Thank you for your letter... It was forwarded to me here as I am now having my belated leave. I have in fact had more than half my month and will soon be going back... I don't know how much the censor let through the post about news from Spain but I know they are fairly strict on any military information. Our last two attacks - Brunete and Belchite - were important in that they showed that the attack was coming from the Government on all fronts except the Basque front.

On that front things have gone very badly indeed. The work we had in June and July was very heavy and there must have been tremendous losses of men, but the Government has gained a certain amount of territory on the various fronts on which it has attacked. I know those two attacks we had through our front line hospital 900 in five days, and 2,000 in three weeks.

The war doesn't look like ending for a long time yet. The government has done wonders with its "Peoples Army", but every time it has appeared to be ready to cope with Franco and his rebellious army, as it was in the beginning, the Germans and Italians have sent more reinforcements.

A Moor ... had been shot in the leg and so immobilised somewhere in the mountains... Five days before they found him... (he was a) starving wizened little chap with this horrible septic leg... he came in and the leg was crawling with maggots... the Spanish surgeon had to amputate... he was hardly fit to stand an amputation... After the operation he was weaker still, nevertheless the local Anarchist military chief came in and cross examined the poor fellow... He died within a day or so.

Gradually people... sort of decided they wanted to go where there really was something to do ... helping with the wounded ... I thought it was time I moved on too... I went to Barcelona ... and with one or two others we were incorporated into a French Battalion - XIVth International Brigade - Franco-Belge... French speaking more or less.

The transfusionist for our Granen hospital was Dr. Reginald (Reggie) Saxton from England, who was also my superior in the lab. One of the first of the English doctors to arrive, he had first worked on the Aragon front. Slim, tall, blond, and soft-spoken, he taught me much of what I needed to know in the lab and helped in the accumulation of more and better equipment. Later, our little lab was located at the division's base hospital. It had become less primitive over the months and, with his help, I grew in the range of diagnostic tests I could do.

Our lab became increasingly an integral part of our medical service. Soon I was not alone. My first co-worker was an Italian, Ricardo, who came to Spain via the Pasteur Institute in Paris. From under his well-trimmed black beard, which hid his acne-scarred face, he projected a quiet voice and a quick temper. He was a tower of strength, doing both laboratory work and blood transfusions. Ricardo also arranged for the transformation of a large Bedford (British Ford) evacuation ambulance. Its structure had been practically destroyed in a bombing attack, but its engine and chassis were in excellent condition. He oversaw its conversion into a mobile laboratory called an autochir. During the first weeks with us, Ricardo spent most of his time at the garage supervising the makeover. When the autochir finally arrived, it had a small oven, an autoclave for sterilizing, an incubator for growing cultures, and even more important, a butane-fed refrigerator that allowed us to store blood ampoules. It had enough racks, drawers, and cabinets for the limited extra equipment we had been able to scrounge, plus room for future acquisitions. This new prize meant that we then had to requisition much duplicate equipment, so that when we went up front the base laboratory could remain functioning.

At the Battle of Teruel, Teruel was captured and then lost again, following which the fascists split the Republican forces in two. It was a very hard battle, there were heavy losses. The terrain was very difficult; mountainous and muddy and snow bound, and most of the time very cold. Our patients were treated in all sorts of odd buildings and we were subjected to air attack and to snipers even, if you got anywhere near the enemy side of the town. We did acquire a lot of medical equipment, foreign equipment, which was in Teruel the time it was taken.

When we had recovered from this battle and came out of Teruel, we had done what we could with the wounded. It was a very trying time. The situation was very unpredictable and so cold and so miserable. At that time I acquired a very large vehicle. I think it was specially built according to my specifications. The body was a laboratory with benches on two sides with a refrigerator in one corner and a sterilizer in another, and across the width of this wide vehicle were a couple of bunks for me and my assistant (between the driving part of the front of the vehicle and the laboratory part at the back). So we were more or less a self-sufficient organization. We had cupboards and a refrigerator where we could store blood. I never intended to get down to actually drawing blood for storage because this required rather more facilities and sterile conditions, and required donors being examined beforehand, and actually taking blood for storage. This was done in Barcelona and Madrid.

