 Section 18 of With the Royal Army Medical Corps in Egypt by Sergeant Major R.A.M.C. This LibriVox recording is in the public domain. Chapter 16 Military General Hospitals in Egypt, Part 2 Looking through the odd casual jottings of this notebook, it strikes me as curious that I have never yet set down anything about my own special sphere of work, that of orderly in the operating theatre. Perhaps this is because, seeing so much of it all day and every day, and often during the night, I am glad enough to forget it when I am off duty, and can sit for a while in the barrack-room window, as I am doing now, smoking, and scribbling in my lap. Our theatre here can be taken as a type of the theatres in all other general hospitals in Egypt, except that, as it does not belong to one of the largest hospitals, its statistics of work done are probably below the average figures. Even with this proviso, our record for a year, the year 1915, is a sufficiently remarkable one. In that period we performed 1,160 major operations. These were mainly for injuries received in battle, but included many of the ordinary type, such as operations for the cure of rupture, appendicitis, hemorrhoids, and the like. The surgical work was performed by various surgeons, but the rest of the work, appertaining to the theatre, was entirely carried through by four people, the sister in charge, a staff nurse, and two orderlies. There is a great deal more to do in an operating theatre than wielding the knife. To begin with, the theatre itself, its whole interior, floor, walls, windows, doors, ceiling, and every article of furniture it contains, must be thoroughly washed at frequent intervals and treated with antiseptics. Not a speck of dust or dirt that could harbour a microbe can be tolerated for a moment in a modern operating theatre. Then the science of asepsis, perfect surgical cleanliness, must be studied in all its endless ramifications by everyone concerned, and its dictates punctiliously carried out in practice. All that the surgeons use or wear, or that comes into contact with the area of operation, must be sterilised. Sharp instruments are steeped in antiseptic solution, blunt instruments are boiled, dressing gauze, lint, swabs, towels, sheets, overalls, and all other textile articles are treated in the high pressure steam steriliser. The surgeons wear rubber gloves, armlets, caps, masks, gowns and aprons, all of which must be sterilised and renewed, of course, at each operation. Every utensil employed, bowls, jugs, dishes, trays, odd glassware and chinaware of various kinds, must be subjected to the like process. And it must all be done over again, and over again, forever. All the antiseptic cleaning, and steeping, and boiling, and firing, and steam sterilising, and renewal of every single thing used or even touched during one operation, before the next operation can be taken in hand. And not only has the theatre staff to carry out all these multifarious and difficult duties, but it has, in our theatre at least, the patients to prepare for their ordeal, and always the actual operation to superintend throughout. It has to attend to the anaesthetist, and provide him with all he requires, no like task in itself. Finally it must convey the patient back to the ward, and deliver him to the ward's sister, together with final instructions from the operating surgeon, the responsibility of the theatre, ceasing only, when the unconscious man is safely delivered into bed, and is seen to be under proper surveillance. It may be interesting to the reader, if these rough notes, set down at odd moments in a busy life, ever achieve the dignity of print, to run over the routine of an average day in an operating theatre. It will, at any rate, serve to show what this branch of R-A-M-C work actually amounts to under the special conditions prevailing in Egypt. In our theatre each day's work really began overnight. The orderlies would receive the list of intended operations for the morrow, and would then bring each patient to the theatre in turn for the necessary preparation. Or, if the patient's condition was too critical for him to be moved, the orderly would have to take all his material to the bedside, and there carry out what was required. The theory of this preparation was that the sight of the proposed incision, together with a large surrounding area, should be rendered bacteriologically clean, and kept so for ten or twelve hours previous to the operation, so that by no possibility could toxic matter be carried in by the knife. The area of the operation had first to be carefully shaved, then it was thoroughly swabbed by three different antiseptic lotions, each having special bactericidal properties. Finally, this area was covered up with sterile lint, the lint being bandaged securely in place. The whole work had to be carried out under the same antiseptic conditions as if the operation were being actually performed. It was a point of emulation with us to carry through these overnight preparations, with all the celerity possible, consistent with the thorough performance of the work, as indeed was necessary with a long list of such preparations before us. But even then the whole evening was fully taken up. An average of half an hour given to each case would represent a pretty good night's performance. Many of the cases could not possibly be prepared in this time. Take for instance that wherein excision of varicose veins from both legs was contemplated, and the surgeon, as was usual, had ordered abdominal preparation. This meant that the entire body from the ankles up to about three inches above the navel had to be shaved, treated with the lotions, and covered and bandaged, as described above. The day's work in the theatre commenced at six o'clock in the morning, when the whole place, already spotlessly, distressingly clean, an outsider might say, received a thorough mopping and damp dusting with cloths, wrung out in crease-old solution. The various boilers and sterilisers were set going. The theatre was laid out with all necessaries for the first operation, a long list of articles, each having its preordained traditional place. A typical programme for a day's work in our theatre would be, say, one major amputation, an appendicitis case, two or three inguinal hernias or hemorrhoids, a bullet extraction or two, with perhaps a screen case, a fimosis or kindred operation to follow. In addition to these, there might be, and generally was, an emergency operation brought in at any moment, and before which all else would have to give way. A favourite time, however, for these emergency cases, was the small hours of the morning. To fling out of bed in the dead dark of night, rushed down to the theatre and set all going, perl-mal, for a critical operation, an amputation, trafining, intestinal stoppage or what-not, was no unusual experience in our workers' theatre orderlies. And a malicious fate generally arranged matters so that these potentious times came at the end of the hardest day's work in the week, when there had been left to you only sufficient energy to drop your clothes on the floor and crawl into bed, dizzy and faint with interminable hours of duty. But a theatre orderly, worthy of the name, never really minds these emergency calls. It is sighing a good deal, but there is probably more pride, more esprit de corps among the theatre orderly class than in any branch of the R-A-M-C servers. We know our responsibility, nay, in dispensability, and keep a pretty stiff neck accordingly. Conceit and gunpowder between them will go far to win any war. In these operating theatres, attached to the Great Base Hospitals in Egypt, we have tried to reproduce, as nearly as may be, the exact methods of procedure appertaining to the best theatres at home. But we have not quite succeeded. The climate makes its influence felt at every turn and modifies conditions, sometimes very materially. The surgeon, fresh out from home, has a deal to learn before he becomes used to things. The excessive dryness of the air at all times, the phenomenal heat of summer and the eternal dust create together a new situation. It may take, for instance, a whole twenty ounce bottle of ether, if that anaesthetic alone be used, to keep a man under for the length of an ordinary operation. The heat too, in a theatre, despite all precautions, is often appalling, with the thermometer standing at 115 or 120 degrees in the shade, to have to dress up in waterproof apron, thick linen gown, rubber gloves and armlets, mask and cap, is something that may well appall a newcomer. Then the flies, and other winged torments of Egypt, are not to be wholly excluded from the theatre, by any means that ingenuity can devise. A few are sure to find their way in, where doors are so frequently opening and shutting. A surgeon, trust up in the way described, is wholly at the mercy of any evil disposed fly who chooses to assail the small portion of his face which is necessarily left uncovered. He is perfectly helpless against his tormentor. He dare not brush it off as his hands are sterile, and his face and the fly are very much the reverse. His