- National Museum of Health and Medicine, Research and Development Activity, Defense Health Agency
2460 Linden La.
Silver Spring, MD 20910 - 301/319-3361
Alan J Hawk
National Museum of Health and Medicine, Historical Collections, Department Member
- Military Sociology, Aviation History, Military Aviation, History of Military Medicine, Transportation, Second World War, and 24 moreFirst World War, American Revolution, Vietnam War, Korean War, Wound care, Advanced Wound Care Modalities, Global War on Terror, Crimean War, Imperial Japanese Army, History, Conflict, Security, War Studies, History of Museums, History of Medicine and the Body, Military Science, Sociology of the Military, History of Military Technology, Aviation History (Transport History), Aviation Military History, Viet Cong, Armed Conflict, Army Medical Museum, and Military Historyedit
- Alan Hawk has been Collections Manager of the Historical Collections of the National Museum of Health and Medicine si... moreAlan Hawk has been Collections Manager of the Historical Collections of the National Museum of Health and Medicine since 1987. He is responsible for care and development of a 15,000 artifact collection documenting the history of medical technology, with an emphasis on military medicine. In 2017, he retired from the U.S. Navy Reserve as a Senior Chief Petty Officer, with a 30 year career that included one deployment to Afghanistan in 2009 as well as previous service in the 1/115TH Infantry in the Maryland Army National Guard. Prior to his present position, he served as Assistant Historic Preservation Planner for the City of Wilmington, Delaware and as a Historical Consultant for the Methodist Action Program. He also assisted in the computerization project of the National Register of Historic Places for the National Park Service. He received his bachelor's degree in History from the University of Delaware in 1983. He is married and has two adult children.edit
physician in the US Army Medical Corps, had a simple mission: lead the medical section of the U.S. Army Engineer Battalion in Nicaragua, created in response to a congressional mandate for a survey of a proposed Transocean canal. The canal... more
physician in the US Army Medical Corps, had a simple mission: lead the medical section of the U.S. Army Engineer Battalion in Nicaragua, created in response to a congressional mandate for a survey of a proposed Transocean canal. The canal was a proposed companion for the recently completed Panama Canal. Just before 10:30 am, Maj. Hawley's mission suddenly changed. A powerful earthquake had just destroyed Managua, the capital and largest city of Nicaragua, in less than 6 seconds, and in the process killed approximately 1000 people. Virtually every building in Managua was leveled to the ground and the city's municipal water and sewage systems were also destroyed. After receiving a cable from Washington DC, Lt. Col. Daniel Sultan (1885-1947), Battalion Commander, organized a relief train with supplies en route to Managua [1]. The train's supplies were desperately needed. Major fires burning in the city would ultimately last into the next day. All the hospitals in the city had collapsed and any medical equipment buried in the ruins needed to be recovered as soon as possible. On board the relief train, Maj. Hawley had nothing to deal with a disaster on the scale he faced upon his arrival in Managua. As a Battalion Linden Lane,
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During the first half of the 20th century, surgeons generally treated fractures with external splints, plaster casts, or by painstakingly assembling the bone fragments at surgery, and holding them together with screws, plates, or... more
During the first half of the 20th century, surgeons generally treated fractures with external splints, plaster casts, or by painstakingly assembling the bone fragments at surgery, and holding them together with screws, plates, or wires.
But at the Surgical Congress in Berlin, Germany in 1940, German surgeon Gerhard Küntscher (1900-1972) proposed inserting a stainless steel, hollow rod into the intramedullary cavity to stabilize the damaged limb (Fig. (Fig.1),1), an approach he based on his preliminary results while experimenting with animals [1, 5, 6].
The attendees of the congress soundly dismissed and ridiculed Küntscher and his surgical concept [1, 4, 6], suggesting he stood as an outsider among the German surgeons inside the Nazi regime [7].
While his German colleagues rejected the technique, one surgeon attending the conference, Lorenz Böhler (1885-1973) managed to smuggle an example of the nail back into his native Vienna [1, 4, 6], a dangerous endeavor considering the heavy restrictions Germany placed on information flow in times of war [4]. Böhler performed the technique in Vienna, where it eventually was accepted; it later spread throughout Nazi-annexed and neutral Europe [2].
But at the Surgical Congress in Berlin, Germany in 1940, German surgeon Gerhard Küntscher (1900-1972) proposed inserting a stainless steel, hollow rod into the intramedullary cavity to stabilize the damaged limb (Fig. (Fig.1),1), an approach he based on his preliminary results while experimenting with animals [1, 5, 6].
The attendees of the congress soundly dismissed and ridiculed Küntscher and his surgical concept [1, 4, 6], suggesting he stood as an outsider among the German surgeons inside the Nazi regime [7].
While his German colleagues rejected the technique, one surgeon attending the conference, Lorenz Böhler (1885-1973) managed to smuggle an example of the nail back into his native Vienna [1, 4, 6], a dangerous endeavor considering the heavy restrictions Germany placed on information flow in times of war [4]. Böhler performed the technique in Vienna, where it eventually was accepted; it later spread throughout Nazi-annexed and neutral Europe [2].
