Dr. Conan Doyle in Bloemfontein
The Medical Conan Doyle III. Dr. Conan Doyle in Bloemfontein is an article written by John D. Crouch published in the A.C.D. - The Journal of The Arthur Conan Doyle Society (Vol. 1, No. 3; Vol. 2, No. 1 and No. 2) in september 1990, spring and autumn 1991.
The article reconstructs Arthur Conan Doyle's medical service in Bloemfontein during the Boer War, detailing his work in the Langman Hospital amid epidemic disease, logistical strain, and military bureaucracy. It shows how this experience shaped both his humanitarian outlook and his later public interventions on wartime medical reform and British military policy.
Dr. Conan Doyle in Bloemfontein
Part One
It is alleged that amongst the motley crew of war correspondents who followed the fluctuating fortunes of the British Forces in South Africa, were some who penned their best copy under the influence of strong liquor. Be that as it may, it is certain that many experienced campaigners regarded it as a convenient prophylactic against the Enteric Fever which had carried off the flower of their profession, George Steevens, in Ladysmith.
When Enteric raged in Bloemfontein in 1900, Mortimer Menpes, a representative of the Black and White magazine, a talented artist and one-time pupil of Whistler, decided to seek out Dr. Conan Doyle who was then working as a physician in Langman's Hospital, a volunteer unit set up in the Bloemfontein Club building.
Most other war artists drew in pencil or in ink for mechanical line engravers back in England, but Menpes sketched and finished off his work with colour washes. He has left us with a record of the war. not in monochrome drawings or photographs, but in brilliant colour: the sparkling dawns and dust-impregnated sunsets; sunshine and storm. He also portrayed the leading personalities of the war: Cecil Rhodes, Sir Alfred Milner, Lord Roberts and Kipling. With great prescience he sought out the young Winston Churchill and Dr. Conan Doyle. (1, 2)
Regarding the latter, he wrote:
- Hitherto, I had rather shunned hospitals as being inartistic and unnecessary for my work: but I was induced to pav a visit to this hospital in the first place in order to make a sketch of Dr. Conan Doyle, its superintendent; in the second place from a real desire to see what was going on. I found Dr. Doyle with his sleeves tucked up working like a nigger. It was difficult to associate him with the Author of Sherlock Holmes; he was a doctor pure and simple, an enthusiastic doctor too.
- "You'll make yourself ill," I said, as he came up to me: "You're overworking yourself."
- "Yes, I am overworked," said he. "We are all overworked just now. We have such a tremendous incursion of patients that it is almost impossible to cope with them, and we are bound to work night and day. Sometimes I have to drag myself to the top of a kopje in order to stir up a little energy to go on with my work."
- But Dr. Doyle did not seem to lack energy. I never saw a man throw himself into duty so thoroughly, heart and soul.
- "And are you writing a book of your experiences out here as a doctor?" I asked.
- "How can I? What time do I have to think of it. You have no idea what a tremendous amount of work we have to do! In the midst of all this agony, I couldn't settle to literary work. For instance, look at this inferno!"
- As he spoke. he threw open the door of one of the principal wards, and what I saw baffles description. The only thing I can liken it to is a slaughter house. I have seen dreadful sights in my life; but I have never seen anything quite equal to this — the place was saturated with enteric fever, and patients were swarming in at such a rate that it was impossible to attend to them at all. Some of the cases were too terrible for words. And here in the midst of all these horrors, you would see two or three black-robed Sisters of Mercy going about silently and swiftly, doing work that would make a strong man faint; handling the soldiers as though they were infants; bandaging and dressing and attending to a thousand little details, all in a calm unruffled way, never appearing in a hurry.
- "What superb women!" I exclaimed involuntarily. Dr. Doyle smiled as he watched them. "They are angels" he said simply.
How Arthur Conan Doyle came to be involved with the Langman Hospital is described in Chapter XVI of his autobiography Memories and Adventures. Following his abortive attempt to enlist in the Middlesex Yeomanry, 40-year old Dr. Conan Doyle was asked by Mr. John Langman, whose son he had met in Davos, to undertake the enrolment of additional medical staff for the Private Hospital which Langman was fitting out for the war in South Africa.
The idea of organising such hospitals had originated in a letter published in The Times on 15 October, 1899, at the very start of the conflict. The writer advocated independent flying hospitals (i.e. mobile hospitals) but, on the advice of the British Red Cross Committee. stationary hospitals of 100 beds were generally adopted. The intention was to attach these to some of the larger Military Hospitals either at the base (e.g. Cape Town or Durban) or on the lines of communication from the base to the Front.
The first hospital, The Portland Hospital. largely paid for by the Duke of Portland, arrived at Cape Town at the end of the year. The successful organisation of this hospital encouraged Mr. Langman, its Honorary Treasurer, to offer to equip a similar hospital at his own expense.
The War Office stipulated that the Langman Hospital was to consist of 100 beds in six 20" x 20' tents, each for 10 beds; five square bell tents each for four beds; seven tents for officers; one tent for use as an office: one for a dispensary; one bell tent for a mortuary: seven ordinary bell tents for orderlies, plus a screen for a kitchen and another for latrines. Mr. Langman also had to provide the necessary bedding, clothing, ward utensils and medical supplies, and to pay all expenses of the staff, along with the upkeep of the hospital for six months from the date of its embarkation until its return to England.
For its part, The War Office supplied free rations to each individual and to the hospital personnel, as well as the diet and "extras" of the patients, and it undertook to transport the hospital to South Africa and back free of charge.
The staff of the Langman Hospital consisted of a Royal Army Medical Corps officer in charge, four civil surgeons and physicians, five medical Students acting as dressers, a Quartermaster and twenty-six subordinate officers and men including cooks, clerks, dispensers and storekeepers. Mr. Langman's son, Lieutenant Archibald L. Langman, Middlesex Yeomanry, served as Secretary and Treasurer to the Hospital.
The chartered transport, Oriental, sailed from Tilbury, London, on 28 February 1900, with the Langman Hospital and some drafts of soldiers on board; called at Queenstown (Ireland) to pick up the 3rd Militia Battalion, Royal Scots Fusiliers, on 2 March, passed Cape St. Vincent on 9 March, and reached Cape Town on 22 March. The ship left Cape Town on 26 March and arrived at East London on 28 March, when the Royal Scots and the Hospital were disembarked.
The Langman Hospital was loaded on two trains for Bloemfontein. Orange Free State, where it opened for service on 8 April 1900. The tents were set up on the Rambler's Club cricket field, and the Club's brick-built pavilion became the principal ward. At one end of the ward, was a stage set for a performance of H.M.S. Pinafore; this was adapted as a latrine for ambulant patients.
The Hospital functioned throughout the height of the Enteric epidemic, moved to Pretoria on 25 July and reopened there on 2 August. There was immense pressure on the railway at the time — every truck was of value and the whole of the equipment and stores of the Hospital were packed into five trucks.
With the capture of Pretoria, Capital of the Transvaal Republic, Earl Roberts considered that the war was over and sailed for England. There was a general exodus on the part of the volunteer element of the British Forces in South Africa. Conan Doyle boarded the Briton at Cape Town on 22 July, and reached England in late August 1900.
On 4 November 1900, the whole of the Hospital's material, tents and equipment, were given to the Government by Mr. Langman as a free gift. The number of patients admitted was 1,211, of which 58 died. The medical cases included 69 officers and 778 men; the surgical cases, 27 officers and 337 men. The Hospital was extended to 180 beds, and four nurses and regimental orderlies added to the staff.
