Military field medicine: From antiquity to our days

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

Wars have accompanied humanity throughout its history. The ways of waging war have changed a lot over the centuries, but death today, as well as three thousand years ago, reaps its abundant harvest on the battlefields. And, just like in the ancient world, specialists who are able to snatch people out of her hands with the help of their knowledge and talent are worth their weight in gold today.

Ancient world

The first mentions of military doctors were found in the ancient Chinese written source "Huang Di nei jing" ("The Yellow King's Treatise on the Inner"). No one even knows the approximate date of writing this document, but it is known for sure that in the 7th century BC. e. healers of the Zhou era actively used it in their work.

The Huang Di Nei Ching treatise looks like a collection of dialogues between the semi-mythical Chinese Emperor Huang Di and his advisor Qi-Bo. The emperor is known to have lived around 2700 BC. e., but information about his biography and deeds are scarce and contradictory.

In the treatise, two sages discuss the subtleties of medicine, as well as philosophical issues and the influence of "heavenly forces" on the life of a single person and an entire state. The conversation between the emperor and the adviser is in places abstract, but part of it is devoted to very specific descriptions of the use of anesthetic herbs, the imposition of tourniquets for bleeding and various kinds of dressings for wounds and burns.

In Europe, the treatise became known only during the Opium Wars of the 19th century, when an interest in everything Chinese was awakened throughout the world. Unfortunately, practical medical knowledge did not particularly attract researchers of the ancient literary monument. Exotic philosophical concepts such as yin-yang opposites have been studied much more closely.

In the history of the West, the medical niche was firmly occupied by Hippocrates and Galen, whose positions among the Aesculapians, both military and civilian, were unshakable. Before Hippocrates, it was believed that any ailment, including a wound received in battle, can be healed by fervent prayers to the gods. In ancient Greece, a person in need of treatment prayed to the god Asclepius and spent the night at his altar.

At the same time, one should not think that all treatment was limited to the expectation of divine will. Doctors applied bandages, prescribed medications, and even performed surgeries. But all this was at such a primitive level that more often than not it did more harm to the patient than good.

The merit of Hippocrates was that he was the first to systematize the medical knowledge of different schools, select the effective ones and put them in the "Hippocrates collection", consisting of 60 medical treatises. In the work of the ancient scientist, much attention was paid to military field medicine. He developed a map of dressings, and also proposed several effective ways to apply splints and reposition dislocations.

One of the most important achievements of Hippocrates was a detailed instruction on craniotomy. Obviously, this leadership saved the lives of more than one soldier who suffered on the battlefield. "The Father of Medicine" did not forget about medicines - his descriptions of medicinal herbal decoctions that help with dysentery, in ancient times were useful for soldiers no less than instructions for dressings.

When the Trojan and Peloponnesian Wars thundered, field doctors were no longer a wonder and accompanied the troops everywhere. This is confirmed by passages from the works of Homer and other ancient Greek authors. Military medics of that time deftly removed arrowheads from wounds, stopped the blood with burning powders, and quite effectively performed dressings.

Even then, copper needles and threads from bovine intestines were used, with which deep cut and chopped wounds were sewn up. It must be said right away that there was no regular medical unit with specified duties in the troops at that time. Most often, the wounded themselves helped themselves or were assisted by comrades in arms.

In the event of a fracture, a simple splint was made from improvised means, and if the limb was severely damaged and because of this there was a threat to the warrior's life, then it was simply chopped off with an ax, then cauterizing the stump with a red-hot iron. The mortality rate during such operations was very high, and even more patients later died from complications. Fighters who received severe penetrating wounds to the body and head were usually doomed to death and simply awaited their hour or miraculous healing, not relying on medicine.

First aid in the army, which can be called organized, appeared in the legions of ancient Rome. There were special units of deputies (from the word deputatus - envoy), which did not have weapons and were engaged only in collecting the wounded on the battlefield and carrying them on a primitive stretcher from poles to the military camp.

In the camp, the victims were awaited by medical personnel, each of whose members had their own duties. The chief physician made diagnoses and sorted the wounded, the main staff did dressings and operations, and the students assisted, carried out various assignments and gained experience.

At first, the priests were engaged in medicine, but then they were not enough and well-trained children of wealthy Romans began to be sent to the military field medical units. One of these immigrants from the Roman elite was the famous Galen, who was almost a thousand years ahead of the medicine of his era.

According to the legend, Galen was given to study as a doctor by his father, who was advised in this by the god Asclepius who appeared in a dream. For four long years, the young man gnawed the granite of medical science in Asklepion - the most famous temple of the healer god in the ancient world, located in Pergamum.

But several years among the priests seemed a little to Galen and he went to study in Crete, and then to Cyprus. There is also a version that after this, the Roman passionate about medicine did not calm down and continued his education at the Great Medical School in Egyptian Alexandria.

