Nursing History: The History of WWII Medicine for Schools
World War II provided the backdrop for a major expansion of medicine. War wounds and infections created the need for more effective and urgent treatments that could be administered easily on the battlefield. Researchers and medical experts responded with new drugs and practices. Sulfanilamide, penicillin, Atabrine, plasma, and morphine were among the chief wartime medical advancements.
The Discovery of Sulfanilamide
Ernest Fournou, a researcher with the Pasteur Institute, is credited with determining that sulfanilamide was one of the active chemical agents produced when a dye marketed as “Prontosil” began to degrade. At the time, no one knew for certain what the value of sulfanilamide was; however German biochemist Gerhard Johannes Paul Domagk was determined to find out. In his 1932 experiments, Domagk began to deconstruct the red dye, its ingredients, and its chemical byproducts. He found that one byproduct, namely sulfanilamide, could kill deadly strains of bacteria. For example, sulfanilamide proved effective in destroying streptococcal bacteria in lab mice.
When his own daughter came down with a strep infection, the doctor treated and cured her with sulfanilamide, proving it could work successfully on humans as well as mice. His daughter had been on the verge of death, but rapidly recovered with the sulfanilamide treatment. This was remarkable since the girl had worsened while being treated with a range of prescription medications. In 1935, Domagk concluded definitively that a group of chemicals known as sulfonamides were responsible for the cure. For this discovery, he received the Nobel Prize for medicine.
- Sulfanilamide and the Nazis: This PBS Webpage looks at the use of sulfanilamide by German doctors in concentration camps and for Nazi soldiers.
- Sulfanilamide & Prontosil: This website explores the relationship between sulfanilamide and the dye Prontosil.
The Use of Sulfanilamide in World War II
Sulfa drugs were widely used by soldiers in World War II to beat infections due to the ability of their main ingredient, sulfanilamide, to kill lethal bacteria. Sulfanilamide, a precursor to sulfonamides, was first mass distributed in 1936 and eventually became widely administered during World War II to fight not only strep infections, but also meningitis and pneumonia, which had been killing and weakening tens of thousands of soldiers. The “sulfa drugs,” as medicines containing sulfonamide and sulfanilamide were called, helped prevent many deaths. Soon, it became routine for soldiers to carry powdered sulfanilamide in their first aid kits; the powder could be easily poured on cuts and scrapes to prevent life-threatening infections. Some historians credit sulfanilamide with helping the Allied Forces claim victory World War II since it kept soldiers healthy.
- First Aid Packets: This site chronicles how five grams of sulfanilamide were packaged in leather first aid packets for portability during WWII.
- The Impact of Sulfa during WWII: This website looks at how sulfanilamide bolstered the Allied Forces to victory during the War.
The Discovery of Penicillin
Sir Alexander Fleming, a bacteriologist from Scotland, discovered penicillin, a type of antibiotic, in 1906. The discovery was accidental and would have been overlooked had the scientist not noticed mold growing in a discarded Petri dish. Fleming took the Petri dish that he had injected with staph bacteria from his sink and examined it. He noticed that staph bacteria around the mold had been killed by the mold.
After analyzing the mold he discovered it was from the class of mold known as Penicillium mold. Fleming formally presented his scientific findings to the worldwide science community in 1929, suggesting penicillin could kill strong, harmful bacteria. His research at the time, however, was greatly overlooked. Fleming continued his research on the antibacterial of penicillin, working alongside a team of British mold specialists. For his discovery, Fleming, in 1945, received a Nobel Prize, which he shared with scientists Ernst Boris Chain, of Britain, and Howard Walter Florey, of Australia. Chain and Florey were credited with purifying penicillin and acquiring a sufficient amount of the chemical to use for human research trials.
- Discovery of Penicillin: This website chronicles the discovery and basics of penicillin.
- Fleming discovers Penicillin: This PBS site shows the photo of Fleming’s nearly discarded Petri dish and discusses how Fleming discovered Penicillin due to mold in the dish.
The Use of Penicillin in World War II
Twenty-one drug companies, having learned of the abilities of penicillin to halt lethal infections, began manufacturing the antibacterial agent for use during World War II. Pfizer, the leading pharmaceutical company distributing penicillin, began mass producing it to serve soldiers on the WWII battlefields in order to protect them from wounds that could lead to infection and eventually gangrene. At least 400 million doses of penicillin were manufactured in 1943 for war use.
- Penicillin History: This University of Hawaii website traces the history of penicillin.
- World War II Medicine: This UK learning site explores not only penicillin, but all medical advancements made during World War II.
The Use of Atabrine to Fight Malaria During World War II
A dearth of quinine-based, anti-malarial drugs during World War II allowed malaria to ravage U.S. Army soldiers stationed in the South Pacific until the military turned to a synthetic drug created by a German chemist. The drug was marketed under the name "Atabrine." It proved just as effective at treating malaria as quinine but came with side effects and an unpleasant taste. Soldiers complained about bitterness of the amber-colored Atabrine tablets and many refused to take them, fearing excess dosages would produce vomiting and headaches. Some soldiers even claimed the tablets incited short-lived psychosis. Eventually, combat soldiers had to monitor the taking of Atabrine at meal time in order to force treatment and stave off additional malaria cases.
- Fighting Malaria with Atabrine: In the section titled “Malaria Lessons from World War II,” this official Army page recalls the use of Atabrine tablets to fight the disease.
- 1943 Intelligence report on Atabrine: This website has published a copy of a 1943 U.S. War Department intelligence report that discusses the use of Atabrine.
The Use of Plasma During World War II
Dr. Charles Drew’s discovery that plasma could effectively replace whole blood in blood transfusions became an important factor during World War II. Transporting plasma to the war zones was easier than transporting blood which degraded quickly and could not be preserved for longer than a few days. Plasma is a liquid constituent of blood; it contains blood platelets, white blood cells, salt, water, and proteins such as albumin. Antibodies and fibrinogen, which helps the blood to clot, are also in plasma which Drew discovered could maintain proper blood volume, proper blood pressure, and effective nourishment if used in transfusions.
When wounded soldiers stationed all over Europe needed blood to mend during World War II, the International Transfusion Association appointed Drew as lead organizer for a “Blood for Britain” program. Under Drew’s leadership, the initiative prepared and transported nearly 15,000 units of plasma to Europe over a five-month time period, saving the lives of many troops. Plasma proved successful in preventing shock from excessive blood loss. Eventually a blood and plasma bank was set up for the United States under the management of the American Red Cross.
- Charles Drew: This bio on Dr. Charles Drew looks at his efforts to process, store, and use plasma during World War II.
- Plasma vs. Whole Blood: Explains what plasma is and how it differs from whole blood.
The Use of Morphine as a Pain Killer During World War II
Morphine, an addictive pain killer derived from opium, became extensively used during World War II as a form of narcotherapy. The drug sedated soldiers who had been seriously wounded. Morphine syrettes, flexible syringe-like devices for injecting the narcotic, were developed by Squibb, a drug company, for the purpose of helping military medics administer morphine more efficiently during the war. Morphine proved to be a reliable pain killer although there was a risk of death by overdose. Medics routinely pinned used syrettes to the collar of a treated soldier to signify that morphine had already been injected, thereby reducing the risk of overdose.
- Journal Entry on Morphine: This official U.S. Navy website page displays a journal entry in which a World War II soldier mentions how morphine was standard in a first aid kit and how he took a few swallows to keep fighting after injury.
- Morphine & Post-Traumatic Stress: This Washington Post article on contemporary post-traumatic stress disorder affirms that morphine has been carried by soldiers for personal injections since World War II (and the Civil War).