There are often comments on the forum about medical advances attributable to the Great War. This list of equipment and treatments comes from the Offical History Medical Services, Volume 1, and I thought it might include some snippets of interest to others. I think No.34 could probably find a use today

Medical History of the War
Appendix E: Table XXIII

Statement of some New Apparatus and Methods of Treatment adopted during the War

1. An immense variety of splints and fracture apparatus, in which metal has largely replaced wood.
2. A large variety of surgical instruments and appliances.
3. Anaesthetic apparatus.
4. Universal stand for gas cylinders.
5. A new pattern hypodermic syringe.
6. Haldane’s oxygen inhalation apparatus.
7. Crutches with adjustable handles.
8. Wound irrigators, including Carrel’s apparatus.
9. Wound applications such as Dakin’s solution, Eusol, Chloramine, Dichloramine, hypochlorite solution obtained by electrolysis of sea-water, hypertonic salt solution, peroxide of hydrogen, acriflavine, proflavine, brilliant green, nikalgin, No.7 paraffin (for burns), B.I.P. paste, dielectric oil.
10. Specially prepared sterilized dressings cut up for rapid use in casualty clearing stations. Sterilized dressings for use on board transports.
11. Sphagnum moss which was largely used as a substitute for cotton-wool – it was put up in muslin bags, loose or compressed, and was impregnated with Perchloride of Mercury.
12. A new pattern first field dressing containing an iodine ampoule (since discarded) and khaki bandage instead of white.
13. Shell dressings, a first-aid dressing for shell wounds, about three times the size of a first field dressing, and also having a khaki bandage and a large ampoule of iodine (now discarded).
14. A first-aid outfit for aeroplanes.
15. A first-aid outfit for tanks.
16. A new pattern field operating table.
17. A new pattern field fracture box in which malleable steel has been substituted for aluminium.
18. New pattern containers for various articles in the field medical equipment.
19. New pattern enamelled iron water-bottle.
20. Camp medicine boxes containing drugs, dressings and appliances suitable for camp use at home.
21. A chemical case for the detection of metallic poisons in water.
22. A chemical case for chlorine estimation in connection with the sterilization of water.
23. Mobile Laboratories, bacteriological, hygiene, X-ray, and dental.
24. Mobile operating theatre.
25. New scale of equipment for River Hospital Steamers and Barges.
26. A complete cholera outfit, with water-testing case.
27. Dental Surgeons’ outfits for home and field service use and Dental Mechanics’ outfits.
28. New designs of X-ray apparatus and equipment.
29. Improved protection for X-ray operators.
30. Giant magnets for assisting in the extraction of pieces of steel, etc., from the eye.
31. The Army pattern spectacles.
32. A new pattern sun-goggle was designed with metal cups containing chlorophyll smoked eyepieces of non-inflammable celluloid.
33. A new pattern ophthalmic lamp.
34. New optical apparatus for detection of malingerers.
35. The extended use off electro-medical and mechano-therapeutic methods of treatment.
36. An electric telephone probe.
37. Galvanometric diagnosis of disease.
38. Various therapeutic remedies such as Kharsivan, Arseno-benzol, Galyl, Double Iodide of Emetine an Bismuth, Absorption Ipecacuanha.
39. Rogers’ intravenous treatment of malaria by means of antimony.
40. Ammonia ampoules for use in cases of “gassing.”
41. The substitution of British-made drugs and bacteriological stains, sugars, reagents and glass-ware for those formerly obtained from enemy countries. Substitutes for Carbolic Acid.
42. Use of Multiple Vaccines, e.g., T.A.B. Vaccine.
43. Various types of stretchers adapted for trench warfare, also a large variety of wheeled stretcher carriers.
44. A variety of bed-tables.
45. An apparatus for the transfusion of citrated blood.
46. Intravenous injection of solution of Gum Arabic.
47. Plaster Pylons (provisional artificial limbs).


Sue

David Cameron would be interested in number 34, Sue !


Seriously, you make a good post...we need to reflect on the way war enhanced medicine.

Phil

Hi Sue

I've often wondered this question myself but am still amazed at the volume of improvements in health care and equipment as a result of WW1. Thanks for posting!

Dianne

I wonder when egg white and oxygen first found favour?

Mick

Don't forget the effective start of aviation medicine!

Just found this

http://www.faqs.org/patents/app/20080306365

How about - first applications of plastic surgery?

I think that the list is intended to reflect investigation, equipment and 'treatments' rather than advances in medicine and surgical techniques, which were obviously far-reaching. As there were other volumes of the Medical History about the actual diseases and wounds of war, I guess those were addressed there, although I don't have copies of them.

Sue

Don't forget the Canadian, Australian, and New Zealand Medical Official volumes -all outstanding works. Some are on the net.

Correction all of them are on the net.

Shame the UK aren't.

Also to be added to this body of work should the Medical & Sanitary Reports on the Russo Japanese War, and if you have access to the body of medical work done by the Indian Army on the Overseas and Frontier Campaigns, stunning.

I wish all these where online, maybe someday I will warm up the scanner.....

