Figure 1.--Here we see some Belgian chikdren outside the 24th Evacuation Hospital along the road from Leopoldsburg to Hechtel, as 'a boggy moor' (September 18, 1944, 400 beds were ready to receive the wounded. The press caption read, "By 19 September, 512 soldiers, including some Germans were already being treated. At full strength, the hospital consisted of 47 officers, 52 nurses and 318 soldiers. The huge US war economy ensured that they lacked nothing. By the end of the war, the hospital had used almost 7,000 scalpel blades and more than 16km of sutures. More than 14,000 morphine injections had been administered and some 18,000 lab tests carried out. Finally, 177km of plaster bandages had also been laid. That is roughly the distance from Leopoldsburg to Arnhem and back again. On 8 October 1944, having cared for more than 2,500 soldiers during their time in Leopoldsburg, 26 of whom did not survive their wounds, and having operated in Leopoldsburg for more than two weeks, the 24th Evacuation Hospital moved towards the Dutch town of Uden." We are not sure why the children are there, but where ever there were Ameruicans candy and chewing gum was usually on offer.,

Throughout history, medical casualties in armies were often higher than combat casualties Whole armies have been destroyed by disease. One of the best examples of this is a French army Emperor Napoleon sent to Haiti to reconquer the island and then America. Its demise led to the Louisiana Purchase hugely expanding the fledgingly United States (1803). This as ironically one of the grates impacts of the Bapoleonic War, but often unrecognized. In the wars of the 19th century, including the American Civil War, the massive battlefield casualties not withstanding, it was medical issues including the actual care that was the major killer. The Civil War was the last major war that was fought without an understanding of germs. Many medical advances were made during wars bcause of the large number of casualties. As a result of huge advances in medicine during the late-19th and early-20 centuries, advance medical practices were for the first time employed during World War I. Even so, the dimensions of the War, especially declining food production and malnutrition resulted in the Flu Pandemic (inaccurately called the Spanish Flu) which killed millions of soldiers and civilians. Important advances were made in the inter-War era, especially the development of penicillin, an amazing antibiotic, in Britain (1928). The problem was producing penicillin in large quantities. The Allies made some progress, the Germans did not. Turning to actual combat casualties, a principle of military medicine is that getting care to wounded soldiers very quickly is vital. The time following injury needed to ensure suitability is referred to as the Golden Hour. This is whybthe American ambulance drivers were so imprtant in World War I -- not only the drivers but the motorized ambulances America provided the Allies. The experience of the wounded soldier in World War II was not hugely different from that of World War I. The most common wounds were caused by shells and bullets. As in World War I, artillery was the principal killer. This may surprise the casual student of World War II which because of TV and the movies are inclined to think that aerial bombardment was the major killer. (Among civilians, murder operations of the Axis powers by a huge proportion were the principal killer.) The World War II system was evacuation through a variably organized system of emergency medical posts, dressing stations and ultimately well-equipped hospitals. While the variably organized system was essentially the same, many developments in World War I led to refinements and improvements in World War II. There was also the wide spread adoption of important medical advances. Bu perhaps the most important improvement was the speed at which the wounded received acre and advanced through the system. A major advance in World War II was blood/plasma transfusion. The wounded received specialist treatment much more quickly than during the World War, critically treatment during that all important Golden Hour. Specialist surgical facilities in particular were moved forward closer to the front line. In addition transport was by motor vehicle, sometimes even evacuation by air. The rapid movement of American units created issues for the Auxiliary Surgical Group hospital units. There were experiments but the first Mobile Army Surgical Hospitals (MASH) were not established until after the War (1946). With the first major use of MASH units in Korea resulting in the huge reduction in the survival rate of battlefield casualties (1950-53). 【King and Booker】 Of course all of this varied from country to country. The most advanced systems were American and British. The Germans had excellent medical facilities, but less access to motor vehicles. The Japanese had high quality personnel, but very limited access to motor vehicles and in the Pacific supplies. We are not sure about Soviet capabilities. The Chinese were the least capable of the major combatants. An important factor here was the battlefield movement. Unlike the World War I Western Front, the World War II fronts were not static. And there were major differences as to the care offered to wounded enemy soldiers. There are several other issues to be addressed, including mrdics, nursing, hospital ships, and psychological care.

Sources

King, Booker and Ismail Jatoi, . "The Mobile Army Surgical Hospital (MASH): A Military and Surgical Legacy". Journal of the National Medical Association Vol. 97, No. 5. (May 2005), pp. 650–51.

Wikipedia, "World War II casualties". Gor our discussion of World War II casualties we ave tended to ue the Wikipedia assessment, supplmented with our research. The Wikipedia is a good basic effort to assess caualties taken nto account that for many countries no precise accounting can be made. We welcome reader contributins with more detailed country estimates. adr

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Last updated: 4:16 PM 2/4/2024