Ambulances - Expo Paris 1889

The exhibition at the Esplanade des Invalides, which shows us, with the Ministry of War, the most perfect means of destruction, could do no less than to place the remedy next to the evil: the ambulance next to the homicidal equipment, and the dressing kit next to these pretty machine guns, which can destroy a battalion in a minute. This Ambulance Exhibition consists of three separate installations:
The French Red Cross, a society for the relief of military wounded, presided over by Mme la maréchale de Mac-Mahon, Duchess of Magenta;
The Union des femmes de France, whose honorary president is Mme Carnot,
And the Association of French Ladies. The last two associations are only branches of the Red Cross, but they have their autonomy and independent existence. Moreover, they differ somewhat in their programme. While the Red Cross, placed under the direct dependence of the Ministry of War, only deals with military wounded, the Union des femmes de France and the Association des Dames françaises, also deal with helping civilians, victims of public calamities. At the Union, the quantum to be used for civilian relief is set at 20/0 of the Society's resources. What feeds the coffers of the three associations is, of course, public charity. It is never lacking; but it must be recognised that the field is wide, and that, if ten times as much were given, it would still be ten times too little.

These are good works, holy, great, patriotic in the broadest sense, human in the best possible way. They were born out of our disasters, and must therefore be more sacred to us. The Society for the Relief of the Wounded, the French Ladies, the Women of France, they represent the union and the effort of all the anguish of mothers, women, daughters and sisters. It is a second army, the one that relieves, alongside the first, the one that relaxes. The duty to be of the one is as narrow as the duty to be of the other.

But there is no need to speak of duty to ask women for devotion, charity, the courage of long vigils at the bedside of the wounded, the courage of research on the battlefields, the more difficult courage of impassivity in the face of bloody operations.
They have all this in a corner of their hearts.
The cult of the wound and the love of rags, said Beaudelaire.
I don't know which grumpy philosopher said that women were only so good ambulance drivers because they like to see men suffer.

This is not a joke, it is blasphemy.


WOUNDED RELIEF SOCIETY

The important Exhibition of the French Red Cross is installed at the very end of the Esplanade, opposite the cannons of the Invalides. It is very simple. A space circumscribed by a barrier, and opening with an arch a few metres high. That is its external appearance. The Exhibition itself is made up of open-air installations, barracks, a station ambulance and a medical train. All of this is very interesting, but before looking at it in detail, it is worth knowing how the so-called Red Cross associations came into being.

In October 1863, an important conference was held in Geneva from 26 to 29 October, the purpose of which was to determine the bases of the law of nations between belligerent parties and the protection of the wounded. The decisions taken by this conference form what is known as the Geneva Convention, to which all civilised countries have successively adhered. The last adherent is Japan, and I believe that China is the only great nation, which is today outside the convention.
This convention places under the protection of the Geneva flag, white with the red cross, neutrals, non-belligerents, the wounded and relief or hospital establishments. The convention flag and the red cross armband are a safeguard that is respected throughout much of the world.
As governments acceded to the Geneva Convention, Red Cross Societies were formed in each country, with official investiture. The French Red Cross was the first to be formed.

As soon as you enter, you find, on the left, a hut in which the linen room is set up, which is in full operation; half a dozen ambulance drivers are cutting and sewing the shirts, sheets, and bandages necessary for an ambulance service.

Cupboards contain the strips, the packages of window cloths, the bags of lint. All this is not very cheerful, but for many it will stir up painful memories, badly slept. One remembers having, in 1870, women, or young children, in the families and in the schools, frayed into lint the old cloth, which one sought at the bottom of the cupboards... Dressing cloths were lacking, and more than once our doctors had to resort to the strangest devices to make up for this shortage.

Today the war may come. God forbid that it should come soon. We are ready on this side, as on the other.
Next to the linen room is a model stable, and then several types of carriages for transporting the wounded. The principle of transport is generally as follows: The wounded person, raised on a stretcher, must not be moved from this stretcher. The transport bed therefore consists of the stretcher, suitably suspended, either by springs or by leather straps. In a medium-sized van, six wounded can be placed on the bed using this system. A strong wooden crossbeam at both ends of the van divides it into two rows of three wounded on top of each other. If the wounded can be seated, benches, which are raised, allow fourteen people to be placed in the same van.

