Dickey: Where the Road Leads: Field medicine through the ages

This is the final article on the Red Clifton Collection at the Cape County History Center, and the last educational tote is about field medicine in the time of war. It’s been said that “war always accelerates technology.” It appears to be true as each war seems to find more efficient ways to kill, but we also need more efficient ways to save the soldier. From clubs, to spears and swords, to catapults and armor, to cannons, rifles and pistols, to tanks and bombs, to aircraft and drones, to cyberwarfare, we’ve seen many advancements in the last 4,000 years of military history. Unfortunately, medicine struggled to keep pace with war technology.

The ancient Egyptians used herbs and honey to try and heal wounds. It wasn’t until the Romans in the first century BCE that battlefield medicine took a leap forward. The Romans realized the importance of sanitation as a key factor in keeping their armies healthy. Latrines were separated from the fresh water and set up so they flowed away from the encampments. They also set up treatment on the front lines. The advancement the Romans made in treating their wounded wouldn’t be surpassed until the 18th century.

Guns came along in the 15th century, adding new ways to use gunpowder. The only advancements in medicine in the 16th century were turpentine, as an antiseptic, and the cauterization of wounds. In 1718 Jean Louis Petit developed the tourniquet. Forceps had been created to remove bullets. John Pringle discovered typhus, a terrible disease that spread quickly through battlefields. Before the close of the 18th century, Dominique Jean Larrey, surgeon-in-chief of the French armies, created the triage system and its criteria. He also created the, “flying ambulance”, a horse-drawn wagon to quickly remove wounded soldiers from the battlefield. By the 19th century, Western medicine had reached and maybe exceeded the Romans.

By the late 19th century into the early 20th century, what we know as modern military medicine emerged. The U.S. survived the Civil War, our bloodiest conflict, where armies used modern technology, such as railroads, telegraph and massive armies. Diseases such as pneumonia, typhus and dysentery were ramped up due to deplorable sanitation. The Spanish-American War saw the rise of new diseases, such as malaria and yellow fever. In World War I, trench warfare presented deplorable sanitation, increasing the spread of disease.

Army physician, Walter Reed, made huge contributions to medical care. His Reed Commission brought yellow fever down dramatically, allowing workers to complete the digging of the Panama Canal. He made numerous suggestions about sanitation, mosquito and malaria control. This led the Army to create the Dodge Commission to examine the shortcomings in medical service. As a result the Army increased the number of doctors, hospitals, nurses and corpsmen and improved organization. Physician Leonard Wood was chief of staff before the outbreak of WWI and oversaw much of this transition into a modern system.

The development of organized, efficient medical care for armies lagged behind technological developments of warfare for three reasons. Until the 20th century, most European countries were run by aristocrats, not trained military officers. The second problem was a lack of understanding public health. The third was army officers were taught strategy and tactics, not logistics.

While sanitation improved, probably the worst health problem soldiers faced has become known as post-traumatic stress disorder (PTSD). Case reports date back as far as the American Civil War. In WWI it was called “shell shock.” British soldiers were shot if they were convicted of cowardice due to the condition. By WWII it was called “combat fatigue”, and it was during this war it became recognized as a psychiatric disease. The Korean War presented new problems for military medicine due to the cold, while Vietnam’s tropical jungle warfare contributed its own strain on medical personnel.

The medical corps in the military have come a long way in improving healthcare for wounded soldiers, but two problems still plague the military machine when it comes to war: disease and PTSD. Gen. William Tecumseh Sherman’s famous quote that “war is hell” is an insightful statement for all aspects of warfare, whether it is the soldier in battle or the medical staff trying to save a life.

Dave is a lifelong resident of Southeast Missouri who has always had a strong interest in local history. Recently retired from the Cape Girardeau School District, Dave can spend more time exploring Southeast Missouri’s history.