Medicine in the Trenches

• The 1st Battle of Ypres

  Oct - Nov 1914
• The 1st Battle of Ypres


  • Part of the Race to the Sea in WW1
  • British kept hold of Channel ports so supplies and reinforcements could still be provided
  • Resulted in 50,000 casualties (dead + injured) on British side
• Use of mines at Hill 60

  April 1915
• Use of mines at Hill 60


  • Germans had strategic hight advantage on the hill, South-East Ypres
  • British view up hill - mines, 450 tonnes - took position
  • 10,000 Germans killed
• Cambrai


  October 1917
• Tanks


  • First large scale use
  • Used against German front lines
  • Over 450 used
• Tanks were not winning as they were not used alongside infantry support
• British lost most of the ground they had won on the first day
• First mobile blood bank used

  1. Advancements in blood storage

  2. Sodium citrate used to keep blood fresh

  3. Discovery of o- blood - can be used on all blood types
• The Second Battle of Ypres

  April - May 1915
• The Somme

  4 July - Nov 1916
• Arras

  April-May 1917
• The Third Battle of Ypres (Passchendale)

  July - Nov 1917
• Wounded men transport


  1. Transported by train or canal to a Base Hospital or the French coast

  2. First ambulance train arrived in France in November 1914

  3. Later these trains equipped with operating theatres

  4. Ambulance trains increased in number from 4 in 1914 to 28 by 1916

  5. Canal barges used to ease burden on railways

  6. Canal journeys were slow, but comfortable

  7. Soldiers sometimes by-passed Base hospitals and were transported onto ships going straight back to Britain
• Percentage of soldiers


  • Firing Line 15%
  • Support Trench 10%
  • Reserve Trench 30%
  • Out of Trenches 45%
• Trench Fever


  Illness spread by lice living in seams of clothing, with symptoms of severe headaches, shivering, pain in the bones and joints lasting about 5 days
• In the last year of the war, the number unable to fight in the British 2nd Army was 15%
• Trench Fever treatment


  1. Disinfecting uniform, clothes fumigated, warmed and ironed

  2. Use of louse repellant gel for prevention
• Horse-drawn ambulances


  • Could not cope with large numbers of casualties
  • Men were shaken about in wagons, often making injuries worse
  • Some soldiers were left to die or be taken prisoner
  • In the worst terrain, six horses rather than two pulled the ambulance wagons
• Motor ambulances

  • Times newspaper ran public appeal for donations
  • By October 1914, enough was raised to buy 512 vehicles
  • By end of January 1915, more than 1,000 ambulances and tractor vehicles had been despatched, carrying 1,000,000 patients
  • Transport was smoother
  • Motor vehicles could not cope with muddy terrain
• Medical Staff Groups


  • Royal Army Medical Corps (RAMC)
  • Queen Alexandra's Nurses
• Royal Army Medical Corps (RAMC)

  • Trained medical staff
  • All male
  • Doctors and support staff
  • In 1918, 113,000 men (12x more than in 1914)
  • Entry age raised from 40 to 45 to recruit more doctors
• Queen Alexandra's Nurses

  • The main body of military nurses accepted by the British Army
  • Well trained
  • Could not go in trenches
  • In 1914, 300 members, in 1918, 10,000 members
• Volunteers turned away found work with French and Belgians
• Female Aid Nursing Yeomanry (FANY)

  A group of volunteer nurses who arrived in France in October 1914 and helped the French and Belgians, as the British would not make use of them. In 1916, the British allowed women to drive ambulances and other vehicles with the FANY unit in the Calais ambulance convoy for 2 years. There were never more than 450 FANYs in France.
• Volunteer Aid Detachment (VAD)

  The best known of the volunteer nurses, mainly from the middle and upper class, whose work involved changing dressings, giving painkillers, cleaning and washing.
• How the wounded were dealt with

  1. Stretcher Bearers recovered dead and wounded, often under heavy fire, carrying only basic supplies like morphine, with only 16 bearers per battalion (1,000 soldiers)

  2. Regimental Aid Post (RAP) was located within 200m of the front line, sometimes in communication trenches or ruined buildings, with only one regimental medical officer who decided who needed to be sent to the dressing station, providing only basic first aid that was not sterile

  3. Dressing Station/Field Ambulance was a mobile unit of medical staff 400-1000m behind the line, staffed by ten medical officers plus orderlies and stretcher bearers, with facilities to cope with 150 men but could not tend to the wounded for more than a week.
• Casualty Clearing Station (CCS)

  Large well equipped medical facility 7-12 miles behind the fighting, accessible by ambulance wagons, often set up in factories/schools
• Triage system at CCS

  Used to sort serious cases from less serious
• CCS

  • Complex operations and X-rays were carried out
• Base Hospitals

  Last place wounded soldiers could go in Belgium, pre-fab hospital / re-purposed building
• Blighty wounds


  Wounds that sent people back to Britain
• Trench Fever was spread by lice living in seams of clothing
• Symptoms of Trench Fever: severe headaches, shivering, pain in the bones and joints lasting about 5 days
• In the last year of the war, 15% of the British 2nd Army was unable to fight due to Trench Fever
• Treatment for Trench Fever


  Disinfecting uniform, clothes fumigated, warmed and ironed
• Prevention of Trench Fever

  Use of louse repellant gel
• Trench Foot


  Long periods standing in waterlogged trenches caused feet to become numb, swollen and blistered, could lead to gangrene and amputation
• One division of the British Army lost one-sixth of its 12,000 men by Jan 1915 due to Trench Foot
• Treatment for Trench Foot

  Change socks twice daily, rub whale oil on feet, men paired to look after each other's feet