You know how this works
HEADS UP: Parts of this story are rated R
WWI tactics amounted to a delicate trade-off between the nightmare of the trenches and the horrors of no man's land. Generals and their staff faced the grueling choice of either sacrificing their men to the trenches, or to the “storm of steel” that decimated so many forces and pushed them underground. They all chose the trenches.
With the trenches came disease. In part 1 of this series, I mentioned that WWI was the first conflict in history where deaths caused by combat exceeded deaths caused by disease. This is primarily a result of improved weaponry, not necessarily improved hygiene or medicine, although both had greatly improved by 1914. The Allied and Central powers were the first armies in history to benefit from modern technologies like antiseptics, mass inoculation programs, and an understanding of bacteriology.1
These new tools saved countless lives and successfully eradicated infections such as tetanus. Tetanus is a bacterial infection that causes rigidity, muscle spasms, and what is commonly known as lockjaw. The bacteria that cause tetanus are found in soil, making the trenches of WWI a hotbed for the torturous disease. Any open wound in the trenches would have made soldiers highly susceptible to tetanus had it not been for advancement in wound debridement and a tetanus antiserum that was widely distributed. Thanks to those two turn-of-the-century technologies, only 23 cases of tetanus were recorded among the American Expeditionary Force.
Nature is not so easily defeated, however. Both sides were unprepared for the battle they’d face with known diseases such as typhus, and with new ones, such as trench fever. No shelter from the elements, rodent infestations, and a general lack of proper hygiene killed many men and gave us some of the most horrific accounts of the war.
Trench Foot
There are common, everyday jobs that require working in a wet ditch. If you lay water lines for a living, or do any sort of underground repair, you've probably spent time in a muddy hole. It's nothing novel. We can all conceive of having wet feet from time to time.
We can also conceive of having cold feet, in the literal sense. We've all walked through snow from the car to the grocery store or skied down a mountain slope during a winter vacation. Cold feet are no big deal. We just take our socks and shoes off and warm our toes up by the fire or heater.
But what happens when you live in what is essentially a drainage ditch? How do you escape a flood when the rain water runs off surrounding fields and roads into where you sleep, work, and eat? How do you drain a drainage ditch? The water has nowhere to go, so it pools up and soaks into the soil. Wet soil of course produces mud.
Now, imagine it's the middle of winter, and that mud is half-frozen, with the consistency of a milkshake. It's difficult to walk through, freezes to your boots, and never dries up.
Finally, imagine what happens when you're trapped in that milkshake-filled ditch for days at a time, sometimes weeks.
Wet and cold feet suddenly become an epidemic if you can't dry them off and warm them up. The men in the WWI trenches lived this nightmare. Trench foot, also known as immersion foot, or non-freezing cold injury, plagued everyone.
The cause of Trench Foot during WWI stemmed from trench lifestyle. A combination of cold (either from the temperature or long periods of wetness), days of sitting still, and tight boots, resulted in poor circulation to the toes, feet, and lower legs. A lack of blood flow causes the tissue to break down and rot. If left untreated, trench foot can lead to severe gangrene, requiring amputation.
LTC Cottel, a medical officer during the war, describes one of his first encounters with the ailment:
G.S, aged 29, … was in the advanced trenches from November 14th to 19th, during which time it was raining and freezing alternately. His feet felt very cold and numb on November 19th, but owing to the fighting he never took his boots off. On November 20th he could not stand and was carried back; he was seen by a medical officer, temporarily dressed, and sent to Boulogne. He embarked on November 24th. The frostbite then (11.30 am) included the toes of both feet, extending up the metatarsus; there were bullae the size of filberts on the big toes. The limb had a dull red irregular blush some 5 in above the ankle, and the legs were edematous nearly to the knees. The temperature was 100°F, and he complained of dull heavy pain, but there was no headache or definite constitutional disturbance.
Trench foot can develop in as few as 10-14 hours. Just one day with wet feet and the tissue starts to deteriorate. It starts with a tingling feeling or an itchy feeling and progresses to numbness of the affected area and eventually, severe pain. Cases of trench foot in cold environments can include cyanosis, which turns the affected area blue. If left untreated, open sores develop as well as blisters that smell like gangrene. Because of how quickly the disease can progress, units implemented routine foot inspections and passed guidance on how to properly wear their boots.
It's estimated 75,000 British and 2,000 American troops died of trench foot during WWI.
Lice
Aside from new, swift illnesses like Trench Foot, forces found themselves fighting disease-carrying pests, such as lice and rats.
