Originally from the French hôpital ambulant, the word ambulance came into common parlance in the wars of the nineteenth century. At first the word must have referred to the walking wounded, because the root is the same as the verb ‘to amble’. At the time of the Crimean War horse-drawn waggons referred to as ambulances were used to carry the wounded from the battlefield to the primitive field hospitals set up by Florence Nightingale.
The motor ambulance came to England in the aftermath of the Great War; with the coming of peace ambulances became available to the general community, but it was a gradual process. The lack of communication made contacting any provider of first aid (not just ambulances) difficult to say the least. This was certainly true until phone boxes began to appear across the country in the 1920s. Then contacting the local doctor (who would have been one of the few individuals to possess a telephone) became easier. The infrastructure of emergency care still had to develop, and without a National Health Service this was inevitably patchy, and there was always the matter of payment hovering in the background.
Before the Second World War ambulances scarcely existed, especially not in rural areas; the possibility of summoning any kind of medical assistance in an emergency was remote. If some kind of assistance eventually arrived it would certainly not have done so speedily. In the days before the phone it was difficult to contact help, but it was not utterly impossible. Since the latter half of the 19th century an increasing number of rural Post Offices had access to the telegraph system. In theory someone could ride on a horse to the nearest Telegraph Office and the local hospital could be informed of the medical condition of the patient, but at that point the hypothetical system would have broken down. The hospital had no way of bringing the casualty in from the countryside for treatment, although in the city it might have been possible to help.
Consequently it would normally be the nearest doctor who would be summoned for assistance. Day or night the long-suffering physician would attend to the critically ill, travelling on horseback or by an early form of motor car. Unlike now, doctors were always available ‘out of hours’. You may read in the book Black Beauty of the journey of a doctor on the galloping horse in the dead of night, to an ill patient. On arrival the doctor was good at looking concerned and taking his stethoscope out of his Gladstone bag, but his ability to help the casualty was severely limited by the lack of the high-tech resources we rely on today. People were resigned to their fate in those times.
It may come as something of a surprise to some people, but the ambulance service in England was run entirely by volunteers well after the formation on the National Health Service in 1948. It was manned by St John’s and the Red Cross. I cannot tell you exactly when paid ambulance staff took over this emergency service, but in 1964, when my friend had appendicitis, he was taken to hospital from Holt to Norwich in a Bristol ambulance driven by Harold Cook, a St John’s Ambulance volunteer. The Red Cross and St John’s Ambulance no longer attend emergencies, which is done by the professional Ambulance Service, but they still perform a valuable scontribution in transferring non-urgent cases between mefical establishments. The sight of a St John volunteer is still a common one at public events.
The early ambulances had no blue flashing lights; there was no siren either, but as with fire engines these vehicles rang a silver bell when on emergency call-outs. You might think the sound of a bell was less noticeable than that of a siren, but there was scarcely a more alarming sound than an ambulance speeding along ringing its bell. The colour scheme has changed from white to yellow, and the provision of medical equipment in the vehicles has increased enormously. These however are minor changes compared to the arrival of ambulances in the first place; today we complain if an ambulance takes a minute longer to reach us than the statutory eight minutes. There are those still living who would have been lucky if they had (for example) broken a leg, to have seen an ambulance within an hour, if one came at all.
Childbirth, which nowadays always merits a visit to the maternity ward, was previously undertaken at home, until almost within living memory. The local midwife (completely unversed in medical terminology but steeped in age-old lore) was still a common feature of Edwardian England. Childbirth was, in spite of its everyday occurrence, a dangerous time. The regular use of anaesthetics, let alone the use of ambulances to transfer pregnant women to hospital, has occurred only relatively recently. The world has certainly changed; we really don’t know we are born!
[My sister writes: As you probably know, Auntie Peggy drove an ambulance at night during the war. (In the day she ran the wool shop which kept the family business going). They would park their cars on the quayside [at Kings Lynn]– no walls to prevent them from falling into the water, and Elsie did– she drove her car over the edge and ended up upside down in the mud. She put her finger out of the gear shaft to show she was alive, and was rescued before the tide came in. Elsie, Auntie’s friend, lived to be over a hundred and died within the last few years, I believe. Auntie Peggie could tell you more. . . I remember her coming down to breakfast in her dressing gown, having been up most of the night.]