sole chance of deliverance lies in a watchful orderly, and it is no exaggeration to say that, with two or perhaps three surgeons and a charged sister or sterile, and therefore a helpless prey to attacking insects, our day's work was materially increased by continual fly-killing forays. I have seen a very eminent surgeon, a great gun from Harley Street attached to the R.A.M.C., for the duration, fairly beside himself with impotent rage at a fly which was clinging to his eyelid, and thus entirely stopping him in the task of plating a fractured femur. Nor were the flies our sole source of anxiety in this way. Perspiration was equally a bet noire with us. The subject verges on the ridiculous, but its serious side is not to be gain-said. Surgical work, especially when an amputation is in progress, is often very hard work indeed, and swaddled up as he is with the thermometer at one hundred degrees or so, the surgeon is sure to perspire profusely. As is well known, perspiration is highly septic, and should a drop, by any chance, fall into the incision, the consequences might be serious. Life itself might easily be lost in that way. Herein dwells a fearful responsibility for the orderly. He must silently pervade the scene, tell in hand, and woe betide him if he fail in his duty. One particular surgeon, whose bad habit it was to operate without the usual mask, used to be the terror of all concerned in this way. He was a man of a generous habit of life, and moreover a trifle short-sighted, so that his custom was to bend much over the case. Many a time I have caught the agonized eye of the charged sister, and rushed up with a towel just in time to prevent disaster. We soon developed an acrobatic agility at this game, but it had its use in leavening somewhat the over-tragic side of our employment. We would look to the operating theatre of a hospital, to provide a spectacle that, on a small scale, may be said to rival Irving's celebrated staging of the scene on the Brocken. And yet such a spectacle does come, and not infrequently, in the round of a day's theatre work. As a bullet or shell fragment is embedded in a man's body in such a situation as to render the taking of an X-ray photograph impracticable. In this case the operation for the extraction, or other foreign matter, may be performed in the X-ray room itself, and then ensues a scene which, for lurid picturesqueness, would be hard to equal in any kind of theatre. Here is the scene, as nearly as a somewhat scubbly pencil-end may serve to reproduce it. The room is large, but lit only by a single electric bulb, a sort of robber's cave hung round with innumerable weird appliances over which play the shadows of those grouped about the central table. The table is of wood, a sort of sarcophagus, with a pane of glass let into its side. The subject lies naked on the table, with the anaesthetist at his head, now engaged in administering the chloroform. Round the table stand half a dozen silent, motionless forms, completely concealed in robes and headdressers of white linen, like a band of druid priests at some dreadful prehistoric rite. We do not talk, because speech would serve us little in the din that is going on. A great dynamo is blaring and burring in the corner. Another electric contrivance of fantastic shape stands upon a high pedestal nearby. It utters one long unearthly screech, loudly clacking a myriad tongues the while. Outside the room a gas-engine proclaims its existence sonorously. There is a rush and ripple of water somewhere in the background. It would be useless to talk when none could hear. What intercommunication is necessary between us from time to time is carried on by signs and gestures. At last, as we wait in the dim ghostly light, the anaesthetist looks up and nods to the surgeon. The surgeon nods to the x-ray operator. The latter turns to his apparatus, falling to work upon certain handles and levers. Out goes the light, and we are left for a space in utter darkness. And then we are all suddenly transported to the diabolical precincts of the scene from Faust. Across the darkness overhead shoot out long cloven tongues of vivid blue, whiplashes of steel-blue light flickering and swaying everywhere. Then through the glass of the table springs up another light, this time of a pale, absinthe green, which in a moment floods the whole room, illuminating its remotest recesses. But it does more than that. It does a thing which is perfectly horrifying to one, witnessing it for the first time. It enables you to see through a man. The case on the table is one of a bullet lodged near the lung. We see the man himself now made apparently of semi-transparent green jelly, wherein we can dimly trace the form and order of his ribs, a jumble of heaving vague shapes within which are heart, lungs, and other vessels, and low down in the muscular tissue opposite the base of one lung, a mysterious dark oblong patch which we know to be a Turkish bullet. The surgeon takes his scalpel in hand. His work is comparatively simple now. Half an hour later the senseless, statoriously breathing man is on his way back to the ward, free of a danger that had liked to have meant festering death to him, or at least a source of discomfort, disability journeying with him to his grave. Sister Z and I had words last night, or rather we should have done if I had not promptly put on my old and well-tried suit of mail, of a genial but scrupulously respectful silence when she descended upon me like a queen hornet disturbed from her nest. The theatre was filthy, she cried. The floor like a pigsty, everything smothered in dust and dirt, she was perfectly ashamed of the place, it wasn't safe to do as much as dress a cut finger in it. She flounced off into the sterilising room with a tempestuous rustle of petticoats. A moment later she was calling me angrily. Just look at the brasses, quoth she. I don't believe they have been touched for a week, and the cobwebs black upon the ceiling, and the foul linen not yet seen to, and all this rubbish lying about. What you lazy men do with your time fairly beats me. I looked round, and saw my face reflected a dozen times in the unsullied splendour of nickel-plated dressing-drum and copper urn. There was no sign of a cobweb that I could see. The linen was still drying after its bath of cresole, and therefore could not yet be dealt with. The rubbish was something she had herself left and forgotten about. But, like the tar-baby, I kept on saying nothing. Presently she fell to pacing up and down the room, twisting her handkerchief into tight little knots behind her. At last it all came out, as I knew it would. That laparotomy of B. Ward has gone septic, she explained, making a furious stab at her eyes with the handkerchief. And Captain Q. says, but I am perfectly sure it is no fault of the theatre. It is absolutely impossible. Why the place is kept like a new pin, and all the care in the world spent on everything, and nothing ever forgotten by any of us. There's no theatre in Egypt kept like mine. I told him so, straight to his face, the very idea. But I won't worry myself any more over such a trifle. And, good gracious, it's past eight o'clock. Why haven't you gone off duty? I do believe you orderlies would never leave off work unless I drove you away from it. And that is a fair sample of the way things go between the masculine and feminine nursing staff of the R.A.M.C. in Egypt, or, for the matter of that, anywhere in the service. It is an old story, of course. You may train a woman's head and hands for any responsible work in the world, but you cannot train her nature. Beneath it all she remains a woman, the theme created out of Adam's rib, ages and ages ago. Complete, finite, unalterable in essence. And the real thing is sure to crop up through the surface time and again, no matter whether she be queen, scullery maid, review star, or a hospital sister wearing the royal red cross. I often wonder whether Sir Alfred Keough realised what a Pandora's box of mingled blessings and troubles he was opening within his realm when he created the present system, setting the women over the men in the nursing branch of the R.A.M.C. We had understood here that I intend to put up no fight against either the act or the fact. I admit that the one was inevitable, and the other its necessary corollary. We orderlies know perfectly well that we were fairly and squarely beaten. It was a fair duel between the sexes, and we lost, as men must always lose in any war of mere wits with women. We were good nursing orderlies, we knew our job, but we had one besetting sin, a craze for militarism. It was this that prevented us organising, and so made our downfall inevitable. While we were playing at soldiering, marching and forming foes, shunning and saluting, getting a dazzle on our boots and buttons, and picking up all manner of other dandy military tricks, just an incoate, happy, hard-working rabble of nursery kids, the women were training and organising, making themselves fit to command us. That they got what they had so thoroughly prepared themselves for, we have no right to complain of, much less to blame