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Career Opportunities in Pharmacy
Medical Treatment in World War 1 I THE GREAT WAR Special


The First World War, for all of its horrors,
was a time of enormous technological progress. We talk in our regular episodes about the
developments in flight, submarines, motorized vehicles, soy sausages, the zipper, and so
forth, but perhaps nowhere did advances come as quickly and as often as in the field of
medicine. In fact, medicine advanced more in the four
years of the war than in any other four-year period in history either before or since. I’m Indy Neidell; welcome to a Great War
special episode about medical treatment during the First World War. Yes, medical treatment. We’ll cover other aspects of medicine in
other specials, since it’s a very large topic. When the war began, the world leaders in medicine
were France, Germany, Britain, and Austria-Hungary. Russia did have fine doctors, but not so many
when compared to its enormous population. Armies’ Medical Corps were called on to
treat wounds, disease, poison gas victims, flamethrower victims, shell shock, and also
to improve sanitary conditions in the trenches. The work was extremely difficult, often dangerous,
and had a myriad of challenges according to each battlefront. The initial challenge was to bring a wounded
man away from the fighting to a medical facility, since the sooner you received medical attention,
the more likely you were to survive. Many wounds were also contaminated and infected
by the filth and the mud of life on the front or in the trenches. The Western Front, because of the stalemate,
allowed the medical Corps to have well-organized structured systems running from the front
lines back to base, and even specialized hospitals far from the front or back home in Britain,
France, or Germany. Wounded soldiers would be carried by stretcher
bearers, often themselves under fire, to a first aid station where wounds could be temporarily
treated to allow further transport to more sophisticated and better equipped facilities. The British army Medical Corps, as an example,
had an evacuation plan as follows. Stretcher-bearers brought the wounded to a
Regimental Aid Post, then an advanced Dressing Station, where the particular case would begin
to be documented, and then they’d be transported to a Casualty Clearing Station, which was
a large unit with seven medical officers and a substantial staff to help the doctors. If they were expecting combat, then surgical
teams would join these stations. They were about 20 kilometers from the front,
and usually treated a minimum of 200 soldiers, though this number could exceed 1,000 during
heavy fighting. This was really the first place the soldier
entered that was like a full-service hospital; with actual operating tents and rooms, and
the first place he’d see a nurse. It might well also be the last, as evidenced
by the large military cemeteries located near Casualty Clearing Stations. A side note here – the British had used X-Ray
machines in the Boer Wars, so they had them here pretty much from the beginning of this
war. Badly wounded soldiers might remain at the
stations for a few weeks, and then be sent to General, Stationary, or Base Area Hospitals,
specialized hospitals for victims of gas, venereal disease, shell shock, or epidemics. They might also be sent to a hospital back
home. In the German army, wounded soldiers wore
two information tags. One to show what injury was diagnosed and
the other to show what treatment had already been given. As you may imagine, whatever the soldier’s
nationality, if he had superficial wounds he may well be glad to enter the chain of
evacuation to have a break from the front until it was determined that he needed no
further treatment and was sent back up. Russia was faced with different problems. For example, they trained thousands of new
nurses but had a tough time transporting them to where they were needed. Interestingly, the Tsarina and her daughters
became nurses, and as you may imagine, nurses with titles were able to get postings far
from the gruesome reality of the front. When the war broke out, the first wounded
Russians were put on trains and sent to Petrograd, where they were just left at the station because
no plans had been made to receive them. Now, the Eastern Front was not static like
in the west and so you couldn’t really build semi-permanent medical facilities, and the
fluctuations in the Eastern Front kind of assured that soldiers quickly getting good
