The Medical Response to the Trench Diseases in World War One

Book excerpt: This book focuses on the trench diseases—trench fever, trench nephritis and trench foot—and examines how doctors responded to them in the context of the Great War. It details the problems that they faced in tackling these conditions, “new” to military warfare. After an introduction to the subject, the second chapter sketches the socio-economic and scientific context within which the response was mounted. The development of bacteriology, sanitation and medical research in the British Army is examined, as is the structure and role of the wartime RAMC, the main body involved in the response to the trench diseases. Divisions between medical practitioners concerning the aetiology of epidemic disease are also described. The third and fourth chapters present a detailed inquiry into how the diseases were defined, and how these definitions were used to counteract them. The effectiveness of the medical response is evaluated in the conclusion, which also examines the impact that the response to the trench diseases had on military-medical progress and medical specialisation. An analysis of the medical response to the trench diseases reveals a conflict between clinicians holding views on disease causation along a spectrum—contagionists, contingent-contagionists and con-figurationists. Faced with their inability to treat the trench diseases effectively, the book argues that the extremely diverse initial interpretation of the trench diseases was replaced by a majority view that all three were a product of the trenches. This enabled an effective response to be mounted, using public health methods, reinforced by discipline, close surveillance, administrative organisation, and cooperation between military and medical branches, as well as within the Army Medical Service.