Medical Research and New Methods of Treatment

Dr. Norman Bethune, assisted by Henning Sorensen, performing a transfusion during the Spanish Civil War, 1935-1938.
Photo by Geza Karpathi. National Archives of Canada, C-067451.
The massive trauma inflicted on the human body by modern artillery and other weapons of war made treatment of shock and the prevention of fatal blood loss obvious priorities for medical researchers. The absence of safe methods of storage and reliable blood-typing in the First World War limited the incidence of blood transfusions to occasions when a donor could be directly connected to the patient by glass pipes and rubber tubes (Desmond Morton, When Your Number's Up, 1993, p. 191). One of the most famous Canadian military doctors was Norman Bethune, a pioneer who worked to develop better methods of battlefield blood transfusions during the Spanish Civil War in 1936 and the Japanese invasion of China in 1938. Early procedures were makeshift by modern standards. In China, Bethune anticipated the creation of mobile medical units that would work to treat wounded soldiers as close to the front as possible, recognizing that the chances of survival improved greatly when the delay in transporting casualties to such units was reduced.

The Second World War saw a further evolution of Bethune's efforts to provide early medical treatment for wounded soldiers. Battles in the Middle East showed that Casualty Clearing Stations and Field Ambulance units were themselves insufficient to provide forward surgical services. Mobile Field Surgical Units (FSUs) were thus created, in which the surgeon "must be prepared to set up his theatre in whatever shelter he can find, and do it quickly. He must be able to disband it rapidly and move forward to another area on short notice." (MacFarlane to Canadian Army OS, 15 June 42, quoted in Bill Rawling, Death Their Enemy: Canadian Medical Practitioners and War, 2001, p. 158). New Field Transfusion Units (FTUs), meanwhile, would use refrigerated trucks to bring blood products forward to resuscitate casualties at an earlier stage of the evacuation chain.

Major P.K. Tisdale, 4th Field Ambulance, R.C.A.M.C., checking the condition of a wounded man before Sergeant W.H. Brigham and Private L.P. Lemieux donate blood before his transfer to a Field Surgical Unit. Ortona, Italy, 15 January 1944.
Photo by Alexander M. Stirton. Department of National Defence / National Archives of Canada. PA-144979.

In addition to such organizational improvements, important medical research with practical military applications was ongoing during the interwar years. One of the most promising areas of study focused on chemical treatments of illness and injury. In the mid-1930s it was discovered that sulphanilamide and other sulphonamide derivatives retard the growth of bacteria and thenceforth sulfa (or sulpha) drugs were widely used to prevent or treat infection in wounds. Sulfa could be given by mouth or used as a powder applied directly to wounded tissue. Experiments with penicillin treatment were conducted early in the war, and by the opening of the Second Front it had come to be administered more systematically, with patients receiving an initial dose at a Casualty Clearing Station or Advanced Surgical Centre with subsequent doses during evacuation and while in hospital.

While important work on blood products like plasma and serum was undertaken at various Canadian universities and the National Research Council, other Canadian projects focused on the particular needs of the air force. With the country's only decompression chamber, scientists at the University of Toronto studied the effects of high-altitude flight on aircrew. Meanwhile, research into the effects of gravity-or G forces-sought to resolve problems of impaired blood circulation resulting from centrifugal force which caused fighter pilots to experience blackouts, loss of vision, and unconsciousness during high-speed manoeuvres such as pulling out of a dive. One of the key figures was Wilbur Franks, who worked under Dr Frederick Banting at the University of Toronto in developing the Franks flying suit. The suit was lined with fluid to counteract the displacement of blood by G forces, and was used operationally in the Royal Navy's Fleet Air Arm although it was not accepted by the air force. Medical research was therefore able-somewhat paradoxically-to improve methods of treating the wounded even as it devised more efficient means for military personnel to do their jobs, perhaps inflicting death on others in the process.
Wilbur Franks' G suit, version D, 18 February 1941.
Department of National Defence / National Archives of Canada, PA-063866.