – is symbolic of a sudden, overwhelming loss of structure, both familial and societal. Five days after the Liberty Loan parade, city leaders in Philadelphia shut down all public institutions and meeting places, even public funerals. Isolation and ignorance combined with rising rates of illness and death, filling Philadelphia residents with a pervasive sense of fear and dread. This shock left people in stasis, unable to process – or document – what was happening at the moment, leaving death certificates as the largest, most complete set of primary sources about the pandemic.

This lack of documentation may also be due to that lack of trained medical staff available in Philadelphia at the time – if you are scrambling for support, medicine, food, and water in the hope of forestalling death, are you going to stop to take a picture, or write a letter?

On September 29, the College will commemorate the 100th anniversary of the pandemic with a day of reflection in the Mütter Museum. In the fall of 2019, the Mütter Museum will debut Spit Spreads Death a permanent exhibit that will highlight that most complete set of extant sources: death certificates. About 20,000 Philadelphia death certificates from 1918-19 will be compiled in a searchable database, available to visitors in a touch map capable of bringing the impact of the past outbreak to present locations (and residents). This dataset will be joined with extant objects and photos, remembrances, public programming, and historical and public health information to form a cohesive chaos that will let visitors explore the fear, loss, and confusion that defined a city in the autumn of 1918. In so doing, the College will create a new material history of the influenza pandemic.

Event: “Medicine as Mission: Black Women Physicians’ Careers, 1864-1941”

~This post courtesy Polina Ilieva, Head of Archives and Special Collections, University of California, San Francisco.

Wednesday, October 10, 12 – 1:15 pm
Parnassus Library, 5th Floor, Lange Room

Join UCSF Archives & Special Collections as we explore the little-known history of African American women physicians’ careers in medicine from the mid-nineteenth to mid-twentieth centuries. Through an extensive survey of the careers of all known African American women who practiced medicine in this period, a complicated portrait of both accomplishment and constraint emerges.

This talk demonstrates that black women physicians succeeded in carrying out their demanding “missions” of attempting to address what we currently term “health disparities” in African American communities. Simultaneously, however, professionalized, scientific medicine in the twentieth century increasingly limited career opportunities available to black women physicians.

Speakers

Historian of medicine, Meg Vigil-Fowler, PhD

Vice Chancellor of Diversity and Outreach, Renee Navarro, MD, PharmD

Assistant Professor, History of Health Sciences at UCSF, Aimee Medeiros, PhD

The World’s Deadliest Pandemic: A Century Later

~Post courtesy Emily Miranker, Projects and Events Manager, New York Academy of Medicine.

Please join us: Thursday, September 27, 2018 6:30-8:00PM at The Museum of the City of New York, 1220 Fifth Avenue  at 104th Street, New York NY 10029.

This year marks the 100th anniversary of the global influenza pandemic of 1918. It infected an estimated quarter of the world’s population and caused the death of more people than the First World War. A century later, this disease is hardly an illness of the past with the CDC estimating tens of thousands of flu deaths in the United States annually. We have a better understanding of viruses, diagnostics and treatments than in 1918 yet societies are more connected than ever and move around the globe–taking our germs with us–than ever before. Historian of science Alan Kraut moderates a discussion between doctor Nicole Bouvier and John Barry, author of The Great Influenza: The Story of the Deadliest Pandemic in History, about the impacts of the pandemic and its legacy in the present day.

This program accompanies the exhibition Germ City: Microbes and the Metropolis(opens September 14, 2018). The program is presented by The New York Academy of Medicine and the Museum of the City of New York, and supported by Wellcome as part of Contagious Cities. To view all of the programs in this series, click here.

John Barry, DHL, is a prize-winning and New York Times best-selling author whose books have won multiple awards. The National Academies of Science named his 2004 book The Great Influenza: The story of the deadliest pandemic in history, a study of the 1918 pandemic, the year’s outstanding book on science or medicine. His articles have appeared in such scientific journals as Nature and Journal of Infectious Disease as well as in lay publications ranging from Sports Illustrated to PoliticoThe New York TimesThe Washington Post, Fortune, Time, Newsweek, and Esquire.

Nicole Bouvier, MD, is an infectious disease specialist whose research focuses on the influenza virus. She received her Doctor of Medicine from the Icahn School of Medicine at Mount Sinai in 2004 and completed her internship and residency training in Internal Medicine at the Mount Sinai Hospital from 2004 to 2007. In addition to research, Bouvier is also a practicing physician and serves as a teaching attending on the General Infectious Diseases consult service at the Mount Sinai Hospital.

