Perhaps first and foremost, medicine became an organized and respected profession. And not only doctors, but nurses, dentists, and veterinarians. The increasing status of medicine in civilian life carried over to the military. Medical professionals were not only better-established in the military services, they were heard at the highest levels. The theories of disease and infection, and immunization, had its roots in the 18th century, but became firmly established through the 19th.
These had great implications for military medicine. By the end of the century, immunizations for tetanus and typhoid fever were available, and there was effective prophylaxis for malaria.
Typhus was known to be transmitted by body lice. These could be controlled by periodic delousing and other measures. Yellow fever was controlled by eliminating the mosquito vector. And the correct identification of bacteria as a cause for wound infection enabled effective treatment for wounds, and prevention of many, although not all, wound infections. Surgery made great strides. The development of general anesthesia meant that longer and more sophisticated operations became practical.
Operations were done with sterile technique, and then aseptic technique. Abdominal surgery became possible, and its development over the last half of the 19th century was rapid and dramatic. Equally, general anesthesia made possible more extensive treatment of wounds. These advances are discussed in more detail elsewhere Wounds and Injuries , but taken in sum, they made military surgery far more effective. X-ray of Forearm. Other aspects of medical therapy, were advancing rapidly.
Intravenous fluids were available by the time of the great war. Early blood transfusion was available, but its use was uncommon. Blood banking was not developed until after the war. Equipment was sufficiently portable to be carried to the battlefield. Medical laboratory studies became available, and incorporated into battlefield medicine. The development of what we now know as modern military medicine occurred over the course of the late 19th century, and into the 20th.
It evolved through major wars, sometimes in adverse environments. This evolution took place across Europe as well as in North America. The development of what we now know as modern military medicine occurred over the course of the late 19 th century, and into the 20 th. Medical and trauma care made slow progress during the limited wars of the 19 th century. It evolved, through major wars, sometimes in adverse environments. American Civil War Hospital The American Civil War was fought with mass armies, modern industrial technology, railroad transportation, and telegraphic communications.
Unfortunately, its health care was barely up to the 18 th century. Both armies had physicians, and organized medical corps. There were systems of aid stations, field hospitals, and medical evacuation on both sides.
But they usually failed to meet the huge demands placed upon them by the large numbers of casualties. Both armies depended heavily upon civilian physicians and makeshift facilities to care for their injured soldiers. Further, public health was not well developed. Twice as many soldiers died of disease as of injuries, often in training camps far from the battlefield. Sanitation was poor. These systematic failures were widely recognized among the medical profession, and there was a growing movement to improve military medicine.
Typhoid, yellow fever, and malaria were new to American troops. Disease killed five times as many soldiers as did enemy action. There was inadequate organization, too few medical supplies, and poor use of resources. The war was highly publicized in the newspapers of the day.
After the war, there was a great public outcry about the number of soldiers dying from disease. The Reed commission paved the way for the construction of the Panama Canal, overcoming the high rate of yellow fever among the workers in previous attempts to dig an Atlantic to Pacific canal. Walter Reed Walter Reed chaired the typhoid board. He was an outstanding Army physician, one of the true heroes of the Army medical corps.
He had immense influence during and after the war. He died in , of appendicitis, but his work was carried on. The subsequent Dodge commission conducted a much more comprehensive review of the shortcomings of the Army medical services. These included poor preparation, poor sanitation in the camps, and failure to organize nursing services. He oversaw much of the transition of the Army medical service into a modern military medical system.
Re-organization of the Army medical service began in Among other changes, the Army Nurse Corps was established. The Medical Corps was recognized as a formal organization in , although the term had been unofficially used for over a century. It was established as a way to identify and mobilize civilian doctors in the case of war. These efforts were a major change in the medical care of soldiers.
And fortunately, they happened in time to provide the framework of medical care in World War I. For example, the Army Nurse Corps, only in , expanded to 20, by the end of The public health aspects of military medicine lagged behind medicine in general.