So this was my laboratory and blood transfusion vehicle which I took with me and a driver. There was one other permanent assistant, who slept on the front seat. Anyway myself, my driver and assistant were always with this vehicle, and occasionally when we stopped for a length of time we did accumulate three other laboratory assistants, one Italian and two Americans. This laboratory when we were stationed long enough took on jobs of ordinary laboratory work....

In this laboratory we had blood donors and I used to do blood grouping. We gathered quite a lot of volunteers to be blood donors. We were a medical unit working for the army and were insulated very much from the civilian troubles that existed. Just occasionally, civilian difficulties would overflow into our work. Getting together volunteer blood donors meant contact with the various civilian organizations that might help or provide us with these donors. There was a little bit of antagonism between them. The Socialist Party would be a bit edgy about the Communist Party or the Republican Party, i.e. who is really going to organize it, who is the more important of these three organizations? Feelings of resentment between these groups interfered to a large extent with the welfare side of the hospital.

At the Ebro I was actually there with my mobile laboratory. The frontline was along the Ebro, along the two sides of the river. It was a very well-planned offensive from our side from Catalonia, and it was supposed to have been coordinated with the corresponding attack from the other side, and there were the fascist forces in the middle. We set up a hospital in some caves on our side of the river to receive casualties at the beginning of the attack. We had this hospital in this cave and the cave was on two levels inside. It had been levelled up inside and was very nicely protected by this enormous hill over the top of it. It was lit up with electric lighting, which an American engineer did for us. On one level there was a ward and an operating theatre, and on another level another ward. In the end we found that we were using one ward for Republican soldiers and the other ward for prisoners of war, and in the valley just below the caves were canteens and feeding arrangements, ambulance parks and a tent or two. It was quite well arranged.

Then we had the first casualties brought back across the river to us in this cave. Our transfusion and laboratory was there. It was quite a temporary affair, and as soon as some territory had been cleared on the other side of the river we took this laboratory and mobile service and went across a pontoon bridge. It was very exciting in a way, going across the pontoon bridge, which the Spanish engineers had organized so well across the River Ebro. They had spare pontoons concealed in various places not far away, where there was vegetation or something to hide them from the aviation because there were a lot of planes. Every day the Italian planes would come over and try to destroy this pontoon bridge, and indeed they hit it on numerous occasions. But since it was all in sections, all standard-sized boats, when one was sunk, that evening a similar pontoon was floated into position. The next morning things would be going across again.

We went across it at night and there were planes all around even then. We got across and drove up to a farmhouse along very narrow roads. We had to stop every now and then to cut down a tree because the road was not wide enough for this very wide vehicle. Then we set up our little hospital in the farmhouse. We were digging ourselves shelter there and our driver was digging a trench beside a car. He was a very energetic, strong young man. He dug us a nice shelter, a trench beside the vehicle and he also cut down lots of branches from the trees to camouflage it for when the wounded came in.

Reginald Saxton was a brave and radical doctor who matched his beliefs by his action, spending the early years of his medical career serving in the front line during the Spanish Civil War. There he transformed the often rudimentary surgical setting by developing a mobile blood-transfusion unit serving the wounded in the heat of battle.

As a politically orientated doctor recently qualified from Cambridge and Bart's he was drawn to socialism and Communism following readings from Major C.H. Douglas's Social Credit (1924) and the series edited by C.R. Attlee "Labour Shows the Way". At Repton, under the discipline of that notorious headmaster Geoffrey Fisher (a future Archbishop of Canterbury), he said later, with that open laughter which so characterised him, "I couldn't somehow make contact with the Almighty."

Attending lectures at Transport House in London and studying economics at Reading Public Library persuaded him that only the left wing had the answers to the social inequalities of the Thirties. At Sidney Sussex, Cambridge, he found himself in a milieu of stimulating like-minded students for whom Communism represented a response to economic and political stagnation. For a year or so he worked for various medical teams at Bart's, including that of Geoffrey Keynes, and here he learnt the skill of blood transfusion.

