War Surgery 1914-18 edited by Thomas Scotland and Steven Hays

How many military historians – people for whom writing about death and injury is part of their vocation – actually have anything more than a rudimentary understanding of battlefield medicine? Nope, me neither. And for somebody who has been specialising in war casualties, that is something I really should remedy.

Therefore I was intrigued to receive this book looking at war surgery in the First World War. It is actually edited by a pair of medical professionals who also have an interest in military history, which for me is crucial. Medicine is such a specialist field, that to be honest I think only medical professionals can really do it justice. But this isn’t just a scientific, geeky look at things that the layman would never understand. It is structured very sensibly, beginning with a basic introduction to the First World War and the Western Front, and also to the history of battlefield medicine.

A very interesting chapter looks at the manner in which wounded soldiers came into contact with medical help – namely, the evacuation chain. Wounded soldiers were treated immediately by their Regimental Medical Officer, aided by a team of stretcher bearers. Men were then taken to a Field Ambulance, usually by ambulance wagons and cars. Lightly wounded might be sent to an advanced dressing station to be patched up and sent back. More seriously wounded would be passed on to a Casualty Clearing Station by motor convoy. From there the wounded would be despatched to a stationary base hospital, usually in French coastal towns such as Rouen, Etaples, Le Havre of Boulogne. Men who did not respond to treatment might be shipped back to England for further care. With much of the war being fought in a stationary, almost siege-like manner, evacuation trains could be implemented, even incorporating river transport.

Obviously, many wounded were in shock, and in need of stabilising and resucitation. And with thousands of men requiring treatment almost on a daily basis, it was an ideal proving ground for medical officers to establish best practice. Anaesthetic had been discovered and pioneered in the later years of the nineteenth century, and with many men requiring operations, anaesthesia was also a key consideration in the treatment of many.

Something I had not really though of is the varying pathology of warfare. Men wounded on the Western Front – in cold, wet and muddy conditions – were very vulnerable to infections, and the heavily fertile Flanders mud was an ideal breeding ground for bacteria. And with a large proportion of open wounds, the early onset of infection was a serious problem. By contrast, men serving in warmer climes were at threat of other illnesses, notably Dysentery in Gallipoli and Malaria in Mesopotamia. As in previous centuries, a large proportion of deaths were to illness rather than wounds received in action.

As with Anaesthesia, X-rays had been pioneered relatively shortly before 1914. Gradually X-ray facilities were established at base hospitals, and a few locations further forward in the medical chain. X-ray machines were relatively large, unwieldy and expensive, and being so far back behind the lines it took time for men to reach them. Another consideration was the quality of imaging, and the ability of medical officers to interpret them and consider an appropriate course of treatment.

With many men suffering broken bones – in particular due to gunshot wounds – orthopaedic surgery was important. a large proportion of broken bones were suffered in the form of fractured femurs. As a major bone, a frature of the femur could be catastrophic, and poorly healed might cripple a man for life. The newly-invented Thomas splint helped medical officers on the front line to immobilise a man quickly, and radically improve their chances of recovery. A great example of how war prompted a remarkable medical innovation.

Throughout military history abdominal wounds had often been regarded as particularly troublesome, as to a lesser extent had penetrative chest wounds. Any wounds in these areas might threaten vital organs, and hence chances of recovery were often very low. Performing delicate operations on vital organs were particularly trying, and not something that could be performed easily in makeshift facilities. Also, the risk of infection was ever-present.

Something I had not ever thought of was the development of plastic surgery during the First World War. As with any way, men suffered horrific scars. I had always thought that plastic surgery was first developed during the Second World War with burnt aircrew, but some of the images of Great War Soldiers having their faces gradually rebuilt with flaps and the like are staggering. The Great War was possibly the first war in which cosmetic injuries were taken seriously.

Something else that really impressed me is the manner in which the medical services expanded to take on what was an unbelievable burden. The Royal Army Medical Corps was tiny in 1914, as was the British Army as a whole. With each Regimental-level unit needing an MO, and countless other medical units needing staffing, where did all these extra doctors come from? It was a considerable balancing act to make sure that there were adequate doctors at the front, but that there were also adequate doctors at home in Britain too.

I’ve got the utmost respect for doctors who serve on the front line. They deal with some of the most traumatic injuries, in trying circumstances and with scant resources. When faced with overwhelming casualties they have to take on an unbelievably tragic method of triage – which casualties have the best chance of success with the resources available? Those deemed unlikely to survive are left to their fate.

