Dr's Casebook: ​A SALUTE TO PRIVATE ERNEST CABLE ON REMEMBRANCE DAY

Dr Keith Souter writes: Thus, begins In Flanders Field, one of the most famous Great War poems. It was written on the Western Front by a Canadian surgeon and poet, Lieutenant Colonel John Macrae in 1915. He was inspired by the sight of so many poppies that had sprung up amid the bleak, muddy landscape of the Western Front battlefields.

Every year I watch the Cenotaph service on Remembrance Sunday. I particularly anticipate the arrival of the pipe bands, for my great grandfather was a piper in the Gordon Highlanders who was wounded at the Battle of Loos in 1915.

It is estimated that 37 million lost their lives during the Great War.

Significantly, one third of deaths were from infections or disease. One such victim was Private Ernest Cable serving with the 2nd Battalion of the East Surrey Regiment.

He was sent to hospital near Boulogne, where he was diagnosed with dysentery, but died from it a few weeks later.

Fortuitously, a doctor took a bacterial sample from him which was kept for future research. His sample was the first and founding culture of what is now among the oldest ‘living libraries’ of bacteria in the world, the National Collection of Type Cultures (NCTC). This exists to support scientists all over the world understand infectious diseases

Now over a century later it has been used by scientists in the on-going fight against dysentery and antibiotic resistance.

The dysentery organism, is called Shigella flexneri. Its genome has been decoded. Private Cable’s sample shows that the bug had already developed penicillin resistance 13 years before Alexander Fleming famously discovered the antibiotic penicillin. It has now been compared with modern isolated samples. This shows that the bug has acquired even more antibiotic resistance in modern times.

This is highly significant, because dysentery still spreads in unsanitary conditions and in war zones, just as it did in the World War 1 trenches. Thus, Private Cable is still contributing to the fight. His sample is showing us how bugs are continuing to evolve and why we must today limit the use of antibiotics.

On Remembrance Sunday, we must remember all those who have given their lives as the direct or indirect result of wars.