Denmark.-Buloswei 24, Copenhagen.

Spain.-Association espagnole de la Croix Rouge. Plazuela del Humilladero 6, Madrid.

France. Société française de Secours aux militaires blessés. Rue Matignon, 19, Paris.

England.-National Aid Society to Sick and Wounded in War. 5, York Buildings, Adelphi, London.

United States, America.—American Red Cross Society, Washington.

Greece. Société grecque de Secours aux blessés. Athènes. Italy.-Central Italian Committee of the Red Cross. Palazzo Lantè, Piazza Capellari 70, Rome.

Holland.-Comité Centrale de la Société Néerlandaise de la Croix Rouge. The Hague.

Prussia.-As for Germany.

Russia. Comité Central russe de la Croix Rouge. Rue des Ingénieurs 9, St. Pétersbourg.

Saxony.-Comité Central des Secours aux militaires blessés. Dresden.

Switzerland.-Société Central suisse de la Croix Rouge.

Zurich.

Periodical Press of the Red Cross :

:

1. "Kriegerheil," organ of the German Societies; monthly at Berlin.

2. "Messenger of the Russian Society." Weekly at St. Petersburg.

3. "Caridad en la Guerra." Madrid; monthly.

4. "Military Medical Journal." Stockholm.

5. "Philanthrop." Organ of the Swiss Society; Zurich. 6. "Bulletin International des Sociétés de la Croix Rouge." Organ of the International Committee, and published at Geneva; quarterly.

Those who desire to learn more about the Red Cross Societies should read Gustave Moynier's "Red Cross and its Future," of which Mr. John Furley has made a translation, which is published by Cassell, Petter, Galpin & Co. London.

CHAPTER IV.

CIVIL OR PEACE AMBULANCE ARRANGEMENTS.

The Ambulance arrangements in American Cities-Need of the same in England-The treatment of Drunken men in the streets-Street Stretcher-lockers - A London Ambulance Service Railway Ambulance arrangements-Poor Law arrangements-Example of a Municipal Ambulance System-The Metropolitan Asylums Board and its work-The Hospitals and Ambulance arrangements -The old Parochial System and its defects-The Ambulance Steamer "Red Cross" on the River Thames-Rural Ambulance Systems The Battle District of Sussex-Lady Brassey's System— The Town of Brighouse in Yorkshire-Civil Ambulance Societies— The St. John's Ambulance Association and its work-The good done by it-The London Ambulance Service-The St. Andrew's Ambulance Association-The Samaritan Society of Kiel.

We have in a previous page of this Manual pointed out that it was mainly owing to the developments of warambulance systems that civil arrangements have sprung up.

The striking effects of a great battle, and its consequent miseries to the wounded, have ever arrested public attention in a manner that the more scattered accidents and sufferings of civil life have failed to do.

Yet when we remember our long-continued industrial warfare, with its daily casualties, and the vast sickness of our civil population, it will be understood how far greater are our civil ambulance needs.

On this point, as on many others, the people want light. Until the average citizen knows what a compound fracture is; how arteries bleed, and why; and understand some of the risks and pains attending the movement of cardiac or dropsical patients, great developments will not come. It is to the great cities of the New World, like New York, VOL. VII.-H. H.

U

Boston or Chicago, we have to turn to learn lessons as to civil ambulance arrangements.

We find in these cities regular ambulance conveyances, and a special staff of surgeons, attendants, drivers and horses, attached to the great municipal hospitals. The great central thoroughfares, the police stations, and the hospitals, are all united by telegraphic or telephonic communications.

At once on the occurrence of a street accident, a telephonic message is despatched to the District Hospital for aid, and, as a rule, in three minutes after the message is received, a specially constructed ambulance carriage, containing a medical official, with appliances and restoratives, is speeding on its way to render aid to the sufferer. The New York system is singularly perfect, and Boston and Chicago are not far behind. When we remember the vast numbers of persons run over and injured by carriage accidents, fall from scaffoldings, or stricken down by the many risks of our great factories, we all must admit that England generally, and our great cities in particular, need such organization of help almost more than America.

