World War I was a blindingly tragic period in human history. But it also catalysed many advances in medicine, chemistry and technology that we use to this day.
Illustration by Sarah Nagorcka
World War I started with a telegram, perhaps marking this time as one in which the world was about to be revolutionised by science and technology. With the rapid industrialisation of the late-19th and early-20th centuries, the war was on its way to being characterised by masses – of production, transportation, injuries and illnesses, and, of course, death.
Despite the horrors of war, however, many inventions of WWI had an overall positive effect on the scientific world and the wider community. With large-scale industrial improvements and medical advances, scientific knowledge gained through WWI has gone on to be of widespread benefit.
Medicine
Medically, WWI presented incredibly challenging circumstances for doctors, surgeons and nurses. Medical professionals were enlisted en masse, as old and new medical problems presented themselves on a large scale. Disfigurements and amputations in large numbers presented a serious challenge for medics and nurses, as did trench foot and trench mouth, venereal disease, and the Spanish influenza. In finding wartime treatments for these diseases and injuries, new medical practices were born, and the contributions to medicine were great.
As well as those who served in the army as doctors and nurses, volunteers with medical backgrounds worked in makeshift hospitals set up to support the large number of injuries and infectious diseases that plagued Europe during the war. While the risk of infection from surgery or wounds was relatively high, given the muddy conditions of the Western Front, other infectious diseases were more prevalent. Infections such as typhus, typhoid, tuberculosis, trench fever, and the Spanish influenza, which were largely due to the mass movement of soldiers and civilians, presented a significant problem for medical workers during WWI.
The discovery of the tetanus antitoxin in the late 19th century meant that tetanus was no longer a danger for soldiers wounded in battle, but infection was still highly likely given the conditions in which wounded soldiers often found themselves. Infection could be fatal, and the war gave rise to a number of methods to prevent the spread of infection.
A hospital ward erected in the Islington Public Library in 1916. Wellcome Images/Wikimedia Commons (CC BY 4.0)
A Belgian medic, Antoine Depage, developed debridement during the war, identifying that foreign bodies and infected flesh must first be removed for a wound to heal. This technique involved cutting away tissue to avoid infection before the sealing of the wound. Other techniques to prevent infection included wrapping wounds in carbolic lotion soaked gauze, and ‘bipping’: the treatment of wounds with bismuth iodoform paraffin paste.
Amputation was also used in many cases to avoid the infection of wounds on a soldier’s extremities. However, the discovery of the Reading Bacillus by Leonard Joyce saw innovation in the treatment of infection. Joyce, a surgeon, discovered a bacterium that broke down human flesh. This could be applied to wounds that would not heal, removing the flesh that was preventing healing, and therefore ridding the wound of infection and promoting recovery.
Infections did not only occur as the result of foreign bodies entering wounds, but also in the form of many infectious diseases that spread easily through the massive number of people involved in the war.
Vector-borne diseases were common during the Great War. Trench fever struck a staggering estimated 500,000 British soldiers alone, though every army involved in the war suffered the disease. Trench fever was spread through body lice. Also known as ‘five day fever’, the disease was characterised by a fever, headaches, skin rashes and leg pains, and became chronic in about 5% of cases. No treatment was found during the war, though prevention involved cleaning clothing to remove the lice. However, given the numbers affected, it wasn’t overly successful. Trench fever is unfortunately still prevalent in homeless populations around the world.
Typhus and typhoid were also a concern during WWI. Typhus is a bacterial infection spread through parasites, like trench fever; and typhoid is a salmonella bacterial infection (S. typhi) often contracted from contaminated food and water. They were both relatively deadly. In response, most soldiers received vaccinations against typhoid going into the war, and delousing stations were used to prevent typhus outbreaks on the Western Front. Without these advances, a much greater rate of infection would have been seen, if the massive typhus outbreak on the Eastern Front were anything to go by.
