The term military medicine has a number of potential connotations. It may mean:
A medical specialty, specifically a branch of
occupational medicine attending to the medical risks and needs (both preventive and interventional) of soldiers, sailors and other service members. This disparate arena has historically involved the prevention and treatment of
infectious diseases (especially
tropical diseases), and, in the
20th century, the ergonomics and health effects of operating military-specific machines and equipment such as
submarines,
tanks,
helicopters and
airplanes.
Undersea and
aviation medicine can be understood as subspecialties of military medicine, or in any case originated as such. Few countries certify or recognize "military medicine" as a formal speciality or subspeciality in its own right.
The planning and practice of the surgical management of mass battlefield casualties and the logistical and administrative considerations of establishing and operating
combat support hospitals. This involves military medical hierarchies, especially the organization of structured medical command and administrative systems that interact with and support deployed
combat units. (See
Battlefield medicine.)
The administration and practice of health care for military service members and their dependents in non-deployed (peacetime) settings. This may (as in the
United States) consist of a medical system paralleling all the medical specialties and sub-specialties that exist in the civilian sector. (See also
Veterans Health Administration which serves U.S. veterans.)
Medical
research and development specifically bearing upon problems of military medical interest. Historically, this encompasses all of the medical advances emerging from medical research efforts directed at addressing the problems encountered by deployed military forces (e.g., vaccines or drugs for soldiers,
medical evacuation systems, drinking water
chlorination, etc.) many of which ultimately prove important beyond the purely military considerations that inspired them.
Legal status
Military medical personnel engage in
humanitarian work and are "
protected persons" under
international humanitarian law in accordance with the
First and
Second Geneva Conventions and their Additional Protocols, which established legally binding rules guaranteeing neutrality and protection for wounded soldiers, field or ship's medical personnel, and specific
humanitarian institutions in an
armed conflict. International humanitarian law makes no distinction between medical personnel who are members of the
armed forces (and who hold military ranks) and those who are civilian volunteers. All medical personnel are considered
non-combatants under international humanitarian law because of their humanitarian duties, and they may not be attacked and not be taken as
prisoners of war; hospitals and other medical facilities and transports identified as such, whether they are military or civilian, may not be attacked either. The
red cross, the red crescent and the red crystal are the
protective signs recognised under international humanitarian law, and are used by military medical personnel and facilities for this purpose. Attacking military medical personnel, patients in their care, or medical facilities or transports legitimately marked as such is a
war crime. Likewise, misusing these protective signs to mask military operations is the war crime of
perfidy. Military medical personnel may be armed, usually with
service pistols, for the purpose of
self defense or the defense of patients.
Historical significance
The significance of military medicine for combat strength goes far beyond treatment of battlefield injuries; in every major war fought until the late
19th century disease claimed more soldier casualties than did enemy action. During the
American Civil War (1860–65), for example, about twice as many soldiers died of disease as were killed or mortally wounded in combat.[1] The
Franco-Prussian War (1870–71) is considered to have been the first conflict in which combat injury exceeded disease, at least in the German coalition army which lost 3.47% of its average headcount to combat and only 1.82% to disease.[2] In new world countries, such as Australia, New Zealand, the United States and Canada, military physicians and surgeons contributed significantly to the development of civilian health care.[3][4]
Improvements in military medicine have increased the survival rates in successive wars, due to improvements in
medical evacuation,
battlefield medicine and
trauma care.[4][5] Similar improvements have been seen in the trauma practices during the Iraq war.[6] Some military trauma care practices are disseminated by citizen soldiers who return to civilian practice.[4][7][8] One such practice is where major trauma patients are transferred to an operating theater as soon as possible, to stop
internal bleeding, increasing the survival rate. Within the United States, the survival rate for gunshot wounds has increased, leading to apparent declines in the gun death rate in states that have stable rates of gunshot hospitalizations.[9][10][11][12]
Bowlby, Sir Anthony and Colonel Cuthbert Wallace. “The Development of British Surgery at the Front.” The British Medical Journal 1 (1917): 705–721.
Churchill, Edward D. “Healing by First Intention and with Suppuration: Studies in the History of Wound Healing.” Journal of the History of Medicine and Allied Sciences 19 (1964): 193–214.
Churchill, Edward D. “The Surgical Management of the wounded at the time of the Fall of Rome.” Annals of Surgery 120 (1944): 268–283.
Cowdrey, Albert E. Fighting for Life: American Military Medicine in World War II (1994), scholarly history, 400 pp
Cowdrey, Albert E. United States Army in the Korean War: The Medics War (1987), full-scale scholarly official history;
online free
Fauntleroy, A.M. “The Surgical Lessons of the European War.” Annals of Surgery 64 (1916): 136–150.
Grissinger, Jay W. “The Development of Military Medicine.” Bulletin of the New York Academy of Medicine 3 (1927): 301–356.
online
Harrison, Mark. Medicine and victory: British military medicine in the Second World War (Oxford UP, 2004).
Whayne, Col. Tom F. and Colonel Joseph H. McNinch. “Fifty Years of Medical Progress: Medicine as a Social Instrument: Military Medicine.” The New England Journal of Medicine 244 (1951): 591–601.
Wintermute, Bobby A. Public health and the US military: a history of the Army Medical Department, 1818-1917 (2010).
Primary sources
Kendrick, Douglas B. Memoirs of a Twentieth-Century Army Surgeon (Sunflower University Press, 19920, U.S. Army