The foundations of wilderness medicine: some historical features.

The surgeons of the navies of the early days of western civilization--Greece, Rome, and the Italian city-states--were most likely the first practitioners of recognizable wilderness medicine. The teachings of Hippocrates and Galen ruled over the practice of medicine in Europe for centuries, but the steady evolution of understanding of the nature and causes of disease was starting to provide a useful foundation upon which to build by the turn of the 19th century. By 1800, nonetheless, the gap between medical theory and knowledge and the real ability to provide effective therapy was still enormous. However, the discovery of anesthesia in the 1840s and Joseph Lister's elucidation and application of the principles of asepsis in 1865 were major steps forward in the history of medicine. Many other improvements in civilian medical care relevant to wilderness medicine, though, have come about as a direct result of military medicine having to determine how to best keep people alive and well, often in very trying combat-related circumstances. The advancement of wilderness medicine has been closely connected to military exploration/operations throughout history, and not surprisingly, this remains in many ways as true today as it was a thousand years ago.