The Spanish influenza tore through Europe in 1918, before the war was over. Around 50 million people died from "La Grippe", as it was known – a greater number of deaths than from the war itself. The reason the disease spread to become a pandemic is likely due to the war. Between large numbers of people moving, their lack of immunity to even the seasonal flu of those from previously isolated populations, and the novel combination of pig and bird flu genes in the Spanish flu’s genetic makeup, the virus quickly devastated wartime Europe. The rapid spread of the Spanish flu was another cause of its deadliness.
While there is much to learn from the Spanish flu – which inexplicably died out in 1919 without a treatment ever being developed – the outbreak was not actually the same disease we now consider to be influenza, but a viral pneumonia.
An Australian WWI poster featuring a Red Cross hospital ship. David Souter Henry/Wikimedia Commons (public domain)
Due to the massive scale of WWI, the number and variation of injuries from battle was extraordinarily high, and required quick transportation and treatment of the injured. Within 24 hours, a wounded soldier could be transported from the battlefield on a stretcher to the aid post of their regiment, then via ambulance to a casualty clearing station, on to a hospital train, and finally to the base hospital. Sometimes the journey took much longer, but motorised ambulances and hospital trains generally provided fast transport for the injured. Once at the base hospital, a wounded or sick soldier could receive treatment and surgery.
It was in these base hospitals that blood transfusions were first used. Blood loss could result in shock, leading to the rapid death of the wounded. The idea of blood transfusions had existed for a good two centuries before the war, but it was only in 1913 that the significance of blood types and the specific utility of the O group were properly understood. O-negative blood is still used today in emergencies if a patient’s exact blood type is unavailable, as it was once thought of as the universal donor. Though we now know even O-negative blood might not be risk free for every patient, it’s easy to see how it could be very useful in WWI conditions.
Blood could not be stored for long, however, and it was not until 1917 when US doctor Captain Oswald Robertson discovered the use of sodium citrate in the storage of blood, establishing the first blood bank.
Chemistry
Along with chemical weapons and explosives, WWI saw the development of chemical inventions with a much broader use in society.
Trenches were fairly enclosed and were difficult to evacuate quickly, making them susceptible to chemical attack. WWI saw a range of different chemicals used as weapons, mainly in gas form.
Chemical weapons used in World War I. Andy Brunning/Compound Interest (CC BY-NC-ND 4.0)
Though chemical weapons were a terrifying new threat, they weren’t particularly deadly. Many injuries were recorded as a result of gas, however, from chemical burns to chronic lung problems.
The chemical weapons of WWI had uses beyond the war. Mustard gas, for example, was found to decrease the white blood cell count in those it was used on. Later on, this would turn out to be desirable when scientists were looking for a chemical that could kill fast growing, cancerous white blood cells. Mustard gas led to the discovery of mustine, or chloromenthine, the first chemotherapy drug.
2,4,6-trinitrotoluene was originally synthesised in the 19th century in an attempt to make dye (an important export in the period before the war), however during WWI, it came to be used as an explosive, and thus TNT was born. TNT offered greater stability than other explosives of the period, such as picric acid. It proved to be relatively safe to handle and hard to detonate, allowing TNT-filled shells to pierce enemy armour before detonating, while picric acid and its contemporaries would explode on impact.
TNT did, however, cause a number of cases of acute TNT poisoning in munitions workers; and in 1917 the Silvertown explosion at a TNT factory rocked London’s East End. Today, TNT is still used in munitions – most notably in landmines – as well as in demolition work, as its high stability makes it easy to handle and relatively safe.
Aside from destruction, WWI enabled the discovery of many chemical processes that help sustain society today. The Haber process is one example: Discovered in Germany by chemist Fritz Haber, the process involves the reaction of nitrogen gas from the air with hydrogen, catalysed by extreme pressure to synthesise ammonia. At the same time, Walther Nernst was working on what would become the third law of thermodynamics, which Haber would later use to complete his synthesis. With help from Carl Bosch, the Haber process, also known as the Haber-Bosch process, was implemented on a large scale. Germany used the ammonia it synthesised to maintain their munitions manufacturing once their supply lines were cut off, as well as fixing nitrogen to use as fertiliser, which is still hugely important in agriculture today. Unfortunately for Germany, their production of ammonia was not quite enough to keep starvation at bay – their defeat in 1918 was in part due to severe famine.
