Emergency medicine has deep military roots. In 1792, the young French surgeon Dominique-Jean Larrey observed that most injured soldiers died for want of immediate attention. Inspired by horse-drawn "flying artillery" he developed a "flying ambulance." This ambulance volante combined with Larrey’s development of the concept of triage became integral to Napoleon’s army.

At full strength, the ambulance corps included 340 men, in 3 divisions, each with 12 light and four heavy carriages. A first class surgeon-major commanded a contingent that included apothecaries, a farrier, a saddler, a bootmaker, "a bearer of surgical instruments with a trumpet" and "a lad with a drum carrying surgical dressings." Few changes were made to his ambulance design until the motorized era.

During the 1799 battle for Aboukir in Egypt, Larrey reported that "none were left more than a quarter of an hour without being dressed." Larrey was also a gifted physician who performed the first successful leg amputation at the hip. This superb care helped troop morale, and even moved the enemy: at Waterloo the Duke of Wellington adjusted his line of fire to let the ambulances work.

SOURCE: "The Revolutionary Flying Ambulance of Napoleon's Surgeon," by CPT Jose M. Ortiz, U.S. Army Medical Department Journal, October-December 1998

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