the Director-General. It is open to us, however, while loyally and sportingly accepting this situation thus created, to try and save a little from the wreck, to point out certain faults in, and abuses of, the present system, which, as a matter of fact, cry out very loudly indeed, for redress. No one who has worked for long in a R-A-M-C General Hospital can overlook the truth that there exists today a certain amount of unnecessary friction, in some cases, downright animosity between the male and female sections of the nursing staff. It is due, I believe, not so much to the shortcomings of the men, as to a lack of interest and understanding on the part of certain of the women. The drawback to the system of setting the women over the men in a hospital ward is that its proper working depends too much on personality. It either succeeds triumphantly, or utterly fails, according to whether the woman in power is great or small-minded. A charged sister who governs her ward with consistent and invariable justice, geniality, and regard to the susceptibilities of her staff, will find roses, roses all the way. The ward work will go like a summer song, but capricious severity, favouritism, willful illogic of deed or word, want of heart and common charity, will make for trouble all round. These together, or any one of them separately, will cause otherwise really conscientious men to do as little, instead of as much, as they can. They will create lead swinging, todyism, and general discontent. Men by nature, frank and independent-minded, are likely to develop under this bad influence either an undisguised, insolent opposition, or at least a covert hostility. The very least that will happen is that orderlies thoroughly suited for hospital ward work will be driven to apply for service in the field ambulances, or even to exchange out of the corps altogether, anywhere out of the way of the women, as was said to me once by a really competent nursing orderly whom I had lost sight of in Cairo, and ultimately lit upon on a cookhouse fatigue somewhere out on the desert. Of this man it was said by the surgeon under whom he worked that he was one of the best orderlies he had ever had, and yet the capricious dislike of an otherwise worthy young woman had succeeded in driving him from the work for which, both by training and inclination, he was peculiarly fitted and had reduced him to peeling potatoes on Sinai Desert. He peeled the potatoes very well indeed, but that only added to the pathos of the situation. He stood for an example of a preventable waste of manpower due to a remediable abuse of woman power. And I respectfully lay the matter before the ladies of the Queen Alexandra's Imperial Military Nursing Service, both in and out of Egypt. Was it right, though the potato peelings may have been as thin as poppy leaves, that this man's higher capabilities should have been lost to his fellows? In effect, by the unreasoning act of one of your sisterhood you said to an unknown number of wounded soldiers, you cannot have your wounds dressed nor your suffering bodies cleansed, but a lot of men will get potatoes in their stew today, a hundred miles away. Does the argument appeal to you? I was alone that when I put it to Sister Z the other afternoon she fired up, said I was talking nonsense, and immediately gave me the whole cupboard full of dressing forceps to clean, a good to our's work, even if it wanted doing, which it did not. But a little later she said, Your friend will soon be avenged anyway. Sister X has got a shift to Mespo much to her disgust, and will be off next week. But I don't think she'll be missed a great deal, except at Salts or Gropes perhaps. Now put all that finicky stuff away, and be off to your tea. How can a real, workable, modus vivendi be established in the hospitals, so that the men and women may each be able to go about their several tasks without friction or strained feeling? The question is about as difficult to answer as that other famous one. How can the state of matrimony be rendered a state of unvarying harmony and goodwill? Another, of course, ever will be answered with logical completeness. Something, however, can be done, I think, if we approach each question from the avowedly a logical standpoint of ignoring irremovable causes and confining our efforts to the nullification of effects. Once in a rueful hour I conceived the notion of writing a book, to be called, Practical Suggestions to Ward Sisters on the Management and Mismanagement of Men. I have grown older and wiser since that saw indignant time. Now nothing would induce me to put pen to paper in so uncouth and visionary an enterprise. But I could talk to the orderlies themselves through three fat volumes, I think, that is, if any of them could be induced to read, much less to mark, learn, and inwardly digest. Of a truth, nursing orderlies, the very best of them, are steep to the eyes in ignorance of women and their ways. That is the bedrock cause of the whole trouble. Not a hundredth part of all the bickering, misunderstandings, and little strifes that occur daily in the wards would ever get beyond the stage of a harmless, salutary breeze, if the men could bring a little philosophy to bear on the occasion. It is all really very simple. We have first to admit, and fully reconcile ourselves with, the fact that as nursing orderlies, we have been placed in subordination to the sisters of the wards, and in their absence to any feminine authority they may depute in their stead. This is the system in force, and however much we may disagree with it and dislike it, we are bound loyally to accept it until such a time as the system may be mended or ended. Whether it ever will be changed is neither here nor there. For my own part, I am not sure that any change in the direction of weakening feminine jurisdiction in a military hospital would be a change for the better. It is indisputable that the presence of women in the wards acts as a potent check on the behaviour of the patients, many of whom have only two great cause for restlessness and ennui, which, with a certain class of men, notoriously tend towards a slackening of discipline. I doubt if a purely male nursing staff, even if we were all NCOs used to the maintenance of military order would be able to keep a proper spirit of discipline alive among the patients. You cannot strafe and you cannot meet out the usual forms of punishment too, a crowd of bedridden or semi-convalescent men. What the mere presence of ladies in a ward absolves all these difficulties. Everyone is kept permanently on his best behaviour. The average soldier does and says all things differently when there are women about. The fact that there is a cool, neat, quiet figure in none-like robes moving about the place, or even the knowledge that any moment such a humanising apparition may come sailing in at the door, keeps a check on all tongues and prevents horseplay or buffoonery. Moreover, there is another reason why the retention of the system is desirable, and in my view, downright necessary, under the present conditions. The director general gave the women the giantess' strength, and there is no doubt that a few of them use it as giantesses, which is very wrong indeed. But the great majority employ their power as alone it should be employed in the due direction of affairs according to their superior knowledge and attainments. There is no blinking the fact of their superiority to us in the matters of technical knowledge and train skill. The education which a R.A.M.C. hospital orderly receives under the official curriculum is manifestly inferior to that possessed by a qualified member of the Queen Alexandra's Imperial Military Nursing Service. To deny this is to deny the plain evidence of one's senses. It only goes in support of what I have already said. Militarism has been the real stumbling block of the R.A.M.C. It has absorbed time which ought to have been devoted to additional training in medical and surgical matters. No doubt the soldiers' coat and bright buttons served the very useful purpose of an inducement to enlist, and therefore commended itself to an astute war-office. But R.A.M.C. orderlies ought to be above these primeval promptings. Being mere men, however, and young men at that, they were nothing of the kind. They elected to be soldiers, and as such, of course, gave up their civilian right to organize. The women were wiser, and their wisdom bore its inevitable fruit. They saw that organization was everything. They created a magnificent institution which turned out a product of equality opposing excellence to our mediocrity. And in the nature of things we were bound to go to the wall, where we are equally bound to stop until we prove ourselves worthy of other destinies. The sisters ruled the wards simply because they are more competent to do so than the brothers. And any other arrangement, for the present at least, seems to be alike contrary to justice, to public policy, and to common sense. In view of these facts, there remains only one thing for the male nursing staff to do, and that is scrupulously to play the game. It is a harder game to