This matter of medical and surgical treatment is of such great importance that s.p.a.ce is here accorded to the letter and diary notes of an American officer, Major J. Carl Hall, our gallant and efficient medical officer of the 339th Infantry, who from his home in Centralia, Illinois, August 6th, 1920, sends us a contribution as follows:

"Take what you can use from this diary. Thought I would avoid the English antagonism throughout but later have decided to add the following incident at Shenkursk, December 12, 1918. I was ordered by the British General, Finlayson, to take the duties of S. M. O. and sanitary officer of Vaga Column, that all medical and sanitary questions, including distribution of American personnel would be under the British S. M. O. Dvina forces--right at the time the American soldiers were needing medical attention most. This order absolutely contradicted my order from the American headquarters at Archangel, making me powerless to care for the American soldiers. I wired the British I could not obey it, unless sent from American headquarters. Col. Graham, British officer in charge of Shenkursk column, informed me that I was disobeying an order on an active front, for which the maximum punishment was death. I immediately told him I was ready to take any punishment they might administer and sooner or later the news would travel back to U. S. A.

and the general public would awaken to the outrageous treatment given the American soldiers by the hands of the British. This affair was hushed and I received no punishment, for he knew that there would have to be too many American lives accounted for. I returned to the base at Archangel and was then placed in charge of the surgery of the American Red Cross Hospital.

"The Russian-English nurse story you know and also add that 75% of all medical stores obtained from the British on the river front, if not stolen by myself and men, were signed over to us with greatest reluctance, red tape, and delay. It was a question of fight, quarrel, steal and even threaten to kill in order to obtain those supplies justly due us.

"Would like very much to have given you a more satisfactory report--but right now am rushed for time--anyway, probably you can obtain most of the essential points.

"Yours very truly, (Signed) JOHN C. HALL."

This faithful and illuminating diary account of Major Hall's is typical of the story on the other four fronts, except that British medical officers dominated on the Railroad front and on the Onega front and at Kodish.

Upon arrival of 339th Infantry in Russia on Sept. 4th, 1918, as Regimental Surgeon, established an infirmary in Olga Barracks, Archangel. After taking over civilian hospital by American Red Cross, I then established a twenty bed military hospital and an infirmary at Solombola.

On Sept. 10th I was ordered to report to Major Rook, R. A. M. C, at Issakagorka, on railroad front, four miles south of Bakaritza, for instructions regarding medical arrangements on River and Railroad fronts.

On Sept. 11th I reported to Col. McDermott, R. A. M. C., A. D. M. S., North Russian Expeditionary Force, and there received instructions that I should leave immediately for Issakagorka.

Accompanied by my interpreter, Private Anton Russel, and Sgt. Paul Clark, boarded Russian launch for Bakaritza six miles up the Dvina and on the opposite bank of the river, where we transferred to train and proceeded to Issakagorka. Upon arrival there and reporting to Major Rook, R. A. M. C., I was informed that I should go armed night and day for they were having trouble with local Bolsheviks and expected an attack any time.

Issakagorka is a village located in a swamp with about 2,000 population, and every available room occupied. The overcrowded condition due to the presence of many refugees from Petrograd and Moscow and other Bolshevik territories. The streets deep. An odor of decaying animal matter, stagnant water and feces is to be had on the streets and in all the homes. At the house in which I was billeted, a fair example of practically all Russian homes, the toilet was inside.

On Sept. 14th I was ordered to railroad front to inspect medical arrangements. Arrived at Obozerskaya and found that Lieut. Ralph Powers had taken over the railroad station and had almost completed arrangements for a Detention Hospital of forty beds. He had just evacuated thirty sick and wounded. The first aid station being in a log hut, one-quarter mile west of station, in charge of Capt. Wymand Pyle, M. C. In this there were ten stretchers which they had used for temporary beds until cases could be evacuated to the rear.

