Throughout recorded history, lessons learned on the battlefield and innovations in treating war wounds have later benefited community health care, and civilian medical research has been accelerated by wartime needs. 

Many researchers at the Military and Veterans Health Research Forum in Quebec City at the end of November will carry on this tradition. “From Science to Service” was the forum’s 2014 motto, but “from science to service…to community” would be equally apropos, as history shows.   

In ancient Greece, the father of medicine, Hippocrates, is credited with saying that war is the only proper school for a surgeon. Lessons learned in keeping wounds clean and dry and stitching up lacerations from sword and spear were put to good use in handling slips of the axe in peacetime.

Many innovations from the battlefield are in use in the civilian world.

The French introduced triage and the flying ambulance in the Napoleonic Wars, which improved survival rates by making sure the most urgent cases were treated fast, and first. The idea was improved upon in the First World War, during which the French alone treated more than four million wounded. We see triage at work in Canada today in emergency rooms when someone who comes in after us gets to see a doctor faster, or we get bumped on a wait list. We can take comfort that the encroachers are in more urgent need—and we will similarly be skipped to the head of the line if ever we need urgent care.

When Henry Dunant, of Switzerland, witnessed the horrific condition of the wounded of the Battle of Solferino in 1859, he lobbied for a treaty to compel armies to care for wounded soldiers and for creation of national societies to help military medical services. The results were the Geneva Conventions and development of the International Committee of the Red Cross and the Red Crescent in the 1860s and ’70s. For his efforts, Dunant was awarded the first Nobel Peace Prize. 

An official branch of what was to become the Canadian Red Cross Society was created in 1896, and supplied money, medical supplies and food during the Boer War (1899-1902).

Thousands of Red Cross volunteers served in Canada and overseas during the First World War. Then followed an explosion of its public health initiatives: clinics, first aid and public health training; home nursing and disaster relief. In 1927, the independent Canadian Red Cross Society was recognized, and its humanitarian efforts in war and peace are legion.      

The Crimean War (1853-56) and American Civil War (1861-65) gave us professional nursing, expanded medical use of anesthetics and better surgical techniques for amputations. Great strides in prosthetics followed the First and Second World Wars and the modern conflicts in Iraq and Afghanistan. Dr. Jacqueline Hebert’s team—at the Glenrose Rehabilitation Hospital in Edmonton, are pioneering nerve transplantation to help amputees mentally operate their prostheses, and receive sensory feedback—feeling in the arm and hand.   

Reconstructive surgery and skin grafts for burns advanced during the First World War. Great leaps were made in storing and transfusing blood. A portable X-ray machine was developed. Prior to this war, more soldiers died of infection than of wounds—a statistic reversed by tetanus vaccine, faster treatment and cleanliness standards. 

Sir Alexander Fleming in London, England, discovered the antibiotic penicillin in 1929, but the Second World War sped up mass production and wartime cross-Atlantic co-operation which also resulted in better supply for blood banks. The British established civilian and military blood banks prior to the Second World War, but demand outstripped donor supply.

Although North American citizens were eager to help, whole blood could not survive the ocean voyage. But U.S. research showed blood plasma could be shipped, and was equally effective for transfusions.  Canadians donated 2.5 million units of blood during the war. Blood drives continued after the war to keep civilian hospitals supplied.

The Korean War introduced mobile surgical hospitals and helicopter evacuation of the wounded, plus improvements in neurosurgery, vascular surgery, plastic surgery—all adopted later for civilian care.

Although advances in surgery, prosthetics, antibiotics and control of bleeding continued in the military conflicts of the 21st century, there’s a new legacy in research in prevention and treatment of blast injury and post-traumatic stress disorder.

In January, Legion Magazine also creates a new legacy, as we bid farewell to Health File, and begin a new column focusing on military and veteran health.