In World War II, Hugh Cairns, Oxford Nuffield Professor of Surgery and brigadier in the Royal Army Medical Corps, designed and administered the mobile neurosurgical units that treated casualties with head injuries in the various campaigns fought by the British Army. Cairns also created the Combined Services Hospital for Head Injuries at St Hugh's College, Oxford, where the staff of the units were trained and where evacuated casualties were received. The excellent outcome of the head-injured in World War II and the impetus to the expansion of neurosurgery in the UK during and after that war were, in large measure, due to Cairns. Others had knowledge of neurosurgery but Cairns inspired surgeons, neurologists and nursing sisters to perform neurosurgery at the highest level on the battlefield.
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References
1.
Peripatetic correspondent. Lancet1944;ii:832.
2.
CushingH. A study of a series of wounds involving the brain and its enveloping structures. British Journal of Surgery1917–18;5:558–684.
3.
JeffersonG. Head wounds and infections in two wars. British Journal of Surgery1947;war supplement no. 1: 3–8. The percentage mortality of wounds penetrating the dura was: Cushing 41.4; Jefferson 36.7; Wagstaffe 50; and Whitaker 9.3. Whitaker's cases may have been selected.
4.
FraenkelGJHugh Cairns. Oxford: Oxford University Press, 1991.
5.
SchurrPHThe contribution to neurosurgery of the Combined Services Hospital for Head Injuries at St Hugh's College, Oxford, 1940–1945. Journal of the Royal Army Medical Corps1988;134:146–8.
6.
Cairns ruled St Hugh's, but nominally in charge were Air Vice-Marshall C P Symonds, Consultant in Neuropsychiatry to the Royal Air Force, and Brigadier G Riddoch, Consultant Neurologist to the British Army.
7.
HughesJTLawrence of Arabia and Hugh Cairns: Crash helmets for motorcyclists. Journal of Medical Biography2001;9:236–40.
8.
CairnsH. The organization for treatment of head wounds in the British Army. British Medical Bulletin1945;3:9–14; Cairns H. Neurosurgery in the British Army, 1939–1945. British Journal of Surgery 1947;war supplement no. 1: 9–26.
9.
The RAMC in World War II is described by Crew FAE. The Army Medical Services. Campaigns: vol. 2 includes Libya and North-West Africa 1942–3; vol. 3 Sicily, Italy, and Greece, 1944–5; vol. 4 North-West Europe 1944–5; and vol. 5 Burma. London: HMSO, 1957, 1959, 1962 and 1966.
10.
RogersL. Neurosurgery in the Royal Navy. British Journal of Surgery1947;war supplement no. 1: 90–5.
11.
MillerD. Infective complications of head battle casualties. Australian and New Zealand Journal of Surgery1942–3;12:55–63.
12.
SlemonHVForward neurosurgery in Italy. Journal of Neurosurgery1945;2:332–9.
13.
The Canadian Neurosurgical Centre, Hackwood Park, Basingstoke. British Journal of Surgery1944–5;32:525–30.
14.
AscroftPBTreatment of head wounds due to missiles. Lancet1943;ii:211–18. Ascroft's papers dealing with MNSU no. 1 are in the RAMC Muniment Collection, Wellcome Library for the History and Understanding of Medicine, 1154, boxes 257 and 258.
15.
ChurchillWSThe Second World War. London: Cassell, 1951: vol. IV, p. 541.
16.
EdenK. Mobile neurosurgery in warfare. Lancet1943;ii:689–92.
17.
Obituary, Kenneth Eden. Lancet1943;ii:653.
18.
OgilvieWHWar surgery in Africa. British Journal of Surgery1943–4;31:313–24.
19.
GillinghamFJNeurosurgical experiences in northern Italy. British Journal of Surgery1947;war supplement no. 1: 80–7.
20.
CairnsHEdenKCSchorstonJ. A Preliminary Report on the Treatment of Head Wounds with Penicillin. Investigation of War Wounds. Penicillin.London: War Office, publication AMD 7/90D/43, 1943. During World War H, Major Schorstein spelt his name “Schorston”.
21.
ConnollyRCThe management of the untreated brain wound. British Journal of Surgery1947;war supplement no. 1: 168–72.
22.
SchorsteinJ. War neurosurgery. Manchester University Medical School Gazette1946;25:58–67.
23.
SmallJMTurnerEAA surgical experience of 1200 cases of penetrating brain wounds in battle, N.W. Europe, 1944–5. British Journal of Surgery1947; war supplement no. 1: 62–74; Small JM, Turner EA, Watt AC. The management of brain wounds in the forward area. British Journal of Surgery 1947;war supplement no. 1: 75–80.
24.
JohnsonRTNeurosurgery in jungle warfare. Manchester University Medical School Gazette1946;25:67–76.
25.
CairnsH (op. cit. ref. 8) (Neurosurgery in the British Army): p.11.
26.
JohnsonRTDickRCSNeurosurgery in the eastern theatre of war. Lancet1945;ii:193–196; Johnson RT. Missile wounds of the head in the Burma campaign. British Journal of Surgery 1947; war supplement no. 1: 172–7.
27.
JohnsonRT (op. cit. ref. 24): p. 68.
28.
JohnsonRT (op. cit. ref. 24): p. 71.
29.
CairnsHEdenKCSchorstonJ (op. cit. ref. 20).
30.
On the use of penicillin in World War II, see the special issue of the British Journal of Surgery1944–5;32:110–224.
31.
CairnsH (op. cit. ref. 8) (Neurosurgery in the British Army): p. 17.
32.
SchurrPHSo That Was Life: A Biography of Sir Geoffrey Jefferson. London: Royal Society of Medicine Press, 1997.
33.
RowbothamGFWhalleyN. A series of wounds of the head from the battle-front of north-west Europe. British Journal of Surgery1947;war supplement no. 1: 87–90.