An echo of Conan Doyle's experience at this time turned up many years later in The Adventure of the Blanched Soldier, (4) when Trooper Godfrey Emsworth of the Imperial Yeomanry found himself in a Leper Hospital:
- "It was morning when I wakened, and it seemed to me that instead of coming out into a world of sanity I had emerged into some extraordinary nightmare. The African sun flooded through the big, curtainless windows, and every detail of the great, bare, whitewashed dormitory stood out hard and clear."
Conan Doyle subsequently found time, whilst in South Africa, to commence his popular history of The Great Boer War. The first edition was published by Smith. Elder later in the year 1900. Enlarged and revised, it went through some seventeen editions. A sixpenny leaflet entitled The War in South Africa. Its cause and conduct. published by Smith, Elder and Newnes in 1902 as a propaganda piece, helped Conan Doyle get his knighthood. A Dutch language edition De Oorlog in Zuid Afrika was published in London, and further editions were published in New York, Toronto, Paris, Berlin, Zurich, Madrid, Christiana, Lisbon, Cardiff, India, Budapest, Odessa and Milan.
The Typhoid epidemic had first been brought to the attention of the British Public by Mr. William Burdett-Coutts, (5) the Unionist M.P. in his reports in The Times, to the British Parliament, and to The Reform Club. He wrote that:
- "hundreds of men to mv knowledge were lying in the worst stages of typhoid. with only a blanket and a thin water proof sheet (not even the latter for many of them) between their aching bodies and the hard ground: with no milk and hardly any medicines; without beds, stretchers or mattresses: without pillows: without linen of any kind: without a single nurse amongst them; with only a few private soldiers — rough and utterly untrained — to act as orderlies; and with only three doctors to attend on 350 patients. The tents were bell tents such as were mentioned in a former letter as affording sleeping accommodation for from six to eight orderlies when working and in sound health. In many of these tents there were ten typhoid cases lying closely packed together; the dying against the convalescent; the man in his crisis pressing against the man hastening to it. There was not room to step between them. Think of this, you who know the sort of nursing a typhoid patient requires. With no beds or mattresses, and only forty-two stretchers in the whole hospital, it follows that 274 patients had to be on the earth. The ground is as hard as stone, and at night the temperature falls to freezing point. Besides other deficiencies which cannot be described, there were no sheets or pillow-cases or pretence of bed linen of any kind; only the coarse rug grated against the sensitive skin burning with fever. The heat of these tents in the mid-day sun was overpowering; their odours sickening. Men lay with their faces covered with flies in black clusters, too weak to raise a hand to brush them off, trying in vain to dislodge them by painful twitching of the features. There was no one to do it for them."
As Kipling put it in his Dirge of Dead Sisters (1902) (For the Nurses who died in the South African War):
- When the days were torment and the nights were clouded terror,
- When the Powers of Darkness had dominion on our soul-
- When we fled consuming through the Seven Hells of Fever,
- These put out their hands to us and healed and made us whole.
At first, Burdett-Coutts was accorded the usual reception given to bearers of unpalatable facts; incredulity, denigration, and claims of exaggeration. Forty years in India had conditioned Field Marshal Lord Roberts to death through disease: he considered that two thousand men in hospital in Bloemfontein, 4% of the strength of the Army, was a small proportion in such a campaign.
However, the Army in South Africa had a different social composition to that serving in India. In addition to the Regular Officers and men. there were many thousands of middle and upper class Volunteers, and tough no-nonsense Colonials. All, Regulars and Volunteers. were inveterate letter writers using an efficient postal service. It was a letter from Lady Violet Cecil to her father-in-law, the Prime Minister, which settled any doubts on the matter.
The temporary halt of some forty thousand men in a town of four thousand inhabitants, its water supply disconnected, and the single line railway back to the principal base on the coast some 1008 kilometres away, compounded with the culpable failure of the Royal Army Medical Corps' officers to enforce simple preventative measures on the march in. made the events which Conan Doyle was to record as follows inevitable:
- The greatest misfortune of the campaign, one which it was obviously impolitic to insist upon at the time, began with the occupation of Bloemfontein. This was the great outbreak of enteric amongst the troops. For more than two months the hospitals were choked with sick. One general hospital with five hundred beds held seventeen hundred sick, nearly all enterics. A half field hospital with fifty beds held three hundred and seventy cases. The total number of cases could not have been less than six or seven thousand — and this not of an evanescent and easily treated complaint but of the most persistent and debilitating of continued fevers, the one too which requires the most assiduous and careful nursing. How great was the strain, only those who had to meet it can tell. The exertions of the military hospitals, and of those others which were fitted out by private benevolence, sufficed, after a long struggle, to meet the crisis. At Bloemfontein alone, as many as fifty men died in one day, and more than 1,000 new graves in the cemetery testify to the severity of the epidemic. No men served their country more truly than the officers and men of the medical service, nor can any one who went through the epidemic forget the bravery and unselfishness of those admirable nursing sisters who set the men around them a higher standard of devotion to duty. Enteric fever is always endemic in the country, and especially at Bloemfontein, but there can be no doubt that this severe outbreak had its origin in the Paardeberg water. All through the campaign, while the machinery for curing disease was excellent, that for preventing it was elementary or absent. If bad water can cost us more than all the bullets of the enemy, then: surely it is worth our while to make the drinking of unboiled water a stringent military offence, and to attach to every company and squadron the most rapid and efficient means of boiling it — for filtering alone is useless. in incessant trouble it would be, but it would have saved a division for the army. It is heart-rending for the medical man who has emerged from a hospital full of water-borne pestilence to see a regimental water cart being filled, without protest, at some polluted wayside pool. With precautions and with inoculation all those lives might have been saved. The fever died down with the advance of the troops and the coming of the colder weather.
References
1. Hodgson, Pat: The War Illustrators; Osprey, 1977
2. Carter, A.C.R.: The Work of War Artists in South Africa; The Art Journal, 1900, pps. 26-29
3. Menpes, Mortimer: War Impressions: Being a record in colour by Mortimer Menpes; Adam & Charles Black, May 1901, pps. 152-154
4. Burdett-Coutts: quoted in The Times History of The War in South Africa, Vol. VI, The Medical Services in the War, pps. 523-524
5. Doyle, A. C.: The Great Boer War; Final (17th) Edition, September 1903
Part Two
SIR ARTHUR CONAN DOYLE
This new portrait, by artist Linda King, will shortly be available to members in the form of postcards and notelets.
Sir Arthur Conan Doyle and The Royal Commission on the War in South Africa
When rumours reached home, in January 1900, that all was not well with the medical services serving in the Army in South Africa, The Times newspaper sent out Mr. W. Burdett-Coutts, M.P., to investigate matters. As a special commissioner during the Russo-Turkish War, he had some experience of war-time medical arrangements. Mr. Burdett-Coutts wrote a series of articles, dwelling on both the good and the bad points of the hospital system in South Africa, when enteric fever, long endemic amongst the civil population, broke out in strength in the army.
Bloemfontein, capital of the Orange Free State, was occupied by the British in March 1900. Many of the inhabitants of the town were of British origin and, so as not to inconvenience them, the troops, already worn out with hardship and short rations, were ordered to bivouac on the open veldt outside the town, initially without tents to shelter them from the rainy weather.
Two field hospitals and ten bearer companies entered the town on 13 March, bringing 200 sick and wounded with them. The number of sick gradually built up to over 4,000 by the end of May 1900, after which it declined. A stationary hospital arrived in Bloemfontein on 29 March and occupied the Raadzaal (O.F.S. Government Building). Three general hospitals followed between 7 and 11 April, and the Irish and Portland private hospitals on 12 and 14 April. Two hospital trains started to evacuate the sick and wounded at this time and these were supplemented by locally prepared trains which often consisted just of open trucks. About 825 sick were eventually housed in the town's buildings, the rest had to remain out on the veldt. Such were the conditions which infuriated Mr. Burdett-Coutts and which prompted him to follow up with a series of most impassioned articles which caused a great sensation when published in Britain.
