Description

During the First World War, Britain's War Office issued a wealth of pamphlets to circulate information quickly and concisely. This pamphlet, aimed at surgeons from the RAMC (Royal Army Medical Corps), draws together conclusions from two surgical conferences held in early 1917. It outlines the surgeon’s role in World War One, as well as the most common war wounds, specific stages of treatment and the main threats to the health of the patient.

The Inter-Allied Surgical Conference

Held at the Val-de-Grace hospital in the centre of Paris, the conferences were attended by surgeons from Great Britain, Belgium, France, Italy, Japan, Portugal and Serbia. Their aims were to develop better understanding of the nature of war wounds and commit to a standardised approach to their treatment. In part, this was a response to recent large-scale Allied operations which had resulted in higher numbers of casualties among troops. Most significantly, Nivelle’s Offensive saw over 134,000 French casualties during the course of nine days.[1]

Key conclusions

This pamphlet shows how the medical profession understood the impact that environmental factors had on the infection and treatment of war wounds. On the Western Front, conditions of ‘heavily manured’ soil and heavy rainfall created a breeding ground for aggressive microbes.[2] The conference concluded that every wound ‘should be regarded as either contaminated or already infected’ (p. 3).

One of the most significant approaches endorsed by the conference was the Carrel-Dakin’s method (pp.3-4). Developed by the surgeon Alexis Carrel and chemist Henry Dakin, this method promoted the use of antiseptics to attack microbes in infected wounds.

The pamphlet also recommends that surgery should be avoided when in close proximity to the front line. This meant that first-response medical units, such as Regimental Aid Posts and Advanced Dressing Stations, should focus on stabilising patients – by cleaning and dressing the wound – before transporting them to better-equipped hospitals.

Thirdly, the conference agreed that the wound should be continually observed by the surgeon with the support of bacteriological examination (pp. 4–6). However, in practice this could not be performed by every medical unit, as many did not have access to pathology laboratories.

Footnotes

[1] Jonathan Krause, 'Western Front', in International Encyclopedia of the First World War, <https://encyclopedia.1914-1918-online.net/article/western_front> [last accessed 07/11/2018]

[2] Surgeon-General Sir Anthony Bowlby, ‘The Bradshaw Lecture on Wounds in War’, The British Medical Journal, (2:2869, 25/12/1915), p.913

Transcript