Some cornerstones of medicine in blood transfusion:

1930 - Karl Landsteiner, the most important figure in transfusion medicine, who discovered the first three human Blood groups, received the Nobel Prize for Medicine.

1932 - The first facility functioning as a Blood bank was established in a Leningrad Russia hospital.

1937 - Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, Illinois (U. S.), established the first hospital Blood bank in the United States. In creating a hospital laboratory that could preserve and store donor Blood, Fantus originated the term 'Blood bank.' Within a few years, hospital and community Blood banks began to be established across the United States. In the U. S., some of the earliest documented were in Cincinnati, Miami, New York and San Francisco.

1939 and 1940 - The Rh Blood group system was discovered by Karl Landsteiner, Alex Wiener, Philip Levine and R. E. Stetson and was soon recognized as the cause of the then majority of transfusion reactions. Known as the Rhesus (Rh) system, once this reliable test for this grouping had been established, transfusion reactions became rare. Identification of the Rh factor has stood next to ABO as another important breakthrough in Blood banking.

1940 - Edwin Cohn, a professor of biological chemistry at Harvard Medical School, developed a cold ethanol fractionation; the process of breaking down plasma into components and products. Albumin, a protein with powerful osmotic properties, plus gamma globulin and fibrinogen were isolated and became available for clinical use. The efficacy of the use of albumin in transfusion was then first demonstrated by John Elliott.

1941 - Isodor Ravdin, a prominent surgeon from Philadelphia, effectively treated victims of the Pearl Harbor attack with Cohn's albumin for shock. Injected into the Blood stream, albumin absorbs liquid from surrounding tissues, preventing Blood vessels from collapsing; the finding associated with shock.

1943 - The introduction by J.F. Loutit and P. L. Mollison of acid citrate dextrose (ACD) solution, which reduces the volume of anticoagulant, permitted transfusions of greater volumes of Blood and longer term Blood storage.

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The Allies had various methods of collecting blood and moving it to the fighting front. The British set up a series of storage depots where blood would be received, inspected, refrigerated, and moved forward again. Refrigerated vans would fan out across Britain, collecting blood and delivering it to a centralized medical unit. Technicians at this "home depot" chilled, processed, and readied the blood for shipment overseas. They flew it in insulated crates to large blood banks in the major theaters of military operation. Experts at these units would receive and store the blood, and estimate the need for additional shipments. From there the blood traveled forward to smaller "field transfusion units" -- mobile transfusion stations that could be moved to the action.

The Free French designed a sophisticated system, complete with processing laboratories, vehicles, and propaganda specialists to encourage donation. Exiled from their home country, they set up a central facility, or "Mother House," in Algiers where they collected blood and plasma from volunteers. From there they shipped the liquids to a "Moving Wing" that traveled with the French Expeditionary Corps in Africa, Corsica, and southern France. Blood banks in Tunisia and Morocco also fed the system. The French doctors called their organization O.R.T., for Organisme de Réanimation-Transfusion, or the Transfusion-Rehabilitation System. Blood donation was benevolent, voluntary, and welcomed from all. To the French the system embodied all that was modern and humane, especially in contrast to the values of the fascist enemy.

America processed blood and its derivatives as the industrial giant it was rapidly becoming. The Red Cross collected blood at centers throughout the country, separated the plasma, and shipped it to a network of pharmaceutical labs. They in turn produced freeze-dried plasma and albumin that was flown and shipped to troops overseas. Later in the war, with the advent of portable refrigerators and better preservation techniques, the nation processed whole blood, mostly for the battles of the Pacific. Blood from all over the country was collected and sent to the Naval depot in Oakland, California. There it was packed into insulated boxes, then flown to Hawaii and Guam, where it was re-iced and forwarded to the Pacific islands. Whole blood, carried in portable refrigerators, traveled as far forward as the medical aid stations behind the lines. Medics carried albumin and dried plasma right up to the fighting

http://www.pbs.org/wnet/redgold/basics/bloodonhoof.html
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PS. One issue concerning seriously wounded soldiers was whether some should be sent back to the States on hospital ships. General George Patton had a somewhat unsympathetic answer to this question: "If you have two wounded soldiers, one which a gunshot wound of the lung, and another with an arm or leg blown off, you save the son-of-the-bitch with the lung wound and let the ******* son-of-the-bitch with an amputee arm or leg go to hell. He is no ******* use to us any more".