Pits had been dug for latrines daily because the ground was so swampy the pit would fill with water by night. The Americans had been instructed to boil water before drinking, but after investigating I found it had been almost impossible for they had no way to boil it only by mess cup, and the officers found it difficult to get the men to strictly observe this order. The return trip from the front to Issakagorka was made on the ambulance train. This train consisted of five coaches, which had been used in the war against Germany, and all badly in need of repair. Two were nothing more than box cars fitted with stretchers. Two were a slight improvement over these, having double-decked framework for beds, which were fitted with mattresses and blankets. The other coach was divided into compartments. One an operating room, which was built on modern plans, and the other compartment was built on the style of the American Pullman, and occupied by the Russian doctor in charge of train, one felcher or a.s.sistant doctor (a sanitar), which is a Russian medical orderly, and two Russian female nurses.

Our sick and wounded were being evacuated by this train from the front to Bakaritza; there kept at the Field Hospital 337th or taken by boat to Archangel.

I reported to General Finlayson on Sept. 16 and was given 50,000 roubles to be delivered to Col. Joselyn, then in charge of river forces, and informed to leave for river front to make medical arrangements for the winter drive.

At noon Sept. 18th, with Lieut. Chappel and two platoons of infantrymen, boarded a box car, travelled to Bakaritza, where we transferred to a small, dirty Russian tug. The day was spent going south on Dvina River, toward Beresnik. At the same time Lieut. Chappel with the platoons of infantrymen boarded a small boat and proceeded up the river.

The tug on which we were had no sleeping accommodations and on account of the number aboard we had to sleep the first night sitting erect.

The c.o.c.kroaches ran around in such large numbers that when we ate it was necessary to keep a very close watch, or one would get into the food.

The following day the infantrymen were left at Siskoe and we went on to Beresnik. Lieut. Chappel was killed two days after leaving us.

Arrived at Beresnik, which is about one hundred and fifty miles from Archangel, after a thirty-eight-hour trip; reported to Major c.o.ker, and then visited British Detention Hospital in charge of Capt. Watson, R. A.

M. C. The hospital being a five-room log building with the toilet built adjoining the kitchen.

In this hospital there were twenty sick and wounded Americans and Royal Scots. The beds were stretchers placed on the floor about one and one-half feet apart. The food consisted of bully beef, M and V, hard tack, tea and sugar, as reported by the patients stationed there. The pneumonia patients, Spanish influenza and wounded were all fed alike.

It was here that I met Capt. Fortescue, R. A. M. C. A general improvement in sanitation was ordered and Capt. Watson instructed to give more attention to the feeding of patients. With Capt. Fortescue I visited civilian hospital two miles northwest of Beresnik; found Russian female doctor in charge, and, looking over buildings, decided to take same over for military hospital. Conditions of buildings fair; five in number, and would accommodate one hundred patients in an emergency. The equipment of the hospital was eight iron beds. Vermin of all kinds, and c.o.c.kroaches so thick that they had to be sc.r.a.ped from the wall and shovelled into a container. The latrines were built in the buildings, as is Russian custom, and were full to overflowing. The four patients who were there were retained and cared for by the civilian doctor. While at Beresnik we stayed at the Detention Hospital.

The following morning, Sept. 21st, with Capt. Fortescue, boarded British motor launch. After travelling for about thirty versts we transferred on to several tugs and barges, and on Sept. 23rd boarded hospital boat "Vologjohnin," and left for front after hearing that there were eight or ten casualties, several having been killed, but unable to ascertain name of village where the wounded were.

After an hour slowly moving up stream, because of sand bars and mines, the tug was suddenly stranded in mid-stream. After trying for two hours the captain gave up in despair. We then arranged with engineers (a squad on board same tug) to make a raft with two barrels. When this was about completed two boats approached from opposite directions. We then transferred to the "Viatka" and proceeded to Troitza and there succeeded in commandeering twenty horses.

The following day with Capt. McCardle, American Engineer, Capt.

Fortescue and Pvt. Russel, with our horses, we crossed the river by ferry and then proceeded to the front. Traveling very difficult on account of the swampy territory and lack of information from natives who seemed afraid of us. The horses sank in the mud and water above their knees. The Bolos had told natives that the Allies would burn their homes and take what little food they had.

