The medical arrangements of the Royal Navy at sea during the First World War have, in stark contrast to those of the British army, received little attention from historians. The dilemmas facing medical officers serving with the navy afloat have been, in effect, a `casualty' of the perceived inactivity of the Royal Navy during the war as a whole. What this article examines is the many problems facing medical officers throughout the war, and how these problems related more broadly to the complex and unexpected nature of life aboard a `modern' fleet, in a `modern' war at sea. The focus of the article is the treatment and evacuation of sailors wounded in action during the war. Medical officers faced three main problems: lack of experience of naval warfare; the need to balance medical needs with the fighting efficiency of a ship's crew; and the restrictive nature of the conditions prevailing in the many vessels of the fleet, conditions which hindered the performance of even the most basic of medical duties. For medical officers the key issue was how to deliver basic medical care in the primitive conditions on board the ships of the fleet on active service. Although in comparison with the army the navy remained in a state of relative inactivity, this article suggests that far from being a rare occurrence, casualty care, or more correctly, its planning and elaboration, was a central concern for the naval medical service, and the naval authorities. This stemmed from the potential for devastating losses in even the briefest of engagements with the enemy. But more than this, medical officers had a burgeoning role in the maintenance of the mental balance, or morale of each ship's crew. Their preparations for action had more than just a practical medical function.
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