La atención sanitaria en los tercios españoles / Health care in the spanish tercios

Durante por más de dos siglos, los tercios españoles fueron la base de los ejércitos de España que participaron en numerosas batallas en las innumerables guerras en el que se vio envuelto el Imperio Español. Su organizador militar fue la base de sus triunfosque les hicieron merecedores de el termino de invencibles por su especial estrategia. La organización interna conllevaba un especialmétodo de asistencia sanitaria bien organizado con recursos y de efectividad para la época. Se analiza en el trabajo, la organización sanitaria los recursos disponibles, las enfermedades que se atendían tanto las comunes como las producidas en el campo debatalla por las diferentes armas de fuego como armas blancas y también de los efectos de la artillería como de las explosiones por el uso de la pólvora. (AU)

For more than two centuries, the Spanish Tercios were the base of the Spanish armies that participated in numerous battles in theinnumerable wars in which the Spanish Empire was involved. Their military organizer was the basis of their triumphs that madethem worthy of the term invincible for their special strategy. The internal organization entailed a special well-organized health caremethod with resources and effectiveness for the time. It is analyzed at work, the health organization, the available resources, thediseases that were treated, both the common ones and those produced on the battlefield by the different weapons, both firearms andbladed weapons, and also the effects of artillery and firearms. explosions due to the use of gunpowder. (AU)

D-Day to December 1944: The odyssey of the third auxiliary surgical group in World War II.

ABSTRACT: As a Major in the US Army Medical Corps, Darrell A. Campbell, MD, led Team 13 of the Third Auxiliary Surgical Group in Europe in World War II. The team began work on June 7, 1944, in a clearing station tent near the beach at Normandy. Subsequently, over the next 7 months, it was assigned to mobile hospitals in 15 different locations in France, Belgium, Luxembourg, and Germany. Major Campbell kept the log books used to record all of the operations done by his team during this time and brought them home where three were discovered more than 70 years later. These log books contain descriptions of more than 500 consecutive operations done by Team 13. They provide a unique insight into the activities of the surgeons who worked to save lives on the front lines of battle in the European Theater of Operations between June and December 1944 and form the basis for this historical perspective.This is an article on the history of surgery.

Impact of World War I on brain mapping.

Although much tragedy was experienced during World War I (WWI), the nature of the war and the advancements of weaponry led to a change in the quality and quantity of injuries which were conducive for study. This paper discusses how trauma during WWI led to advances in brain mapping from occipital injuries. Gordon Holmes was a British neurologist who was able to create a retinotopic map of the visual cortex from studying more than 400 cases of occipital injuries; his work has contributed immensely to our understanding of visual processing. There have been many extensions from Holmes' work in regard to how we analyze other sensory modalities and in researching how the brain processes complex stimuli such as faces. Aside from the scholastic benefit, brain mapping also has functional use and can be used for neurosurgical planning to preserve important structures. With the advent of more advanced modalities for analyzing the brain, there have been initiatives in total brain mapping which has added significantly to the body of work started by Holmes during WWI. This paper reviews the history during WWI that led to advances in brain mapping, the lasting scholastic and functional impact from these advancements, and future improvements.

In Close Combat: Vice-Admiral Lord Horatio Nelson's Injuries in the Napoleonic Wars.

Born in Norfolk, England, on September 29, 1758, Horatio Nelson was the sixth of eleven children in a working-class family. With the help of his uncle, Maurice Suckling, a captain in the Royal Navy, Nelson began his naval career as a 13-year-old midshipman on the British battleship Raisonnable. His courage and leadership in the battle marked him for promotion, and he rose quickly from midshipman to admiral, serving in the West Indies, East Indies, North America, Europe, and even the Arctic. As his rank ascended, Nelson's consistent strategy was close engagement, an approach that led to success in combat but placed him in direct danger. Thus, Britain's greatest warrior was also her most famous patient: Nelson suffered more injuries and underwent more operations than any other flag officer in Royal Navy history. His career reached a climax off Cape Trafalgar, where he not only led the Royal Navy to victory over the combined French and Spanish fleets but also met his own death.

