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SYDNEY-EMDEN
ENGAGEMENT
9TH NOVEMBER 1916
_________________
H.M.A.S. Sydney.
Sir,
I have the honour to submit a report on the action with S.M.S. Emden
on 9th November, 1914,off Cocos Island.
At 7.30 a.m. I heard the rumour that a strange war ship was at the
entrance to Cocos Island, 50 miles distant. Soon this was confirmed,
and though we had had many false alarms previously, 1 went to the
sick bay and gave instructions to S.B.S. Mullins to get everything
below and prepare for action.
The stations for the surgical party are the fore and after
ammunition lobbies for the stretcher bearers with their stretchers,
and two theatres, one for each surgeon and his assistants, are
prepared in well separated stokers' bathrooms, which are situated in
the tube running up in the centre of the ship. The bathrooms are 10
feet by 8 feet by 7 feet in size, and are supplied with hot and cold
water, also they contain lockers in which dressings can be stowed.
Though not quite below the water-line they are well protected-above
by two decks, and on the sides by armour and by coal bunkers. One of
these bathrooms 1 have appropriated, and it is permanently rigged
out as a theatre, with operating table, instruments, and dressings
stored there for immediate use.
Unfortunately, only two days before the action I had everything
taken up to the sick bay, and had the bathroom painted out,
intending to return to it on this very day when the paint was dry.
Before the action began at 9.30 a.m., there was only time to get
things down below without proper stowing, so that there was
confusion, and one could not put one's hand on things as quickly as
would have happened at any other time. The No. 2 action theatre is
not kept ready, but is hurriedly fitted out with a sick bay mess
table as an operating table, and stores are taken along the tube
from No. 1 theatre. Adjacent to these stations are six other
bathrooms, which are cleaned up as well as possible under the
circumstances, and are very useful as shelter places for the wounded
as they are brought below. In addition to the water supply in the
bathrooms I had an emergency supply of boiled water in the Captain's
and the wardroom galley further aft along the tube. It was fortunate
this was so, as ten minutes after our guns had been firing, the
water came through the bathroom taps black, muddy, and useless.
On sighting smoke I went round the guns and to the fire control
stations to see if the first-aid bags were correct, thence to see if
anything useful had been left behind, and before I was able to get
below, our guns had opened fire. The Emden soon hit us, and five
minutes to ten minute's the first wounded man was brought below to
me by an unengaged gun's crew, the stretcher party, having orders
from me not to go on deck during the action unless directly ordered.
The first man was " A," Ord. Sea., R.A.N. He had a fractured right
leg and thirteen shell wounds besides. He was in great agony, and I
gave morphia, and ordered Mullins, S.B.S., to attend to the wounds
and quickly apply a splint, as by this time a constant stream of
wounded men, who required urgent attention, was being brought below.
The second case was " B," A.B., R.A.N., shot through the chest and
bleeding freely,, with the apex of the heart beating through a hole
in the chest, loud inrush of air through the wounds and marked air
hunger. Pads were rapidly applied to the wounds with tight bandages
and a large dose of morphia was given.
Before this case was attended C," A.B., R.A.N., was brought down. He
had various shell wounds in the right leg, thigh, and buttock, and
his right eye had been pierced at the same time by a small fragment
of shell. "D". P.O., RN., and "E," A.B., R.A.N. were carried below
immediately after. These latter. two were very badly wounded, and
the former was in terrible agony. He had been shot through the
abdomen left hypogastric area, the fragment emerging from the right
lumbar region, leaving 8 inches of omentum hanging out of this
wound. Besides this, patient was burnt from head to foot. "E" was
shot through the base of the heart and soon died. I hurriedly
administered large doses of morphia and attended to first dressings.
Meantime, two more men, " F." A.B., R.A.N., and " G." Ord. Sea.,
R.A.N., had been brought down, and all available space near my
station was taken up, so I gave orders to the stretcher party, some
of whom had arrived to give first aid assistance to convey the
wounded who were temporarily dressed to the ward room, and place
them on beds and blankets taken from the cabins.
"F" was badly wounded in both feet, the left foot being almost shot
away. "G" had a large gaping wound in the right thigh and had severe
cordite burns of face, hands, and forearms. Whilst these men were
being attended to, I received a message from the Captain to send for
a wounded man on the upper bridge. I gave orders to the forward
stretcher party to bring this man down to the theatre. Soon after
this, all the wounded, with the exception of "E," A.B., who had died
within ten minutes of coming down, had been removed to the ward room
and laid upon the beds on the deck. This place was only protected by
thin armour, but room had to be made near the theatres for probable
fresh cases, and this was the only available space. Fortunately, no
damage was done to this part of the ship, and now the Emden was not
so dangerous. Another case, " H " A.B., R.A.N., who had been wounded
in the left thigh and right arm, was soon dressed and taken to the
ward room.
