In 1927, eight years after John Edward Bowskill had been demobbed from the 5th Battalion of the King’s Own Yorkshire Light Infantry, he began to suffer a fever.

The Bradford Corporation tram driver began to breathe fast. He became confused. He went home and was nursed by his wife Blanche, to no avail.

On October 23, 1927, he died. His death certificate recorded the cause of death as septicemia and ‘Gas Gangrene’, directly resulting from a bullet wound he received in 1918.

This story, which can be found in Tim Lynch’s book They Did Not Grow Old is not the only one of its kind. Being shot in the First World War was not like being shot in any other war previously.

In her book Wounded: From Battlefield To Blighty, 1914-1918, Emily Mayhew, describes the difference. She writes: “The Flanders casualty was almost torn apart. Gone were the neat round holes made by rounded ammunition, that flew slowly in the hot, dry African sun, could easily be located and extracted, and didn’t leave much damage behind.

“Instead, the cylindro-conical bullet fired by the new powerful weaponry hit fast and hard, went deep and took bits of dirty uniform and airborne soil particles with it. Inside the human body, it ricocheted off bones and ploughed through soft tissue until its energy was spent.

“Shrapnel fragments were just as bad. They created jagged wounds, huge blooms of trauma that didn’t stop bleeding and, if the casualty could survive long enough, provided the perfect environment for infection and sepsis.

“And there were so many of them. At the base hospitals soldier after soldier arrived with the most dreadful injuries – deep, ragged wounds to their heads, faces, limbs and abdomens.”

Hollywood-style shootings in films – the only example most people have of the damage done by bullets – don’t come anywhere near the reality, not even in Dirty Harry.

Tim Lynch wrote: “When a bullet is fired it creates a shockwave in front of it that pulverises flesh before the bullet itself hits home. In its wake, comet-like, it trails the residue of the explosive charge used to fire it, along with any dust, gas or bacteria in the air, which is then sucked into the wound.

“That had happened to John Bowskill. Even had antibiotics been available, they would not have been enough.”

John Bowskill had been hit in the right buttock by a bullet that went on to hit his hip. The wound he received in France evidently killed him in Bradford.

As the technology of warfare inflicted greater and grosser wounds, the manner of dealing with the wounded changed. Medical units moved further forward towards battlefields. Stretcher bearers had to be more than beasts of burden, as Emily Mayhew pointed out.

“A dedicated stretcher-bearer corps was created. Bearers were specially recruited and trained in advanced first aid, including the vital skill in controlling the haemorrhages.

“They became the very first step in the care for the wounded, finding and treating them where they fell in the middle of the fighting. In under a year, in time for the battle of the Somme in July 1916, a new and essential medical trade was created on the Western Front.”

There were four grades of treatment depending on the nature of the battlefield injury. The first was the Regimental Aid Post (RAP), set up as close to the fighting as possible and run by a battalion medical officer with orderlies and stretcher-bearers.

More seriously wounded men were sent to an Advanced Dressing Station (ADS), run by a divisional Field Ambulance unit. The aim was to collect the sick and wounded from RAPs to get them fit again for action.

Tim Lynch writes: “Although better equipped, they could still only provide limited medical treatment, and if the casualty was not fit enough to be returned to his unit he was collected by horse or motor ambulance and taken to the Main Dressing Station (MDS).

“The MDS had a limited surgical capacity to enable emergency life-saving operations, but its main role was to hold stable casualties for up to a week if they could be returned to duty after that time.

“If not, they would be passed to a Casualty Clearing Station (CCS). With at least fifty beds and 150 stretchers, a CCS could handle 200 casualties at any one time and include specialist surgical teams, X-ray technicians, dentists, pathologists and nursing staff in large complexes about 20 kilometres behind the front.”

The very seriously wounded were sent back by ambulance train or inland water transport to a base hospital. Tim Lynch said this system became so well developed that a man badly wounded in France in the morning could be in a hospital in England by nightfall.

Hospital trains, as we know them, were first used during the 1899-1902 Boer War in South Africa. The first-ever such train, the Princess Christian, carried 7,548 badly injured British soldiers to Cape Town.

During the First World War, British railway companies built 30 hospital trains to War Office specifications. These trains augmented the three already at work in France. Between them these three trains carried 461,844 patients.

Alison Kay, assistant archivist at the National Railway Museum in York, said: “The standard ambulance train consisted of 16 cars, including a pharmacy car, two kitchens, a personnel car and a brake and stores van. In accommodated about 400 lying and sitting cases in addition to Royal Army Medical Corps personnel.

“Each ward car contained 36 beds in tiers of three. The middle bed folded back to enable sitting cases to use the lower one. The train generated its own electricity for lighting and driving overhead fans and all cars were steam heated.

“Boulogne was the principle port of embarkation for the wounded. The main disembarkation points in the UK were Dover and Southampton.

“From February 1915 to February 1919, Dover dealt with 1,260,506 casualties. They were then sent by one of 20 home standard ambulance trains, or by an emergency ambulance train, to a receiving station where they were transferred to road vehicles which took them to their destination hospital.”

One of these hospitals was the Keighley War Hospital, centred on the Keighley and Bingley Fever Hospital at Morton Banks, with branches at Victoria Hospital, the Infirmary at Fell Lane, Spencer Street and Skipton.

Morton Banks had 746 beds and reportedly dealt with more than 13,000 sick or wounded military men, some of whom came from as far away as Canada and the Fiji islands.

Those not killed or maimed by the war risked falling mortally sick to an attack of Spanish Flu, or ‘Blue Death’ as it was called, which swept the world from the spring of 1918 and reputedly killed another 20 million.

The hundreds of thousands of soldiers buried in battlefield graves of some description had to be located and re-buried in proper cemeteries. At least 500,000 were missing.

The vast task of burying the dead and accounting for the missing was given to the Imperial Commonwealth War Graves Commission, created in May 1917.

Exhuming hastily-buried British and Commonwealth soldiers and interring them properly took the efforts of between 12,000 and 15,000 volunteers who were awaiting demobilisation.