Total casualties in France and Flanders 1914-1918   Year Average strength of BEF in France and Flanders Killed Died of Wounds Died of disease or injury (not battle related) Wounded Sick or injured 1914 220,572 13,009 3,657 508 55,689 78,049 1915 662,342 48,604 14,934 5,722 224,963 576,831 1916 1,337,055 107,413 36,879 5,841 463,697 637,280 1917 1,968,879 131,791 49,832 8,422 564,694 1,033,844 1918 1,989,374 80,476 46,089 14,420 578,402 1,169,581 Data taken from History of the Great War: Medical Services published in 1931

Records show that some 4,000,000 cases required evacuation from casualty clearing stations to the base by ambulance transport, and that 1,160,672 required evacuation from bases to ports [in the UK]… 2,981,232 cases of wounds or disease, or 54.03 per cent of the total admissions were returned to duty in the theatre of war. To this total must be added the numbers who returned to duty after evacuation to the United Kingdom, if the true value of the medical services is to be appreciated. History of the Great War: Medical Services p.106, published in 1931

In 1914-15, the mortality rate of compound fractures of the femur was 70-80%. The Thomas Splint was introduced to deal with this problem. The splint applied traction to the entire leg, overcoming muscle spasm in the thigh and maintaining good fracture alignment. Blood loss was also reduced. By 1917, the mortality rate had fallen to 15%. Adapted from T Scotland in The First World War and it influence on the development of orthopaedic surgery, Journal of the Royal College of Physicians of Edinburgh, 2014

It was the First World War which decisively advanced skin transplants It was the First World War which decisively advanced skin transplants. Confronted by horrific facial injuries, Harold Gilles set up a plastic surgery unit at Aldershot in the south of England. He was one of the first plastic surgeons to take the patient’s appearance into consideration. After the Battle of the Somme in 1916, he dealt personally with about 2,000 cases of facial damage. Roy Porter in The Greatest Benefit to Mankind: A Medical History of Mankind, published in 1997

By 1917 blood transfusion was firmly established in the Casualty Clearing Stations as a routine measure and by the end of the war, shock and its management were far better understood. There was a move from Ether and Chloroform anæsthesia to Gas and Oxygen which was safer and gave better results. Great advances were made in plastic surgery, also in the design and fitting of artificial limbs. The experience of widespread wound infection, which killed many men who might have survived the wounds themselves, spurred bacteriologists to search for effective antibacterial agents. Alexander Fleming, himself a Great War Medical Officer, eventually discovered Penicillin, the first antibiotic, in 1928. Dr Eric Webb, Military Medicine on the Western Front, published in 2011 http://myweb.tiscali.co.uk/drericwebb/docs/mgw.pdf

It was the First World War which really confirmed the importance of X-ray in surgery. More machines were quickly manufactured to meet the new demands and they were soon installed in major hospitals all along the Western Front. X-rays immediately improved the success rate of surgeons in removing deeply lodged bullets and shrapnel which would otherwise have caused fatal infections. Medicine and Health through Time by Ian Dawson and Ian Coulson, published in 1996 Operation on a wounded soldier during World War 1 with the surgeon using a fluoroscope to locate the bullets. This was a type of X-ray machine.

High velocity bullets and shrapnel produced severe wounds High velocity bullets and shrapnel produced severe wounds. X-rays of bones became commonplace. Bone surgery developed as a highly skilled branch of surgery. Despite steel helmets, 10% of all injuries were to the head. Surgery to the eye, face, ear, nose and throat, and brain and plastic surgery developed rapidly during the War. Medicine at War by C. Spring, published in 1970