Medicine: WW1 Western Front

Question 1

Ypres

Answer 1

• Most direct route to Calais and Dunkirk ports
• Germany wanted to cut off ports (no supplies for British Army)
• Ypres Salient was vulnerable land and Germany had land overlooking it (e.g. Hill 60) from above so could fire down
• When Allies attacked Hill 60 mines were dug and the top of the hill was blown off

Question 2

Arras

Answer 2

• Before this battle NZ and northern England soldiers dug a network of tunnels beneath Arras
• The chalky earth made tunnelling easy
• Had running water and electricity
• Rooms for soldiers to sleep in
• A hospital with 700 beds and operating theatres
• Tunnels also used for shelter from artillery fire and conveying troops to the front

Question 3

The Somme

Answer 3

• 60,000 casualties on first day alone
• Total 400,000 allied casualties
• Total 450,000 German casualties
• Only 5 miles of gained land
• Lots of pressure on medics

Question 4

Cambrai

Answer 4

• First large scale use of tanks, 450 used against German front line
• Not enough infantry (surprise attack) so British lost all the land they had gained in the first day
• Blood banks first used

Question 5

Front line

Answer 5

• Trench nearest the enemy where soldiers would fire from
• Most dangerous trench, at risk of shelling, sniper fire
• In worse condition due to constant attack and heavy use
• Had firing step, duckboards, parapet
• Soldiers spent 15% of time there

Question 6

Support trench

Answer 6

• Had more men and supplies to support front line
• At risk artillery fire, but safer then front line
• Connected to front line by communication trenches
• Soldier spent 10% of time there

Question 7

Communication trench

Answer 7

• Connected front line with other trenches
• Used for communicating orders and news
• Used for transporting supplies, wounded and reserve troops
• Often very crowded and muddy due to heavy use

Question 8

Reserve trench

Answer 8

• Furthest from front line so safest and in best condition
• Troops would wait here in case enemy broke through front line
• Soldiers spent 30% of time there

Question 9

Command trench

Answer 9

• 10-20 metres behind front line

- Linked to front line by communication trenches

Question 10

Traverse trench

Answer 10

Protected soldiers from shell blasts, stopped the enemy moving quickly along the trenches

Question 11

Parapet

Answer 11

Bank of earth thrown in front of trench, elbow rest whilst firing, protection from incoming fire
*Parados was the equivalent, but at the back of the trench

Question 12

Revetting

Answer 12

Support on sides of trench (wood, netting or congrugated iron) to stop them caving in during bad weather or enemy shelling

Question 13

Firestep

Answer 13

Simple platform in side of trench for soldiers to stand on whilst firing without showing any part of their body

Question 14

TERRAIN problems with treatment on the Western Front

Answer 14

• Soldiers had to collect wounded from No Man’s Land at night and under fire
• No Man’s Land was deep in mud and featured deep shell craters, many flooded

Question 15

TRANSPORT problems with treatment on the Western Front

Answer 15

• Trenches could be clogged with equipment and men going in different directions
• Stretchers had to be manoeuvred around corners and often under fire
• There could be many wounded men

Question 16

COMMUNICATION problems with treatment on the Western Front

Answer 16

• Telephones and the wireless required lots of working parts which were easily damaged in the constant firing
• Messages and orders were shouted but it was very noisy

Question 17

Rifles

Answer 17

• Efficient
• Automatic, rapid fire
• Pointed bullet shape drove them deeper into the body from a longer distance

Question 18

Machine guns

Answer 18

• Same as the firepower of 100 rifles
• Major part of trench defences
• Had devastating impact against enemies approaching over No Man’s Land
• Mass produced by industry on both sides

Question 19

Artillery

Answer 19

• Successors of the cannon grew bigger and more powerful throughout war
• British developed a horwitzer which could send 900kg shells across over 12 miles
• Bursts of shell fire lasted longer
• Factories made millions of shells, so continuous bombardments could last weeks, months
• Artillery fire was greatest killer of all weapons, causing half of all casualties

Question 20

Shrapnel

Answer 20

• Hollow shell packed with steel balls or led, with gunpowder and a timer fuse
• Designed to explode mid air above enemy causing maximum casualties
• Was most effective against advancing troops

Question 21

Trench fever

Answer 21

•Cramped conditions spread lice
-High fever, headaches, aching muscles, sores on skin
+Stay clean, disinfect clothes

*July 1917-18 15% men unfit for duty due to trench fever

Question 22

Trench foot

Answer 22

•Flooded trenches meant wet feet
-Loss in blood circulation, socks could start to grow on feet
+Rest, whale oil, amputation in severe cases

*1914-15 wet winter increased cases of trench foot

Question 23

Shell shock

Answer 23

•Constant shelling scarred men
-Panic, paralysis, blindness, deafness, depression, insomnia, heart palpitations, dizziness
+Rest, food, talks

*1916 became major medical concern with 16,000 cases in 6 months

Question 24

Wounds

Answer 24

•Bullets, shells, shrapnel due to constant attacks
-Broken bones, pierced organs, shrapnel in skin
+Arms or legs amputated, steel or leather helmets

*1915 more extensive surgery to remove tissue surrounding bullets and shrapnel to prevent infection

Question 25

Infection (gas gangrene)

Answer 25

•Soil from trenches got into wounds
-Wounds hugely swollen with gas and turning white then green and making bubbling sound or sensation when pressed
+Amputation, keeping wounds clean

Question 26

Gas

Answer 26

•Became a popular weapon after Ypres
-Death, runny noses, blindness, blisters and sores, breathing problems
+Protective masks were given to all soldiers, bathing and washing fumes off clothes

