Trenches provided relative protection against increasingly lethal weaponry. Soldiers dug in to defend themselves against shrapnel and bullets. On the Western Front, trenches began as simple ditches and evolved into complex networks stretching over 250 miles (402 kilometres) through France and Belgium.
But conditions in the trenches could be severe and, in their attempts to break the deadlock created by trench warfare, the armies on the Western Front introduced weapons and tactics that would cause millions of injuries and deaths. This entrenching tool was carried by all non-commissioned ranks in the British Army. They were usually used to hastily dig basic, shallow trenches or holes for protection, but were also sometimes used as weapons in hand-to-hand combat.
2. Steel helmet
The introduction of new weapons and the improved performance of existing ones forced armies to develop better protective equipment. Before steel helmets became standard issue in 1916, the British Army issued soft cloth caps that offered no protection against artillery, machine gun and rifle fire. In the relative protection of a trench, a soldier's most vulnerable area was his head. The British steel helmet, shown here, was designed to offer increased protection from shrapnel and other projectiles falling from above. Although not impenetrable, the helmets reduced head injuries by 75 per cent.
By the start of the First World War, most European armies wore single-shade uniforms in muted colours. These were more subdued than the brightly coloured uniforms of the nineteenth century that were intended to clearly identify, impress or intimidate enemy forces. The improved accuracy of rifles and artillery, particularly at long range, and the use of aerial reconnaissance forced armies to make their troops less visible, and therefore less vulnerable. The armies on the Western Front wore less conspicuous khaki, grey, or 'horizon blue' uniforms. In addition, various items of clothing were specially designed to camouflage and protect a soldier on patrol, like this suit. It is coloured to match no man's land, helping the wearer to blend into his environment and making him harder to spot for enemy snipers.
4. Gas helmet
Chemical weapons were first used on a major scale by the Germans in 1915 to try and break the deadlock on the Western Front. Early gas masks were simply cotton pads soaked in chemicals or poorly ventilated hoods with eyepieces that fogged up and cracked. But as chemical weapons developed, so did protective equipment. The 'tube' helmet pictured here has glass eyepieces and a rubber tube through which a soldier could breathe. It was infused with chemicals to counter phosgene gas, one of the most dangerous poison gases. However, the mask could be uncomfortable to wear. One of the chemicals caused eye irritation and skin blisters. The 'tube' helmet was eventually replaced by the Small Box Respirator mask, which was the most effective of the wartime gas masks. On the Western Front, death rates from gas were relatively low - about 3 per cent - but the physical effects were agonising and it remained a pervasive psychological weapon.
Many of the most important medical developments and practices of the last century have their origins in the First World War. Vaccines were first used on a major scale during the war and most British servicemen sent abroad were vaccinated against typhoid. As a result, deaths from the disease were significantly reduced. In this photograph, soldiers of the Liverpool Scottish show off their arms after being vaccinated, c.1914.
6. Mosquito net
The First World War was the first major conflict in which British deaths in battle outnumbered deaths caused by disease. This was largely due to medical advances in the prevention and treatment of disease and a better understanding of the importance of good hygiene in limiting its spread. This net was issued to British troops to protect them from mosquitoes and other insects that could spread diseases like malaria. This danger was more common in fighting theatres in Gallipoli, East Africa and the Middle East, where the proportion of non-battle casualties was generally higher than on the Western Front.
7. First field dressing pack
The quicker a casualty received first aid, the better his chances of survival. Immediate treatment, particularly to limit blood loss, could be the difference between life and death. This British First Field Dressing pack contained two field dressings and gave men the means to give themselves limited but rapid care before medical personnel arrived. Relatively minor injuries could become fatal if they became infected, but the First World War also saw major improvements in the treatment of wound infection and over the course of the war the number of gangrene cases fell dramatically.
8. The Royal Army Medical Corps
The Royal Army Medical Corps (RAMC) was responsible for providing medical care and maintaining the health and fighting strength of forces in the field. Each battalion was assigned a medical officer and at least 16 stretcher bearers. Stretcher bearers were usually the first to reach a wounded soldier and were responsible for administering initial first aid.
They worked in extremely dangerous conditions, often under fire and over difficult terrain. They usually had basic medical training and carried haversacks, like the one pictured here, containing shell dressings and iodine. Stretcher bearers evacuated the wounded to a Regimental Aid Post, staffed by a medical officer and the first stop in a chain of medical services available to the wounded during the First World War.
9. Chain of medical services
A wounded soldier would be taken through a series of aid posts, dressing stations and hospitals where stretcher bearers, medical officers, nurses and doctors would provide different levels of medical care.
This chain of medical services began at the Regimental Aid Post, where wounds were assessed and the battalion medical officer would provide initial care before the wounded were evacuated to a dressing station. Many of the personnel who provided this initial care were members of Field Ambulance units. This is the headquarters sign of 141st Field Ambulance, which served on the Western Front. Casualties needing further treatment were taken to a Casualty Clearing Station. These were basic field hospitals where, by 1916, most surgical procedures could be carried out. If a casualty required further treatment they would then be sent to a Base Hospital well behind the lines. A network of horse-drawn and motor ambulances, ambulance trains, canal barges and hospital ships were used to transport the wounded through the medical chain to hospitals in Britain to receive further treatment and to convalesce.
10. Pocket surgical kit
Surgery most often took place at Casualty Clearing Stations or in hospitals behind the lines, but basic surgery could be initially performed closer to the battlefield in emergency cases. This pocket surgical kit belonged to Major-General Patrick Henderson DSO, who served in the Royal Army Medical Corps in Salonika, Russia and on the Western Front. Surgical techniques developed rapidly as surgeons were forced to confront increasingly complex injuries caused by modern weaponry.