About the Moderator

Alan M. Kraut, PhD, is University Professor of History at American University, and an affiliate faculty member in the School of International Service. He is also a Non-resident Fellow of the Migration Policy Institute. He specializes in U.S. immigration and ethnic history, the history of medicine in the U.S. His best known volumes include: Silent Travelers: Germs, Genes, and the “immigrant Menace” (1994); The Huddled Masses: The Immigrant in American Society, 1880-1921 (2nd ed. 2001); and Goldberger’s War: The Life and Work of a Public Health Crusader (2003). He is the past president of the Immigration and Ethnic History Society and currently chairs the Statue of Liberty-Ellis Island History Advisory

From Our Partners: Base Hospital No. 30, One Hundred Years Later – Part Two: France

~This post is courtesy Polina Ilieva, UCSF Archivist.

This is a guest post by Aaron J. Jackson, PhD student, UCSF Department of Anthropology, History and Social Medicine. 

One hundred years ago, the men and women of U.S. Army Base Hospital No. 30—the University of California School of Medicine Unit—arrived in France to support the American war effort after more than a year of preparation in the United States. They had already faced many challenges by the time they first set foot in Europe, including navigating the Army bureaucracy, going through extensive military and medical training, traveling from San Francisco to New York, and treating thousands of soldiers who had developed acute infections as a result of the massive mobilization efforts taking place in 1917 and 1918. They crossed the Atlantic in late April and arrived in France in May, expecting to occupy a prepared site, where they could set to the important work of caring for America’s wounded soldiers as the American Expeditionary Forces moved into the Western Front and helped blunt the German Spring Offensive of 1918. But they would still have to overcome significant obstacles before that work could begin. In this entry—the second part of four planned posts—I will cover the experience of Base Hospital No. 30 as they landed in France and made preparations to support the wounded between May and June, 1918. These stories are derived from primary source materials on Base Hospital No. 30 kept at the UCSF Archives & Special Collections, and it is with great appreciation to the archivists there that I am able to write about the experiences of the men and women of the University of California School of Medicine and their experience in the Great War. If you have not done so yet, please read Part One: Organization, Mobilization, and Travel here.

The U.S.S. Leviathan arrived in Brest, France on May 2, 1918. The port city at that time was a bustle of activity as the Americans established supply depots and warehouses and scrambled to offload the massive influx of war materiel and men arriving from across the Atlantic. Base Hospital No. 30 was but one of hundreds of American units transitioning into France at the time. Until that point, the unit managed to keep track of the $100,000 worth of Red Cross supplies and equipment it had drawn from the quartermaster and medical supply depot back in San Francisco. But with everything operating at a frantic pace in Brest, they found it impossible to ensure that these supplies remained with the unit. They received orders to board a train for Royat a mere two days after arriving in Brest, and while they were assured that their supplies would catch up, Lieutenant Colonel Eugene S. Kilgore later recalled that the unit was “dismayed at the apparent rough handling of [their] cargo in shipment, and were not surprised that much of it failed to reach us in Royat.”

“Royat les Bains is a small town, situated in the very heart of France, in the Auvergne Mountains,” begins the U.S. Army Hospitalization Report prepared by acquisition officers who scouted the location and rented the buildings that Base Hospital No. 30 was to occupy. Royat was (and remains) a spa town that advertised its natural hot springs and a history dating back to the Roman occupation of Gaul—the Romans constructed baths that utilized the hot springs, making Royat’s tourist heritage a truly ancient affair. Unfortunately, for an American hospital unit interested in operating a modern medical institution, Royat’s ancient roots left much to be desired, despite its charms.

In their hospitalization report, the acquisition officers noted that the town was “clean, quiet and healthful” with plenty of fresh air and sunshine—an atmosphere that attracted a clientele “of a very high class, comprising, as it does for the most part, the wealthy and nobility.” Due to this, the acquisition officers noted that the rents were quite high in Royat, but the environment seemed appropriate to them for a hospital due to the town’s reputation as a health resort and the advertised healing properties of its thermal springs, which “are taken for gout, rheumatism, gravel, kidney and bladder trouble, and… anemia, blood trouble, diabetes and dyspepsia.” With this in mind, the acquisition officers rented eleven buildings—eight hotels, one villa, one casino, and one garage—for the purposes of establishing a base hospital in the town. They left detailed instructions for the officers of Base Hospital No. 30 regarding the costs of tram fares to the nearby city of Clermont, the costs of maintaining and operating telephone service in the rented buildings, and how to go about securing sewage and garbage disposal. They were even so helpful as to provide the locations of local laundries and markets and to coordinate with local restaurants and cafes to ensure that price lists were printed in English as well as French “to prevent the unfair exploitation of foreigners.” However, they advised the officers of Base Hospital No. 30 that, as elsewhere in France, manpower for labor was in drastically short supply as almost all of it was involved in the war effort. They warned that the enlisted men of the hospital unit would likely be tasked with “street cleaning and watering and removal of rubbage and waste,” for which the local municipality would be grateful.