Another type for one person - the so-called town car - has a bed for the wounded and a bench for the doctor or his assistants.

Of course, instruments, apparatus and supplies follow in other vans. But all this is reduced as much as possible. Thus the kitchen van, although so wonderfully fitted out, has none of the research that we will find in the other ambulances. These, in fact, are for the front line, they are the battlefield ambulances. They have to operate with all the materials they can get their hands on and carry only simplified equipment.

So the real type of front-line ambulance is provided by the means of transport, ships and railways. The development of railways will almost always make it possible in the future to bring a medical train within range of the battlefield and to evacuate the wounded from there.

This has led to numerous trials of casualty trains. The Compagnie de l'Ouest created a railway ambulance system. The wagons were shown at the War Ministry Exhibition. But this trial is mainly based on the use of existing wagons and their transformation into casualty wagons. Here we find a train completely composed for the ambulance service. It consists of no less than eight wagons painted in light grey - almost white - with the red cross and the flag of Geneva on each car. This train was curiously visited by everyone, especially by the soldiers, who found in it the assurance of enlightened care, in case of misfortune.

The first carriage was the supply car. The canned goods, fresh meat, wine, bread, in a word all the provisions necessary for the feeding of the wounded are there, stowed in a well determined order and under the hand of the cook, who reigns in this carriage and in the next.

This one is the kitchen. It is set up as well as that of a large restaurant. In the four corners, large tanks hold several hundred litres of water. The battery is all copper.

The three wagons that follow - there would be seven or eight times as many in a real train - form the ambulance itself; they each contain either 15 or 18 beds. The 15-bed wagons contain, instead of the 3 missing beds, the washbasins and wardrobes. These beds are quite comfortable. However, they lack flexibility in the suspension. The jolts of walking must mean terrible shocks for the wounded.
The lingerie, the pharmacy, the library and the various equipment occupy the seventh wagon. The next one, which is the last one, is used as an office and a bedroom for the doctor and the nurse or ambulance driver.
The ambulance on the railway line, known as the evacuation ambulance, was bound to lead to the creation of the station infirmary, either as the departure or arrival point of the medical train. Since 1884, the Minister of War has entrusted the Red Cross with the establishment and service of infirmaries in 54 stations.
In some cases, all that was needed was to transform the existing premises. But in others, everything had to be created, and mobile ambulances had to be used.
The one shown here is a portable construction from the Daecker system. It is the first model of a series that will soon be sufficient to provide our station infirmary service wherever it is needed.
It is 27 metres long and 6 metres wide and comprises: a vestibule, a storeroom, a nurse's room, an ambulance room for 15 beds, an officer's room, a doctor's room, a kitchen, a laundry room, a pantry and a pantry.
All this is made of cardboard panels mounted on wooden frames. The panels are double. The outer one is waterproof. The inner one is non-flammable. Between the two, there is an air mattress, which ensures a constant temperature in the ambulance.
To transport the entire infirmary, it is packed into 40 boxes, which, when the construction is assembled, form the floor. These boxes weigh about 200 kilograms each, so the total weight is 8,000 kilograms. As for the assembly, it requires no other tool than a hammer, and three or four men, without any special knowledge, can assemble the infirmary in less than ten hours, just by following the numbering of the parts.

The ambulance ship, which is represented by a reduction, is of a system easy to understand; the whole of the part below deck is converted into dormitories. The antiseptic precautions must be extremely meticulous, because of the many nooks and crannies that a boat offers.
Next to this boat is a collection of the artificial limbs which the Red Cross gives to its amputees, and in order that it should not be supposed that a cripple is a man forever useless, the society has exhibited one of its ex-pensioners, who, equipped with an artificial arm, is engaged in the most arduous and complicated work.
With a few transformations, which he has made to some of his tools, he can perform any manual task: writing, planing, sawing, chiselling, filing; he also handles the hammer, the cold chisel, the plane or the crankshaft.
This is consoling and there is not much reason to feel sorry for the loss of one or two limbs, since they can be so easily replaced. It is the shoulder that moves all the joints of this artificial arm. An anecdote on this subject:
It is known that the tenor Roger had - without being proud of it - an artificial arm. It was a very sophisticated device that almost gave the illusion. One evening, in I don't know which opera, Roger raises his arms to the sky, one arm for good and the other. A click is heard.
It was a spring in the artificial arm that had shifted, and the arm had to stay in the air, much to Roger's annoyance, who had to go backstage to set the rebellious limb straight.


