World War Two was a time when huge advances were made in medicine and these medical advances were a direct response to new weaponry that had been developed between 1939 and 1945 and a natural advance in knowledge that would be expected as time progressed.
|“If any good can be said to come of war, then the Second War War must go on record as assisting and accelerating one of the greatest blessings that the 20th Century has conferred on Man – the huge advances in medical knowledge and surgical techniques. War, by producing so many and such appalling casualties, and by creating such widespread conditions in which disease can flourish, confronted the medical profession with an enormous challenge – and the doctors of the world rose to the challenge of the last war magnificently.”Brian J Ford.|
The very nature of warfare between 1939 and 1945 forced the medical world to rush forward the pace of advance in medicine. Advances in the treatment of infection had occurred pre-war but with the turmoil of war, research pioneers pushed forward to find solutions to very pressing problems. In 1936, ‘M+B’ was produced by the firm May and Baker – the first effective sulphonamides that could be used for a variety of infections. Called ‘M+B 693’ it was used as a treatment for sore throats, pneumonia and gonorrhea. A development of ‘M+B 693’ was ‘M+B 760’. Both proved very effective as treatments against infections. However, the very nature of war meant that both treatments were needed in far greater quantities than during peace time. Therefore, probably for the first time since World War One, medical production was put onto a war footing so that the supplies that were required were produced. In 1943, Winston Churchill was given ‘M+B 693’ as a treatment for pneumonia and on December 29th, 1943, he told the nation:
|“This admirable ‘M+B’ from which I did not suffer any inconvenience, was used at the earliest moment and after a week’s fever the intruders were repulsed.”|
While penicillin had been discovered pre-war by Sir Alexander Fleming, it took the war to force companies to develop a way of making the highly effective medicine on an industrial scale. Credit for this goes to Howard Florey (photo above) and Ernst Chain and many soldiers wounded in combat had both men and their team to thank. For this research and achievement, Florey, Chain, and Fleming shared the Nobel Prize for Physiology or Medicine in 1945. By the end of the war, such was the research into penicillin that several strains were developed. Also the 1945 version of penicillin was some 20 times more potent that the 1939version. The mass production of penicillin was always of great importance to the Allies yet it was also a difficult thing to achieve. The first mass production unit of deep-fermentation penicillin in Britain was established in 1945 in Castle Barnard. Prior to this, the majority of Britain’s penicillin had been made by Glaxo. Penicillin was used en masse after D-Day on wounded men and it was found to be especially effective against gangrene. Despite the changes in warfare, one problem that barely changed was the time lapse between when a man was wounded and when he could be operated on by a surgeon. In the British Army, the average time lapse was acknowledged to be 14 hours. Prior to the use of penicillin, such a period of time allowed a wound to fester. With the use of a penicillin dressing, the chance of a wound getting infected was vastly reduced and survival chances greatly increased.
Along with increasing the chances of survival for those wounded, the other major development in World War Two was the treatment of those who had received severe wounds. The legendary work of Archibald McIndoeand his team at the Burns Unit at Queen Victoria’s Hospital, East Grinstead, has been well documented. Less well known is the work of the Russian Filatov who is credited with pioneering the work now taken for granted on skin grafts. The Russians also worked on ‘biogenic agents’ that encouraged healing and the re-growth of a damaged area.
World War Two also saw the growth of the blood transfusion service from a relatively primitive organisation at the start of the war to a sophisticated well-oiled machine at the end, storing blood and distributing it to where it was needed.
The war also saw the first full-scale investigation into mosquito bites. Sir Neil Hamilton Fairley, using Australian soldier volunteers, probed the problem in some detail and paved the way for the work of Shortt and Garnham in 1948. Fairley showed that one tablet per day of mepacrine could keep malaria at bay. His work was matched by the Germans who produced atebrin – though German soldiers were not involved in tropical warfare.
Though work on tetanus had started in World War One, it was developed and refined in the war years. By immunising soldiers, the risk of tetanus dramatically fell. At Dunkirk in 1940, it would not have been possible to administer a serum on the ground to soldiers who had been wounded in the withdrawal to the French port. However, of the 17,000 men wounded at Dunkirk and who had been immunised before the campaign started, none got tetanus.
A great deal of research was done on coping with a weapon that was never used – chemical warfare. While drugs were found to help cope with a gas attack, most success came in the development of gas masks. While the physical appearance of a gas mask changed little during the war, there were significant developments in the carbon used to absorb poison gases found in the face piece of the mask. The Americans developed a material known as whetlerite that proved to be highly effective in tests against most known poison gases. A head-wound gas mask was developed for those in hospital recovering from a head wound – the wearing of a normal gas mask would have been impossible with bandages etc being worn.
All of the medical advances in World War Two went on to benefit society after the war had ended. Whether such developments would have occurred at the same pace in peace time will never be known.