The ensuing furore resulted in the appointment of a Royal Commission in July 1900 which was asked to report on the care of the sick and wounded in South Africa. The President was Lord Justice Romer and members included Sir David Richmond, Lord Provost of Glasgow, Dr. Church, President of the Royal College of Physicians, Professor D.J. Cunningham, Professor of Anatomy at Dublin University, and Mr. F. Harrison, General Manager of the London and North Western Railway. The first meetings were held in London and the Commission then embarked for South Africa where it stayed until 9 October 1900.
Needless to say, by the time the Commission arrived to do its work in South Africa, many of the hospital personnel had moved on; patients had been dispersed: some sent back to their units and many invalided to Britain or laid to rest in Bloemfontein Cemetery.
One Civil Surgeon, Mr. F. E. Fremantle, called before the Commission to give evidence, was struck by the "gorgeous Red Cross train of four or five saloon and corridor coaches, replete with secretaries, typists, shorthand writers, cooks, waiters in livery and everything it could want," and noted that "the line was blown up during the night at Leeuwspruit, but the Commissioners came along at one p.m. and took me on board; and their genial chief secretary began by regaling me with a lunch-menu and a bottle of Bass to steady the nerves, in return for which I offered to give evidence as often as he wished." (1)
According to Fremantle, the "Whitewashing Commission" became known as such because of its charitable and reassuring criticism and partly on account of the cleansing process which preceded its visit to many hospitals in one hospital, heavy rain fell during the night after a liberal application of whitewash, and the Commissioners had to pick their way through puddles of diluted whitewash.
The Commission published a Report in January 1901, which drew attention to the defective professional skill and experience of the officers of the Royal Army Medical Corps, the deficient organising ability of some of the senior Medical Officers, the huge amount of clerical work carried out at the hospitals, and the need for the appointment of Sanitary Officers for towns and large camps.
The chaos which had existed at the 12th Brigade Field Hospital and at No. 8 General Hospital in Bloemfontein, first brought to the attention of the public by Mr. Burdett-Coutts, was partly substantiated and the general lack of surgeons and nurses was noted. It is highly indicative of the state of knowledge of the Principal Medical Officer of the Army in South Africa, that the Commission considered his statement that "he knew of the absence of bed-pans, but it was always made light of, more or less, on account of the fact that enteric fever was not as a rule accompanied by diarrhoea," to be "unfortunate." Diarrhoea is a frequent, but by no means a constant, symptom of enteric fever.
King Edward VII, who was then at Balmoral, signed a Royal Warrant on 9 September 1902, authorising the setting up of a Commission to enquire into the military preparations and other matters connected with the war. Lord Kitchener's departure for his new command in India was imminent, and it was considered essential to obtain his evidence as a witness. The Commission sat in private on 55 days, and heard the evidence of 114 witnesses whose statements were recorded in two volumes of Minutes of Evidence which were annexed to the official Report, and which contained the answers to 22,200 questions. The Secretary released a precis of each witness' evidence to the Press on a daily basis.
Apropos medical matters, the Commission considered that it had a duty to enquire into the personnel and equipment of the Royal Army Medical Corps during the war, but it had no reason to re-open the enquiry made by the previous Royal Commission in 1900.
Many of the civil witnesses were men at the top of their profession, and they were not inhibited by the Royal Commission. Mr. A. D. Fripp, C.B., C.V.O., M.S., M.B., F.R.C.S., who had served with the Imperial Yeomanry Hospital and had visited many of the military hospitals in South Africa, stated that R.A.M.C. officers did not understand the treatment of enteric fever and that "they do now that they have had an enormous experience, but they did not understand how even to write its name down in the slightest cases, because they called it simple continued fever, unless it had very marked symptoms; and they allowed that man with simple continued fever to go about and infect other people, so that the other people so infected may have the acutest enteric."
Enteric fever is the generic name for Typhoid and Paratyphoid, the symptoms of which are very similar, and which are caused by the bacteria Salmonella Typhosa. The disease had been known before the time of Hippocrates and was particularly prevalent in times of warfare and other disturbance. Typhus Fever had been clearly distinguished from other continued fevers by P. Brettoneau in 1820; its infective and contagious nature had been recognised by William Budd in 1856, and he had postulated its spread through contaminated water and milk. Typhoid Bacillus had been identified by C.J. Eberth in 1880 and had been isolated in pure culture by G. Gaffky in 1884.
Sir Arthur Conan Doyle was called before the Commission on Tuesday, 24 March 1903, the fiftieth day of its sitting. The evidence of a large number of eminent men, military and civil, had been collected and gone through, and there seemed little left to discuss with regard to the medical services.
The Committee on the day, consisted of the Chairman, the Earl of Elgin, and seven other members including the Viscount Esher and the Secretary. The Chairman commenced the examination. The following extracts are given verbatim:
| 20561 | When did you go out to South Africa? I went out in February of 1900. |
| 20562 | What part of the war then did you see? I came to Bloemfontein just at the time of its early occupation, within a fortnight of the entrance of the British troops, and I was there for about three and a half months, during the enteric epidemic. I then went on to Pretoria; I went part of the way with Lord Roberts' army, and saw one or two operations, and I afterwards went back to Bloemfontein, and then I went up to Pretoria, and was there a very short time. I came back to England in August 1900. |
| 20563 | You have been good enough to give us a precis of the evidence you wish to give, and in the first place you wish to speak of the medical side? I think that is the only side perhaps that I am really qualified to speak on, because I was personally engaged in it. |
| 20564 | Of course, we had to take into account that there has been a Royal Commission inquiring into the medical case on the spot, but we have had some medical evidence, and we shall be very glad to hear what you have to say. As you say, you were at Bloemfontein at the time of the epidemic? Yes, right through from the very beginning of that epidemic. |
| 20565 | What would you like to say about that? I thought that the medical service was somewhat unjustly blamed for not having everything ready for so abnormal a thing a thing which has never occurred before, and probably will never occur again. I think it was impossible to keep any service always ready to cope with such an emergency as that; it would be a waste during all the time when the emergency did not come, and it might only occur once in a century. I thought no blame was due to anybody; everybody did their best to meet the very exceptional circumstances. I think that the epidemic was due to the fact that the Boers had cut the water supply; when an attempt was made to drive the Boers away five weeks later they went without fighting at all, and it is a very great question whether they would have gone at once, immediately after Sanna's Post. Of course, it is a side on which a civilian hardly ventures to offer an opinion, but still, I think there are facts and grounds for thinking they would; and with 30,000 men in Bloemfontein, it was a very great misfortune that we did not recapture the water supply. We were thrown back on the old wells in the town, and there is no doubt that those 8,000 or 9,000 cases of enteric which occurred in Bloemfontein were entirely due to drinking the water of the old wells. If we had recaptured the waterworks there would not have been an enteric epidemic. |
| 20566 | Do you not think that the epidemic did not begin before that? I do not think so; there was no evidence of it as far as I could see or hear. |
| 20567 | It was not due to the exhaustion in consequence of the march? I do not think that exhaustion in itself would ever produce a specific disease like typhoid; I think that exhaustion, and then drinking bad water on the top of exhaustion, would be very likely to do so. |
| 20568 | It would cause it to be a very severe epidemic? Yes, I question whether there would be an epidemic from mere exhaustion. I was very much struck with the wonderfully good work that the private hospitals did, and how impossible it would have been to meet the situation without them. |
| 20569 | Was that with regard to the Bloemfontein epidemic or generally? That is the only thing I am qualified to speak about really, because that was the only medical work I did during that three and a half months in Bloemfontein. |
