This article examines the care provided for the welfare of soldiers by the three combatant countries – China, Korea and Japan – during the East Asian War of 1592–8. Also known as the Imjin War, this large-scale military conflict can also be understood as an encounter between different state cultures and strategies of military medicine. This study focuses on cold-induced injuries, epidemic outbreaks and external wounds suffered during the war. I illuminate provision of prophylactic measures against cold by the Ming state, as well as attempts by the Sino-Chosŏn medical alliance to manage epidemics and treat wounded soldiers. I contrast these measures with the lack of similar centralised support for the Japanese forces, and examine the effect these differences had upon on military outcomes during the war. The difference in the amount of time, efforts and resources that the three combatant states devoted to sick and injured soldiers has implications not only for our understanding of the war but also for illuminating the early modern history of military medicine in East Asia. By exploring East Asian military medicine during and after the Imjin War, this article responds to recent calls for more detailed examination of histories of military medicine in premodern periods and non-European regions.

When introducing environmental enrichment in laboratory animals, positive and/or negative effects on behavioural and physiological parameters should be evaluated. This three-step randomised controlled trial in male C57BL/6 mice investigated the effect of supplementing the environment with one or more hemp ropes. In part 1, the effect of a hemp rope on aggressive and social behaviour, stress and anxiety levels was assessed by social interaction test, elevated plus maze behaviour, and faecal corticosterone metabolites, respectively (n = 224 mice). In part 2, the effect of 1, 2 or 7 hemp ropes on aggressive behaviour in mice subjected to routine handling was evaluated by assessing the number of wounded companion animals and wounds per animal (n = 224). In part 3, climbing activity in the rope and amount of material shredded from the rope was assessed (n = 56). Mice housed with one hemp rope engaged in social behaviour for longer time than mice housed without a hemp rope, while no difference was detected in stress and anxiety levels. No difference was seen in the number of wounded animals or wounds per animal when adding 1, 2 or 7 hemp ropes to the existing environment in mice undergoing minimal human handling. The mice continuously shredded and climbed the rope, even when provided with a new rope, although time spent climbing decreased slightly over time. Thus, a hemp rope can be used as additional environmental enrichment amongst male C57BL/6 mice.

The St Petersburg declaration, signed in 1868, is a milestone in the history of warfare and humanitarian law, as it prohibits the use of explosive bullets, which are considered to cause unnecessary suffering. As this article shows, the framing of this declaration that put suffering at its centre, as well as the development of the humanitarian movement, favoured the birth of a new field of expertise: wound ballistics. The wars that broke out after the declaration was signed are the subject of intense scrutiny, while the advances in weaponry, and notably, the creation by the British of a new expansive bullet, provided physicians with new fields of investigation. Numerous experiments have attempted to reproduce the effects of bullets on different materials, including corpses. Based on numerous medical reports and publications, as well as military archives from France and the United Kingdom, this investigation critically examines the notion of pain, its assessment and its use in the monitoring of war violence. It argues that, paradoxically, the greater attention paid to suffering has resulted in a need to objectify pain. This rationalisation and the quest for the quantification of suffering have not been without bias and have shifted attention away from care and treatment.

The 26 December 2004 Tsunami resulted in a death toll of >270,000 persons, making it the most lethal tsunami in recorded history. This article presents performance data observations and the lessons learned by a civilian team dispatched by the Australian government to “provide clinical and surgical functions and to make public health assessments”. The team, prepared and equipped for deployment four days after the event, arrived at its destination 13 days after the Tsunami. Aspiration pneumonia, tetanus, and extensive soft tissue wounds of the lower extremities were the prominent injuries encountered. Surgical techniques had to be adapted to work in the austere environment. The lessons learned included: (1) the importance of team member selection; (2) strategies for self-sufficiency; (3) personnel readiness and health considerations; (4) face-to-face handover; (5) coordination and liaison; (6) the characteristics of injuries; (7) the importance of protocols for patient discharge and hospital staffing; and (8) requirements for interpreter services.

Whereas disaster medical relief teams will be required in the future, the composition and equipment needs will differ according to the nature of the disaster. National teams should be on standby for international response.

Post-intubation laryngeal dysfunction is well documented. Both common and rare patterns of injury have been described in the literature. An unusual pattern of intubation injury is described in this case report. The different patterns of post-intubation laryngeal injury are discussed as well as the possible aetiology in the case described.

The current incidence of missile injury to the temporal bone (MITB) is very low in the United Kingdom. However, the increasing frequency of firearm violence in Britain suggestsa greater risk of occurrence. This, along with the devastating potential sequelae of MITB (facial palsy, dead ear, intracranial damage, major vascular injury and cosmetic disfigurement), requires otolaryngologists to be conversant with all aspects of their management. The risk of major complications is much higher with MITB than with temporal bone injury following blunt trauma, and surgical management is, therefore, much more common. We present one such case, and review the literature outlining the pathogenesis, clinical features, and recommended management.

Since at least WWII, some open, contaminated wounds involving massive soft tissue injury and vascular damage have resulted in “irreversible shock,” despite prompt rescue, hemorrhage control, and blood and fluid replacement, without signs of clinical infection.

In animal studies, survival time was related statistically to the dosage of Clostridium perfringens in multicontaminated explosive wounds. Survival time was lengthened by the application of some topical antibacterial agents, but actual recovery was achieved only with topical mafenide hydrochloride solution aqueous spray, which resulted in negative clostridium. perfringens cultures. Although not related statistically to survival time, the mafenide hydrochloride spray also controlled the Pseudomonas aeruginosa in these wounds.

Mafenide hydrochloride had the American trade name of Sulfamylon from about 1942 until 1998, when another pharmaceutical company patented Sulfamylon as the trade name for mafenide acetate, a weaker antibacterial agent. However, mafenide hydrochloride still is available from chemical companies.

Mafenide hydrochloride solution spray has been used successfully in treatment of patients with severe by contaminated wounds and deep burns, and its use in initial care should be revisited.