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Hmmm...Not only Germans were ill prepared for winter in 1941 but so wete the US troops in 1944...

Cold injury which was so prevalent among line soldiers in the winter of 1944-45 was for the most part caused by the lack of warm winter clothing and boots. General Omar Bradley described how this had come about as a result of the euphoria that existed among the western allies in September of 1944: "When the rains first came in November with a blast of wintry air, our troops were ill prepared for winter time campaigning. This was traceable in part to the September crisis in supply for, during our race to the Rhine, I had deliberately by-passed shipment of winter clothing in favor of ammunition and gasoline. As a consequence, we now found ourselves caught short, particularly in bad weather footgear. We had gambled in our choice and were now paying for the bad guess."

The winter of 1944-45, was the coldest, wettest winter period western Europe had experienced in thirty years. By late November American officers learned how General Winter could disable an army that was ill-equipped for cold, wet weather. GI field shoes were not waterproof and the dub bin supplied each soldier was probably useless. The symptoms of trench foot were a numbness followed by a painful swelling, and often tissue death and gangrene. In cold feet the small blood vessels constricted, cutting off the blood supply to the extremities. Result was that the small blood vessels and nerve endings were permanently damaged so that the effect of the injury persisted in that the damaged tissue would be unable to resist cold.

More than 45.000 soldiers were hospitalized as cold injury casualties between November, 1944 and April 1945. Men with severely frost-bitten feet were unable to walk and were litter-carried at the front and given bed care in hospitals. In the Third Army, for every ten men evacuated there were six with cold injury. The most likely to suffer cold injury were men with combat boots only and no overshoes
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Sulfa drugs and penicillin contributed remarkable to the saving of lives in the European Theater. Each GI in forward positions carried a first-aid packet, complete with bandage, sulfa pills, and sulfa powder. Normally, sulfa drugs do not actually kill bacteria, instead they prevent the microbes from multiplying. The body's regular defenses kill bacteria. The difference between penicillin and sulfa drugs is that sulfa stabilizes the bacteria while penicillin kills the organisms. There were certain problems with penicillin. It was a new drug and still short supply in 1943. However, by D-Day, the combined output of British and American drug companies produced the amounts needed for the Normandy invasion. By June of 1944 penicillin also had become the drug used against syphilis in the ETO.

American soldiers who were hospitalized in Europe recall the frequent penicillin injections endured by many patients in their wards. Penicillin was absorbed rapidly and excreted rapidly through the kidneys, making frequent drug administration essential --- often every four hours, day and night. When it was learned that penicillin could be extracted from urine, an extracting plant was set up at Rhone-Poulenc, France, and penicillin was recovered at the rate of 100000 units (100 doses) of penicillin from 300 liters of urine. The urine was from wounded American soldiers being treated in the Paris district hospitals. The penicillin recovered was used to treat the wounded of the French Army.

The value of anti-biotic was demonstrated by the smaller death rate from disease as compared to World War One. In World War I, pneumonia took the lives of 18000 American soldiers, while World War II, even during the 1944-45 winter, the coldest and wettest in 30 years, only 70 GIs died of pneumonia in the European Theater of Operation.

http://users.skynet.be/bulgecriba/medics.html

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[img]smile.gif[/img]

[ 30. January 2003, 07:36 AM: Message edited by: Kai-Petri ]

