Edexcel GCSE History - (WIP) Medicine in the British Sector of Western Front

Context of The Western Front

• oct 1914 - first battle of ypres where BEF stopped germans from advancing

• april to may 1915 - second battle of ypres, germans first use of gas

• july to nov 1916 - battle of the somme

• april to may 1917 battle of arras

• nov to dec 1917 - first tank battle at cambrai

Cross section of a trench

The trench system

Impact of terrain

• collecting the wounded from no mans land was dangerous and might have to be carried out under fire or at night

• no mans land and the trenches could be deep in mud making movement difficult and dangerous

transporting the wounded: ambulances

• horse drawn ambulances were unable to cope with the casualty numbers and often shook the patients making their injuries worse

• motor ambulances made transport easier but were difficult to operate in the mud

transporting the wounded: Trains and Canal Barges

• wounded men were sometimes carried by train to base hospitals, however thus was stopped when concerns were raised that they were clogging the rail network of northern france

• canal barges were chosen as the alternative method. although they were slow they were comfortable and could transfer patients directly onto ships back to britain

Trench Foot

• painful swelling of the feet, caused by standing in cold mud and water and then gangrene

• rubbing whale oil into feet alongside keeping feet dry and regularly changing socks were common solutions

• if gangrene developed the foot would need to be amputated to prevent it spreading to the leg

Trench Fever

• flu-like symptoms - high temperature, headache and aching muscles

  • major problem because it affected 500k on the western front

• by 1918 cause of trench fever discovered as contact with lice

• delousing stations were set up[ and afterwards there was a decline in cases

Shellshock

• symptoms included tiredness headaches nightmares loss of speech or even mental breakdowns

• the condition was not well understood at the time

  • some sufferers were extradited to britain for treatment, while others were accused of cowardice and were punished or even shot

New Major Weapons: Rifles and Machine Guns

• rifles had become more efficient

  • bolt action rifles allowed soldiers to carry more than one round in their gun and allowed them to shoot more rapidly

• bullets were also designed with a more pointed shape

• new guns which could fire 500 rpm and were a major part of trench defenses

• were mass produced by both sides

New Major Weapons: Artillery and Shrapnel

• bigger and more powerful renditions of cannons

  • could shoot a 900kg shell 12 miles

• would be used to bombard to enemy for weeks

• caused 50% of casualties

• shrapnel was a new type of shell filled with steel or lead balls, which would explode above an enemy to cause maximum casualties

Chlorine Gas

• First used by the Germans in 2915 at the second battle of Ypres

  • led to death by suffocation

• Gas masks were given to all soldiers in July 1915, however before soldiers hat to improvise and used cotton pads soaked with urine

Phosgene and Mustard

• Phosgene first used at the end of 1915 near Ypres, it was similar to chlorine but killed faster

• Mustard was used by the Germans in 1917

  • an odourless gas which worked within 12 hours and could cause internal and external blisters

Royal Army Medical Corps

• RAMC was the medical group assigned to the army

  • were in charge of transporting injured troops from battlefield to base hospital depending on severity

• in 1914 most of the nurses were from the Queen Alexandra Nurses who were well trained

• but due to the rising casualties more women were employed as volunteer nurses however they were mostly left to do menial jobs as they were inexperienced

Arras Underground Hospital

• Hospital built in tunnels underneath the town of arras

• had a capacity of 700, an operating theatre, waiting rooms and a mortuary

• had running water and electricity, but was abandoned in 1917 when a shell destroyed the water supply

New medical developments: Aseptic surgery

• a septic surgery had become normal by 1900:

  • surgeons were dressed in gowna and wore gloves

  • the air ws sterilised by being pumped over the heating system

  • all medical staff were required to wash their arms faces and hands

New medical developments: X-Rays

• X-Rays were developed by William Roentgen in 1895

• X-Rays allowed Doctors to make diagnoses easier which greatly helped medical treatment

New medical developments: Blood tranfusions

• Blood coagulation was resolved by using a soluble sodium citrate solution to slow clotting

• Blood rejection was solved when an Austrian doctor discovered the existence of blood groups

Path to Treatment (1)

• Stretcher bearers - recovered the dead and wounded, administered basic treatment, 16 stretcher bearers per battalion

• Regimental aid Post - within 200m of the frontline, could not deal with serious injuries, purpose was to give immediate first aid

• Dressing Station - A mobile support unit for Doctors, nurses and support staff. Often set up in tents or derelict buildings between a quarter and a whole mile from the frontline

Path to Treatment (2)

• Casualty Clearing Stations - first large well equipped facilities, could hold 1000 casualties, contained mobile operating theatres

• Base Hospital - Contained specialist centers like gas treatment, located near the coast for easy transport back to Britain, could take 2500 casualties

Treating Wounds and Infection

• new techiques included

  • removing tissue around a wound to stop infected tissue from spreading

  • using a sterilised salt silution in the wound through a tube - however the solution didnt last long so was only made when needed

• However if all else failes amputation was done to stop infection taking over the whole body and killing the patient

The Thomas Splint

• The Thomas splint pulled the leg in an effort to make it more tense. This stopped the break in the bone from moving and stopped internal bleeding

• Survivual rate from leg injuries increased to 82% after the thomas aplint

Mobile X-Rays

• X-Rays ere very useful for surgeons because it allowed them to pinpoint where shrapnel was and remove minimal flesh

• Between 1914 and 1916 three mobile X-Rays were equipped to allow rotation while others were on cooldown

• However X-Rays overheated quickly and the patient had to stay still for an uncomfortable amount of time

Blood Transfusion

• Blood transfusions were necessary because without them soldiers would often go into shock and die

• Lawrence Robertson used an indirect method of transfer where the blood was mioved using a syringe

• Geoffrey Keynes designed a portable blood transfusion kit able to be used on the frontline

Blood Storage

• 1915 - Richard lewison discovers adding sodium citrate can allow indirect transfusions

• 1915 - Richard Weil discovers blood can be stored wirh sodium citrate for 2 days

• 1916 - Rous and Turner discover sodium citrate glucose and blood can be stored for up to 4 weeks

Brain Surgery

• Doctors realised men with head injuries who were operated on faster had a better survivual chance

• Casualties were given blood beforehand to decrease the chance of death by shock

• Local anaesthetic was used because General anaesthetic made the brain swell

Plastic Surgery

• Mainly used to currect facial injuries

• Skin was grafted from the chest onto the face