Lice infested the entire front. Historians estimate nearly ninety-five percent of British troops coming out of the trenches on the Western Front were infested with lice.2
If treated, lice aren't much of an issue. Grade school children catch and spread lice every school year, but modern treatments can stop the spread of lice once they're discovered. A lack of preventative measures like proper hygiene, however, makes lice a much bigger problem.
Lice reproduce rapidly, hatching their eggs in just six to nine days. The females excrete a sticky substance that bonds their eggs to hair follicles making them difficult to remove. Soldiers would sit naked and pick through their uniforms, brushing out eggs one by one, during "chatting"3 sessions. But of course, this method failed. Lice nits are tiny and easily mistaken for dandruff. Miss just one and it'll hatch and reproduce quick enough to replace all the eggs removed in a delousing session.
Lice live inside the seams of uniforms, in dirty, unwashed hair, and in troop's bedding. Infestations spread through close contact and through shared belongings. Soldiers of the trenches shared sleeping huts, blankets, and would often take clothes off the dead.
Lice itch like crazy. They bite at your skin and cause a tickling sensation when they walk across the infested area. Without swift treatment, a lice infestation eventually spreads throughout the entire body. Not only will your scalp itch, but you'll experience intense and ceaseless pubic itching as well.
It is difficult to explain just how prolific lice were in the trenches. British war correspondent Philip Gibbs does just about as good a job as any when he describes the "Hole Shirt of Nieppe". He explains how the shirt belonged to a British officer and was used as a testament for all to the invasive quality of lice in the trenches:
It was the Holy Shirt of Nieppe, which should be treasured as a memorial in our War Museum—an object-lesson of what the great war meant to clean-living men. It was not a saint’s shirt, but had been worn by a British officer in the trenches, and was like tens of thousands of other shirts worn by our officers and men in the first winters of the war, neither better nor worse, but a fair average specimen. It had been framed in a glass case, and revealed, on its linen, the corpses of thousands of lice.
He goes on to describe the pace at which men in the trenches were infected with lice:
That vermin swarmed upon the bodies of all our boys who went into the trenches and tortured them. After three days they were lousy from head to foot. After three weeks they were walking menageries.4
Accounts from men on the front paint a picture of lice with a preference. Evidently, lice prefer a clean host. Either that, or men simply grew accustomed to the annoyance and noticed the lice less and less the longer they were in the trenches. Soldiers new to the trench seemed to be affected by lice to a greater degree than the dirty men near the end of their rotation. Percy Webb of the Dorsetshire Regiment recalled his first encounter:
I was in the trenches at Le Transloy, and I suddenly realised that I began to itch and swing my clothes round my body where I was, you know, trying to… and of course you’d just swung your clothes round your body and you’d scratch and scratch and scratch. And the men that had been out there longer than I had were used to it, you see. Well they always said that the lice was more active on a new body, a fresh body, if you understand what I mean, than they were on people that’d had the lice for a long time! You see they were most destructive things, lice were. And I think that was one of the biggest humbugs of the British Army, lice in the trenches.
Soldiers in the trenches became close companions with lice, as well as the diseases they carry. Lice on the Eastern Front often carried typhus, while Western lice carried the newly discovered Trench Fever.
Symptoms of Trench Fever include headaches, body aches, and severe pain in the legs, mostly radiating from the shins. These symptoms were severe enough to take soldiers out of the fight for up to three months.
Researchers on both sides of the conflict did not initially know the cause of Trench Fever. American researchers were the first to blame lice, but it was the British who discovered the actual root cause, being lice feces coming in contact with open wounds.
It's estimated British, French, and Belgium troops suffered 500,000 Trench Fever cases from 1915 to 1918.
Rats
The men on the Western Front of WWI lived side by side with rats, sharing beds, eating together, drinking together, and oftentimes, harassing each other like rival siblings. Captain Bill Murray wrote his family in 1915 about his annoying roommates:
There are five families of rats in the roof of my dug-out, which is two feet above my head in bed, and the little rats practise back somersaults continuously through the night, for they have discovered that my face is a soft landing when they fall.5
Troops considered the rats uniquely disgusting and much worse than other critters of the trench. As a Colonel with the British Expeditionary force put it, he could befriend a mouse, but rats were the devil:
Rats are the worst plague,” said a colonel, coming out of the battalion headquarters, where he had a hole large enough for a bed and table. “There are thousands of rats in this part of the line, and they're audacious devils. In the dugout next door the straw at night writhes with them … I don't mind the mice so much. One of them comes to dinner on my table every evening, a friendly little beggar who is very pally with me.6
Rats are opportunist animals. They cleaned up after troops in the sense that no food went to waste. If a troop dropped a ration, they could soon expect a gang of rats to appear and battle over the scraps. Of course, trench rats didn't limit their meals to just the leftovers of the troops. Many soldiers reported rats raiding their ration bags and snacking on their foreheads while they slept. James Harvey tells the story of rats biting up his buddy:
Rats were common, very common, you didn’t dare leave a bit of food about or else there’d be swarms of rats round you. And all the time you didn’t attack them, they didn’t attack you. But on one occasion where we got a bayonet and stuck one; needless to say we got out of that place quick! There were thousands of rats, must’ve been thousands, the number I couldn’t count them – didn’t stop to count ’em! Didn’t matter what part of the line you was in, you’d got these rats. One of our men who was asleep, and had his forehead all bitten by them. Oh yes, he had to go into hospital special for it.
