The Italian mobile surgical units in the Great War: the modernity of the past.

Medical services in WWI had to face enormous new problems: masses of wounded, most with devastating wounds from artillery splinters, often involving body cavities, and always contaminated. Tetanus, gas gangrene, wound infections were common and often fatal. Abdominal wounds were especially a problem: upon entering the war the commanders of all medical services ordered to avoid surgery, based on dismal experiences of previous wars. Surgical community divided into non-operative and operative treatment supporters. The problem seemed mainly organizational, as the wounded were rescued after many hours and treated by non-specialist doctors, in inadequate frontline settings or evacuated back with further delay of treatment. During initial neutrality, Italian Academics closely followed the debate, with different positions. Many courses and publications on war surgery flourished. Among the interventionists, Baldo Rossi, to provide a setting adequate to major operations close to the frontline, with trained surgeons and adequate instruments, realized for the Milano Red Cross three fully equipped, mobile surgical hospitals mounted on trucks, with an operating cabin-tent, with warming, illumination and sterilizing devices, post-operative tents and a radiological unit. Chiefs of the army approved the project and implemented seven similar units, called army surgical ambulances, each run by a distinguished surgeon. Epic history and challenges of the mobile units at the frontline, brilliant results achieved on war wounds and epidemics are described. After the war they were considered among the most significant novelties of military medical services. Parallels with present scenarios in war and peace are outlined.

The Norwegian Mobile Army Surgical Hospital in the Korean War (1951-1954): Military Hospital or Humanitarian "Sanctuary?"

During the Korean War (1950-1953) the Norwegian government sent a mobile army surgical hospital (MASH) to support the efforts of the United Nations (UN) Army. From the first, its status was ambiguous. The US-led military medical services believed that the "Norwegian Mobile Army Surgical Hospital" (NORMASH) was no different from any other MASH; but both its originators and its staff regarded it as a vehicle for humanitarian aid. Members of the hospital soon recognized that their status in the war zone was primarily that of a military field hospital. Yet they insisted on providing essential medical care to the local civilian population as well as trauma care to UN soldiers and prisoners of war. The ambiguities that arose from the dual mission of NORMASH are explored in this article, which pays particular attention to the experiences of nurses, as expressed in three types of source: their contemporary letters to their Matron-in-Chief; a report written by one nurse shortly after the war; and a series of oral history interviews conducted approximately 60 years later. The article concludes that the nurses of NORMASH experienced no real role-conflict. They viewed it as natural that they should offer their services to both military and civilian casualties according to need, and they experienced a sense of satisfaction from their work with both types of patient. Ultimately, the experience of Norwegian nurses in Korea illustrates the powerful sense of personal agency that could be experienced by nurses in forward field hospitals, where political decision-making did not impinge too forcefully on their clinical and ethical judgment as clinicians.

[The treatment of wounds during World War I].

The First World War was a huge tragedy for mankind, but, paradoxically, it represented a source of significant progress in a broad series of human activities, including medicine, since it forced physicians to improve their knowledge in the treatment of a large number of wounded soldiers. The use of heavy artillery and machine guns, as well as chemical warfare, caused very serious and life-threatening lesions and wounds. The most frequent causes of death were not mainly related to gunshot wounds, but rather to fractures, tetanus and septic complications of infectious diseases. In the first part of this article, we describe the surgical procedures and medical therapies carried out by Italian physicians during the First World War, with the aim of treating wounded soldiers in this pre-antibiotic era. Antibacterial solutions, such as those of Dakin-Carrel and sodium hypochlorite and boric acid, the tincture of iodine as well as the surgical and dressing approaches and techniques used to remove pus from wounds, such as ignipuncture and thermocautery or lamellar drainage are reported in detail. In the second part of the paper, the organization of the Italian military hospitals network, the systems and tools useful to transport wounded soldiers both in the front lines and in the rear is amply discussed. In addition, the number of soldiers enrolling, and those dying, wounded or missing during the Great War on the Italian front is estimated.

[The pharmacist and deputy Henri Schmidt, the law voted in 1913 and said «for three years¼ and the position of mobilized pharmacists at the beginning of First World War].

Henri Schmidt was, with his fellow the senator Paul Cazeneuve, the main defender of the mention of pharmacists and pharmacy students in the articles of the law voted in 1913 for the recruitment of the army. After the description of their interventions to attain this end, and a short biography of these two politicians, the paper explains the activities of the pharmaceutical parliamentary group, during the early years of the war, in view to obtain the admittance in the medical corps of the pharmacists and students unprovided of rank, for the new creation of «auxiliary pharmacists¼, for the appointment as soon as possible of the maximum number of colleagues at this rank, and then for their promotion to the rank of «aide-major¼, resolution that appeared more difficult to obtain.