play, perhaps, in Egypt's hot, trying climate than in the soft serenity of Netli, but there is nothing in it that needs to pass the wit of man. The main fact to remember is that, though a woman may be a skilled and long-experienced hospital sister or matron, with half the letters of the alphabet after her name, by nature and instinct she yet remains a woman, and must invariably be treated as such. The least that is due to her at all times are an inexhaustible patience and a courteous conciliatory manner from each male member of her staff. If all sisters were like Sister Z, nothing more than these would be needed to make things go as smoothly as any human relationship can be expected to fare from day to day. Sister Z has all the inconsequences of her sex, and sometimes she uses her tongue with as little selective intent for harm, and as much dire execution as one who should swing a naked sword about in a crowded room after the gas has gone out. Yet she has a true woman's heart, and is, moreover, the best theatre sister that I ever knew or heard of. But ward sisters in Egypt are, unfortunately, not all like Sister Z. The climate tries them sorely. In many cases they are systematically overworked. Responsibility, though they unhesitatingly assume it, is not naturally a feminine attribute, and they assume it at heavy cost, paid for in the suppression of many of their finer qualities. Nor is it natural that women should boss men, and I think in their heart of hearts they rather despise us for having come under their yoke, which in itself is not a circumstance likely to promote good feeling from either side. To these ingredients, of an admittedly delicate situation, must be added one more, the undoubted fact that a few, very few, possess not the smallest instinct of ladyhood, a direful shortcoming indeed for any woman in authority, as well as for her unhappy subordinates. Yet in spite of all these complications, what is our plain policy towards the establishment of the much-desired modus vivendi advocated above? The answer is simple enough. It can be put in a nutshell, or rather a series of nutshells. Perhaps, however, the professional metaphor of a tabloid would be more to the purpose. And here are some tabloids which have proved efficacious in the cure of many a little disorder in my own somewhat-checkered career as a nursing orderly, and may be of like service to others. I set them down haphazard as they occur to me. First and foremost, the hospital ward orderly's sheet anchor, his grand motto, his triple body shield, patience, endurance, silence. Any sort of silence is silver, courteous silence is gold. Silence, courtesy, sympathy, conciliation, ready amendment of anything, anyhow and anywhere, make together a diadem of precious stones. Keep this piece of regal furniture always at hand, and put it on at the first sign of an electrically-overladen atmosphere. Always be in the right, but never say you are so. Let facts speak for themselves. It is a great mistake to suppose that women are by nature illogical. The more unthinking of us get that notion through judging them by first words and first acts, which, in a woman, amount to no more than trying a pen on the blotting paper before settling to write. They are as little to be taken as guides to what will eventually be thought or done than the first broth on a wine vat is gauge of the true quality of liquor that will ultimately be beneath. Intuition really guides a woman, and intuition is instant, although not instantly perceived by her. She must feel about, so to say, before she gets into touch with it, which explains the apparently inconsequent preliminaries. Trust the facts to do all the necessary talking, and at the right moment. Hasty, in opportune words, often put the rightest man in the wrongest place. Many an orderly has got confined to barracks merely because he had put the truth in the wrong words at the wrong time. Never try for the last word. The real last word is the true one, and the true word, if it must be said, is better said first than last. If circumstances compel you to speak, say what you have to say once and clearly and have done with it. Reassivation only clouds an issue. Know your job as nursing orderly through and through, but do not mind if she elects to teach it you with unnecessary vehemence every time the wind blows off the desert, or the surgeon has found fault with her, or she has had a letter, or hasn't had a letter, as the case may be. If the sister has made a mistake in the course of her ward work, try to obliterate its consequences for your own sake, quietly and unobtrusively, but keep your mouth shut about it to her, and especially to others. If the mistake is serious and likely to attract action from high quarters, you may be compelled to say and do what is necessary to prevent yourself being drawn into the maelstrom of trouble. Just content yourself with the bare minimum in this direction. Above all, do not seek to make capital out of it for your own advantage. The orderly who tries to score off the sister is about as sensible as a man who plays football with a beehive. He is deliberately foregoing his chance of future peace and quiet for the sake of a little doubtful present entertainment. Let Nemesis attend to her own job. Don't join in the ablution room parliaments. The chance gatherings of orderlies in course of the days round for cigarettes and mutual confidences, which are a common feature of military hospital life or the empire over. There are times when an occasional draw becomes well nigh a necessity to most of us. If a pipe full of tobacco has many a time restored a tired man's nerve and sent him back to the ward ready and bright for another long spell of duty, but these precious stolen moments in the day are best enjoyed in solitude. For some unfathomable reason women always regard gossiping as a heinous offence in men. Lastly it comes last in these random jottings, but in portance it should come earlier, resist every tendency or shadow of a tendency to a familiar relationship with any member of the female nursing staff. All sisters are regarded officially as holding the equivalent of commissioned rank. It is our policy as well as our duty to insist that this fact should never be lost sight of, either by them or ourselves, and it is by far the wiser plan for an orderly to include all nurses of whatever grade or qualification in the same inviolable category. There are many women in the Army Nursing Service whose normal attitude towards the men they work with is one of exquisitely delicate forethought and Christian charity. Women who never forget that orderlies are human beings of a like creation with themselves, and who love to leaven the dreary lump of the day's common task with a word or little act of common human kindness. With these it is a hard matter to appear irresponsive, to let a kind word fall stillborn in the humdrum waste of daily affairs. Nor is it at all necessary thus to drive a principle to the death. There are a hundred little ways in which appreciation can be shown outside the grosser form of spoken phrases. But there are equally many women in the service from which it is a like perilous to accept favours in word or deed. You are never on sure ground with them. One day you are overwhelmed with anaphusifurbanity, or find yourself the recipient of private confidences that fairly take away your breath. The next day the barometer has fallen headlong. There is nothing but a lowering sky for you, the chill pattern of rain and a steely lightning glitter of glances. Even your modest claim to be regarded as human pabulum may seem to be contemptuously rejected. The very dormat of the annex in the lowly favours extended to it seems better off than you. Such a game of social seesaw is intolerable for any self-respecting man. The only thing to do is to meet all, advances and repulses alike with the same quiet, unvarying civility, being neither exalted nor cast down, and preserving the even, busy tenor of your way regardless as to whether the road be rough or smooth, the atmosphere barmy or tempestuous. If manhood stands for any certain definite qualities in a woman's eyes, it stands for consistency, equanimity, magnanimity. Women trust us and depend on us much more than they will admit to us or to themselves. Much more, indeed, than they ever know. In the pages of this Chronicle, much ground which is familiar to the general student of the war has necessarily been traversed. It is doubtful, however, if the particular branch of RAMC activity in the Near East now to be dealt with will fall within the knowledge of many. It is even possible that the vast majority of British readers will never have heard of it at all. And yet, the story of what the Royal Army Medical Corps has done for the great army of native Egyptian workmen employed concurrently with the British forces in this part of the world is a record of what may well be called a remarkable, even a redoubtable achievement. The device of making use of Egypt's great natural resources in unskilled, yet far from unintelligent labor towards the prosecution of the war in its various