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While on a trip to Europe in 1890, Major John Shaw Billings (1838-1913), Curator of the Army Medical Museum, made a peculiar purchase from noted French anatomist and model maker Jules Talrich (1826-1904): a collection of 20 plaster casts... more
While on a trip to Europe in 1890, Major John Shaw Billings (1838-1913), Curator of the Army Medical Museum, made a peculiar purchase from noted French anatomist and model maker Jules Talrich (1826-1904): a collection of 20 plaster casts of female pelvises “showing either narrowing or flattening, rachitic or non-rachitic, symmetrical or non-symmetrical; mostly scoliotic” [6].
His purchase was strange because none of the characteristics represented by this collection were under the purview of a military surgeon. Scoliosis and rickets would be disqualifying conditions for any man interested in the Army, and women could not serve. Despite having the commonality of scoliosis, these models depicted the pelvis, the hip portion of the femur, and only the bottom two or three lumbar vertebrae—not more of the curved spine as one might expect
His purchase was strange because none of the characteristics represented by this collection were under the purview of a military surgeon. Scoliosis and rickets would be disqualifying conditions for any man interested in the Army, and women could not serve. Despite having the commonality of scoliosis, these models depicted the pelvis, the hip portion of the femur, and only the bottom two or three lumbar vertebrae—not more of the curved spine as one might expect
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Two American inmates of a Japanese POW Camp in Burma created a prosthesis for fellow POW Cpl. Bert Jones in 1942. Cpl. Jones’ leg was amputated after developing a tropical ulcer due to the unsanitary conditions in the camp. The two POWs... more
Two American inmates of a Japanese POW Camp in Burma created a prosthesis for fellow POW Cpl. Bert Jones in 1942. Cpl. Jones’ leg was amputated after developing
a tropical ulcer due to the unsanitary conditions in the camp. The two POWs fashioned the leg of the prosthesis from the remains of a leather belt and metal folding chair
using only a pocketknife. The leg was constructed in secret for fear that the Japanese Guards would discover and confiscate their tools and equipment before completion.
a tropical ulcer due to the unsanitary conditions in the camp. The two POWs fashioned the leg of the prosthesis from the remains of a leather belt and metal folding chair
using only a pocketknife. The leg was constructed in secret for fear that the Japanese Guards would discover and confiscate their tools and equipment before completion.
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Robert Liston (1794-1847) held a (well-earned) reputation as the fastest surgeon of his time. One contemporary recalled of Liston: “It is told that when he amputated, the gleam of his knife was followed so instantaneously by the sound of... more
Robert Liston (1794-1847) held a (well-earned) reputation as the fastest surgeon of his time. One contemporary recalled of Liston: “It is told that when he amputated, the gleam of his knife was followed so instantaneously by the sound of the bone being sawn as to make the two actions appear almost simultaneous” [7]. Before each of his procedures, he told the observing medical students, “Now gentlemen, time me” [6]. In at least one instance, the amputation took less than 30 seconds.
He is better known, perhaps apocryphally, for accidently amputating a patient’s testicle in addition to his leg [1]. Another time, he allegedly performed a procedure with 300% mortality. Let me explain: A spectator dropped dead at the shock of being slashed with the surgical knife, an assistant succumbed to infection after part of his hand had been cut off as well, and of course, the patient who developed postoperative gangrene [3].
In short, he was remembered as the stereotypical cocky early 19th century surgeon who would not be above proclaiming a procedure a success despite leaving the patient dead on the table. However, Liston’s approach to amputation, and more importantly, to pain management, had a positive motive. His need for speed derived from empathy for his patients rather than from his ego.
He is better known, perhaps apocryphally, for accidently amputating a patient’s testicle in addition to his leg [1]. Another time, he allegedly performed a procedure with 300% mortality. Let me explain: A spectator dropped dead at the shock of being slashed with the surgical knife, an assistant succumbed to infection after part of his hand had been cut off as well, and of course, the patient who developed postoperative gangrene [3].
In short, he was remembered as the stereotypical cocky early 19th century surgeon who would not be above proclaiming a procedure a success despite leaving the patient dead on the table. However, Liston’s approach to amputation, and more importantly, to pain management, had a positive motive. His need for speed derived from empathy for his patients rather than from his ego.
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At the beginning of WWII, physicians had no means of determining the quality of nerve conduction for a soldier sustaining a gunshot wound to the upper or lower extremity. Part of the decision of whether to try to salvage the limb depended... more
At the beginning of WWII, physicians had no means of determining the quality of nerve conduction for a soldier sustaining a gunshot wound to the upper or lower extremity. Part of the decision of whether to try to salvage the limb depended on whether any large nerves were degenerating, had degenerated, or were regenerating. At that time, the only way a surgeon could determine whether a nerve had been severed was by using a galvanic-faradic nerve stimulator to see whether the muscle twitched. Something more-precise was needed.