medical treatment would be few and far between. By 1917, wounded Russian soldiers, loaded
onto trains, might wait four or five days for basic medical care. The death of doctors prompted foreign nationals
to join the Russian Medical Corps. American surgeon Dr. Malcolm Grow volunteered,
was eventually awarded the Cross of St. George by the Tsar personally, and would later become
the first Surgeon General of the United States Air Force and a Major General. As I said, different fronts presented different
problems, and one real front-specific problem was malaria on the Salonika Front. Up to 40% of the British and French soldiers
there were disabled by malaria, and it killed more troops there than combat did. People referred to the Salonika Expeditionary
Force one giant infirmary. During the course of the war, over 1.5 million
troops in total were infected with malaria. But that was just a fraction of the millions
upon millions of sick and wounded soldiers the war produced. Mud, filth, feces, rotting corpses, stagnant
water, rats, and tightly packed men in trenches produced some of the worst sanitary conditions
possible. When food was scarce, things got even worse
as soldiers became more susceptible to disease. Illnesses and epidemics were sometimes more
deadly than the war itself. The Spanish flu, which we’ll cover in detail
later on, took about as many American soldiers as combat did, and they were being ravaged
by it even while still training at home in the states. But as a result of the enormous number and
variety of wounds and illnesses, medicine made great leaps and bounds. Cellucotton, blood transfusions, and blood
banks were big advances that grew out of the war. Motorized ambulances transported the wounded
at a faster rate and mobile x-ray machines could scan the wounded immediately. Plastic surgery was invented for the hundreds
of thousands of disfigured men whose faces were too terrifying for them to lead normal
lives. Morphine had been around for decades, but
it was used extensively and effectively as a painkiller, and sphagnum moss turned out
to be an excellent dressing for war wounds. It’s light, has antiseptic properties, absorbs
many times its own weight in fluids, and grows throughout Britain. Another thing that was discovered was the
sterile properties of maggots. Yeah, you heard that right. A badly wounded soldier stuck in no-mans land
for two days was finally brought in. The wounds he had were typically fatal because
of infection, but the doctor attending him saw that the wounds were clean; there was
new pink growth, and no infection. The wound WAS, though, covered in maggots. That doctor was a professor of surgery at
Johns Hopkins Medical School and he publicized his findings. Research found that the maggots had medicinal
properties; they ate only dead tissue, so they in fact cleaned the wounds, they crawled
into tiny recesses where topical antiseptics couldn’t be applied, they gave off urea,
which itself is an antiseptic that destroys staphylococcus and other bacteria, and they
promoted the growth of healthy tissue. Penicillin wasn’t invented yet and until
it became widespread, maggots were cutting edge medical treatment. They’ve even made a comeback today for use
with certain skin ulcers. The advances in medical treatment and medical
technology changed the nature of war and the wounded. When the war began, if you were badly wounded
you very probably died, but by 1918 you very probably lived. That is an enormous difference. Even because of just one advance, the Thomas
splint, you could see a huge difference. In 1914, 80% of soldiers with broken femurs
died, but because of the splint, by 1916 80% of soldiers with broken femurs lived. But the advances in the organization of medicine,
and the chain of treatment, particularly caused by the stalemate of the Western Front, were
reflected first at home in Britain, France, and Germany, and then the rest of the world,
with chains of organization eventually creating the modern medical systems of hospitals, clinics,
and ambulances that we rely on today, rather than simply a local general practitioner or
a cottage hospital run by a charity. And that is perhaps the biggest advance of
them all. Thanks to John Dewar Gleissner for helping
with the research for this episode. He actually wrote a whole book about the use
of maggots in medicine and you can check that out by following the link in the dublidu. If you want learn more about the live in the
trenches and the conditions there, you can click right here to check out our first ever
special episode. See you next time.

