Trench Foot: Causes & Impact

Trench foot is a disease that appeared during the World War I. The illness infected many soldiers. One of the main causes of the illness was that soldiers had been stationed in muddy trenches for days and even weeks. As a result, their feet were exposed to cold, wet water for a long time. The water penetrated through the soldiers’ boots. As a result, the skin of their feet began to rot.

There are several reasons for the onset of trench foot. First of all, soldiers suffered from immersion in waterlogged trenches. Long periods of time were spent standing in muddy water, and the skin on the feet suffered greatly from this. Many boots that were worn by soldiers were not waterproof or did not have sufficient insulation. Even with the best boots, they would often become wet, and fail to dry in a short period of time. Poor hygiene also played a large role in the cases of trench foot. Many soldiers lived in poor conditions in the trenches, and as a result, it was very difficult for them to keep their feet and the rest of their body clean. This would allow for the spread of infection, and in turn, the foot would worsen in severity (Kravets et al., 2022).

Soldiers affected by trench foot experienced numbness in their feet. This numbness enabled soldiers who were affected by the foot to continue fighting as the affected foot felt as though it had been numbed by Novocain. In some cases the numbness in the affected foot would subside and be replaced by numbness in the rest of the foot. In severe cases of the foot, the skin on the affected foot could become severely discolored and even turn black due to the serious damage that had been done to the tissue in the affected foot. The symptoms of trench foot caused sufferers a great deal of pain and meant that they were unable to carry out a number of tasks. Many soldiers were unable to complete a number of marches, as the pain in their feet made walking extremely difficult. Others were left struggling to complete a number of orders as the pain in their feet made it difficult for them to carry out a number of tasks (Bush et al., 2023).

The problem of trench foot to a large extent reveals other problems in health of soldiers during World War I. Environmental influences on health in time of war were an important part to consider. Study of the disease also has special significance for leaders of the army and military medical services, since it reveals the requirements of improvement of living conditions for troops, of suitable footwear and of greater attention to personal hygiene in the trenches. Military medical services in face of this serious problem had to undertake measures to improve health of soldiers and to work out new methods and ways of treating various casualties. They brought about changes in military medical services (Mistry et al., 2020).

Trench foot is another disease that shows up the often dire circumstances that the soldier was sent to fight in. Even in relatively recent times it is a sign of a failure in military medicine. To date the best ways of preventing cold-weather illnesses have often to be worked out by troops in the field as they face problems that military medicine has failed to solve. In the case of the losses that were caused by trench foot in World War I, it emerged as a serious problem for the fighting troops on the front line. As well as reducing individual soldiers’ morale, it also led to a deterioration in the troops’ ability to fight as effective fighting troops. Even though it was caused by fairly natural circumstances in the type of fighting that was being conducted from wet, muddy trenches, in the event, it revealed serious failings by the military. This was especially the case as there were a great number of troops who contracted the illness. In consequence they were not able to perform their military duties. These circumstances did little to raise the morale of other troops, that were not affected by the illness (Atenstaedt, 2006).

In combat trenches water-logged areas frequently occurred, where in wet boots with poor insulation troops stood for long periods of time. Trench foot can be caused by a number of factors but is a condition that results from the feet being exposed to cold wet conditions for long periods of time. Research has shown that that one of the major causes of trench foot was the type of footwear that were being issued to the fighting troops, i.e. wet boots made from inappropriate materials that did not dry out quickly (McWhinney, 2016). Once trench foot had occurred treatment was often laborious and time consuming. As a result much more time and effort was required to treat cases of trench foot than were necessary with most other medical conditions, which had led to the search for effective measures of prevention.

The effects of trench foot on soldiers were felt in both their physical health and ability to be deployed on the battlefield. Many cases of severe trench foot required soldiers to be evacuated from the field for treatment of injuries including amputations of parts of the foot. The sheer number of cases of trench foot contracted by soldiers lead to changes in the health policies of armies during WWI. They recognized the problem of providing soldiers with living conditions that did not lead to contraction of trench foot and work to change conditions of mud and wet in the trenches.

During and after World War I many methods of treatment and prevention of trench foot were introduced. In the first place the feet must be kept dry and warm. The best method of prevention of trench foot is to change the socks frequently and to wear footwear made of materials that breathe. In order to improve the living conditions of soldiers in the trenches, better designs of trenches with systems of drainage of water were introduced. Many of the lessons learned from the effects of trench foot on soldiers during World War I were used in military medical services and in emergency care of other patients. They showed the great role of non-freezing cold in the production of cold injuries and the importance of good methods of prevention and treatment of cold injuries on the basis of the individual needs of patients suffering from cold injuries (Vitaliyovych et al., 2023).

Trench foot was a serious problem during World War I for the soldiers fighting in wet, cold conditions in the trenches. The suffering caused by the condition of the feet of soldiers led to changes in the treatment of patients suffering from the condition. In the first place, the condition of the living conditions of the soldiers in the trenches was improved by implementing better hygiene. The soldiers were taught how to keep their feet dry and clean. Regular checks of the feet of soldiers were implemented in order to diagnose cases of trench foot early enough in order to treat them before the condition had worsened. Often enough, simple measures were enough to treat cases of trench foot in good time (Castellani et al., 2006).