The importance of public health in military medicine was poorly recognized through most of the 19th century. All Army camps smell that way. There was a sort of pessimistic complacency. Senior officers knew that if they could keep down losses from disease, they would have more men to fight. This changed. Public health finally came into its own as a crucial component of military medicine in the early 20th century.
American military medicine during World War I was able to incorporate many advances of the previous 60 years, and apply them on the battlefield. The great accomplishment of the war was to take the best of civilian medicine in , move it overseas, and apply it on the battlefield. To accomplish this, some of the finest American physicians of the day, such as George Crile, Harvey Cushing, and the brothers William and Charles Mayo, served during the war.
See "Mobilizing of American Medicine". The Army was not well-prepared for the Great War. Less than 20 years earlier, the Spanish-American war was a medical wake-up call. Poor organization and lack of preparation resulted in adequate casualty care and very high rates of disease.
Five times as many soldiers died from disease as were killed by enemy action. The resulting public outcry had prompted reform of the military medical services, chiefly the Army. As a result, the Army Medical Department had done a great deal to prepare for war. The Medical Corps had been formalized, the Army Nurse Corps formed, and training had been greatly improved. A Medical Reserve Corps had been established to provide doctors to the active services in the event of war.
But even with all these preparations, the Army was still not ready for a war of million-man armies, and huge battles. The Medical Corps was proportionally small. There were active duty Army doctors, including reservists. Before the war ended, over 20, nurses would be serving on active duty. Dentists were in the Dental Section of the Personnel Division. It went from 86 officers, mostly contract dentists at examining stations, to 5, A separate Dental Corps was established after the war.
All of these were professionals, commissioned officers. They were supported by far larger numbers of enlisted men: orderlies, technicians, stretcher bearers, ambulance drivers, and many others. Veterinary Corps Poster And then, there was the Veterinary Corps, which was newly created, and contained 62 officers at the start of the war. They were responsible for food inspection and for animal care. Like all other armies of the day, the US went to war with horses and mules in large numbers.
Motor vehicles, even heavy tractors, were simply not up to the demands of the battlefield, particularly pulling artillery and other heavy equipment.
Horses and mules were used for all those things. Officers rode horses, to be able to get around the battlefield. The large number of animals required a significant amount of veterinary care. Besides veterinarians, who were officers, there were enlisted veterinary specialists, as well as blacksmiths, farriers, and an array of others.
A new Ambulance Service and a Sanitary Corps were created. Besides providing organizational structure for both of these essential functions, they also provided a way to supplement the limited supply of physicians with other professionals who could carry out non-medical duties.
Engineers, public health administrators, bacteriologists, chemists, and other experts could be brought into the Sanitary Corps. Facilities and supply were limited. In , the Medical Department could staff seven field hospitals and nine ambulance companies. There were 38 field hospitals and 26 ambulance companies in the National Guard. At this time, the Guard was under the control of the governors of the individual states.
Supply was equally limited. There was some expansion capability, but planning had envisioned an Army of , men, not more than 3 million. The recruiting and training of civilian physicians and surgeons was the most obvious and pressing need. The American Medical Association, which included about two-thirds of practicing physicians, was indispensable in this effort. Screening its list of members, some 69, letters were sent out to physicians under fifty, asking for volunteers.
Some 10, joined in the first three months alone. Other camps trained enlisted specialists, including stretcher bearers, the predecessors of today's medical corpsmen, nursing assistants, operating room technicians, ambulance drivers, and many others. They were instrumental in mobilizing the American Medical Association to support the war effort. Both were promoted to Brigadier Generals after the war, and continued to support the Army Reserve efforts.
Charles Mayo, Establishing base hospitals was an early priority. These were mobilized, staffed, and equipped with the support of the Red Cross. Six hospital units, consisting of personnel from major teaching hospitals, went overseas in May, They were assigned to support the British army, as no American units were yet in combat.
