Abstract
Much has been written about the First World War in the making of the modern world — of the paradox of that awesome dance of death giving birth to modernist vision.1 But the significance of 1914–18 for modern medicine and its image has been little explored. Instead, on the basis of an abundant medical literature, it has largely been accepted that, for all its horrors, the ‘Great War’ was not only great for medicine, but was good for humanity in general, encouraging medical innovations, stimulating new therapies, drugs, surgical techniques, and so on.2 This chapter is not concerned with challenging this overtly positivist, implicitly militarist, and profoundly simplistic message so much as with pointing to its irrelevance in interpreting one of the assumed-to-be most significant and enduring of the medical benefits of the war: specialization.3 Through the wartime history of orthopaedics, we shall show, the perception of specialization as a straightforward beneficiary of war — comparable, say, to the munitions industry — is at best superficial, at worst wrong.
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Notes
See especially Modris Eksteins, Rites of Spring: the Great War and the birth of the modern age (New York, 1989);
Paul Fussell, The Great War and Modern Memory (Oxford, 1975); and
G. D. Josipovici, ‘The Birth of the Moderns: 1885–1914’ in Clive Emsley et al. (eds), War, Peace and Social Change in Twentieth-Century Europe (Milton Keynes, 1989), pp. 72–88.
For a review and critique of this literature, see Roger Cooter, ‘Medicine and the Goodness of War’, Canadian Bull. Hist. Med., 7 (1990), pp. 147–59, and idem, ‘War and Modern Medicine’ in W. F. Bynum and Roy Porter (eds), Encyclopedia of the History of Medicine (London/New York, forthcoming).
Joel Goldthwait, The Division of Orthopaedic Surgery in the A.E.F. (Norwood, Mass., 1941), p. 13;
Sir W.G. Macpherson, History of the Great War, Medical Services [hereafter Off. Med. Hist.], General History, vol. 1 (1923), p. 390.
See G. Murray Levick, D. Macrae Aitken, and J. P. Mennell, ‘Organisation for Orthopaedic Treatment of War Injuries’, in Off. Med. Hist: Surgery of the War, vol. 2 (1922), pp. 381–408;
Robert Osgood, ‘The Orthopedic Centers of Great Britain and their American Medical Officers’, AJOS, 16 (1918), pp. 132–40; ‘Orthopaedic Centres in Scotland for the Treatment of Disabled Soldiers and Sailors’, Lancet, 27 July 1918, pp. 118–19; and
Robert Jones, ‘Military and Orthopaedic Surgery: its scope and aims’, Inter-Allied Conference on the After-care of Disabled Men — 2nd annual meeting, reports presented to the conference (HMSO, 1918), pp. 519–28.
Field Marshall French, as quoted in Frederick Watson, The Life of Sir Robert Jones (1934), p. 171. French soon became an enthusiast of orthopaedics; in 1917 he was among those who inspected the RNOH. See
John A. Cholmely, A Brief History of the Royal National Orthopaedic Hospital from its Origin in 1905 to 1982 (1982), p. 5.
Recounted in T. B. Layton, Sir William Arbuthnot Lane (1956). On the use of Balkan frames in the war see
Fred M. Albee, A Surgeon’s Fight to Rebuild Men: an autobiography (1950), pp. 911ff. On the origins and popularization of the frame, see
Daniel de Moulin, A History of Surgery, with emphasis on the Netherlands (Dordrecht, 1988), p. 322.
S. Dumas and K. O. Vedel-Petersen, Losses of Life Caused by War, ed. Harald Westergaard (Oxford, 1923), pp. 94–5; Cooter, ‘War and Modern Medicine’; and
Thomas Longmore, Amputations: an historical sketch (Glasgow, 1876).
Alexis Carrel and G. Dehelly, The Treatment of Infected Wounds, trans. Herbert Child, with an introduction by Anthony A. Bowlby (1917). On Henry Dakin and Carrel, see Albee, Autobiography, pp. 56, 100ff. The Carrel-Dakin method had become general in medical units of the BEF in France by the summer of 1917. See Intelligence Summary for 28 Aug. 1917 in PRO:WO/95/46.