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sulphonamides appeared in the early stages of the war, being used topically as well as systemically. As a result in North Africa, the Mediterranean sunlight provoked photosensitivity and other inflammatory patterns were also noted. Grant Peterkin of Edinburgh, serving in that theatre, wrote of his extensive experience of sulphonamide sensitivity. The first appearance of penicillin was as secret as it was exciting for it was prescribed for Winston Churchill's pneumonia; it was then to become available, most sparingly, for dermatological use. Its effects in the first place seemed nigh to miraculous and were reported by Hellier and Hodgson among others. DDT proved invaluable in eradicating the infestations which scourged so many prison camps. Malaria prophylaxis was vital to preserve a soldier's fighting capability; once this had been assured by the swallowing of a daily mepacrine pill, the improved performance of our forces in the tropics brought added kudos to the medical establishment.

http://www.bad.org.uk/about/history/ww2/

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Statistics and Data: in WW2 efficient medical care reduced overall losses to only 4 in each 100 wounded (WW1 8 out of 100) . Better surgery, penicillin, plasma and whole blood are responsible in varying degrees, however the credit must be shared by the entire personnel of the Medical Department, whose painstaking care, surgical skill and devotion to duty under trying conditions saved thousands of lives and preserved the fighting strength of our combat forces ! The soldier with an infection of his wounded leg, or with an open chest wound, or a mutilated face, or an injured brain, was certain to receive, after a short interval, the care of an orthopedic, plastic or neuro surgeon – until he could reach his specialist, the G.I. received the type of care which would get him to that specialist in the best possible condition . Army nurses also gave widely varying types of skilled and sympathetic (=angels) service, some in field hospitals and others in general hospitals farther back . WW2 was also the first war in which nurses automatically held officer rank ! (May 1945 17,314 nurses in ETO) .

Prior to D-Day, June 1944 ETO medical personnel totaled 132, 705, of whom 62,000 were with combat forces and the rest with the Services of Supply (S.O.S.) – by March 1945 the number had increased to 245,387 men . During WW2 the Medical Department’s field forces totaled 13,174 casualties, of which 2,274 were killed . Overall battle casualties in the ETO were as follows: 554,031 men & women (up to V-E Day) . This can be subdivided into KIA = 98,812, WIA = 373,018, MIA = 42,278, POW = 24,783, died of wounds = 15,140 . The percentage among arms and services was split into Infantry = 75.02%, Air Forces = 9.36%, Artillery = 5.40%, Corps of Engineers = 3.03%, Medical Department = 2.47%, Armored Forces = 1.01%, and others = 3.71% . Also, deaths from disease in WW1 were more than 31 times greater than those suffered in WW2, while lost service due to venereal disease (V.D.) was 30 times higher in WW1 than during WW2 … (although WW2 still numbered 606 men who came down with VD each day) .

http://home.att.net/~steinert/wwii_m...department.htm
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Found this site so if any interested go ahead..it includes for instance the Spanish civil war

Secondary Wars and Atrocities of the Twentieth Century

http://users.erols.com/mwhite28/warstat3.htm

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In 1943 concern still existed that the Germans might have prepared extensively for bacteriological warfare; had they, for example, already inoculated their troops against any specific virus?

In August 1943 George Merck, director of the War Research Service (the controlling body for bacteriological warfare in the United States) had proposed to the British experts at Porton that RAMC medics and American medical officers collaborate in sampling the blood of German prisoners of war.

Dr Paul Fildes, the head of the Biology Section, Experimental Station, Porton, near Salisbury, who was almost entirely responsible for the work, replied on September 8 that he thought nothing useful would come of such an investigation.


On May 21, 1944 Churchill wrote to Ismay reminding him that great progress had been made in bacteriological warfare, and Britain had ordered half a million bombs from American for use should this mode of warfare be employed by the Germans.
'I think we should be in a position to make and fill these bombs here,' he suggested, but was concerned that putting this before the chiefs of staff would widen the circle of those in the know.

