The devastation caused by new weaponry in WWI led to numerous medical innovations still used today. Tanks, chlorine gas, machine guns and living in trenches infested by disease all contributed to the need for medical advances to treat infections and save lives. Millions of people died in World War I and millions more were injured. In fact, over 40,000 amputations had to be performed, many of them caused by infections contracted in the trenches. Anaesthesia, antiseptic, blood transfusions, facial reconstructive surgery and portable x-ray machines were all born out of the necessity to treat these millions injured by devastating and violent weaponry in WWI.
Marie Curie and Radiology
Even though several hospitals were equipped with X-ray machines by 1914, they were far from battlefields. Marie Curie (who won the Nobel Prize for her discovery of radium) and her daughter created military radiology services and brought the X-ray machines to the front in cars converted into X-ray vans called “petites Curies”. This technology allowed doctors to scan wounds directly at the front, and thus save lives, because they could see shrapnel and bullets, and thus remove them.
(Photo: Bibliothèque nationale de France)
At the start of WWI, the practice of anesthesia was an unstructured specialty with techniques and methods varying between institutions. During the war, the practice adapted and developed at an accelerated pace, becoming its own subspecialty for both physicians and nurses. Several leaders took note of the new conditions and helped institutionalize changes, including Captain Arthur Guedel, who helped define the stages of anesthesia to support the education of anesthesiologists and nurses. The creation of specialty posts for anesthesiologists also allowed for increased support for and research in blood transfusions and resuscitation, which were vital for preventing deaths and treating patients suffering from shock. In Casualty Clearing Stations, essential nursing and surgical care worked at such a fast pace that analgesic gas treatments were combined, which benefited the patient and would eventually lead to the development of an anesthetic machine that could more accurately monitor and dispense treatments. Also, in 1915, at the American Ambulance Hospital, Dr. George Crile and nurse Agatha Hodgins showed their colleagues how to use a mixture of nitrous oxide and oxygen to anesthetize patients. This method would be used for reconstructive surgery, among other procedures.
(Image: Wellcome Library)
A number of medicines were developed in times of war. For example, in 1915, Henry Dakin, a British biochemist, perfected a sodium hypochlorite solution, which killed dangerous bacteria without burning flesh. He used it to flush out and clean open wounds before they were closed off (either by stitching, burning, or amputation) to prevent infection. The technique became known as the “Carrel-Dakin Method”, and was adopted by doctors across Europe during the war. Morphine also became quite popular and was used to ease pain and to allow the badly wounded to die painlessly. Nurses were trained and ready to administer these antiseptics, anesthetics, and other medicines when needed.
(Photo: Alexander Fleming Laboratory Museum)
The history of blood transfusions began in the early 1700s, but the practice at that time used erratic methods and produced poor results. As modern medicine developed in the early 1900s, a series of doctors began to explore the potential benefits of human blood transfusions. Prior to WWI, Dr. Edward Archibald in Montreal and Dr. Lawrence Bruce Robertson in Toronto independently took an interest in and began practicing blood transfusions with patients at their respective hospitals. At the onset of war, these two Canadians both enlisted and quickly realized the benefits of blood transfusions to patients who were hemorrhaging and in shock.
These two men continued their efforts to advance the cause, and both published influential articles. The following summer, with the arrival of the U.S. forces in 1917, American Dr. Oswald Hope Robertson was able to add his own research into the preservation of blood and its adaptation for blood transfusions on the battlefield. He created the first blood bank, using donated blood stored with sodium citrate as an anticoagulant. The combined research of these three doctors had a major impact not only on the war, but on the entire practice of medicine and surgery, the results of which are still important today.
(Photo: Science Museum London)
With the invention of the first artificial leg by Benjamin Franklin Palmer in 1847, the world of medical rehabilitation was forever changed. Wounds caused by artillery and subsequent gangrene caused many soldiers to lose limbs. Even though amputated soldiers would never fully recover, the use of prosthetic limbs greatly improved their mobility and quality of life. Nurses also served as physiotherapists for recovering soldiers learning to use their prosthetic limbs.
(Image: British Pathé)
In a sense, nurses were pioneers of mental healthcare. The care and comfort they provided allowed soldiers to speak up about the horrors that they witnessed on the battlefield. Some nurses had a background in social work and psychiatry, which gave them an edge for helping soldiers deal with their experiences.
(Photo: National Museum of Health and Medicine)
Treating the Wounded
Images: BAC-LAC, Imperial War Museum, Michel Italien