In this post, Dr Frances Houghton examines a puzzling medical mystery in the Royal Navy in 1942, and explains how this illuminates close bonds of shared Allied friendship and international medical co-operation in the Second World War. Frances is currently a Simon Research Fellow (University of Manchester), examining medical ‘cultures of care’ in the Royal Navy. She is working closely with us on bringing together histories of Free French and British medicine, gender, and emotions.
On 23 October 1942, the British light cruiser HMS Phoebe was torpedoed by an enemy submarine 6 miles off Pointe Noire on the coast of French Equatorial Africa. 49 sailors lost their lives in the attack. As a result of this action, a number of the ship’s company sustained curious respiratory injuries, producing an intense medical crisis that required all the best efforts of local British, French, and US military medical personnel to overcome. For years after the war, the official report of the ship’s Medical Officer, Surgeon Lieutenant Commander R. Noraworthy, RN, remained classified as ‘Secret’. Nevertheless, the disastrous plight of the Phoebe in 1942 unfolds an impressive story of transnational medical co-operation in a difficult and remote location, in which Allied generosity and willingness to share medical supplies and knowledge helped to save many British lives.
When the torpedo struck, the ship sustained heavy damage to its ‘B’ turret and magazine. Reports rapidly filtered through of a thick column of ‘particularly yellow’, ‘very acrid and choking’ smoke. The toxic fumes spread out quickly to fill the Boys’ and Marines’ Messdecks and other nearby spaces, including the Sick Bay. Although it was known that there were casualties in these areas, immediate rescue proved impossible and it was some time before the smoke cleared sufficiently for help to be rendered. When the bodies of the dead were pulled out, it was noticeable that their skin colour was largely bluish rather than pink, and a horrid froth dribbled from their noses and mouths. These signs indicated intense pulmonary irritation.
Among the survivors, although some men had managed to don anti-gas respirators, most had not time to respond. A number of cases had to be treated immediately after exposure to the smoke, which left men coughing and vomiting copiously. With only a few exceptions, these sailors recovered rapidly and were able to resume their duties. However, this recovery was a deceptive temporary state of affairs, and matters were soon to become very much worse.
After about an hour and a half, men were beginning to report to the medical distributing station, complaining of difficulty in breathing and tightness across the chest. It became evident that there had been a strange latent period between the attack itself and men succumbing to breathlessness. Throughout that afternoon and evening, continuing for up to 16 hours after Phoebe was torpedoed,increasing numbers of new cases reported sick. Most of the casualties who began to besiege the ship’s medical staff had initially (after brief choking and retching upon first contact with the yellow smoke) then felt fine and put in hours of hard work before suddenly being forced to report sick later on.
Three hours after being hit, Phoebe made harbour at Pointe Noire. At this point, the precise nature of the condition afflicting the seamen had not been identified, and it was with considerable relief that Surgeon Lt. Commander Noraworthy welcomed the offer of help from medical colleagues in the nearby French and American military forces. In answer to a signal requesting immediate medical assistance, the British ship was boarded by Captains Iovine and Dunham of the US Army Medical Corps, and Dr Hermann Tempel, a Polish doctor who was attached to the Forces Navales Françaises Libres (FNFL) . There were practically no oxygen supplies to be found in the local vicinity, so a decision was made to send only the surgical cases ashore and to keep the lung cases aboard the ship. As more and more men reported sick, a pattern began to emerge in which medical staff detected the onset of classic symptoms of pulmonary oedema (excess fluid in the lungs), a painful spasmodic cough, production of bloodstained frothy sputum, and vomiting after each paroxysm of coughing. Cyanosis was also apparent, and patients’ skin turned various shades of blue and ashy grey due to lack of oxygen in the blood.
The unusual respiratory injuries sustained by the ship’s company as a result of the torpedo attack gave rise to fears that a new form of chemical weapon had been used against the Phoebe. However, despite these initial suspicions, the hard-pressed medical staff realised they were dealing with the effects of gassing by nitric and nitrous fumes which had, in all likelihood, been formed as a result of the torpedo explosion and subsequent fire in the ship’s ‘B’ turret and magazine. The mystery of the poisonous gas had been solved; the problem of how to keep the injured breathing had not.
