d practically all with Spanish influenza and, in
addition, many with gangrenous wounds. Tried to enlighten the Russian
doctor in charge with the fact that fresh air would be beneficial to his
cases. But he seemed to think I was entirely out of my sphere and
ignored what I said. I reported the situation to British headquarters
and thereafter he reluctantly did as I suggested. Then arranged with
headquarters to send Russian medical officer and felchers with American
medical officers out to villages where assistance was needed most,
instructing each to impress on the natives the necessity of fresh air
and proper hygiene. They found there was such a shortage of the proper
kind of food that the people had no resistance against disease, and were
dying by the hundreds. In the meantime established annex to civilian
hospital in a school building. Had wooden beds made and placed felchers
in charge.

Tried to segregate cases in Shenkursk and immediate vicinity as much as
possible. After getting everything in working order I found a shortage
of doctors. So I proceeded to villages not yet reached by others. Report
from Ust Padenga that Lieut. Cuff and fourteen enlisted men killed or
missing on patrol Nov. 29th; some of the bodies recovered.

Weather growing colder. Twenty degrees below zero, with snow four inches
deep. Evacuated sick and wounded from Ust Padenga eighteen versts beyond
Shenkursk in sleds filled with hay and blankets necessary for warmth.
Shakleton shoes had not arrived at that time. Most cases coming back in
good condition, but pneumonia cases would not stand the exposure.
Condition at Ust Padenga very uncertain. Lieut. Powers and Lieut.
Taufanoff in charge of ten-bed detention hospital. Advised them to keep
their hospital clear for an emergency.

Action reported on Dvina and hospital captured; later retaken. Slight
action every day or so at Ust Padenga. Lieut. Powers caring for all
civilians in and around that place. Visited one home where I found the
father sick and in adjoining room the corpse of his wife and two
children. In another village I found twenty-four sick in four families;
eight of which were pneumonia cases. In one peasant home, six in family,
all sick with a child of eight years running a fever, but trying to care
for others. All sleeping in the same room; three on the floor and
balance together in a loft made by laying boards between the sills. They
informed me that no food had been cooked for them