Arrived at Zastrovia and saw American troops who informed us that the hospital was located in the next village. Lower Seltso about three miles farther. Upon arrival there we located the hospital, which was in a log hut, considered the best the village afforded, in charge of Capt. Van Home and Lieut. Katz with eight enlisted Medical detachment men. Lieut.

Goodnight with twenty or thirty Ambulance men had just arrived at this place. Eight sick and wounded Americans were being treated in hospital.

Arranged for two more rooms so capacity of hospital might be increased.

It was vitally important that these cases be evacuated at once, but there was no possible way except by river, which was heavily mined.

Decided it best to attempt evacuation by rowboat. Sgt. Clair Pet.i.t volunteered to conduct convoy to hospital boat at Troitza. Convoy was arranged and patients safely placed on board hospital boat, where they were hurriedly carried to Archangel.

Returned to headquarters boat the following morning and all seemed to be suffering from enteritis, due to the water not being boiled. Sanitation in these villages almost an impossibility. Barn built in one end of home, with possibly a hallway between it and the kitchen. The hay loft is usually on a level with the kitchen floor, a hole in many houses is cut through this floor and used as a toilet. Or it quite often is nothing more than a two-inch board nailed over the sills. In the very best southern villagers' homes there may be a closed toilet in the hallway between the barn and kitchen. These are the billets used by the Allied troops on the river front in North Russia. The native seldom drinks raw water, but nearly always quenches his thirst by drinking tea.

Wired Major Longley at base Sept. 22nd for one-half of 337th Field Hospital to be sent to Beresnik, to take over civilian hospital.

Communication with the base was very poor. Unable to get any definite answer to my telegrams.

Another trip was made from Troitza to Beresnik with hospital boat "Currier." Sick and wounded Royal Scots taken to Field Hospital at Beresnik. After arrival they were loaded on two-wheeled carts and hauled two miles to the hospital.

Upon arrival at Beresnik found Capt. Martin, with one-half of Field Hospital 337th, had taken over civilian hospital.

On Sept. 28th it was decided to establish a detention hospital at Shenkursk, so Capt. Watson and twelve R. A. M. C. men with medical supplies for a twenty-bed hospital were placed on board hospital boat "Currier." After posting two guards with machine guns on the boat we started on the trip to Shenkursk. A distance of about ninety-five versts from Beresnik on the Vaga River.

All along the way the boat stopped to pick up wood and at each stop natives would come down to the river banks with vegetables and eggs, willing to trade most anything for a few cigarettes or a little tobacco.

Arrived at Shenkursk at 5:00 p. m., Sept. 29th, and about one-half hour later the American Headquarters boat docked next to the hospital boat.

When the various boats docked at Shenkursk all the natives of the town came down to the banks of the river and were very curious as well as friendly. The village of Shenkursk is situated on a hill and surrounded by forest. One company of Americans and a detachment of Russians in control of town. It had been taken only a few days before.

Capt. Fortescue and I looked over civilian hospital and found it to be very filthy. Owing to the fact that it was so small and occupied to its full capacity, decided to look further. Directing our steps to the school, we found a very clean, desirable building, large enough to accommodate at least one hundred patients.

After consulting the town commandant, were given permission to take over building for military hospital. Capt. Watson and Capt. Daw, with equipment for thirty beds, were placed in charge. Stretchers were used as beds, until it was possible to make an improvement or procure some from base. Employed two Russian female nurses. Wired to Major Longley for one-half of Field Hospital 337th to take over this hospital, and in addition more medical officers and personnel, for Ambulance work. On Oct. 2nd Capt. Fortescue returned to Beresnik, which left me as A. D. A.

D. M. S. river forces. The same day we took quarters with Russian professor and established an office in same building.

Upon investigation we found that the American troops had not been issued any tobacco or cigarettes for several weeks and were smoking tea leaves, straw or anything that would smoke. The paper used for these cigarettes was mostly news and toilet paper.

