Physicians in battle zones have always had to make do with difficult working conditions to treat wounds, often achieving stunning results, and sometimes making long-lasting contributions to medical knowledge.
The challenging conditions of this nation’s Civil War, for example, yielded several now-standard medical procedures. Notorious for poor supply chains, a dearth of trained medical personnel, and massive casualties, this war nevertheless produced the foundations of a triage system for trauma care, the routine use of anesthetics, the beginnings of the use of sanitary practices such as handwashing, and the discovery that shock was a condition that needed specialized treatment.
During World War I, necessity again propelled innovation, as the severity of injuries kept pace with modern weaponry. Triage evolved to favor first treating patients with critical but less complicated wounds over those with the most severe injuries. Other advances included the use of splints to immobilize fractured femurs and the use of ligature to help stanch bleeding from gunshot wounds. While no one would say that war provides an ideal classroom, physicians, in their quest to save lives and limbs, have used it to learn how to care for the wounded in new, and lasting, ways.