We were now clear round our station, and I went aft to see the
wounded in the ward room, on my way passing Surgeon Todd's station.
He had all this time been equally busy, and been handicapped by the
fact that on four occasions his sick-berth attendant had fainted. He
had attended to Lieut. "J." R.N., wounded in both calves and right
thigh, with much haemorrhage;
"E," A.B., R.A.N., slight wound left knee; "L," Ord. Sea., R.A.N.,
severe cordite burns of face, hands, and forearms; "M," Ord. Sea.,
R.A.N., wounded left kidney; "N." P.O., R.N., shock and injury to
left knee.
After visiting the ward room I returned to No. 1 theatre and found
that the stretcher-party had returned from the upper bridge with the
above-mentioned wounded man. It had been a very difficult place to
get at. However, with the aid of a Neil-Robertson folding stretcher
it had been achieved with no great loss of time. This stretcher, by
the way, was found to be most useful and well adapted to a ship of
this class, with steep stairways and narrow hatchways and passages.
The wounded man was "O." A.B., RN., his left leg had been shot away
at its junction with the body, and was a horrible sight. He had lost
a tremendous amount of blood, and was almost dead on arrival below.
I sent for Surgeon Todd, and got the patient's clothes cut away
rapidly, and had him placed on the operating table. We then
administered one pint of normal saline subcutaneously, and started
to trim up the stump, which consisted of a ragged end of skin,
fascia, muscles, nerves, and vessels, longer anteriorly than
posteriorly. In fact, there was scarcely enough flap left to cover
the stump. After having made a few cuts in clearing away the ragged
ends, the patient died. He had been wounded some time and the
haemorrhage had stopped when he arrived below, but it was hopeless
from the outset, and he must have lost a fatal amount of blood in a
few seconds during a hot period of the engagement, when nothing
could be done for him.This was the last of our wounded, excepting
two slight cases -- "P.'' Ord. Sig., R.A.N., small fragment of shell
in right forearm, and,"Q," A.B. R.A.N, slight wound in foot. These
latter two were attended to some hours later. Cease fire sounded at
11.15 a.m. after we had been working two solid hours In confined
atmosphere, and a temperature of 105 degrees F. The strain had been
tremendous, and S.B.S. Mullins who had done wonderfully well with
me, started off to faint but a drink of brandy caved him, and
likewise myself. Our clothes were saturated with blood and
perspiration, and altogether it bad been a terrific two hours of
high tension. We had been ably assisted by the first aid party, and
specially by Tilbrook, Off. Std., R.A.N., Holley, M.A.A. R.N.,
Paymaster Norton, R.A.N. and Chaplain Little, R.A.N.
The ward room now contained eleven cases, and most of them were
restless and groaning in agony. The initial dose of morphia in no
case less than ½ gr. had been of slight value and I have good
reasons to suppose that the solution in the ampoules supplied had
deteriorated. Fresh doses of, morphia were administered, and iced
water, soda water, and brandy, to various cases as thought fit. The
initial lotion used for wet dressings and cleaning was hydrarg.
perchlor., mainly because it was convenient. The picric acid
dressings in the first aid packages were found most useful in the
case of burns. . During the, action the space below seemed like a
mad inferno. The tube was full of men belonging to the ammunition
and fire parties, and, at the best of times, there is little room
here, so the constant supply of wounded men was considerably
hindered. All this time we knew not how the fight was going. We
could only hear the shouts for ammunition and the continued rapid
fire of our guns. At one time we heeled over, and the operating
table, with "O" upon it, took charge. It seemed as though we had
been hit, but it was only a sudden alteration of course, as we soon
found out.
Our constant attention was now taken up by two cases- "D" and "B".
Normal saline was administered, in the first case subcutaneously, in
the latter intravenously; wounds were re-dressed, and all methods of
reducing shock tried. "D" was hopeless from the first, and died two
hours after being wounded, after going through much pain. "B"
somewhat improved after the saline, but air-hunger was pronounced
and he complained of constriction round the chest, and tried to
remove the bandages. There was oozing of blood from the wound and
pulse was very weak. The other cases were not quite so urgent, but
many were in considerable pain, and all that could be done was
temporary until operative interference could be carried out. The
ward room was hurriedly rigged up as a hospital, and lotions,
dressings, and instruments were placed about. The first-aid party
did excellent work now in looking after the wants of the wounded.
The actual extent of the injuries could not definitely be made out
until the cases were on the table. As soon as the sick berth staff
could be spared, I gave orders for the sick bay to be rigged up as
an operating theatre with all despatch. This entailed an enormous
amount of work on account of the state of the recent site of
activities and of the sick bay which was flooded with water from the
fire mains.
