WW1 - medicine development and The trenches

The trenches 

The trench system was massive in WW1, it consisted of four trenches called the Front Line Trench, Support Trench, Reserve Trench and the Communication Trench. The front line trench was were the attacks would have been made from. The support trench was 80 metres behindthe front line and that's where the troop would have retreated if the front line came under attack. The reserve trench was atleast 100 metres behind the support trench. This is where the reserve troop would have been. they could be mobilised for a counter-attack f the front line was captured. Lastly the communication trench, it ran beteen the other trenches so it can pass messages. The trenches were dug in zig-zag patterns. This wasso if hter was any shell firing it would only damage a certain part of the zig-zaged trench and not ruin a whole lot more. 

First Battle of Ypres:

• Near the sea
• 50,000 casualties
• Bear the British channel so supplies can be provided
• Autumn 1914

Second Battle of Ypres:

• 22 April - 25 May 1915
• Germans used Chlorine gas
• England lost 59,000 men
• Germans moved 2 miles closer in the end
• Hill 60:
• Man made hill
• Germans captured it in December 1914
• The German had an advantage
• British dug tunnelsand blew it up

Battle of Somme:

• Launched on the 1st July 1916
• Enormous number of casualties on both sides
• In the first 5 days the number of the British casualties was 57,000 and the number of deaths was 20,00 men
• Creeping barrage - artillery launched towards the German trenches
• Tanks - First time tanks were used in warfare,however not very successful.
• Ended in 1916 - 400,000 casualties

Battle of Arras:

• Chalky area
• England decided to create an underground network and connects to the paths made by the Romans - 1916 decided to link the two together
• They used them as shelters if they were attacked
• Fully functioned; had lights, water, trains, hospitals, electricity and could hold up to 25,000 men 

• 1917:
• 24,000 men who were hidden attacked the Germen trenches
• The British advanced 8 miles
• Lare number of casualties - 160,000 British/Canadian

Third Battle of Ypres:

• Purpose was to break out of the Yprs sulient 
• Wanted to remove the advantage the Germans had of higher ground
• The British launched theirmain attack on the 31st july 1917
• Ground became water logged - soldiers drowned in mud
• 245,000 casualties

Methods of transport:

Horse and cart: Horse and cart-drawn wagons coudn't cope witha large number of casuaties. The men who were injued were shaken which made their ijnuriies worseand increased the pain, The shaking made the injury worse and often they left the wounded soldiersto die or taken by the Germans as prisoners.                                                                                                                    Stretcher Bearers: here would usually be four to a stretcher, and it was difficult to see at night. The problem with this was that there were too many casualties and it was even harder to trvavel in the night. Water that had logged up and made it very muddy made it even harder.                              Ambulance: The first motor ambulance was sent by the Red Cross. The problem with motor ambulaces was that they couldn't operate in muddy terrains.                                                          Train: Trains were used at the final stage of the evacuation to the base hospital. There were too many casualties and it costs a lot of money as well.                                                                  Barges: These were used instead of railways but they were too slow.

RAMC -  Royal Army Medica Corps (funded in 1898)

FANY - First Aid Nursing Yeomanry:

- Volunteers

- Volunteers were women

- Consisted of 450 women 

- They did jobs such as medical support on  the front line, drive ambulances and first aid emergency

- They were not very effective as there was only 450 of them

1.) Stretcher Bearers: there would usually be four to a stretcher, and it was difficult to see at night. The problem with this was that there were too many casualties and it was even harder to trvavel in the night. Water that had logged up and made it very muddy made it even harder. This was the first art of the process of evacuation.                                                                                                         2.) Regimental Aid Post: It was located within 200m of the front line. They were on commuication trenches or deserted buildings. The purpose was to rpovide immediate First Aid.                           3.) Field Ambulance and Dressing Station: They were located wherever possible. They could have been in biulding or dug-outs.                                                                                                              Triage: When soldiers arrived they were split into 3 groups: the walkig wounded, those who arein need of hospital treatment and those who were so severlywounded that there was no chance of survival.                                                                                                                                               4.) Casualty Clearing Station: These were located a sufficient distance fromthe front line but close enough for sccessibility by wagons. They were set-up in buildings such as factories.                       5.) Hospital Train: These were used to take wounded soldiers to the Base Hospital. They were expensive and had too many casualties to take. The tracks were often blocked by the enemies.

6.) Base Hospital: The base hospital was on the Western Front, near the French and Belgium coast. This is so that the wounded could be transpoted home to Britain for further treatment. There were to hospials ut they worked ina similar way: The Stationary Hospital and the General Hospital. The hospital were too far too travel so operations began to take place in Clearing Stations because the men got infections/infected. 

1.) Trench Fever: PUO-Pyrexia of Uknown Origin. Symptoms: headaches, shivering, pain is bones/joints for 5days which came and went, spread by lice. Conditions or weapons: due to the tight space in training camps trainees were already infected before joining the front line trench, this spread the infected lice. The front line was overcrowded, damp/flooded and full of rats. Treatments or preventions: focued on disinfecting clothes, when men came out of the front line their clothes were washed dried and ironed, bathhouses were built to keep the men clean, they were issued with louse repellent gel and  other chemicals to put on tier clothes and their bodies.

2.) Trench Foot: Symptoms: numb, swollen,blistered feet cused by tight boots which stopped blood circulation. Conditions or weapons: water logged trenches, 12,000 men died dueto trench foot. Treatment/preventions: wore 3 pairs of socks, changed their socks twicce a day,rubbed whale oil.

3.) Infection: Gangrene-bacteria in soil. Symptoms: green/yellow wounds which swelled up. Conditions or weapons: bullets/shell fragments went deeper into the body, gas was used to kill soldiers. Treatments/preventions: gas masks were worn.

4.) Shell Shock: psychological impacts and reactions to danger and loud noises. There were 16,000 cases in 6 months and 80,000 cases overall. Condtions or weapons: bomb explosions.

Brain Surgery: 

• Very few doctors had experience in 'neuro surgery' before war
• Despite lack of experience, observation led to improvements in methods of treatments
• Issue wit infection applied just as much to the head as the body
• Harvey Cushing:
• An American neuro surgeon
• He developed new techniques
• Experiment such as the one where he used a magnet to remove a metal fragment from the brain
• Used local anaesthetic ( keeping patient awake) instead of general anaesthetic
• Operation survival rate using local anaesthetic was 71% compared to general anaesthetic rate of 50% he operated on 45 patients on 1917

Platic Surgery:

• Development of plastic surgery was largly the work of the New Zealand doctor Harold Gillies

• He was sent to the Wesyern Front i January 1915
• Men who needed plastic surgery were sent to Britain
• Queen's Hospital in Kent was the key  providingthis type of surgery from August 1917
• Gillies was involved in the design of the hospital to suit his needs
• 12,000 operations had been carried out

Blood transfusions:

• The problem was keeping blood fresh, storage for/of blood, being transfused with the wrong blood
• Geoffrey Keynes made a portable kit
• American doctor Richard Lewis discovered that adding sodium citrate blood tranfusions could be done indirectly (blood doner doesn't need to be in room) 
• Richard Wail discovered blood with sodium citrate can be stored for two days
• Francis Rousand and James Turner found addng citrate glucose to blood enabled it to be stored for 4 weeks