Question 27

Royal Army Medical Corps (RAMC)

Answer 27

• Organised and provided medical care
• All ranks of medical officers and men
• Expanded to cope by increasing men by over 12 times by 1918 for number of wounded
• Responsible for keeping men healthy through good sanitation (and treating injured and sick)
• More doctors able to be recruited by raising the age you could serve abroad to 45, but they had to learn quickly to work in these conditions

Question 28

Volunteer Aid Detatchment (VAD)

Answer 28

• Main body of military nurses in 1914 were the well trained Queen Alexandra’s nurses
• 300 of them in 1914 but 10,000 by end of war due to change in attitudes towards nurses serving in front line
• In 1914 British only accepted QA nurses (other volunteers found work in French and Belgian armies instead)
• But number of casualties was too high, so soon thousands of women were supporting the British army
• Best known volunteers were the VADs, mainly middle and upper class women with little experience before war (started off just cleaning, but by 1917 were nursing)

Question 29

First Aid Nursing Yeomanry (FANY)

Answer 29

• Founded in 1907 by a soldier who was injured in Sudan, Africa
• He wanted it to be a nursing cavalry on horses, riding through battle and rescuing the wounded
• Nearly 500 women helped the wounded, but as ambulance drivers and nurses
• Also worked for Belgian army until 1916, when British changed policy and started recruiting women
• One FANY unit ran the Calais ambulance convoy for 2 years with 22 drivers and 12 ambulances
• Others carried supplies to front, driving motorised kitchens and even mobile baths which could give baths to 40 men an hour

Question 30

Barge ambulances

Answer 30

Used in July 1916, with a fleet of ambulance barges carrying wounded along the River Somme

Question 31

Stretcher bearer

Answer 31

Found it hard to move across rough terrain, especially under fire
Couldn’t move many people at a time

Question 32

Ambulance trains

Answer 32

We’re an important development, able to carry up to 800 casualties
There were 4 ambulance trains in 1914, but 28 by July 1916 (Somme)

Question 33

Horse ambulance

Answer 33

Continued to be valuable, but tricky in muddy and cratered ground and not enough to transport lots of wounded at time

Question 34

Motor ambulances

Answer 34

By November 1914 there were 250 motor ambulances in France with more arriving daily, when earlier the horse ambulances were struggling with the numbers of wounded

Question 35

Medical development: treating wounds and infection

State the problem tackled, method and benefit

Answer 35

•Cause of death and infection

-Antiseptic method*, carbolic acid to kill bacteria, chemical solution flows through wounds

+Continuous treatment, fewer amputations

*Carrel-Dakin method

Question 36

Medical development: the Thomas Splint

State the problem tackled, method and benefit

Answer 36

•Blood loss, bones grinding

-Thomas splint pulled leg lengthways to stop grinding and reduce blood loss

+Reduced death rate from 80% to 20%, fewer amputations, more operations in CCS without too much blood loss

+Soldiers could get back to front line quicker

Question 37

Medical development: mobile X-ray machines

State the problem tackled, method and benefit

Answer 37

•Couldn’t locate the fragments and bullets, lead to infection

-X-rays made surgery to remove shrapnel easier, they could find wherever they were

+Reduced death rate from infections, used in CCS and hospitals to find injury

*1914-15 only 2 mobile X-ray units in France but by 1916 in most hospitals and CCSs

Question 38

Medical development: blood transfusions and storage of blood

State the problem tackled, method and benefit

Answer 38

•Couldn’t store blood without it clotting

• With right blood types, could safely transfuse blood from one person to another
• Added citrate to stop the blood clotting

+More lives could be saved with blood transfusions

+Blood banks first used at Battle of Cambrai

Question 39

Medical development: plastic surgery

State the problem tackled, method and benefit

Answer 39

•Facial dysfunctions due to bad injuries

-Use skin graphs to restore previous appearance

+Could look unaffected by war and injury, go out in public without embarrassment

*Nov 1915 7 hospitals in France had specialist plastic surgery areas

Question 40

Medical development: brain surgery

State the problem tackled, method and benefit

Answer 40

•Severe wounds to the head

-Used rubber bands to apply pressure and then located and removed any bullets

+Many soldiers were kept alive and fit

Question 41

Chain of evacuation: stretcher bearers (1)

Answer 41

•They carried wounded to RAP from front line

-Only 16 medics per battalion, so was hard to help everyone

Question 42

Chain of evacuation: regimental aid post (2)

Answer 42

•The RAP was near the front line

• Only 1 medic per battalion
• Only treated light wounds

Question 43

Chain of evacuation: dressing station (3)

Answer 43

-Dressing stations were set in derelict buildings
•Serious cases were treated first
•Field ambulances were mobile medical support
•Triage was when serious wounds were sent to the CCS

Question 44

Chain of evacuation: casualty clearing station (4)

Answer 44

•The CCS was the first large, well equipped station
•They provided x-rays, operations
•Treated up to 100 casualties
-7 doctors with staff worked there
-7 to 12 miles away from front line

Question 45

Chain of evacuation: base hospital (5)

Answer 45

• Located several miles away from towns
• Soldiers arrived by train and barge ambulances
• Treated up to 2500 casualties
• Had specialist units (e.g. gas)
• When they left soldiers were sent for convalescence then returned to front line or sent home

Question 46

Types of primary sources for follow up questions

Answer 46

• Diaries/letters of soldiers (useful for personal experience)
• CCS records (would record wounds, illnesses, treatments, deaths and recovery rates of patients)
• War office casualty lists (recorded numbers of missing, killed, wounded)
• Newspaper accounts of battle (would tell us what happened)