The Committee on Medical Research of the Office of Scientific Research and Development contracted researchers at Northwestern University to develop a better understanding of muscle and nerve damage resulting from trauma. One of the neurologists at Northwestern, LTJG James G. Golseth MD, USN-MC at Percy Jones General Hospital in Battle Creek, MI, USA, collaborated with engineer James A. Fizzell BS to develop a constant current impulse stimulator to measure the current flowing through a nerve, called an electromyograph (EMG) [7].
The Committee on Medical Research of the Office of Scientific Research and Development contracted researchers at Northwestern University to develop a better understanding of muscle and nerve damage resulting from trauma. One of the neurologists at Northwestern, LTJG James G. Golseth MD, USN-MC at Percy Jones General Hospital in Battle Creek, MI, USA, collaborated with engineer James A. Fizzell BS to develop a constant current impulse stimulator to measure the current flowing through a nerve, called an electromyograph (EMG) [7].
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Benjamin Tredwell Jr. (1735-1830) possessed a set of amputation knives (Fig. (Fig.1)1) that resembled tools rather than surgical instruments. The sickle-shaped blades, with the cutting edge on the concave or inside of the curve [3], have... more
Benjamin Tredwell Jr. (1735-1830) possessed a set of amputation knives (Fig. (Fig.1)1) that resembled tools rather than surgical instruments. The sickle-shaped blades, with the cutting edge on the concave or inside of the curve [3], have an unpolished surface due to being sharpened many times with a grinding wheel. The smaller knife was likely designed to amputate a finger, a larger knife made to amputate an arm or leg, and the largest such knife was used to amputate from the thigh. Amputations of the period were performed using a circular stroke, rather than creating flaps for the residual limb. An assistant pulled up the skin proximally while the surgeon cut through the dermis and subcutaneous tissue.
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BACKGROUND: Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to... more
BACKGROUND: Just over 200 years ago, surgeons were puzzled that the use of the tourniquet to control hemorrhage as common sense during surgery was a relatively recent development. Within the last 20 years, much progress has been made to controlling hemorrhage in the prehospital context. Then, as now, it was surprising that progress on something that appeared obvious had occurred only recently , begging the question how controlling blood loss was common sense in a surgical context, but not for emergency treatment. METHODS: This article is a historical survey of the evolution of the medical understanding of hemorrhage along with technological response. RESULTS: The danger of blood loss had historically been consistently underestimated as physicians looked at other explanations for symptoms of how the human body responded to trauma. As the danger from hemorrhage became apparent, even obvious, responsibility for hemorrhage control was delegated down from the surgeon to the paramedic and eventually to individual service members and civilian bystanders with training to " stop the bleed. " CONCLUSION: Hippocratic medicine assumed that blood diffused centrifugally into periphery through arteries. William Harvey's observation in 1615 that blood ran through a closed circulatory system gradually transformed conventional wisdom about blood loss, leading to the development of the tourniquet about a century later by Jean-Louis Petit, which made amputation of limbs survivable. However , physicians were cautious about their application during the First World War over concerns over effects on patient recovery. Hemorrhage had generally been seen as symptom to be managed until the patient would be seen by a surgeon who would stop the bleeding. More thorough collection and analysis of data related to case histories of soldiers wounded during the Vietnam Conflict transformed how surgeons understood the importance to hemorrhage leading to development of the doctrine of Tactical Combat Casualty Care in the late 1990s. (J Trauma Acute Care Surg. 2018;85: S13–S17.
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George Tiemann & Co also had a reputation for creating innovative surgical instruments. One such instrument was an amputation saw with a pistol grip handle, designed by Edward Pfarre, an instrument maker and partner in the company. Many... more
George Tiemann & Co also had a reputation for creating innovative surgical instruments. One such instrument was an amputation saw with a pistol grip handle, designed by Edward Pfarre, an instrument maker and partner in the company. Many of the smaller surgical kits included a backsaw with the Pfarre handle.
This design was marketed under a variety of names after the Civil War until it became widely identified as ‘‘Satterlee’s Saw’’. The curious thing about the Satterlee Saw was that it was neither designed by Satterlee nor specified by him. The saw, marketed by Tiemann as ‘‘Pfarre’s Amputating Saw’’ in 1872, was described as ‘‘Satterlee’s Capital Saw’’ 5 years later.
This design was marketed under a variety of names after the Civil War until it became widely identified as ‘‘Satterlee’s Saw’’. The curious thing about the Satterlee Saw was that it was neither designed by Satterlee nor specified by him. The saw, marketed by Tiemann as ‘‘Pfarre’s Amputating Saw’’ in 1872, was described as ‘‘Satterlee’s Capital Saw’’ 5 years later.