100 thoughts on “Medical Treatment in World War 1 I THE GREAT WAR Special

  1. Absolutely I worked at a specialist plastic surgery centre. Maggots were routinely used to deal with necrotic tissue.

  2. He stated that wounded soldiers might stay at casualty clearing stations for a few weeks. According to my research, that is not correct. They were cycled through CCSs as quickly as possible–the majority of patients within 24 hours. The only exception was if they were recovering from surgery, but they were still evacuated as soon as they were well enough to be transported down the line to a stationary or general hospital.

    He also stated that German soldiers wore two information tags indicating diagnosis and treatment. The British also had "field medical tags" attached to their tunic button stating diagnosis and treatment. The patient's name and other "particulars" were also logged into a ledger which allowed him to be traced through the evacuation chain.

    Finally, although it is correct that the Spanish flu was devastating, I believe overall, WW1 was the first war where more soldiers died from actual wounds than from disease. And indeed, if a man was seriously wounded in 1914 (particularly femur fracture or abdominal wound) he likely died. By 1918, due to medical advances, he likely lived.

    Fascinating study! They were a lot smarter back then than we give them credit for.

  3. I am half Russian half Hungarian, because my great-grandfather on my father's side was Russian. He fought in the great war and injured and became a P.O.W in Hungary.
    He worked in a manor, where he met her Hungarian wife, later he settled down and found a family. I know that he was a gentleman's tailor, but I don't know that in Russia or in Hungary…

  4. So uh…this might be quite disturbing, but is it safe to say that wars dramatically contribute to our evolution as a species?

  5. The Faces of War. We never learn do we? Probably because the sorrows are condemned and shunned out of sight while glories and heroics are heralded.

  6. Hey. I don't know if you guys will even see this but that clip of a French hospital stacking the dead is on YouTube under ww1 Battle of Verdun 3/4.

  7. One of the most interesting and educational videos you have made to date. Thank you and keep up the good work.

  8. Just a big THANK YOU guys for producing this episode. It was an absolute delight hearing Indy say "Staphylococcus" and other medical terminology. You could be teaching Medical lessons and we all be paying attention. Cheers from a Mexican doctor!

  9. I've been watching this channel nonstop for like an hour and I've learned more about world war 1 than I have in every single year of schooling in my life combined

  10. Is there any chance to make special episode about UK nurses that went to Serbia to help. Some of them even got medals and stayed to live in Serbia. I recently read "My diary in Serbia: April 1 1915-Nov 1 1915" by Monica M. Stanley. she was nurse that spent some time in Serbia. I simply love her description of Serbia and people during the war. She was even mentioning that they had some prisoners as their help in hospitals. Book isn't big and it has a lot of great informations. Thanks for the great show!

  11. @6.33 there is a clip of a nurse setting up what appears to be a plastic blood bag. The Plastic blood bag wasn't invented until the 50's.Is this bag something else or is this just not a period clip?

  12. Yay for maggots! Leeches are also used in modern surgeries when you need to have blood pumping without coagulating. Those little critters and their saliva are chockfull of anti-clotting agents.

  13. "And one for whatever treatment had already been administered." Geez, given the combination of how terrible doctor's handwriting looks with combat situations it's not surprising people were getting limbs lopped off left and right.

  14. RE; Maggots. My dad was in a MASH unit during the Korean War. He said that we always knew that a wounded soldier was going to make it if he had maggots in his wounds.

  15. coffee enemas were invented then. Germans would give soldiers who were gut shot enemas to reduce infection. when they were short on clean water a doctor started using coffee because it was available and noticed soldiers recovered better.

  16. I would like to add some more info relating to advances in medical treatment. Malta, then known as the nurse of the Mediterranean, was used as a hospital base by the British and was home to 27 hospitals treating wounded coming from various battle fronts. Some sources cite that about 2000 casualties per day were admitted for treatment into these hospitals. Curiously I came across the mention of the earliest documented heart surgeries carried out at St. Elmo hospital on a certain Trooper Martin who sustained a serious chest injury in the Salonika campaign in November 1917. The intervention was successful, but unfortunately the patient succumbed to infections.

    https://www.timesofmalta.com/articles/view/20140106/local/first-heart-op-on-soldiers-was-performed-in-malta-in-wwi.501526

  17. Quite a lot of medical advancement in 4 years. I had forgotten that penicillin didn't come along until later (1922?). I have heard of maggots being used occasionally in modern times for certain types of wounds. The nurse who posted makes a great point about modern overuse of antibiotics. That has been going on for years, and there are numerous strains of resistant bacteria. Staph infections seem to be getting more common. Nowadays u can get them from wrestling mats, gym equipment, etc. Gotta be careful how we use our modern meds. Great episode. Looking forward to the other medical ones

  18. "I'm hurt, doc, and I'm worried the wound will get infected. Please do something, I don't want them to cut off my leg!"

    "Not to worry, lad, I've got just the solution."