| 20570 | You were working yourself? I was the head physician of the Langman Hospital, which was one of the private hospitals, and I was working myself. |
| 20571 | (Sir Frederick Darley) Had you many men in your hospital? We had about 150 cases all the time; we were only supposed to take 100. We had 100 beds, but the pressure was so extreme that we took 50 per cent more than we were supposed to take. |
| 20572 | (Chairman) Do you think that the service was not sufficiently acknowledged? I think that the gentlemen who fitted out the hospitals have been ignored unduly. I think that they did a great patriotic action; they spent a lot of money, they did the service really an incalculable good, and I think that there would have been a terrible scandal and disaster if it had not been for the presence of these hospitals; and the gentleman who fitted out this particular hospital, Mr. Langman, has never had one word of official thanks of any kind whatsoever, except in the field, where the General on inspecting the hospital complimented him on its efficiency. I meant that he had received no acknowledgement from the home authorities; he has had not only no reward, but no thanks of any sort. |
| 20573 | (Lord Strathcona and Mount Royal) It has not been officially recognised? Not in any way, and I think that when we need men to do a patriotic action in the future it will take the keen edge off them a little that they have been ignored in the past. |
| 20574 | (Sir Frederick Darley) Was Mr. Langman there? He went out for a month at the end to see his hospital actually working, but his only son was in administrative charge of it. The only son, I may say, got some decoration given him, but that he deserved for his own efforts quite apart from the fact that his father had fitted out the hospital. At the end of nine months the whole thing was given as a going concern to the Government without the Government being charged a penny. Mr. Langman kept it up for nine months, and at the end of that time he gave the tents and drugs and everything, so that some thanks were due to him. |
| 20575 | (Chairman) It was taken over by the Government? Yes, just the plant, not the personnel. |
| 20576 | (Sir Frederick Darley) Was it a surgical hospital as well as a field hospital? We supposed we would get more surgical than medical cases, but when we came to Bloemfontein we found there was nothing but medical cases. Later, I believe they got a large number of surgical cases when they went to Pretoria. |
| 20577 | (Chairman) The medical service itself was short-handed?w It was very short-handed, and I think that could hardly be helped with such a demand as there was. |
| 20578 | (Lord Strathcona and Mount Royal) Do you consider that the arrangements and methods of the Medical Board were quite up to the requirements of the moment? I do not think that they always were so. I think that the different hospitals varied very much according to the administrative capacity of the man who was in charge, and I think some were exceedingly efficient and I think that some were not. |
| 20579 | With regard to the supplies sent out and the medicines, were they not very much antiquated and obsolescent in many cases? I think after the first pressure it was all right all the drugs and everything needed was there; but during the first two months there was such a great pressure on the railway that I think many things were wanting which should have been there. Everything was wanting, in fact; all the conveniences, such as bedpans and things you really could not do without, you had to vamp up. |
| 20580 | They had not given sufficient regard to the concentration of medicines; that is, to medicines in the concentrated form of capsules, and so on? I never heard of their running short of actual drugs; I heard of their running short of all sorts of accessories, such as bedpans and so on, but I never heard of drugs being actually short. |
| 20581 | (Chairman) That was only for the time when the railway was being opened up? Exactly; the railway was running at the time, and had been for two or three weeks, and the pressure on it was extreme. |
| 20582 | The single line had to bring up all the supplies also? Exactly. |
| 20583 | You do not attribute any blame on that account? No, I think not; I think that they did very well. |
| 20584 | There were civil surgeons sent out by the Government. Were you satisfied with those you saw? No, I thought they were a very mixed lot indeed; they were sent out singly and not as a hospital. The men in the hospitals were excellent, but as to the single surgeons who were sent out, each just to do any duty allotted to him with the troops, I believe that many of them were men of drunken habits, and not of a good character, and, on the other hand, some of them were splendid. I think the Government should have taken more pains to test their men. |
(The next few questions concerned the problem of recruiting surgeons and doctors for the Army Medical Service in time of war, and on the usefulness of Voluntary as opposed to Regular soldiers.)
| 20617 | (Lord Strathcona and Mount Royal) We have had it in evidence that the instruments used by the Army Medical Officers were very far inferior to those of the civil surgeons out there; that they were antiquated, and not such as were recognised as proper at the present day for surgical operations? I could not speak on the point; our own were the very best procurable, but what the others had I do not know. |
| 20618 | We have it in evidence, also, that the sanitary arrangements of some of the hospitals were very bad? There, again, that would be talking about the other hospitals, and I do not know. We were so hard worked in our own hospital that if we did get out for an hour the last thing we thought of was to go and look at any other hospital, and all we wanted was to get a little fresh air. I was confined very closely to my own hospital for those three months. |
| 20619 | Had you an opportunity of forming an opinion of the services of the female nurses? I think those nurses that got up to the front (I know nothing about those at Cape Town) were simply admirable, and I do not know that we could have done without them. |
| 20620 | They did excellent service? Admirable; and we had such confidence in them that when we had a really serious case, and the drugs had to be given at a certain hour of the night, we did not ask the orderlies, although they were good men; we knew the nurses were infallible, that they would never sleep, and were bound to do their duty. The orderlies sometimes made a mistake, but the nurses never, and we had the utmost confidence in them. They were splendid, self-sacrificing women. Only three of them were in our hospital, and I believe that two of them are dead. There is one other small point I should like to mention, and that is that it was very strongly borne in upon me over that epidemic that any breach of sanitary law ought to be made a military offence; the soldier never recognises anything except a military offence. You may argue with him, and give him advice, and he will not do it; but if they had made the drinking of foul water (and I have seen the soldiers drink from the puddles by the wayside) a military offence, they would not have done it. No efforts were made to cut the thing off at the fountain-head, so as to prevent the men getting enteric; when they did get it, every effort was made to cure them, but no effort was made to stop them getting it, and as far as I know, right through the war there was no military order against drinking foul water, and no precautions of that sort were taken. We wanted preventative medicine very badly, I think, all through the campaign. |
| 20621 | (Chairman) Precautions were taken in certain cases; we had at least one witness who told us that precautions were taken in his regiment? I think it depended very much on the Colonel; I think if he liked it was done, but there was no general order, I am convinced, as to boiling water. |
| 20622 | (Sir George Taubman-Goldie) Do you not think it would be a simple thing to have interesting lectures given at the different recreation rooms at barracks, showing the microbes and impurities in water? I do not know that familiarity might not breed contempt. |
| 20623 | In addition to the men, some of the younger officers know nothing about the dangers of microbes? No; but I am sure that if the soldier was told he would be punished if he drank that water, he would take a direct interest in microbes then. |
| 20624 | We have it on the highest authority that it was impossible to keep him from drinking it? I think a military offence he will never commit. |
(The remaining questions put to Sir Arthur Conan Doyle (20625 to 20629) concerned the possibility of keeping a peacetime registry of medical officers willing to serve in time of war.)
Conan Doyle's evidence had confined itself to matters within his personal experience; he had avoided speculation on matters outside that experience but which must have been known to him by hear-say.
However, he was blunt in his censure of the lack of acknowledgement by the military of the valuable services and financial contributions given by the individuals who had funded the Private Hospitals. It is not clear just how much money the Langman Hospital cost its founder; the Portman Hospital, which was of similar size, is recorded as having drawn subscriptions of some £13,647 of which a balance of £6,069 remained at the end of its work.
