The Medical Service of HMAS Sydney during the Engagement with SMS Emden on 9th November 1914.(1) 

This paper, written by Dr M. G. Miller, © was published in Sabretache, the Journal and Proceedings of the Military and Historical Society of Australia, Vol. LV, No. 2, June 2014, Pages 11-16.

The account of HMAS Sydney's medical service during the engagement with SMS Emden off the Cocos-Keeling Islands naturally falls into three sections. The first is a description of the medical facilities available to the medical service before and during the engagement, most of these being inadequate. Then follows an account of the management of HMAS Sydney's casualties during the actual engagement. Finally is the post-engagement activity, when suddenly a large number, two sources give between 70 and 80, of German wounded were evacuated from the wreck of SMS Emden to HMAS Sydney for treatment.

1. HMAS Sydney, a 5,400 ton British Chatham Class 6 inch light cruiser, was commissioned into the RAN as a new ship in 1913 under the command of Captain John Glossop RN., who had been seconded to the Royal Australian Navy. She was armed with eight 6 inch (15.2 cms) guns and was originally designed as a long distance cruiser with a pre-war crew of 376, but was over-crowded with her wartime crew of 475 composed of members of the Royal Australian Navy and the Royal Navy. She was designed as a fighting ship and very little provision had been given for the management of any wounded apart from a Sick Bay; there were steep stairways, ladders and narrow passages that made the movement of wounded men on stretchers through the ship very difficult.

The two medical officers were Surgeon-Lieutenant Leonard Darby, age 24, the Senior Surgeon, who had qualified as a medical practitioner two years previously in 1912 and who had joined the Royal Australian Navy the same year. The Assistant Surgeon was Surgeon-Lieutenant Arthur Charles Robert Todd, aged 25, who had qualified as a medical practitioner in 1914 and had joined the ship only a fortnight before the engagement. There were two sick berth attendants and, when the ship was at action stations, stretcher bearers and a First Aid Party whose usual occupations were the regulatory, commissary and clerical staff. First Aid bags were also situated at each gun and at the fire control stations.
Before the action, one of the stoker's bathrooms had been converted into a permanent operating theatre. The bathroom was 10 feet (3.05 metres) x 8 feet (2.44 metres) and 7 feet (2.134 metres) in size and was equipped with hot and cold water. Unfortunately this water supply failed to survive the concussion of the guns, and, as Dr Darby wrote in his report to Captain Glossop, it came 'black, muddy and useless' through the taps after ten minutes of gunfire. However Dr Darby had the foresight to ensure that an emergency supply of boiled water was stored in the Captain's and the Wardroom's galley.

This permanent operating theatre was equipped with an operating table, instruments and dressings that were stored for immediate use. It was subsequently found, however, that the instruments for eye surgery were so old that they could not be used and the immediate supply of morphine had passed its use-by date and was ineffective. Unfortunately, only two days before the action, the operating theatre had been cleared for painting and there was very little time for the equipment to be replaced and properly stowed, thus causing considerable confusion and delay when the theatre was first used.When the ship went to action against SMS Emden and the wounded men began to be brought down to the sick-bay, another stoker's bathroom was converted to a temporary second operating theatre. This was hurriedly fitted out with a mess table as an operating table and equipment that was brought from the first operating theatre. Six other bathrooms were also cleaned and served as shelters for the wounded as they were brought below.

The Engagement off the Cocos-Keeling Islands on Monday, the 9th. of November, 1914
SMS Emden had put a landing party ashore on Direction Island, one of the northern Cocos-Keeling Islands, to capture and destroy the wireless station of the Eastern Telegraph Company. However the Telegraph Company was able to send a message about the approach of the Emden and HMAS Sydney was detached from convoy duty to investigate. SMS Emden's wireless operator intercepted the message that dispatched HMAS Sydney to the Cocos Islands and, when she saw masts on the horizon, SMS Emden quickly weighed anchor. She was able to open well-aimed fire on the Sydney causing fifteen casualties. The faster and more heavily armed Sydney soon found the range of the Emden and caused massive damage to her, setting fire to her stern. Her Captain, Karl von Müller ran SMS Emden ashore on North Keeling Island, the northernmost Island of the chain, in order to surrender and reduce the casualties.