In short, while the acquisition officers obviously considered Royat to be an ideal location for a hospital due to its atmosphere, access to clean water, location relative to a railway, and the availability of seemingly suitable buildings—assuming, of course, that one believes a hospital and a resort hotel are sufficiently alike as to seem suitable—they noted that Base Hospital No. 30 would have its work cut out for it. The acquisition officers had done what they could and moved on. The rest would be up to the medical personnel, some of whom arrived in Royat on the morning of May 7, 1918, and immediately set about the task of transforming the sleepy spa village into a modern medical facility.

The nurses of Base Hospital No. 30 were diverted to Vichy, France for a short stay while the men went ahead to prepare the hospital site. In Vichy, the nurses attached to Base Hospital No. 1, which had organized out of Bellevue Hospital in New York City. While there, the nurses tended to a number of personnel who had contracted measles, which head nurse Arabella Lombard described as “a childhood pleasure evidently foregone in younger days.”

In Royat, Base Hospital No. 30’s officers immediately noted that the requisition team had secured the most undesirable hotels in the town and that the task before them to prepare the site to receive patients was indeed Herculean. The kitchens, primarily located in hotel basements, were particularly bad. Lt. Col. Kilgore later recalled in The Record that the kitchen in the hotel Continental was a veritable dungeon, but it had to be used because the adjoining mess hall was the only place large enough to install the main patients’ kitchen. Unfortunately, concerns about the kitchens were only the beginning.

The electrical supply, generated by hydraulic powerplants and initially reported to be ample, was found to be woefully insufficient in the dry summer months, leaving the hospital without electricity three days out of every seven and without power to run the new X-ray and laboratory incubator equipment. The hospital personnel installed multiple gas lines only to find that France’s coal scarcity reduced the gas pressure to such a point that the lines were practically useless. Worse, the water supply to the hotels, intended for a few dozen tourists, was inadequate for the needs of a several-hundred bed hospital. After installing a make-shift shower and bath system, hospital personnel discovered that it could not be operated without completely depriving at least one of the hotels of water entirely, and it was necessary to carry water in buckets up several flights of stairs in order to operate toilets and wash dishes. In spite of these complications, hospital personnel were able to establish well-prepared surgical clinics and patient wards, but the continuous complications they encountered certainly made the work more difficult than they anticipated.

The many complications were frustrating, “but worse than all these together was the hopeless inadequacy of the drainage system,” reported Lt. Col. Kilgore. Only two of the buildings had direct access to sewer lines with the rest relying on antiquated cesspool systems that were, again, intended to service the needs of at most a few dozen tourists. Kilgore noted that, “even in our condition of what we felt to be disgraceful water economy, it was evident that the numbers we put in the buildings and the use they made of water was greatly in excess of that contemplated by those who have used the buildings heretofore as summer hotels and boarding places. And very shortly after our hospital became open to patients, our cesspools began to overflow.” This problem was compounded on multiple levels. First, the only way to deal with an overflowing cesspool was to have it pumped by the Societe d’Assainissement of Clermont, whose horse-drawn steam pump and tank wagons—dubbed “honey wagons” by the Americans—had to serve the entirety of Clermont and Royat and so required three weeks’ advance notice for services. This was an impossible situation for Base Hospital No. 30 as the cesspools would overflow again as soon as seven days after they had been emptied, and even when the honey wagons could be secured, they were insufficient to empty all the hospital’s cesspools at one time, often leaving the work half done, at best. And if the misery of overflowing cesspools alone was not enough, the pools were often located directly under the hotel basements, where the kitchens were often located, including the main patients’ kitchen in the basement of the Continental. Thus, when the Continental’s cesspool overflowed, it did so directly into the newly refurbished main patients’ kitchen and dining hall. The officers and enlisted men attempted to deal with these issues as they were able, but they often lacked the tools and experience necessary to properly tackle the various tasks. The problems grew so great that the Army was forced to divert an engineer detachment from the front lines in August to install better drainage, additional cesspools, showers, wash troughs and heating stoves.

