Biomedical Ephemera, or: A Frog for Your Boils

Gas gangrene in amputated arm of injured soldier

In WWI, most cases of gas gangrene were caused by infection with Clostridium perfringens, and Group A streptococcus. Other bacterial infections were occasionally found, as well.

The infecting bacteria could be pretty easily differentiated by the type of pus that was exuded or found when the necrotic tissue was cut into. C. perfringens produced very thin, "dishwater"-like pus, and smelled "sweetly putrid". The other bacterias produced much thicker pus, and did not smell sweet.

Not that it made any difference what bacteria was causing the gas gangrene - in the Great War, antibiotics weren't nearly effective enough to halt the progress of infection, and amputation was the default treatment modality for cases brought in from the front.

British Medicine in the War, 1914-1917. British Medical Association, 1917.

WWI. Indian motorcycle modified for use as an inexpensive but effective ambulance during the warmer months.

Not to be disrespectful to the Korean War soldier who is down one arm, but I can't look at this arm-in-a-bucket and not see Thing T. Thing from The Addams Family.

Soldier being embalmed by surgeon during US Civil War - though embalming was an art pioneered by a few specialists on the east coast, embalming duties after battle (at least in the Union) often fell to the same surgeons who may have had to attempt to save that soldier's life just hours earlier.

Young drummer boy (W. Black) injured in US Civil War. Photograph by Mathew Brady.

Photograph by Mathew Brady, injured soldier being tended to in an abandoned camp. US Civil War, 1865.

Splinting broken limbs on the battlefield.

From Illustrated Lectures on Ambulance Work. R. Lawton Roberts, 1888. Commissioned by England's War Department.

From Illustrated Lectures of Ambulance Work. By R. Lawton Roberts, 1888. Commissioned by England's War Department.

More recent history. Not too much of this on here, but the story behind the photo (from the National Archives, history from Time or Life magazine [the story clipping PDF with the photo didn't have the magazine name, but it's in a similar style to late 1990s Time]) just touched on what the people on the front lines of war went through, and still go through. I believe that it was part of a larger story on the state of mental health care provided by veteran's services.

The man on the stretcher apparently survived, but one of the men carrying him back contracted an infection while in the swamps. Something happened resulting in him not getting treated until he was septic, and he died. The man on the stretcher wrote home about how troubled he was, about how much he hated himself for not dying right away so that his buddy wouldn't have had to help with transport. His mom said that he was an extremely straight-laced person before he left, but after his friend's death (which was doubtless not the only friend who died, but the one he felt guilty for), he fell apart. Even when he was shipped home, his extreme PTSD and guilt/anxiety/severe depression was treated as nothing; the only thing he could get care for was physical therapy and continuing care for his legs. He killed himself 18 months after getting back.

The photo is one of those also available on the National Archives online. If anyone knows the complete source of the story, let me know; I'd love to read the rest of the article. 

Though battlefield medicine has been documented and practiced since before Upper and Lower Egypt were united, the United States Civil War was the first time that the concept of treating wounds during a battle (and not killing medics!) was really pervasive. That was the first time that there were multiple dedicated medics (even if not well-trained) per unit, and at least one ambulance cart per regiment. Union military physicians Joseph Barnes and Jonathan Letterman worked to ensure this, as well as worked to design an effective prehospital care system. 

Casualties were still huge, and the dangers of infection were there both on the field and if one had surgery performed. Something that most people don't realize about Civil War medicine is that when available (basically anywhere besides the quagmires of the Deep South and when there were in insurmountable number of injured who needed surgery), around 90% of surgeries done on Union soldiers were done using a general anesthetic- chloroform. Since most of the surgeries were relatively quick (amputations and bullet removals), there were actually relatively few deaths caused by anesthesia problems. 

An amputation kit from the 1870s, was labelled from the Civil War, but that was over in 1865. 

Manual on treating battlefield wounds for surgeons, Confederate States of America, 1863.