Have I Told You About WWI? Medical Advancements.

At the start of World War I, the practice of medicine was lagging far behind the scientific discoveries of the age. Widespread myths and anecdotal cures, including harmful ones like arsenic and strychnine, were still a common part of medical practice, despite the emergence of germ theory and a host of other scientific developments. The war, and the enormous demand for effective treatment that it created, catapulted medicine to the cutting edge of science. Medical advancement was arguably the most important achievement to come out of the First World War. Here are a few of the highlights.

Field hospitals. With the opening of war, combatant nations hurried to establish clean, organized hospitals equipped with state-of-the-art medical technology to treat their wounded. Within the first few months, these hospitals were largely abandoned. Located hundreds of miles behind the front lines, they were too far away to be of any use to wounded soldiers who required treatment immediately after being removed from the battlefield. Their supplies were stripped and transported to field hospitals (known to the British as Casualty Clearing Stations) in wooden huts or tents only a few miles from the front. For the first time, medical treatment was adaptive to battlefield conditions, as field hospitals moved with the front lines to provide immediate medical assistance to the wounded and sick.

A British Casualty Clearing Station with tents and raised walkways in an effort to avoid the mud. Some CCS’s and field hospitals were so large that, like this one, they had signposts to point visitors and the newly arrived to the right tent. From “Wounded” by Emily Mayhew.

Triage. This word first came into wide usage in French field hospitals on the Western Front. Medical staff were absolutely overwhelmed by casualties throughout the war, frequently exceeding the capacity of their clearing stations, hospital trains, and field and base hospitals. No one was prepared for the enormous onslaught of injury and illness caused by this first modern war, but the French least of all. French medical facilities were constantly flooded, and as a result, far higher numbers of French wounded eventually died of their injuries than did their British or German counterparts. French medical personnel developed a brutal system of “conservation of effectives,” an early form of the triage that was eventually adopted by medical teams of all the combatant nations. Under this system, those with less severe wounds who, when treated, would be likely to return to active service were attended to first. Those more seriously injured, who would recover but be unlikely to be any more use to the war effort, were cared for as time and resources allowed. Those likely to die from their wounds, especially during a battle when incoming casualty numbers were highest, were all but ignored. Though this system may seem inhumane, it was necessary in areas and times of highest casualties, and it would lay a foundation for medical personnel to be able to immediately identify the most serious cases, a skill invaluable in any trauma situation.

Vaccines. Infectious diseases were rampant in all the armies at the fronts. The isolation of toxins by scientists allowed the development of vaccines; the horrific conditions of life in the trenches necessitated their widespread administration. Tetanus and typhoid vaccine, where available, were administered to every wounded soldier and as many healthy ones as possible. One British soldier, wounded in the face and rendered incapable of speech, recalled being inoculated with typhoid vaccine three times by three different nurses on the same day; so eager were medical staff to protect their wounded charges against further complications.

Radiology. The study and practice of radiology was in its infancy at the start of the war, but medical personnel very quickly realized the impact it could have on battlefield medicine. Marie Curie, radiologic pioneer, organized a small fleet of radiology vehicles which travelled around to various field hospitals and casualty clearing stations near the front to provide the opportunity to get x-rays. These images could be used to visualize broken bones, shell fragments, and shrapnel buried in the bodies of wounded soldiers before they were opened up in surgery. The advancement in precision this supplied to the surgeons was invaluable in preventing infection and unnecessary reopening of wounds.

Antiseptic. Infection was the most common killer of wounded men at the front. Antibiotics were not available during World War I (penicillin, though discovered prior to WWII, would not be manufactured on a large scale until it was shown to be effective against the venereal diseases decimating Allied forces in 1943). However, newly discovered antiseptic solutions were found to be highly effective at cleaning wounds and keeping them free from infection as they healed. When careful, regular cleanings with antiseptic followed surgical debridement of a wound (removing dead or damaged tissue) the results were nearly miraculous. When such careful treatment of a wound was available — and it was treated early enough, which was unfortunately far too rare — it was shown to be highly effective.

These are just a few of the medical innovations accelerated and perfected during the First World War. In four years, medicine advanced by leaps and bounds as doctors and nurses experimented and adapted to treat complaints and wounds they had never encountered before. These new procedures and treatments were an important foundation for military medicine in World War II and beyond, but they also translated to civilian medicine after the war, and medicine in all its forms was forever transformed.