The muddle below was unavoidable owing to the lack of space and the
speed with which one had to work, so it took some time to sort out
things and have everything conveyed back and arranged in the sick
bay.
Besides this, there were many interruptions due to requirements of
the cases, and all through the afternoon and evening German sailors
were being picked up from the water, some of them in a very
collapsed condition. One man had been in the shark-infested sea for
nine hours, and he was brought round after much trouble. Next day he
was no worse off for his immersion.
It was found impossible to do any operative surgery until the
following day for numerous reasons, nor was it considered advisable
on account of the condition of the wounded. The sick bay staff were
too done up to get the theatre ready, with instruments and dressings
sterilized for the first day, and neither Surgeon Todd nor myself
were in a fit state to undertake operations until we had rested.
Until midnight we were attending to the wants of the patients, doing
dressings, giving hyperdermic injections, passing catheters, &c. The
two sick-berth ratings were sent to bed at 10 p.m., thoroughly
exhausted, and Surgeon Todd and myself took four-hourly watches from
midnight. The first-aid party and volunteer nurses under Tilbrook
and Holley, were told off into watches to do the nursing. Early next
morning we arrived off Cocos Island, near the cable station, and
having ascertained the damage done we took off the Eastern Extension
Telegraph Co.'s Surgeon, Dr. H. S. Ollerhead, to help us with the
German wounded. We then steamed back to North Keeling Island to the
Emden. We now had the sick bay rigged up as a theatre, having
unshipped the beds and made as much room as possible. Our great
difficulty was lack of space and trained assistance. We had used up
all the sterile towels on the previous day and had no chance of
getting more.
The shortage of trained theatre staff, with lack of conveniences,
caused much delay in the preparation of the theatre between each
case, and the actual operations were delayed for the same reason.
There was also much delay in getting instruments sterilized,.and one
could not get what was required in good time. Consequently, the
asepsis was not what it might have been. Later in the day we
organized a theatre staff from volunteers. They helped to clear up,
held basins and receptacles and and did remarkably useful work with
composure that was astonishing, - since they were present at many
bloody operations and gazed upon some sights to which none of them
had been previously accustomed. Surgeon Todd acted as anaesthetist
and Dr. Ollerhead assisted me with the operations.
The first case we took was "B," A.B. He had had a restless night,
and from his dyspnoea and the oozing of blood, it was obvious that
there was much blood in his pleural cavity. His colour was bad,
likewise his pulse. Chloroform was administered. Examination showed
that a fragment the size of sixpence had entered his chest in the
right axilla and had tracked downwards and forwards to the left,
through the pleural cavities, finally emerging through a large
ragged hole just below the apex of the heart. In fact, soon after
the injury the apex of the heart could be seen emerging with each
thrust. A piece of the sixth rib had been carried away leaving a
gaping wound. This wound was enlarged, a piece of the rib removed,
and a search was made for bleeding points. This search could not be
prolonged owing to the patient's condition, so I swabbed out the
blood from the left pleural cavity, and a considerable amount of
gauze was inserted therein and a tight binder and pad then applied.
The patient was removed to the only bed left in the sick bay, and
saline given subcutaneously. The patient rallied considerably, but
later on haemorrhage occurred, and he died two or three hours after
operating.
The next case taken was "J." This case was shorter and less serious.
He had been struck from behind by a bursting shell and obtained
numerous wounds in both lower limbs. His left leg had been traversed
by a fragment which left a jagged sinuous hole through the calf,
just below the knee joint. His right calf was pierced, having a
large ragged hole, charred at the edges, the fragment being deep in
the muscles. There was another smaller deep hole in his right thigh
on the inner surface, and numerous smaller wounds on buttocks and
back. The patient had had considerable haemorrhage which was
controlled by plugging and pressure. Search was made for fragments,
but none could be felt with a probe, and it was decided not to cut
down and look for them because more harm than good would have been
done. The wounds were, therefore, thoroughly cleaned and syringed
out with hydrogen-peroxide and plugged with iodoform gauze and with
careful dressing they remained clean, and patient was doing well
when he left the ship.
There was a good deal of destruction of muscle and nervous tissue,
but the main vessels and nerves had, presumably, not been damaged.
An "X-Ray" photograph, taken at the Colombo Hospital, showed
numerous pieces of shell in his right leg, none very large, and it
was there decided that it would be unwise to remove them then.