On April 21, 1944 Fildes submitted a report on the operational tests with the four-pound 'N' bomb. These trials had produced in part catastrophic results - 'Even in our operations with N,' he would report some months later, 'we did not succeed in keeping our agents within bounds and have created conditions which will require consideration after the war.'
The bomb would be scattered in clusters over a two hundred yard square patch releasing their toxin as an odourless aerosol cloud which would cause death by inhalation of half the human beings up to a mile downwind from it, or up to two miles if they were running (the risk increasing with exertion).

Taking the city of Stuttgart as an example, the scientist assessed that a BW raid would need nearly two thousand clustered projectiles (each one being a five hundred pound container of the four-pound anthrax bombs); these could be carried by 83 Stirlings, 142 Lancasters, or 166 American B-17s and B-24s, and ideally be released simultaneously at the end of a conventional HE attack.
'An operation of this short,' promised Fildes, 'should kill a considerable number of people, either rapidly by inhalation or ore slowly by skin infection.'

In June 1944, the War Cabinet appointed an inter-Service sub-committee on Biological Warfare. They learned that no definite order had yet been placed in the United States for the manufacture of 'N' bombs; further trials were still being conducted on these frightful weapons. Churchill had however authorised top priority for all counter-measures to BW, and possible collaboration with SOE on BW operations.

Fildes now (July 21) reported again on BW. On August 14, he re-evaluated the half-million bomb order, and decided that the saturation figures needed revising.
At that time (January 6, 1944) they had believed that ten clusters would saturate one square mile, and that the six cities selected - Aachen, Wilhelmshaven, Stuttgart, Frankfurt, Hamburg and Berlin - would have 538 square miles of built up territories. This would require 570,280 anthrax bombs.



http://www.fpp.co.uk/bookchapters/WSC/Bwar1.html

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I live on an old army base from WWII called Camp Swift and there are still alot of items left over from the 1940's. In a creek near my house are alot of blood transfusion kits. They put a small rubber hose and two HUGE needles inside a sealed tin can. These cans are rusting now so the needles are out in the open. Anyway if you are as big a coward as I am when it comes to needles, they could have shot my Mother and I would have not donated any blood due to the large size of the needles they used.

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I need a bailout of only $500,000

Whoh, really? Heck, if you can get ahold of any thrown-away WWII medical stuff, lemme know! That's one of my main interests!

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Living History at http://oldreliable9_47.tripod.com

I will take a look this week end and see what is left. Most of the cans are rusted out, so all that is left is the rubber hose and the big needles. You can look through the end and see day light with no problem ! That is how big these things were.

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I need a bailout of only $500,000

On "Truth" serums:

A sure-fire truth drug has been high on the wish list of U.S. intelligence agencies at least since 1942, when scientists working for the Office of Strategic Services (OSS), the CIA’s wartime predecessor, were asked to develop a chemical substance that could break down the psychological defenses of enemy spies and POWs, thereby making it easier to obtain information from them.

After testing several compounds, the OSS scientists selected a potent extract of marijuana as the best available "truth serum." The cannabis concoction was given the code name TD, meaning Truth Drug. When injected into food or tobacco cigarettes, TD helped loosen the reserve of recalcitrant interrogation subjects.

In 1947, the U.S. Navy launched Project Chatter, which included experiments with mescaline, a hallucinogenic drug derived from the peyote cactus (with effects similar to LSD). Mescaline was studied as a possible speech-inducing agent after the Navy learned that Nazi doctors at the Dachau concentration camp had used it in mind-control experiments. The Nazis concluded that it was “impossible to impose one’s will on another person, even when the strongest dose of mescaline had been given.”

http://www.commondreams.org/views02/0604-06.htm

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The classic "truth serum" is sodium pentothal, which is basically an anesthetic.

http://www.strategypage.com/dls/articles/20020429.asp

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Barbiturates such as scopolamine, sodium amytal, and sodium pentothal were first touted as truth serums in the early 20th century. Because they inhibit control of the central nervous system, truth serums were supposed to induce a hypnotic "twilight" state that elicited a mechanical recitation of truth. In reality, though, the only good truth serums are found in bad science fiction.

http://slate.msn.com/id/2057471/

http://www.a1b2c3.com/drugs/lsd09.htm

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Well. I think you all know about the Japanese using bombs with thousands of fleas infected with plague. They used them at China with devastating effects and in their balloon bombs sent to the USA...