On Oct. 3rd, with Russian medical officer and six American enlisted medical men, we proceeded to Rovidentia, the advance front, about thirty-five miles from Shenkursk on Vaga River. Established a small detention hospital here of ten beds, leaving the Russian medical officer and six American enlisted medical men in charge. This village was occupied by two platoons of Americans and about one hundred Russians.

In comparison to previous villages I visited in Russia, Shenkursk was an improvement over most of them. Mainly because of its location, there being a natural drainage, and the water was much better, containing very little animal and vegetable matter.

On Oct. 7th with Pvts. Russel and Stihler again embarked on hospital boat "Vologjohnin," and the following morning at 8:00 a.m. proceeded to Beresnik with a few Russian wounded, arriving at 2:00 p.m. Made inspection of hospital. Capt. Martin with one-half of Field Hospital working overtime, making beds, cleaning wards and hospital grounds, and at the same time caring for thirty sick and wounded patients. Marked improvement over previous condition.

Left Beresnik Oct. 9th on hospital boat "Vologjohnin" with headquarters boat and small gunboat. Downpour of rain. Gunboat landed on sand bar and headquarters boat turned back, but the "Vologjohnin" kept on going until dark. Anch.o.r.ed opposite an island and at daybreak proceeded further, finally reaching the only boat, the "Yarrents," left on the river front.

Before leaving Beresnik three more men were placed on board the boat.

The personnel aboard at this time consisted of Capt. Hall in charge, two Russian female nurses, five American medical men and two British.

Upon arrival at Toulgas I received word from Major Whittaker that sixteen wounded and six sick Royal Scots were located in the hospital at Seltso, but that Seltso had been under sh.e.l.l fire that day and would be too dangerous to bring hospital boat up. That night, under the cover of darkness with all lights extinguished, I ordered hospital boat to Seltso. We arrived at Seltso but the British troops who were stationed there stated they knew nothing of the sick and wounded Royal Scots, but that Royal Scots were stationed across the river. They stated that it would be very dangerous to attempt to go across the river, and no one on the hospital boat knew the exact location of the Royal Scots. After a while a British sergeant stated that he would go along and direct the way, but when the boat pulled out the sergeant was not to be found. But we went across the river. The barge directly opposite was empty, so we went to the next barge about two versts farther up. That one had been sunk, so we went a few more versts to the third barge which had been used by the Royal Scots but which had been evacuated by them that day. I decided that we had gone far enough, and we returned to Toulgas. On the way back we picked up two wounded officers of the Polish Legion, who had just come from the Borak front, in a small rowboat, and stated it was at that place that they had the sick and wounded Scots. It would be impossible to reach this place by boat, because they had quite a time in getting through with a small boat. They would not believe that we had come up the river so far, and made the remark that we had been within a few yards of the Bolshevik lines.

On Oct. 11th, after getting in touch with Major Whittaker, who stated that the Royal Scots would be placed on the left bank of the river opposite Seltso, I ordered the boat to Seltso to make another attempt to get the Royal Scots. Although we had the window well covered, the Bolsheviks must have seen the light from a candle which was used to light the cabin. They began firing, but could not get the range of the boat. We then returned without success.

On the afternoon of Oct. 12th, while Seltso was under sh.e.l.l fire, the "Vologjohnin" was docked about twenty-nine yards behind the Allied barge with the big naval gun, and did not leave until the sh.e.l.l fire became heavy. About 8:00 p.m., after transferring the sick troops and female nurses from the "Vologjohnin," another attempt was made, although the Russian crew refused to make another trip, and would not start until I insisted that the trip had to be made and placed several armed guards, American Medical men, on the boat. On this night the medical supplies were handed over to Capt. Griffiths, R. A. M. C, and casualties were safely placed on board. After returning to Toulgas the female nurses and sick troops who had been left there were again placed on board. The "Vologjohnin" proceeded to Beresnik where all casualties, totaling forty-three, were handed over to the 337th Field Hospital.