By this time we had returned to the Emden, which was flying distress
signals, and arrangements had now to be made for the transhipping
and receipt of about 80 German wounded. The figures are the
estimates of the surviving German surgeon, and there was never
opportunity of verifying them, but they are considered approximately
correct. All available stretchers, hammocks, and cots were sent to
the Emden with a party, under Dr. Ollerhead, who did not return
until the last patient left the Emden some five hours later. Even
then some Germans who had got ashore could not be brought off until
the following day (Wednesday). The transhipping was an exceedingly
difficult and painful undertaking, as there was a large surf running
on the beach where the Emden went ashore, and she was so much of a
shambles that the shifting, collecting, and lowering, of the wounded
into the boats was necessarily rough. They were hoisted on board us
in cots and stretchers by means of davits, but there were no such
appliances on the Emden One German surgeon, Dr. Luther, was intact,
but he had been unable to do much, and for a short time was a
nervous wreck, having, had 24 hours with so many wounded on a
battered ship with none of his staff left and very few dressings,
lotions and appliances. The state of things on. board the Emden,
according to Dr. Ollerhead was truly awful.
Men were lying killed and mutilated in heaps, with large blackened
flesh wounds. One man had a horizontal section of the head taken
off, exposing mangled brain tissue. The ship was riddled with gaping
holes, and it was with difficulty one could walk about the decks,
and she was gutted with fire. Some of the men who were brought off
to the Sydney presented horrible sights, and by this time the wounds
were practically all foul and stinking, and maggots 1/4 inch long,
were crawling over them, i.e., only 24 to 30 hours after injury.
Practically nothing had been done to the wounded sailors, and they
were roughly attended by our party and despatched to us as quickly
as possible. A cook's mate, named Fulton, did some exceedingly
disagreeable work with, great credit to himself in connexion with
this.
The best arrangements possible were made under the circumstances for
the receipt and treatment of the wounded as they arrived. . All
blankets and beds available were drawn from the stores, and most of
the officers went without them. Still we had nothing like enough,
and the German sailors had, in many cases, to put up with beds most
unsuitable for wounded men. As they came on board they were taken
down to the temporary hospital in the ward room, where Surgeon Todd
and myself attended the more serious cases and directed the first
aid party with the simpler ones. I tried hard to keep the sickbay
clear and ready for operations later, but we were soon crowded out
of the ward room and the sick bay had to be used as a dressing
station, the wounded being placed along the neighbouring corridors
and spaces adjacent and soon there was scarcely room to move there.
Besides the 70 wounded received that day, there were over 110
prisoners and 20 Chinamen from the sunken collier, so the crowding
can be imagined, seeing that we were a crowded ship before. Of
necessity the work done now was only immediate and temporary till
the cases could 'be sorted out and put under anaesthesia in a clear
theatre. From 35 to 40 of the cases were serious, the rest being
more or less slightly wounded, and they were able to help themselves
somewhat and wait. The condition of many was pitiable. Some had legs
shattered and just hanging; others had shattered forearms ; othes
were burnt from head to foot; others had large pieces of flesh torn
out of limbs and body. One man was deaf and dumb, several were stone
deaf, in addition to other injuries. The worst sight was a poor
fellow who had his face literally blown away. His right eye, nose,
and most of both cheeks were missing. His mouth and lips were
unrecognisable. The tongue, pharynx, and nasal cavity were exposed,
part of his lower jaw was left and the soft tissues were severed
from the neck under his chin, so that the face really consisted of
two curtains of soft tissue hanging loosely front the forehead, with
a gap in the centre, like an advanced case of rodent ulcer. In
addition, the, wound was stinking and foul with copious discharge.
The case was so bad that I had no hesitation in giving a large dose
of morphia immediately, and after cleaning the wound as well as
possible, a large dressing was applied, and he was removed to the
fresh air on deck. The odour was appalling and it was some time
before the sick bay was clear of it. The patient lingered from four
to six hours afterwards in spite of repeated liberal closes of
morphia. Another face injury was almost as bad. Practically the
whole right side of the face was completely blown away. His
temporal, pterygoid, and maxillary regions were deeply exposed, and
temporo-mandibular articulation was entirely removed. One had not
time to examine these cases for minute details, but they were very
instructive, and showed how hard it is to kill a man with face
injury. In addition, the wound was septic and most offensive. I had
no hopes for his life when he arrived, but he seemed to struggle on
and five days later, on arrival at hospital at Colombo, it seemed
likely that he would live. Later news tells us that the patient is
doing well and they hope to fit him out with an artificial right
half to his face.
There were four cases of fractured forearm, two of which I amputated
in the middle third of the arm - both did well. There were, only two
cases of fracture of the lower limb, both being the leg, which was
in each case badly mutilated. One was amputated successfully in the
middle third of the leg by the German surgeon; in the other case I
had to amputate through the lower third of the thigh. This case
died.