zones, had its instigation very early in the times of the Dardanelles campaign. Our overseas base at Mudrose, in Byron's romantic isle of the Aegean, splendidly fit and practicable, a fulcrum for a great military lever to work from, as it eventually became, consisted at first of nothing but the rawest of raw material from which to fashion a great military depot and offensive port. Keys, docks, landing stages had to be constructed. A thousand and one various buildings erected, roads suitable for the passage of large bodies of troops and heavy impedimenta of war, had to be made between the various camps. A water supply by condensation on a large scale had to be devised. No source of fresh water worthy of the name existing on the island. For all these enterprises, labor on a very extensive scale was needed. The necessary skilled labor and supervisory personnel was obtained through the usual channels, but for the prosecution of the large amount of navvy work involved, we were up against a difficulty. No local supply of labor was available. We conceived, therefore, the project of importing large numbers of workmen from our Egyptian base overseas. Theoretically, the idea was a capital one, and so long as the men retained their health, it worked exceedingly well. Eventually we had in mud roads a large number of Egyptians, these being principally employed in road making, a class of work for which there was great need, roads of any military value being practically non-existent on the isle of Lemnos. But, unfortunately, the wild bitter climate of these Aegean isles proved too much for the sun-nurtured Egyptians, and a large amount of sickness prevailed in their ranks. We of the RAMC did our best for them, despite innumerable difficulties, but in the absence of a properly organised medical system exclusively devoted to these dusky hordes from the south, their sick and death-rates mounted inconveniently high. It was an experience dearly bought, yet one by which we did not fail to profit in the time that followed. When, after the excavation of the peninsula, the great offensive-defensive scheme for the protection of the Suez Canal came into force, and again vast numbers of Egyptian labourers were needed. The whole problem of securing their well-being while in our employment was thoroughly taken in hand. Hitherto the vast proportion of preliminary work within the canal zone had been carried through by Egyptian contractors who supplied their own native labour. But now the authorities decided to adopt the principle of employing the Egyptian workmen at first hand. The whole scheme was organised on military lines. The Egyptian labour corps and the camel transport corps were created and placed under British commanders with staffs of British officers. Recruiting stations were opened at convenient centres throughout the Nile area. Fair terms with clothing and rations for a minimum of three-month service were offered and readily accepted. The organisation expanded rapidly until eventually we had a force of many thousand Egyptian labourers continuously employed on military works and service in connection with the canal defences and the expedition across the Sinai Desert. The Egyptian lower-class workmen, in fact, has proved himself an invaluable asset to the Empire in all sorts of ways. The Egyptian labour corps has supplied all the unskilled labour necessary for the construction of roads, railways, defence works, etc. throughout the whole Suez Canal defensive scheme. It has also provided the men who built the railway across the Sinai Desert to Gaza, who laid the wonderful water main over the same route and who constructed all the roads, reservoirs and other innumerable works with which this 230-mile stretch of desert is marked from end to end. It supplied, in addition, men for various duties such as sanitary routine, scavenging and the like in all camps and permanent stations under the Egyptian command east or west. The Camel Transport Corps has rendered equally important service. Throughout our advance over the desert where heavy-wield vehicles were impossible the Camel Transport Corps has undertaken the conveyance of all baggage, stores, water, ammunition, everything, in fact, that our troops operating month after month while in advance of the railway needed for the furtherance of their difficult task. The medical supervision of this big army of natives would have been no-light task even if the men had been concentrated in a single district. As it was, however, the exigencies of their service caused them to be scattered in large and small parties over hundreds of miles of desert and they were, moreover, continually shifting their positions as the various works progressed or the troops advanced. Any medical surveillance of them, therefore, to be effective had to be undertaken on complete and well-thought-out lines and the present organization was instituted. A separate department of the RAMC was created and placed under the charge of an experienced medical officer. Under this new organization a network of Egyptian hospitals, detention camps, etc. gradually came into being, eventually extending right across the Sinai Desert and throughout the whole canal zone from Port Said in the north to Suez at the southern extremity of the canal. The western desert was also included in the same organization. The hospitals being established at Mersa Matru and Solemn. This service, at the date of writing absorbs the whole attention of twenty medical officers and sixty-five RAMC orderlies. These being assisted by sixty native doctors and some four hundred native orderlies or tumultures. Taking one typical period of six months from November 1916 to April 1917 we find that about twenty-four thousand patients were treated in these hospitals all being men from the Egyptian Labor Corps or the Camel Transport Corps. The conditions of service for the staff in charge of these native hospitals were peculiarly trying and difficult. Though several of the hospitals notably those at Ismailia and Cantora were permanent or semi-permanent in character most of them had to shift their ground in accordance with the movements of the bodies of laborers whose interests they were serving. As the railway was pushed forward over the desert or our army advanced the native population moved with them and hospital accommodation had to be readjusted accordingly. This chain of hospitals being so maintained that wherever gangs of laborers or transport men were congregated or wherever dumps employing native labor existed medical aid was always within easy reach. Apart from this peripatetic character of the hospitals which necessitated much heavy work on occasion and materially increased the problem of maintaining medical supplies the actual conduct of the hospital work was fraught with difficulty. The average lower class Egyptian is a prey to various obstinate and often obscure diseases of which however by far the most important in regard to frequency is that known as relapsing fever. This fever was so common among our Egyptian labor corps and camel transport corps native laborers that usually as many as 80% of the patients in a hospital would be suffering from it. It was the great cause of the depletion of manpower in the two Egyptian corps and from the very earliest days in the campaign all medical effort and ingenuity were focused on the problem of its prevention. At first its cause and vehicle of dissemination baffled all attempts at discovery but at length our bacteriologists succeeded in clearing up the mystery. The specific organism of relapsing fever was definitely isolated and the guilt of its propagation finally brought home to an old offender the ubiquitous body louse. Thereafter the treatment of this complaint both curative and preventive became straightforward if not easy. While as yet no actual cure for the fever has been discovered certain materia medical have been employed against it with promising results and as regards the body pests the inveterate war which wasn't once instituted against them among the native workmen resulted in an enormous reduction in the number of cases of the disease occurring. This latter question however belongs properly to another branch of the R.A.M.C Egyptian Hospitals Organisation and will be dealt with in a subsequent paragraph. In addition to the large number of relapsing fever cases treated in this widely comprehensive system of native hospitals there were a great many cases of eye trouble skin diseases and of injuries due to accidents and to camel bites. The camel has been of the utmost service to us in this desert war. Indeed it is difficult to see how we would ever have got our army through the Sinai wilderness without his aid. We owe him a heavy debt but we have this to lay to his charge as a user. He has proved himself a very shy lock among quadrupeds never failing literally to take his pound of flesh whenever the chance presented itself. These cases of camel bites are constantly occurring among the native drivers. They are always serious, the cruel jaws crushing through everything flesh and bone resistlessly and the wounds thus caused are