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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 gratest impacts of the Napoleonic 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.
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 before preeceeding o North Ameroica. Its demise led to the Louisiana Purchase hugely expanding the fledgingly United States (1803). This as ironically one of the gratest impacts of the Napoleonic 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 continued to be he 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 because of the large number of casualties. Wars often result in major scientific advances. And this includes medical advances. The umber od edical procedure sky rocket during war. This was sespeially important at a time f ajorvmedical discoveries.
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. A major imrovement was the speed of getting medical care for wounded soldiers. This was espercially true on the Western Front where the front was so stable for much of the war. Abulances which were motorized foir the first time got the wounded to mecical facilties in record time. Time s a key factor in saving lives. The War led to new medical technologies and techniques, fundamentally transforming wear-time medical tratment, many of which had carry-over benefits for the civilian population. Important advances included facial reconstruction, vaccination for infectious diseases, mobile medical imaging, and blood preservation and transfusion. The war brought attention for the first time, and the impact of psychological trama. Authors began writing about of 'shell shock'. We medical care system which emerged involved both both static and mobile environments. There was a hierarchy of medical care operations from the front line to the rear area. The United States entrred theWar (1917). The U.S. Army Medical Department's system organized in France was based on the American Civil War experience and the practices developed from the French and British during the first 3 years of the War. The medical care system rapidly adopted the the advancements in medical technology and showed the ability to adjust to the changing battlefied conditions. 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 at the end of the War and in the aftermath.
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 why the American ambulance drivers were so important 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. Of course all of this varied from country to country. The primary factor was the economic capabilities of the country which deterined 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 garisons thoughout the Pacific soon ran out of both food and medical supplies. In China, wounded soldiers wre rted with great care. In the Pacific War badly wonded soldiers wre expecte to commit suiside or were killed by comrads so as to not waste scarce resources. They were not evacuated abd returned hoime. 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. Wounded soldiers received specialist treatment much quicker than in World War I. Thiswas 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】 There was also the wide spread adoption of important medical advances. A major imprivement in World War II was blood/plasma transfusion. Whole blood was not avaialable at the front because of the need for refigeration, 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). . Thee 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. 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 addrssed by medical teams. First the Marins, 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 avilable to the Japanese. Thee were a range of safty improvements, including crash helmets, safety belts, flak jackets and other importnt ptotctived measures. . 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 Pattob almost got fired for avusing traumaized GIs. After the War it became known as 'post-traumatic stress disorder'. Ipacted GIs were given a safe place in rear araea 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 soldies inevitably fell into hostile hands. And there were major differences as to the care offered to wounded enemy soldiers. The Japanese simply killed them. Ameicn and British policies were correct. German policies were genrally 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 mrdics, nursing, and hospital ships. Another impotant matter is recovering service members. Americans bdly wounded wee sent back home and out of the War even after recovery. This was not necesarily the case in other countries. We are not sure about the Nritish. But in Germny you were back into the fight as quickly as possible. The best example here is Graf Von Stauffenberg -- the offuce who played a key ole in the July 1944 bomb plot that nearly killed Hitler. He was straffd by a British plane in Nrth 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.
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, supplmented with our research. The Wikipedia is a good basic effort to assess caualties taken into account that for many countries no precise accounting can be made. We welcome reader contributins with more detailed country estimates.
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