Having studied all the subtleties of medicine that were available at that time, Galen returned to Pergamum and began to practice as a healer. His first patients were gladiators, to whom the doctor provided such high-quality care that only five patients died in four years of work. To understand the effectiveness of a doctor, it is worth mentioning that more than 60 people have died during the last six years.

The fame of a skillful healer led Galen to Rome, where he was entrusted to heal the Emperor Ark Aurelius himself, and then Commodus. Later, after completing active practice, the already middle-aged Galen sat down for scientific works. Having systematized fragmentary knowledge and methods, he created a unified harmonious medical doctrine, which is still impressive to specialists.

For his time, Galen was just a genius. The scientist proved that it is the brain, not the heart, that controls human actions, described the circulatory system, introduced such a concept as the nervous system and founded pharmacology as a science.

Hippocrates, despite all his merits, took only a step towards real medicine. Galen continued his work and from abstract concepts created a completely effective science of the human body and its healing.

Middle Ages

The Middle Ages gave mankind many outstanding doctors who followed in the footsteps of the great Galen. This period of history is filled with large and small military conflicts and epidemics, so not a single specialist had a lack of practice.

Military medicine in these conditions moved by leaps and bounds. Doctors were trained at universities along with theologians and the demand for both those and others was incredibly high. The best specialists were poached by monarchs and military leaders from each other, offering decent wages and ideal conditions for practice and scientific research.

Unemployment did not threaten even the least skilled physicians. If the luminaries of medical science were used by kings, barons and bishops, then those healers who were simpler actively healed the townspeople and peasants or disappeared for days in the dissecting rooms, opening plague and cholera corpses.

One of the very first famous doctors of the Middle Ages can rightfully be called John Bradmore, who was considered the court surgeon of the English king Henry IV. The royal physician excelled not only in medicine, he is also known as one of the most skilled counterfeiters of the 14th-15th centuries and an excellent blacksmith.

In 1403-1412, Bradmore wrote the main work of his life - the medical treatise "Philomena". There was not too much practical benefit from it, since most of the tome was occupied by boastful descriptions of which eminent patients entrusted their health to the court surgeon.

But this does not detract from the merits of Bradmore. The most famous patient of the surgeon was the future King Henry V, wounded in the face by an arrow at the Battle of Shrewsbury. Immediately after the injury, the 16-year-old prince was taken to the nearest castle, where the doctors only managed to extract the shaft of the weapon.

The arrow hit Heinrich under the left eye and entered the head by at least 15 centimeters. The tip, which miraculously did not touch the brain, remained in the wounded man's head and no one knew how to remove it. That is why they sent for John Bradmore, considered the most skillful surgeon in the kingdom.

The doctor, having examined the patient, realized that it would not be possible to remove the tip with poultices and decoctions. Therefore, on the same evening, the skillful blacksmith Bradmore forged a unique instrument of its kind in the form of hollow oblong tongs. The device had a screw mechanism, which made it possible to precisely regulate the force when gripping objects.

The operation took a little time - the surgeon inserted the device into the wound on the face of the future king, felt a foreign body and securely fixed it in the forceps of the screws. After that, it remains only to gently loosen the tip and carefully but confidently remove it out.

This operation, incredible for the 15th century, which saved the life of the heir to the throne, forever inscribed the surgeon, blacksmith and counterfeiter in the history of world medicine. But having pulled out a foreign body, Bradmore did not go to rest on his laurels, as he knew perfectly well that the fight for the patient had not yet been won.

To exclude suppuration, the doctor treated a deep wound with white wine and dipped cotton swabs soaked in a special composition containing honey into it. After the wound was partially healed, Bradmore pulled out the tampons through a specially left hole, and then treated the damaged area with a secret ointment Unguentum Fuscum, which consisted of 20 plant and animal components.

Heinrich recovered and all his life was reminded of a battle wound only by an impressive scar on the left side of his face. Royal people in the Middle Ages died often and the causes of death were much less serious than a head wound, so Bradmore made a real breakthrough for his time.

New time

By the 18th century, wars had evolved from local skirmishes to large-scale campaigns between entire empires, which also influenced field medicine. Finally, there were more doctors in the army than chaplains, and they began to approach healing from the point of view of materialism.

Among the great minds of military medicine in the 18th century, it is worth mentioning Dominique Jean Lorray, who is considered the father of the ambulance. This French physician was the first to propose the use of horse-drawn mobile field hospitals, which saved many lives.

Of course, our story about the great military doctors would be incomplete without mentioning the great Russian surgeon and anatomical scientist Nikolai Ivanovich Pirogov. In 1847, during the Caucasian War, he first successfully applied chloroform and ether anesthesia. Previous attempts by British doctors were unsuccessful and led to the death of the patient or lack of the desired effect. Another important invention belongs to Pirogov - a plaster cast for fractures.

The 20th century, rich in global military conflicts, has advanced military medicine far ahead, giving rise to many new directions and techniques. Today, field medicine keeps pace with the art of war and not only seeks solutions to problems as they arise, but also boldly looks into the future.