THE AMBULANCE SERVICE OF THE PREFECTURE OF POLICE

Behind the exhibition of the Red Cross, under a small shed, the Prefecture of Police has grouped its particular ambulance and health services; they are quite small. It must be said that the real ambulances of Paris, those organised by the Société des ambulances urbaines, are not there. They are on the Champ de Mars.
Here we find first of all a model of those tents which the Prefecture has erected at crossroads when there are crowds of people in the streets. Next to this tent, the canopies for the transport of feverish people and the mobile steam disinfection oven, which is placed - very few people know it - at the disposal of all those who request it, based on the stay at home of a sick or dead person, as a result of a contagious disease.


THE FRENCH LADIES

The aim of the Association des Dames françaises, like that of the Union des Femmes de France, is not to provide front-line ambulances, such as those we have just seen, but to prepare ambulances in peacetime and the necessary dressing equipment in wartime. It is on-the-spot ambulances that they tend to organise, therefore most often quite far from the battlefield, generally in the third line. Also the type that the French Ladies present to us is the most perfected that can be in the present state of science. It is a temporary and transportable hospital, with about twenty beds, based on the principles of the most rigorous antiseptic treatment. It is known that there are two surgical regimes for sanitary facilities. One, based on the impossibility of producing infectious microbes - pathogens, according to the faculty; the other on the destruction of these microbes. The first system is aseptic, the second is antiseptic.
At the Society for the Relief of the Wounded, we do not have any firm ideas on this. It is the doctor in charge of the ambulance who, according to the conditions in which he finds himself, and also according to his personal preferences, determines which system will be followed.
In the ambulances of the French Ladies, the system is resolutely antiseptic. All the equipment was made of metal or cloth, which was resistant to the terrible bacilli. The ambulance exhibited at the Esplanade, close to the Ministry of War, is a fraction of a very ingenious system of transportable ambulances, composed of four cross-shaped buildings forming four wards for the wounded, joined by a fifth building containing the kitchens, the shops, and the doctor's or doctors' office.
These outbuildings have been added to the ambulance itself, which could otherwise contain about twenty casualties. The equipment of the four rooms and the common part forms the load of two carriages with two horses each.
This tent is made of canvas. It is double, i.e. it is made up of two tents, one inside the other, separated by a space about one metre wide, which forms an air mattress against temperature variations. The outer tent is non-combustible, the inner tent is antiseptic. The outer tent is non-combustible, the inner tent is antiseptic, and has no direct communication with the outside air, as all openings open onto the separation corridor.
The height, which can be raised to four metres in summer, can be lowered to three metres in winter, thus avoiding heating costs.
The entire frame is made of iron, as are all the bed parts. As for the sleeping material itself, it has been made as antiseptic as possible, and the main blankets are made of wood wadding stitched between two light fabrics. Such a blanket, very warm and very light, is easy to disinfect. Moreover, as it does not cost more than one franc, it can be sacrificed without great damage.
Everything that the most demanding surgeon could wish for in order to carry out an operation has been gathered together in a small room at the entrance to the tent. On a board suspended from the ceiling are the jars which, by means of siphons, allow the antiseptic to be applied around the patient. Three pharmacy and dressing canteens, and one for surgical instruments, complete the equipment, which is up to date with the latest scientific discoveries. There is a ward for the nurse, and a room for the duty officer, isolated from the ward, just as the kitchen is isolated from it. Each bed is equipped with a call bell.
A very ingenious and simple device, also based on the use of wood wool, allows ice to be kept for eight or ten days, which may be needed either for drinks or for dressings.
I am not talking about the cloths and dressing devices. The French Ladies exhibited a series of their works in the Hygiene and Assistance pavilion. There is nothing better to do than what they have done.
Before leaving the French Ladies, two pieces of information about their association. - The head office is at 24, boulevard des Capucines, in Paris, and the annual subscription is ten francs.


