World War I: Tetanus And Plastic Surgery

July 2017

VICTIMS OF mustard gas, American soldiers of the 82nd and 89th divisions lie in a field north of Royaumeix, France, too numerous to be cared for in the nearby field hospital. New weapons like gas and the increasing efficiency of conventional weaponry meant ever larger numbers of wounded men: this war saw dramatic improvements in the number and quality of hospitals and in triage—the method of sorting the wounded. At the right of the photograph, a nurse does what she can to alleviate suffering. An Army Nurse Corps had been established in 1901, thanks in part to pioneering efforts by Florence Nightingale in the Crimean War and Clara Barton in the Civil War. World War I was the first of America’s conflicts in which nurses had professional training. They quickly made themselves indispensable. Visible at left is one of the motorized field ambulances that had replaced the mule-drawn wagons of earlier wars. Doctors noticed improved recovery rates when the wounded were removed from the front lines before infection had set in.

World War I battlefields were rich farmland fertilized with manure, ideal conditions for tetanus bacilli. Army doctors tried a new antitoxin, with impressive results. The major disease killer of the war, influenza, was not brought under control until later.

By 1914, surgical techniques were considerably more sophisticated than in previous conflicts. Unfortunately the science of war had kept pace, and surgeons faced a larger percentage of serious injuries caused by shells and shrapnel. But this development, too, propelled medicine forward. Perhaps the greatest lessons of the war were in the field of plastic surgery: the large numbers of men with wounds of the face and jaw prompted daring reconstructive surgery that expanded and developed this new medical specialty.