Another face injury was rather severe. He had his right cheek turned
down as a flap from the level of the upper lip, in addition the
mandible was fractured and a piece of skin, fascia, and muscle the
size of a large plate was blown out of the middle of the inferior
surface of the left thigh. Later, when we were attending this case,
it was suggested to me that the limb be removed. but though there
was much destruction of tissue and the wound was very foul, I
refused to allow this to be done and after events proved the wisdom
of this, as the wound cleaned up and the limb was saved. There were
many cases of severe burns, two of which had head injuries in
addition, and died on board. One of these was an engineer, who had
suffered from pneumonia for six weeks on board the Emden. Altogether
four deaths occurred on board us from among the German wounded. Most
of the remaining cases had multiple lacerated shell wounds, with
smaller or larger pieces of flesh blown away or penetrating tortuous
holes, with metal buried in the tissue. Quite often this metal, was
found just under the skin on the opposite side of the limb. Most of
the wounds were charred. In one case a large amount of gluteal
tissue was taken out in the region of the right anterior superior
iliac spine, with fracture of the ileum. This man, in addition had a
compound fracture of the right arm and numerous other wounds. A man
was very lucky if he had less than three separate shell wounds. He
was in a very low condition when we landed him, and it is doubtful
if he will live.
In cases where large vessels of the leg or arm had been opened, we
found tourniquets of pieces of spun yarn, or a handkerchief, or a
piece of cloth bound round the limb above the injury. In some cases,
I believe the majority, they had been put on by the patients
themselves. One man told me he had put one on his arm himself. They
were all in severe pain from the constriction, and in all cases
where amputation was required, the presence of these tourniquets
made it necessary to amputate much higher than one would otherwise
have done, but no doubt their lives had been saved by the
tourniquets. There was very little evidence of any skilled treatment
before they arrived on board. Naturally the German surgeon had been
very much shaken and handicapped. His station in action was the
stokehold, which was uninjured. His assistant surgeon was less
fortunate, his station being the tiller flat aft, and when they were
badly struck, fire broke out above him, whereupon he went up and was
blown overboard, slightly wounded. The steering party remained in
the tiller flat and were unhurt. After being blown overboard the
surgeon managed to get ashore, and during the night he lay helpless
and exhausted, dying of thirst, along with a few others who had also
got ashore. After much persuasion he got a sailor to bring him some
salt water, of which he drank a large quantity, and straightway
became raving mad and died.
Having now cleared up most of the immediate work, we had the theatre
straightened up once more and cleared, after the constant stream of
filthy cases had left it in a pretty mess. Operations had had to be
discontinued at noon, but we recommenced at about 6 p.m., and did
not stop till 4.30 a.m. Wednesday morning. The first case taken was
a German whose right leg had been almost severed just above the
ankle. The German surgeon, assisted by Dr. Ollerhead, with Surgeon
Todd as anaesthetist, amputated the leg successfully in the middle
third. The case did very well.
We now gave our attention to our own wounded, and after dinner
started on "A" This boy had over thirteen separate shell wounds,
most of them very severe. They involved the right thigh, buttock,
leg, and foot, both bones were fractured 2 inches above the ankle
and, in addition, there was a large area blown out of his left
groin, exposing the femoral vessels and spermatic cord. It looked at
first as though we would have to amputate, but we decided to give
him a chance, and after cleaning up the wound with soap and water,
hydrogen-peroxide, and iodine, and removing the metal accessible,
iodoform grains were inserted, and the leg was put up in a back and
side splints. It took Dr. Ollerhead and myself, working hard, two
solid hours to complete the case. Dr. Todd gave the anaesthetic,
which the patient stood very, well. This poor fellow had been in
considerable pain. He was now put in charge of a special nurse in
the Commander's cabin. All future dressings had to be done under
anaesthesia for about fourteen days, but the latest report is that
the leg has been saved.
After doing the operation mentioned above, the German surgeon became
more of a hindrance than a help. During the evening he broke four of
our syringes without successfully giving a hyperdermic injection,
and he was sent to take a rest which he badly needed. Next morning
he had improved considerably, and he was able to take the place of
Dr. Ollerhead when the latter returned to Cocos Island.
The next case taken that night (Tuesday) was "M". He had a shell
wound in his back the size of a half-crown, just below the last rib
on the left side. Earlier in the day he had retention of urine, and
a catheter was passed, drawing off almost pure blood, so evidently
the fragment had lodged in, or passed through, the kidney. The
patient had had a good deal of pain and haemorrhage, but, apart from
the pale colour, he was very fit. Under chloroform the wound was
cleaned up and I traced the track of the fragment with a probe below
the twelfth rib, 3 inches from the middle line, but could feel
nothing. The wound, which was foul, was enlarged with a scalpel and
I tried to get my finger on to the metal, without success.