Conan Doyle's reproach drew attention to a singular lack of common courtesy, if not good manners, on the part of those individuals responsible for reporting on the medical services to the military command in South Africa, and from thence to the War Office and the British Government.
Conan Doyle's active participation in the war, both as a member of the medical service in South Africa, and as a propagandist for the British cause, coupled with his being known to the man in the street as the creator of one of the most intriguing fictional personalities, meant that his remarks could not be ignored by the military. The Principal Medical Officer in South Africa, Surgeon-General Sir W. D. Wilson, took this task upon himself.
Reference
- Francis E. Fremantle, Impressions of a Doctor in Khaki; John Murray, 1901
Part Three
Sir Arthur Conan Doyle became involved in the discussions on Army Reform which took place after the Boer War had ended:
- 'I was so struck by the factors in modern warfare and I had thought about them in Africa that I wrote about them with some freedom and possibly with some bitterness... Perhaps as a civilian I should have expressed my views in a more subdued way, but my feelings had been aroused by the conviction that the lives of our men, and even the honour of our country, had been jeopardised by the conservatism of the military and that it would happen again unless more modern views were advanced.' (1)
Conan Doyle described a debate in which he took part concerning the proper arms and use of cavalry (2):
- 'Sir Taubman-Goldie was in the chair. Three of us, all civilians, upheld the unpopular view that they should lose all their glory and become sombre but deadly riflemen. It is curious now to record that the three men were Erskine Childers, Lionel Amery and myself. Childers was shot at dawn as a traitor to Ireland as well as Britain (3), Amery became First Lord of the Admiralty, and I write this memoir.'
Childers had served as a Driver in the City Imperial Volunteers, and recorded in his diary (4):
- May 24 Thursday: Soon after we passed through Bloemfontein, a quiet dull-looking place, like a suburb of Cape Town, mounted a long hill, and came out on to another broad plain, kopjes in the distance, and tents dotted far and wide. The first moving thing I saw was a funeral slow music, a group of khaki figures, and the bright colours of a Union Jack glinting between.
- May 28: The usual sight as I passed the cemetery, thirteen still forms on stretchers in front of the gate, wrapped in the rough service blanket, waiting to be buried.
- (On that day the bands were busy at the ceremony which proclaimed the annexation of the Orange Free State to the British Crown.)
- May 30 Wednesday: In the afternoon Williams and I went to visit a friend in Langman's hospital. Bloemfontein is a town of hospitals, red crosses flying at every turn. The mortality is high, even, I was surprised to hear from our friend, among sisters and hospital orderlies. Out of six sisters in his hospital, which seemed a very good one, four had enteric at the time, and one had died of it.'
Mr. Burdett-Coutts' 'sensational' letters from Bloemfontein led to the exposure of the situation there and to the setting up of the Royal Commission on Hospitals in South Africa in 1900. The evidence of eminent Civil Surgeons and others present substantiated the variety of much of his testimony. However, some of the evidence relating to 'irregularities' was discounted for lack of corroboration.
Lady Elizabeth Briggs gushed:
- 'The British nation has ever lead the way in all hospital work and nothing has appealed more forcibly to its sentiments than the care of the sick and wounded who suffer from shot or shell or from the effects of the climate whilst fighting for their Queen and country; and I think I am right in saying that nothing has caused greater disappointment than the aspersions cast on the Royal Army Medical Corps by Mr Burdett-Coutts in his letters to The Times.' (5)
The evidence of Fred Manson of the Warwickshire Regiment (6) is of greater relevance:
- 'At this time my old chum Harrison, of the D Company, had been ill with dysentery for thirteen weeks, and not allowed into hospital. I met him on duty when I was going off to my punishment, or 'defaulter's drill, as we call it; and he looked very ill. I asked him how he was getting on. He answered: 'I shan't want rocking to sleep tonight,' and dragged himself off to his tent, where he lay down and died; and the same day, sewn up in his blanket, we buried him among the many unknown graves at Bloemfontein.' (7)
Conan Doyle wrote to The British Medical Journal at that time (8):
- 'I know of no instance of such an epidemic in modern warfare. I have not had access to any official figures, but I believe that in one month there were from 10,000 to 12,000 men down with this, the most debilitating of all diseases. I know that in one month 600 men were laid in the Bloemfontein cemetery. A single day in this one town saw 40 deaths.
Regarding the sick soldiers he commented:
- 'They are uniformly patient, docile, and cheerful, with an inextinguishable hope of getting to Pretoria'. There is a gallantry even about their delirium, for their delusion continually is that they have won the Victoria Cross. One patient whom I found the other day rummaging under his pillow informed me that he was looking for 'his two Victoria Crosses.' Very touching also is their care of each other. The bond which unites two soldier pals is one of the most sacred kind. One man shot in three places was being carried into Mr Gibbs' ward. I lent an arm to his friend, shot through the leg, who limped behind him. I want to be next Jim, 'cos I'm looking after him,' said he. That he needed looking after himself never seemed to have occurred to him.'
The situation at Langman's hospital can be gauged from the following:
- 'He is not a picturesque figure, the orderly, as we know him. We have not the trim, well-nourished army man, be we have recruited from the St John Ambulance men, who are drawn, in this particular instance, from the mill hands of a northem town. They are not very strong to start with, and the poor fellows are ghastly now. There is none of the dash and glory of war about the sallow, tired men in the dingy khaki suits which, for the sake of public health, we hope may never see England again. And yet they are patriots, these men; for many of them have accepted a smaller wage in order to take on these arduous duties, and they are facing danger for twelve hours of the twenty-four, just as real and much more repulsive than the scout who rides up to the strange kopje, or the gunner, who stands to his gun with a pom-pom quacking at him from the hill.
- Let our statistics speak for themselves; and we make no claim to be more long-suffering than our neighbours. We have three on the staff (Mr Gibbs, Mr Scharlieb, and myself). Four started, but one left us early in the proceedings. We have had six nurses, five dressers, one wardmaster, one washerman, and eighteen orderlies, or thirty-two in all, who actually came in contact with the sick. Out of the six nurses, one has died and three others have had enteric. Of the five dressers, two have had severe enteric. The wardmaster has spent a fortnight in bed with veldt sores. The washerman has enteric. Of the eighteen orderlies, one is dead, and the eight others are down with enteric. So that out of a total of thirty-four we have had seventeen severe casualties fifty per cent in nine weeks. Two are dead, and the rest incapacitated for the campaign, since a man whose heart has been cooked by a temperature over 103 degrees is not likely to do hard work for another three months. If the war lasts nine more weeks, it will be interesting to see how many are left of the original personnel. When the scouts and the Lancers and the other picturesque people ride in procession through London, have a thought for the sallow orderly, who has given of his best for his country. He is not a fancy man you do not find them in the enteric wards but for solid work and quiet courage you will not beat him in the whole army.'
This is probably the closest Conan Doyle ever came to revealing the actual state of affairs at the Langman Hospital, which, as we have seen, was considered by observers to have been a very good one. It is characteristic of the man that he remains an observer narrating the heroism of his inarticulate St John's Ambulance men and other self-sacrificing individuals.
Sir Arthur Conan Doyle's evidence to the Royal Commission on the War in South Africa was widely reported in the national press, and Surgeon-General Sir W.D. Wilson, (9) who had been the Principal Medical Officer in South Africa, took it upon himself (or was instructed) to make a formal reply.
