Sir Ronald Ross’ work on dysentery in Alexandria, Egypt during the Great War

The Ross Collection in the Archives of the London School of Hygiene and Tropical Medicine holds material on dysentery during the First World War.
Sir Ronald Ross is famous for being the discoverer of the mosquito transmission of malaria and the first Briton to be awarded the Nobel Prize for Medicine.

Ross and colleagues in Alexandria, 1915

During World War One he was appointed a consultant physician on tropical diseases to Indian troops and was sent to Alexandria for four months to investigate an outbreak of dysentery which was hampering troops in the Dardanelles. In the report he made at the end of his service, he states that on visiting seven large hospitals in Alexandria, nearly all medical cases belonged to five groups of diseases usually prevalent in British troops in warm countries: typhoid, jaundice, malaria, dysentery and mixed cases. Of these, dysentery (an infection of the intestines that causes diarrhoea containing blood and mucus) was the principal cause of sickness in the Mediterranean Expeditionary Forces. Figures from a report show that from 29 August to 9th October 1915 there were 32,528 cases of diarrhoea and dysentery with 231 deaths.

Post mortems on cases showing dysenteric ulceration of colon at 21 General Hospital, Alexandria June 28-October 27 1915 by George Bertram Bartlett

He found that many of the cases were amoebic dysentery which meant prolonged illness and cases of liver abscesses. Ross instructed that all patients showing dysenteric symptoms at the front be given emetine and this resulted in patients reaching Alexandria in a less critical condition.
Ross finished his report with a number of suggestions, including increasing the number of pathologists in each hospital, and that those patients who have been treated successfully for malaria and dysentery be sent home with medical cards outlining their medical notes in case of relapse.

Ross at the Regina Hotel, Alexandria, Egypt

While Ross is remembered for his work on malaria and dysentry, this remarkable man was also a mathematician, epidemiologist, sanitarian, editor, novelist, dramatist, poet, amateur musician, composer, and artist. He died, after a long illness, at the Ross Institute on 16 September 1932.

“…With tears and toiling breath,
I find thy cunning seeds,
O million-murdering Death.”

(fragment of poem by Ronald Ross, written in August 1897, following his discovery of malaria parasites in anopheline mosquitoes fed on malaria-infected patients)

Information Sources:

Library & Archives Service, The London School of Hygiene and Tropical Medicine

Flies, Filth and Desert Soldiering …

It has often been repeated that the daily existence of Commonwealth soldiers during the Great War campaigns across the Middle East was extremely arduous. The soldiers accounts and recent archaeological surveys of the better preserved battlefields illustrate just how inhumane and gruelling the conditions were for both the Allied and Turkish Forces alike. Many factors contributed to making the desert battlefield an almost unendurable place for soldiers. The constant noise, terrible food, cramped unsanitary conditions, disease, stenches, daily death of comrades, lack of rest and thirst all contributed to the most arduous of conditions.

A typical Desert ‘Bivvy’ tent which provided some protection from the searing heat, heavy rainstorms and ‘khamsin’ winds

The logistics of supplying fresh food whilst on campaign was a major challenge. The rations issued to the soldiers provided very poor nutrition due to the unvarying diet of processed foods: canned meat, hard tack biscuits and watery jam. These rations were intended to be lived on for only short periods of time by British army divisions, not for extended periods as proved to be the case on the Gallipoli peninsula. Living on these rations caused major health problems for the soldiers due to their poor nutritional content. An unappetising and unvaried diet affected morale and increased susceptibility to disease which spread rapidly during the summer months of a campaign.

Disease swept through both the Commonwealth and Turkish forces at Gallipoli. Dysentery, tetanus and septic wounds plagued the soldiers and necessitated the evacuation of thousands of men from the battlefield to the hospitals in Egypt. Battlefield latrines were open and rudimentary which attracted the presence of flies. Flies spread diseases rapidly through the troops living in cramped, over-crowded trenches and inflicted utter misery on soldiers. Bertram George who served with the Dorset Yeomanry in Egypt, wrote home that the ‘sounds in Egypt never cease – the creaking of the waterwheels, the sound of frogs and the buzz of flies .. writing is an impossibility in the evening for as soon as the sun goes down if a lamp is lighted, the air all round is thick with the little grey sand flies which bite disgustingly’.   

Lice also became a major problem for soldiers during the summer months. Lice caused trench fever which resulted in headaches, aching muscles, skin sores and fever. Lice have an enormous capacity for infestation, a heavy infestation could involve literally thousands of insects and thousands of eggs. During the Great War, treatment of lice was by Naphthalene, usually in the form of “NCI” (Naphthalene, Creosote & Iodoform) powder or paste, and lice in the clothes were killed by the use of heat, either by dry heat, or steam.

As heating facilities were not available on the front lines the soldiers had to attempt to remove the lice as best they could. This removal, a procedure known as “chatting up” was usually by hand, picking out the lice from the clothes, or with the flame from lighted candles run up and down the seams of the clothes. (This was the origin of the verb “to chat” as the soldiers made the removal of their lice into a social event). These attempts at removal, unfortunately, only removed the lice temporarily and did nothing to halt the spread of trench fever because the infectious louse excreta was not sterilised; actual sterilisation of the clothes could only performed by washing in very hot water – and water was a scarce commodity in the desert.

De-lousing at Zeitoun in Egypt, 1915 or early 1916

Soldiers in front-line positions were issued only small amounts of water per day and the water quality was poor. The official ration, when it was met, was 4.5 litres/1 gallon of water per man per day.  Of this, the majority, five pints, went to the cookhouse for the preparation of meals and the steady supply of tea that the army required on a daily basis. Thirst and dehydration were common amongst the men.

‘A rare treat’ A member of the Australian Light Horse washing in the desert
Image Source: The Australian War Memorial

In February 1916 construction began on a railway line which would eventually stretch hundreds of miles to the Palestine border in order to support British forces. Further support was given by 170,000 Egyptian members of the Camel Transport Corps who between 1916 and the end of the Sinai and Palestine campaign in 1918 transported water on 72,500 camels to and from the British front lines. Each camel could carry between 50 and 70 litres of water, and though they were slow, they usually arrived on time.

Corporal Joseph Egerton with a train truck of water tanks in the Sinai Peninsula.
Image Source: National Army Museum 2002-05-1-110

So how did troops navigate their war effectively in a terrain largely devoid of markers? Gordon Harper, of the Canterbury Mounted Rifles used a wrist mounted compass to guide his men across the featureless plains and hillocks of the desert. Harper wrote ‘It is like being at sea out in the vast desert and it is not easy to see very far owing to the wavy formation of the sand.’The men were constantly on the move seeking out evidence of Ottoman forces. They were constantly on the lookout for brackish water for themselves and their horses. To know their position was vital. 

A wrist mounted compass from the Harper Collection
Image Source:

In the end Gordon Harper summed up his thoughts on desert warfare succinctly when he decided that it was not the Ottomans, but ‘the desert which is our chief enemy. There is nothing so inscrutable as its changeless face; there is so little indication of the hidden enemy; and there is no warning of the scorching blast which rises from its red hot sands, and envelopes the unfortunate troops who are struggling in its grip.’