This post and the next look at the men who ‘survived’ the War. As indicated in earlier posts, the number of men in the group who embarked for overseas service and then served – either in the Middle East or on the Western Front; and, commonly, they served in both locations – came to 753. Of this figure there were 168 deaths, which leaves a figure of 585 who survived the War.

Of the 585 ‘survivors’, nearly half (280: 48% ) were discharged from the AIF as ‘medically unfit’ (MU). Half of this number were discharged at some point over the course of the fighting, from the landing at Gallipoli through to the final battles on the Western Front. Many of this group were back living in the Shire before the Armistice. As we have already seen, they were routinely involved in various commemorations and dedications in the local area. The other half of the men discharged as MU were actually discharged after the War. These were men who were returned to Australia, principally in 1919, and then assessed as MU at the point of their discharge from the AIF.

Obviously, the fact that virtually half ( 48%) of those who survived the War were discharged as medically unfit is a strong indication of the negative impact the War had on the men’s health at the time. It was also a pointer to the degree to which war service would compromise their future health.

However, to gauge the true impact of war service, you need to look beyond just those discharged as medically unfit. The analyses in this post, and the next, will show that the health of the 305 men not discharged as MU but discharged as TPE (Termination of Period of Enlistment) was in many cases as compromised as the health of those who were officially discharged as MU.

It is also worth noting that of the entire cohort of the 585 survivors, the number of men who were not hospitalised at any point in their overseas military overseas – from either wounds or sickness – was just 34 or 6%. Being wounded and/or finding yourself in hospital with some serious, if not life-threatening, disease were very common experiences for the men.

Arguably, the two most significant statistics are that of the cohort of 585 survivors (a) 294 men were hospitalised at least once with wounds and (b) 478 men were hospitalised – again, at least once – with disease, injury or other sickness. Obviously, many of the cohort experienced both conditions; and many experienced both conditions more than once.

A note on the data

The analysis in both this post and the next relies heavily on the service records of the individual soldiers. As these records tracked the movement of the soldier over their military service they always included periods of hospitalisation. So it is possible to ascertain the date of hospitalisation, the length of hospitalisation and the location of the hospital. Generally, you can also track the sequence involved. For example, in the case of a soldier being wounded in France, you can track the movement through regimental aid posts, casualty clearing stations, field hospitals and then repatriation to the UK; and, once there, the sequence of hospitals and related institutions.

Generally, these records also included brief details for either the wound or sickness that related to the hospitalisation. However, as stated, these records were essentially intended to track the movement of the soldier’s service, on a day-to-day basis. They were not intended to be detailed medical records. In some cases there are additional, very specific medical records included in the individual service file. For example, occasionally there are detailed hospital records of the patient’s condition and treatment. Sometimes there are extensive reports from various medical boards. But there is no consistency in terms of the availability of such additional material. Consequently, the analysis featured here relies principally on these movement records which cover only minimum details on the reason for the hospitalisation. At the same time, the movement records do provide the opportunity to establish an essential, background picture of the men’s health.

The survivors: the wounded

This first post looks at those survivors who were wounded. A quick point to note at the start is that there was a very small number of cases – less than 10 – where the records states that the soldier was wounded but ‘remained on duty’.

For the analysis, I have categorised 4 distinct classes of wounds: (1) gunshot wounds (gsw), (2) shrapnel wounds (sw), (3) gas, gassed or gas poisoning and (4) what I have described as ‘psychological trauma’.

As noted, some men were wounded more than once. The following is a breakdown of the multiple occasions men were wounded and then hospitalised.

wounded once: 211
wounded twice: 74
wounded 3 times: 9
wounded more than 3 times: 1

number of individual soldiers: 294
total number of hospitalisations for wounded: 386

The soldier wounded more than 3 times was White, Charles Herbert. In December 1916 he was hospitalised for a gsw right clavicle and left knee and also shellshock. The next month – January 1917 – he was readmitted with shellshock. In late February 1917 he was hospitalised with gsw right shoulder; and finally in mid June 1917 he was again hospitalised with shellshock. It appears that there was significant amount of hospital re-admission for recurring conditions He returned to Australia at the end of July 1919 and was discharged as TPE. He is an example of someone with an extensive medical record who was not discharged as medically unfit.