Wilson had appeared before the Royal Commission on Tuesday, 28 October 1902, (10), the tenth day of its sitting. He reported that the Royal Army Medical Corps was wholly inefficient in staff and material at the start of the war, and that it was not so constituted as to be speedily enlarged or improved. His difficulties in getting medical services up to Bloemfontein were put down to transport difficulties on the disrupted single-line railway, and to the need to give priority to arms, ammunition and provisions for the Army in the field. These observations were correct.
Wilson considered that his own medical officers were to be preferred to civilian surgeons and medical doctors, and that St John's Ambulance men and Army regimental orderlies had to be trained for their duties. Regarding the lack of bedpans, Wilson maintained that the enteric cases did not require them as the ordinary symptoms of diarrhoea were absent as a rule. (11) Apropos the suffering and discomfort of the patients he remarked:
- 'That only occurred for a short time at Bloemfontein, and I think that they made the most of it at one hospital a hospital the staff of which did not get on well together.'
This was a reference to No. 8 General Hospital (12), where two senior R.A.M.C. officers were considered to be one of the greatest hardships. It was typical of Wilson that he should base his rebuttal of Conan Doyle's evidence on the basis of carefully assembled statistics and percentages, thus substantiating the comment of the Civil Surgeon who had come out to South Africa from a big British hospital who declared that the R.A.M.C. officers appeared to be more interested in diet sheets than diet, and in returns rather than cures. Surgeon General Wilson's letter follows:
- LETTER FROM SURGEON-GENERAL SIR W. D. WILSON, K.C.M.G., RESPECTING THE MEDICAL ARRANGEMENTS IN SOUTH AFRICA.
- From, Surgeon-General Sir W. D. Wilson, K.C.M.G.,
- late Principal Medical Officer,
- South African Field Force.
- To, The President,
- The Royal War Commission,
- u/c The Director-General,
- Army Medical Service.
- Sir: In the précis of the evidence of Sir Arthur Conan Doyle concerning the medical arrangements in South Africa, published in the daily press last week, I observe that he has stated that but for the Civil Hospitals, there would have been a 'disastrous breakdown' of the medical arrangements.
- I am not clear whether this remark is intended to apply to Bloemfontein alone, or to the whole war.
- I am the last man in the world to depreciate the work which was actually done by the Civil Hospitals, but I cannot with faimess to my own Service, allow this statement to pass unchallenged.
- As you can easily understand, the statistics of so long a campaign, in which so many troops were engaged, cannot be completed for some time, but I am in a position to give you a statement regarding Bloemfontein, from which you will see that Sir Arthur Conan Doyle's remark, by no means expresses the position of affairs in that place.
- The troops marched into Bloemfontein on March 13th. The first Civil Hospital opened there during the week ending April 13th; the last closed there during the week ending July 13th. There were three Civil Hospitals in Bloemfontein during this period of fourteen weeks, the Portland, Irish and Langman, each nominally of 100 beds, or giving a total of 300 beds. The weekly returns in my possession show that the total number remaining in these three hospitals on each Friday during this period only twice exceeded this number, viz., 324 on April 27th, and 313 on June 1st; while on six occasions, the number fell below 200, and on six was between 200 and 300.
- These Civil Hospitals, according to the returns rendered to me by them, received during this period 619 direct admissions, a weekly average of 44; the Military Hospitals received 12,591, or a weekly average of 900, roughly twenty times the number admitted to the Civil Hospitals. Owing to technicalities, this does not form a satisfactory method of comparison, which I can, however, obtain in another way.
- The total number of cases remaining in hospital' on each Friday of these 14 weeks for all hospitals in Bloemfontein amounts to 44,528. Of this total, the Civil Hospitals contribute 2,950, or 6.62 per cent. Putting it another way, the average number under treatment in Bloemfontein on each of these Fridays was 3,181. Of these, the Civil Hospitals had 211, the Military 2,970. I attach a tabular statement showing the weekly percentage of the total sick who were treated in the Civil Hospitals, from which it will be seen that only on two occasions was there any material increase above this average percentage, viz., on 20th and 27th April to 10.6 and 11.5 respectively. On these dates the General Hospitals were not yet fully opened.
- It is, of course, obvious that assistance to the extent of even 10 or 11 per cent, which these hospitals gave during two weeks at the worst period did not amount to the prevention of a 'disastrous breakdown.' But the attitude taken in this connection seems to me to be far from justifiable; these hospitals did not drop from Heaven at an opportune moment to save the situation, they offered accommodation for 300 sick before leaving England; it was known when they would be available, and their presence was calculated on. No doubt the patriotism of the subscribers to these hospitals saved the Army Medical Department from providing other Military Hospitals in their place, but they were in South Africa as an integral part of the Medical Organisation, and not as unexpected additions to it.
- If Sir Arthur Conan Doyle's statement applies to the campaign generally, I have to point out that this period was the only great strain on the Military Hospitals. My statement shows what proportion of the work was done in Bloemfontein by the Civil Hospitals, and I find that in the end of July 1900, 88 per cent of the whole sick in South Africa were under treatment in Military Hospitals, about 5 per cent in the Imperial Yeomanry Hospital, and the remaining 7 per cent in the Civil Hospitals. So that the extension to the whole area makes very little difference at this period, and later the proportion became less. The Imperial Yeomanry Hospital, though staffed by civilians, was part of the Imperial Yeomanry, sent with them for their particular use, and so can hardly be classed with the voluntary Civil Hospitals which were for general service.
- As I have already said, I do not wish to diminish the importance of the work done by these hospitals, but they formed a very small part of that Medical Organisation by which, as the Royal Hospital Commission found, in no campaign have the sick and wounded been so well looked after as this.'
- In justice to the Medical Service, I trust that you will allow this statement the same publicity which has been granted to the statement of Sir Arthur Conan Doyle. Further, in the interests of the public service, as changes in organisation may follow on the report of your Commission, I trust that I may be given an opportunity of checking any statement reflecting on the administration of the Medical Service during the late campaign.
- I have the honour to be, Sir,
- Your obedient servant, W. D. Wilson,
- Surgeon-General, Army Medical Services.
Wilson purported to be 'the last man in the world to depreciate the work of the Civil Hospitals' but the main aim of his ponderous calculations was to show that the three Civil Hospitals with a capacity of 300 beds handled only 6.62% of the total sick and wounded, an average of 211 patients per week over a total of 16 (sic) weeks.
His statistics were meaningless as they omitted any details regarding the Military Hospitals in Bloemfontein: their nominal and actual totals of patients and ratios of patients to staff, and the facilities available for the proper treatment of the sick and wounded. Wilson even gerrymandered his figures by suggesting that the Imperial Yeomanry Hospitals were not a civil provision. (14) This claim was quite risible.
Wilson's error was to fail to take account of the popular support for the many War Charities and the roles of various Volunteer services, including the Central British Red Cross Society, in the active prosecution of the war. His biggest folly was not to appreciate the new King's long term interest in the sphere of hospital reform, and that his nephew, Prince Christian Victor, a serving soldier, had died of enteric at Pretoria on 29 October 1900. King Edward's life had been saved by Frederick Treves, who had previously served as a Volunteer surgeon in South Africa. Treves had operated on the King for what was diagnosed as Perityphlitis, then considered a very risky business, more so given the King's age.
The actual sequence of events at Bloemfontein in 1900 was as follows:
- 13 March: Ten Bearer Companies and ten Field Hospitals entered the town bringing 200 sick and wounded with them. A Bearer Company in theory consisted of 8 stretcher squads of 4 men each, ten ambulance wagons and no tents. A Field Hospital, only nominally a hospital, as it did not provide long term treatment or beds, carried blankets and waterproof sheets for 100 men, 25 tents for 4 men each, transported on 4 buck-wagons and a Scotch cart.