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In an effort to improve upon these prostheses, a multinational consortium known as the Groupe pour l’utilisation et l’´etude des proth`eses articulaires (GUEPAR) formed at the Pavillon Ollier,Hˆopital Cochin in Paris, France and quickly... more
In an effort to improve upon these prostheses, a multinational consortium known as the Groupe pour l’utilisation et l’´etude des proth`eses articulaires (GUEPAR) formed at the Pavillon Ollier,Hˆopital Cochin in Paris, France and quickly settled on developing a hinged knee design, rather than a less constrained prosthesis. In order to more closely duplicate the motion of the joint, the group moved the pivot of the hinge joint closer to the knee’s natural axis of rotation, allowing for greater flexion. The prosthesis, made of chrome cobalt-molybdenum alloy, was manufactured with both straight stems and 7o valgus stems to match the alignment of the patient’s limbs.
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The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died... more
The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered. We review the most important trends in US and Western military trauma management over two centuries, including the shift from primary to delayed closure in wound management, refinement of amputation techniques, advances in evacuation philosophy and technology, the development of antiseptic practices, and the use of antibiotics. We also discuss how the lessons of history are reflected in contemporary US practices in Iraq and Afghanistan.
Research Interests: Military History, Military Medicine, History of Medicine, Napoleonic Wars, Second World War, and 13 moreAmerican Civil War, Vietnam War, First World War, American Revolution, Ancient Greek History, Korean War, Crimean War, Wound care, Global War on Terror, Tissue Viability, Greek and Roman Warfare, Drug Interaction, and Advanced Wound Care Modalities
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When his unit, the 2nd Surgical Hospital (MA), was established at An Khe in January 1966, MAJ Rich began collecting retrieved foreign bodies along with documentation of the wound. A museum displaying these objects was established at one... more
When his unit, the 2nd Surgical Hospital (MA), was established at An Khe in January 1966, MAJ Rich began collecting retrieved foreign bodies along with documentation of the wound. A museum displaying these objects was established at one end of the operating room Quonset hut. During Rich's tour of duty, there were 324 cases where the patient was wounded by a punji stick, representing 38% wounds because of hostile action
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A large shell fragment penetrated Union Army Private John Reardon’s (1841-1902) right shoulder and fractured his humerus during a skirmish near Culpeper, VA, USA on October 11, 1863. The next day, Dr. D. Willard Bliss (1825-1889), the... more
A large shell fragment penetrated Union Army Private John Reardon’s (1841-1902) right shoulder and fractured his humerus during a skirmish near Culpeper, VA, USA on October 11, 1863. The next day, Dr. D. Willard Bliss (1825-1889), the Union surgeon treating Pvt. Reardon, made an unusual decision. Rather than amputate the arm, he made a straight incision and used a hand-held chain saw to extract the head and proximal 6 inches of the humeral shaft. Rather remarkably, Dr. Bliss did
not have to ligate any arteries and Pvt. Reardon lost an “ordinary amount of blood.” Within 5 days, the patient was healing and doing well
not have to ligate any arteries and Pvt. Reardon lost an “ordinary amount of blood.” Within 5 days, the patient was healing and doing well
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The centennial of the First World War (1914–18) has spurred interest in its medical aspects. To a growing body of literature, historian Fiona Reid (Univ. of South Wales) has now added a well written, deliberately anecdotal or “bottom-up”... more
The centennial of the First World War (1914–18) has spurred interest in its medical aspects. To a growing body of literature, historian Fiona Reid (Univ. of South Wales) has now added a well written, deliberately anecdotal or “bottom-up” account of medicine during the war.
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I know of no previous medical history of the Seven Years War (1754–63; also called the French and Indian War). Erica Charters (Oxford Univ.) now makes good that gap in the literature in a fine study that will interest serious students... more
I know of no previous medical history of the Seven Years War (1754–63; also called the French and Indian War). Erica Charters (Oxford Univ.) now makes good that gap in the literature in a fine study that will interest serious students eighteenth-century warfare and anyone curious about historical advances in military medicine and government-funded biomedical research.
Research Interests: Military History, Military Medicine, Public Health Nutrition, British History, British Empire, and 10 moreBritish Imperial and Colonial History (1600 - ), Biomedical informatics, Infectious Diseases, Eighteenth-Century British Army, Seven Years War, Biomedical Research, The relationship between the Royal Navy and British national identity, The Seven Years War, Royal Navy, and 18th century Royal Navy
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General considerations of the preservation of pharmaceuticals in museums. Paper describes both legal and conservation considerations. Under normal museum handling procedures, pharmacteutucals are not hazards.
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The Historical Collections division documents the material culture of medicine. Based on the Museum's history as a military institution, many of the artifacts in the collection were used or purchased by the U.S. Army and reflect the... more
The Historical Collections division documents the material culture of medicine. Based on the Museum's history as a military institution, many of the artifacts in the collection were used or purchased by the U.S. Army and reflect the concerns of military medicine. The collection includes medical instruments used in every major conflict that the U.S. armed forces were involved in from the American Revolution to the Global War on Terrorism.
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This document describes the classification of artifacts in the Historical Collections of the National Museum of Health and Medicine, an element of the Defense Health Agency. Included is the 206 and the 2023 versions.