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"War is less costly than servitude, the choice is always between Verdun and Dachau." - Jean Dutourd, French veteran of both world wars

"A mon fils: depuis que tes yeux sont fermes les miens n’ont cessé de pleurir." - Mère française, Verdun

Trench foot

If you thought this was "not a big deal"...

Check this picture if you dare...

www.spartacus.schoolnet.co.uk/FWWfoot.jpg

Trench foot was one of the most widespread and debilitating that affected men from both sides of the lines, it is linked with WW1 hence the name "Trench foot". The disease's origin isn't in WW1 but was first noted in Napoleons army in 1812. It was on the retreat from Russia that it became prevalent, and was first described by Larrey. He observed that this condition didn't occur during the freezing cold of the campaign but when the temperature was near to zero degrees with the presence of moisture. Here lies the clue. During the First war men were exposed to Cold but not freezing conditions often up to their ankles in water that was permanently in the bottom of the trenches. The feet would swell, appear red and blood blistered, the pain would be severe, until the sensory nerves had been damaged and would then be numb causing the man to be evacuated hopefully. The treatment would be basically to elevate the limb, some modest warmth and wait. After a few weeks the limb would return to normal in most cases, but some severe ones that became gangrenous could result in amputation, with all the complications that went with that, some of those that did recover would have nerve damage. . As for the battalion pride in having low trench foot rates, some cases could be prevented with care. Some situations made trench foot more likely, such as poor fitting boots restriciting the circulation, immobility, amount of water and temperature of water in the base of the trench. Some of the preventative measures used were the issuing of gumboots where possible, but keeping feet dry was impossible. I have read accounts of men being forced to apply whale grease to the feet i presume to impart some waterproofness to them. Either way I believe some cases were practically unavoidable, and must have been the devil itself if you got it. The army went to great lengths to find out how to prevent it, employing hygienists, doctors all sorts and the general conclusion was military discipline and good hygiene. That meant where possible boots off and foot inspections carried out, greasing, and charging men who appeared to be neglecting these instructions, remember that there would be individuals who would deliberately contract this illness to get out of the line. Nowadays this illness is still known as trench foot or immersion foot, on the Falklands campaign it amounted to 14% of casualties.

http://ourworld.compuserve.com/homep...let1/tfoot.htm

Controlling the negative effect of winter on front line forces was a critical aspect of combat management. The phenomenon of "trench foot" was one of the important considerations. Bradley had wrestled with the basic problem of replacing battle casualties and was discussing it with Eisenhower when they received the first reports of the German Ardennes offensive. As Bradley wrote later, "Within five short weeks, the winter attack had cost us 64,000 casualties . . . And, as if this were not already a strain, on the bankrupt replacement system, trench foot added almost 12,000 more. Though listed as non-battle loss, trench foot exacted its heaviest toll among the riflemen on the line . . .because the malady caught us unaware partially as a result of our own neglect. By the time we disciplined troops to the care and treatment of wet feet, the infirmity had fallen upon us with the suddenness of a plague." Bradley accepted responsibility for having held up shipment of winter clothing in favor of ammunition and gasoline in support for the race eastward.

http://www.wood.army.mil/2-10IN/Hist...0Bulge%20I.htm

Something interesting from the same site:

Bill observed that by the time the 10th had received its winter clothing, while still in the Saar area, his people had become so ensured to the less warm attire that for some the Army's winter boots seemed too warm. He wasn't aware of this until a doctor came to report something "strange" -- he was treating men in U.S. uniforms that were wearing German boots. When Bill checked into it, he found that the men were taking boots from German soldiers because their own were "too hot."285 Meanwhile, Germans were seizing American boots when the opportunity presented itself.