- 16 March: The number of sick and wounded had increased to 327.
- 29 March: The first Stationary Hospital arrived. Stationary Hospitals were light units which provided for 100 patients on stretchers.
- 2 April: The Langman Hospital arrived in Bloemfontein, a fully equipped medical and surgical unit.
- 2-8 April: Two Hospital Trains, plus locally improvised trains, went into use decanting sick and wounded down the line to other hospitals. The improvised trains were made up of returning carriages and open trucks lined with straw.
- 7 April: Mr Burdett-Coutts, M.P., arrived. 1,678 patients in hospitals.
- 7-11 April: Three General Hospitals each with a capacity of 520 patients arrived. Nos. 8, 9 and 10 General Hospitals first received patients on 23, 19 and 30 April respectively.
- 10 April: Mr Fremantle, a civil doctor with the Highland Brigade Field Hospital wrote: 'The Bloemfontein paper now edited by British war-correspon- dents, under the title of The Friend, although it contains excellent articles by the best writers in the army, Conan Doyle, Kipling, Ralph, Hands & Co., gives hardly any idea of what is going on.'
- 12 April: The Irish Hospital arrived. 2,181 patients in hospital.
- 14 April: The Portland Hospital arrived.
- 11 May: A large part of the Irish Hospital left for Pretoria. 4,563 patients in hospital. (18)
- 1 June: 4,206 patients in hospital.
- 13 July: 2,210 patients in hospital.
Australian Army Medical Corps officers were openly critical of the situation in Bloemfontein, recognising that elementary sanitary precautions had been absent from the outset of the war in South Africa. One Australian War Correspondent19 later declared:
- 'I will tell you why they died, and tell you in language so plain that a wayfaring man, even though a fool, cannot misunderstand me. Those men were done to death by wanton carelessness upon the part of the men sent by the British War Office. They were done to death through criminal neglect of the most simple laws of sanitation. Men were huddled together in camp after camp; they were allowed to turn the surrounding veldt and adjacent kopjes into cesspools and excreta camps. In some cases no latrines were dug, no supervision was exercised. The so-called Medical Staff looked on, and puffed their cigarettes and talked under their eye-glasses — the fools, the idle empty-headed noodles. Had proper care been taken in regard to these matters, four-fifths of those who now fill fever graves in South Africa would be with us, hale and hearty men, today.'
Australian distrust of the British Military establishment had been heightened by Kitchener's execution of Handcock and Morant, guilty of the murder of Boer prisoners. British officers involved in the affair, such as the sadistic Lieut. A. Taylor, known as 'Bulala' (Killer) Taylor, were conveniently posted far away from the scene of the crimes. (20)
Kipling went up to Bloemfontein at Lord Roberts' request to edit the Bloemfontein paper The Friend, formerly Friend of the Free State, but returned to England in late April after 'sixteen days of active service'. (21) His comment on the epidemic was as follows:
- 'Our blood 'as truly mixed with yours All down the Red Cross train.
- We've bit the same thermometer in Blooming-typhoidtein.
- We've ad the same old tem'rature the same relapses too,
- The same old saw-backed fever-chart. Good-bye — good luck to you!' (22)
British writers were expected to be not only patriotic, chivalrous and fair, but also to 'keep a stiff upper lip' and be reticent on unpleasant matters. Only a woman could be permitted to take an emotional approach, and we are indebted to the courageous Mrs Bagot for a completely uninhibited account of the epidemic. (23)
- 'Is there anyone indeed, who, remaining in that fever-stricken place during the months of April and May, can now suppress a feeling of unutterable pity, not only for those who suffered but for those who laboured for them also? For Bloemfontein was the city of death — death for the man and his officer, and too often, alas! death for the many men and women who toiled for them.
- Not only were General Hospitals 8 and 9 at work, but the Voluntary Hospitals, the Irish', the 'Langman' and the 'Portland' were full of patients. In addition to those movable hospitals, there was the 'Volks Hospital', usually the principal one in Bloemfontein, the large Raat Saal with enormous accommodation, Grey's College Hospital, and several others in connection with religious organisations.
- Until the general advance of the troops took place, the Field Hospitals attached to the different brigades were encamped round the town, and doing all in their power to deal with any overflow of patients who could not be accommodated in the ordinary hospitals.
- It proves conclusively how amazingly rapid the descent of the epidemic upon us must have been, that so large a provision of hospitals was inadequate to cope with the amount of sickness.
- It is impossible to speak very fully about any of the hospitals but our own. I had only time to visit the Langman' once, and then saw the little theatre which formed part of its accommodation, with rows and rows of comfortable beds within it; I also went to see a sick man in Hospital No. 9; and here, with one exception only, my acquaintance with the hospitals ends.' (24)
Eventually the time came for the Army to proceed again in its advance north to Pretoria and Mrs Bagot wrote (25):
- 'almost like the fading of a dream did Lord Roberts and all his magnificent force dissolve into space, with no beating of drums or flourish or display; they just rode away at dawn, or crept silently into the night, and were no more to be seen.'
The army carried the epidemic with it. (26) At Pretoria Lord Roberts handed over his command to Kitchener, but his return to England was delayed until November; his daughter, Aileen, had nearly died of enteric.
The death rate from enteric amongst the military continued until the end of the war, (27) but was overshadowed by the mortality rate amongst the civilian population which had been rounded up and 'concentrated' in makeshift camps on the open veldt. It has been established that some 27,927 Boers died in these camps: 26,251 women and children and 1,676 men above the age of sixteen. In addition, considerably more than 13,315 Africans died in concentration camps during the war. A recent historian has summed the matter up (28):
- 'The Boer War was seriously damaging to Imperialism partly because of its inefficiencies, and partly because of the publicity given by the Government's liberal critics to Kitchener's concentration camps: conditions in these were, of course, the inevitable consequences of Kitchener's notorious lack of interest in the medical care of even his own troops. He was hardly likely to show much imagination in his treatment of enemy aliens even if they were women and children. The Boer War did lasting damage to the British Empire chiefly because it made too many Englishmen as uncritically ashamed of Empire as, before 1899, too many had been uncritically proud of it.'
There had always been a small but vociferous section of the British population which had actively opposed the war; part pacifist, part political opportunists, part paid collaborators, and part those with a sentimental conception of the Boers as 'plucky freedom-loving farmers.' However, the Witwatersrand gold-mining boom had fed not only the Uitlander financial interests but also the political aspirations of the Transvaal Government. (29) By 1899, 1,147 kilometres of railway line was in use: the capital to finance this vast expansion had come from Dutch and German banks, much of the material used in the construction and equipment of the railways had also come from Dutch and German companies. At the start of the conflict, the Transvaal Government, through its agents, widely canvassed British politicians, Intellectuals, Clergy and men of letters for support. Conan Doyle made his attitude clear when asked to support the South Africa Conciliation Committee:
- 'Any Society for truth should begin by muzzling Dr Leyds, whose name would be better without the d.' (30) (Leyds was the Transvaal Agent in Europe.
The 'Pro-Boers', as they were called at the time, unleashed a barrage of pamphlets on the British Public. Conan Doyle's reply The War in South Africa — Its Cause and Conduct sold some 300,000 copies within six weeks of its publication in January 1902. By this time, the pro-Boer opposition to the war had been augmented by humanitarian support, notably from the Society of Friends, who by no means agreed with all of the 'Pro-Boers' political messages and activities. Conan Doyle was able to maintain his own particular view of the war against the emotional appeals of his mother because of his realisation of the lack of imagination, and incompetence, of Kitchener and Surgeon-General Wilson as far as medical matters, including the enteric epidemic, and the handling of concentration camps were concerned.