To stimulate all this humane work, what is needed is light. Every one rushes to aid in an accident; but, alas! the people do not know how to give aid, they know not what to do, or what not to do; and so it is that injuries, in themselves light, are gravely complicated by ignorant handling. How needful then is it that we teach the people, and that we by so doing sow the seed for the development of ambulance-organizations!

The removal also of people suffering from heart-disease, rheumatic affections, infectious disease, dropsies, is also a subject of great importance, and it would be possible to tell many painful stories of the suffering caused by the absence of suitable stretchers and carriages for use in such cases.

Take, again, the question of drunkenness in our streets. Can anything be more degrading to human nature than to see a body of policemen struggling with a man in the mad stage of drink-poisoning? The struggles of a drunken man in his excitement are as surely the symptoms of poisoning, as

the muscular cramps of strychnine poison mark the action of that deadly drug. The treatment in one case should be as carefully guarded as in the other; yet have we not seen the murderous and cruel "frog's march" practised on drunken men, where the poisoned sufferer is carried with his head within a few inches of the ground, and all the blood of his body gravitating towards it. How many cases of police-cell apoplexy have really been murders, from ignorance from want of organization and education on this head ?

The day will most surely come when such sights will be no more seen. The stretchers so needed for these cases will not be found in police offices only; but in every street of our cities red-painted lockers, like enlarged post-boxes, will contain a stretcher ready for use. Every policeman or local householder will have a key.

Every post-office will have such a stretcher, every railway station in the country; and shall we say every public house also, so that they who sell the poison may also keep on hand a physical relief for its effects?

A drunken man shall then be at once overpowered and strapped on the stretcher, and so borne to the hospital or police ward told off for such cases.

Nay more, we shall one day have municipal ambulance (sick transport) waggons attached to our great hospitals, or to special ambulance stations, and these waggons shall receive both accident cases or drunkenness cases on the stretcher as they are, and so place them in the waggon and drive them rapidly to the relief centre. It is only in this way we can free our streets from painful and degrading sights, and at the same time provide for accident cases. London and every city should be mapped out in districts, and these districts allotted for ambulance-purposes to the local hospitals and the local police centres.

Telephonic communication should run from the streets to the hospitals and the police depôts, and at the hospitals the waggons or carriages should stand ready for constant use to drive to the scene of the accident. Trained medical

officials should be on duty, ready to leave with each carriage and to assist the injured person. The stretcher in the carriage should be interchangeable with the one in the street-stretcher-locker, and should replace it at once, receiving in return the sufferer and the other stretcher.

For the carriage of the sick, and those enfeebled and handicapped by disease, a special arrangement is needed, which only a strong municipal government will ever be able to organize.

The London Hospitals should come under a central Board, and their funds be "pooled" in a common fund, having in reserve the municipal rates to fall back upon.

The existing hospitals, and the many other municipal hospitals needed, should be distributed with system over our great city. A chain of outposts in the shape of municipal dispensaries should bring medical relief within a quarter of a mile of every citizen. Here first aid should be ever ready, and here the outpatients now swarming and crowding at our great hospitals should be dealt with in detail and by districts. At certain hours in the morning, midday, and evening, the sick-transport waggons from the great central hospitals should call at these outlying dispensaries, and carry in comfort the cases chosen for admission to the district central hospital. But far more than this is needed, for a ring of great hospitals, combining in the same extensive grounds both convalescent and treating sections, should surround London at a distance far removed from the smoke and overcrowding of our great city. Alike on the Sussex coast, on the Surrey hills, or mid the heaths of Berkshire, should be found those great outlying, overflow convalescent and treating municipal hospitals, to which, according to the nature of the case, each patient could be forwarded, but how? By special ambulance railway trains, leaving every morning with sick and returning every afternoon with the recovered. These trains, well fitted for every ailing case, will one day be as common as the sleeping-cars of the Pullman trains are becoming common, and an inestimable boon they will be to all using them.