Dr. Edwin Ernst -- Base Hospital 21 Radiologist



Captain Edwin Ernst conducting an X-ray at Base Hospital 21, in Rouen, France, ca. 1917

Recently, project staff digitized WWI Era X-rays at the St. Louis Science Center. The X-rays are a part of the Dr. Edwin Ernst Collection. Ernst, a St. Louis native, was a Captain in the U.S. Army Medical Corps during WWI. He served in Rouen, France with Base Hospital 21, which was staffed by Washington University in St. Louis, Missouri. Ernst was one of many St. Louis doctors who left their private practices to support the war effort.

Dr. Edwin Ernst received his Medical Degree in 1912 from Washington University and went into private practice in St. Louis in 1914. Ernst was an expert in the use of radium and x-ray and in 1915, became Director of the Radiology Department at the Washington University School of Medicine. From 1917-1919, he used his expertise to treat British soldiers that were wounded in WWI. In the following excerpt from “Base Hospital 21 During World War I – 1914-1918 Base Hospital 21 and the Great War” , the author describes how techniques used by Ernst and other hospital staff revolutionized the treatment of these soldiers.

 
Although chronically understaffed, Base Hospital 21 developed new procedures, methods and techniques. the developments, plus the staff's efficiency, kept the hospital functioning remarkably well throughout the war.... The Washington University doctors quickly realized that both diagnosis and treatment had to be speedily expedited, particularly during heavy patient load, Consequently, instead of taking stretcher wounded to tents, they were routed directly to the X-ray hut. There, Captain Edwin C. Ernst, with the aid of the Royal Engineers, German carpenters from a nearby prison camp and his own scavenging, had designed and constructed the best and safest fluoroscopic apparatus in the Rouen area. The operators’ hands, feet and body never contacted the roentgen rays, an unusual precaution for the time. [29] The attendant placed the stretcher and patient on two wooden horses. A foot-controlled, roller-bearing, lead-lined X-ray tube holder, otherwise called a trochoscope, sat between the two wooden horses. As the examiner’s hands placed a lead-rubber strip against the patient’s body in the region to be examined, his left foot guided the trochoscope to the proper spot beneath the stretcher. His right foot then held the base of the unit steady for a fluoroscopic examination. Immediately thereafter his left foot shifted the upper carriage, which held the tube, a fixed distance of 10 centimeters. That way he could make a double exposure on the fluoroscope during a single examination – one on a bony landmark and one on the foreign metallic fragment. Their relationship, based on the 10 centimeter displacement shift, cut the time to localize a foreign body from minutes to seconds. [30] 

X-ray equipment without table

After taking X-rays, the examiner classified the seriousness of the soldier’s wound, pinned a report on his tunic and sent him off to an adjoining operating room. There five surgical teams efficiently shared three nurses and three orderlies. A surgeon and an internist reviewed the fluoroscopic report and made a final assignment. The emergency cases required immediate operation. Other, less serious cases were deferred until the emergency load cleared. The less seriously wounded were rerouted immediately to other hospitals. The English stretcher wounded, diagnosed as non-operative cases were sent home to “Blighty”; the French and Americans were sent to southern France.

This method of expediting the care of the stretcher wounded, which Base Hospital 21 developed, actually showed that patients suffered less pain and trauma when examined on their original ambulance stretchers. It also avoided unnecessary congestion in the wards by classifying the patients before assignment to a hospital bed. However, the most significant contribution to wartime medicine was the roentgenological apparatus. For the first time, a simply designed, portable X-ray machine, safe in both direct and secondary roentgen exposure, had been designed for field work. The extent to which the hospital made use of Dr. Ernst’s equipment may best be realized from the fact that Base Hospital 21 used more X-ray plates than all the other base hospitals of the A.E.F. combined. [31]

Below is an X-ray, taken by Ernst, of shrapnel metal fragments and a penetrating fracture of the frontal skull table:

 

Glass plate x-ray, Base Hospital 21, Rouen, France, 1917-1919

After the War, Ernst became an internationally-renowned radiologist and cancer researcher. In 1936, he was awarded a gold medal by the Radiological Society of North America for his work in obtaining worldwide acceptance of the Roenthgen unit as the standard of measurement in the application of X-rays. In 1950, he developed a method for treating uterine cancer. In 1959, he received the highest award of the International Congress of Radiology for this treatment which bore his name.

Until his death in 1969, Ernst was active in the Ernst Radiology Clinic, in St. Louis, Missouri, whose staff included his three sons - all radiologists.
Sources:

Edwin Ernst Collection, Saint Louis Science Center, St. Louis, Missouri.

"Dr. Edwin C Ernst Dies; Acclaimed Radiologist." St. Louis Post Dispatch, March 15, 1969, Necrology scrapbooks, Volumes 1-32, Missouri History Museum, St. Louis, Missouri.

Munger, Donna Bingham,“Base Hospital 21 During World War I – 1914-1918 Base Hospital 21 and the Great War”