Ambulance

AMBULANCE, a term applied in England and America to the wagon or other vehicle in which the wounded in battle, or those who have sustained injuries in civil life, are conveyed to hospital. More strictly it signifies a hospital establishment moving with an army in the field, to provide for the collection, treatment and care of the wounded on the battlefield, and of the sick, until they can be removed to hospitals of a more stationary character. In 1905-06 the term "field ambulance" was adopted in the British service to denote this organization. The description of the British service given below applies to the system in vogue in the army after the experience gained in the World War.

The ambulance organization which, variously modified in de tails, now prevails in all civilized armies, only dates from the last decade of the 18th century. Hitherto surgical assistance did not reach the battlefield till the day after the engagement, or even later. In 1 792 Baron Dominique Jean Larrey (1766-1842) of the French army introduced his system of ambulances volantes, or flying field hospitals, like the "flying artillery" of that time. They were adapted both for giving the necessary primary surgical treat ment and for removing the wounded quickly from the sphere of fighting. A corps of brancardiers, or stretcher-bearers, was organ ized about the same time.

Geneva Convention.

Animportant step towards the ameli oration of the condition of the wounded of armies in the field was the European convention signed at Geneva in 1864, by the terms of which, subject to certain regulations, the wounded and the official staff of ambulances and their equipment were declared neutral.

The American Civil War marked the beginning of the modern ambulance system. The main feature of the hospital organization throughout that war was the railway hospital service. Hospital trains and ships equipped with medical staff, nurses, stores and ap pliances, for the transport of cases from the front to the base, were rapidly introduced into other armies.

In the Japanese army a special feature is the sanitary corps, whose duty is the prevention of disease among the troops; it has been brought to a great pitch of perfection, with the result that in the Russo-Japanese War (1 go4–o5) the immunity of the troops from all forms of preventable disease surpassed all previous expe rience. Not only was the army accompanied by sanitary experts who advised on all questions of camping grounds, water supply, etc., but before the war began the Intelligence Department col lected information as to the diseases of the country likely to be the scene of operations, unhealthy places to be avoided, etc.

British Army

System.—Coming now to the ambulance sys tem of the British army, we shall trace the progress of a wounded man from the field of battle to his home.

When a soldier is wounded the regimental surgeon and stretcher bearers apply the "first field dressing"—a packet of antiseptic material which every officer and man on active service carries stitched to his tunic. From the field he walks or is carried on a stretcher by bearers of the Royal Army Medical Corps to the col lecting station, where he is placed on an ambulance wagon and taken to the dressing station. Here his wound is examined if neces sary, but as on the field the first medical officer who examined him has already attached a "specification tally" to the patient, giving particulars of the wound, it will probably not be disturbed. Any urgent operation, however, will be here performed, nourishment, stimulants and opiates administered if required, and the patient moved to the field hospital in an ambulance wagon. From the field hospital he is transferred as soon as possible by ambulance train to the general hospital at the advanced base of operations, and from there, by one or more stages, he is ultimately either re turned to duty or sent home in a hospital ship. In warfare in hilly or uncivilized countries special arrangements for transport of the wounded are adopted. The Indian Medical Service is self-con tained, and by reason of caste restrictions special modifications have been introduced, but the general arrangements resemble those of the Home army.

Different regulations are made by various powers as to the work of the Red Cross societies under the Geneva flag (see RED CROSS). Whereas in Germany and France such aid is officially recognized and placed under direct military control, the English Red Cross societies have acted side by side with, but independently of, the military ambulance organization.

St. John Ambulance Association.

Greatattention has been paid to civil ambulance organization in England. In 1878 the British ambulance association of St. John of Jerusalem was founded. Its object was to render first aid to persons injured in accidents on the road, railway or in any of the occupations of civil life. As the result of the initiative taken by this association, ambulance corps have been formed in most large towns of Great Britain; and police, railway servants and workmen have been in structed how to render first aid pending the arrival of a doctor. The Association, whose headquarters are in Clerkenwell, London, has branches in most parts of the British empire.

Ambulance Wagons.

Britishambulance wagons are built to convey f our patients lying down, one seated, and the driver, or fourteen persons all seated. The Indian ambulances are small two wheeled carts drawn by two bullocks or mules; very strongly made, they are capable of holding two men lying down or four sitting up, besides the native driver.