La Sanidad Militar española durante la primera mitad del siglo XX. Una aproximación histórica. Antecedentes, Guerra Civil - "Método Español" y Proyección Internacional - Autogiro de Juan de la Cierva / Spanish Military Healthcare in the first half of the 20th century. A historic approach. Background, Civil War, "Spanish Method" and International Projection- Juan de la Cierva's Autogyro

La Sanidad Militar es una parte esencial dentro del organigrama de cualquier ejército. Dentro de España, ha sido desarrollada hasta nuestros días, con un impulso forzado durante los conflictos bélicos, especialmente la Guerra Civil (1936-1939). Con unos claros antecedentes, derivados de su propia historia y experiencias, la Sanidad Militar durante la Guerra Civil desarrolló y puso en práctica nuevas técnicas sanitarias como el "Método Español". Junto a lo anterior, una de las mayores innovaciones de orígen español será la invención, en 1920, del autogiro de Juan de la Cierva. Predecesor de los helicópteros, esta aeronave fue puesta al servicio de la Aviación Sanitaria europea y mundial. Todas las innovaciones, militares y sanitarias, surgidas en España durante el conflicto civil, tendrán un reflejo y aplicación en los diferentes países europeos, sobre todo en la II Guerra Mundial. Dicha contribución generalmente ha pasado desapercibida dentro de nuestras fronteras, pero no así en ámbito internacional donde son ampliamente reconocidas personalidades como Juan de la Cierva o el Doctor J. Trueta i Raspall

The military health is an essential part within the organization of any army. In Spain, it has been developed to the present day, with momentum forced during armed conflicts, especially the Civil War (1936-1939). With a clear background, derived from its own history and experiences, the military health during the Civil War developed and implemented new sanitary techniques such as the "Spanish method". Along with the above, one of the major innovations of Spanish origin was the invention, in 1920, of Juan de la Cierva's autogiro. Predecessor of the helicopters, this aircraft was at the service of European health and global aviation. All the innovations, both military and health, arising in Spain during the civil conflict, had a reflection and application in different European countries, especially during World War II. This contribution has generally gone unnoticed within our borders, but not at international level where Juan de la Cierva or Doctor J. Trueta i Raspall are widely-recognized figures

Unrealized potential of the US military battlefield trauma system: DOW rate is higher in Iraq and Afghanistan than in Vietnam, but CFR and KIA rate are lower.

LEVEL OF EVIDENCE: Observational/retrospective/historic controls, level IV.

How hemorrhage control became common sense.

BACKGROUND: Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to controlling hemorrhage in the prehospital context. Then, as now, it was surprising that progress on something that appeared obvious had occurred only recently, begging the question how controlling blood loss was common sense in a surgical context, but not for emergency treatment. METHODS: This article is a historical survey of the evolution of the medical understanding of hemorrhage along with technological response. RESULTS: The danger of blood loss had historically been consistently underestimated as physicians looked at other explanations for symptoms of how the human body responded to trauma. As the danger from hemorrhage became apparent, even obvious, responsibility for hemorrhage control was delegated down from the surgeon to the paramedic and eventually to individual service members and civilian bystanders with training to "stop the bleed." CONCLUSION: Hippocratic medicine assumed that blood diffused centrifugally into periphery through arteries. William Harvey's observation in 1615 that blood ran through a closed circulatory system gradually transformed conventional wisdom about blood loss, leading to the development of the tourniquet about a century later by Jean-Louis Petit, which made amputation of limbs survivable. However, physicians were cautious about their application during the First World War over concerns over effects on patient recovery. Hemorrhage had generally been seen as symptom to be managed until the patient would be seen by a surgeon who would stop the bleeding. More thorough collection and analysis of data related to case histories of soldiers wounded during the Vietnam Conflict transformed how surgeons understood the importance to hemorrhage leading to development of the doctrine of Tactical Combat Casualty Care in the late 1990s. LEVEL OF EVIDENCE: Background Information: Economic/decision study.

Maxillofacial surgery: the impact of the Great War on both sides of the trenches.

"War is the father and King of all", Heraclitus the obscure philosopher, declares. It certainly appears that the specialty of maxillofacial surgery was greatly advanced during WWI. This article focuses on the circumstances under which the specialty was developed, the significant events and the important figures that played a leading role in the advancement of a new fascinating surgical specialty. The literature leaves no doubt that trench warfare despite its devastating outcome for humanity has forged the shape of modern maxillofacial surgery.

