| Medical
Research and New Methods of Treatment |
Dr.
Norman Bethune, assisted
by Henning Sorensen, performing
a transfusion during the
Spanish Civil War, 1935-1938.
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| Photo
by Geza Karpathi. National
Archives of Canada, C-067451. |
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The massive trauma inflicted on the
human body by modern artillery and other
weapons of war made treatment of shock
and the prevention of fatal blood loss
obvious priorities for medical researchers.
The absence of safe methods of storage
and reliable blood-typing in the First
World War limited the incidence of blood
transfusions to occasions when a donor
could be directly connected to the patient
by glass pipes and rubber tubes (Desmond
Morton, When Your Number's Up, 1993,
p. 191). One of the most famous Canadian
military doctors was Norman Bethune,
a pioneer who worked to develop better
methods of battlefield blood transfusions
during the Spanish Civil War in 1936
and the Japanese invasion of China in
1938. Early procedures were makeshift
by modern standards. In China, Bethune
anticipated the creation of mobile medical
units that would work to treat wounded
soldiers as close to the front as possible,
recognizing that the chances of survival
improved greatly when the delay in transporting
casualties to such units was reduced.
The Second World War saw a further evolution
of Bethune's efforts to provide early
medical treatment for wounded soldiers.
Battles in the Middle East showed that
Casualty Clearing Stations and Field
Ambulance units were themselves insufficient
to provide forward surgical services.
Mobile Field Surgical Units (FSUs) were
thus created, in which the surgeon "must
be prepared to set up his theatre in
whatever shelter he can find, and do
it quickly. He must be able to disband
it rapidly and move forward to another
area on short notice." (MacFarlane
to Canadian Army OS, 15 June 42, quoted
in Bill Rawling, Death Their Enemy:
Canadian Medical Practitioners and War,
2001, p. 158). New Field Transfusion
Units (FTUs), meanwhile, would use refrigerated
trucks to bring blood products forward
to resuscitate casualties at an earlier
stage of the evacuation chain.
Major
P.K. Tisdale, 4th Field
Ambulance, R.C.A.M.C.,
checking the condition
of a wounded man before
Sergeant W.H. Brigham
and
Private L.P. Lemieux donate
blood before his transfer
to a Field Surgical Unit.
Ortona, Italy, 15 January
1944.
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| Photo
by Alexander M. Stirton.
Department of National Defence
/ National Archives of Canada.
PA-144979. |
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In addition to such organizational improvements,
important medical research with practical
military applications was ongoing during
the interwar years. One of the most
promising areas of study focused on
chemical treatments of illness and injury.
In the mid-1930s it was discovered that
sulphanilamide and other sulphonamide
derivatives retard the growth of bacteria
and thenceforth sulfa (or sulpha) drugs
were widely used to prevent or treat
infection in wounds. Sulfa could be
given by mouth or used as a powder applied
directly to wounded tissue. Experiments
with penicillin treatment were conducted
early in the war, and by the opening
of the Second Front it had come to be
administered more systematically, with
patients receiving an initial dose at
a Casualty Clearing Station or Advanced
Surgical Centre with subsequent doses
during evacuation and while in hospital.
While important work on blood products
like plasma and serum was undertaken
at various Canadian universities and
the National Research Council, other
Canadian projects focused on the particular
needs of the air force. With the country's
only decompression chamber, scientists
at the University of Toronto studied
the effects of high-altitude flight
on aircrew. Meanwhile, research into
the effects of gravity-or G forces-sought
to resolve problems of impaired blood
circulation resulting from centrifugal
force which caused fighter pilots to
experience blackouts, loss of vision,
and unconsciousness during high-speed
manoeuvres such as pulling out of a
dive. One of the key figures was Wilbur
Franks, who worked under Dr Frederick
Banting at the University of Toronto
in developing the Franks flying suit.
The suit was lined with fluid to counteract
the displacement of blood by G forces,
and was used operationally in the Royal
Navy's Fleet Air Arm although it was
not accepted by the air force. Medical
research was therefore able-somewhat
paradoxically-to improve methods of
treating the wounded even as it devised
more efficient means for military personnel
to do their jobs, perhaps inflicting
death on others in the process.
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Wilbur
Franks' G suit, version
D, 18 February 1941.
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Department
of National Defence /
National Archives of Canada,
PA-063866.
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