The nurses arrived from Vichy on May 23 and found that the hospital was far from the promised state of preparedness required. They immediately set to work sanitizing the hotels to “get them ready for the boys from the front,” as Arabella Lombard put it. The nurses scrubbed the rooms so thoroughly that one of the officers remarked that “three coats of paint were scrubbed off before we considered the buildings ready for occupancy.” It was hard work that left the nurses weary and sore, but there were breaks. On May 28, the nurses were invited to celebrate Decoration Day—the precursor to Memorial Day, celebrated in honor of the Civil War dead through the decoration of grave markers—with an aviation unit stationed in nearby Clermont. They observed an afternoon of sports, enjoyed a buffet dinner outside the Red Cross Headquarters overlooking the hills and the setting sun, and were entertained by a band concert, speeches, and dancing after dark.

By June, the men and women of Base Hospital No. 30 were still dealing with the cacophony of unforeseen difficulties associated with occupying Royat. The cesspools were still overflowing from time to time, the water and electrical supplies were still inefficient, the enlisted men were still helping clean the streets of Royat and installing new kitchens, and some of the old hotel rooms remained to be cleaned and refitted for the purpose of housing patients, but the hospital was operational enough to receive its first trainload of patients on June 12, 1918. Thankfully, the 360 patients aboard the train were convalescent for the most part, but even so these men represented a significant difficulty for hospital staff as the kitchen installations were not yet complete.

After more than a year of preparation for the deployment to France, the men and women of Base Hospital No. 30 found themselves scrambling to prepare their ad hoc hospital to receive patients, and time had run out. Patient trains were arriving, and the hospital was about to get very busy indeed. Approximately five-hundred kilometers north of Royat, near Château-Thierry, the German Spring Offensive of 1918 was grinding forward as the Germans attempted to cross the Marne River. Standing in their way were the men of the 5th and 6th Marines and the 9th and 23rd Infantry. The resulting fighting was among the most intense experienced by any Americans in the war, and as Base Hospital No. 30 attempted to figure out how they were going to feed their first trainload of convalescent patients, several more hospital trains carrying troops fresh from the front lines and in need of surgery were making their way to Royat.

In Part Three of this four-part blog installment, we will explore what Lt. Col. Kilgore characterized as the “Work of the Hospital” in treating battlefield casualties and how they dealt with the Influenza Pandemic of 1918. We will also discuss the experiences of the forward-deployed surgical teams led by Lt. Col. Alanson Weeks (Surgical Team No. 50) and Maj. Herbet S. Thomson (Surgical Team No. 51), who operated under extreme conditions between June 1918 and the Armistice in November.

Figures:

5 – “Loading at Brest for a Long Journey,” circa 1918, Woolsey (John Homer) Papers, UC San Francisco, Library, Special Collections, Calisphere, https://calisphere.org/item/8caee2bc-704e-4647-9218-d32ed2a4d9c8/, accessed May 21, 2018.

6 – “Royat Advertisements,” author’s compilation from “Affice Chemin de Fer D’Orleans Auvergne Geo Dorival,” circa 1910 (left) and “Royat Vintage Poster” by Gustave Fraipont, c. 1900 (right).

7 – “Base Hospital #30 at Royat, France,” ca. 1917-1919, Woolsey (John Homer) Papers, UC San Francisco, Library, Special Collections, Calisphere, https://calisphere.org/item/2cb5cbf5-d0c0-412a-9e15-a161a291d1e2/, accessed May 21, 2018.

8 – “Surgical Clinic, Metropole Hotel,” 1918, Base Hospital #30 Collection, UC San Francisco, Library, Special Collections, Calisphere, https://calisphere.org/item/b7ca9276-989e-468f-adb2-ece162e4ad01/, accessed May 21, 2018.

9 – “Base Hospital #30 Nurses,” 1918, Woolsey (John Homer) Papers, UC San Francisco, Library, Special Collections, Calisphere, https://calisphere.org/item/500d7be8-79c5-430e-86f6-f3a15d3a0d87/, accessed May 21, 2018.

10 – “Hospital Train with Hiram Miller and ‘Rug’ Ruggles,” 1918, Woolsey (John Homer) Papers, UC San Francisco, Library, Special Collections, Calisphere, https://calisphere.org/item/f4ec0c1f-b30c-48b4-9746-2d34420fcc4d/, accessed May 21, 2018.