Sue

A fascinating list; thankyou for posting it. It was the arseno-benzol that particularly caught my eye. Can you imagine anyone, today, combining a heavy metal poison with a known carcinogen for the treatment of an STD?
The treatment had to be worse than the disease surely.
Oh well that's medicine for you. If it doesn't kill you it'll cure you

Garth

Really interesting Sue
Keep the posts coming. I'm off to collect my sphagnum moss for a "green" first aid kit!
Glen

On the other hand, it's surprising what's there that endured through many decades - Eusol, hydrogen peroxide; and how many ex-medics/nurses remember gloopy, yellow Proflavine? In this area it was only about ten years ago that it was discontinued - it was still much loved by the older surgeons, but was unstable and costly as the little bottles had to be discarded within a day or two of being opened.
And surprising about the iodine being discontinued for use with field dressings - the OH says of it:

Iodine ampoules containing 30 minims of tincture of iodine were introduced in the early days of the war for use in conjunction with the first field dressings which contained gauze impregnated with 2 per cent. to 3 per cent. by weight of double cyanide of mercury and zinc. In July 1917, however, it was represented from France that the consulting surgeons there were of the opinion that the addition of iodine to the first field dressings served no useful purpose, and caused blistering of the skin in many cases when used in conjunction with cyanide gauze. Consequently, after careful consideration of the whole question in all its aspects by the consulting surgeons at home and abroad, it was decided to abolish the use of the iodine ampoule in conjunction with the first field dressing.

Sue

Well given that mercury had long been a treatement for syphilis

I think war does not attribute to medicine, at least by far not as much as times of peace do (and certainly not from a scientific point of view). Just giving a list of things invented in wartime, does not mean a thing. And if it attributes, than only on those fields of medicine that are of any value to warfare. Please read: http://www.metamedicavumc.nl/pdfs/mcs-julsep2007.pdf

Anybody explain no 46, the intravenous Gum Arabic - is it to help with clotting?

A very interesting question, which means I don't know. There are two aspects that may have been useful. It is possible that it was used as blood volume enhancer (not a clotting agent) in cases of shock due to blood loss. I have no evidence to support this, but gum arabic is similar to compounds like Haemaccel that were used for this purpose in recent times (see here). Alternatively, it was used as an agent to facilitate the intravenous use of drugs that are not very water soluble. This seems unlikely as an explanation for line item 46.

Robert

I've often heard it said that the progress made in medicine and surgery during wartime are the only positives to come from what is otherwise an obscene occupation.

I think I agree.

Fascinating post, Sue. Thanks.

Cheers,

Nigel

Thanks for post #17 Robert - appreciated.

To-day, quite by chance, I was looking up "general paresis/paralysis of the insane" - a euphamism for mental degeneration due to syphilis, and was surprised to discover that in 1917, the deliberate infection of a patient with malaria was identified as a means of slowing or halting the progression of it. The discoverer, Julius Wagner-Jauregg, later received the Nobel Prize for his work.

I'm curious to know how deliberate infection was undertaken; did the medical profession have a supply of mosquitos for this purpose?

Andy.

The malaria parasite can be 'stored' in body tissue cultures, and does not need to kept alive in mosquitos.

Robert

Interestingly, as an ENT surgeon I used BIPP (Bismuth Iodoform & Paraffin Paste) -see item 9 - in the operating theatre today.
Jerry

Wagner-Jauregg - as his colleague Kozlowski - was one of the socalled medical torturers of WWI (As the German Kaufmann, the Frenchman Vincent or the Englishman Yealland). The difference was that Jauregg did not (mis)use electricity but indeed self induced feaver to get the psychiatric cases back to front or weapons factory. As with the socalled Kaufmann-cure, not everyone survived. Nevertheless, in 1927 Wagner-Jauregg received the Nobel-prize. See: Lerner's Hysterical men [I'm not sure if he means the patients or the doctors] or my Before my Helpless Sight (p. 365-400). Psychaitric colleagues like Fritz Wittel or Freud critized them for their misuse of medicine for military purposes. Wittel wrote: 'Maria Theresia had abolished torture, the nerve doctors reintroduced it during the war', and Freud called them 'machine guns behind the front'. He did thios in a trial shortly after the war in which Wagner-Jauregg indeed was accused of torture by one of his patients (or better: a patient of Kozlowski, but he had feld from Vienna and therefore Wagner-Jauregg, as his superior, was called to the stand). By the way: he was rehabilitated.

I cannot comment on the specifics of Wagner-Jauregg's history, in respect of the accusations about war. It is not surprising, however, that he attempted to use fever as a potential cure. High fever had long been regarded as a curative response to infection, not least because the resolution of the febrile crisis in pneumonia, a relatively common illness, was associated with a return to normal senses from a state of delirium. Wagner-Jauregg had been interested in the therapeutic effects of fever on psychosis for some time before the war. During WW1, he was able to try blood from a patient with malaria, knowing that malaria can cause very high fevers. He injected the blood into a person with the advanced stages of syphilis, who was showing signs of gpi. The person contracted malaria and was allowed to experience several bouts of high fever. The initial results demonstrated seeming improvement, and several other patients were treated the same way. The majority also showed signs of improvement as well.

It is hard to know what the cause of any improvement might have been. Nonetheless, Wagner-Jauregg's work was rightly regarded as a breakthrough in understanding some psychiatric disorders as having a 'physical', as opposed to 'mental', basis.

Robert

Robert

Wagner-Jauregg's work may have been the beginning of an understanding of the physiological basis for the pathophysiology
of psychiatric disorders, but the medical profession clearly dropped the ball subsequent to the Great War. For the next
five decades the psychoanalysts were the predominant group acknowledging any physical causation in the clinical practice
of psychiatry (cf "Psychosomatic Medicine," Franz Alexander et al.). Of course, figures like Walter Freeman and the developers of ECT may be regarded as the inheritors of Wagner-Jauregg's scientific legacy--or, perhaps, Josef Mengele. Your reference to
"a breakthrough" will be misread by some as implying a continuity in clinical progress that simply did not occur during the postwar era.
While you made no such claim, it is a necessary reminder that clinical practice did not incorporate such knowledge for many
years.

Regards

Trelawney

Trelawney