A Regimental Aid Post was the first post in the medical chain during the two world wars. They were often set up in buildings and cellars close to the fighting. Casualties would be given basic treatment before being sent further back for more thorough care. This scene was witnessed by the official war artist Leslie Cole as fighting continued in Normandy following the D-Day landings.
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The experience of a battle casualty in the Second World War was not radically different to that of the First World War. The most common injuries were caused by shells and bullets, and a casualty would be evacuated through a similarly organised chain of medical posts, dressing stations and hospitals.
But the Second World War saw many medical developments of the First World War further refined and improved. It also saw some of the most significant developments of the last century come into common use.
On the front line, a casualty of the Second World War received specialist treatment more quickly. Specialist surgical facilities were closer to the front line and transport was by motor vehicle, sometimes even by air.
For those who experienced psychological trauma, psychiatrists were closer to the front line. The ‘shell shock’ of the First World War had become ‘battle exhaustion’ – a reflection of the better understanding of the complexity of mental trauma.
Blood transfusions became commonplace, with the Army Blood Transfusion Service providing expertise and large quantities of blood across the globe. Penicillin was developed from Alexander Fleming’s accidental discovery into a mass-produced medicine, transforming the treatment of infection. Diseases were combatted more effectively, with DDT sprayed over large areas to lessen incidences of malaria and typhus amongst troops and civilians.
Specialist treatment at home also improved, with more advances in plastic surgery and the treatment of burns.
The Second World War saw more extensive use of motor vehicles to evacuate casualties. Here a wounded soldier is transferred from a Jeep to a larger truck, as he is moved further away from the fighting. The lack of a major railway network in the North African desert meant motor vehicles and aircraft were vital for transporting casualties.
Casualties are tended by medical orderlies of No.1 Air Ambulance Unit, Royal Australian Air Force, while being evacuated from the battle area in North Africa, Second World War. The use of aircraft was important in evacuating casualties across the wide expanses of desert in North Africa. Air evacuation was also vital in the thick jungle of Burma.
A soldier undergoes an X-ray prior to plastic surgery at No.4 Maxillo-Facial Surgical Unit, at 94th General Hospital in Algiers, 1943. By the Second World War, both X-ray technology and advanced facial plastic surgery were available close to the front line.
A patient is injected with Pentothal at No. 41 General Hospital, at Kantara East in Egypt, 1943. Pentothal was used to produce a state of drowsiness in which a patient became more amenable to suggestion, allowing a psychiatric doctor to find out more about the cause of their psychological condition.
The Battle of Egypt, 1942: Blood-Transfusion, 1942, by Anthony Gross. The efforts of the Army Blood Transfusion Service in the Second World War ensured that blood could be given to casualties soon after they were wounded. Here a wounded soldier is being given a blood transfusion in a medical tent in the North African desert. Replacing lost blood quickly increased the chances of survival and recovery.
The Army Blood Transfusion Service Needs Blood Donors, by Abram Games. Britain’s Army Blood Transfusion Service was the first of its kind and provided large quantities of blood to casualties in all the fighting theatres of the Second World War. It was supported by a wide public campaign to encourage people to donate blood.
Professor Alexander Fleming in his laboratory at St Mary’s Hospital in London, 1943. Fleming first discovered the mould Penicillium Notatum that later became penicillin in 1928, realising that it had great anti-bacterial properties. Fleming and fellow scientists Howard Florey and Ernst Chain all received the Nobel Prize for Medicine in 1945 for discovering and developing penicillin.
Queen Alexandra's Imperial Military Nursing Service: Dressing a Leg Wound with Penicillin, 1943, by Robert Sargent Austin. By 1943 penicillin was becoming available in increasing quantities. This was due to the work of Howard Florey and Ernst Chain, who led the team that turned Alexander Fleming’s discovery into a mass-produced medicine. Here it is being used to prevent infection in a leg wound. Penicillin could be used for a range of infections, including venereal diseases, which were a drain on manpower.
Saline baths were commonly used during the Second World War to help cleanse and heal burns. It was often found that airmen who had crashed in sea water suffered slightly less severe burns, so saline became widely used. Here the RAF airman tensely holds the edges of the bath, bracing himself against the pain of the burns on his legs.
RAF airmen prepare to load bags of DDT for spraying by aircraft, Sicily, 1943. DDT was a powerful insecticide used to control typhus and malaria. Its development was one of the most important scientific advances of the Second World War, as these diseases affected civilians as well as soldiers.
An orderly of a Royal Army Medical Corps hygiene section tests some water samples in Burma, 1945. Local conditions and enemy action could often affect the quality of water sources, which meant water had to be treated to make it safe to drink. Poor hygiene could cause disease and illness amongst military personnel, so tests like these were vital to maintain manpower.