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Nursing and medicine in WW2

Pics and stories

For example the doctor´s view from St Nazaire- operation Chariot

BBC - WW2 People's War - Photo Gallery: Nursing and Medicine

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Very interesting thread, thanks for bringing it back

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...Or Thiopentone as we call it in the UK. It is indeed an anaesthitic induction agent, and is still in use today for patients undergoing emergency anaesthesia/surgery where getting the patient off to sleep quickly is necessary, its also a good choice for people with epilepsy, and is also used when people are allergic to more modern agents.

I believe it is part of the 'lethal injection' too. Which is just a seriously heavy duty anaesthetic with a little something to screw the heart up. I think its Thiopentone, Pancuronium, and Potassium.

Nice thread, hadn't noticed it before. I recently acquired Lifeline, a wartime Ministry of Information book about the blood transfusion service. It gives a great insight.

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Regards,
Gordon
Scotland's Prisoners
www.spanglefish.com/scotlandsprisoners
FortressScotland-http://s2.photobucket.com/albums/y20/Historian/

What about morphine? Did both Allies and Axis powers use this?

Methadone or a derivative was also used as a pain killer by Germany:

From History of Methadone

In 1939 Otto Eisleb and a colleague O Schaumann, scientists working for the large chemicals conglomerate I G Farbenindustrie at Hoechst-Am-Main, Germany, discovered an effective opioid analgesic drug which they numbered compound 8909 and called Dolantin.3 This was the discovery of pethidine. As with diamorphine (heroin) before, and buprenorphine (Temgesic) since, the early hopes of it being 'a new non-addictive analgesic' were not realised.

• Water-soluble hypnotic (sleep-inducing) substances5
• Effective drugs to slow the gastrointestinal tract to make surgery easier6
• Effective analgesics that were structurally dissimilar to morphine - in the hope that they would be non-addictive5 and escape the strict controls on opiates.

All German patents and trade names, including those for polamidon, were requisitioned by the allies as spoils of war. The I G Farbenindustrie factory was in a US occupation zone and therefore came under American management. The US Foreign Economic Management Department sent a 'Technical Industrial Intelligence Committee' team of 4 men (Kleiderer, Rice, Conquest and Williams) to investigate the war-time work at Hoechst.

Project MUSE

The fact that Germany failed to produce sufficient penicillin to meet its military requirements is one of the major enigmas of the Second World War. Although Germany lost many scientists through imprisonment and forced or voluntary emigration, those biochemists that remained should have been able to have achieved the large-scale production of penicillin. After all, they had access to Fleming's original papers, and from 1940 the work of Florey and co-workers detailing how penicillin could be purified; in addition, with effort, they should have been able to obtain cultures of Fleming's penicillin-producing mold.There seems then to have been no overriding reason why the Germans and their Axis allies could not have produced large amounts of penicillin from early on in the War. They did produce some penicillin, but never in amounts remotely close to that produced by the Allies who, from D-Day onwards, had an almost limitless supply.

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Fabulous thread, thank you again Kai!

Would this gentleman have anything to do with Merck labs or is this coincidence only?

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They simply had not discovered and had no access to a good method of mass production of PCN. Given time, I'm sure the Germans would have eventually come up with their own method, but that is the nature of scientific and technological discovery. Despite having a long and glorious tradition in chemistry, medicine and pharmaceuticals, that confers no lock on the ability to always be first.

I'm sure if I spent a little more time I could quote a better source than Wiki but here is the basic history. Penicillin - Wikipedia, the free encyclopedia

Also from About.com: http://www.invent.org/hall_of_fame/107.html

Also History of Penicillin - Alexander Fleming - John Sheehan - Andrew Moyer
And this also http://explorepahistory.com/hmarker.php?markerId=974

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"I do not have to tell you who won the war. You know, the artillery did." - Gen. George S. Patton
"In 9 months and 3 days of combat on the Continent the 949th FA Bn had fired 51,000 rounds of ammunition, approximately 2,550 tons." - Unit History