To combat both the insane number of rats infesting the trenches and the boredom that comes with a stalemate, Soldiers organized rat hunting parties. At one point during the war, armies offered their men a bounty for every rat pelt they turned in. The reward for a rat was one halfpenny, the equivalent of $0.80 in 2021 dollars. One British unit managed to kill more than 8,000 rats in a period of two weeks. This cost the British Army just 16 pounds, or a little under $2,600 in 2021 dollars.
Other means to suppress the rat population included poison and train carts full of Terriers. But the combination of rat bounties, poison, and dogs was not enough to dry up rat infestations. The trenches were just too fertile of a breeding ground.
The rats often took up a living inside the decomposing bodies of the unburied, which were not hard to come by. Corpses occupied every position in the trenches. With nowhere to put them, they often sat out in the open to rot on the floor of the trench or in no man's land.
The sheer volume of men killed in action or taken by disease and the short time span in which they often died made it impossible to properly bury them. Both armies were woefully unprepared for the casualty rates they would face during the war. Thousands of men died, sometimes in one day, and in concentrated locations. Wherever men were ordered to vacate their trench and go on the assault, there, piles of dead bodies would stack, shredded by machinegun fire, coordinated rifle fire, and artillery shells.
Once fighting ceased, where could they put the dead? There were too many for the trench floors and burying them outside the trenches was—depending on how you went about it—either a perilous task or an exhausting one. Burying them at the rear meant dragging the bodies through what could be miles of trench, and burying them just over the trench walls meant climbing out and exposing oneself to machinegun or sniper fire. There was no good solution.
Journalist Philip Gibbs tells a story of dead bodies ending up in sandbags. When digging to fill new sandbags, troops unearthed dead bodies from the floor of the trench, and with nowhere else to put them, mixed their dead friends in with the soil and stacked them against the walls of the trench:
In digging new trenches and new dugouts, bodies and bits of bodies were unearthed, and put into sand-bags with the soil that was sent back down a line of men concealing their work from German eyes waiting for any new activity in our ditches.
“Bit of Bill,” said the leading man, putting in a leg.
“Another bit of Bill,” he said, unearthing a hand.
“Bill's ugly mug,” he said at a later stage in the operations, when a head was found.
As told afterward, that little episode in the trenches seemed immensely comic. Generals chuckled over it. Chaplains treasured it.7
With rats came disease, specifically typhus. While rats themselves did not carry typhus, they carried something that did; Fleas. Similar to lice, the fleas carried by rats carried Rickettsias, the microorganism that causes Typhus.
Fleas do not normally parasitize humans. But when humans invade fleas' homes, it's only natural for the fleas to hop from rat to human. The fleas spread Typhus not only through bites but through inhalation, which would often cause pneumonia.
Part 3 will be published in the next 2-ish weeks
Strachan, Hew. (2014) 2014. The First World War. [Edition missing]. Simon & Schuster. https://www.perlego.com/book/782013/the-first-world-war-pdf.
Strachan, Hew. 2014. The First World War. Simon & Schuster. https://www.perlego.com/book/782013/the-first-world-war-pdf
Gibbs, Philip. (2019) 2019. Now It Can Be Told. [Edition missing]. Good Press. https://www.perlego.com/book/1944909/now-it-can-be-told-pdf
Gibbs, Philip. (2016) 2016. Now It Can Be Told (WWI Centenary Series). [Edition missing]. Read Books Ltd. https://www.perlego.com/book/954555/now-it-can-be-told-wwi-centenary-series-pdf.]
Strachan, Hew. (2014) 2014. The First World War. [Edition missing]. Simon & Schuster. https://www.perlego.com/book/782013/the-first-world-war-pdf
Gibbs, Philip. (2019) 2019. Now It Can Be Told. [Edition missing]. Good Press. https://www.perlego.com/book/1944909/now-it-can-be-told-pdf
Gibbs, Philip. (2019) 2019. Now It Can Be Told. [Edition missing]. Good Press. https://www.perlego.com/book/1944909/now-it-can-be-told-pdf