Technology
The use of automatic weapons in WWI saw soldiers discharging up to 600 rounds in 60 seconds (compared with four rounds a minute at the Battle of Waterloo in 1815), resulting in far greater devastation and loss of life. While rifles were standard issue to all soldiers, machine guns were put into first major use for the first time during the war. Based on a design from 1884, they sustained a high fire rate and were good for stopping attacking soldiers as they advanced.
WWI also saw the use of flamethrowers and mortars, and serious scientific advancements in artillery in both the production and accuracy of weapons. Killing more people than any other weapons class, artillery became so advanced during WWI that some long-range weapons had to take the curvature of the Earth into consideration in order to remain accurate.
Trench warfare posed the problem of a stalemate, and tanks allowed for an army to cross enemy defences and rough terrain. As the battlefield terrain was a problem for horses and regular vehicles, US Caterpillar tractors were used to transport supplies to the trenches. From here, the tank evolved. The first model to see battlefields was the British Mark I, which was far from the tanks of today. The Mark I was relatively unreliable and provided a hot inside environment filled with fumes – it wasn’t uncommon for the Mark I to kill its occupants should there be a spark. In 1918, the French developed the lightweight Renault FT, which offered a significant improvement on the Mark I and was considerably more reliable. Overall, the Allies produced about 600 tanks in WWI, though it wasn’t until WWII that they became truly frightening in battle.
Submarines also saw some of their earliest uses in battle during WWI. At the beginning of the war, the Germans had 29 U-boats in their fleet, sinking five Allied ships in the first few months. Submarines proved an effective sea weapon, though eventually vulnerable ships were escorted by warships, and the effectiveness of submarines declined. Since submarines in WWI generally surfaced to shoot with guns mounted on top, they were visible to enemy battleships, meaning they could not safely surface. While they did have torpedoes, these did not reliably hit their targets, as homing technology was not developed until WWII.
With submarines came the need to locate underwater vessels. Originally called Sonar by the Americans and ASDIC by the British, the primary method for detecting underwater ships during WWI – echolocation – used the reflection of sound waves to determine the position of submarines. While Sonar was discovered in the late 19th century, WWI drove the use of more powerful equipment due to technological advances over the previous 20 years. Though in common use throughout WWI, it wasn’t until 1976 that this technology was used medically. Ultrasound was first commercialised in Australia after the CSIRO discovered that ultrasound echoes could be used to identify internal anomalies in the human body. One of its most common modern uses is to non-invasively monitor the growth of a fetus during pregnancy.
Of course, submarines and tanks weren’t the only battlefield machines of WWI. The use of aircrafts on a large scale for the first time in WWI has left its mark on the following century of air combat. While planes were originally used to monitor enemy movements, their utility was quickly realised by both sides, and a need for a defensive system in the air became evident. At first, pilots just took shots at each other with their revolvers, but as technology evolved, the mounting of machine guns to the aircraft became standard. Soon, bombs would be used in the air too. Bombing raids further developed the roles of aircrafts in warfare. Such raids could be devastating, such as when Germany launched long range bombing attacks on London with Zeppelins and Gotha bombers.
While the first world war saw the use of weapons on a scale unseen in the years before 1914, as well as many inventions geared towards large-scale destruction, it also provoked a lot of scientific and medical progress. Without the war and the scientific advances that it brought, medical procedures and drugs might not have been developed. For instance, chemotherapy is used widely today, and the infection of wounds is relatively uncommon. While it is hard to ignore the massive amount of death and destruction brought by war, the challenges and pressures of wartime have historically driven necessarily fast developments in science, technology, medicine and engineering – many of which have gone on to have wider reaching applications in peacetime as well.