This is a brilliant book. Considering that the editors and contributors are medical professionals, it reads incredibly well as a history book – much more readable than many a military history text! I recommend it wholeheartedly to any historian of the Great War who wishes to develop a broader understanding of battlefield medicine. It has certainly helped me to broaden mine, and I must confess, I now think that researching casualties of war without looking at surgery in war is simply inadequate.

War Surgery 1914-18 is published by Helion

About these ads

16 Comments

Filed under Army, Book of the Week, Uncategorized, western front, World War One

16 responses to “War Surgery 1914-18 edited by Thomas Scotland and Steven Hays

  1. John Erickson

    I’ll have to keep a lookout for you concerning a US TV program. I distinctly remember a series of photos on one show, showing men undergoing work to look “more natural” after facial wounds. Some of the “work” consisted of partial masks and such (including, and I am completely serious here, a variation on the “Groucho nose and mustache” glasses for men with damaged noses and upper lips), but there was footage of reconstructive surgery. I’ll see what I can find.
    Something else a lot of folk forget about is how recent both penicillin/sulfa and blood plasma are. Those two items contributed greatly to the drop of percentage of casualties dying after evacuation, WW2 versus WW1.
    An idea for you to gain some knowledge, without getting deluged with technical terms, is to check into whatever the UK equivalent of the US Boy Scouts are, and look for a first aid manual. It has to be simple for young minds to understand, but (at least back in my ancient days) remarkably well detailed about major blood vessels and bones. Just a thought.

  2. Reblogged this on ww1ha and commented:
    Fractured femurs often led to death until the Thomas splint came along. Remembered Phinney in “A Separate Peace” dying after he broke his leg? (Fell out of a tree, yes?)

  3. Pingback: New books in the library – war surgery, Spanish flu and more « Wellcome Unit for the History of Medicine Library

  4. Woah! I’m really enjoying the template/theme of this site. It’s simple, yet effective.
    A lot of times it’s very difficult to get that “perfect balance” between usability and appearance. I must say you’ve done
    a very good job with this. Additionally, the
    blog loads super quick for me on Chrome. Superb Blog!

  5. Everyone loves what you guys tend to be up too. This sort of clever work and reporting!

    Keep up the wonderful works guys I’ve added you guys to my blogroll.

  6. You get iHome iP99BR, AC adapter, remote control and
    3 docking adapters in the box. Lately, sources have reported that twenty million S3 gadgets have been
    sold. Hmm, now I question what Apple will do with all that cash?

  7. Pretty section of content. I just stumbled upon your blog and in
    accession capital to assert that I get in fact enjoyed account
    your blog posts. Any way I will be subscribing to your augment and
    even I achievement you access consistently fast.

  8. Please let me know if you’re looking for a author for your
    site. You have some really good articles and I feel I would be a
    good asset. If you ever want to take some of the load off, I’d really like to write some
    articles for your blog in exchange for a link back to
    mine. Please blast me an email if interested.
    Cheers!

  9. Continuous disconnection was noticed, but Apple set this issue with their subsequent releases
    of iOS four updates. That indicates that you can effortlessly, I don’t know, view a video clip or some thing.

  10. Make your boilies without boiling them and steam them fast instead.
    These inflatable cushions are easy to pack and
    carry anywhere. s perception towards everything change with the passage of time.

  11. They are worth 100 coins and can be harvested in only two hours.

    While some supply series products, some creatures is only planning to supply coins or electricity.
    Click on recognize every time watching your XP go up.

  12. Unii oameni se simt bine despre relațiile sexuale informale .
    Nu am avut nici – un interes și actualizate aceasta ca
    întreg Malarkey . Prin urmare, îmi imaginez nu va fi nici rolul principal în ” Pretty Woman II – Phone Zeita” pentru
    mine .

  13. I do consider all the ideas you have offered to your post.
    They are very convincing and will definitely work. Nonetheless,
    the posts are too brief for novices. May you please lengthen them a bit from subsequent time?
    Thanks for the post.

  14. If some one wishes to be updated with newest technologies afterward he must be go to see this web page and be up to
    date all the time.

  15. It’s a pity you don’t have a donate button! I’d without a doubt
    donate to this brilliant blog! I guess for now i’ll settle for bookmarking and
    adding your RSS feed to my Google account. I look forward to brand new updates and will share this blog with
    my Facebook group. Chat soon!

  16. It is not my first time to pay a quick visit this web site, i am browsing
    this web site dailly and get fastidious data from here all the time.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s