nearly always septic the camel being a particularly unclean beast about the mouth. This and the many accidents which befell members of the working gangs necessitated frequent operations in the Egyptian hospitals and required the provision for each of a full surgical equipment and staff. There is perhaps no more interesting or informative experience for the students in the art of empire making than that afforded by a visit to one of these field units under the sway of the Egyptian hospitals branch of the R.A.M.C. In them you see the best of Britain's traditions appertaining to the government of oriental races in full, smooth, triumphantly successful working order and you see them on a scale sufficiently large and under conditions sufficiently varied to enable a fairly accurate estimate to be formed as to our chances of making good in the empire sense with this which for all our lengthy occupation of Egypt must be regarded as the newest and latest of eastern peoples to come under our sway. For so long as the old paralyzing clog of Turkish suzerainty remained upon Egypt we were too busy a nation to devote over much thought to a country whose future as part of the British empire seemed indefinitely obscured. Now however that all this ambiguity of relationship between Egypt and the empire has been finally cleared away. We, that is at least the men of the British army in Egypt who may fairly be regarded as typical of their nation are looking at the country and the people with new eyes and wholly new interest as well as appreciation of all that recent changes may portend for Britain and Egyptian alike. When we speak of the Egyptian people it would be as well to make it quite clear that we mean the great bulk of the middle and lower class native born Muslim population the men who do all the work on the land and who vastly outnumber every other class and of these men or bear to the humbler sort you obtain a pretty clear perception in regard to their qualities as human material by a quiet survey of any of our native hospital camps. Practically these camps are all under canvas not only on account of the need for mobility but because the big canvas marquee has proved itself most suitable for almost every hospital purpose on the desert. Taking the same period of six months as before November 1916 to April 1917 we find that there were 17 of these native hospitals under the RAMC in various parts of the war area including the Egyptian base and that in these hospitals an aggregate of some 2,000 beds was provided except at the non-mobile establishment at Ismailia where iron bedsteads are in use these beds consist simply of a waterproof ground sheet and blankets laid upon a given space of sand within the marquee this form of accommodation being found sufficient for all native requirements at Cantara where the whole system can be very conveniently studied there is at the time of writing tentage sufficient for 1,200 beds but this provision can and frequently is extended to over 1,500 the Cantara Egyptian hospital is situated on a well raised plateau of firm sand immediately eastward of the Suez Canal and far enough from the bustling war base to be as quiet as need be for sick and suffering people the first impression you get on arriving within its precincts is one of a seaside camp large and populace but eminently quiet and orderly to all intents and purposes the Suez Canal with its clean, abruptly sloping sandy shores and broad stretch of glittering blue water is the sea and when the wind blows across it the air is as pleasantly salt laden as on any breezy diet Margate the hospital is conducted as nearly as possible on British R-A-M-C lines especially in regard to sanitary matters but it is neither practicable nor necessary to enforce white man routine in its entirety on these bronze-busaged Orientals the Cantara hospital was started in April 1916 with 150 beds since which date it has steadily expanded to the dimensions already stated to keep pace with the increase in the number of natives employed in the district it now serves as the base hospital for over 50,000 Egyptians the average daily admissions are about 100 beside the Egyptian labourers over 700 wounded Turks have also been treated in it from time to time the British personnel consists of 10 medical officers and 8 R-A-M-C men the ward orderlies being natives mainly recruited from reservists of the Egyptian Army Medical Corps the material for the following slight sketch of a day's routine and the work generally of this admirably conducted hospital is derived from an account given personally to the writer on a recent visit by the commanding officer himself and it will be of interest not only because it indicates the difference between the systems of management of our R-A-M-C British and native hospitals but because it incidentally throws various quaint side-lights on lower-class Egyptian character and temperament in this hospital it may be remarked the small separate tent is estued as far as possible the wards consisting of a number of large lofty marquees placed end to end their canvassides being removed except in the rare seasons of inclement weather the wards therefore are more in the nature long spacious sun-shelters open on all sides an arrangement admitting abundance of light and air vastly to the health and comfort of the patients soon after 5 a.m. of each morning the hospital presents a busy scene as it is being cleaned for the day the whole site consists of sand and the patients are expert in giving this attractive appearance the territory of each ward is marked out by a small surrounding sand bank the entrances being indicated in the same way the surfaces of this bank are carefully smooth and sometimes ornamented the gangway down the middle of the ward is treated in the same fashion the patients then lying in a long row on either side the whole interior surface of the ward is smoothed over each patient attending to his own small area he will thus sit or rather squat for hours contentedly patting and stroking it with his lean brown hands this daily grooming of the sand results in a fresh surface being continually exposed but at intervals the whole superficie is removed a new clean sand brought in from outside in the wards the patients lie on the ground each with his blankets and macking toss sheet only the more helpless cases having beds in the special wards before going to sleep the men encase themselves entirely in their blankets head and foot a method which effectively wards off winged pests the helpless patients have their food brought to their bedside but the others gather for meals in the open air in an enclosure marked off by the inevitable sand bank hard by each ward all are given milk at six o'clock each morning breakfast is at eight a.m. and consists of rice milk only for the milk diets but for the rest of lentils dates and bread at midday tea and milk or rice milk only are given dinner is served at four p.m. and is made up of rice milk or meat onions or other vegetables rice and bread the final meal is taken at eight p.m. and consists of milk only the meat at dinner is an unheard of luxury for most of this class of native the more affluent of them would only get it once or twice a week at home in the hospital the official meat ration is a very small one no more than two ounces daily but all the men have a pound of bread for their day's supply which is more than twice that given to the British soldier when eating the Egyptian uses his fingers alone for every purpose the food is served out in fairly large bowls and a group of men squat around each bowl making common cause with its contents there is however never any difficulty with them as to sharing the procedure as regards the medical officers daily round does not differ from that common to other hospitals all cases needing surgical treatment are sent to the Wooden Hut which serves as operating theatre and dressing station only bedridden cases being attended to in the wards it is wonderful with what fortitude, fatalistic composure and childlike faith in the skill of the Effendi Inglesi the native Egyptian submits himself to the most painful wound dressing processes and to what are no doubt the inexplicable methods of British medical science in this regard the Egyptian compares very favourably with his European comprare usually very little discussion and explanation are required to obtain from him a ready consent to an operation the injuries that befall him in his service to the Empire are often of a very trying character as beyond the ordinary accidents of the working day he is as before mentioned especially liable to camel bites which are frequently severe and always badly infected they are therefore very slow in healing and involve many painful dressings while the worst bites may lead to loss of a limb or even the death of the patient with natives in hospital almost the entire day is spent in talking interminable animated discussions go on between them as they sit in conclave the principal topics dealt with being their small money matters and the latest exploits of the dreaded Turk when they are not wrangling together