The painkiller of battlefields

The use of morphine, an opiate medication derived from the poppy plant, during World War II was nothing new in the history of warfare, but its delivery systems were.  Given the increased destructive capabilities of Second World War weapons compared to those of the First World War, soldiers (not to mention civilians) had an ever-greater need for effective pain relief.
 
Variations of opium have been around for centuries – likely longer – and morphine, named after Morpheus, the god of dreams in Greek mythology, was developed partly as an alternative to opium and alcohol. Doctors soon realized, however, that morphine was more addictive than either. In 1853, the hypodermic needle was developed and the use of morphine became more widespread. Nevertheless, morphine’s analgesic qualities were undeniable, and its use was widespread in Europe, namely Germany, during the 19th century, as well as in America, particularly during the Civil War.
 
Some estimates suggest that as many as 400,000 soldiers became addicted to morphine during the Civil War, an armed conflict in which few combatants actually died from bullets or cannon balls as opposed to the diseases that resulted afterwards. Opiates were used to treat not just wounds but chronic campaign diseases such as diarrhea, dysentery, and malaria. During the First World War, morphine was injected with a syringe, but during the interwar period scientists developed self-contained morphine administrators.
 
Shortly before WWII, the E.R. Squibb & Sons pharmaceutical company from Brooklyn, New York developed an expendable device, a so-called syrette, for the administration of morphine. The Army started using it from 1940. It was similar to a syringe but it had a closed flexible metal tube instead of a rigid tube and piston. On top of the tube, there was a hypodermic needle with a transparent plastic cover which was inserted a metal wire loop, designed to pierce the inner seal of the tube to allow the medication to flow by squeezing the tube.

The needle had to be inserted under the skin at a shallow angle. It was recommended to use the part of the body which could be accessed the easiest, for instance the abdomen, the upper arm or the thigh. During WWII, the morphine syrette came in different numbers and packaging in the first aid kits of the soldiers depending on the units they were issued to. For example, paratroopers were equipped with a single tube (Medical Item No. 9115700), while medics had a set of 5 syrettes in a cardboard box (Medical Item No. 9115500) in their pouches.

The full effects of morphine were normally not felt for 20-30 minutes, and soldiers receiving morphine would have to wait for any surgical operation until after the effects had worn off which could take 3-7 hours. In an effort to prevent overdosing and possible addiction (“May be habit-forming” as indicated on the packaging), medics were instructed to attach the used syrette to the patient's collar. A second injection was not recommended to be given within 2 hours after the first dose. In the post-war years, several surplus aid kits were sold or stolen for the morphine. Many addicts changed to heroin after they had run out of the surplus morphine.

Americans were not the only ones who suffered from morphine addiction. Nazi Germany’s Reichsmarschall, Herman Göring, was shot in the groin during the 1923 Beer Hall Putsch in Munich and was operated in Austria. He was given morphine for the pain and remained addicted to the drug until the Nuremberg Trials. His addiction led probably to his weight gain and mood swings that changed him from the good-looking fighter pilot into the fat Nazi leader who was subject to many caricatures. When he was taken into custody before the trials, he was forced to a strict diet and detox. Eventually, he committed suicide with a cyanide capsule the night before his hanging.

You can see the use of morphine and the syrette in some of the famous war movies and series, too. In one of the most tragic scenes of the 1998 war movie Saving Private Ryan, the medic of Captain Miller’s team “Doc” Irwin Wade, played by Giovanni Ribisi, gets shot when the group assaults a German position. When he sees that he is fatally wounded, he asks his fellow soldiers to give him a double dose of morphine. It is noteworthy that the method of injecting the morphine in the film is probably incorrect. Instead of the stabbing method used in the movie, the syrette should have been inserted at a shallow angle, as mentioned above.

In the “Bastogne” episode of the Band of Brothers HBO miniseries, the viewer can follow medic Eugene Roe, played by actor Shane Taylor, as the tries to collect badly needed medical equipment, including morphine, from his fellow paratroopers through crawling from foxhole to foxhole in the freezing cold in the woods at Bastogne during the Battle of the Bulge.