During the action HMAS Sydney's wounded, some being very badly injured, were transported below to the medical officers. These included a man with a fractured right leg and thirteen different shrapnel wounds and another with a chest wound that exposed his heart; this could be seen pumping at the left front of his chest. There was a man with multiple shrapnel injuries and a fragment of shell penetrating his eye, another with severe burns from head to foot and a man whose foot was shot away. Crew members suffered burns and one man had an abdominal wound that was soon to be fatal. Most suffered from loss of blood. The last casualty was from the bridge, his left leg had been shot away at the junction with his body
and he too was suffering from marked loss of blood. His carriage below through the winding passages and narrow hatches caused significant delay before he could be treated.

All patients, apart from the last, had arrived in a steady stream and had to be assessed individually by a surgeon before operative treatment could be given. Morphine and first aid was given while the assessment was continuing and the Wardroom was commandeered to accommodate them, beds and blankets were taken from the cabins.

The casualty from the bridge was given priority for immediate surgery and was given a pint (0.57 Litres) of saline under his skin as blood transfusion was at that time too dangerous for general use. Unfortunately he died of blood loss and shock during the long operation to close his wound. It is noteworthy that the safe use of blood transfusion, containing citrate to prevent blood from clotting during transfusion, was first described by a Belgian, Albert Hustin, in 1914, the same year as the Sydney-Emden engagement.(2)

The medical staff worked for two hours, non-stop, in a temperature of over 400 Centigrade, assessing the wounded and giving them treatment. Surgeon Todd was handicapped due to his Sick Berth Attendant fainting four times in the heat. There had been four deaths but the eleven surviving cases were occupying beds in the Wardroom by eleven am. Most were restless and groaning in pain and it was only then discovered that the morphine had deteriorated in the ampoules supplied and was so ineffective that fresh morphine had to be given.

As soon as the sick bay staff could be spared, Dr Darby ordered the conversion of the sick bay into a better temporary operating theatre as soon as possible. The sick bay had been flooded with water from the fire mains and there was an enormous amount of work clearing up from this and the recent activities.

The volunteer First Aid party, including the Paymaster and the Chaplain, nursed the wounded and the wardroom was converted into a hospital ward. The surgeons' work was frequently interrupted all through the afternoon and evening as German sailors were being picked up after they had jumped, or been blown overboard, from the Emden. One man had been in the shark infested sea for nine hours, and in Dr Darby's words, "...was brought round after much trouble. Next day he was no worse off for his immersion".

It was impossible to do any operative surgery until the next day because of overcrowding, the flooding of the sick bay, a shortage of trained theatre staff and the need for the two surgeons to rest before they could perform any reparative operative work. As it was, they were up until midnight caring for their patients. The sick bay attendants had been sent to bed at 10 pm and the surgeons then took 4 hourly watches from midnight. Volunteers from the crew and the First Aid party, even though untrained, also took 4 hourly watches doing the nursing, under the supervision of the Paymaster and the Chaplain.

The Post-Engagement Period
Early on Tuesday, the next morning, the ship arrived off Direction Island to find that the Emden's landing party had escaped on board a captured schooner on the approach of HMAS Sydney. Dr H. S. Ollerhead, the Australian Medical Officer to the Telegraph Station, and his two assistants, came on board HMAS Sydney to assist the medical staff and it was now possible to assess the wounded under chloroform anaesthesia.

Chloroform can cause burns if used in direct contact with the skin and accordingly, it was administered by a drop bottle onto a piece of cloth stretched over a metal frame, called the Schimmelbusch mask. This was placed over the patient's mouth and nose. Chloroform also has to be administered slowly and very carefully by the anaesthetist as chloroform poisoning and liver damage is always possible if too much is used. Despite these limitations, a total of 2 pounds, or nearly a kilogram, of chloroform was used during and after the engagement. Ether was first used to demonstrate the value of anaesthetics by a dentist, Dr Morton, in 1846, at the Massachusetts General Hospital in America, but this much safer anaesthetic was not available aboard HMAS Sydney in 1914(3).

The first case to be operated on was the Able Seaman whose heart was exposed, unfortunately he died of blood loss two hours after extensive surgery to the chest. While they were operating on the next case, the ship arrived off North Keeling Island, about ten miles (16 Km.) north-west of Direction Island. SMS Emden was beached there and was flying distress signals so HMAS Sydney anchored and a party under Dr Ollerhead went aboard.

The exact number of German wounded on board the wreck is not known, but according to Dr Luther, the surviving German surgeon, there were about 80.(5) Captain von Müller's Report to the German Admiralty stated a total of 65 (6) but his numbers do not accord with the report of Dr Danby of between 70 and 80. Julian Corbett in the "History of the Great War", Naval Operations (7), gives 56 but does not state from where he obtained this information.

