How A World At War Changed Medicine

Part 4 of The Sarasota Memorial Centennial Series

Nothing spurs human innovation quite like war.

There’s just something about an aggressive person with a pointy stick that makes everyone else want a pointy stick of their own. A better one, at that. And from Ancient Greeks experimenting with the world’s first flamethrower to the modern drone warfare of today, that arms race has never stopped.

But not all wartime innovation is about taking lives. From GPS navigation and Jeeps to teabags and t-shirts—not to mention, the internet itself—the results of military research can be surprising and far-reaching. And as physicians in times of war worked desperately to keep their soldiers alive, lifesaving discoveries were made.

In 1954, Sarasota Municipal Hospital was renamed Sarasota Memorial Hospital, in honor of those who served in World War I or II. Their impact can still be seen in how we practice medicine today.

To learn more about Celebrating a Century of Care with Sarasota Memorial, click here.

Medical Advancements in World War I: Ambulances, Antiseptics, & More

From 1914 to 1918, the great armies of the world fought across Europe, Africa and Asia with a ferocity and a futility not yet seen in the modern age. It was the birth of trench warfare, defined by horrible new inventions like machine guns and chemical weapons, armored tanks and airplanes. More than 35 million people died.

That number may have been even higher if not for these inventions:

• Motorized Ambulances: After the Battle of the Marne in September, 1914, a thousand wounded French soldiers were left in desperate need of transport to the hospital. US Ambassador Myron T. Herrick responded by calling on all of his colleagues and forming a rescue fleet of impromptu ambulances, saving countless lives and limbs.
  
  By October, the American Volunteer Motor Ambulance Corps had formed and the Red Cross established a motor ambulance department, which operated more than 2,000 motor ambulances throughout the war, losing 94 to enemy action.
   
• Antiseptics: In the trenches, infection was a killer. Clostridium perfringens ran rampant, causing a lethal necrosis known as gaseous gangrene. Even the smallest injury could result in amputation, and some doctors reported a 100% casualty rate for any abdominal wound corrupted by the bacteria. None of the available antiseptics could stop it.
  
  In response, a British biochemist named Henry Dakin invented a new antiseptic, sodium hypochlorite, that destroyed dangerous bacteria without burning healthy tissue. Working with a French physician named Alexis Carrel, they pioneered a new process for disinfecting battlefield injuries. Dubbed the “Carrel-Dakin Method,” it became a life-saving standard for the rest of the war.
   
• Prosthesis & Plastic Surgery: With modern weaponry inflicting increasingly gruesome injuries but modern medicine keeping these wounded men alive, many physicians during and after World War I were tasked with the challenge of helping them return to normal life. Masks were a common solution, detailed by artists as a restorative prosthesis, and doctors such as Sir Henry Gillies made amazing advances in skin-grafting techniques, enabling larger grafts for use in facial reconstruction.
   

Medical Advancements in World War II: Penicillin, Chemotherapy, & More

Just 20 years later, the world was at war once again. This time, the devastation was even greater. Yet, even as conflict spread across the globe, there were those fighting to save as many lives as they could. A newfound international focus on the importance of blood donation and transfusion saved countless wounded soldiers who would have died from shock, as did these other discoveries:

• Penicillin: Although Alexander Flemyng first discovered penicillin and its antibacterial properties back in 1928, pharmaceutical companies were uninterested at the time. It was not until World War II that the world would truly take notice. Faced with the prospect of thousands upon thousands of wounded soldiers at risk of infection, scientists from America and Britain collaborated to adapt the deep-tank fermentation method to mass-produce penicillin on an industrial scale.
  
  As a result, the death rate from bacterial pneumonia dropped from 18%, as measured in World War I, to less than 1%. And when the Allied forces stormed the beaches of Normandy in 1944, they had 2.3 million doses ready to treat the wounded. By the time the war was over, US manufacturers were making 650 billion doses each month.
   
• Human Serum Albumin: In WWI, more soldiers died from blood loss and shock than bullets and shrapnel, so the US government approached a Harvard scientist named Edwin Cohn and asked him to find a solution—before the country was drawn into another World War. Cohn proposed using albumin, an abundant protein that could be separated from blood plasma, stored and shipped without spoiling, and then administered on the battlefield with the same benefits as plasma or whole blood.
  
  Cohn’s ideas were put to the test on December 7, 1941, when albumin shipped directly from his lab was used to successfully treat several severely burned seamen at Pearl Harbor. By early 1942, concentrated human albumin was an accepted blood substitute in the US military, and is still used today.
   
• Chemotherapy: One of the great horrors of WWI was mustard gas, an insidious chemical weapon that, once absorbed through the skin, brought a long and painful death. But researchers also noted its effect on lymphatic tissue, speculating that it could be used to treat lymphomas or leukemias. This would not be pursued further until WWII, when the US government, fearing the return of chemical warfare, renewed funding research across the nation.
  
  This included Yale, where a pair of assistant professors began using nitrogen mustard (a mustard gas derivation) to treat lymphoma in mice. The first clinical trial came shortly after, using doses of nitrogen mustard to treat a man in the terminal stages of lymphosarcoma, achieving brief remission. The results were a military secret until 1946, but he was arguably the first patient in the world to receive chemotherapy. Nitrogen mustard is still used to fight cancer today.
   

At Sarasota Memorial, we’re proud to continue this tradition of innovation and invention in medicine. And through the Sarasota Memorial Research Institute—and the upcoming Kolschowsky Research and Education Institute—our physicians and medical scientists are discovering lifesaving technologies and techniques to give patients every option, while exploring the big questions of today that become the next cures of tomorrow.

To learn more about the Sarasota Memorial Research Institute, click here.

To learn more about the upcoming Kolschowsky Research and Education Institute, click here.

More Articles from the SMH Centennial Series

A Brief History of Anesthesiology

Celebrating Heroes In Medicine: Vivien Thomas

From Experiment to Essential: The History of Blood Donation

Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY, and used to have nightmares about boot camp.