Some more notes on the records

Any analysis of the men’s service files quickly indicates some of the complexities associated with uncovering the picture of the men’s wounds. Take, for example, the distinction between a gunshot wound and a shrapnel wound. There are records where the wound was initially listed as a gunshot wound but then changed to a shrapnel wound at some later point. The converse was also true. Obviously, in the dreadful aftermath of battle, when under pressure and dealing with multiple casualties, making what was probably the fine distinction between gunshot and shrapnel wounds would not have mattered as much as dealing with the medical trauma at hand.

Similarly, you can come across descriptions of wounds where the site of the actual wound appears to change. For example, in one entry you can read of a gsw right arm and in the next the arm in question is denoted as left. In some instances the difference is more significant than right or left.

There is also the issue of how much detail was recorded. Some entries were very brief. In a small number of cases – approximately six – the only entry was wounded, plus the date and hospitalisation details.

Further, where one record might just record sw face, another could be far more descriptive: bomb wound, compound fracture of skull and burns to face and arms. Equally, where you can find just shellshock in some entries, others will extend the description to shellshock/neurasthenia or shellshock/concussion/ neurasthenia. One entry recorded the more informative, buried, shellshock and another shellshock, loss of voice, gas.

There is a related issue here because the more formal and detailed papers relating to medical discharge, when they occasionally appear in a service file, can feature information that does not appear in the conventional (tracking) records. For example, there could be a reference to an amputation that was not recorded anywhere in the service file. Also, it is not uncommon to come across references to the effects of gas in medical discharge papers, where there has not been any reference in the relevant service record to the soldier being gassed. Presumably, in this type of case the individual was not hospitalised and the gassing was not reported at the time but, months later, at the time of his discharge from the AIF, the effects were evident to trained medical staff.

There is one final point worth noting in terms of the records. Being wounded in battle – hit by rifle fire, machine gun fire, shrapnel blast from artillery, mortar, grenade ….. – was not, as it were, a clean cut experience. While there are many entries that indicate that a single wound occurred – for example, gsw right hand, slight – there are many others that indicate that more than one ‘wound’ occurred at the same time. The following examples are all actual descriptions from the files. Obviously, shrapnel could hit multiple parts of the body; and, presumably, the gunshot wounds here are the result of machine gun fire:

sw head and right heel

sw face and hands

gsw right clavicle and left knee; shellshock

gsw right arm and right thigh, arm amputated

bomb wound head and left hand

sw multiple/ lower limbs and abdomen – accidental explosion of ammunition

gsw throat and arm, severe

gsw abdomen and right hand, severe – fingers amputated

While from a record-keeping perspective there is only one entry, the medical reality is that individuals could experience multiple wounds at the one time. With this in mind, the following overview describes all the wounds experienced by the men. In other words, the focus is not on the number of hospitalisations – 386 for the cohort of 294 wounded – but on the number of wounds, which comes to the significantly larger figure of 420.

With all these reservations in mind the following is a breakdown of the ‘wounds’ that characterised this cohort of men.

Gunshot and shrapnel wounds

It is hardly surprising, given the nature of the fighting – and more particularly the effects of machine guns and artillery – that these 2 classes represent the greatest concentration of wounds. In fact, you could argue that the two should be combined. The combined figure comes to 340 separate ‘wounds’ as the result of enemy fire.

Again, we need to remember that men could be wounded more than once; and when they were wounded, because of the weapons being used, they could be ‘hit’ in more than one site on their body. It is strikingly clear that the incidence of being wounded by ‘enemy fire’ was very high.

Gunshot wounds
The total number of gunshot wounds across the cohort was 250.

hand/wrist: 44
foot/ankle: 11
legs/knees/hips/thighs: 80
arms/elbows/shoulders: 56
torso/chest/back: 30
other (essentially, these were all head wounds – eyes, neck, face, cheek, throat …): 29

Shrapnel wounds
The total number of shrapnel wounds across the cohort was 90.

hand/wrist: 7
foot/ankle: 3
legs/knees/hips/thighs: 37
arms/elbows/shoulders: 14
torso/chest/back: 9
other (essentially, these were all head wounds – eyes, neck, face, cheek, throat …): 20

Combined Gunshot wounds and Shrapnel wounds
The total number of wounds across the cohort was 340.

hand/wrist: 51
foot/ankle: 14
legs/knees/hips/thighs: 118
arms/elbows/shoulders: 70
torso/chest/back: 39
other (essentially, these were all head wounds – eyes, neck, face, cheek, throat …): 49

On these figures, there was a higher chance of being hit in the general area of the legs than anywhere else. The comparatively lower figures for the general torso area probably reflect the fact that wounds in that area were more likely to prove fatal.