Reform of the Medical Services began at the end of 1900, when Mr. Brodrick, the new Secretary of State for War, formed a strong committee, composed mainly of civilians, but which included Lieutenant-Colonel A. Keogh, who had run one of the better hospitals in South Africa with considerable success. Sir A. Keogh was made Deputy-Director-General of the medical service over the heads of thirty or forty senior officers.
A new edition of the Royal Army Medical Corps training manual gave prominence to sanitation and prevention of disease; a text book entitled Military Hygiene and Sanitation by Colonel C.M. Melville, R.A.M.C., followed in 1912. The management of Army medical services in subsequent wars was generally satisfactory (there were exceptions such as the care of the sick in the 1916 campaign in South-East Africa.)
Conan Doyle's part in the fight to achieve proper care for the sick and wounded was, most definitely, not a minor one.
References and Notes:
1. Conan Doyle, Memories and Adventures, p.213, Hodder & Stoughton, 1924.
2. ibid. p.214
3. Time has softened our view of Erskine Childers, particularly with reference to the circumstances of his death. Childers edited Volume 5 of The Times History of the War. This covers the period of guerilla warfare, a time virtually relegated to a postscript by modern British writers, usually more concerned with the political and jingoistic aspects of the first year of what was actually a 32-month affair. Childers wrote The Riddle of the Sands, one of the finest yachting adventure stories and, in December 1914, flew as a R.N.V.R. Observer on the Cuxhaven Raid, the first-ever precursor of the carrier-borne air strikes of the 1940s.
4. Childers, E., In The Ranks of the C.I.V., pp.65-72; Smith, Elder & Co., 1900.
5. Briggs, Lady, The Staff Work of the Anglo-Boer War, p.391; Grant Richards, 1901.
6. Milton Small, Editor, Told from the Ranks, p.228; Andrew Melrose, London, June 1901.
7. List of Casualties in South African Field Force, 1900 2603 Private J. Harrison, The Royal Warwickshire Regiment, died of disease, Bloemfontein, 21 April 1900.'
8. Conan Doyle, The British Medical Journal, 1900. Reprinted in From Aldershot to Pretoria, Rev. W. E. Sellars, pp.155-158; The Religious Tract Society, London, 1900.
9. Sir W.D. Wilson, gazetted Colonel, 1894; Army Medical Staff, 1898; Afghan War Medal, 1878-79-80; Egyptian Expedition Medal and Bronze Star, 1882-84; Mentioned in Dispatches, Soudan Medal with two Clasps, 1884. Went to South Africa in 1899 as Principal Medical Officer to Sir Redvers Buller. Remained at the Base in Cape Town when Buller's Army Corps was split up and Buller went to Natal, then the principal theatre of operations. Organised the Medical Services in South Africa, for which service he was knighted.
10. Minutes of Evidence, Royal Commission on the War in South Africa, Vol 1; pp.152-162, 1903.
11. Bedpans wee in short supply, but this does not excuse Wilson's lack of medical knowledge in 1903, e.g., regarding the R.A.M.C. diagnosis of the enteric outbreak in Quetta, India, in 1898.
12. Fremantle, F.E., Impressions of A Doctor in Khaki, p.243; John Murray, London, 1901.
13. Minutes of Evidence, Royal Commission on the War in South Africa, Vol 2, Appendix 40, p.297, 1903.
14. Howe, Countess, The Imperial Yeomanry Hospitals in South Africa, Vols. 1 & 2; London, 1902.
15. Whates, M.R., The Life and Times of King Edward VII, Vol. 3, pp.80-86, Cassell. 16. Treves, Sir Frederick, The Tale of a Field Hospital; Cassell, 1900.
17. Whates, M.R., The Life and Times of King Edward VII, Vol.4; p.75. Typhlitis: Inflammation of the Caecum or Blind Gut. Would this be described as acute appendicitis today?
18. The Times History of the War in South Africa, Vol. 6: The Medical Services in the War; Sampson, Low, Marston & Co.; 1909.
19. Males, A.G., Paper read to the Australian Medical Conference in 1908; quoted from Wallace, R.L., The Australians at the Boer War; p.5; The Australian War Memorial and The Australian Government Publishing Service; 1976.
20. Breaker Morant and the Bushveldt Carbineers, edited Davey, A; Van Riebeech Society; Cape Town, 1987.
21. Durbach, R., Kipling's South Africa; Chameleon Press; 1987.
22. Rudyard Kipling's Verse; Inclusive Edition; 1885-1918: The Parting of the Columns p.533-4.
23. Bagot, D., Shadows of the War; pp.135-200; Edward Arnold, 1900, p.155. Only a brave and compassionate woman, a volunteer nurse, could have written this book; the most vivid and factual account of what life was like in a civil hospital ('The Portland') in Bloemfontein at the height of the epidemic.
24. ibid. Stricken Ones; p.155-74
25. ibid. Bloemfontein; pp.135-144
26. Spies, S.B., Methods of Barbarism; p.169
27. Spies, S.B., ibid., p.265.
28. Seaman, L.C.B., Post-Victorian Britain, 1902-1951; p.9; Methuen, 1966.
29. NZASM 100; (Netherlands South African Railway Company Centenary); Pretoria, 1988.
30. Davey, A., The British Pro-Boers: 1877-1902; pp.122 and 159; Tafelberg, 1978.
31. Enteric Fever is the generic name for Typhoid and Paratyphoid, the symptoms of which are very similar, and which are caused by the bacteria Salmonella Typhosa. The disease enters the body through the mouth, the incubation period is 14 days or less, a temperature of 1030 or 1040 Fahrenheit is reached after 7 to 10 days; the fever continues with slight remissions for another 10 to 14 days and begins to decline at the start of the fourth week. It is disseminated through water, milk or food, flies and direct contact from cases of the disease or a carrier, water being the principal means of spread.
32. The Langman Family were accorded the proper recognition for their services in South Africa as Conan Doyle had asked in his evidence to the Royal Commission in 1903. Sir Lawrence Langman (1846-1928) was created 1st Baronet by King Edward in 1906. He had been mentioned in Dispatches and held the Queen's Medal for the War in South Africa with three Clasps. He was also a Knight of Grace of the Order of St John of Jerusalem. The award to his son in 1902, (mentioned by Conan Doyle in his evidence) was the C.M.G. Sir Frederick Lawrence Langman (1872-1949), the second Baronet, had also been mentioned in Dispatches and awarded the Queen's Medal with three Clasps for his services in South Africa, and made an Honorary Associate of the Order of St John of Jerusalem. A Major in the North Somerset Yeomanry, he was appointed High Sheriff of Somerset in 1938.
John D. Crouch has been interested in Conan Doyle since the age of eleven, though not, he emphasises, through initially reading the Sherlock Holmes stories. His grandfather, William Frederick Crouch, rejoined the Army as a Reservist in 1899 and fought under Lord Methuen in some of the early battles, including Belmont. He marched with the 2nd Battalion, the Northamptonshire Regiment, to Bloemfontein and beyond. Somewhere along the line, he fell out, sick with dysentery and enteric, and was invalided back to England.
Mr Crouch founded the flourishing Victorian Military Society in 1974 and has pursued his interest in The Boer War for many years, visiting most of the major battlefields in South Africa. His own military service was with the Royal Artillery in Malaya.
- Article courtesy Christopher Roden, founder of The Arthur Conan Doyle Society (1989-2003).
