A question of rank
As pharmacy families dealt with the blow of losing their sons and grappled with the challenges of keeping the family business going, the profession itself was engaged in its own war of wills over its standing within both the Australian and British armies.
The role of pharmacists in their medical service structures initially followed the British army model, which meant that Australian pharmacists who signed up for the Army Medical Corps (AMC) could only attain the non-commissioned rank of staff-sergeant. Army dispensers didn’t require registration, but only had to pass an Army examination in order to work in an AMC dispensary.
In the Australian Reserves, the honorary lieutenant rank was available for pharmacists, but this didn’t transfer to the regular forces when war was declared. There was simply no place in the AMC establishment for the role of the highly qualified professional pharmacist.
Moreover, the 1912 regulations (Military Order 408) provided for the appointment only of compounders, not qualified dispensers.1 The army sought men with a knowledge of Latin names for drugs and medicines, the instructions commonly employed in the use of these and poisons, and in prescription dispensing. Prospective compounders received about nine months of army training. In a slight to members of the Pharmaceutical Society, soldiers who held civilian qualifications in pharmacy were acceptable to the army – just as compounders.
As the Australasian Pharmaceutical Notes and News reported in 1915: “Doctors, dentists, veterinarians and automobile drivers are given commissioned rank, but not pharmacists.”
In a presentation to current serving Australian Defence Force (ADF) military pharmacists in June 2018, historian Lea Doughty, a current PhD candidate at the School of Pharmacy at the University of Otago, whose topic is ANZAC military pharmacy during WWI , said that very often the skills of qualified pharmacists were wasted.
She quotes Colonel Arthur Edmund Shepherd, the Deputy Director-General of Medical Services in 1915, who lamented the fact that pharmacists “had given years to study to go in the ranks and fight in the trenches, when they could give more efficacious and valuable help to the medical officers in looking after the health of the regiment.” 2
A concerted campaign for change began with a strong push from the Victorian profession and the Queensland Pharmaceutical Society, then later the Council of Pharmaceutical Societies of Australasia. Those campaigning recognised that field dispensing (for example, duties carried out in the Field Ambulances) didn’t justify a commission rank, and that extra levels of responsibility were required to meet the leadership qualities that a commission entailed. They then set about identifying ways that they could add value and responsibility to their service, such as bacteriology services, (for example, urine testing) and water quality analysis and sterilisation, which would utilise the pharmacist’s training in chemistry.
By January 1916, the Australian Army Pharmaceutical Service was gazetted as Military Order 6, and the establishment for the new service was determined. The first Senior Pharmacists were nominated by the Pharmaceutical Societies for the four principal states and were appointed with the rank of Honorary Captain. They were responsible for the organisation of Pharmaceutical Services for each of their Military Districts, including appointing Lieutenant-Quartermasters in charge of Base Depots for Medical Supplies.
By March 1916, all dispensers on board troop transports carrying more than 500 men were required to be registered pharmacists, and unqualified men were no longer permitted to dispense. The previous rank of Army-Dispenser or Army-Compounder was disestablished, much to the delight of the Pharmaceutical Societies. Registered dispensers working on hospital ships were also quickly promoted to commissioned rank.
Overseeing the operation was the newly appointed head of the Australian Army Pharmaceutical Service, the first Chief Pharmaceutical Officer in the Australian armed forces – Major David Alexander Cossar, a graduate of the Melbourne College of Pharmacy and president of the Pharmaceutical Society of Victoria from 1915 to 1919.
The Australasian Journal of Pharmacy wrote of a farewell dinner for Major Cossar thrown by Victorian pharmacists in August of 1917 as he prepared to depart for England.
Mr Chas E Towl, President of the Pharmacy Board of Victoria, chaired the event and Surgeon General Fetherston, Director General for Medical Services, toasted Cossar, acknowledging the efforts of Australian pharmacists in fundamentally changing the role of pharmacy in the military. According to Doughty, Fetherston had “initially been resistant to the idea of pharmacists holding commissions”. He considered that the work pharmacists did was very basic, and it is possible that he was referring solely to field dispensing, which was indeed simple, and certainly did not justify a commission. By August 1917, he’d very much changed his tune.
The Journal’s account of the toast read:
“For the very first time in the history of military matters in connection with the British Empire, they were privileged to propose the toast of the Staff Officer for Pharmaceutical Service.”
“He did not think there was a pharmacists’ corps in any other part of the British Empire, and it was for Australia, apparently, to be the pioneers in this kind of work. It was something for Australia to say that she had her pharmacists trained to a keen pitch of perfection as required by the nation at such a time as this. Major Cossar was going home imbued with the idea of doing his very best for his country, and for the service he represented.”
An obituary for Major Cossar in the Australasian Journal of Pharmacy in January 1960 reads:
“In his efforts to obtain proper recognition for Australian pharmacists serving in the Army, Major Cossar made a splendid contribution of service to the profession and the foundation laid by him was undoubtedly a factor leading to the eventual granting of commissions for all qualified pharmacists serving in
Doughty writes: “Cossar’s aim was for there to be no requirement for unqualified Army trained Sergeant-Dispensers and Compounders as previously allowed for in the British structure. There had been a number of cases of fatal injuries caused by drug dispensing errors by unqualified dispensary staff. In one case, the patient was given strychnine instead of quinine, and in another, a patient was given carbolic acid instead of quinine. The containers had been stored next to each other with no regard for poison control, and the unqualified dispenser had accidentally taken the wrong bottle. Both patients died. By ensuring that only registered and qualified pharmacists were handling medicines and drugs, the integrity of both the profession and its practitioners was maintained, and risk to the patients was reduced.”
Current students and pharmacists would be aware of 'Cossar Hall' but perhaps not aware that the hall was named in honour of Australia's first Chief Pharmaceutical Officer, Major David Cossar.
However, while Cossar achieved great progress for the profession of pharmacy within the military, his war experience did not go untouched by tragedy. The Major lost his son, who was also a pharmacist, to World War II, in May 1942.
Lieutenant Neil Alexander Cossar is buried far from home in the Gaza War Cemetery.
He died at the age of 28.
1 Harris, K, Sister dispensers-- Australian trained nurses in pharmacy., Pharm Hist Aust, 2008, 4 (34), pp. 3–5
2 Lea Doughty, PhD Candidate at the School of Pharmacy at the University of Otago