The Wounded

The First World War changed how war was conducted. It also changed forever the injuries suffered by servicemen. The use of tanks, high explosive fire and automated weapons, caused new and horrific types of injuries, unimaginable in previous conflicts. The emergence of wet, cold and squalid trench warfare, brought with it untold discomfort and suffering. From conditions, such as ‘Trench Foot’, chlorine and mustard gas poisoning, hideous facial injuries and shell shock, to illnesses such as tonsillitis, life threatening ‘Spanish Flu’, even in-growing toenails and lice, few men escaped unscathed. Living in cramped, insanitary conditions, surrounded by death, disease, and other hardships, troops were placed under severe phychological pressure.The trauma of trench conditions meant the average life expectancy for front line soldiers was six weeks. 

Nearly 1.7 million British servicemen were wounded in the First World War. 1.5 million of these were wounded in France. 80,000 were gas victims, 30,000 were made deaf, 80,000 had ‘shell shock’, and there were 250,000 amputees. The wounded increased over time. By the end  of 1928, nearly 2.8 million war veterans were receiving a disability pension. 

Medical Miracles

In response to the rising casualty lists, medical advancements were made to save lives, treat injuries and cure conditions. For example, in 1916, the ‘Thomas Splint’, (named after pioneering Welsh surgeon Hugh Owen Thomas), was created to secure broken legs. Previously, 80% of all soldiers with a broken femur died. By the end of the war, 80 % of soldiers with this injury survived. Other medical advances during World war One, included, plastic surgery, X rays, plasters, compression bandages, blood banks, blood transfusions, antiseptics and improved medicines. The war encouraged speedier treatments, better hygiene and improved cleanliness, to contain infection and reduce disease. There developed a greater understanding of psychological distress to deal with shell shock. Surgeons also pioneered new operational techniques to treat complex spinal and head wounds. Blood transfusions were one of the most important advances, but getting the blood type was learnt by trial and error. Surgery and operating tables were given lighting by trucks and x-rays were introduced by the French (December 1918). Injuries to the nervous system, such as; complex regional pain syndrome and phantom-limb syndrome, were also discovered.  With hundreds of thousands of injured soldiers returning home, World War One also led to a new emphasis on rehabiliation and continuing care. New techniques in facial surgery and burns were developed – and there were huge advances in prosthetic limb technology – to meet the needs of hundreds of thousands of amputees. 

Did You know?

* 1.7 million British troops were wounded in World War 1

* 64 per cent of wounded soldiers were returned to fight on the front line.

* 8 per cent  (182,000 men) were discharged as medically unfit for service

* 7 per cent died of wounds, sustained in action

* 18 per cent were transferred to second line duties

* By the end of the war, 50 per cent of civilian Doctors (13,000) were working in the Armed Forces

* there were a few female Doctors (most women worked as Matrons, sisters and nurses)

* 6,783 members of the RAMC and Stretcher bearers were killed and wounded during WW1

* Officers and other ranks were intially kept in separate wards.

* Servicemen wounded in action recieved a War Pension for the first time.

 

What happened to sick and wounded soldiers?

 

Wounded were evacuated from the battle field, by stretcher bearers, often under fire. Stretcher bearers carried only basic medicines such as bandages and morphine. The wounded were firstly taken to a Regimental Aid Post, usually a few meters behind the front line trench. This was usually a basic dugout to protect against enemy snipers or a ruined building. Here basic first aid was administered, to either patch up the wounded and return them to the fight, or move them on to the next stage. Field Ambulances were usually located a half mile behind the front line. They were not vehicles, but usually a tented area. It comprised of an Advanced Treatment Centre, which would provide another level of triage and treatment, ideally sending men back to fight, or a Main Dressing Station, which would treat soldiers deemed unfit for battle. These soldiers were transferred to a Casualty Clearing Station (CCS), usually located 12 miles behind the front. This collection of tents provided most things for the very sick and wounded. This included operating theaters, mobile X Ray Units, surgical wards, stores, clean toilets and staff accommodation. Typically stretching over half a square mile, three CCS’s, would work in relay, one would be closed to new patients, preparing severely wounded men to be transported onward by train: a motorised or horse driven ambulance wagon transporting patients, and the next, dealing with the wounded. A typical CSC would have 50 beds, and 150 stretchers, and treated up to 200 men at any one time. General or Stationary Hospitals were usually civilian hospitals, or large buildings, near railway stations which could transport wounded quickly. Hospital Departments and equipment, included bacteriological laboratories, X Ray Units, isolation and quarantine wards. Some had specialist centres for treating conditions, such as mustard gas poisoning. The railways transported wounded home for either further treatment and discharge. Specially adapted railway carriages took them to the nearest functioning Channel port. Hospital Ships, which were usually converted passenger liners wound then return the wounded to Britain by sea. At home, British hospitals might be civilian or military. They would take in, those with head injuies or chest trauma, long standing conditions, or a need for mouth, jaw, face and neck surgery. The most severe cases were treated in Military Hospitals, which attracted the best and most pioneering practitioners. Those not requiring surgery, but extended recuperation, were sent to converted stately homes.

After the war most medical service records were destroyed. Many were also lost during the Blitz ,or in Goverment space clearing exercises. Only 2% of WW1 medical records remain. They are kept in the National Archives, where they are coded MH106. One million casualty records have so far been transcribed. The first of these were from  the 51st Field Ambulance. This was a mobile medical unit, based 400 yards behind the front line, responsible for about 12-14,000 men from the 17th Infantry Division. The top 20 medical conditions they recorded were as follows:

1. Pyrexia (fevers of unknown origin)                    11. Shell shock

2. Inflamation of skin tissue                                   12. Gonnorhoea

3. Trench foot                                                         13.  Lung Infection

4. Influenza                                                             14. Syphilis

5. Scabies                                                              15. Fractured femur

6. Shrapnel                                                             16. Urinary tract infection

7. Gunshot wound                                                  17. Lice

8. Mustard Gas posioning                                     18. Other STD’s

9. Diarrhoea                                                            19. Gangrene

10. Rheumatism                                                     20. Wasp stings

 * Thank You to the BBC and FORCES-WAR-RECORDS.CO.UK for this information.