Footwear too, was another area that received much improvement, in the boot designs and the materials used for their construction. Soldiers were now issued with boots that had improved warmth and protection from moisture, the design of the boot having been altered to include better drainage as well as insulation. As soldiers spent most of their time standing in muddy trenches, it was most important that they were able to wear footwear that could keep their feet dry and warm for long periods. It was a case of waiting and seeing if all the changes made to the way that soldiers lived, were enough to help them cope in the appalling conditions of the trenches.

Following the War, researchers were looking into the incidence of trench foot and similar conditions that had affected soldiers fighting in cold climates. The outcomes of these investigations led to technological advancements, and ways of preventing non-freezing cold injuries that were not only to be of use to the military, but to other people too who worked or played in cold weather. There was also a growing recognition of the importance of education and of training for survival in cold weather, with military training programs including information on the various cold injuries, and their treatment. This was not to be limited to the military though, and would be of use to hikers and mountaineers, and to workers of all kinds in cold climates, such as in construction, and in the search and rescue services.

Moreover, education and training in cold-weather survival has become increasingly recognized as vital to safety. Military units have started to include information on cold injuries and their treatment in field training. Many units also now conduct regular exercises in cold weather to give soldiers experience of the challenges and to test out cold-weather gear. Such training not only helps soldiers to deal with cold-weather conditions while on military operations but is also relevant to many civilian activities, such as hiking, climbing, and work in outside cold environments.

However, despite these improvements there are still many problems with non-freezing cold injuries that affect individuals working in cold environments and suffering from cold-related illnesses. Like WWI soldiers suffering from trench foot, many workers and outdoor enthusiasts and athletes are at risk of suffering from cold injuries if they do not have the correct equipment or training to work in cold environments (Imray et al., 2011).

Trench foot also is considered an important chapter in the history of military health. Advances developed during World War I and implemented since have provided a basis for current treatment and prevention of non-freezing cold injuries. Military and civilian sectors and businesses are recognizing the value of good equipment, good hygiene, and good education in the work that individuals do in the cold. The study of this condition helps appreciate the advances that have occurred in treating injury and preventing its occurrence and also recognize the need for continued effort to protect individuals in the cold.

Citations:

Mistry, K., Ondhia, C., & Levell, N. J. (2020). A review of trench foot: a disease of the past in the present. Clinical and Experimental Dermatology, 45(1), 10-14. https://academic.oup.com/ced/article-abstract/45/1/10/6597735

Kravets, O. V., Yekhalov, V. V., Trofimov, N. V., Sedinkin, V. A., & Martynenko, D. A. (2022). Trench foot and other non-freezing cold injuries (literature review). Emergency Medicine, 18(8), 7-13. https://emergency-journal.com/index.php/journal/article/view/1538

Bush, J. S., Lofgran, T., & Watson, S. (2023). Trench foot. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482364/

Atenstaedt, R. L. (2006). Trench foot: the medical response in the first World War 1914–18. Wilderness & Environmental Medicine, 17(4), 282-289. https://journals.sagepub.com/doi/abs/10.1580/06-WEME-LH-027R.1

Mendes, B., Salomé, G. M., Pinheiro, F. A. M., Júnior, M. R. M., da Cunha, D. R., & Ferreira, L. M. (2018). Preventing and treating trench foot: validation of an educational manual for military personnel. Journal of Wound Care, 27(Sup10), S33-S38. https://www.magonlinelibrary.com/doi/abs/10.12968/jowc.2018.27.Sup10.S33

Vitaliyovych, Y. V., Viktorivna, K. O., Mykhailovych, S. D., & Oleksandrivna, P. Y. (2023). Trench foot is an urgent problem of our time. Olga Timofeeva, 88. https://dspace.uzhnu.edu.ua/bitstreams/6c7b852b-39ec-498f-9277-3966b3f0c925/download#page=89

Karthick, S., Kermanshachi, S., Pamidimukkala, A., & Namian, M. (2023). A review of construction workforce health challenges and strategies in extreme weather conditions. International journal of occupational safety and ergonomics, 29(2), 773-784. https://www.tandfonline.com/doi/abs/10.1080/10803548.2022.2082138

McWhinney, G. (2016). Disease ridden outfits: contaminated uniforms and British preventative medicine in the First World War (Doctoral dissertation, Macquarie University). https://figshare.mq.edu.au/ndownloader/files/34526264

Castellani, J. W., Young, A. J., Ducharme, M. B., Giesbrecht, G. G., Glickman, E., & Sallis, R. E. (2006). Prevention of cold injuries during exercise. https://apps.dtic.mil/sti/html/tr/ADA459418/

Imray, C., Richards, P., Greeves, J., & Castellani, J. W. (2011). Nonfreezing cold-induced injuries. BMJ Military Health, 157(1), 79-84. https://militaryhealth.bmj.com/content/157/1/79.short