At a meeting in August 1936 attended by barely 20 people and addressed by a Labour MP he volunteered to join the Spanish Medical Aid Committee; he left for Barcelona in September, and was sent to set up the First British Hospital, north of Aragon, "a muddy dirty old building with a perfectly useless drainage system". Frustrated by the internal politics, he returned to Barcelona and joined the 35th Medical Division Unit - attached to the French Battalion the XIV International Brigade. This brigade took the initial brunt of the Nationalists' push at the Battle of Jarama in February 1937. There 10,000 Republican soldiers died and Saxton set up hospital as an advance party in Villarejo de Salvanés.

It was the middle of the night and the circumstances were near-farcical, with a building being seconded to them, in the dark and in broken Spanish, by a mixture of threat and misunderstanding. That comic element rapidly vanished in the sleepless nightmare of the casualty clearing station. After two days Saxton crawled away to sleep under a pile of benches before being summoned back. In his letters home he writes, "One became almost an automaton... it was hard slog all the time... one long struggle to keep keeping on."

The front line was along the... river. I The left hand bank I was in Republican hands, right hand in Fascist. It was a very well planned offensive ... very well organised. As soon as some territory had been cleared on the other side of the river... we ... went across a pontoon bridge. It was very exciting in a way, going across a pontoon bridge which the Spanish engineers had organised so well. They had spare pontoons camouflaged in various places not far away to hide them from the aviation. Every day Italian planes would come over and try and destroy the pontoon bridge. Indeed they hit it on numerous occasions, but since it was all sections standard size boats... the same evening an exactly similar pontoon was floated into position and things were got going again.

The group from Grañen went on to play a crucial role during the battles for Madrid. They improvised a hospital at a hotel in the Sierra de Guadarrama, running it until early February 1937, when ferocious fighting broke out around Franco's attempts to close the circle around the capital. With Dr Alexander Tudor-Hart, and the distinguished Catalan surgeon Moisès Broggi, Saxton had set up a field hospital in a country club, at Villarejo de Salvanés using the bar as a theatre, and operating on three table-tops. In the first five days, 700 wounded were brought in.

Saxton worked out new methods for blood transfusions, thereby saving many lives. He also classified the blood of every brigadier who might be a potential casualty or donor and, wherever possible, of locals. One of the greatest contributions to military medicine of the Republican medical services, and one in which Saxton played a significant role, was the organisation that permitted early treatment at forward field hospitals, backed up by mobile surgical hospitals

At the end of May 1937, he moved on to the Sierra de Guadarrama, organising the transfusion services at the hospital set up in a mountain ski station. He then organised a hospital just outside Madrid, where his duties included dealing with a Spanish chief surgeon who hated foreigners, and the failure of the food and water supplies. His blood transfusion skills were crucial during the July 1937 diversionary offensive at Brunete, when nearly 50,000 Republican troops smashed through enemy lines, and for 10 days, defended the resulting salient at the cost of 20,000 troops. Now moved to El Escorial, Saxton worked interminable hours, and at one point vainly tried to save the badly wounded Julian Bell, son of Vanessa Bell and nephew of Virginia Woolf.

By autumn 1937, Saxton was directing a newly improvised hospital at Grañen, where there was virtually no food or clean water and a typhoid epidemic. By January 1938, he was co-organising a hospital north of Teruel. Under constant air bombardment, the staff shared their food with the peasants and set up reading classes for the village women who helped out, but most would not attend because the priests told them it was a godless thing to do.

In 1938, he designed a mobile laboratory, which was assembled on the chassis of a bomb-damaged Ford ambulance. This was used for blood and urine analysis as well as water and milk supplies. Saxton explored the possibility of making transfusions from cadavers, but abandoned the experiment because of ethical considerations and technical obstacles. Nevertheless, his work on transfusions was publicised by the Lancet and was influential in the setting up of wartime British blood banks.

From summer 1938, a Republican offensive across the river Ebro aimed at joining the two halves of the loyalist zone. During the ferocious three-month battle, Saxton took his mobile transfusion unit to an emergency hospital in a hillside cave near the village of La Bisbal de Falset. "One day," wrote a South African journalist, "I thought as I gazed into the dark cave a statue may be erected in front of this cave by the new and free Spaniards. A statue to honour a man called Dr Reginald Saxton."