[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.

A plear for commonality: disability history, discourses of rehabilitation, and the individual / Un alegato a favor de lo compartido: historia de la discapacidad, discursos de rehabilitación, y el individuo

Since the late twentieth century, disability history has grown out of its infancy. Scholars from a variety of backgrounds have increasingly become convinced of the value of looking at the past through the lens of disability. Many studies have focused on the constructed nature of disability and thus deliberately tried to deconstruct contemporary distinctions between able-bodied and disabled individuals. By positively revaluing the particular position of the individual with disabilities on the basis of historical narratives, an attempt was made to counter ongoing tendencies of discrimination and oppression. In this article, we would like to remind the reader of another approach which sometimes runs the danger of being snowed under, namely a historical venture that seeks to uncover commonalities: places where the distinctions between persons with and without disabilities are temporarily forgotten and/ or erased, moments when the boundaries between the self and the other are being reconfigured. In order to do so, we will draw on an influential discourse from the history of disability itself: the discourse of rehabilitation. Going back to the early twentieth century, we will present the work of French scientist Jules Mardochée Amar and two Belgian disabled soldiers from the First World War. Amar’s ideas on rehabilitation would prove influential for the actual practices of rehabilitation during and after the war. The two Belgian disabled soldiers were retrained in a professional institute for rehabilitation established by the Belgian government in the north of France. By juxtaposing Amar’s discourse with the experiences of the two Belgian soldiers, we will demonstrate how, besides the discursive individual of rehabilitation, one also can find moments when that individual is absorbed by a real and tangible commonality. As a consequence, everybody —whether able-bodied citizen or mutilated soldier— becomes part of a community of equals (AU)

Desde finales del siglo XX la historia de la discapacidad ha madurado. Investigadores de muy diversa formación se han convencido cada vez más del valor de mirar al pasado a través de la lente de la discapacidad. Numerosos trabajos se han centrado en el análisis de la naturaleza construida de la discapacidad y, en consecuencia, han intentado de manera deliberada deconstruir las distinciones actuales entre las personas sin discapacidades y las personas discapacitadas. Reevaluando positivamente la particular posición del individuo con discapacidades sobre la base de narrativas históricas, este artículo intenta mostrar las tendencias presentes de discriminación y opresión. Con este trabajo nos gustaría además recordar al lector otro tipo de aproximación que, en ocasiones, corre el peligro de quedar oculta, concretamente la tarea histórica que intenta desvelar lo que se comparte: lugares donde las distinciones entre las personas con o sin discapacidades son temporalmente olvidadas y / o borradas; momentos en los que las fronteras entre el yo y el otro son reconfiguradas. Para llevar esto a cabo, vamos a utilizar un discurso de gran influencia dentro de la historia de la discapacidad: el discurso de la rehabilitación. Retrocediendo hasta el comienzo del siglo XX, presentaremos el trabajo del científico francés Jules Mardochée Amar y de dos soldados belgas con discapacidad de la Primera Guerra Mundial. Las ideas de Amar sobre la rehabilitación influyeron en las prácticas de rehabilitación desarrolladas durante y después de la guerra. Los dos soldados belgas discapacitados fueron rehabilitados en un instituto para la rehabilitación profesional establecido por el gobierno Belga en el norte de Francia. Al yuxtaponer el discurso de Amar con las experiencias de los dos soldados belgas, demostraremos cómo, junto al discurso individual de rehabilitación, pueden encontrarse también momentos en los que el individuo es absorbido por una 'commonality'-un conjunto de características comunes- real y tangible. Como consecuencia de esto, todo el mundo - ya sean ciudadanos físicamente capaces o soldados mutilados- pasa a formar parte de una comunidad de iguales (AU)

[Battle-field surgery in the beginning of 21st century].

The authors underwent an analysis of doctrine changes of battle-field surgery. The terminology is specified, the ways of improvement of effectiveness and quality of medical care for the wounded, taking into account the new doctrine, are formulated. In accordance with Federal law No 323-FZ of 2011.11.21 the term < is suggested for description of medical care at medical forward treatment unit instead of equalfied aid>.

[Physicians as Experts of the Integration of war invalids of WWI and WWII]. / Ärzte als Experten bei der Integration Kriegsbeschädigter und Kriegsversehrter nach dem Ersten und Zweiten Weltkrieg.