On some occasions there would an additional note designating the wound as slight but it could also have been severe or penetrating. The significant point was that it involved a hospitalisation, generally ranging from a minimum of one week to several months; and in many cases the hospitalisation extended right through to – and even beyond – the point at which there was a medical discharge. For men for whom there was no medical discharge, the period before they rejoined their unit could be very extended. After repatriation to and hospitalisation in the UK, there was commonly a further period spent in convalescence and then even more time spent in training before they were eventually returned to their unit.

Psychological trauma

It is reasonable to argue that the number of cases (21) where men were hospitalised with the effects of some form of psychological trauma was a significant under-representation of the problem. At the time, the medical science covering such trauma was very limited. Additionally, the attendant behaviour, rather than being seen through a medical lens, could readily be interpreted as being in breach of military orders and a threat to military discipline. Further, individual soldiers would be unwilling, for a variety of reasons, to admit to the disability. In fact, it is arguable that it is significant to get this pronounced cluster of such cases. Some of these cases involved a 2 -3 month period of hospitalisation.

In about half the cases, the only reference given for the hospitalisation was shellshock ; and in a handful of cases (3) there was just a reference to neurasthenia. In other cases there was more description, and it looks as if shellshock was often associated with concussion. Perhaps concussion was seen as a more credible medical condition. Unsurprisingly, there also appeared to be a link between shellshock and being ‘buried’. Further, as noted, the one period of hospitalisation might have been the result of multiple wounds at the one time, and so shellshock could appear together with more ‘conventional’ wounds like being shot or gassed.

We also know from reports of welcome home functions held in the Shire that it was not uncommon for a returning ‘hero’ to be referred to as ’struggling’ mentally or emotionally.

Overall, the statistics uncovered here give but a glimpse of the true nature and extent of the psychological trauma experienced by the soldiers.

Gas

There were 59 cases where men were hospitalised with gas. Occasionally, there would be a specific reference to ‘mustard gas’ but generally the simple term ‘gas’ was used.

As already noted, this figure would have to be taken as a minimum. It refers specifically to men hospitalised at the time because of the effects of the gas on their skin, eyes and respiratory system. However, the very nature of gas as a weapon – particularly the varieties that were odourless and invisible – relied on it settling and remaining in the trenches the men used. Inevitably, the number of men exposed to gas – and, arguably, on multiple occasions and for extended periods – but who were not hospitalised at the time would have been high.

Equally, the effect of gas on the individual soldiers would have played out over a long period and would have depended in part on their general health. As we will see in the next post, many men had pre-existing respiratory problems – some going back before their enlistment and others brought on during the war – that would have compounded the effects of gas, both at the time and also into the future. Gas itself did not directly and immediately lead to many deaths. It was more of a ‘legacy’ wound where the effects would play out over a very long time.

Overall

The previous post highlighted how those who died had additionally endured significant trauma and suffering before they made the ‘ultimate’ or ‘supreme’ sacrifice.

This post points to an equivalent situation for those from the Shire who survived the War and returned home to Australia. It highlights how half of those who survived were discharged – either during the War or after it – as medically unfit (MU). Further it argues that for the other 50% – discharged as TPE – there was also a very high level of hospitalisation as the result of either wounds or sickness. In fact, the number of men who survived without ever being ‘hospitalised’ was only 6% of the cohort.

This post also shows that half (294) of the survivor cohort (585) experienced at least one period of hospitalisation as the direct consequence of being wounded in battle. Further, given that men were wounded more than once, the total number of hospitalisations as the result of being wounded came to a figure of 386. However, even this figure does not give the complete picture because the nature of the weapons being used – this was particularly in relation to the effects of machine guns and artillery – meant that the individual soldier could be wounded in more than one site on a single occasion. By this reckoning, the total number of ‘wounds’ comes to 420.

In a sense, this finer description of the extent of the wounds as a direct result of battle is academic. It is the general picture that is more relevant; and that picture is definitely one that has half the survivors returning home with high levels of physical and mental trauma brought on by the specific experience of being wounded in battle.

The next post will examine the additional trauma associated with sickness, disease and (non conflict) injuries that the surviving soldiers experienced.

References

As indicated, the principal resource is the individual service file for each soldier.