are being, 0: on the most colonies there ence is gained and at all eve army medica pointed out, Leave for stu proposed, but establishmen of his time a gress that ar not merely valuable live Lansdowne, if these mer and if the time to tim range of c absolute c be low. As rega time of v useful if officers t accordin place, it course, had the For ins vacanc a pay surge certai on cc surg a ye. was per] exp sys . troupe, wuse the corps troops a te ver leac Lompital assigned to them aler more sitogether. The theory & I main at the base, for the ze lines of communication. da değilim and bearer companies to provide 1 var, somni le Caribented throng: im tim w to performing the complete work of a hospital in all parts, and not to supplying a framework for the adsion of civil aid when necessary. Consequently, as soon pressure arises, where is the civilian to go? To the t-that is, to the field hospitals and bearer companies? the closer the work is to the front the more does it and a military training. Are, then, the civilians to nain at the base? But the base hospitals, though pertting, according to regulations, a certain number of ilians, are largely provided for already. The solution of e difficulty is that the existing staff of a base hospital may analysed up into that which is administrative and that ich is medical, the whole consisting of 166 men and 11 omen-177 persons in all. The administrative section ay, perhaps, be restricted to army men, but the medical ction, numbering about 128 persons, could almost wholly filled up by civilian doctors, orderlies, and nurses, organed under the control and supervision of the administrative ection, which is presided over by a colonel, who is the rincipal medical officer, and a major, who is secretary and egistrar. Now in time of war the vacancies occur, of ourse, mainly among the staff of the bearer companies and of the field hospitals, who are exposed to the risks of an active campaign. Hence, if the staffs of the base hospitals were left as a skeleton into which civilians could be poured in time of war, this would release a large number of trained military men for service at the front. And what applies to the base applies similarly to the stationary hospitals. The second reason why no very clear system has been in working order during the campaign in the relations between the civilian and military members of the profession at the seat of war is the advent of a number of hospitals organised and manned almost wholly by civilians. Among the many services which these have rendered to the State there is one bearing directly on the matter before us, for they have shown what very little military training is required by those who manage a hospital in time of war. Take the case of the Imperial Yeomanry hospital established at Deelfontein about thirty miles south of De Aar. Though equal in point of the number of their beds to a general hospital, they began at once not with t Their staff of so one member of tem, so admir m, to a critic gulation nine, but with forty nurses. persons did not include more than ular Army Medical force. Yet this its practical rets, is open, as a his very cog to the point at of the hospital itself. The situation has been saved to some extent by volunteer societies, and principally by the St. John's Ambulance Brigade. Here, again, the system has been somewhat haphazard, and the men of the brigade, though admirable and willing, have not had the advantage of a practical training. This might be placed at their disposal in peace time by the State, which in return would have the advantage of knowing the quality and capacities and numbers of fully trained men on whom it could lay its hand in time of war. Such men could also be directly enlisted in the great centres of labour, trained in the evenings in the various duties of hospital orderlies, taken out once a year for a fortnight's field training, and given a retaining fee to come when called for. In this way a fine reserve of male nurses could be created, ample for all emergencies. Having now dealt with the weaknesses disclosed and remedies suggested by the present war in the organisation and training in peace-time of the medical officers, nurses, and orderlies, let us deal as clearly and as concisely as possible with the proper principles which should govern the disposition of this personnel and its equipment on the outbreak of hostilities, using this war to illustrate and enforce them. According to the published arrangements, the first army corps was assigned four general hospitals, four stationary hospitals, twelve field hospitals, and eight bearer companies, one to each of the eight brigades into which the army corps was divided. Each of the brigades has also a field hospital —that is, eight altogether-and the total of twelve above named is accounted for by the fact that each of the three infantry divisions has a field hospital attached to its divisional troops, while the corps troops of the army corps have another field hospital assigned to them also—that is, twelve field hospitals altogether. The theory is for the general hospitals to remain at the base, for the stationary hospitals to be on the lines of communication, and for the field hospitals and bearer companies to provide for the immediate requirements of the fighting force. The question at once presents itself as to how the personnel of civilians, which we have already dealt with as the necessary reserve