LES FEMMES DE FRANCE

... "The Rear-Admiral commanding in chief the naval division of the Indian Sea and the expeditionary corps of Madagascar;
"Knowing the feelings of the troops and sailors serving under him, puts on the agenda,
"The Society of the Union des Femmes de France and that of the Relief of the Wounded, both of which by their enlightened zeal and patriotic solicitude have contributed so much to the welfare of our sick and wounded.
"Whatever our gratitude to them may be, it will never be equal to the services they have rendered us.
This is the order of the day which, on 14 March 1886, Rear-Admiral Miot signed in Tamatave harbour. It says more than a long explanation of what the women of France have accomplished. Let us see what their means of action are.
In all the districts of Paris, and in each of the 108 provincial committees of the Union, elementary courses in hygiene and minor surgery, bandages, etc., are organised.
The aim of these courses was to train a corps of hospital nurses, qualified after examination, capable of helping doctors in wartime. The Union also trained nurse-brancardiers, for the heavy work that women could not perform, either in the ambulance or on the battlefield.
The ambulance exhibited by the Union is an aseptic hut, raised on beams to allow air circulation. The equipment is antiseptic. The organisation here is much less perfect than that of the French Ladies. The Union des femmes de France aimed to provide a lot of equipment if necessary, and a considerable number of nurses, rather than to have a rigorously scientific organisation. Thus, in order to avoid storage costs in peacetime, donations in kind for the training of the Union's equipment were left with the donors and only claimed in wartime.
On the central table of the Union hut is the bust of a noble and holy girl, Sister Marthe, a nun from Besançon, on whose chest are as many decorations as on the uniform of an old general. She was one of the ancestors - if we can speak of a nun in this way - of all the devoted ambulance drivers we see today.
The women of France could not have had a more beautiful patronage.


THE PEACE LEAGUE

It will not be out of place to devote a few lines here to other women who have also taken up the cause of war, not to heal the wounds it causes, but to suppress the war itself.
They are American women who have set up behind the Social Economy Exhibition, in a corner of the pavilion occupied by the Universal Society of Women for Temperance. Their exhibition is limited to a few pamphlets, which they distribute with a deep conviction which alone would prevent them from being considered ridiculous.
They do not seem to me to be laughable, these women, utopians if you like, who believe that it is better not to be injured than to have to heal injuries.
At the beginning there were only a handful of them. Today they are supported by powerful societies, in France, England, Italy and especially in America. The idea that they have sown, through mockery and in spite of machine-gun fire, is germinating. It will become a great tree. They did well, these women, who believe in the superiority of arbitration over war, to come and plant their peaceful flag here.
Listen to this indictment of war:
"The means of discussion adopted by the great kingdoms of Europe is that of the wild beasts. The two antagonists fight until one of them is put out of action, until thousands of homes are desolated by mourning, and the earth reddened by the blood of the slain.
"Only events are more considerable when two nations are at war than when two workers quarrel. There are horses and guns and the sound of battle; newspaper correspondents write vivid accounts, and people say that this or that battle was a glorious victory, even some go into the churches to give thanks to God with hymns of praise.
"In spite of this, you may be sure that the principle of war is everywhere the same, and that the results are in some measure similar, but in different proportions, when two nations fight with power, or when two poor ignorant men fight like savages, until the one falls and the other can see little to guide him.
I can hear the answer from here: the best way not to have war is to be able to make it. Listen again to this eloquently sarcastic page by Adolphe Roussel:
"Armed peace! Two words that scream to be together. It is as if one were saying: a living corpse. Tacitus said: Si vos pacem para bellum: if you want peace, prepare for war; would he not have done better to say: If you want peace, prepare for peace! You want one result and you are preparing for the opposite result. That is what armed peace is. An enormous contradiction which only lived because it had a Latin saying to support it... You melt cannons, you make cartridges, you multiply the elements of destruction. But don't you bring the match closer to the tinder? Are you quite sure that you, who do not want a fire, will not be burnt in your house? That is armed peace!
For us, after these two studies made here, on the occasion of this great congress of peace, on war and the means of repairing the evils it causes, we can only hope that one day this old disease, almost inherent in human nature, will disappear for ever and that everywhere in the universe, the good word will resound which fell upon the world, nearly nineteen centuries ago: "Peace on earth to men of good will."

©Livre d'Or de l'Exposition - Paul Le Jeinisel.