Mitchiner memorial lecture, 1988: July 1st 1916.

On the morning of July 1st 1916, after five days of intense artillery bombardment, the British Fourth Army under General Sir Henry Rawlinson, with a ration strength of 519,324 men, supported by two divisions of the Third Army, under General Sir Edward Allenby, advanced into what was to be known hereafter as the first day of the Battle of the Somme. Within the first 60 minutes of that attack, those troops sustained some 30,000 casualties, dead and wounded, and that number would be doubled by the end of the day. This lecture, founded in memory of the life and work of Philip Mitchiner, surgeon at St Thomas' Hospital and life-long friend of the Royal Army Medical Corps, tries to convey to you how the RAMC coped with the most enormous casualties in wounded men sustained by our forces in anyone day of any campaign before or since. Before considering the purely medical aspects of that day, let me briefly describe the military background of the battle. 1915 had seen the abortive attempt to break the stalemate on the Western Front by the Allied landings at Gallipoli. The Allied plans for 1916 were for combined French and British attacks on the West with a simultaneous Russian advance in the East. However, the German attack at Verdun in February 1916 rendered the French army incapable of joining in a combined offensive on a large scale and made the French, moreover, desperate for relief from the British allies. But the old British regular army had almost gonedecimated in the early battles of '14 and '15 and at Gallipoli. The BEF casualties in 1914 alone had amounted to 86,000 men. Kitchener's "New Army" of half a million volunteers was still training, was largely untested in battle and had few experienced officers. In the original plan, the French were to advance on a 25 mile front while that of the British stretched north for another 18 miles. Because of Verdun, the French front was reduced to eight miles. The French high command issued what almost amounted to an ultimatum; they told Sir Douglas Haig, commander in chief of the BEF, that the French army would not be able to hold out after July 1st, a date earlier than Haig himself would have wished.