Military Medical History

War and medicine are two of society's more powerful forces and their impact on each other is a significant part of his tory (i). In American history the two greatest examples are the Second World War and the Civil War. However, the impact of war on medicine, on the one hand, and medicine on war, on the other, is multifaceted. The Second World War can serve as a brief example. That war brought antibiotics, led by penicillin, to public awareness as one of the several contributions of science that encouraged American society to invest in scientific re search in the postwar years. Penicillin had a dramatic impact on the care of soldiers and was partially responsible for the reduction in the number of troops who died of wounds in the European Theater of Operations, from 4 percent of casualties to about 2.5 percent by war's end. There were similar reciprocal ef fects in non-scientific innovations, the best example being the im pact on specialization. At the beginning of the Second World War the Army Medical Depart ment requested the cooperation of new spe cialty boards in selecting qualified physicians for the expanding military hospital system. The re suit was that board certified specialists received jobs in general hospitals, while non-boarded practitioners were given lower ranking operational medical jobs closer to the hostile action. Sick and wounded troops in all branches of the armed services were cared for by specialists, and doctors perceived that society valued specialists more highly than generalists. After the war, physicians pursued specialty training in unprecedented numbers and patients began to look to specialists for treatment. The va riety of social changes needed to facilitate this shift from generalist to specialist care?including expanded health insurance, more hospitals, and more specialty training slots?were all encouraged by wartime deci sions and experiences. The Civil War is in some ways more difficult to study than World War II because the medicine is less clear and familiar; the medical ideas of the mid-nineteenth century were in transition from the ancient to the modern. The Civil War, however, had a profound impact on medi cine in late nineteenth century America and in many ways facilitated the shift to recogniz ably modern medical practices (2). To begin with, medicine in the United States in i860 was exceeding diverse. The monolithic profes sion of the twentieth century can be seen in embryonic form, but it hardly dominated early industrial culture. The formal profession as recognized by the U.S. Army, however, was the ancient medical tradi tion called regular or allopathic, recognized by the M.D. degree and based in a rationalistic reductionism of experi mental science. The chief advantage of the federal recognition of their regular profes sion was that other forms of practitioners could not claim the heritage of service to the nation in its hour of great need. In retrospect, it was not so much that the physicians were obviously effective as it was that they were there and their competitors were not. The first major battle?at Bull Run in northern Virginia?was a medical as well as a military disaster. The walking wounded some ^^^^^B^^^^^^^H^fKBI^B?^BPi?l^^B^^BH?

American history · Ancient history · Criminology · Military history · Political science · Social studies · Spanish Civil War · Medical History and Innovations · Psychology · History · Law