Essay: The Development of Prosthetic Limbs and Malaria Drug Development Programme during the Pacific War

Of Mosquitoes and Men – the Impact of the US Military in Driving Medical Innovation During the Civil War (1861 – 1865) and the Pacific War (1941 – 1945).
It is undeniable that war is one of the greatest tragedies to befall humankind yet borne of this tragedy are tremendous advances and innovations in the field of medicine be it surgical techniques, new drugs or new insight into patient aftercare. The tragedy of war often rightly shrouds any simultaneous positive discoveries and innovations. Such innovations, as is often the case within medical research, arise from necessity. This essay will consider two innovations which were entirely necessary in the period of war during which they were developed – the development of prosthetic limbs during and immediately after the Civil War and the Malaria Drug Development Programme during the Pacific War.
US troops found themselves face to face with a force far greater than that of any legion of men during both these wars: disease. During the Civil War almost 50,000 members of the Union Army died of infection secondary to their wounds. This figure will not equate to the total number of deaths subsequent to wound infection during the Civil War as Confederate medical records were lost in the great fire of Richmond however it is predicted than another 160,000 Confederate soldiers died from infection/disease (Gilchrist, M. 1998). Comparatively only 67,000 Union men were lost on the battlefield meaning that only 17,000 more men died in combat than from infection. Medics needed a new solution and fast to prevent further loss of life and this came in the form of amputation – removing the entirety of the insulted limb rather than letting the disease fester. As a result amputation became the most common field surgery executed during the Civil War, around 30,000 amputations performed in the 4 year period (Sorene, P. 2015). For both Rebel and Union leaders at the time a large number of their men being disabled by war was a potential economic and social problem with the majority of employment at the time, particularly for soldiers, being in manual labour. The leaders worried that disability secondary to amputation would breed ‘idleness and immoral behaviour’ necessitating the need for a solution that would replenish the pool of working, able-bodied men. The solution was prosthetics.
“The history of malaria in war might almost be taken to be the history of war itself…” – Col. C.H. Melville, Royal Army Medical College, London (1910).
Malaria is an antiquated disease that has played a significant role in human conflict for many years and much like wound infections and disease during the Civil War accounted for more deaths during conflict than bullets, knives or shells. It was the tremendous number of cases of malaria in the conflict setting that enabled military doctor Alphonse Laveran to study and determine the cause of the disease, which had previously been believed to be ‘bad air’ – the word malaria being derived from the Italian ‘mala’ bad and ‘aria’ air (CDC.gov, 2015). Indeed the environments in which the disease was most prevalent, swamps and other such damp, humid areas, were accompanied by malodour, proving evidence enough for doctors of the era.
• Background to us conflict
• Background to prosthetic/amputations
• Background to malaria
• Conflict and inaccessibility of drugs
• How field medicine sparks growth in medical field – impact on subsequent and current medicine