    "What's that?"

    "I'm gonna stuff your leg wound full of maggots!"

    "……..I'm actually a lot more ok with the amputation now, honestly."

  19. I don't really believe this you probably think I'm crazy but from everything I heard there were soldier left in trenches with there leg blown off for weeks or so many soldier hurt they were barley helping people shot threw the stomach also heard of i guy that's chin shattered and was hanging down really far and the guy fixed it with wires

  20. gran vídeo señor y muy interesante esto me sera de gran ayuda en las clases de medicina legal sobre el avance de la medicina

  21. I'm in the hospital right now recovering from a broken femur. Excruciating pain that it is watching this episode makes u truly appreciate the medical advances WW1 brought forward. Thank you for another amazing episode Indy, Flo, & the great war team

  22. Hey I wanted to tell you something since you know war so I got a medical Switzerland backpack it’s a new one but in a medical compartment. There was a sticky thing that had flowers please let me know.

  23. I'm very happy to see you're covering medical treatment and advances made during the war. Everyone is interested in weapons and tactics and battles and generals and how they all affected the outcome, but throughout the history of warfare (until very recent times) losses to disease outnumbered combat losses by anywhere from 3:1 to 10:1.

  24. as a physician myself i can only say….what a fucking nightmare must be treating that many patients and treat such complicated injuries with not so adequate equipment

  25. Maggots for wound cleasing; Sphagnum moss for wound dressing; leeches for high blood pressure; coc*s**kers who like seafood for "crabs." Ah-h, modern medical care.

  26. In response to malaria cases on the Salonica front the French and British built hospitals to treat them in the hills around the city of Salonica, The cooler temperatures meant that mosquitos were less prevalent. Some of these hospitals still exist.

  27. As a soldier and nurse with Wartime experience myself I find Great War and Korean War medicine fascinating as it is the Start of effective battlefield medicine and was one of the first wars with effective treatment for disease. Also some medical treatments from the world war are making a comeback on the battlefields of Afghanistan and Syria- Dakins solution (bleach water. Essentially ) and giving fresh whole blood are two ww1 era interventions to come back in today’s war.

  28. If you want you can look up Hospital in Valjevo, Serbia. Short version is that the whole town became a hospital during the first world war.

  29. It is interesting that it took until WW1 for maggots to officially be recognized for their abilities… There are many times that I can think of on the American frontier in the 16-1800’s that Maggots saved lives. Hugh Glass is the first that comes to mind but many cases happened besides that.

  30. I do history would this help with medicine in ww1??? I think it would because I have heard a little of information about the western front and the soldiers

  31. A vast improvement over medical treatment in the amercian civil war. .the amputations were rampent . I'm a c.w. reenactor .capt. 108th ill . medical inf .

  32. How an episode on surgery i.e orthopedic surgery during the Great War? Bangkok Johnnie CarSanook Media Thailand

  33. How an episode on surgery i.e orthopedic surgery during the Great War? Bangkok Johnnie CarSanook Media Thailand

  34. How an episode on surgery i.e orthopedic surgery during the Great War? Bangkok Johnnie CarSanook Media Thailand

  35. How an episode on surgery i.e orthopedic surgery during the Great War? Bangkok Johnnie CarSanook Media Thailand

  36. 4:21

    While it is true the Empress and her daughters – Along with other Aristocratic Women who became nurses – didn't ever go to the front, they still did the same things an ordinary nurse would do. The daughters for example were witnessing amputations by early 1915 while assisting the surgeons. It wasn't just a PR move, they were legit Nurses.

  37. My 2 times great grandfather died of the Spanish flu before heading to France in 1918. He was 42. Son of American Civil War vet, father, and grandfather of WW2 vets.

  38. Those who'd like to know what it was like to work at combat clearing stations might read Unknown Warriors: The Letters of Kate Luard RRC and BAR Nursing Sister in France 1914-1918. It's a collection of letters she wrote home, some of them quite gristly. At times, her CCS was so close to the front that artillery from both sides passed over her head.

  39. Yeah, I agree; terrible as they were, WW1 and WW2 gave us the society we have today. People often forget this. Just imagine a society based on 1900 values.

