Medical Treatment in World War 1 I THE GREAT WAR Special

The First World War, for all of its horrors,
was a time of enormous technological progress. We talk in our regular episodes about the
developments in flight, submarines, motorized vehicles, soy sausages, the zipper, and so
forth, but perhaps nowhere did advances come as quickly and as often as in the field of
medicine. In fact, medicine advanced more in the four
years of the war than in any other four-year period in history either before or since. I’m Indy Neidell; welcome to a Great War
special episode about medical treatment during the First World War. Yes, medical treatment. We’ll cover other aspects of medicine in
other specials, since it’s a very large topic. When the war began, the world leaders in medicine
were France, Germany, Britain, and Austria-Hungary. Russia did have fine doctors, but not so many
when compared to its enormous population. Armies’ Medical Corps were called on to
treat wounds, disease, poison gas victims, flamethrower victims, shell shock, and also
to improve sanitary conditions in the trenches. The work was extremely difficult, often dangerous,
and had a myriad of challenges according to each battlefront. The initial challenge was to bring a wounded
man away from the fighting to a medical facility, since the sooner you received medical attention,
the more likely you were to survive. Many wounds were also contaminated and infected
by the filth and the mud of life on the front or in the trenches. The Western Front, because of the stalemate,
allowed the medical Corps to have well-organized structured systems running from the front
lines back to base, and even specialized hospitals far from the front or back home in Britain,
France, or Germany. Wounded soldiers would be carried by stretcher
bearers, often themselves under fire, to a first aid station where wounds could be temporarily
treated to allow further transport to more sophisticated and better equipped facilities. The British army Medical Corps, as an example,
had an evacuation plan as follows. Stretcher-bearers brought the wounded to a
Regimental Aid Post, then an advanced Dressing Station, where the particular case would begin
to be documented, and then they’d be transported to a Casualty Clearing Station, which was
a large unit with seven medical officers and a substantial staff to help the doctors. If they were expecting combat, then surgical
teams would join these stations. They were about 20 kilometers from the front,
and usually treated a minimum of 200 soldiers, though this number could exceed 1,000 during
heavy fighting. This was really the first place the soldier
entered that was like a full-service hospital; with actual operating tents and rooms, and
the first place he’d see a nurse. It might well also be the last, as evidenced
by the large military cemeteries located near Casualty Clearing Stations. A side note here – the British had used X-Ray
machines in the Boer Wars, so they had them here pretty much from the beginning of this
war. Badly wounded soldiers might remain at the
stations for a few weeks, and then be sent to General, Stationary, or Base Area Hospitals,
specialized hospitals for victims of gas, venereal disease, shell shock, or epidemics. They might also be sent to a hospital back
home. In the German army, wounded soldiers wore
two information tags. One to show what injury was diagnosed and
the other to show what treatment had already been given. As you may imagine, whatever the soldier’s
nationality, if he had superficial wounds he may well be glad to enter the chain of
evacuation to have a break from the front until it was determined that he needed no
further treatment and was sent back up. Russia was faced with different problems. For example, they trained thousands of new
nurses but had a tough time transporting them to where they were needed. Interestingly, the Tsarina and her daughters
became nurses, and as you may imagine, nurses with titles were able to get postings far
from the gruesome reality of the front. When the war broke out, the first wounded
Russians were put on trains and sent to Petrograd, where they were just left at the station because
no plans had been made to receive them. Now, the Eastern Front was not static like
in the west and so you couldn’t really build semi-permanent medical facilities, and the
fluctuations in the Eastern Front kind of assured that soldiers quickly getting good
medical treatment would be few and far between. By 1917, wounded Russian soldiers, loaded
onto trains, might wait four or five days for basic medical care. The death of doctors prompted foreign nationals
to join the Russian Medical Corps. American surgeon Dr. Malcolm Grow volunteered,
was eventually awarded the Cross of St. George by the Tsar personally, and would later become
the first Surgeon General of the United States Air Force and a Major General. As I said, different fronts presented different
problems, and one real front-specific problem was malaria on the Salonika Front. Up to 40% of the British and French soldiers
there were disabled by malaria, and it killed more troops there than combat did. People referred to the Salonika Expeditionary
Force one giant infirmary. During the course of the war, over 1.5 million
troops in total were infected with malaria. But that was just a fraction of the millions
upon millions of sick and wounded soldiers the war produced. Mud, filth, feces, rotting corpses, stagnant
water, rats, and tightly packed men in trenches produced some of the worst sanitary conditions
possible. When food was scarce, things got even worse
as soldiers became more susceptible to disease. Illnesses and epidemics were sometimes more
deadly than the war itself. The Spanish flu, which we’ll cover in detail
later on, took about as many American soldiers as combat did, and they were being ravaged
by it even while still training at home in the states. But as a result of the enormous number and
variety of wounds and illnesses, medicine made great leaps and bounds. Cellucotton, blood transfusions, and blood
banks were big advances that grew out of the war. Motorized ambulances transported the wounded
at a faster rate and mobile x-ray machines could scan the wounded immediately. Plastic surgery was invented for the hundreds
of thousands of disfigured men whose faces were too terrifying for them to lead normal
lives. Morphine had been around for decades, but
it was used extensively and effectively as a painkiller, and sphagnum moss turned out
to be an excellent dressing for war wounds. It’s light, has antiseptic properties, absorbs
many times its own weight in fluids, and grows throughout Britain. Another thing that was discovered was the
sterile properties of maggots. Yeah, you heard that right. A badly wounded soldier stuck in no-mans land
for two days was finally brought in. The wounds he had were typically fatal because
of infection, but the doctor attending him saw that the wounds were clean; there was
new pink growth, and no infection. The wound WAS, though, covered in maggots. That doctor was a professor of surgery at
Johns Hopkins Medical School and he publicized his findings. Research found that the maggots had medicinal
properties; they ate only dead tissue, so they in fact cleaned the wounds, they crawled
into tiny recesses where topical antiseptics couldn’t be applied, they gave off urea,
which itself is an antiseptic that destroys staphylococcus and other bacteria, and they
promoted the growth of healthy tissue. Penicillin wasn’t invented yet and until
it became widespread, maggots were cutting edge medical treatment. They’ve even made a comeback today for use
with certain skin ulcers. The advances in medical treatment and medical
technology changed the nature of war and the wounded. When the war began, if you were badly wounded
you very probably died, but by 1918 you very probably lived. That is an enormous difference. Even because of just one advance, the Thomas
splint, you could see a huge difference. In 1914, 80% of soldiers with broken femurs
died, but because of the splint, by 1916 80% of soldiers with broken femurs lived. But the advances in the organization of medicine,
and the chain of treatment, particularly caused by the stalemate of the Western Front, were
reflected first at home in Britain, France, and Germany, and then the rest of the world,
with chains of organization eventually creating the modern medical systems of hospitals, clinics,
and ambulances that we rely on today, rather than simply a local general practitioner or
a cottage hospital run by a charity. And that is perhaps the biggest advance of
them all. Thanks to John Dewar Gleissner for helping
with the research for this episode. He actually wrote a whole book about the use
of maggots in medicine and you can check that out by following the link in the dublidu. If you want learn more about the live in the
trenches and the conditions there, you can click right here to check out our first ever
special episode. See you next time.

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