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Background – In November 1721, a small bomb was thrown through the window of the house belonging to Rev. Cotton Mather. Attached to the bomb, which did not detonate, was a note, ‘Cotton Mather, you dog, dam (sic) you! I’ll inoculate you... more
Background – In November 1721, a small bomb was thrown through the window of the house belonging to Rev. Cotton Mather. Attached to the bomb, which did not detonate, was a note, ‘Cotton Mather, you dog, dam (sic) you! I’ll inoculate you with this; with a pox to you.’ Cotton Mather was a very influential pastor in pre-revolutionary Boston, which was in the middle of a smallpox pandemic, advocated variolation against smallpox, a technique he learned from Onesimus.
Methods – Paper is a historical survey of the evolution of the vaccine and vaccine hesitancy.
Results – Opposition to vaccination, even violent opposition, is as older the vaccine itself and is part of a larger discomfort about public health mandates. Historical arguments against vaccine are recognizable during the COVID pandemic; the introduction of a disease, even an attenuated version, into the body of a healthy body; assessment of risk from the disease; the injection of chemicals into the body and, lastly, public health versus individual autonomy.
Discussion – Public health campaigns have a long and complicated history. In 1771, George Washington ordered inoculation against smallpox, the first time a commanding general required this kind of a public health measure. Smallpox was a significant factor in the failure of the Quebec Campaign. Edward Jenner proved that an attenuated vaccine, cowpox, was effective in preventing smallpox. In 1812, the U.S. Army required vaccination against smallpox. During the Civil War, the massive mobilization led to shortages of the vaccine and soldiers fearing smallpox resorted to self-inoculation inadvertently infecting themselves with syphilis or erysipelas. Although compulsory vaccination doesn’t appear to have been controversial in the military context, while state and local governments efforts to mandate vaccination against smallpox generated opposition. In a similar situation during the Second World War, the public health effort against malaria generated opposition from soldiers who feared the side effects of the then novel antimalarial atabrine, requiring the unit command to enforce compliance. Success of public health campaigns relies on a couple of factors; trust in the leaders and the individuals assessment of risk, comparing the possibility of a catastrophic outcome (high risk) to possible benefits.
Methods – Paper is a historical survey of the evolution of the vaccine and vaccine hesitancy.
Results – Opposition to vaccination, even violent opposition, is as older the vaccine itself and is part of a larger discomfort about public health mandates. Historical arguments against vaccine are recognizable during the COVID pandemic; the introduction of a disease, even an attenuated version, into the body of a healthy body; assessment of risk from the disease; the injection of chemicals into the body and, lastly, public health versus individual autonomy.
Discussion – Public health campaigns have a long and complicated history. In 1771, George Washington ordered inoculation against smallpox, the first time a commanding general required this kind of a public health measure. Smallpox was a significant factor in the failure of the Quebec Campaign. Edward Jenner proved that an attenuated vaccine, cowpox, was effective in preventing smallpox. In 1812, the U.S. Army required vaccination against smallpox. During the Civil War, the massive mobilization led to shortages of the vaccine and soldiers fearing smallpox resorted to self-inoculation inadvertently infecting themselves with syphilis or erysipelas. Although compulsory vaccination doesn’t appear to have been controversial in the military context, while state and local governments efforts to mandate vaccination against smallpox generated opposition. In a similar situation during the Second World War, the public health effort against malaria generated opposition from soldiers who feared the side effects of the then novel antimalarial atabrine, requiring the unit command to enforce compliance. Success of public health campaigns relies on a couple of factors; trust in the leaders and the individuals assessment of risk, comparing the possibility of a catastrophic outcome (high risk) to possible benefits.
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The practice of nineteenth century dentistry was extracting teeth and constructing prostheses. Dentists donated a variety of prostheses, not only from western dentistry, but also representing non-European cultures and improvised... more
The practice of nineteenth century dentistry was extracting teeth and constructing prostheses. Dentists donated a variety of prostheses, not only from western dentistry, but also representing non-European cultures and improvised solutions. These artifacts highlighted the importance of dentistry by documenting what people were willing to do to replace lost teeth. The donors were impressed by the craftmanship represented by these artifacts. National Museum of Health and Medicine Mission: NMHM promotes the science and history of medicine, with a special emphasis on tri-service American military medicine. NMHM identifies, collects and preserves unique resources to support a broad agenda of innovative exhibits, educational programs and scientific, historical and medical research. NMHM maintains a National Historic Landmark collection of objects that sustains and promotes military medical history and research to the Department of Defense and civilian communities. The museum is open 10:00 a.m. to 5:30 p.m. every Wednesday to Sunday. Admission is free. Consult the museum's website (QR Code above) or our social media channels @medicalmuseum to confirm current operating status.
