The British military experience in the First World War has been the subject of memoirs, histories, and narrow studies almost too numerous to count. Yet most of these works have concentrated on the course of the fighting and the experiences of the men on the front lines. Far less thoroughly examined has been their experiences after combat, when casualties were evacuated for healing and rehabilitation. In this award-winning study of British medical operations in the First World War, Mark Harrison takes a panoramic view of his subject, surveying the processes and care of the wounded to understand how they were cared for and how that care varied over the main fronts of the war.

As Harrison notes at the start of his book, attention to the treatment of wounded soldiers was still a fairly recent development. Starting with the Crimean War, the coverage of medical provisions by the popular press turned a previously neglected issue into one of political concern, forcing the army leadership to make provisions for it. These preliminary arrangements paled in compared to their German and French counterparts, however, and the development of what Harrison terms the “medical machine” really began only with the start of the war in 1914 and the initial discovery of the scope of the problem facing the military.

Harrison’s three chapters on medical operations on the Western Front form the heart of his book. The experience of the Royal Army Medical Corps (RAMC) reflected that of the British Army more generally, as the provisions at the start of the war soon gave way to a wholesale reorganization as the duration and scope of the conflict became evident. Much of Harrison’s focus here is on the process of “clearing the battlefield,” as evacuating casualties was the first and in many ways most important step in treating them. Taken first to casualty clearing stations before transportation to field hospitals, the wounded and dying were processed in an operation that adjusted to both the scale of the problem and the many demands upon finite resources. This was especially true in terms of transportation, as moving men and munitions to the front lines took priority over casualty evacuation. The nature of war on the Western Front also posed challenges, as medical personnel coped with the challenges of gas-gangrene and the use of poison gas as a weapon. While not uncritical, Harrison is generally complimentary of the men involved in running the medical services and describes a system that ran reasonably well from the Somme onward.

Though the Western Front is the main focus of Harrison’s work, he does not neglect the other main theaters in which British troops fought. Here the picture is similar, as transportation quickly emerged as the primary problem at both Gallipoli and early in the Mesopotamian campaign. In some of these campaigns there was less time for adaptation, but when such time did exist reforms followed the models established on the Western Front. Yet soldiers fighting in Africa and the Near East faced the added problem of tropical diseases, which posed additional strains upon medical services that were not always successfully addressed.

Nevertheless, Harrison concludes his book by giving the British medical services and their personnel high marks for the professionalism and efficiency under the circumstances of their time. Similar praise is warranted for his book, which draws upon both organizational records and secondary sources to describe the performance of British military medicine in the First World War. While limited in its study of both medical procedures and the social history of the men and women who worked in the various facilities, it is nonetheless a fine survey of its subject, one that is absolutely indispensable for anyone seeking to understand this very important yet too often neglected aspect of the British military effort during the First World War. ( )