Medicine and Warfare

By Philip Curzon in A doctor's life on Monday, June 8, 2009 @ 11:32

In the margins of a recent meeting I was having a discussion with Dr Philip A Kalra, author of PasTest's bestselling Essential Revision Notes for MRCP 3rd Edition (ISBN: 9781905635467) and we began talking about the role of medics in the development of warfare.

I explained that received wisdom sees the role of medics on the battlefield as positive, with their interventions allowing lives to be saved and the impact of wounds to be mitigated. The chief advances have surrounded the availability of plasma on the battlefield to keep wounded soldiers alive and penicillin to fight subsequent infection. From memory both of this developments were first used to significant effect during the Spanish Civil War; I seem to recall Fleming discovered penicillin in 1928.

Less well understood is the strategic military response. Teams reviewing the lessons learned in the aftermath of the Great War were not slow to observe the enormous logistical effort that medical evacuation incurred. Prior to 1914 the British Army had only been involved in expeditionary warfare and the systems of medical evacuation for regular soldiers were of less public import than arrangements for conscripts. As press reporting became more critical and conscript armies became the norm, so the expectations of adequate medical evacuation provision increased.

In observing this liability, military strategists also concluded that the burden to enemy infrastructure would be increased if they could wound rather than kill soldiers. Much effort was given over to the development of non-lethal weapons on the basis that a wounded soldier created a far greater burden to the enemy than a dead soldier!