Combat casualties and battle-field medicine through the ages: Part 1/2

Starting with the Roman Empire, it has been estimated that Roman Armies suffered about 885,000 casualties over a nine-hundred year period from 400 BC to 500 AD—that adds up to less than 1,000 average combat deaths annually. Source: Body Count of Roman Empire

It seems that the old way of fighting with swords and spears wasn’t as destructive as modern warfare.

The ancient military physicians of the Greeks and the Romans had discovered that certain treatments, such as the application of honey and salt mixtures to wounds—mostly from cuts and jabs—aided the troops to recover.

The decline of the Roman Empire didn’t happen overnight. It took centuries, and when the Roman Empire fell in the 5th century AD, military medical support was almost gone. With the decline of an empire, also came the end of effective medical care in Europe.

About a thousand years would go by before the rebirth of military medicine in Europe in Spain near the end of the 15th century after the Spanish drove out the Islamic Moors. During the wars, the Spanish military copied the mobile hospitals used by the Moorish armies.


But in the 15th century, the introduction of gunpowder in combat caused more casualties, because almost all gunshot wounds became infected due to the injury—clothing, dirt, and other debris was often forced into the wound by the musket ball—and/or from unsanitary conditions following the injury caused by the surgeon probing for the musket ball or shrapnel with unwashed fingers and/or unwashed surgical instruments.

It isn’t as if sterilizing surgical instruments was going to be a new concept. The ancient Chinese, Persians and Egyptians all used methods for water sanitation and disinfection of wounds. In fact, Mercuric chloride was used to prevent infection in wounds by Arabian physicians in the Middle Ages but not in Europe.

In fact, in Europe and American in the 1800’s, infections after surgery caused almost half of the deaths of troops wounded in combat.

Though the number of killed and wounded in the Civil War (1861 – 1865) is not known precisely, most sources agree that the total number killed was between 640,000 and 700,000 resulting in an average of 160,000  – 175,000 combat deaths annually—a massive leap from the average annual combat deaths during the Roman Empire where the well trained and highly disciplined Roman military also had observant medics who wrote down treatments that worked and passed this knowledge on to be used by the next military doctor. In fact, Roman surgeons used about the same tools that American doctors did only one hundred years ago.

However, as it turns out, the bloodiest war in American history was also one of the most influential in battlefield medicine. Civil War surgeons learned fast, and amputation of arms and legs saved more lives from death by infection than any other wartime medical procedure. Sources: Mental,  American Civil War Casualties and Military Medicine through the Eighteenth Century

Continued on Wednesday, June 12, 2013 in Combat casualties and battle-field medicine through the ages: Part 2


Lloyd Lofthouse is a former U.S. Marine and Vietnam Veteran.

His latest novel is the award winning suspense-thriller Running with the Enemy. Blamed for a crime he did not commit while serving in Vietnam, his country considers him a traitor. Ethan Card is a loyal U.S. Marine desperate to prove his innocence or he will never go home again.

And the woman he loves and wants to save was fighting for the other side.

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