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Prolonged Field Care (PFC) is a continuation of a long-running conversation among military surgeons as to where to place the surgeon in relation to the wounded patient and what can be accomplished where in order to decrease patient... more
Prolonged Field Care (PFC) is a continuation of a long-running conversation among military surgeons as to where to place the surgeon in relation to the wounded patient and what can be accomplished where in order to decrease patient mortality. "We have been accustomed to view missions in terms of patient treatment stages, such as seen in Tactical Combat Casualty Care (TCCC). This is less useful when planning for PFC because of the more comprehensive list of capabilities needed to consider across a wider spectrum of operational realities. Instead of echelons of patient care, we propose to use a system of mission or evacuation stages to simplify and standardize our language, using the following terminology: RUCK-TRUCK-HOUSE-PLANE (RTHP)."-Christopher Mohr, Prolonged Field Care Working Group Position Paper (4) The PFC concept was developed in the early 21st century for operational planning of medical support for special operations missions with a minimal logistical footprint. Superficially, this construct is a repudiation of a complex infrastructure developed by the Military Health System over the past 150 years. It is an effort to ensure that the medical capabilities of Role I, Role II, and even Role III care can be handled in what is essentially a Role I facility.
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When your line leadership asks you the biggest lesson learned of COVID…the first is our nation needed us. When our healthcare system was stressed, it could not, without our help, deal with this pandemic…that is an important lesson. There... more
When your line leadership asks you the biggest lesson learned of COVID…the first is our nation needed us. When our healthcare system was stressed, it could not, without our help, deal with this pandemic…that is an important lesson. There are lots of discussions about the future of military medicine and some of them revolve around, hey, there is an easy answer, let the civilian healthcare community do more for the military. But the civilian healthcare system is relying on us to do more for them when they are stressed; it was a great partnership. That is a big lesson learned, when things got tough, they turned to us."
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This presentation explores how the “Spanish Flu” spread through Montgomery County, Maryland, and its effect on its population. Even a century after the pandemic, Montgomery County continues to have a role in characterizing and... more
This presentation explores how the “Spanish Flu” spread through Montgomery County, Maryland, and its effect on its population. Even a century after the pandemic, Montgomery County continues to have a role in characterizing and understanding 1918 Influenza Virus. In 1918, Montgomery County, Maryland was a rural county with a growing suburb served by the Metropolitan Line of the B&O Railroad and an expanding trolley car network. When the Spanish Flu arrived in the county it was mobilizing for World War I. On September 28, a 9-year old boy died of Lobular Pneumonia and Influenza in Forest Glen, Maryland. During the next five months, over 200 Montgomery County residents would die of influenza and/or pneumonia. However, Montgomery County’s role with the Spanish Flu did not end in 1919. In 1996, Jeffrey Taubenberger and Ann Reid of the Armed Forces Institute of Pathology used pathological specimens to isolate and sequence a portion of the genetic structure of the influenza virus. Nearly a century after the pandemic, federal civilian and military public health agencies monitor any incidences of emerging novel influenza strains that may arise worldwide to ensure the best available and proper countermeasures are in place before a pandemic occurs.
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June 1951-Hospitals in the IX Corps AOR began admitting patients with a mysterious set of symptoms. Patients complained of high fever, headache, and mild depression followed quickly by the appearance of red spots on the arms and trunk.... more
June 1951-Hospitals in the IX Corps AOR began admitting patients with a mysterious set of symptoms. Patients complained of high fever, headache, and mild depression followed quickly by the appearance of red spots on the arms and trunk. They drank heavily due to thirst, but despite administration of intravenous fluids to prevent dehydration, they got worse. Their skin became flushed as their capillaries dilated, and their body temperature and blood pressure dropped. As they went into shock, their vision blurred and they slipped into delirium, convulsions, or a coma. The face of this patient appeared flushed due to dilation of the capillaries. Severe vomiting could also cause blood vessels in the eye to rupture. National Museum of Health and Medicine Mission: To preserve and explore the impact of military medicine. Vision: To preserve, inspire, and inform the history, research, and advancement of military and civilian medicine through world-class collections, digital technology, and public engagement.
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U.S. armed forces have often been deployed to malaria-prone regions generally avoided by civilians. The subsequent concentration of malaria patients placed military surgeons and medical researchers at the forefront of prevention and... more
U.S. armed forces have often been deployed to malaria-prone regions generally avoided by civilians. The subsequent concentration of malaria patients placed military surgeons and medical researchers at the forefront of prevention and treatment. Malaria has remained a constant, ever-evolving challenge in more than 200 years of military operations. The military healthcare system adapted to protect American service members from this disease through the development of pharmaceuticals used both prophylactically and as a treatment for malaria according to an evolving understanding of the disease.