Eventually, before doing too much cutting, and from fear of carrying
in infection too deeply, I decided to wait and contented. myself
with draining the wound. The blood in the urine was much less on,
the following day and the patient had no retention. He continued to
improve and within two days there was no trace of blood in his
water. . He was landed in hospital very fit but still with a
fragmentin his kidney, and some slight discharge from the wound.
Later news says that he is convalescent. It was now about 12.30 AM
and, after a solid and anxious day, all were pretty well done up,
especially the two sickberth ratings. They had worked wonderfully
and had now to be sent to bed thoroughly exhausted.
After a spell of about half-an-hour, Dr. Ollerhead, Surgeon Todd,
and myself, with the assistance of three volunteers, got the theatre
cleaned .up with lotions, dressings and instruments ready, and
recommenced operations. The patient was a German with a shattered
right leg, which was fractured and mutilated in the middle third.
The wound was horribly offensive and alive with maggots, 1/4 inch in
length, gangrene had set in, and infection was spreading up the
veins to the thigh. This was 36 hours after injury.
There was a tourniquet round his leg just above the knee, and though
the man must have lost a good deal of blood, his condition was very
fair considering all things. Under chloroform it was decided to
amputate above the knee. This was done by an anterior skin flap, and
a modified skin and muscle flap by transfixion posteriorly. A good
covering was obtained with a very satisfactory stump. Some
difficulty was .experienced in finding the large arteries, as they
did not bleed freely on loosening our tourniquet. The patient was
put to bed in the sick bay at 4 a.m. with two German sailors to
watch over him. He began to kick the stump about on coming to, and
had to be tied down. A large dose of morphia was administered, and
we retired to rest after a cup of Bovril at 4.30 a.m.
No sooner was I in bed than I was called up to the sick bay to this
case, and found him pulseless. Strychnine was administered and heart
massage and artificial respiration tried without success. It was
most disappointing, and I was unable to decide whether he had died
from shook or from morphia poisoning. Possibly the latter, as I had
had such disappointing results with our morphia previous to this
case that I increased the dose. An injection into the vein after
operation may have made a difference, but it was not available at
the time of the operation, nor was it thought necessary.
Early on Wednesday morning the sick berth staff turned to and
attended to a stream of less severely wounded, who presented
themselves at the sick bay. The remainder of the Germans who had got
ashore at North Keeling Island, some of them wounded, were brought
on board by a party from this ship, which on account of nightfall
and the surf had been unable to return on Tuesday. . We then
returned to Cocos Island and landed Dr. Ollerhead, who was not able
to come on With us. I cannot lay too much stress on the great
assistance so generously afforded by the Eastern Extension Co.'s
surgeon. He was always cheery and energetic throughout the 24 hours
he was with us, and he kindly left behind some instruments, lotions,
and dressings, which were most useful to me in after treatment.
We then set sail for Colombo at 20 knots, much to our relief, having
had to spend some 48 hours round the Emden after the action. We
attended to the last batch of German wounded, only two of which were
serious cases. One was put on the table in the forenoon, the other
later in the afternoon.
After breakfast, "F" A.B., was the first case. Of course, he and
many others should have been done before, but it would have taken at
least six fully-manned operating theatres to have dealt with the
cases as they required. This A.B. had the distal half of his left
foot shattered by a bursting shell. Besides, there were numerous
fragments buried in the tissues of the left leg and thigh.. The
outer side of the sole of the right foot was furrowed down to the
metatarsals, and one toe was carried away. With Surgeon Todd as
anaesthetist, and S.B.S. Mullins as assistant, we cleaned up the
wounds, which were by now quite offensive, with hydrogen-peroxide,
alcohol, and iodine, removing metal where possible, and draining the
wounds. The left foot was amputated at the transverse tarsal
articulation, sufficient sound tissue having been obtained from the
sole to make quite a satisfactory covering. The case took some time
owing to the number and state of the wounds. A drainage tube was
left in the stump, which healed quite quickly. The patient has been
since pronounced convalescent. During the operation the German
surgeon was attending to the dressings of his fellow countrymen on
the waist, deck, where they were taken, after operation. The sick
berth attendant was overcome and had to be sent on deck for an hour
to recover. All this added to our difficulties seeing that 50 per
cent. of our staff was hors de combat.
We next' had "C" taken to the sick 'bay for operation. Dr. Luther
was anaesthetist and Dr. Todd assistant. This man, besides having a
hole in his left buttock, and through the left palm, had various
shell wounds. all up the right leg, and a minute splinter had
entered his right eye through the upper lid, carrying a minute
fragment of the orbital bone into the eye and disintegrating that
organ. I had hoped to be able to leave this case for a specialist in
Colombo, but, the eye became inflamed and swollen, and a large
amount of pus collected in the orbit, so that it was decided to
remove the organ. On account of the antiquity of the Service eye
instruments. it was impossible to remove the eye through the optic
nerve, so I had to be content with cutting away the anterior portion
of the globe, syringing out with weak antiseptic and draining the
orbit with iodoform, gauze. This temporary treatment saved any
spread of the infection to the meninges, and the patient did well.
