Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter
IV: Cold Injury
Historical Aspects
United States Department of Defense
Although cold injury is seen only sporadically in the population in peacetime, it can
be of paramount importance to an Army. Cold injury has played a major role in the outcome
of a number of military operations throughout history. Larrey's description of the loss of
over 250,000 soldiers of Napoleon's Army in Russia in 1812 identified cold as the major
force in the defeat of this Grand Army. In the Crimean war (1852-1856), 309,000 French
troops experienced 5,215 cases of frostbite, of which 1,178 were fatal. In just two
nights, in Sevastopol, 2,800 cases of frostbite occurred, 900 of which were fatal. In
World War I, the British incurred 115,000 trenchfoot or frostbite injuries. In one
six-week period in one hospital in Rouen, there were 1,131 casualties with frostbite. In
the Dardenelles, in the winter 1915-1916, there were 14,584 admissions for cold injury.
U.S. Army cold injury losses in World War I amounted to 2,061 admissions, which translated
to a total of 97,200 man days lost. In just two months in World War II, December 1941 and
January 1942, the German army suffered 100,000 cold injuries requiring 15,000 amputations.
That was a major factor in their defeat on the eastern front. U.S. experience in World War
II and Korea reveals that fully 10 % of the wounded casualties (90,000 in World War II and
9,000 in Korea) were cold injuries. Recent British experience in the Falklands listed
trenchfoot as the major medical problem in that conflict. Argentine amputations in the
same conflict exceeded 200. Clearly, the impact that cold injury can have on military
operations is a lesson that seems to have to be learned and relearned in each successive
conflict.
Any force that is poorly fed, poorly clothed, or in retreat is more likely to sustain
serious cold injury. Adding to the problems of command prevention of cold injuries, the
medical personnel who provide care are often unaware of the seriousness of the threat and
have little or no experience in dealing with these types of injuries.
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Operational Medicine 2001
Health Care in Military Settings
Bureau of Medicine and Surgery
Department of the Navy
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Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
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