[Norman Bethune (1890-1939), an involved doctor, icon of the blood transfusion history]. / Norman Béthune (1890-1939) médecin engagé et icône de la transfusion sanguine.

Norman Bethune was born in 1890, in Gravenhurst (Ontario, Canada). Thereafter a strong surgical training, he implied in thoracic surgery and fight against tuberculosis. His political opinions led him to join the Republicans in the Spanish Civil War. He played an important part in the development of blood transfusion on the battlefield. Then he joined China with communist troops and therein developed surgical units and accelerated training for health personal. He died of septicemia in 1939.

Mobile radiography units in Balkan Wars.

INTRODUCTION: It is known that the first radiological units were widely used during war conflicts, whereas the first application of military radiology took place during the Greco-Turkish War in 1897. However, until recently automobile radiology units were assumed to be used for the first time during World War I. METHOD: Historical archives and reports were researched, and extensive research in available literature was also conducted. RESULTS: The automobile radiology units were purchased from France and were probably constructed under the guidance of Marie Curie (1867-1934). The figure of Dr. Dimitrios Vasilidis (?-1937), a pioneer in Radiology in Greece and the first president of the Hellenic Radiological Society, is highlighted. DISCUSSION: This short historical note describes the first use of a mobile radiology unit during the Balkan Wars (1912-1913), predating its previously presumed first use in World War I. It also briefly highlights the contributions of some notable figures in 20th Century Greek scientific development.

The Red Cross and the Liverpool Field Hospital, Hope and Despair during 1915.

The outbreak of the First World War in August 1914 was met with much jingoistic enthusiasm by the Australian population. Men volunteered in their hundreds for service for God, King, and Country; to defend the Empire; for adventure; and to see the world. Women on the homefront formed up Red Cross branches across the country in small country towns and city suburbs to serve 'their boys'. Unfortunately for the men who enlisted their desire to serve the Empire was not met with a similar level of organisational efficiency by authorities in Australia. The military were completely overwhelmed by the progress of the war, especially the level of casualties that resulted from the Gallipoli campaign.

French Mobile Dental Vehicles during the Great War.

The development and implementation of mobile dental clinics in World War I is described.

100 Years of British military neurosurgery: on the shoulders of giants.

Death from head injuries has been a feature of conflicts throughout the world for centuries. The burden of mortality has been variously affected by the evolution in weaponry from war-hammers to explosive ordnance, the influence of armour on survivability and the changing likelihood of infection as a complicating factor. Surgery evolved from haphazard trephination to valiant, yet disjointed, neurosurgery by a variety of great historical surgeons until the Crimean War of 1853-1856. However, it was events initiated by the Great War of 1914-1918 that not only marked the development of modern neurosurgical techniques, but our approach to military surgery as a whole. Here the author describes how 100 years of conflict and the input and intertwining relationships between the 20th century's great neurosurgeons established neurosurgery in the United Kingdom and beyond.

Wars, disasters and kidneys.

This paper summarizes the impact that wars had on the history of nephrology, both worldwide and in the Ghent Medical Faculty notably on the definition, research and clinical aspects of acute kidney injury. The paper briefly describes the role of 'trench nephritis' as observed both during World War I and II, supporting the hypothesis that many of the clinical cases could have been due to Hantavirus nephropathy. The lessons learned from the experience with crush syndrome first observed in World War II and subsequently investigated over many decades form the basis for the creation of the Renal Disaster Relief Task Force of the International Society of Nephrology. Over the last 15 years, this Task Force has successfully intervened both in the prevention and management of crush syndrome in numerous disaster situations like major earthquakes.

Deployable, portable, and temporary hospitals; one state's experiences through the years.

This article will review the use of temporary hospitals to augment the healthcare system as one solution for dealing with a surge of patients related to war, pandemic disease outbreaks, or natural disaster. The experiences highlighted in this article are those of North Carolina (NC) over the past 150 years, with a special focus on the need following the September 11, 2001 (9/11) attacks. It will also discuss the development of a temporary hospital system from concept to deployment, highlight recent developments, emphasize the need to learn from past experiences, and offer potential solutions for assuring program sustainability. Historically, when a particular situation called for a temporary hospital, one was created, but it was usually specific for the event and then dismantled. As with the case with many historical events, the details of the 9/11 attacks will fade into memory, and there is a concern that the impetus which created the current temporary hospital program may fade, as well. By developing a broader and more comprehensive approach to disaster responses through all-hazards preparedness, it is reasonable to learn from these past experiences, improve the understanding of current threats, and develop a long-term strategy to sustain these resources for future disaster medical needs.