It was headed by Dr. George Crile, one of the leaders of the surgical profession, a professor of surgery at Western Reserve University. Crile had previously served in Europe as part of a hospital from Western Reserve supporting the allies, and it was he who originated the concept of base hospitals drawn from individual communities.
It was led by Dr. Harvey Cushing, a world-famous brain surgeon, who had also served in Europe previously. Eventually, many hospital units were sent from communities and teaching hospitals, including the University of Kansas, Duke University, Bellevue Hospital, Washington University, Johns Hopkins, and many others. George Crile.
The two of them were instrumental in mobilizing the American College of Surgeons to support the war effort. He had to issue his own orders. SS Baltic Pershing and his headquarters arrived in early June. With Pershing was his nominee for chief surgeon, Col. Merritte Ireland. In the event, however, Col. Ireland eventually replaced him. The Red Cross hospitals in Europe, established in support of the allied armies, were an invaluable resource. Hospital units at all levels above field and evacuation hospitals were consolidated under the Services of Supply.
This system worked well enough, but there was considerable organizational confusion. Camp hospitals, for example, were local, and under the control of the local or divisional commanding general. Hospital centers and base hospitals, on the other hand, were controlled through the chief surgeon of the AEF.
The total number of hospital beds grew from 30, in May, , to , by the end of October, with the Meuse-Argonne offensive in full swing. Too, by the end of the war, the influenza epidemic was claiming an ever-increasing number of victims, and requiring increasing numbers of hospital beds. Harvey Cushing Surgeons were in short supply even among the allied armies, and the influx of American civilian surgeons was extremely helpful to the allied armies.
Orthopedic surgeons were in particularly short supply. A group of 20 orthopedic surgeons tasked with supplementing British hospitals was sent with Base Hospital Number 21, from Washington University in St. Crile had brought with him 18 large cylinders—3, gallons—of nitrous oxide.
He gave surgical demonstrations using a nitrous oxide-oxygen mix—just enough to put a patient to sleep, but not into a state of shock—for Carrel, Dakin, and other French surgeons. Antiseptics and anesthesia saved lives once they arrived at the hospital, but without motor ambulances and hospital trains to get them there, wounded soldiers stood little chance. From the impromptu rescue of soldiers from Meaux in September , the American Ambulance Field Service grew to number more than ambulances by the end of the first year of the war.
Philanthropists such as Anne Harriman Vanderbilt bought cars, as did civic groups from cities around the United States. Volunteer drivers arrived from 48 American universities, and the ranks of the ambulance service grew to some 2, by the end of the war. Harvard had 55 men in France in , driving in the pitch night on gutted roads to pick up soldiers from field stations just behind the lines.
While saving others, 21 of these Harvard men lost their own lives. Dick was wounded in three places, the head, the side and the thigh, and killed at once. His body lay there, among the wreck of his car, all night. Our merry convoy passed without seeing it. I saw one of the gasoline cans by the side of the road, and stopped to pick it up, wondering who dropped it.
The service of the drivers, along with the doctors, nurses and social workers who brought the number of American volunteers to the thousands, did not go unnoticed by the French. I tell you tears are pretty near sometimes. What inspired these major advances in medicine? There was a deep need, and people stepped up to find solutions. Some links may take you there. If you can't find what you're looking for, try ukri. Following the end of the First World War, the soldiers returned home to resume their lives.
However, the state could not look after them all, with many having to rely on charitable institutions or family.
As part of the World War 1 Centenary commemorations, engagement centres have been supporting community groups to research how the war impacted on medical and social care provision around the country. See also other World War One features at ahrc. Read the blog by Dr Jessica Meyer from the University of Leeds about her research about how the returning soldiers were cared for. In Exeter, 35, patients from all over the Empire were treated in the Red Cross temporary war hospitals, making it one of the largest voluntary provincial medical centres.
The hospitals were first-line hospitals, taking patients direct from ambulance trains from Southampton.
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