However many there were, these injured men, about 35 to 40 being very severely injured, had been lying without any medical attention for up to 30 hours in a wrecked ship without water and in tropical heat. Their wounds were crawling with large maggots and were seriously infected. All available stretchers and hammocks were sent to Emden where, in the Report of Dr Darby to Captain Glossop: "Men were lying killed and mutilated in heaps, with large blackened flesh wounds ... the ship was riddled with large gaping holes, and it was difficult to walk about the decks, and she was gutted with fire."
The wounded were evacuated from SMS Emden to be taken by boat to HMAS Sydney. This transfer was difficult, and most painful for the injured, as there was a large surf running on the beach and the Emden was such a shambles that the lifting, carrying and lowering of the wounded from the ship onto the boats was necessarily rough, and SMS Emden had no functioning boat davits left. When they reached HMAS Sydney the injured men were hoisted on board, in cots and stretchers using her davits, and taken below to the temporary Wardroom hospital.

SMS Emden's assistant surgeon had been blown overboard and had swum ashore to the beach. There he had suffered from such severe thirst that in desperation he had drunk sea water and died (8). SMS Emden's surviving surgeon, Dr Luther, was physically unwounded as his station in action was the stokehold, but was described by Dr Darby as being "... a nervous wreck" for a short time as he had been alone on the wrecked ship with so many injured men and had no equipment and none of his staff. He was temporarily unable to help treat any injured on board HMAS Sydney, but eventually recovered and was then able to assist in the care of the wounded by performing surgery and giving anaesthetics.

As the German wounded were taken on board to the wardroom, it soon became overcrowded and many of them had to put up with most unsuitable accommodation for wounded men. They had to be placed along the corridors near the sick bay and soon there was scarcely room to move. All available cots and beds were drawn from the stores and blankets were given up to them by the ship's officers, but these were insufficient and some of the lesser wounded perforce went without any cover. It must also be remembered that the already overcrowded ship had taken on board not only the wounded but over 128 unwounded prisoners from the Emden and from the attending collier that had been scuttled after the engagement.

Further surgery on the patients from HMAS Sydney was ceased until an initial assessment could be made of the German wounded. Drs Danby, Todd and Ollerhead attended the more severe cases in the wardroom hospital and directed the First Aid party on how to treat the simpler ones. Some 35 to 40 of the German wounded were very serious. Some had legs hanging by ligaments, others had arms nearly blown off by shell explosion and all these required amputation of the limbs. There were several with severe facial injuries and one particular man had an extensive facial injury that was severely infected with foul-smelling pus. The odour was so appalling that, after cleaning and dressing the wound under morphia, he had to be removed from the Wardroom to the fresh air outside. This man died six hours later. Overall four German wounded died on board HMAS Sydney.

During the action, many of the injured had applied tourniquets of spun yarn, handkerchiefs or a piece of cloth to their limbs to stop bleeding. This had saved them from bleeding to death but they had failed to release their tourniquets, causing the limb below the constriction to become gangrenous and require amputation.

Operations on the German wounded started at 6 pm on Tuesday the 10th of November and continued until 4.30 am. on Wednesday the next morning, involving some ten and a half hours of very intensive surgery. The ship sailed to Direction Island on that day to return Dr Ollerhead, and then set sail for Colombo. The last batch of German wounded were given surgical attention during the day and the operating theatres had then to be cleaned again before they could be used.

On Thursday the 12th. of November, attention was able to be given to HMAS Sydney's own wounded. These had been stabilised before the wounded from SMS Emden came aboard but had not been given any surgery. The first patient had thirteen wounds due to shell fragments and one fragment had fractured both bones of the lower right leg above the ankle. In those pre-antibiotic days the usual treatment for a compound fracture, that is a fracture that communicates with an open wound, was amputation because of the danger of infection. However Dr Darby attempted to save the foot and, after two hours of surgery the patient was placed in charge of a volunteer nurse in the Commander's cabin. His dressings had to be given under anaesthesia for the next fourteen days but the foot was eventually saved.

By nightfall the three doctors had finished all the major surgery, Dr Luther and Dr Todd alternating as anaesthetists and surgeons. There was no time to treat the lesser wounded cases, these were treated by the first aid party, and the wardroom hospital and its equipment had to be reorganised. The patients were fed and nursed by the First Aid Party and unwounded German prisoners helped with the German injured. The casualties from HMAS Sydney were nursed in the wardroom, but often had to be taken on deck because of the oppressive heat. The Germans filled the waist deck, they were cooler there, although they were regularly washed by heavy rain despite awnings and side curtains. A special party, under the Chaplain, was formed to look after the feeding of all the patients. The stretcher party attended to the movement of patients to and from the sick bay but this was difficult because of the overcrowding of the ship and the narrow hatchways and doorways.