  40. Ha we just made a LMG made with wood furnished in steel that can saw a man in half oh what's that you need to be put back together well shouldn't joined the army

  41. Couldn't imagine how painful, and downright abhorrent, trench foot would have been….to actually have one's feet literally rotting away and the infections that accompany such horror are almost too much to comprehend.

  42. Speaking of those stretcher bearers, in my small, American town, the anniversary of the first man to die that was from here just happened. He offered to head out and collect the body of a man out in no man's land. He was shot while carrying the body, and his comrade was wounded and died soon after.

  43. Australians had the highest rate of VD among the British troops at about 20%. The average time off duty was around 30 days.

    On average Australians were hospitalised three times while overseas for disease and wounds. Around 50% of Australian soldiers were wounded and 20% killed. Only England had a higher rate. NZ had a higher percentage based on population.

    Those wounded received a stripe for their sleeve.

  44. I have wondered when medical treatment changed from the country doctor to the hospital system we use today – the answer – what was learned between 1914 and 1918 – if you were were wounded in 1914, you probably died – if you were wounded in 1918, you probably lived – all because of the new system including hospitals used for medical treatment. This episode was simply awesome. Thank you Team Niedell!

  45. So what was death rate of wounded soldiers during WW1? I have collected some data of 1939-42 wounded and it looks like that death rate of wounded (really wounded, not sick and wounded) was somewhere between 7 and 9% (depend on conditions, terrain and combat situation). However American armed forces (army) could push it down to less than 5%. But in some armies very slightly wounded soldiers who return to service during the next few hours were not even counted. That's why it has been hard to compare those results of different armies.

  46. Plastic surgery wasn't invented during the Great War. The American Civil War had a plethora of cases of men being given new "identities" thanks to surgical procedures. Prosthetic noses, cheeks, arms, legs, and all other sorts of new body parts were made for wounded men.

  47. who are these people disliking high quality videos on youtube like this one? like actually where do these people live, under a rock?

  48. I once heard that tampons were invented in the war to plug bullet holes but that the nurses found out they could be used for something else as well. I've always wondered wether this is a myth or a true story?

  49. my great uncle was wounded in World war I He was serving with the Canadian Army .His name was Leonard Chiassion was a sapper and they were digging a tunnel or a section of trench when The Germans must have seen what they were doing and shells started to explode around the tunnel entrance so the officer in charge told them to get out as they were leaving a German machine gun opened fire on them and Leonard was hit in the groin . The wound caused allot of damage and he lost allot of blood He saved himself by jamming his finger in the bullet hole to check some of the bleeding and he had to lay there for about 2 hours with his finger in the bullet hole until the fighting died down at which time they were able to get him. he lost quite a bit of blood and they got him to an aid station where they saved him . he was then sent to a military hospital where the Doctors operated to fix some of the damage caused by the bullet. This was July 1916 . and after surgery he was sent to England for 6 months to a convolesent hospital . Than after an accessment he was discharged from the army his record simply says "Soldier Discharged Medically unfit for duty " He ended up Marrying a Girl in St John New Brunswick where he died in 1947 . Did they have any sort of blood transfusion in 1916 ? from what I read in his records he was in bad shape when they finally got to him

  50. I understand it and the technology/medical reality of the day but……(forgive me) the words operating and tents ( together in a sentence ) is still very scary!

  51. As WWI was coming to and end the world was swept by the famous swine flu or Spanish flu pandemic that killed millions worldwide. In the late 1960's I had a bad case of the flu and was having a hard time keeping my fever down with aspirin. I stopped at a pharmacy in Hot Springs Arkansas where I worked at a Hospital and ask an old pharmacist if he had anything else for fever and he gave me Quinine tablets which work fine ,but he cautioned me not to switch back to aspirin, because of his experiences in WWI as a pharmacist treating swine flu . He said that many of the soldiers who they gave aspirin and switched to quinine and then back to aspirin died but those who remain on aspirin or quinine tended to live more often.

  52. I don’t believe the first thing you said what is the biggest thing a medical history be the invention of medicine

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