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The significance of hemorrhage was not immediately apparent to the medical community. Medieval surgeons considered blood to be one of the four humors, levels within the human body needed to be managed rather than conserved.... more
The significance of hemorrhage was not immediately apparent to the medical community. Medieval surgeons considered blood to be one of the four humors, levels within the human body needed to be managed rather than conserved. Inflammation, or excess accumulation of blood, was considered a bigger risk than blood loss. Conventional wisdom was transformed with William Harvey's (1578-1657) observation that blood circulated within a closed system. Eighteenth -century surgeons began employing crude tourniquets to stop hemorrhage during amputation, dramatically increasing the chances of survival for the patient. Jean Louis Petit (1674-1750) developed a tourniquet that used a screw mechanism to keep the band constricted instead of requiring an assistant for that task and his design was widely used for the next two centuries. As the application of anesthesia became more sophisticated by the turn of the twentieth century, surgeons had more time to perform surgical procedures employing improved techniques to prevent blood loss. Hemorrhage control became a first aid issue. First responders, known as corpsman or combat medics, were trained in basic lifesaving techniques relying on bandages to stem blood loss. The tourniquet had become a first aid technique, whose use was discouraged. When it was possible for a surgeon to save a limb, the risk of damage to the limb by a tourniquet left on too long was considered a greater risk than hemorrhage. However, by the late 1980’s, when it was recognized that up to one-third of all combat deaths resulting from exsanguination could have been prevented with the use of more effective hemorrhage methods, the U.S. Army’s Combat Casualty Care Research Program focused on the development of more effective hemostatic products than gauze. The first prototype of Dried Fibrin Sealant Dressing applicable to trauma surgery was developed at the Letterman Army Institute of Research in early 1993. This innovation led to the development of chitosan and fibrin dressings which have widely been used on the battlefield to arrest hemorrhage. A new generation of tourniquets was developed and has become a standard component in the Individual First Aid Kit. This success changed the approach to trauma care leading to the development of civilian applications of this approach. On Oct. 6, 2016, President Obama unveiled the “Stop the Bleed” campaign to empower bystanders to act as immediate responders. Working with the Departments of Homeland Security and Health and Human Services, FEMA, the private sector, not-for-profit organizations, and the medical community, the “Stop the Bleed” campaign aims to raise awareness of life-saving strategies and provide public access to bleeding control tools already used by first responders and the military.
Learning Objectives
o Describe how an understanding of the importance of hemorrhage has evolved.
o Describe the development of technological interventions to control hemorrhage.
o Understand the influence of science on the practice of medicine.
Learning Objectives
o Describe how an understanding of the importance of hemorrhage has evolved.
o Describe the development of technological interventions to control hemorrhage.
o Understand the influence of science on the practice of medicine.
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The National Museum of Health and Medicine (NMHM) is a multi-service Department of Defense museum aligned within the Research and Development Directorate (J-9) of the Defense Health Agency. NMHM was established during the Civil War as... more
The National Museum of Health and Medicine (NMHM) is a multi-service Department of Defense museum aligned within the Research and Development Directorate (J-9) of the Defense Health Agency. NMHM was established during the Civil War as the Army Medical Museum to serve as a center for the collection of specimens and devices for research in military medicine and surgery. In 1862, Surgeon General William Hammond directed medical officers in the field to collect "specimens of morbid anatomy together with projectiles and foreign bodies removed" and to forward them to the newly founded museum for study. The museum has been assembling, documenting, presenting, and arranging for scientific inquiry such materials ever since. The collection now numbers more than 24 million items, draws from federal agencies and medical enterprises worldwide, and offers public visitors and behind-the-scenes researchers a unique perspective on military medicine as it is one of the few places where the public can actually see the effects of traumatic injury and disease on the human body.
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President Abraham Lincoln sustained a gunshot wound to the head at the hands of John Wilkes Booth at Ford’s Theatre. He died on April 15, 1865 just under 9 hours after assassination. This presentation will use the two autopsy reports, one... more
President Abraham Lincoln sustained a gunshot wound to the head at the hands of John Wilkes Booth at Ford’s Theatre. He died on April 15, 1865 just under 9 hours after assassination. This presentation will use the two autopsy reports, one written by Asst. Surg. Joseph J. Woodward assigned to the Army medical Museum, and one written by Dr. Robert Stone, Lincoln’s personal physician, to look at how the medical aspects of Lincoln’s death was understood at the time and compare it to contemporary understanding of neuroanatomy.
Using the Historical Collections of the National Museum of Health and Medicine, we will provide a 21st century interpretation of the events surrounding the assassination of President Lincoln using documents and actual medical instruments used to describe the treatment of and physical observations to the final minutes of the president’s life.
The Neuroanatomical Collections, which is composed of over eleven different Neuroanatomical Collections relating to subject matter in Human Development, Traumatic Brain Injury, Comparative Neuroanatomy, Brain Tumors and Normal and Pathology, will be used to overlay the two autopsy reports’ description of the path and final resting place of the bullet to interpret from a Neuroanatomical perspective the affected areas of the wound.
Using the Historical Collections of the National Museum of Health and Medicine, we will provide a 21st century interpretation of the events surrounding the assassination of President Lincoln using documents and actual medical instruments used to describe the treatment of and physical observations to the final minutes of the president’s life.
The Neuroanatomical Collections, which is composed of over eleven different Neuroanatomical Collections relating to subject matter in Human Development, Traumatic Brain Injury, Comparative Neuroanatomy, Brain Tumors and Normal and Pathology, will be used to overlay the two autopsy reports’ description of the path and final resting place of the bullet to interpret from a Neuroanatomical perspective the affected areas of the wound.
