HX01 From bog to battlefield: Sphagnum moss and the roots of modern wound care

Abstract

Plant-based materials have been used in wound care since antiquity, yet the innovations of Edinburgh military surgeon Charles Walker Cathcart during World War I merit renewed recognition. Alongside botanist Sir Isaac Bayley Balfour, Cathcart transformed scientific observation into wartime practicality by identifying Sphagnum papillosum and Sphagnum palustre as superior alternatives to surgical cotton. As cotton supplies were diverted for munitions production, these botanical dressings became essential for military surgery and dermatological preservation. This analysis synthesizes historical records from the British War Office and clinical reports from 1914 to 1918 to evaluate the efficacy of bryophyte-based wound management. It maps the transition from localized harvesting in British bogs, such as Dartmoor, to a global logistical operation. The wartime adoption of Sphagnum moss reflects a rare convergence of surgical ingenuity and civilian mobilization. Cathcart and Balfour’s research, published in The Lancet, highlighted the moss’s remarkable capacity to absorb 20 times its weight in fluid – far surpassing cotton and offering mild antiseptic properties. This triggered a massive domestic effort where civilian volunteers, including Boy Scouts and women’s groups, processed moss for the Western Front. By 1918, harvesting expanded across Canada and the USA under British War Office contracts. Over 1 million Sphagnum dressings were distributed to military hospitals across Europe, Africa and Asia, successfully managing suppurating wounds and ‘trench foot’ when industrial supplies were severed by blockade and scarcity. The clinical success of Sphagnum moss demonstrates that under the pressure of trade wars and supply chain collapse, native botanical resources can provide lifesaving medical alternatives. This historical model of ‘resourceful dermatology’ continues to guide modern innovation in wound management and the preservation of the skin barrier in resource-limited global health settings.