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The experience of the wounded soldier in World War II was not hugely different from that of World War I. Of course all of this varied from country to country. The primary factor was the economic capabilities of the country which determined how well they could fund and maintain military medical services. The most advanced systems were American and British. The Germans had excellent medical facilities, but less access to motor vehicles and supplies. The Japanese had high quality personnel, but very limited access to motor vehicles and in the Pacific supplies. While the the Japanese did have an effective medical service, the cut off garrisons throughout the Pacific soon ran out of both food and medical supplies. In China, wounded Japanese soldiers were treated with great care. In sharp contrast, badly wounded Japanese soldiers in the Pacific were expected to commit suicide or were killed by comrades so as not to waste scarce resources. They were not evacuated and returned home. This is why Japan had so few seriously wounded veterans after the War. We are not sure about Soviet capabilities. The Chinese were the least capable of the major combatants.
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.) Battlefield medicine improved considerably throughout the course of the War. Probably the most important improvement was the speed at which the wounded received and advanced through the system.
We know most about American medical services. The American 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. This was vital because the speed at which a wounded soldiers received care was the primary factor determining survival. A major improvement in World War II was blood/plasma transfusion. Whole blood was not available at the front because of the need for refrigeration, but plasma could be canned. At first, only plasma was available to front-line medics as a substitute for serious wounds and blood loss (1941). By the end of the War, serum albumin was developed. This is whole blood that is rich in the red blood cells that carry oxygen and much more than just plasma (1945).
There were new surgical techniques. One important one was removing dead tissue. This led to fewer amputations than ever before. Also important in the treatment of bacterial infections, penicillin or streptomycin were administered for the first time on a large-scale in combat situations. Service members were also inoculated with vaccinations for smallpox, typhoid, tetanus, cholera, typhus, yellow fever and bubonic plague, depending where they were sent.
Unlike World War I, American service member were deployed in a wide range of often unfamiliar environments. In the tropical Pacific, malaria was a serious threat. It ravaged the cut off men on Bataan. But beginning on Guadalcanal, it was addressed by medical teams. First the Marines, but than the Army as well got — a group of medications used to protect against malaria — before going into affected areas. As far as we know, this was not available to the Japanese.
Thee were a range of safety improvements, including crash helmets, safety belts, flak jackets and other important protective measures.
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There was a better understanding of psychological trauma. psychiatrists were closer to the front line. The term fer World War I 'shell shock' of the First World War had become ‘battle exhaustion' suggesting a better understanding of the complexity of psychological trauma. This was most advanced in the American system. General Patton almost got fired for abusing traumatized GIs. After the War it became known as 'post-traumatic stress disorder'. Impacted GIs were given a safe place in rear areas with food and rest. One source claims that this resulted in about 90 percent of the affected GIs recovering enough to return to combat units.
An important factor here was the battlefield movement. Unlike the World War I Western Front, the World War II fronts were not static. This mean that large numbers of enemy soldiers inevitably fell into hostile hands. And there were major differences as to the care offered to wounded enemy soldiers. The Japanese simply killed them. American and British policies were correct. German policies were generally correct toward the Western Allies, but murderous toward the wounded Red Army soldiers. We are not sure about Soviet behavior. There are several other issues to be addressed, including medics, nursing, and hospital ships. Another important matter is recovering service members. Americans badly wounded wee sent back home and out of the War even after recovery. This was not necessarily the case in other countries. We are not sure about the British. But in Germany you were back into the fight as quickly as possible. The best example here is Graf Von Stauffenberg -- the officer who played a key role in the July 1944 bomb plot that nearly killed Hitler. He was strafed by a British plane in North Africa. His right hand as well as ring and small fingers of the left hand had to be amputated. He lost his left eye. Thee were also knee joint and middle ear operations. Yet he was returned to active duty.
The experience of the wounded soldier in World War II was not hugely different from that of World War I. Of course all of this varied from country to country. The primary factor was the economic capabilities of the country which determined how well they could fund and maintain military medical services. The most advanced systems were American and British. The Japanese had high quality personnel, but very limited access to motor vehicles and in the Pacific supplies.
