History of the ambulance

The history of the ambulance begins in ancient times, with the use of carts to transport patients. Ambulances were first used for emergency transport in 1487 by the Spanish forces during the siege of Málaga by the Catholic Monarchs against the Emirate of Granada, and civilian variants were put into operation in the 1830s. Advances in technology throughout the 19th and 20th centuries led to the modern self-powered ambulances.

There is evidence of forced transport of those with psychiatric problems or leprosy in ancient times. The earliest record of such an ambulance was probably a hammock-based cart constructed around 900 AD by the Anglo-Saxons.

During the Crusades of the 11th century, the Knights Hospitaller set up hospitals to treat pilgrims wounded in their battles in the 'holy land', although there is no clear evidence to suggest how the wounded made their way to these hospitals.

The Normans used a litter suspended between horses on two poles. Variations on the horse litter and horse-drawn wagons were used until the 20th century.

The first record of ambulances being used for emergency purposes was the use by Isabella I of Castile, in 1487. The Spanish army of the time was well treated and attracted volunteers from across the continent; and among their benefits were the first military hospitals or 'ambulancias', although injured soldiers were not picked up for treatment until after the cessation of the battle, resulting in many dying on the field.

A major change in usage of ambulances in battle came about with the ambulance volantes designed by Dominique Jean Larrey (1766–1842), Napoleon Bonaparte’s chief physician. Larrey was present at the battle of Spires, between the French and Prussians, and was distressed that wounded soldiers were not picked up by the numerous ambulances (which Napoleon required to be stationed two and half miles back from the scene of battle) until after hostilities had ceased, so he set about developing a new ambulance system. Having decided against using the Norman system of horse litters, he settled on two- or four-wheeled horse-drawn wagons to transport fallen soldiers from the (active) battlefield after they had received early treatment in the field. These 'flying ambulances' were first used by Napoleon's Army of the Rhine in 1793. Larrey subsequently developed similar services for Napoleon's other armies, and adapted his ambulances to the conditions; including developing a litter which could be carried by a camel for a campaign in Egypt.

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