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Providing for the Casualties of War

Providing for the Casualties of War: The American Experience Through World War II

Bernard Rostker
Copyright Date: 2013
Published by: RAND Corporation
Pages: 324
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  • Book Info
    Providing for the Casualties of War
    Book Description:

    War has always been a dangerous business, bringing injury, wounds, and death, and--until recently--often disease. What has changed over time, most dramatically in the last 150 or so years, is the care these casualties receive and who provides it. This book looks at the history of how humanity has cared for its war casualties and veterans, from ancient times through the aftermath of World War II.

    eISBN: 978-0-8330-7821-6
    Subjects: Health Sciences, History, Psychology

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Foreword
    (pp. iii-iv)
    Ronald R. Blanck

    The above quote applies especially to military medicine: Weaponry has become increasingly lethal, but medical advances are making horrific wounds survivable. It was my job as the Surgeon General of the Army to build a robust medical presence on the battlefield and a sophisticated system of recovery care and rehabilitation for our wounded soldiers. InProviding for the Casualties of War, Dr. Bernard Rostker sets my task against the backdrop of history.

    Histories of military medicine usually concentrate on battlefield care and transportation, occasionally on recovery in hospital systems, and rarely on rehabilitation. Efforts to consider all aspects of care,...

  3. Preface
    (pp. v-vi)
  4. Table of Contents
    (pp. vii-xii)
  5. Figures
    (pp. xiii-xiv)
  6. Tables
    (pp. xv-xvi)
  7. Acknowledgments
    (pp. xvii-xviii)
  8. Abbreviations
    (pp. xix-xx)
  9. CHAPTER ONE Introduction: Looking to the Past for Lessons . . . to Apply in the Future
    (pp. 1-4)

    How the nation cares for its war casualties today, both during their service and as veterans, is the result of progress along a well-established path that extends back before the dawn of history and continues with our most recent conflicts in Iraq and Afghanistan. The clinical characteristics and health needs of our current casualties, however, are very different from those of the past, with death rates and amputations at an all-time low. In past conflicts, the most serious battle injuries were typically wounds resulting from gun and artillery fire. Today’s improvised explosive devices planted along roadsides are the scourge of...

  10. CHAPTER TWO Evolution of the European System of Providing for Casualties: Greece, Rome, the Middle Ages, and the Renaissance
    (pp. 5-26)

    War has been part of the human experience since before recorded history.¹ Freud suggested that this may be an inherent trait, that “conflicts of interest between man and man are resolved, in principle, by the recourse to violence” (Einstein and Freud, 1931–1932). Although people have not been able to overcome their essential proclivity to make war on one another over the millennia, there has been some progress in how the casualties of war are treated. Early efforts to care for those maimed in combat were established for four reasons: First, the wounded represented a valuable asset that, with proper...

  11. CHAPTER THREE Evolution of the European System of Providing for Casualties in the Age of Enlightenment: France and Britain as the Antecedents of the American System of Care
    (pp. 27-56)

    Leaving the Renaissance, we continue the story by focusing on the two countries that most affected developments in the American colonies and in the United States, up to and including the First World War, France and Great Britain. First as protagonists and later as allies, the ways each of these countries cared for its war casualties were well studied by their American colleagues to learn lessons about what to emulate and what to avoid.

    After the French civil wars, Henry IV (1589–1610) responded to the plight of his former soldiers, who often were “reduced to beggary, a shameful thing...

  12. CHAPTER FOUR The American System of Providing for the Wounded Evolves
    (pp. 57-74)

    The events of 17th century England were familiar to the American colonists, whose own medical treatment and care of the wounded closely reflected contemporary English practices in terms of both the provision of care and the treatment received. The first colony to address the care of a wounded soldier was the Plymouth Colony (Massachusetts). In 1636, it provided for the conscription of soldiers and ordered that a soldier sent outside the colony if “maimed or hurt” be “maintained completely by the colony during his life” (McMurtrie, 1919a, p. 22). The colony appointed the first surgeon to support the militia in...

  13. CHAPTER FIVE The Civil War
    (pp. 75-112)

    The Civil War drew heavily on the manpower resources of the country. On the eve of the war, the Regular Army numbered about 15,000 officers and men. This grew sharply over the ensuing months and years. By one account, “nearly one-half of the men eligible for service in the North . . . enlisted . . . in the Union forces” (Sparrow, 1952, p. 5).¹ In 1868, the Adjutant General reported that a total of 2,336,942 white or “colored” men had enlisted or were commissioned (2,073,112 white enlisted men; 83,935 commissioned officers; and 178,895 colored enlisted men) in the Union...

  14. [Illustrations]
    (pp. None)
  15. CHAPTER SIX From the Civil War to the World War
    (pp. 113-122)

    Even with the demands of Reconstruction in the South, the authorized manpower for the Regular Army in November 1866 was only 54,000.¹ The Army Medical Department largely returned to its prewar structure, size, and function. By the end of 1865, only 97 soldiers remained in Army hospitals, down from an estimated population of 65,000 just six months earlier. Regular and contract surgeons declined from 1,997 (July 1865) to 217 medical officers and 264 contract surgeons in July 1866. The Medical Department disbanded the ambulance corps; closed supply depots; and sold or otherwise disposed of hospital transports, hospital trains, and general...

  16. CHAPTER SEVEN The World War
    (pp. 123-174)

    During World War I, the United States had more citizens under arms than had fought in all its wars to that point.¹ For the European powers, this was a global war, but for the United States, the focus was on Europe. The American Expeditionary Forces (AEF) were transported to Europe to support the Allies on the Western Front, the area along the Franco-German border. This was a new kind of war that made use of the new technologies of communication (telephone and wireless), transportation (motorized ambulances and trucks, railways, and steam ships), combat vehicles (armored cars, tanks, and aircraft), and...

  17. CHAPTER EIGHT World War II
    (pp. 175-240)

    In the 43 years between the start of the Spanish-American War and the start of World War II, the United States evolved, albeit reluctantly, from a largely isolated regional power into a world power. The congressional decision to reject the League of Nations in 1920 was one sign of this reluctance, as was the relatively small growth of the U.S. military after World War I relative to its prewar levels.¹ Active military strength remained relatively stable, at about 250,000, from 1920 until the nation started to prepare for war after the fall of France in 1940.² Figure 8.1 shows the...

  18. CHAPTER NINE Summary: What Happened?—What Have We Learned?—How Did We Get Here?
    (pp. 241-266)

    The accounts presented in the previous chapters have shown that the level of care today’s casualties of war receive is relatively new in human history, dating back less than a century. From the time of the Greeks to World War I, just being a soldier was an open invitation to death from the countless communicable diseases that were the scourge of military camps. For the wounded, the inability to control infections meant that simple wounds often turned into festering sores, often with deadly results. Moreover, the difficulties of organizing medical services and evacuating the wounded from the battlefield added to...

  19. APPENDIX Military Personnel and Casualties from Principal U.S. Wars
    (pp. 267-270)
  20. Bibliography
    (pp. 271-286)