See William Thorburn, ‘The 2nd Western General Hospital’, Brit. J. Surg., 2 (1914–15), pp. 491–505 at p. 492.
Redmond McLaughlin, The Royal Army Medical Corps (1972), pp. 38–9. Beyond this organization, but linked to it in various financial and other ways, were the auxiliary voluntary hospitals in France and in Britain, coordinated by the Joint Committee of the Red Cross and Order of St John.
Sydney Holland, In Black and White (1926), p. 272.
See Sir Cuthbert S. Wallace and Sir John Fraser, Surgery at a Casualty Clearing Station (1918); Bowlby, ‘Surgery at the Front’ p. 128.
Quoted in Guy Hartcup, The War of Invention: scientific developments, 1914–18 (1983), p. 166. On Keogh (1857–1936) see also DNB; Med.Press and Circular, 3 July 1957, p. 21; and R. K. May, ‘The Forgotten General: Lieutenant General Sir Alfred Keogh’, Br. Army Rev., no. 76 (1984), pp. 51–59.
Quoted in Ronald Rompkey, Grenfell of Labrador: a biography (Toronto, 1991), p. 188.
For Germany, see Robert W. Whalen, Bitter Wounds: German victims of the Great War, 1914–1939 (Ithaca, 1984); for France, see
Antoine Prost, Les Anciens Combattants et la Société Française, 1914–1939 (Paris, 1977), 3 vols.
On Amar, see George Humphreys, Taylorism in France: the impact of scientific management on factory relations and society (New York, 1986), pp. 217–18, and
Anson Rabinbach, The Human Motor (Berkeley, 1992), pp. 185–8, 246–9, and 337n. et passim.
Cf. Glenn Gritzer and Arnold Arluke, The Making of Rehabilitation (Berkeley, 1985), pp. 43–4.
See Alfred Cox, Among the Doctors (1950), pp. 115–16;
Lindsay Granshaw, St. Mark’s Hospital London (1985), pp. 185–6; cf. Abel-Smith, Hospitals, p. 281.
H. Jackson Burrows, ‘The Orthopaedic Department’, St Barts Hosp. J., 69 (1965), pp. 355–6. The appointment in 1920 of A. S. Blundell Bankart as the first orthopaedic surgeon to the Middlesex Hospital, while notable, is hardly an exception, since he was granted only one outpatient clinic a week and was given no hospital beds. See the interview of Jones and G. R. Girdlestone with Sir George Newman, 5 Mar. 1920: PRO:ED/ 50/153. Jones’s appointment in 1919 as Director of Orthopaedic Surgery at St Thomas’s seems to have been little more than token.
See Paul B. Johnson, Land Fit for Heroes: the planning of British reconstruction 1916–1919 (Chicago, 1968).
Shepherd’s Bush and Alder Hey each employed more than 50 masseurs in their physiotherapy departments. See Osgood, ‘Orthopedic Centers in Britain’, p. 137; Levick et al., ‘Organisation for Orthopaedies’, pp. 393–8. Almost all were recruited from the Chartered Society of Massage and Medical Gymnastics. See Jane H. Wickstead, The Growth of a Profession, being the history of the Chartered Society of Physiotherapy 1894–1945 (1948).
See David Cantor, ‘The MRC’s Support for Experimental Radiology During the Inter-War Years’, in L. Bryder and J. Austoker (eds), Historical Perspectives on the Role of the MRC (Oxford, 1989), pp. 181–204. By the 1930s leading advocates in this field were identifying orthopaedics as one of ‘the stronger boys’ who had stolen the ‘toys’ of the radiologists. See
A. E. Barclay, ‘The Dangers of Specialisation in Medicine’, Br. J. Radiology, 4 (1931), pp. 60–82 at p. 78.
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Cooter, R. (1993). The Great War. In: Surgery and Society in Peace and War. Science, Technology and Medicine in Modern History. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-137-10235-5_6
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