Combat Casualties and Battlefield Medicine through the Ages by Lloyd Lofthouse

Posted by on Apr 10, 2017 in 20th Century US, Featured Book, Historical Tidbits | Comments Off on Combat Casualties and Battlefield Medicine through the Ages by Lloyd Lofthouse

It has been estimated that the Roman Empire’s Legions, over a nine-hundred year period, lost an average of one-thousand troops annually from combat.

When we compare modern combat deaths, this is amazing.

Though the number of killed and wounded in the U.S. Civil War (1861 – 1865) is not known precisely, most sources agree that the total number killed added up to an average of 160,000  – 175,000 combat deaths annually. In the Korean War, the US lost an average of 18,081 from combat deaths annually. In the Vietnam War, that number dropped to 3,063. In Desert Storm (1990-1991) there were only 378 deaths or an average of 54 a month. In Afghanistan, the average has been less than 200 annually compared to the more than 30,000 civilians that die in the United States in vehicle accidents on the roads each year.

The reason why the ancient Romans were so successful at saving lives after combat might surprise you. The ancient military physicians of the Greeks and the Romans discovered that certain treatments, such as the application of honey and salt mixtures to wounds that were from cuts and jabs helped wounded troops to recover.

The decline of the Roman Empire didn’t happen overnight. It took centuries, and when the Roman Empire fell in the 5th century AD, the medical care that has saved so many lives for almost one thousand years effectively ended in Europe.

About a thousand years would pass before the rebirth of military medicine in Spain near the end of the 15th century after the Spanish drove out the Islamic Moors. During that war, the Spanish military copied the mobile hospitals used by their enemy, the Moorish armies.

Then in the 15th century, the introduction of gunpowder to combat caused more casualties, because almost all gunshot wounds became infected due to the clothing, dirt, and other debris often forced into the wound by the musket ball, and from unsanitary conditions following the injury caused by the surgeon probing for the musket ball or shrapnel with unwashed fingers or unsanitized surgical instruments.

It isn’t as if sterilizing surgical instruments was an undiscovered concept, because the ancient Chinese, Persians, and Egyptians all used methods of water sanitation and disinfection of wounds. In fact, Mercuric chloride was used to prevent infection in wounds by Arab physicians in the Middle Ages, but not in Europe.

That helps explain why in Europe and America in the 1800’s, infections after surgery caused almost half of the deaths of troops wounded in combat.

However, as it turns out, the bloodiest war in American history was also one of the most influential in battlefield medicine. Civil War surgeons learned fast, and amputation of arms and legs saved more lives from death caused by infection than any other wartime medical procedure.

With the introduction of gunpowder, combat casualties increased dramatically, but medical treatment in the battlefield also improved. Field hospitals were introduced by Napoleon. During the U.S. Civil War, World War I, and World War II, trained military medics joined combat units to treat casualties in the field as troops were wounded.

The use of honey or sugar wasn’t the only ancient cure for combat wounds. Knowledge Weighs reports, “Black pepper (so is cayenne pepper) is naturally antibacterial and makes blood coagulate quickly and stop bleeding. Black pepper was commonly used by soldiers in the Second World War (and the 1st World War), and even today it is often used in professional kitchens (probably due to its availability) to stop cuts from bleeding.”

For instance, when I joined a wood-carving club, I was told that my wood carving tool kit had to include pepper. I stocked it with cayenne and have used that red pepper many times to stop cuts from bleeding, protect the wound from infection, and to speed up the healing process. Knock-on-wood, that pepper has worked every time even for cuts that went clear to the bone.

The biggest challenge today is to discover how to treat the invisible wounds that come from combat, and in Running With the Enemy, my historical fiction novel, set in the early years of the Vietnam War, Ethan Card, the main character, struggles through the novel with Post Traumatic Stress Disorder (PTSD) as he fights desperately to save the woman he loves and prove his innocence from allegations that he is a traitor. He also must deal with physical combat wounds while continuing to fight. The enemy doesn’t ignore you because you are wounded. Even wounded, you must fight to survive.

What about the wars in Iraq and Afghanistan? reported there were more U.S. military casualties from suicide than combat. In 2012, the number of active-duty casualties from suicide (349) outnumbered the combat deaths (295) in all of Afghanistan, but it gets worse if you look at the number of suicides by America’s veterans after they come home. reports that in 2014, an average of 20 Veterans died from suicide every day.

Lloyd Lofthouse, April 10, 2017