After the First World War the large number of war invalids posed a medical as well as a socio-political problem. This needed to be addressed, at least to some extent, through healthcare providers (Versorgungsbehörden) and reintegration into the labour market. Due to the demilitarization of Germany, this task was taken on by the civil administration, which was dissolved during the time of National Socialism. In 1950, the Federal Republic of Germany enacted the Federal War Victims Relief Act (Bundesversorgungsgesetz), which created a privileged group of civil and military war invalids, whereas other disabled people and victims of national socialist persecution were initially excluded. This article examines the continuities and discontinuities of the institutions following the First World War. A particular focus lies on the groups of doctors which structured this field. How did doctors become experts and what was their expertise?

The 13th Stationary/83rd (Dublin) General Hospital, Boulogne, 1914-1919.

Casualties from the Western Front during the First World War were often evacuated to base hospitals on the northern coast of France for more advanced and specialist care. These temporary base hospitals frequently had more than 1,000 beds and were typically staffed by older, more senior doctors than were present nearer the front line. The 13th Stationary Hospital opened in October 1914 on the Boulogne docks and became the main specialist unit for the treatment of eye, face and jaw injuries. In May 1917 it was renamed the 83rd (Dublin) Hospital when the staff was augmented by volunteer staff from Irish hospitals. The hospital subsequently housed an innovative 'physical medicine' or rehabilitation unit. The hospital remained open for the duration of the War, moving to Langenfeld in the Ruhr following the Armistice.

Colonel B.K. Ashford, A Brief Military Medicine Historical Review.

Colonel (Col.) Bailey K. Ashford was a turn of the 19th century Army medical corps officer who made great contributions to military medicine in the areas of infectious disease, public health, and education. His service period spans from the Spanish American War to the early 1920s. Although not as well-known as some of his contemporaries, he is an important figure, contributing to the diagnosis and treatment of "new world hookworm" in the tropics, training medical units in World War I, and the creation of the Institute of Tropical Medicine.

Contemporary wars and their contributions to vascular injury management.

INTRODUCTION: Man's inhumanity for man still knows no boundaries, as we continue as a species as a whole to engage in war. According to Kohn's Dictionary of Wars [1], of over 3,700 years of recorded history, there have been a total of 3,010 wars. One is hard pressed to actually find a period of time in which here has not been an active conflict in the globe. The world has experienced two world wars: WWI (1914-1918) and WWII (1939-1945). The total number of military casualties in WWI was over 37 million, while WWII so far, has been the deadliest military conflict in history with over 60 million people killed accounting for slightly over 2.5% of the world's population. MATERIAL AND METHODS: The purpose of this study is to review contemporary wars and their contributions to vascular injury management. It is precisely wartime contributions that have led to the more precise identification and management of these injuries resulting in countless lives and extremities saved. However, surgeons dealing with vascular injuries have faced a tough and arduous road. Their journey was initiated by surgical mavericks which undaunted, pressed on against all odds guided by William Stewart Halsted's classic statement in 1912: "One of the chief fascinations in surgery is the management of wounded vessels." CONCLUSION: Contemporary wars of the XX-XXI centuries gave birth, defined and advanced the field of vascular injury management.

Lower jaw reconstruction and dental rehabilitation after war injuries: The experience of Paul Tessier in Iran in the late 1980s.

Iraq-Iran war resulted in more than 400,000 people requiring prolonged medical care in Iran. An international team of prominent reconstructive surgeons led by Paul Tessier, the founder of craniofacial surgery, was invited to Iran during the war by official organizations entitled to support war victims. This team provided up-to-date oral and maxillofacial rehabilitation to patients with severe trauma defects in the lower third of the face. We collected the medical notes of 43 patients operated on by the Tessier team in Iran in the 1980s (files property of AFCF). The parameters we collected were: age of the patient, nature of the trauma (when available), previous procedures, number of implants placed (mandibular and maxillary), associated procedures (bone grafts, soft-tissue procedures, orthognathic surgery). A protocol based on soft-tissue rehabilitation using local flaps, parietal or iliac bone grafts and implant placement 6 months later was used in all patients. Paul Tessier's approach emphasizes the importance of keeping high standards of care in difficult situations and maintaining standard protocols.