SOUTHWESTERN INTERNAL-MEDICINE CONFERENCE - THE ARTS OF WAR AND MEDICINE - A STUDY IN SYMBIOSIS

Practitioners of warfare and medicine have both considered their respe ctive disciplines part art and part science. Each has seen dramatic ad vances over the past several centuries, and the histories of progress in warfare and medical practice are inextricably intertwined. For exam ple, the congregation of large armies inspired the development of epid emiologic analysis and preventive medicine, which forestalled the disa strous loss of life that typified all wars through the U.S. Civil War. Warfare also helped to clarify the critical distinction between medic ine and health in several ways. Battles generate tremendous demands on the trauma surgeon, which triggers advances in understanding of traum a, surgery, fluid and electrolyte management, first aid, and triage. S imilarly, the health of soldiers before and after combat is a result o f public health measures that physicians have been ill-suited to manag e. The dramatic severity of epidemics in armies progressively forced h ealth professionals and politicians to seek solutions to illnesses tha t had plagued the general population to lesser degrees for millennia. The exigencies of war inspired creation of the nursing profession, wit h the burden and opportunity falling on women. Women were not allowed to hold positions of responsibility in caring for the sick until the e normity of the Civil War prevented men from occupying all such positio ns. Because each generation tends to view itself as ''modern,'' its in herent weaknesses often go uncorrected and even unobserved. The interc onnected histories of war and medicine provide a warning to remain ope n to discovering those practices that need radical reform to prevent t he current generation of physicians from appearing utterly ridiculous to physicians 100 years hence. This treatise focuses, therefore, on th e symbiotic advances in warfare on health before this century because death in war due to trauma was statistically far less important than d eath due to disease.