in their inimitable gentle bantering way they are telling each other long tales of enchantment after the style of the Arabian knights or lie crowded together in every spot of shadow fast asleep at three o'clock of each afternoon those who are fit for it go down to bathe in the canal often two hundred or three hundred of them may be seen at a time splashing lustily about like a delighted covey of coots or squatting up to their necks in the shining azure water at this time also they wash their thin summer suits both clothes and men under the fierce desert sun being sufficiently dry for reunion by the time they can be prevailed upon to return to the hospital tales be it understood are an unknown commodity in the lower class Egyptian world the great event of the day however takes place at five o'clock on each evening this is the discharge parade the commanding officer sits in state within the big e-pip tent which serves him for office and receives one after the other all those who are eligible for discharge from the hospital or seek to be liberated for various reasons practically all are eager for their discharge hospital life under British control being rather an ordeal for the native probably his sole experience of the healing art hitherto has been confined to an occasional visit to the village barber who in rural Egypt still for the most part fills the office of medical man to the community quite in the medieval way the native hospital patient however is not always in a hurry to exchange his snug quarters and easy life for the rough and tumble of the desert again now and then a man will be found apparently willing and anxious to spend the rest of his life in the hospital and he will resort to every expedient and exhaust all his powers of persuasion with the medical officer to that end in this case he becomes an adept at making the most and the longest of his affliction and will feign all sorts of ills to get his term of incarceration prolonged not the least difficult of the officer commanding's duties and his discharge parade is to discriminate between real and fictitious disabilities in this matter a thorough knowledge of the quaint variety of Arabic spoken in rural Egypt is almost a signe quay non with the officer in fact all RMC medical officers doing duty in native hospitals are adept at this it would be well indeed if the possession of a fair knowledge of the Egyptian Arabic were officially regarded as a necessary part of the professional equipment of all RMC men stationed in Egypt the language is not an easy one to read or write but it can readily be picked up by ear and a certain facility in this direction should be required of all our men coming into contact with the natives the sequel to this discharge parade is usually a picturesque one those fortunate enough to obtain their discharge especially those whose time of service has expired and therefore are now to return to their homes and immediately go into paroxysms of joy at their deliverance hastily gathering their belongings together they make for the railway station in a delighted vociferous crew clapping their hands rhythmically chanting weird folk songs and waving improvised flags generally in their excitement they crowd into the open trucks that are to bear them away westward to the land of their fathers and long after the train has disappeared round the curve of the line the sound of their rejoicing lingers on the evening breeze you turn your back to the hospital feeling glad somehow that the world is not all progress and culture and that there are still some odd corners left in it where man, as nature made him can yet find a little elbow room the RMC medical officer in command of the cantara establishment possesses all the dominant racial traits which have made British rule over eastern peoples such a success wherever our flag flies but in addition to these his government of the hospital evidences another quality much rarer though also essentially British that of being able to tell one black man from another to realise the fundamental divergences of character and temperament between the various coloured races and to adopt his methods accordingly the writer has no experience of the oriental peoples under our sway east of Suez where the best is like the worst but from a fairly extended acquaintance with the lower class Egyptian the typical Egyptian labour corps or camel transport corpsman he is convinced that upon a true estimation of his peculiar racial qualities depends all our success in governing him both in the present time of war and here after the average Nabob from the far east seems to regard his authority over the native orientals with whom he comes into contact as dependent on the preservation of a demeanour compacted of bridged aloofness suspicion and contempt the whole being reinforced by a carefully nurtured reputation for a ready resort to harshness or downright brutality on occasion but nothing of all this will do in Egypt and the sooner we realise it the better the pure blooded Egyptian is at heart a child and a child of in many ways very attractive and lovable qualities into the bargain childlike what we choose to make of him now he will become and after the like kind he will bring up those other children he is begetting in such large numbers after the nature of the child all the world over he possesses within him the seeds of every good responsibility and the responsibility lies upon us now to see that he develops on the right lines the most disastrous mistake we could well make would be to attempt to rule him mainly by the rod not because he does not sometimes deserve and indeed often gets a sharp cut from the cane of his British overseer he is by nature essentially unwarlike and therefore in the main incapable of profiting in the right way by physical punishment this indeed must be the key note of all our dealings with the Egyptian if he is ever to grow out of childhood into real manhood under our hegemony as in the training of all children the fact must be first established that we are not to be trifled with nor deceived by dissembling or other elemental guile but once this wholesome spirit has been instilled into him our further policy is clear it must be frankly directed towards the development of his undoubted qualities of industry, sociability a good and often keen understanding and a trainable capacity for all those little arts of life which for the want of a better word in his case we must call civilized in these daunting days when we are all high and low taking our turn at blowing the national trumpet the writer need make no excuse for planting here a little fanfarinade on his own account the greatest good thing that ever happened to the middle and lower class Egyptian or indeed for that matter to every man in the country, Muslim or Christian willing to get an honest living by the work of his own head or hands is the fact that Egypt has now unconditionally thrown in her lot with the British Empire the goodness and greatness of this thing may not be so apparent to those in the country falling within the category named upper class hereditary idleness as part of an obsolescent national system never does expire amiably nor even picturesquely the mistletoe is able to live very comfortably at the expense of the apple tree and it can hardly be expected to display much enthusiasm during the first acute stages when it is being compelled to subsist by its own roots but the sentiments of Egypt's mistletoe class of humanity need not concern us here it is the tree itself the mental-hearted, courteous, ease-loving yet truly industrious folk that make up the bulk of the nation towards whom we must direct all our hopes and efforts it is not for nothing that Egyptians have been a subject race have lived under the yoke of one conqueror after another for thousands of years back what they have lost in one way and what they have immeasurably gained in another they lack initiative and dread responsibility as a cat dreads water but they have a chameleon-like power of ready adaptation to imposed ideas that is almost Japanese in quality we have it in our power therefore now to make or mar them the writer were asked to put into one short phrase the vital policy which should govern all our future efforts to bring Egypt into line with the rest of the empire this would be the answer treat the Egyptians as if they were a nation of Boy Scout recruits start them right at the beginning of every elementary principle of honour, discipline, good form healthy hardyhood of body and mind and all the wholesome reasonable give and take comprised in the word neighbourliness it will not be done in a month or a year nor perhaps in many years but it can be done the raw material for the work is no sales air but good silk all through silk purse is sure to materialise in time the Egyptian hospital system for the treatment of the sick and injured of the two native service corps covers as we have already seen all the canal zone between Port Said and Suez as well as the entire desert line of March between the Cantara base on the canal and are further most trenches under Gaza in