War: A Violent Root of Medical Progress

by Zaid Safiullah

β€œWar is the only proper school for a surgeon.” These words were spoken by Hippocrates, a physician known as The Father of Medicine in the ancient times of Classical Greece. War and medicine may seem like antonyms: medicine helps preserve life, whereas war often takes it away, but the two have had an intimate relationship since ancient times. Before the age of robotic simulations and cadaver training, surgeons had to rely on the gruesome injuries sustained by warring soldiers to develop and practice their skills. The battlefield was the first operating theater; ancient Roman physicians became skilled in the art of tourniquets, to stem bleeding, and amputations, the earliest form of disease prevention that inhibited the spread of gangrene. Wars gave a focus for medical discovery; the brutality of the American Civil War and mass casualties from disease gave motivation to make antiseptic wound treatment and general hygiene necessities by the time of World War I. As weaponry evolved, medical machinery evolved to heal its destruction; the use of gaseous nerve toxins in World War I led to the innovation of gas masks to defend troops from weapons of mass destruction, eventually leading to its widespread implementation as a medical respirator.

The trend of medicine evolving to heal the destruction of war persists even today. As a result of the wars in Iraq and Afghanistan, medical care on the battlefield has improved for traumas and tissue damage. The need for more advanced bio-prosthetics has arisen from the vast increase in the presence and number of makeshift explosive devices, and incredible new prosthetics that connect with the human nervous system are being developed with war veterans in mind.

A further application of military technology in modern medicine is the use of Raman spectroscopy, used by the military to detect toxic chemicals, in a hand-held optical scanner as a method of detecting skin cancer. Raman spectroscopy was invented in 1928 by Sir CV Raman, who won the Nobel Prize in Physics for his work on light energy measurement. Raman spectroscopy measures the vibrational energy of molecular bonds in response to different wavelengths of monochromatic light, the source of which is usually a laser that emits rays in the visible, near-infrared, or near-ultraviolet range. The laser shifts the energy of molecular bonds, and the resulting vibrations give information on the composition of the substance. Raman spectroscopy is used routinely by homeland security agencies for detection of chemical or biological weapons and is also commonly used in other military laser systems. Whereas the military uses Raman spectroscopy to sense dangerous war zones and toxins, the same technology has become a useful tool in the medical community, allowing dermatologists to detect skin abnormalities.

A recently developed hand-held optical scanner uses Raman spectroscopy-based imaging technology to illuminate the skin with ten different wavelengths of light. The different wavelengths detect the molecular composition of the tissue being imaged. The scanner then takes this molecular structural information and, through the use of high-powered algorithms, compares its analysis of the image to a database of melanomas. The scanner then returns a probability that the imaged tissue is malignant.

The scanner is not just impressive because of its engineering but also because of its remarkable efficiency In a clinical trial for melanoma detection reported by the Cleveland Clinic, 13,000 patients were scanned using the handheld optical scanner. The researchers found that the scanners picked up 98 percent of all melanomas. The ability to detect even the smallest melanomas and such a high rate of success gives far reaching implications for the future of skin cancer treatments, for instance, a decrease in the need for invasive biopsies as well as the number of false-positive diagnoses. Further, the success of Raman spectroscopy could prompt supplemental studies of its efficacy and utilization and could ultimately lead to an increase in its application within the medical field. Although we may normally associate war with violence and loss of life, its dynamic relationship with medicine has also resulted in the preservation of life for soldiers and civilians alike. War induces the advancement of medicine out of necessity, resulting in valuable surgical practices and futuristic technologies and treatments. War is more than a surgeons’ best teacher; it is also an impressive motivator to the entire field of medical science.