On arrival at Colombo I advised further surgical treatment by a
specialist, and the patient is now reported to have left the
hospital convalescent. The next case was a German whose left forearm
had been mutilated. Bellies of muscle had herniated through the
skin, and both large vessels had been severed. A tourniquet, placed
on the lower third of the arm, had saved the patient from breeding
to death, but necessitated amputation of the arm. The German surgeon
now relieved Dr. Todd as anaesthetist; the latter being unwell, had
to go and rest awhile. S.B.S. Mullins ably assisted at the operation
of circular amputation of the left arm. A drainage tube was inserted
into the wound, and the stump healed with slight sepsis. This man
refused operation at first, but eventually consented on the advice
of his messmates and the German surgeon. The next case was similar
to the above, only his forearm was even more damaged. He had managed
to get a tourniquet placed round his arm, and was later blown
overboard. He succeeded in swimming ashore-through the surf, and was
brought off to this ship after being ashore for 40 hours. Besides
the above injury, he had a large septic flesh wound of the left
thigh which afterwards became erysipelatous.
By the time he got to us all his wounds were in a shocking condition
and were crawling with large maggots. The patient was weak from loss
of blood and exposure, and his life was saved on shore by our party,
who gave him coconut milk through the night. His constitution was
wonderful and his stature and physique were magnificent. He appears
to have been the only man on the upper deck saved. Under chloroform,
with Dr. Luther as anaesthetist and Surgeon Todd as assistant,
circular amputation in the middle of the arm was performed. The case
was somewhat more difficult, owing to the great muscular,
development of the arm. A satisfactory stump was ,obtained which
healed well, but for three days the patient ran a very high
temperature, due to the erysipelatous wound in his left thigh. The
remainder of this day (Wednesday) was occupied in cleaning up and
dressing wounds and putting up fractures, most of them under
anaesthesia. At midnight we went to bed after a spell of over 40
hours without sleep. Early on Thursday morning minor injuries were
attended to in the sick bay until breakfast. In the forenoon we did
general cleaning up and dressing wounds under anaesthesia, and we
opened up a knee joint which had become enormously enlarged through
an accumulation of pus not three days after receiving a small wound
of the knee. A tube was inserted into the joint after free incision
and much pus was drained away. By night we had finished off all the
operations and the bigger work, as far as initial treatment was
concerned, but we had by no means been able to take to the theatre
all the cases which required careful and thorough attention. They
simply had to be left to the tender mercies of the first aid party.
All this time we had to organize and arrange the hospital with its
equipment, and the feeding and nursing of the patients. Up till now
this had been turned over to the first aid party, and they received
the cases straight from the theatre. In the ,ease of the Germans, we
had a party told off from the prisoners to help our staff. We had
two large wards, the ward room and the waist deck, and various
special wards - a few cabins given up by the officers. Our wounded
were in the ward room and were sometimes carried on deck, as it was
very hot below. The Germans filled the waist deck, and though cooler
here, they were regularly washed down with heavy rain, despite the
extra awnings and side curtains, and sweepers told off by the
Commander. A special party, under the chaplain, was told off to look
after the feeding of the patients.
The moving of the patients to and from the sick bay was
considerable, and in consequence of narrow hatchways and doorways,
combined with limited space, it was rather awkward work. The
stretcher parties were kept very busy. By Thursday night one could
look round with a feeling that some impression had been made on the
work before one, and late that night the German surgeon and myself
sorted out the cases we proposed to send off next day to the Empress
of Russia, an armed liner which had been despatched to help us with
the wounded, and to relieve us of some of our extra 230 men. By 10
a.m., this ship joined us and we had all the wounded ready for
transhipment. Fortunately, the weather was calm, and about 60
patients besides 100 prisoners had been moved within two hours. We
sent over all the cases who could walk and about 25 to 30 cot cases.
But for the fact that we had to wait for our cots to be returned in
order to send over more patients, the work would have been finished
much quicker. We also got rid of eighteen Chinamen, the crew of the
sunken collier, and we had now more clear space on the decks for the
wounded we had kept - 2 in all. I kept back all our own wounded men
and the severest of the Germans, including the cases we had operated
on. It was thought. inadvisable to move these, and though the
Empress had fine accommodation and plenty of bedding, she had only
two surgeons and one S.B. rating.