Palestine it also extends along the northern boundary of the desert to the west of Egypt with this system there exists concurrently a series of isolation hospitals for the treatment of any cases of cholera that may occur among the native population such cholera camps have been established at Deir el-Bala and Sheikh Nuran on our extreme eastern defences and at Rafa el-Arish and Cantara on the desert line of communication there is in addition a special cholera hospital containing 60 beds at Deir el-Bala used exclusively for prisoners of war the great bulk of sick and wounded prisoners is dealt with at the main RMC prisoners of war hospitals in Cairo, Alexandria and elsewhere these establishments being staffed by British orderlies and nursing sisters of the Queen Alexandra's Imperial military nursing service and in themselves form no considerable portion of the general work of the RMC in Egypt but we have well appointed camp hospitals of 200 beds each wholly confined to the treatment of wounded prisoners and those suffering from diseases other than cholera at both Deir el-Bala on our extreme front and at Cantara also a prisoners of war hospital of 60 beds in connection with the Egyptian hospitals branch of the RMC at Port Chufik near Suez all together the enemy can have no reason to complain of any neglect on our part in respect of those who have fallen into our hands and are in need of medical aid apart however from the immense amount of hospital work which has fallen to the lot of the RMC in Egypt through casualties and sickness occurring among the men of the Egyptian labour corps and the camel transport corps we have had much else to do in connection with these native services during the whole of the campaign on the formation of these services recruiting stations were opened in all the important centres of industry in Egypt and at each of these RMC medical officers were continually in attendance to ensure that none but thoroughly fit men were accepted for the work during the same typical period of six months hitherto dealt with some 130,000 natives presented themselves to our doctors for examination at these recruiting stations and of this number 30,000 had to be rejected for various causes mainly eye trouble to which the native Egyptian is peculiarly liable once accepted for service the new recruit is put through a regular curriculum and he becomes a full blown Egyptian labour corps or camel transport corps man taking the methods adopted by the RMC 95th sanitary section attached to the hadra Egyptian labour corps camp as typical of those in vogue at other centres we see a batch of recruits on arrival at once proceed to what is known as the recruits compound this is a walled in enclosure fitted with latrines, ablution benches shower baths, cooking places and living tents and is reserved entirely for new recruits here the men are detained until their turn comes for subjection to the very necessary processes of being washed and disinfected pending this each man has his head close clipped and his exilai and pubes shaved and then usually within 12 hours of his arrival he is ready to proceed with his squad to the disinfection station close by carrying with him his blankets and all personal effects on arrival at the steam disinfector he removes his clothing wraps it together with his other belongings in one of the blankets and leaves the bundle to be dealt with by the disinfecting staff his other blanket serves him as a robe on his passage to the bath house the bath enclosure being gained these remaining blankets are collected from the men to another disinfector which exists on the spot for the purpose the recruits are then introduced two at a time into a large bath of fluid consisting of a solution of Creosol, soft soap, paraffin and sulfur a combination which can be relied upon to put an end to any insect plague in or out of Egypt in this bath each man gives himself and his companion a thorough scrubbing after which he has a plunge into clean water and then proceeds to the equipment store a few yards away where he has served out with a new Egyptian labour corps uniform consisting of brown linen slacks and tunic and also a great coat there remains now nothing for him to do but to put his civilian belongings from the main disinfector and march back to the store where the rest of his equipment boots, putties, cap, etc. is completed the whole process thus described occupies an average time of three quarters of an hour in which period the new recruit is changed into a fully equipped member of the Egyptian labour corps and is ready for service in any part of the war area be it Palestine, Salonika or France but this preliminary lustration by which he has started clean sound and fresh clothes on his new job and his subsequent care in hospital with sick by no means exhausts the list of services rendered to the Egyptian labour corps a camel transport corps man by the Army Medical Service of Egypt having once got him and his belongings clean and free from vermin our whole art is directed to the task of keeping him so no easy task as all will agree on coming to consider the conditions in the case of a great force of native labourers in large or small gangs over a wide and difficult country and these gangs continually shifting from place to place the most carefully devised system of sanitary control is liable to aberration in this matter however the RMC sanitary sections have succeeded admirably even perhaps a little beyond any reasonable expectation the ideal was conceived of giving every native labourer in the service a thorough antiseptic cleansing and his kit a thorough sterilization at least once a fortnight and this ideal has been fairly well realised in addition to the disinfecting installations at all Egyptian hospitals and recruiting depots we established disinfecting stations at three of the most important centres in the military system these were able to deal with the men within a large radius of their several positions but to reach those gangs of labourers scattered about on or near the various ramifications of the desert railroad we had to work on a different plan we equipped three disinfection trains having sterilizing vans supplied with steam from the engine and carrying with them all appliances necessary for the establishment of temporary disinfection stations in sightings of the line within which the train might pull up whenever and wherever the train made a pitch native camps in the surrounding area were duly notified and the men willingly flocked in with their belongings to undergo what could not fail to be a very welcome process to all throughout the period of hostilities from the time these systems came into vogue our ramc sanitary men have dealt with an average of 80,000 native labourers monthly which is a record of useful if rather unromantic service of which we may be reasonably proud seeing that the great scourge of these lower class Egyptians and principal cause of inefficiency among them relapsing fever originates in infection conveyed by the body louse it is small wonder that the military campaign against personal cleanliness among the natives came into full force the incidence of this disease has decreased by 50 or 60% before leaving this well nigh inexhaustible subject of our work for the native Egyptians in our armies employee we must briefly mention what has been done in the matter of quarantine in the last few months as between Egypt and the eastern theatre of war the system of enlisting these labourers for so short a term of service as 3 months though it proved a popular measure and thus materially swelled the stream of recruits had nevertheless one serious drawback it created a condition wherein there was a constant dribble of time expired men back from the war area into all parts of rural Egypt cholera being always more or less present with the Turkish forces and the danger of infection through prisoners deserters etc. being therefore considerable we had to take special measures to safeguard Egypt against this scourge through infection by our returning Egyptian labour corps and camel transport corps men the difficulty was met through the agency of the Egyptian hospitals branch of the R.A.M.C. by establishing two great segregation camps the one at El-Arish and the other at Cantara where all time expired labourers could be detained for such period as would ensure their freedom from contamination in these camps also thorough disinfection of the person and belongings of all men was carried out so that the men returned to their homes free from parasites as well as from germs of disease not the least important outcome of the work of the R.A.M.C. in Egypt lies perhaps just in this small fact every native who enters our service and then goes back to his fellows does so as a living illustration of the advantages of personal cleanliness and with such a receptive, imitative people as the Egyptians his example cannot but have far reaching results the Oriental who has acquired the daily habit of washing himself has already taken a great step along the road to empire or to British ideas of empire at least End of section 19