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The mission of the National Museum of Health and Medicine is to inspire interest in and promotes the understanding of medicine -- past, present, and future -- with a special emphasis on tri-service American military medicine. American... more
The mission of the National Museum of Health and Medicine is to inspire interest in and promotes the understanding of medicine -- past, present, and future -- with a special emphasis on tri-service American military medicine. American military medicine has historically been on the front lines of many of important epidemics. Most museums, by nature, think of themselves as historical institutions and are reactive in nature, waiting for things to come into the door and waiting for trends to become clear. However, being reactive runs the risk of missing the moment as the items are perishable and the principle actors are so frequently caught in the moment not to preserve the material culture. This paper will discuss Prospective Collection (Collecting contemporary artifacts to document current and emerging trends in the evolution of the practice of medicine, biomedical engineering, and medical education) though examples of artifacts documenting AIDS and Ebola epidemics.
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The Historic Resources of Market Street are significant for their association with both the history and the architecture of the most important commercial street in the City of Wilmington. This nomination, incorporating properties in the... more
The Historic Resources of Market Street are significant for their association with both the history and the architecture of the most important commercial street in the City of Wilmington. This nomination, incorporating properties in the 500 through 800 blocks of Market Street, is focused primarily on late 19th and early 20th century commercial buildings, and stresses the difference in how evolutionary changes affected the structures above Fifth Street, creating an architectural mirror of the dynamic forces active in Victorian and early 20th century Wilmington's commercial life. The district and buildings included in the Historic Resources of Market Street are eligible to be listed in the National Register of Historic Places under Criterion A, associated with the evolution of the area as the center of commercial and financial activity immediately before and after the turn of the 20th century. The buildings are also eligible to be listed under Criterion C, as examples of commercial interpretations of various architectural styles during Wilmington's Urban Growth Phase (1880-1930).
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The Lower Market Street Historic District was nominated to the National Register of Historic Places as representing three centuries of Wilmington's residential and commercial architecture. Ranging from the 18th to the early 20th century,... more
The Lower Market Street Historic District was nominated to the National Register of Historic Places as representing three centuries of Wilmington's residential and commercial architecture. Ranging from the 18th to the early 20th century, the architectural styles served to document the growth and change which occurred in the Market Street area during this period.
The Lower Market Street Historic District Amendment is eligible to be listed in the National Register of Historic Places under Criterion A because it was the commercial center of the City of Wilmington during the Industrialization (1830-1880) and the Urban Growth (1880-1930) phases of development. The buildings that contribute to the amendment are significant under Criterion C, for including a wide range of 19th century styles such as Federal, Greek Revival, Italianate, Second Empire, and Queen Anne. However, the majority of the buildings in the district represent examples of mid to late 19th century revival styles. Very few of the buildings are "pure" styles, and most represent a crossbreed of styles, which is typical of the Victorian architectural philosophy that combined different stylistic elements to create a unique effect.
The Lower Market Street Historic District Amendment is eligible to be listed in the National Register of Historic Places under Criterion A because it was the commercial center of the City of Wilmington during the Industrialization (1830-1880) and the Urban Growth (1880-1930) phases of development. The buildings that contribute to the amendment are significant under Criterion C, for including a wide range of 19th century styles such as Federal, Greek Revival, Italianate, Second Empire, and Queen Anne. However, the majority of the buildings in the district represent examples of mid to late 19th century revival styles. Very few of the buildings are "pure" styles, and most represent a crossbreed of styles, which is typical of the Victorian architectural philosophy that combined different stylistic elements to create a unique effect.
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The boundaries of the Eighth Street Park Historic District were determined by the age of the buildings within the district and the pattern of development In the area. The buildings within the district boundaries Illustrate the themes... more
The boundaries of the Eighth Street Park Historic District were determined by the age of the buildings within the district and the pattern of development In the area. The buildings within the district boundaries Illustrate the themes discussed In the statement of significance. Buildings adjacent to the district, particularly to the east, are potentially eligible for the National Register, but development In this area responded to different Influences than those Involved In the Eighth Street District.
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The Church of St. Anthony of Padua is an Italian Romanesque church built on the northwest corner of West Ninth and North duPont Streets. It was built in 1926 to serve the Italian-American community located in the Westside section of... more
The Church of St. Anthony of Padua is an Italian Romanesque church built on the northwest corner of West Ninth and North duPont Streets. It was built in 1926 to serve the Italian-American community located in the Westside section of Wilmington. It has served as a catalyst for Italian cultural pride and remains today as a uniquely Italian church in the city.
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Cultural Resource Survey of Wilmington, Delaware: Evaluation of Cultural Resources in Midtown Brandywine Analysis Area.
Record Identifiers
NADB document id number(s): 43379
NADB citation id number(s): 000000243424
Record Identifiers
NADB document id number(s): 43379
NADB citation id number(s): 000000243424