We know most about American medical services. The American 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. This was vital because the speed at which a wounded soldiers received care was the primary factor determining survival. No country matched the speed at which wounded soldiers received medical attention. Note the wounded GI here receiving plasma infusion near the front line (figure 1). Wounded Americans received specialist treatment much quicker than in World War I. This was vital 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. This was the first war in which air evacuation of the wounded became available, although was still on a limited scale. The rapid advance 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】 Unlike World War I, American service member were deployed in a wide range of often unfamiliar environments. In the tropical Pacific, malaria was a serious threat. It ravaged the cut off men on Bataan. But beginning on Guadalcanal, it was addressed by medical teams. First the Marine s, but than the Army as well got — a group of medications used to protect against malaria — before going into affected areas. As far as we know, this was not available to the Japanese.
The Chinese were the least capable of the major combatants.
The Germans had excellent medical facilities, but less access to motor vehicles and supplies.
While the the Japanese did have an effective medical service, the cut off garrisons throughout the Pacific soon ran out of both food and medical supplies. In China, wounded Japanese soldiers were treated with great care. In sharp contrast, badly wounded Japanese soldiers in the Pacific were expected to commit suicide or were killed by comrades so as to not waste scarce resources. They were not evacuated and returned home. This is why Japan had so few seriously wounded veterans after the War.
One topic commonly ignored in World War II histories is the health care system. And in no country was the health care system more important than the Soviet Union. This was the case for two reasons. First, was the scale of the Ostkrieg. There were more men Soviet soldiers killed and injured than in any other country. (China may have had more men, but in most cases they were not well armed and trained.) And medical care was not just a humanitarian matter, saving lives and returning as many as possible to combat was a matter of military necessity. Contrary to popular opinion, even the Soviet Union did not have inexhaustible manpower reserves. The Soviet military medical system made huge improvements in surviveability and recovery during the War. Second, the country's civilian industrial work force producing the implements of war by 1942 were starving. This was because Stalin's Collectivization of agriculture (early-1930s)included the murder of the kulaks (the country's best farmers) which significantly reduced harvests. The food situation was significantly worsened as a result of Barbarossa with the Germans seizing must of the most productive agricultural land of the Soviet Union. The Soviets had to severely ration food. Front line troops, workers in the arms industry, and young children got the largest allocations, but even they were hardly well fed. And the rest of the population bordered on starvation. There were significant health consequences to the food shortage and the Soviet health care system did not do much to alleviate them in the civilian population, but American Lend Lease food shipments did allowing some improvements (1944).
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.) Battlefield medicine improved considerably throughout the course of the War. Probably the most important improvement was the speed at which the wounded received and advanced through the system.
There was also the wide spread adoption of important medical advances.
A major improvement in World War II was blood/plasma transfusion. Whole blood was not available at the front because of the need for refrigeration, but plasma could be canned. At first, only plasma was available to front-line medics as a substitute for serious wounds and blood loss (1941). By the end of the War, serum albumin was developed. This is whole blood that is rich in the red blood cells that carry oxygen and much more than just plasma (1945).
There were new surgical techniques. One important one was removing dead tissue. This led to fewer amputations than ever before. Also imprtant in the treatment of bacterial infections, penicillin or streptomycin were administered for the first time on a large-scale in combat situations. Service members were also inoculated with vaccinations for smallpox, typhoid, tetanus, cholera, typhus, yellow fever and bubonic plague, depending where they were sent.
An important factor here was the battlefield movement. Unlike the World War I Western Front, the World War II fronts were not static. This mean that large numbers of enemy soldiers inevitably fell into hostile hands. And there were major differences as to the care offered to wounded enemy soldiers. The Japanese simply killed them. Ameican and British policies were correct. German policies were generally correct toward the Western Allies, but murderous toward the wounded Red Army soldiers. We are not sure about Soviet behavior. There are several other issues to be addressed, including medics, nursing, and hospital ships. Another important matter is recovering service members. Americans badly wounded were sent back home and out of the War even after recovery. This was not necessarily the case in other countries. We are not sure about the British. But in Germany you were back into the fight as quickly as possible. The best example here is Graf Von Stauffenberg -- the officer who played a key ole in the July 1944 bomb plot that nearly killed Hitler. He was strafed by a British plane in North Africa. His right hand as well as ring and small fingers of the left hand had to be amputated. He lost his left eye. There were also knee joint and middle ear operations. Yet he was returned to active duty.
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". For our discussion of World War II casualties we have tended to ue the Wikipedia assessment, supplemented with our research. The Wikipedia is a good basic effort to assess casualties taken into account that for many countries no precise accounting can be made. We welcome reader contributions with more detailed country estimates.
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