The British armed liner, the Empress of Russia, joined HMAS Sydney at sea on the evening of Thursday the 12th. November. She had been sent to help with the wounded and to relieve HMAS Sydney of the German prisoners from SMS Emden and the Chinese seamen from the collier. The weather was calm and on Friday the 13th of November, the unwounded prisoners, the walking wounded and the cot cases were transferred. All of the Sydney's wounded and the more serious of the German wounded were kept back, including all those who had had surgery. New bedding was also transferred from the 'Empress of Russia', this was very necessary as most of HMAS Sydney's bedding that had been used on the patients was, in Dr Darby's words: "...most horribly filthy, foul and offensive." and had to be thrown overboard.

Now that they had more room, every case had a change of dressing, some badly needing this. The remaining bedding and blankets were put through the steam disinfector. The parts of the ship adjacent to the wounded were in a filthy condition because the hot humid weather had contributed to the rapid decomposition of blood and wound discharge that had unavoidably leaked onto the corticene decks. The decks of the sick bay, the ward-room and starboard corridors had to be scraped and scrubbed, but despite this an offensive odour still persisted in the lower decks.

It had been decided to make for Colombo because there was a Military Hospital there and HMAS Sydney arrived on the morning of Sunday the 15th November. The German wounded were sent to the Military Hospital, and when this was full to the Civil Hospital. The Sydney's wounded remained on board but the ship was still in a most unsanitary condition and the Colombo health authorities were brought in to inspect and spray the ship. All this was done hurriedly as the Captain was anxious to put to sea after coaling. She left Colombo on Thursday the 19th November, her medical staff continuing to treat those of her wounded who had not been taken off in Ceylon.

In concluding this paper it should be emphasised that in November 1914, during and after the engagement with SMS Emden, the young medical officers of HMAS Sydney treated the eleven surviving casualties from their own ship and then were suddenly required to treat about 70-80 wounded German sailors from SMS Emden, of whom at least 35 were very seriously injured. Dr Darby, who had qualified as a doctor only in 1912 and Dr Todd, who had qualified only in 1914, were required to perform complicated chest, facial and abdominal operations and many amputations under the most difficult conditions imaginable on board a ship that had quite inadequate medical facilities.

Dr Charles Todd remained with HMAS Sydney until June 1916 when he developed pneumonia following an attack of influenza and was returned to Australia. He was subsequently invalided out of the Royal Australian Navy in 1917 and died from chronic heart disease ten years later in 1927.(9)

After the action Dr Darby was given accelerated promotion to Staff Surgeon (Surgeon Lieutenant-Commander) and was promoted to Surgeon Commander in 1922. He had a distinguished career in the post war Australian Navy, retiring as Surgeon Captain and a Commander of the British Empire. He had held the positions of the Director of the Australian Medical Services and then had two terms as Honorary Surgeon to His Excellency the Governor-General of Australia. He died in March 1980.(10).

1. Parts of the preparation of this paper relied on the Post Action Report on the Action between HMAS Sydney and SMS Emden on the 9th November 1914, by Dr Darby, the Principal Medical Officer of HMAS Sydney, to his Captain. This was published in Australia in 1915 by the Government Printer of the Commonwealth of Australia. [This is referred to in the Notes as the 'Post Action Report']

2. Hustin, A. (1914) "Note sur une nouvelle methode de transfusion.
Annales et Bulletin des Seances": Societe des Sciences Medicales et
Naturelles de Bruxelles, 72e Annee, 104, 111.

3. In later years chloroform was used only for the induction of anaesthesia and the much safer ether was then used to continue the operation.

5. Post Action Report.

6. Captain von Müller's Report to the German Admiralty, in "Official History of Australia in the War of 1914-18", Vol IX, A. W. Jose, page 202.

7. "History of the Great War", Naval Operations, Vol. I, Julian Corbett, 1920, page 384.

8. Post Action Report. Dr Darby wrote that "After much persuasion he got a sailor to bring him some salt water, of which he drank a large quantity, and straightaway became raving mad and died."

9. The Australian National Archives.

10. The Medical Directory of Australia and the Australian National Archives.

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