In World War I, over 200,000 American soldiers were wounded in battles throughout France and Germany. Getting them to the American hospitals that were constantly being moved nearer to new front lines and then to the more permanent base hospitals became a logistical nightmare. With functional helicopters not invented until after this war, trains, trucks, and ambulances served to transport the wounded from the battlefield to a place of relative safety where they could be treated for their wounds and sent back to the U.S. or back into battle.
Adding to the problem were attacks by the Germans which temporarily disrupted the railroads and congestion on the few usable roads due to heavy damage from bombings and artillery fire. At times there were not enough hospital trains to quickly evacuate wounded soldiers from field hospitals or to move the hospital equipment to new locations. The American trains, shipped over by boat, were better equipped and larger than the French ones, but with the demand so high at times, the Allied Forces shared what they had.
In some of the heaviest fighting, surgeons worked 20 out of each 24 hours. One American evacuation hospital set a record for operating on 350 cases in one day during the last offensive before the Armistice!*
William Gillespie Blaine, the youngest son of Dr. Harry G. Blaine, served in the U.S. Army on Hospital Train #54 in France from early 1918 to the middle of 1919. Even though the Armistice had been signed on November 11, 1918, Will was still working later that month, “returning from a trip that has taken four days and three nights with a trainload of sick and wounded that are being sent back to the States,” as he shared in a letter to his mother. He never mentioned any details of his work, so one can only guess at the horrors he witnessed while transporting wounded comrades to safety.
At least for the wounded of this Great War, medical advances in surgical techniques, along with the invention of diagnostic equipment like x-ray machines, greatly increased their chances of survival. And the hospital trains played a crucial role in providing interim care on their journey to recovery.