Calling California “home” has definite advantages, some of which become increasingly apparent as we move into summer (plenty warm, but low humidity…). On the other hand, one of the big disadvantages of left coast living is the physical impossibility of dropping in to the Archives for an afternoon of ad hoc research on a hot topic. One is left, then, with on-line sourcing, and this is particularly fraught in an area of interest so specialized as the history of maritime medicine.
Last week we observed the 70th anniversary of the stunning American naval victory over a larger Japanese fleet at the Battle of Midway. It occurred to me that it might be informative to look back at combat casualty care aboard ship in that battle early in the Pacific campaign. I hoped against hope that I might find a Medical Annex to Nimitz’s Battle of Midway Action Report on-line. In that, I was disappointed; but a report from the Commanding Officer of USS Yorktown, containing a medical paragraph, is available, thanks to the Naval History and Heritage Command.
Flash burn: a lesion caused by exposure to an extremely intense source of radiant energy or heat. Flash burn commonly occurs on the corneas of arc welders.
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
A truism that bears perpetual repetition is that we often must re-learn the lessons of previous wars early in a new one. One of the lessons re-learned early in World War II was the importance of wearing garments to protect against flash burns resulting from exposure to exploding ordnance. We discover that in the early part of the war in the Pacific, flash burn was common. For victims of bombing during the Japanese attack on Pearl Harbor, the “lack of clothing was responsible for … a large number of flash burns” according to a sanitary report from USS Helena (CL-50) (1). Albert E Cowdery, in his book about military medicine in World War II, comments that at the Battle of Coral Sea 5 months later, “[a]s usual in the early days of the war, two-thirds of the patients were burned more or less severely, for men had not yet learned the value of going into combat fully clothed against the flash of exploding ordnance.”(2)
By Midway a month later in June, however, the lesson had apparently sunk in. The Commanding Officer of USS Yorktown (CV-5) makes specific note that medical personnel prepared for the upcoming Japanese air attack by lying down, pulling the hoods of their flash proof clothing over their heads and covering their faces with their arms. Further, only one patient with serious burns was among the 55 rescued from Yorktown who required hospitalization; this suggests that the rest of the crew had taken similar care to wear flash proof clothing.(3)
I find it interesting that the Manuals of Standard Practice promulgated for use by military physicians (and endorsed by the Surgeons General of both the Army and Navy) by the National Research Council in 1942(4) made no mention whatever of flash burn, nor did Trueta’s contemporaneous “Principles and Practice of War Surgery”.(5) The Navy’s medical history of World War II makes no mention whatever of casualties at Midway, say nothing about flash burn prevention.(6) Even the most modern combat surgery textbook, “War Surgery in Afghanistan and Iraq – A Series of Cases, 2003-2007″(7) fails to mention this potential source of mass casualties in a combat situation. How can we learn from the past if the topic isn’t even mentioned in contemporaneous manuals?
Next Week: On the challenges of casualty care aboard ships in combat.(1) “Pearl Harbor Navy Medical Activities”, page on website of Naval History and Heritage Command, accessed 7 June 2012, http://www.history.navy.mil/faqs/faq66-5.htm (2) Cowdrey, Albert E., “Fighting for Life – American Military Medicine in World War II”, (New York, The Free Press [Macmillan], 1994) (electronic version) p 72 of 497. (3) Battle of Midway: 4-7 June 1942, Online Action Reports: Commanding Officer, USS Yorktown, of 18 June 1942, from Naval History and Heritage Command (Naval Historical Center) Selected Naval Documents, http://www.history.navy.mil/docs/wwii/mid7.htm, accessed 7 June 2012. (4) National Research Council “Military Surgical Manuals”, Philadelphia, W. B. Saunders Company, 1942. I consulted reprints, issued in 1943, of Manual I “Manual of Standard Practice of Plastic and Maxillofacial Surgery”, Manual II,”Ophthalmology and Otolaryngology” and Manual V, “Burns, Shock, Wound healing, and Vascular Injuries”. (5) Trueta, M.D. K., “The Principles and Practice of War Surgery With Reference to the Biological Method of the Treatment of War Wounds and Fractures”, St. Louis, The C. V. Mosby Company, 1943. (6) “The History of the Medical Department of the United States Navy in World War II – A Narrative and Pictorial Volume Navmed P-5031 Volume 1”, Washington, Government Printing Office, 1953, p. 66. (7) Nessen, DO, Shawn Christian, Dave Edmond Lounsbury, MD, and Stephen P Hetz, MD, Editors, “War Surgery in Afghanistan and Iraq – A Series of Cases, 2003-2007”, Washington, Office of the Surgeon General, United States Army, and Borden Institute, 2008. ©2012 Thomas L Snyder