Medicine Through Warfare

• Developed caverns under the city of Arras to prepare tunnels which assault troops could use to get close to enemy trenches before emergig to charge them
• Plans to use the system in the April 9th attack were affected be the German withdrawal to the Hindenburg line
• One of the 14 divisions involved in the attack was able to use some of the northern tunnels to attack enemy trenches, but the speed of the advance soon left the tunnel exits well behind

• 60 metres above sea level
• Battle ground
• Created by the spoil from the cutting for the railway between Ypres and Comines
• Railway opened in March 1854

• Usually 7 ft deep and 6 ft wide
• Front of trench is called parapet
• Top two or three ft of the parapet and the parados (rear side) consist of thick line of sandbags to absorb bullets or shell fragments 
• Behnd front-line were support and reserve trenches
• Three rows of trenches covered 200 to 500 yards of ground
• Communication trenches at an angle to front-line trench, used to transport men, equipment and food supplies

• Usually 7 ft deep and 6 ft wide
• Front of trench is called parapet
• Top two or three ft of the parapet and the parados (rear side) consist of thick line of sandbags to absorb bullets or shell fragments 
• Behnd front-line were support and reserve trenches
• Three rows of trenches covered 200 to 500 yards of ground
• Communication trenches at an angle to front-line trench, used to transport men, equipment and food supplies

• Arm injuries often caused by high explosive artiliery shells
• Leg wounds commonly recorded area of injury
• Amputation often necessary
• Mud caused infection
• Standing in water for long periods caused trench foot, infection leads the flesh of the foot to decay and die

• Chlorine gas is yellow-green and smells like bleach, when makes contact with moist body tissues it produces an acid that can cause servere tissue damage
• More chemical attacks followed launched by Germans and Allied forces
• Phosgene gas causes breathing difficuties and heart failure
• Mustard gas damages respiratory tract and causes servere eye irritatio  and skin blistering

FANY

• First Aid Nursing Yeomany
• Link organisation between frontline units and field hospitals
• Early women recruits were drawn mainly from upper middle classes
• Ran field hospitals, drove ambulances and set up soup kitchens and troop canteens

RAMC

• Royal Army Medical Corps
• Special system called triage where sick soldiers were put into three groups: slightly injured, need hospital and beyond help

Transport

• Horses were main source 
• Warfare became more prominent and horses became useless and weak against enemy machine guns and barbed wire

• Reduced rate of mortality fron fracture (particularly of the femur) from 80% to 20% in 1918
• Intention of stabilising a fracture and preventing infection

• 5 mobile x-ray units available at the front
• In addition to many casualty clearing stations and base hospitals 
• Bulky equipment used was not particularly well suited to imaging dental injuries

• Most transfusions were performed as they had been in 1818
• Blood from one patient was given directly to another because the blood would clot if it left outside the body too long
• Usually lightly wounded soldiers with blood type O, they woulg give about two cups of blood
• It would be put in a bottle and treated with sodium citrate
• Bottles would be stockpiled near the the fighting in ammuition boxes and packed with sawdust and ice which helped to keep them for a few weeks
• First "blood depot" in 1917
• Not all soldiers who recieved the transfusions from the blood depot survived
• Transfusion kits were soon taken into the field allowing medics to give blood quickly to soldiers in shock

• The Queen's Hospital aimed to reconstruct wounded men's faces as fully as possible so they could lead a normal life
• Gillies knew that healthy tissue needed to be moved back to its normal position
• After this, any gaps could be filled with tissue from elsewhere on the body
• Surgeons already had a degree of experience in skin grafts
• After work had been completed on the bone structure of a man's face, they were ready to reconstruct the soft tissues