A fresh supply of blankets was obtained from this ship, and I had
most of our bedding and blankets thrown overboard, as they were most
horribly filthy, foul, and offensive, and we had no chance of
disinfecting them for some time. Having now more space and things
being much straighter and cleaner, we could look after the remaining
cases better, and were able to take down the dressings of, and
examine the cases we had done earlier in the week. Some of them
sadly needed it. Between now and Saturday night we had every case
thoroughly overhauled, and were able to discharge them on Sunday in
a fairly clean condition, though most of them were more or less
septic. During these six days the ship was in a filthy condition and
was stinking in all parts adjacent to the wounded. This was due to
the foul wounds and the fact that the hot damp climate tended to
rapid decomposition. We had the decks washed every morning with
sanitas, and each patient who could be was moved with his bedding
and replaced when his position was dry. We arrived at Colombo at 10
A.M., Sunday morning, and after much delay from the shore the
military took over the wounded, depositing them in the Military
Hospital till that was full, and then sent the overflow to the Civil
Hospital. After the wounded left, the ship was in a most insanitary
and .dangerous condition, and it was some days before she could be
cleaned, as we were coaling for two days.
The corticene decks of the ward room, sick bay, and starboard
corridor had to be scraped, as they were thick with marine glue,
which had been unavoidably fouled by dressings and discharges from
wounds. All these places were then scrubbed out and next day the
Colombo health authorities were brought off and they sprayed out
with cyllin the whole of the living places of the ship. It was only
with difficulty I could get this done because the Captain was most
anxious to put to sea as soon as we had coaled. Even then it was
very hurriedly done. Some of the remaining bedding was destroyed;
the rest., with the blankets, were put through the steam
disinfector, and numerous heavier articles, such as gymnasium mats,
which had been used as beds, were sent ashore to be disinfected.
At 9 a.m. on Thursday we left Colombo after having gone through a
very trying ten days, and the whole of the staff was worn out and
could very well have done with a rest. Instead of that we had
another operation the first day at sea.
It would be very difficult to imagine a more trying set of
circumstances for the medical staff of a cruiser, and an action
where so many wounded would 'be rescued. Had the Emden sunk before
she reached the beach, our work would have just halved itself, as
many wounded must have drowned. Thus we had an abnormal list in the
enemy ship added to our own. The ship was overcrowded and most
unsuitable at any time as a hospital ship; we were delayed 48 hours
round the scene of action, and we were four days steaming from the
nearest hospital at 18 knots.
The services of Surgeon Todd, R.A.N., were invaluable, and he was at
the disadvantage of having served afloat only fourteen days, and
those immediately preceding the action. also he was in indifferent
health at the time.
I specially recommend the services of T. Mullins, S.B.S., whose
endurance and energy were wonderful.
The work done by the first aid and volunteer party was most useful,
unstinted, and remakably intelligent. I might mention in this
respect the names of :-
Frances Holley, M.A.A., R.A.N.
William Sweetland, 2nd S.S., R.A.N.
Frederick Tillbrook, Off. Std., 2 cl., R.A.N.
John Donnelly, P.O., R.N.Herbert Holmes, A.B., R.N.
James Hill, A.B. R.A.N.,
John Fulton, Cks. Mte., R.A.N.,
Below is a list of stores used during the period
Chloroform, 2 lbs.
Drainage tubing 1 yard
Sal. alembroth wool, 12 lbs
Absorbent wool. 18 lbs.
Surgeon's lint, 16 lbs.
Boric, lint, 10 lbs.
Bandages, 4-in., 10 dozen
Bandages, 3-in., 10 dozen
Bandages, 2-in., 15 dozen
Cyanide gauze, 12 yards each,
6 tins Moist gauze, 6 yards each, 1 jar
Iodoform gauze, 6 yards each,
1 carton Triangular bandages, 24
Iodine, 1 pint.
Mosetig battist, 6 yards
Christies tissue 6 yards
Catgut ligature, 3 spools
Silkworm gut, 1 tube (50)
Horse hair, 1/8 hank
Soloids sod. chlor., 12
Hyd. perchlor., 500 soloids
Hydrogen peroxide, 2 lbs.
Acid, carbolic, 1 lb.
Adhesive plaster, 2-in., 1 spool
Adhesive plaster, 1 spool
Picric acid dressings, 20
Lysol, 1 lb.
The above list is as near correct as it is possible to estimate.
The most useful antiseptics were found to be hydrarg. perchlor.,
iodine, and alcohol, with hydrogen peroxide a most useful cleanser
of foul wounds.
I have the honour to be,
Sir,
Your obedient servant,
LEONARD DARBY, M.B.,Ch.B., S.M.0.
Surgeon, R.A.N.
The Commanding Officer,
H.M.A.S. Sydney.