Sickness and Service: The British Army and the First World War

Hill, Christine Ann (2004) Sickness and Service: The British Army and the First World War. Doctoral thesis, University of Central Lancashire.

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This researchc oncernss icknessa nd ill health experiencedb y the British Army during the First World War. A review of the literature has confirmed that this issue offers considerable scope for further exploration by historians, and is an issue that continues to remain in the shadow of the wounded.The focus within past research has been so successfully placed upon battle injuries, that it is difficult to uncover the situation concerning non-combat casualties.
This research aims to open up debate, establish the types and extent of illness experienced by the troops and some of the causes of sickness and disease. The thesis also explores links between the health of the troops and military effectiveness. In order to undertake this assessment in any meaningful way, indicators of military effectiveness need to be determined,
and six such indicators are defined within the thesis.
To establish a better understanding of how far the British Army was prepared for sickness by 1914, the approach taken by the army towards illness over the years leading up to the First World War is considered. The Crimean War marks the starting point of historical context setting in this case, and this research has investigated how far experiences gained in war during the latter half of the nineteenth century, shaped army planning concerning the health of the troops by 1914. Rarely used primary sources have been consulted, including regimental archives at Fulwood Barracks Preston, press reports, professional journals, government reports, and documents held at the Public Records Office, Kew, including War Diaries of active service units, Casualty Clearing Station records, Hospital records, personal diaries and individual service records. A range of secondary sources have also been explored together with autobiographical accounts and personal letters. A further historical source of value is the content of professional medical journals, and the content of a number of contemporaneous journals also underpin the thesis.
In November 1996, approximately 750,000 individual service records of men discharged by the army during the years under examination within this study were released for public scrutiny for the first time. This remarkable new archive offers to extend our knowledge regarding the health of the troops, and analysis of these records forms an important element within this study. A pilot of fifty records was undertaken which combines history with computer technology, and involved the compilation of a spreadsheet wherein discharge diagnoses, age, height, chest measurement and weight were analysed in order to arrive at a
better understanding about the health of the men. Evaluation of the pilot study was informative, and as a result it was extended to include analysis of a total of five hundred and thirty-three individual service records of rank and file men serving within over one hundred various regiments, corps, and services during the First World War.
This thesis represents worthwhile and original contribution to historical debate about sickness within the British Army during this time, by establishing the historical context of sickness, exploring the types and extent of illness, and by examining organisational problems directly and indirectly contributing towards rising sickness rates. The thesis also determines that two broad categories of illness beset the army from the start, and these were firstly preexisting illnesses from civilian life and secondly illnesses acquired as a result of service. The thesis further shows that a costly 'revolving door', of recruitment and discharge beleaguered the army from the outset of the war, and that neither refinements to the recruitment process or the implementation of conscription made very much difference to the overall health of the British force. Establishing links between sickness and military effectiveness is in itself both original and challenging, and relatively new primary sources have been consulted in order to offer a fresh perspectivein this case. Whilst the issue of sickness amongst the troops during
the First World War remains relatively unexplored, historical debate will remain wanting.

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