of the Army Medical Corps to be called up in time of war, should be distributed throughout this system. There has been wanting in our present war any very definite method in this respect, and that for two reasons. The staff of a base hospital is constructed in the main with a view to performing the complete work of a hospital in all its parts, and not to supplying a framework for the admission of civil aid when necessary. Consequently, as soon as pressure arises, where is the civilian to go? To the front-that is, to the field hospitals and bearer companies? But the closer the work is to the front the more does it demand a military training. Are, then, the civilians to remain at the base? But the base hospitals, though permitting, according to regulations, a certain number of civilians, are largely provided for already. The solution of the difficulty is that the existing staff of a base hospital may be analysed up into that which is administrative and that which is medical, the whole consisting of 166 men and 11 women-177 persons in all. The administrative section may, perhaps, be restricted to army men, but the medical section, numbering about 128 persons, could almost wholly be filled up by civilian doctors, orderlies, and nurses, organised under the control and supervision of the administrative section, which is presided over by a colonel, who is the principal medical officer, and a major, who is secretary and registrar. Now in time of war the vacancies occur, of course, mainly among the staff of the bearer companies and of the field hospitals, who are exposed to the risks of an active campaign. Hence, if the staffs of the base hospitals were left as a skeleton into which civilians could be poured in time of war, this would release a large number of trained military men for service at the front. And what applies to the base applies similarly to the stationary hospitals. The second reason why no very clear system has been in working order during the campaign in the relations between the civilian and military members of the profession at the seat of war is the advent of a number of hospitals organised and manned almost wholly by civilians. Among the many services which these have rendered to the State there is one bearing directly on the matter before us, for they have shown what very little military training is required by those who manage a hospital in time of war. Take the case of the Imperial Yeomanry hospital established at Deelfontein about thirty miles south of De Aar. Though equal in point of the number of their beds to a general hospital, they began at once not with the regulation nine, but with forty nurses. Their staff of some 200 persons did not include more than one member of the regular Army Medical force. Yet this system, so admirable in its practical results, is open, as a system, to a criticism which is very cogent to the point at issue. When did the first of these hospitals arrive at the seat of operations? This was the Portland Hospital, which may be said to have opened at Capetown there months after the war broke out. And the Portland was no larger than a section of a base hospital, containing, that is, some 104 beds, while the larger Yeomanry hospital did not get into working order until five months of the war had passed. This delay clearly might have rendered the movement very much less useful than it has actually proved, if it had not happened that the war was prolonged and that sickness did not become serious till March. Clearly it would have been better that some framework, some cadre, should have been provided by the Government, or should be provided in future, into which private enterprise should fall at once. Leaving the base hospitals and moving, so to speak, to the front into the sphere of the stationary and field hospitals and bearer companies, it should be premised that when a man falls wounded in action it is the duty of members of the bearer company to convey him to the collecting and dressing stations, whence he is passed by the ambulance into the field hospital. If the army is on the move, the field hospitals have to be evacuated as soon as possible and their inmates passed into a stationary hospital, which is established on the lines of communication. A stationary hospital differs from a field hospital mainly in this respect that it is equipped to receive patients, not temporarily, but for the period wherein they may become fit to return to the fighting line on the one hand, or, on the other, wherein it becomes clear that they must be returned to the base on account of permanent or of prolonged incapacity. If the force, however, is not on the move, it becomes an administrative question as to whether the sick and wounded shall be passed down to the stationary hospitals, or whether the stationary hospitals shall be moved up to the front. For instance, on Lord Roberts's march to Bloemfontein the sick and wounded at the early stages of the march were moved back to Jacobsdal, to Kimberley, and to Enslin; but as the march proceeded the sick and wounded were no longer sent back. After the battle of Driefontein, on March 10, they were left at that place with a field hospital, and then, soon after the entry of the army on March 13 into Bloemfontein, they were sent for and conveyed into that town. Henceforth the business was not to return the sick and wounded to their medical equipment, but to send the medical equipment to the |