World War I: "In this war most casualties were caused by bomb fragments and the figures were enormous."

S Afr J Surg. 2017 Sep;55(3):67.

HOLDING THE TORCH UP HIGH - A MEDICAL HISTORICAL EVALUATION OF SURGICAL ADVANCES DURING THE GREAT WAR 1914-1918, IN MEMORY OF THOSE THAT SERVED AND FELL.

Scharf G1.

Author information

1

Senior Surgeon, University of Pretoria.

Abstract

"How wide and varied is the experience of the battlefield and how fertile the blood of warriors in raising good surgeons" Sir Clifford Allbutt (1898). With these sentiments of the medical lessons learned in war and conflict, with the background of the poem of "In Flanders Field", written by a doctor who had South African War connections, reasons (the Somme and third Ypres battles) will be given that this was indeed a "GREAT WAR" as the world history, weapons, strategy, tactics and wounding patterns had changed dramatically. These changes are still affecting all at present, as eventually the Second World War came from it, as well as the Cold "Third World" War. In this war most casualties were caused by bomb fragments and the figures were enormous. It was the war of massive troop movements (railroads), the Schlieffen plan, trench warfare, artillery, the machine guns, end of cavalry and the initiation of tanks, air warfare/reconnaissance and gas/chemical warfare. The surgical experiences of previous wars were obsolete. Urgent rethinking of surgical principles and protocols had to be devised, with the death rates of dying due to wounds, sepsis and tetanus exceeding 60 percent of all casualties. Abdominal wounds were treated conservatively, but soon there came advances in resuscitation, anaesthetics, aggressive wound and exploratory surgery, orthopaedics, plastic and reconstructive surgery, physiology, wound pathology and microbiology. All sides concentrated on ambulance stations, field hospitals and then rapid transfer to bigger referral and base hospitals. It seems that lessons learned where indeed exchanged (? by the Red Cross to all combatant medical personal). Even to the present day, frameworks of this are still used effectively (Vietnam War, Falklands War and our recent border wars). The lessons are well learned and the Torch is ours to hold up high!