The Italian mobile surgical units in the Great War: the modernity of the past
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HISTORICAL ARTICLE
The Italian mobile surgical units in the Great War: the modernity of the past Contardo Vergani1,2 · Marco Venturi2 Received: 11 June 2020 / Accepted: 25 August 2020 / Published online: 2 September 2020 © The Author(s) 2020
Abstract Medical services in WWI had to face enormous new problems: masses of wounded, most with devastating wounds from artillery splinters, often involving body cavities, and always contaminated. Tetanus, gas gangrene, wound infections were common and often fatal. Abdominal wounds were especially a problem: upon entering the war the commanders of all medical services ordered to avoid surgery, based on dismal experiences of previous wars. Surgical community divided into non-operative and operative treatment supporters. The problem seemed mainly organizational, as the wounded were rescued after many hours and treated by non-specialist doctors, in inadequate frontline settings or evacuated back with further delay of treatment. During initial neutrality, Italian Academics closely followed the debate, with different positions. Many courses and publications on war surgery flourished. Among the interventionists, Baldo Rossi, to provide a setting adequate to major operations close to the frontline, with trained surgeons and adequate instruments, realized for the Milano Red Cross three fully equipped, mobile surgical hospitals mounted on trucks, with an operating cabin-tent, with warming, illumination and sterilizing devices, post-operative tents and a radiological unit. Chiefs of the army approved the project and implemented seven similar units, called army surgical ambulances, each run by a distinguished surgeon. Epic history and challenges of the mobile units at the frontline, brilliant results achieved on war wounds and epidemics are described. After the war they were considered among the most significant novelties of military medical services. Parallels with present scenarios in war and peace are outlined. Keywords World War I · Mobile health units · Ambulances · Wound and injuries · Disease outbreaks · Surgery
The new war The outbreak of World War I, in August 1914, found all Armies unprepared. Army medical services were still oriented to past trends: military doctors had a general medical training, and the organization, following a hasty dressing in the field, aimed mainly at rapidly evacuating the wounded. Soon the conflict turned into a horrific war of position. Thousands of men holed up in the trenches awaiting to go “over the top” to attempt breaking through enemy lines, despite barbed wire fences and machine-gun fire. Every * Contardo Vergani [email protected] 1
Dipartimento di Fisiopatologia Medico‑Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
Day Surgery Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Pad. Zonda, 20122 Milan, Italy
2
attack turned into carnage. The wounded in No Man’s Land were rescued at nightfall, several hours after injury. The Sezioni di Sanità (comparable
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