A silver lining out of wars is perhaps the medical innovations from the battleground. Due to serious casualties and limited resources, doctors, nurses, and paramedics had to be creative on the battlefield. Here are some of the medical innovations used in modern medicine that were developed during wars.

Stop the bleeding!

Ambroise Paré developed a tie-the-wound method to stop the bleeding of wounded soldiers. Photo credit: Encyclopaedia Britannica
Ambroise Paré developed a tie-the-wound method to stop the bleeding of wounded soldiers. Photo credit: Encyclopaedia Britannica

The battlefield has seen many men suffer from haemorrhage for centuries. The Romans and Arabs used to tie a belt or rope onto the wounded body part, but it was a 16th-century Italian war that popularised a method to slow or stop the bleeding, developed by French barber-surgeon, Ambroise Paré.

Caring for soldiers at the Siege of Turin, Paré came up with the tie-the-wound method with ligatures he created, tying them onto soldiers near their wounds—to stop the bleeding.

During the Iraq and Afghanistan wars, military medics came up with the idea of using haemostatic powders on open wounds to stop the bleeding. Since then, hospitals have been using haemostatic powders to manage gastrointestinal bleeding.

Tourniquets were also used during the same war to control severe injuries. These days, there are also modern tourniquets that can be applied to stop bleeding.

Survive better with glowing infections

Photorhabdus luminescens, the glowing nematode responsible for “the angel’s glow” during the Battle of Shiloh. Photo credit: Naked Scientists
Photorhabdus luminescens, the glowing nematode responsible for “the angel’s glow” during the Battle of Shiloh. Photo credit: Naked Scientists

Ways to treat infections came about in 1928 by Scottish bacteriologist, Alexander Fleming, and 1932 by German biochemist, Gerhard Johannes Paul Domagk—through the development of antibiotics like penicillin and sulphanilamide.

Their developments need little explanation. But, it was war that brought about the mass production of such antibiotics, making penicillin and sulphanilamide a standard treatment for infections in all hospitals currently.

More interestingly, the Civil War’s Battle of Shiloh in 1862, yielded an important discovery. Medical personnel in the war noticed a glow in the wounds of soldiers, further discovering a better survival rate associated with it. The phenomenon was known as “the angel’s glow”, indicating the soldiers were healed with heavenly light bestowed by celestial beings.
In 2001, some 140 years later – after learning of the phenomenon at a history exhibit, 17-year-old Bill Martin asked his microbiologist mother, who studied bioluminescent bacteria, whether those could be the cause of “the angel’s glow”.

It was discovered that as soldiers crawled through the mud, their wounds attracted insects – and consequently, tiny parasitic worms called nematodes. The nematodes’ bacteria broke down the insect bodies and also killed off competing microbes, which saved the soldiers.

Now, medical scientists are looking into Photorhabdus luminescens as a way to treat antibiotic-resistant infections, while other are developing a protease inhibitor to treat HIV and other diseases.

The harrowing past of plastic surgery


Commonly known as plastic surgery these days, reconstructive surgery also had its contributions from military surgeons. The best examples of this come from the work of two New Zealand surgeons, Archibald McIndoe and Harold Gillies, who worked in London, during the World War One.

In 1917, Gillies treated Walter Yeo, who sustained facial injuries including the loss of lower and upper eyelids while manning the guns on HMS Warspite in 1916. The sailor from Plymouth, Devon, was given new eyelids with a ‘mask’ of skin grafted across his face and eyes.

Gillies went on to develop and refine techniques for restoring appearance and functionality after trauma to the jaw and nose or secondary to burns, many of which are used today. His contribution was deemed so significant that he was knighted in 1930.

McIndoe, a cousin of Gillies, joined him in further refining the techniques against the backdrop of the Battle of Britain that saw large numbers of burn victims. McIndoe’s most important contributions were the development of a burn rehabilitation unit and the aggressive use of pedicles. He also developed the walking-stalk skin graft technique and discovered that immersion in saline promoted healing and improved survival rates for victims with extensive burns.

Time is of essence in medicine

(left) Jonathan Letterman developed an efficient and effective ambulance system (right) to help carry injured soldiers from battlefields to hospitals. Photo credit: Iron Brigader
(left) Jonathan Letterman developed an efficient and effective ambulance system (right) to help carry injured soldiers from battlefields to hospitals. Photo credit: Iron Brigader

During the Civil War in the 1860s, an Army doctor by the name of Jonathan Letterman, developed an efficient and effective ambulance system to help carry injured soldiers from battlefields to hospitals.

The transport used back then, which consisted mostly of motley collection of vehicles, were operated by anyone available. Knowing that not many vehicle operators were suitable for the job, he designed an ambulance system that remains the model for many systems of emergency transport globally. Letterman set up caravans of 50 ambulances at each battle, with each vehicle carrying medical supplies, morphine and bandages, a stretcher and medical staff.

Since then, Letterman further improved the ambulance with equipment to secure the drugs and supplies from theft, spring suspensions for a smoother ride over bumpy terrain and many more. These ultimately led to better, faster recovery from war wounds.

Needle in the bone

Lumbar punctures are examples of how the needle-in-the-bone technique is used in the modern world. Photo credit: Academic Life in Emergency Medicine
Lumbar punctures are examples of how the needle-in-the-bone technique is used in the modern world. Photo credit: Academic Life in Emergency Medicine

Injured soldiers could not be given regular IVs due to the volatile situation on the battlefield, instead, they were given needles inserted into their bones, or more commonly known as intraosseous cannulation.

"When somebody is bouncing around at the back of a helicopter, it's virtually impossible to put a needle into a vein," says the epidemiologist at King’s College London, Richard Sullivan. The situation was also applied to patients on bumpy and unpaved roads, in the vehicles heading towards the hospitals.

This medical innovation from the battlefield is deemed the better option because the needle in the bone holds up better, and helps deliver vital fluids to trauma patients. Despite the technique being successfully used in many hospitals, many first responders in poor countries do not utilise it – due to a lack in the knowledge required.

However, they could easily learn the technique – as Sullivan says, “It’s not a complicated thing.” MIMS

Read more:
First implant surgery carried out by a robot marks significant dental breakthrough
Sanofi calls it quits on Zika vaccine collaboration with US Army
Wartime doctors: Restoring the wounded in times of chaos

Sources:
https://www.npr.org/sections/goatsandsoda/2015/04/03/397106186/how-lessons-from-warzones-could-save-lives-in-poor-countries
https://www.statnews.com/2017/11/10/medical-innovations-war/
https://www.acep.org/_Critical-Care-Section-MicroSite/Advances-in-Emergency-and-Critical-Care-Medicine---from-the-Frontlines/#sm.00uetcgx19vkd3w11nk149aioiamg
https://gizmodo.com/the-secret-wwii-club-that-healed-burned-pilots-and-revo-1740271808
http://www.telegraph.co.uk/news/uknews/2636507/Pictures-of-first-person-to-undergo-plastic-surgery-released.html
https://www.thenakedscientists.com/articles/features/photorhabdus-luminescens-angels-glow