For the medical staff caring for the afflicted sailors, this was an intensely difficult period. Medical provisions afloat and ashore were insufficient to cope with the crisis. Transnational efforts to alleviate the suffering of the British sailors were ramped up, and Surgeon Lt. Commander Noraworthy’s report expressed heartfelt appreciation for the generosity of French and American aid to the stricken ship. He noted that during the whole of the Phoebe’s stay at Pointe Noire, the French and Americans were ‘unstinting’ in offering medical help and drugs.  The latter was particularly appreciated, as Noraworthy knew that supplies of medical drugs were also short for the French and Americans, yet they were quick to offer to share what they had.
In the midst of this medical crisis, international sharing of medical knowledge, drugs, and equipment saved many lives. Phoebe’s fellow RN ship, HMS Sirius, sent across all their available supplies of oxygen. The French lent the British their equivalent of a ‘Novox’ machine, resuscitation apparatus that included a cylinder containing oxygen and a small quantity of carbon dioxide, a breathing bag, breathing tube, and face mask. In addition to giving the British a small quantity of Sulphadiazine from their own US Army Medical Corps stores to prevent burns becoming infected and ease the condition of the worst-afflicted patients, the Americans contacted their 23rd Station Hospital in Leopoldville to request that three large cylinders of oxygen be flown the 300 miles to Pointe Noire.
Why is this episode, a single thread buried in the great tapestry of a global war, so significant? Partly because the image of chemical gas flooding the lungs of hapless victims instantly produces its own story of sheer visceral horror. Unlike the 1914-18 war, gas warfare was never a major feature of combat in the Second World War, and there are almost no accounts of naval and medical personnel having to mobilise to deal with the effects of mass gas poisoning as Phoebe’s officers and ratings had to. The mystery of whether the enemy were using a devastating form of new chemical warfare also heightened the emotional atmosphere of fear and pressure in which medical staff were working. Effectively, they were trying to play clinical ‘catch up’ whilst dealing with both an unknown situation and extremely limited supplies. This was also a story of tremendous Allied collective endeavour to keep fresh oxygen flowing through the lungs of badly injured British sailors. Whilst Surgeon Lt. Commander Noraworthy’s official report of the incident was conventionally emotionally detached, he freely and frequently gave thanks in his account for the lengths to which Britain’s wartime Allies went to help save the lives of British sailors in a remote location on the coast of French Equatorial Africa, especially when this meant sacrificing their own supplies.
That spirit of transnational friendship and shared sacrifice was kept alive. Two years later, on 11 November 1944, an Armistice Day Ceremony of Remembrance was held at Pointe Noire to honour the men killed in the attack on HMS Phoebe in 1942. The ceremony was very much an international and inter-service affair, with British and French diplomats and service personnel attending. Memorial wreaths were presented by the British Vice-Consul, the British Naval Liaison Officer and Staff, the French Navy, French military veterans, and serving personnel in the French Army. In the foreground of the photograph of the war memorial below, we can see a card attached to one of the wreaths, which expresses the sorrow of French war veterans for the loss of their British ‘comrades’ in Phoebe. As this episode demonstrates, wartime medical co-operation and bonds of friendships and shared sacrifice spanned national borders and military services in ways that surely carry heightened meaning for the global health challenges of early 2021.
 According to Guy Chauliac, Hermann Tempel joined the Free French on 23 August 1940. Guy Chauliac Le Service de Santé de la France Libre. 1940-1943 (Paris, 1994), p. 42.
 On the history of the Forces Navales Francaises Libres, see, for instance, Emile Chaline and Pierre Santarelli Historique des Forces Navales Francaises Libres, Service Historique De La Marine, 5 vol. (1994-2006).
 Surgeon Lt. Commander R. Noraworthy, RN, ‘Medical Report on Casualties due to the Torpedoing of H.M.S. Phoebe on October 23rd 1942’, The National Archives (TNA), ADM 261/1.