Abstract
BACKGROUND: The role of neutral Switzerland during World War I is somewhat mysterious and its diplomatic history has never been fully disclosed. One of the activities might have determined its role: based on its relationship to the International Committee of the Red Cross, wounded multinational prisoners-of-war were interned in Swiss hospitals and Swiss physicians worked in a medical capacity in military hospitals on both sides of the front. QUESTIONS/PURPOSES: The main question is whether the activities of the Swiss authorities reflected a charitable diplomatic role while retaining the country's traditional neutral stance. Supplementary practical questions included: How did Switzerland carry out the exchange of severely wounded prisoners of war? How did Swiss physicians function in the war zones? What were the medical objectives and the ultimate results of wartime surgery in Switzerland? METHODS: This study is based on archival material from the Swiss Federal Archive in Bern (BAR) and original publications of Swiss and German physicians in professional journals. The search was performed manually in the BAR evaluating the file "Landesverteidigung (national defense)" from 1848 to 2009. Original publications and journals were searched manually in the central libraries of Munich, Heidelberg, Zurich, and Bern. RESULTS: The evaluation of Swiss diplomatic activities confirmed that Switzerland's charitable mission was aimed to enforce its neutral position and that Swiss authorities were able to efficiently manage the resulting problems. The engagement of Swiss surgeons in war surgery contributed to their experience and knowledge and yielded the development of many innovative medical devices and operating procedures, numerous of which are still known today. CONCLUSION: While maintaining its neutral position, Switzerland was able to deal with the practical problems while gaining innovative medical knowledge still valid today.